Health Care Liberty and Justice News

Committee Taking Up H1N1 Vaccine Rule

The Joint Government Operations Committee is reviewing a plan today to let paramedics administer H1N1 flu vaccines.

The measure allows emergency medical personnel (pdf) to issue the flu shots at mass vaccinations in an effort to curb spread of the flu while keeping other public health personnel, like doctors and nurses, from getting sick.

The H1N1 rule is one of thirty up for approval before the  committee today.

Rules are not laws. Rather, they dictate how laws are enforced.

The H1N1 rule went into effect in late October, although it still needs to be OK’d by the committee and the General Assembly. Other rules will go into effect in January or as late as March.

Some rules are more routine, such as a rule up for approval today bridging the gap between old and new regulations for assisted care living facilities.

Others are more urgent, according to officials, and require immediate enactment. These rules are effective immediately after filing but will expire after 180 days.

The committee meets today at 10:30 a.m.

Health Care News Tax and Budget

Cuts Coming to State Employee Health Plans?

NASHVILLE – Gov. Phil Bredesen said Wednesday Tennessee government-worker medical coverage won’t be spared the budget scalpel, and that benefit-reductions and co-pay increases are cost-savings measures under review in the current fiscal climate.

The $820 million the state spends for employee health care is “a huge piece of the equation” and “a big pot of money…that’s growing rapidly,” Bredesen said during a hearing with Department of Finance and Administration officials. Controlling those costs is “something we need to look at,” he said.

The budget allotment for employee medical benefits “is bigger than our Corrections Department, for example,” said Bredesen, who earlier this week heard prison officials suggest they’ll have to release roughly 3,300 inmates to meet the kinds of reductions in their FY2011 spending plans the governor wants them to prepare for.

“Everywhere else I’m telling people they’ve got to give up six and nine percent, and (the state employee health-benefits package) is coming in at what it is, plus another $65 million,” Bredesen told reporters after the hearing. “I want to provide good health insurance and health care to people, but in this environment…you can’t just let that happen without pulling it apart a little bit and seeing if there are ways you can make it work better.”

Bredesen also said he’s skeptical that substantial short-term budget savings can be realized through creating more employee-incentives for “healthy behaviors,” as one state official suggested might be possible.

“All of this stuff about health behavior is very politically correct,” said Bredesen. It’s nevertheless “very difficult to show it has any effect on health care costs,” he added.

Said Bredesen later: “We’ve talked a lot about preventative care, and there are a lot of things I’m in favor of with all this kind of stuff, (but) it’s not going to change the cost next year. It just isn’t going to do that. I need to change the cost next year.”

Bredesen described “the big-ticket items” in the state budget as TennCare, higher education, K-12, public safety and government health benefits. There’s no balancing the budget “without tackling those in some fashion,” he said.

“I’m just saying, nothing’s off the table,” Bredesen said.

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Committee Questions Need for Sex-Offender Oversight Board

NASHVILLE – A state panel that develops standards and guidelines for monitoring and treating sex offenders after they’re released from prison is in limbo due to spotty board member attendance at regular meetings.

Lawmakers discussing whether or not to advise the full Legislature that the Tennessee Sex Offender Treatment Board should continue to function chose to offer “no recommendation” this week after the board failed to produce members’ attendance records for the last two years as requested by a recent Division of State Audit performance inquiry.

Rep. G.A. Hardaway, a member of the Joint Government Operations committee, also called it “disturbing” that members known to be repeatedly absent from the treatment board’s meetings typically never sent proxies to sit, observe or act in their place.

At a subcommittee hearing Oct. 21, the Memphis Democrat said he wonders if the absences reflect a fading need to keep the board running.

Hardaway added that he wouldn’t support the board’s continued existence until it had at least complied with the request by auditors to examine board-meeting attendance records.

“I don’t see how we can evaluate this…we don’t even know if the board members are showing up,” said Hardaway.

Sen. Bo Watson, R-Hixson, who chaired the hearing, warned that “failure to respond to questions appropriately” by members of boards, commissions and departments called before Joint Government Operations subcommittees for performance reviews will result in a “no recommendation” finding. A “no recommendation” subcommittee stamp means that a board or agency will have to convince the full Government Operations committee of its legitimate necessity during the 2010 legislative session, or face sunset termination.

Created in 1995, the board is charged with establishing best-practices for how sex offenders should be treated after they’re released to ensure public safety. The board designs treatment programs, trains treatment providers and assesses the likelihood of recidivism.

Board member Dr. J. Michael Adler, a licensed psychological examiner, says the board’s goal is to change behaviors among sex offenders by setting guidelines and offering training to treatment providers.

Adler was nominated to chair the board after Dr. Jeanine Miller, former director for the Department of Corrections’ mental health division, left the post after taking a job with TennCare.

Adler says less than 15 percent of sex offenders are rearrested after undergoing treatment programs. Sex offenders who haven’t undergone treatment programs have a 30 percent chance of being arrested again for similar acts, he said.