February 15, 2008

Governor presents budget proposal 

     State Senators moved passage of two key health care bills this week aimed at helping elderly or disabled Tennesseans receive more options in their health care, including staying in their homes for as long as possible.  The long term care legislation is part of a series of bills aiming to help citizens “age in place.”  

            “We must look at all of our laws to help give citizens more options regarding their health care so that they can age in place in their homes with dignity,” said General Welfare Committee Chairman Rusty Crowe (R-Johnson City).  “This is one of several bills we hope to pass this year aimed at providing more choices and options to elderly and disabled Tennesseans to help them stay in their homes as long as they can.” 

One bill, SB 1157, approved by the Senate General Welfare, Health and Human Services Committee, calls for a pilot program for a “self-directed care program” where individual patients get the opportunity to choose services they think they need and who provides them.  Consumers would receive a monthly budget based on their needs, and could use this money to hire personal assistant services, make home modifications, and more.  

The self-directed care program requires consumers to develop plans that show how they would use the allowance to meet their personal care needs.  It would provide counseling and financial assistance to help them plan and manage their responsibilities. Consumers who are unable to manage their care themselves may designate a representative, such as a family member, to help them or do it for them. These features make this program adaptable to consumers of all ages and with all types of impairments. Basically, it gives frail elders and adults with disabilities the option to manage a flexible budget and decide for themselves what mix of goods and services will best meet their personal care needs. 

The federal government made it significantly easier for any state to introduce a self-directed care option through the 2005 Deficit Reduction Act. As of January 2007, federally approved “waivers” are no longer required for states to offer flexible budgets to eligible Medicaid consumers and their families so that they may purchase the disability services and supports of their choosing. In addition, the 2006 reauthorization of the Older Americans Act (OAA) makes it possible to now include such options in the provision of OAA-funded services.  

Arkansas, Florida, and New Jersey were the pioneers of this self-directed health care concept.  Since that time, 12 other states have expanded their choices. In Arkansas, there was a 40% reduction in nursing home admissions in the second year of the program, and the total Medicaid cost per person under the self-directed car plan was about the same as that for the traditional agency model.  Studies show that, by every measure, self-directed care is succeeding and that consumers with this option are reporting greater satisfaction, better quality of life, and fewer unmet needs.  

“Republicans laid the foundation for home and community-based care last year through the Property Tax Relief Act, sponsored by Senate Majority Leader Mark Norris.  “As more seniors will be able to afford keeping their homes, we are now focusing on giving them the tools they need to make the most of it.” 

 “Tennessee has been last in the nation for too long in the number of healthcare choices for elderly and disabled citizens on Medicaid-supported services, a problem that has kept them from being able to stay in their homes and age with dignity,” said Senator Diane Black, sponsor of the legislation. “I know from speaking with citizens in my district that this is an issue that concerns many of them, and I can sympathize with their lack of options.”   

“Family members who provide care to the elderly or disabled are the backbone of our nation’s long term care system, even though this can often become exhausting and financially difficult,” said Senator Raymond Finney (R-Maryville), a retired physician.  “This program allows us to help support them in their efforts.”   

Tennessee spent approximately $1.1 billion on long term care last year.  Out of the 22,000 seniors on Medicaid in Tennessee, only a few thousand get home- and community-based care services.   

The second bill approved this week to help provide more options for elderly and disabled citizens was SB 2614, which was approved by the full Senate on final consideration.  The bill, sponsored by Senator Diane Black (R-Gallatin), broadens the definition of assisted living to include hospice services.  This bill would make it clear that any assisted-care living facility resident who qualifies for hospice care under Medicare can continue those services and also receive reimbursement for assisted living services. 

“These bills are positive steps towards making our laws friendlier to assisted-care living,” Sen. Jim Tracy (R-Murfreesboro) added.  “I am pleased the Senate and General Welfare Committee have passed this legislation and hopeful that the House of Representatives will take it up soon.” 

Judiciary Committee hears anti-crime and DUI bills 

The Senate Judiciary Committee heard testimony on several anti-crime bills this week, including one sponsored by Senator Randy McNally (R-Oak Ridge) requiring individuals to report crimes where serious injury or death occurs.  Under this bill, it would be a Class B misdemeanor offense for a person to fail to report a crime that results in serious injury and a Class A misdemeanor when the attack results in death.  

            McNally said the bill, SB 2637, comes after several cases of unreported violent crime nationwide, including one in Nevada where Jeremy Strohmeyer followed a seven-year old girl around in a Las Vegas Casino while her father was gambling.  Strohmeyer played hide and seek with the girl, eventually following her into the restroom where he sexually assaulted and murdered her.  Strohmeyer’s friend, David Cash, saw the man pursue the girl and even followed them into the restroom where he saw a struggle.  Cash, who failed to report the crime to anyone, was not charged by authorities since he did not take any affirmative action to cover up the crime. Cash later made public statements indicating he felt no remorse for failure to report the crime, and in fact bragged about his notoriety in the case.   

            “Those who idly sit by and watch violent crimes being committed should be punished to the full extent of the law,” said McNally.  “Each of us has a duty as a citizen to come to the aid of our fellow man when others inflict harm upon them.”  

The Judiciary Committee also heard testimony on a bill that would require ignition interlock devices to be installed on motor vehicles driven by DUI offenders.  The bill, SB 3439, sponsored by Senator Tim Burchett (R-Knoxville) aims to cut down on the number of deaths on Tennessee highways due to drunk driving.  

“Research shows that ignition interlock devices are one of the most effective ways to keep drunk drivers from continuing to drive drunk,” said Senator Burchett.   “Unfortunately, they’re significantly underused across the state.  Passage of legislation to require use of these devices will greatly help in our efforts to get drunk drivers off our roads.” 

Ignition interlocks act like a breathalyzer that can prevent a vehicle from starting if it detects alcohol. The driver blows into a breath analyzing machine, and if they pass the test they can start the vehicle.  

Jefferson County General Sessions Judge Ben Strand testified before the committee in support of the legislation.  Strand, who regularly requires the device for those with a .15 BAC or greater, said it would not be unusual to see 50 DUI cases on “a Wednesday afternoon”  in his court.  He estimated the average BAC level in his court at .15.  Strand estimated about 75 percent of those convicted of DUI “are going to drive anyway.”  He said installing the devices would minimize that chance. 

The committee has deferred action on the bill for two weeks.  Next week, the committee will take up a number of other DUI bills, including measures that would lower the standard for extreme drunk driving, require automatic license revocation, ban open containers, and impose tougher sentences for those who drink, drive and kill. 

Johnson voter confidence bill would provide a voter-verified paper trail 

Senator Jack Johnson (R-Franklin) won approval of legislation in the Senate State and Local Government Committee that would require new voting machines to have a voter-verified paper trail to go along with computerized voting machines when tallying election results.  Johnson said the legislation, SB 824, is one of two bills coming from a special committee studying the issue last year.   

Only two of Tennessee’s 95 counties keep paper trails of ballots.  Most counties use a direct recording electronic touch screen voting machine that does not allow for a paper record that can be audited or recounted in cases of suspected fraud.   

“The citizens of Tennessee need confidence in their election system,” said Johnson.   “I believe this bill will go far to protect the integrity of our election process.”  

Ramsey resolution honors Tennessee’s fire fighters 

            Firefighters were honored this week with passage of a resolution, HJR 642, in the Tennessee State Senate marking February 11 as “Fire Fighters Memorial Day.”  The resolution, sponsored by Lt. Governor Ron Ramsey, recognizes the service of firefighters and the sacrifices they make in the line of duty. 

“Everyday across Tennessee, brave firefighters put on their uniforms and report for duty with the knowledge that some day they may have to pay the ultimate price for the job that they do,” said Ramsey.  “It is appropriate that we have this day set aside to honor them and pray for their safety, and to commemorate those fallen heroes who lost their lives.” 

There are 23,553 fire fighters in Tennessee, of which 7,074 are full-time and 16,479 are volunteers.  Seventy-six fire fighters have died since 1954. 

“Tennessee is truly the volunteer state, as evidenced by the number of volunteer firemen who are willing to risk their lives to protect their neighbors,” Ramsey continued.  “I am pleased this resolution has passed, and hope that it raises awareness in our communities of the sacrifices fire fighters make every day.” 

Issues in Brief 

Storm Update -- This week President Bush authorized a major disaster declaration for eight additional Tennessee counties. Benton, Hickman, Houston, Lewis, Montgomery, Perry, Trousdale and Williamson will now receive federal funding to assist individuals and businesses affected by the tornados last Tuesday.  Hardin, Macon, Madison, Shelby and Sumner Counties, which were among the hardest hit in last week's storms, were authorized to receive federal aid last week. The federal aid authorized will supplement state and local recovery efforts that began on Feb. 5 when the storms first struck Tennessee.  It includes grants and loans to individuals or businesses to help pay for temporary housing, home repairs and other serious disaster-related expenses.  President Bush, FEMA Administrator David Paulison, and Homeland Secretary Michael Chertoff toured impacted areas of Tennessee last week. 

Open Government -- The Senate Government Operations Committee sent to the State and Local Government Committee this week two measures which came from the work of the Joint Open Government Study Committee.  The Government Operations Committee simply reviews rules or regulations associated with legislation, and refers them to the proper committee for a full hearing.  Currently, it is a violation of the Sunshine Law for two or more locally elected officials to have any conversation outside their official public meetings regarding public business.  The joint committee looked at changes to the law last fall and recommended SB 3275 allowing up to three members to meet, unless it constitutes a majority of members of the governing body.  Government Operations Committee members also moved SB 3280 to the State and Local Government Committee, which leaves current law in place regarding that key provision of the open meetings act but puts into place many other reforms.  The bills will be heard in a special subcommittee of the State and Local Government Committee next Thursday. 

Child Safety Training -- The full House voted 26 to 6 to approve legislation, sponsored by Senator Jack Johnson (R-Franklin) to give parents more information and “a say” in personal safety instruction given to three, four and five-year old children in child care centers across the state.  The bill, SB 3419, addresses curriculum to prevent sexual abuse provided by the State Department of Human Services that many child care centers feel is too graphic or inappropriate for children of that age.  The legislation would allow centers to alter the curriculum, while still providing safety training.  It also requires a note be sent to parents of the children, who could then review the curriculum at the center and opt their child out if they believe it is inappropriate for their child.  

Hargett takes oath – Former House Republican Leader Tre Hargett took the oath of office this week after confirmation of his nomination to the Tennessee Regulatory Authority.  Lt. Governor Ron Ramsey nominated Hargett to serve on the body, which sets the rates and service standards of privately owned telephone, natural gas, electric and water utilities. 

NRA -- Members of the National Rifle Association (NRA) will be able to purchase a specialty earmarked license plate under legislation sponsored by Senator Paul Stanley (R-Germantown) and approved by the full Senate this week.  The bill, SB 2934, allocates 50 percent of funds derived from sale and renewal of such plates to TWRA for hunter education. 

Veteran’s Highway – Senator Bo Watson (R-Hixson) led to passage SB 2608 to designate a segment of U.S. Highway 127 in Hamilton County as the Veterans Memorial Highway. 

Hunting and Fishing Rights – The State Senate heard two of the three required readings of  House Joint Resolution 108 this week to amend the Tennessee Constitution by protecting the right to hunt and fish.  The measure would be voted on in the same manner as the "Victim's Rights Amendment" in 1998, the “State Lottery Scholarship Amendment” of 2002, or the recent amendment to give property tax relief to the elderly.  If approved by the legislature this year and by a two-thirds majority in the next General Assembly in 2009, citizens could expect to see the resolution on the ballot in November.  

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