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 quality measures.

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 reform.

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 level.

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 programs.

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.

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.

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 care disciplines.

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.