Jan. 30, 2020: State Advocacy Update

Steven J. Stack, MD, was appointed this week as the Commissioner of Kentucky's Department for Public Health by Gov. Andy Beshear. Dr. Stack, an emergency medicine physician, was AMA President from 2015-2016.

The Kentucky Medical Association congratulated Dr. Stack, saying, "Dr. Stack is an experienced leader and advocate, and we look forward to working with him to continue moving the health of Kentuckians forward."

"Kentucky will be well-served by the leadership and commitment Steve has demonstrated to his patients throughout his career," said AMA President Patrice A. Harris, MD, MA.

"I am proud to be a part of health programming that is innovative, accountable and focused on making Kentuckians' lives better," Dr. Stack said. "Our state health officials are here to support and enhance local health departments. We can't forget that health care is local, and we have to balance a practice of targeting the right care with the approach of maximizing our state and federal resources."

Scope of practice legislation has been introduced in states across the country and the AMA's state advocacy team is working to keep patient safety at the center of the debate, emphasizing the importance of education and training to protect patient safety. The AMA expects hundreds of individual bills this year, and currently opposes legislation in Idaho (H.B. 317) and Nebraska (L.B. 828) that would allow optometrists to perform surgery, legislation that would allow psychologist prescribing controlled substances in Nebraska (L.B. 817) and legislation in South Dakota (S.B. 50) that would allow CRNAs to practice outside of a physician-led health care team.

The AMA also is concerned that the Idaho Board of Nursing is considering whether to allow nurse anesthetists to use the term 'nurse anesthesiologists'. The AMA urged the board to "put patients first and not authorize CRNAs to refer to themselves as 'nurse anesthesiologists'" which is "both misleading and confusing to patients and does not further the IBN's mission to protect the health, safety and public welfare of the people of Idaho."

The AMA is urging physicians to make their voices heard to protect patient safety. South Dakota S.B. 50 passed the Senate last week and will be heard in the House Health and Human Services Committee likely next week. In its current form, the legislation allows CRNAs to provide anesthesia care and pain management without any physician supervision or collaboration. The bill also grants CRNAs broad prescriptive authority for controlled substances. South Dakota has a short legislative session, so action is needed immediately.

The AMA and South Dakota State Medical Association encourage all South Dakota physicians to contact members of the House Health and Human Services Committee and urge them to oppose S.B. 50.

Legislation that would criminalize gender-affirming care of transgender minors is advancing in the South Dakota legislature. On Jan. 22, a House committee voted to move the bill to the House floor. The bill, as approved by the committee, would make it a misdemeanor for medical professionals to provide certain services, including hormone therapy and surgeries, to minors for the purpose of gender transition regardless of whether the services are medically necessary. The original version of the bill would have made the provision of such services a felony.

In coordination with the South Dakota State Medical Association, the AMA is opposing this legislation as a dangerous legislative intrusion into the practice of medicine.

On Jan. 21, Governor Phil Bryant signed legislation to prohibit the sale and distribution of flavored e-cigarettes and other vaping products in New Jersey. The prohibition applies to all flavors except tobacco and includes mint and menthol. The law will take effect in April.  

In 2019, eight states (MA, MI, MT, NY, OR, RI, UT, WA) banned the sale of flavored e-cigarettes via executive action. Massachusetts subsequently enacted legislation to make its flavor ban permanent. The AMA supports prohibitions on the sale of all flavored tobacco and e-cigarette products.  

• Jan. 30, 2020: Advocacy spotlight on Physicians respond to request for feedback on Medicare scope of practice 
• Jan. 30, 2020: National Advocacy Update 
• Jan. 30, 2020: Judicial Advocacy Update