2016 IDAHO LEGISLATURE
UPDATE
February 22, 2016 through February 26, 2016
Throughout the 2016 Idaho Legislative Session, Nurse Leaders of Idaho and the Idaho Nurses Association will provide periodic updates on legislation and activities of interest to nurses, especially in the area of healthcare policy. In addition to these Updates, e-mail communications will alert NLI and INA members to take action in communicating to legislators about bills of interest.
Located at the end of the Updates,is a Call to Action section that will provide background information to assist in communicating with legislators. With bills of interest to nursing being introduced, hearing agendas are updated daily.
Week 7
After the surprise vote last week in House State Affairs to deny funding for the Primary Care Access Program (PCAP), this week has been more hopeful. Politics and the primary election in May are beginning to form positions on legislation. So far few opponents to incumbent legislators have surfaced. The deadline for filing is March 10th, so many legislators are waiting to see who their opponents will be and are avoiding controversial positions until then. So far 206 bills have been introduced in the House and 168 in the Senate. The sheer number of bills and the variety of content to consider added to the convoluted process of committee hearings on each side plus consideration in the full House and the full Senate leading to the Governor’s desk for each bill, is mind boggling.
Medicaid Expansion
By the end of last week PCAP was clearly dead, and talk was skeptical for any Medicaid expansion this year. However late last week, the Governor met with House and Senate Leadership including Chairs of the Health and Welfare Committees to resuscitate a plan. There is stirring interest in revisiting the hybrid Healthy Idaho Plan that extends Medicaid coverage to those below 100% of the federal poverty level and provide subsidies under the Health Insurance Exchange to those between 100% and 130% of poverty levels who are currently ineligible for the Exchange. Initially the Healthy Idaho Plan would be 90% funded by the federal government. Rumor is that leadership has a plan, but legislators will not want to take on any controversial issues prior to the March 10th deadline for declaring candidacy for the May primary. So the expectation is that Medicaid expansion, if it is considered, may be the “going-home” issue of this legislative session.
ALICE – United Way
Monday, United Way presented data from the Asset Limited, Income Restrained, Employed (ALICE) project conducted by Rutgers University.
The study analyzes what a “survivable” income would be for a single adult or family of four by state and county. It offers a detailed look at income versus the cost for housing, childcare (the greatest expense for the working poor), food, transportation, healthcare, and a small amount for miscellaneous expenses. In Idaho 15% of families fall below the federal poverty line. However, 22% fall below what is calculated as a survivable income. In Boise, 38% are in the ALICE group; Pocatello, 39%; Idaho Falls, 40%; Ketchum, 42%; Mountain Home, 52%. In much of central and northern Idaho greater than 50% of families are struggling. For a single adult, the federal poverty line is $11,400. The ALICE line is $16,600 ($8.00/hour). For a family of four the federal poverty line is $23,000. The ALICE line is $46,176 or $22.00/hour for a family of four with a single wage earner. Representative John Rusche noted that Idaho’s median income is $46,700. 85,896 Idaho families and 42,000 single Idaho adults exist on the verge of financial stability only covering necessary expenses and occasionally falling behind. Looking at those employed who struggle with poverty helps put some perspective on the necessity for closing the Medicaid gap.
Board of Nursing Legislation
The two compact bills passed the Senate and have been sent to the House Health and Welfare committee.
- Nurse Licensure CompactS1251
- Advanced Practice Nurse Licensure Compact S1250
The Definition of Nursing bill was pulled prior to its hearing in the Senate Health and Welfare Committee to provide an opportunity for Sandy Evans with the Board of Nursing to work on compromise language with the Idaho Medical Association. The IMA had taken a position opposing the bill with concerns over the word “autonomous” in the description of nursing practice. Sandy is working with the Senator Heider, Chair of the Senate Health and Welfare Committee, to reintroduce the bill with the compromised language.
Old Language
“Practice of nursing” means assisting individuals or groups of individuals to promote, maintain or restore optimal health throughout the life process by assessing and evaluating their health status, planning and implementing a strategy of care to accomplish defined goals, and evaluating responses to care and treatment the autonomous and collaborative performance of acts and services requiring specialized knowledge, judgement, and skill that assist individuals, groups, communities or populations to promote, maintain or restore optimal health and wellbeing throughout the life process. Nursing practice encompasses a broad continuum of services delivered in, but not limited to, areas of clinical practice, education, administration, research, and public and volunteer services. Nursing practice occurs at the physical location of the recipient.
New Compromise Language
"Practice of nursing" means assisting individuals or groups of individuals to promote, maintain or restore optimal health throughout the life process by assessing and evaluating their health status, planning and implementing a strategy of care to accomplish defined goals, and evaluating responses to care and treatmentthe autonomous and collaborativeperformance by licensed practical nurses, registered nurses and advanced practice registered nurses, of acts and services requiring formal nursing education andspecialized knowledge, judgment, and skill, that assist individuals, groups, communities or populations to promote, maintain or restore optimal health and wellbeing throughout the life process. Nursing practice encompasses a broad continuum of services delivered in healthcare and non-healthcare environments; for remuneration or as volunteer service. Nursing practice may be, but not limited to, areas of clinical as well as non-clinical, in such areas as practice,education, administration, research, and public and volunteerservice, to name a few. Nursing practice occurs at the physical location of the recipient.
Suicide Prevention
The statistics on suicide in Idaho are staggering. Nationally, suicide has reduced life expectancy of white males age 15 –54 while all other demographic groups have extended life expectancy. Suicide is the second leading cause of death among Idahoans age 15 - 34 and for males age 10 – 14. Idaho ranks 9th in suicide deaths. Idaho is consistently among the states with the highest suicide rates.
- In 2014, 320 people completed suicide in Idaho; a slight increase from 2013.
- Between 2010 and 2014, 78% of Idaho suicides were by men.
- In 2014, 60% of Idaho suicides involved a firearm.
- 19.8% (1 in5) of Idaho youth attending regular public and charter high schools reported seriously consideringsuicide in 2015. 9.8% (1 in 10) reported making at least one attempt.
- Between 2010 and 2014, 96 Idaho school children (age 18 and under) died by suicide. Twenty of these were age14 and under.
The Health. Quality Planning Commission (HQPC) prepared the Idaho Suicide Prevention Plan with four critical objectives,
1) Create an Office of Suicide Prevention in the Department of Health and Welfare Office of Public Health;
2) Develop Youth Training for Suicide Prevention (1 in 5 high school students in Idaho, 20%, have had seriously considered suicide. 1 in 10 high school students, 10%, have considered suicide);
3) Fund the Idaho Suicide Prevention Hotline with 60% state funds and 40% private contributions, and
4) Focused Public Awareness Campaign tied to behavioral health and community resources.
Thursday, the Idaho Suicide Prevention Coalition sponsored a legislative day at the Capitol. Senate bill 1326 codifies Suicide Prevention to the Department of Health and Welfare.
- Suicide Prevention S1326
Friday, the Joint Finance Appropriations Committee will consider funding for Suicide Prevention with $20M from the Millennium Fund.
Right to Try Bill
Representative Melissa Wintrow’s “Right to Try” bill passed the House Health and Welfare Committee Thursday on an 8 – 2 vote. The two physicians on the committee, Chairman Fred Wood and Representative John Rusche, opposed the bill. The Right to Try bill would allow terminally ill patients to try investigational drugs that have passed Phase 1 safety review by the FDA, but have not completed full efficacy investigation. The bill now goes to the House floor.
Faith Healing and Religious Exemption
Governor Otter sent a letter to legislative leadership on February 9th regarding Faith Healing and the death of children who would likely have been cured had they received medical attention. So far there are no bills pending related to the religious exemption. There is talk about an interim committee this session to draft and introduce legislation. Senator Heider, Chair of Senate H&W has voiced some question as to whether the state can intercept religious freedom even when a child’s life is at stake. Here is the text of the Governor’s letter:
February 9, 2016
The Honorable Brent Hill
Senate President Pro Tempore
700 W. Jefferson
Boise, ID 83720
The Honorable Scott Bedke
Speaker of the House
700 W. Jefferson
Boise, ID 83720
Dear President Pro Tem and Mr. Speaker,
The Governor’s Task Force on Children at Risk formed the Idaho Child Fatality Review Team, under Executive Order 2012-03, to review deaths of children under the age of 18. Its charge is to identify common links or circumstances in these deaths in order to provide recommendations that may help prevent similar tragedies.
The review team reported its findings in April 2015, including an analysis of two deaths related to refusal of medical care because of religious or personal beliefs. However, interest in the issue has grown in the past few months and further review may be needed.
I understand it is a challenge to balance the desire to protect children while still being supportive of religious freedom, but I believe we must give this issue a thorough examination. I am therefore asking that you consider convening a legislative workgroup to assess the Child Fatality Review Team’s report along with other sources of research and testimony regarding this policy issue.
Thank you for your consideration and I am happy to help you in any way I can with this process.
As Always – Idaho, “Esto Perpetua”
CLO/tpC.L. “Butch” Otter
Governor of Idaho
Idaho Medical School
Governor Otter announced Thursday the creation through a public-private partnership of the Idaho College of Osteopathic Medicine. The plan evolved just since January through the Department of Commerce. The Medical School will be funded entirely by private investment with tax incentives to support scholarships to encourage graduates to stay in Idaho. The College of Osteopathic Medicine will be housed with the Meridian Campus of Idaho State University. Construction will begin in 2017 with the first class of 150 students accepted in 2018.
CALL TO ACTION
Bills to Watch
H0341 Patient freedom of info act 02/25/2016 Senate - Reported out of Committee with Do Pass Recommendation; Filed for second reading
H0375 Health care task force 02/19/2016 Senate - Read second time; filed for Third Reading
H0421 Health insurance exchange 02/01/2016 House - Reported Printed and Referred to Ways & Means
H0480 Exec directors, licensure 02/25/2016 House - Read second time; Filed for Third Reading
H0481 Right to try act 02/25/2016 House - Read second time; Filed for Third Reading
H0482 Boards/qualifications/consumer member 02/25/2016 House - Read second time; Filed for Third Reading
H0484 Primary care access program 02/15/2016 House - Reported Printed and Referred to Health & Welfare
S1204 Medicaid, eligibility expansion 01/25/2016 Senate - Reported Printed; referred to Health & Welfare
S1205 Medical assist/eligibility standard 01/25/2016 Senate - Reported Printed; referred to Health & Welfare
S1250 Adv practice registered nurse compact 02/24/2016 House - Read First Time, Referred to Health & Welfare
S1251 Nursing licensure compact 02/24/2016 House - Read First Time, Referred to Health & Welfare
S1252 Nursing, definition revised 02/04/2016 Senate - Reported Printed; referred to Health & Welfare
S1326 Suicide prevention/director authority 02/16/2016 Senate - Reported Printed; referred to Health & Welfare
As you hear of issues or have question about the legislature, please let Mike know by e-mail at .