2007 Regular Session Highlights
Health & Hospitals
by: Michelle Ducharme
HEALTH CARE REDESIGN
After the hurricanes of 2005 devastated the health care
infrastructure in Louisiana, the evaluation and redesign of Louisiana's health
care system has been a priority. During the 2006 Regular Session of the
Legislature, the Health Care Redesign Collaborative was created for the purpose
of advising the Department of Health and Hospitals in the development and
implementation of an evidence-based, quality driven health care system for
Louisiana. Many of the ideas discussed in the Governor's Health Care Reform
Panel and the Louisiana Health Care Redesign Collaborative were used in the
development of the health care reform legislation that was introduced during the
2007 Regular Session.
The goal of Senate Bill 1 by Senator McPherson
(enrolled) is to provide evidence-based, quality driven health care services
that are affordable and sustainable to the Medicaid eligible and low income
populations. The Health Care Reform Act of 2007 creates a new model for the
delivery of health care, utilizes health information technology, and establishes
Louisiana Health First will consist of a medical home
system of care that is patient-centered continuum of quality-drive, integrated,
and accessible health care services. The medical home system of care may consist
of public, private, or public and provide providers, including primary and
preventive care, speciality services, hospital care, access to prescription
drugs, and basic dental care.
Health information technology (HIT) is the second major
component of the Health Care Reform Act of 2007. HIT will promote evidence-based
clinical practices, interconnect clinicians, personalize health care, and
improve population health and patient safety.
The final component of the Health Care Reform Act of
2007 is quality assurance. In Senate Concurrent Resolution 35 by Senator
McPherson (enrolled) and House Concurrent Resolution 75 by Representative Durand
(enrolled) the Department of Health and Hospitals is requested to engage
with public and private organizations to establish the Louisiana Health Care
Quality Forum. The Health Care Quality Forum will utilize best medical practices
to develop protocols to guide provision of care in the medical home model
producing the most efficient and effective health care delivery system possible.
One major component of the Louisiana Health Care Redesign
Collaborative was the development of an insurance connector. Senate Bill 307
by Senator Cassidy (Assigned to Senate Health and Welfare) seeks to create
the Louisiana Health Insurance Exchange in the Department of Insurance. The
exchange would serve as a state clearinghouse to coordinate and facilitate the
recognition, identification, and classification of individuals, persons, and
insurers having a common interest in establishing affordable health insurance
Senate Concurrent Resolution 118 by Senator McPherson
(Subject to call-Senate Referral) would create the
Louisiana Health Information Task Force. This task force would study HIT and
make recommendations on HIT to the legislature, the governor, and the Department
of Health and Hospitals.
House Bill 964 by Representative Kenney (enrolled)
provides for the confidentiality of certain records of
non-profit health care quality improvement corporations. This is companion
legislation to the Louisiana Health Care Quality Forum resolution that will seek
to ensure provider participation and the confidentiality of certain records.
House Bill 542 by Representative Walker (enrolled)
creates the Louisiana Children and Youth Health Insurance Program. This program
is an expansion of LaCHIP. and will seek to insure children whose parent's
income is between two hundred and three hundred percent of the federal poverty
HEALTH CARE WORKFORCE
Senate Concurrent Resolution 88 by Senator McPherson
(enrolled) requests the Louisiana Interagency Task
Force on the Future of Family Medicine to work with Department of Health and
Hospitals to develop evidence-based strategies to increase the primary care
medical workforce in Louisiana and expand the surveillance of the state's family
medicine, primary care, and rural health workforce and medical education
House Bill 246 by Representative McDonald (enrolled)
creates a pilot program within the Department of Health and Hospitals for the
certification of medication attendants. This pilot program will be restricted to
licensed nursing homes and will terminate on August 1, 2011. Certified
medication attendants will work under the supervision of a licensed nurse to
deliver and administer certain medication to residents of the nursing home.
NURSING HOMES AND HEALTH CARE
Legislation regarding the civil money penalties assessed
against nursing homes and other health care facilities was introduced this
session. Senate Bill 82 by Senator McPherson (Senate adopted conference
committee report) increases and makes consistent the penalties for nursing
homes and health care facilities. This bill also addresses the nursing home
moratorium on replacement facilities and extends the facility need review
approval until 2010 for certain licensed nursing homes or intermediate care
facilities for people with developmental disabilities.
Several bills were introduced this session to exempt
certain nursing facilities from the moratorium on replacement facilities and the
licensing of new beds. The majority of the bills introduced were narrowly
crafted to only affect specific facilities. In addition, legislation was
introduced to establish a moratorium on the licensing of hospice facilities.
Examples include the following:
Senate Bill 74 by Senator Dupre (Act 165) exempts
certain nursing facilities from the replacement facility moratorium in Lafourche
Parish so long as certain other conditions are met.
Senate Bill 97 by Senator
Schedler (enrolled) permits licensure of a limited number of additional
nursing beds in certain existing nursing facilities.
Senate Bill 181 by Senator Nevers (enrolled)
exempts Washington Parish from the moratorium on any additional nursing
facilities or additional beds in nursing facilities.
House Bill 518 by Representative Daniel (Assigned to
Senate Health and Welfare) would repeal the moratorium on the replacement of
existing nursing facilities.
House Bill 632 by Representative Strain (conference
committee report received by the House) would
impose a moratorium on hospice facilities for a period of eighteen months.
SCOPE OF PRACTICE
In the past five regular legislative sessions, more than
seventy-five bills and resolutions were introduced that dealt with the scope of
practice of various medical and health care disciplines. During this legislative
session, the Senate Committee on Health and Welfare debated instruments that
made changes to the scope of practice for the following professions: respiratory
therapists, dentists, social workers, podiatrist, optometrist, registered
professional nurses. Senate Concurrence Resolution 109 by Senator Schedler
(enrolled) requests the committees on health and welfare of the Senate and
House of Representatives to study the feasibility of creating a scope of
practice council to advise the legislature regarding various medical and health
In 1997, the Louisiana Legislature enacted legislation
making the performance of a partial birth abortion a crime. However, in 1999 the
Federal District Court for the Eastern District of Louisiana declared the law
unconstitutional in Causeway Medical Suite v. Foster, 43 F. Supp. 2d 604
(E.D. La., 1999), affirmed 221 F3d 811.
In 2003, President George W. Bush signed into law the
Partial Birth Abortion Act of 2003. The ban was challenged and declared
unconstitutional in the courts of appeals for the Eighth and Ninth Circuits.
These courts enjoined the United States Attorney General from enforcing the Act.
The United States Supreme Court reviewed the decisions to determine the
constitutionally of the Partial Birth Abortion Act of 2003. On April 18, 2007,
the United States Supreme Court in a 5-4 decision upheld the constitutionality
of the Partial Birth Abortion Ban of 2003.
Since the United States Supreme Court's opinion was
published, two legislative instruments were filed to create the crime of partial
birth abortion similar to the federal partial birth abortion ban.
Senate Bill 161 by Senator Nevers (passed the House)
and House Bill 614 by Representative Beard (enrolled) prohibits the
performance of partial birth abortions. Both bills make the performance of a
partial birth abortion a crime, but they differ on the approach for civil
penalties. HB 614 mimics the federal Partial Birth Abortion Act, while SB 161
specifics a wrongful death claim.
For the second consecutive year, legislation was filed
relative to the Woman's Right to Know. House Bill 25 by Representative Crowe
(enrolled) requires that, at least twenty four hours before an abortion,
the physician who performs the abortion shall inform the woman about the
availability of anesthesia to alleviate or eliminate organic pain to the unborn
child and about the option of reviewing and receiving an explanation of an
obstetric ultrasound image of the unborn child.