[Editor’s note: Due to a cut-and-paste error, the first half of this column was accidentally deleted in the print version of the paper. We will reprint it next week, May 10.]
The 110th General Assembly adjourned on April 25 to become a part of Tennessee history with the state budget and legislation to attack Tennessee’s opioid epidemic highlighting this year’s action. In this first in a series of three articles regarding the recently adjourned session, we will look at actions taken this year to curb opioid abuse, increase job opportunities, enhance education, protect students and teachers, reform welfare, improve healthcare and provide greater protections to some of Tennessee’s most vulnerable citizens.
Combating Opioid Abuse
The General Assembly took a multifaceted approach this year in tackling opioid abuse in the areas of enforcement, treatment, prevention and education. As part of the TN Together plan, legislation was approved this year to better track, monitor and penalize the use and distribution of dangerous and addictive drugs and to provide incentives for offenders to complete treatment programs while incarcerated. The second part of the TN Together package was a bill aiming to prevent opioid addiction and, ultimately, misuse and abuse by limiting the supply and dosage of opioid prescriptions with an emphasis on new patients, while providing exceptions for patients with extreme pain.
Major legislation was approved this year to cut off the flow of funds used to purchase opiates. The bill addresses the use of gift cards obtained through retail theft. Nationwide, the loss from retail theft is estimated at $12-15 billion, with almost all being related to the illicit drug trade. Bills also passed this year to set up a Toll Free Abuse Hotline and to move toward electronic prescriptions (e-prescribing) in order to curb prescription abuse.
Drug dealers will face stiffer penalties when a death occurs as a result of their actions under two significant bills that passed this year. This includes Henry’s law, which stiffens penalties against drug dealers when a minor dies as a result of an overdose on Schedule I or II drugs distributed by them. A separate measure passed that designates the unlawful distribution, delivery or dispensation of fentanyl, carfentanil or a combination of any controlled substance and fentanyl as second-degree murder when it is the proximate cause of death.
On opioid education, a bill was approved calling for physicians to inform a woman of child-bearing age about the risks of opioids on a newborn before prescribing the drug to prevent Neonatal Abstinence Syndrome (NAS). NAS occurs when a baby is born dependent on drugs used by the mother during her pregnancy, causing the newborn to experience withdrawal symptoms. More than 1,000 infants in Tennessee are born dependent on drugs each year. Similarly, lawmakers approved legislation requiring TennCare providers to check on a patient’s pregnancy status and contraceptive use before prescribing opioids and to provide counseling on the risks of becoming pregnant while using the drugs, as most NAS babies are born to TennCare enrollees.
In addition, several bills passed this year to ensure that patients who use opiate treatment facilities receive high-quality care that empowers them to overcome their battle with addiction, including a measure calling for revisions of the rules for nonresidential office-based opiate treatment facilities.
Jobs and Successes
On the jobs front, legislators continued efforts this year to accelerate the state’s robust economic momentum. Tennessee has the lowest unemployment rates in state history and a job growth rate greater than 17 percent.
Several bills passed legislative approval this year to help Tennessee capitalize on opportunities for growth resulting from new technologies. This includes legislation to enhance investment in mobile broadband infrastructure and prepare Tennessee for the next wave of economic development in the digital economy via 5G technology. Similarly, broadband expansion is encouraged under a measure that allows electric coops to access existing property, right-of-ways or easements in public thoroughfares, which is particularly helpful to extend services to rural communities. The budget adopted this year continues Year 2 of $45 million in grants authorized under the Broadband Accessibility Act to expand services to unserved homes and businesses in Tennessee.
Legislation was approved this year expanding Tennessee’s Visual Content Act to capitalize on the state’s competitive advantages to be a national leader for creative technology jobs, which is the fastest-growing cluster of jobs in the entertainment industry. The General Assembly also updated Tennessee’s law regarding independent Internet marketplace platform contractors to keep up with the growth of the “gigabyte economy” and encourage development of this industry. In addition, a measure was approved recognizing the legal authority of “distributed ledger technology,” which includes “blockchain technology” used in smart contracts that now appear in a variety of commercial applications.
Legislation met approval this year to help businesses avoid unintended consequences that arose out of the adoption of the federal tax reform act passed by Congress last year by decoupling Tennessee’s franchise and excise taxes from being matched to that law. It also ensures the Economic and Community Development grants provided by Tennessee to businesses in order to encourage job growth are not taxed by the state due to it being tied to the federal tax reform law.
On employment and economic opportunity, the state budget adopted this year adds $133 million to aid job growth. This includes $71 million in infrastructure and job training assistance and $14.5 million for rural development initiatives, in addition to the $15 million to expand broadband access. Tennessee has seen strong rural job growth with a 31.7 percent increase in new job commitments over that of five years ago.
Education was a top priority of the 2018 session as legislators continued efforts to improve high school and college graduation rates and to create a highly qualified workforce for new and existing businesses.
Tennessee students are posting the largest gains and highest high school graduation rates the state has ever seen, and the “college going” rate has increased from 53.8 percent to 62 percent since 2007.
The budget provides $247 million in new funds for K-12 schools for the upcoming budget year, including a $30.2 million for grants to keep students safe at school.
In March, Governor Bill Haslam directed the Tennessee Department of Safety and Homeland Security to work with education officials to implement a statewide assessment of every public elementary and secondary school in the state to identify areas of risk. The grants will be used to address the identified risks.
One such area of risk commonly identified is the availability of trained school resource officers, or SROs. For schools that do not have SROs on site, lack of funding is often cited as the primary reason. To aid in this effort, the General Assembly passed legislation authorizing school districts to hire off-duty law enforcement officers as armed school security officers during regular school hours or during school-sponsored events conducted on the school’s premises.
Student safety is also the impetus behind the appropriation of $3 million in the 2018-2019 budget for grants to school districts for the purchase of school buses equipped with seat belts. The appropriation follows legislation passed by the General Assembly last year addressing school bus safety. That law called for background checks, training and supervision for school bus drivers after two high profile crashes where driver error was at fault caused fatalities.
Protecting Students, Teachers / TNReady
The General Assembly passed legislation to protect students and teachers from any adverse action resulting in whole or in part as a result of student achievement data generated by the 2017/2018 TNReady assessments after the system experienced problems this year.
The bill reaffirmed previous action taken to hold teachers and students harmless, as well as prevent student performance and student growth data from the TNReady assessments from being used to assign a letter grade to a school.
Another key education bill approved this year incentivizes employers to hire secondary education students in work-based learning programs. The measure clarifies the liability framework for students enrolled in work-based learning and creates a tax credit of $500 for employers who participate.
It is modeled after Tennessee’s successful Labor Education Alignment Program (LEAP) adopted by the General Assembly in 2013, which gives students in Tennessee’s Colleges of Applied Technology (TCAT) the opportunity to work, earn and learn.
To help students who are struggling, the General Assembly approved “response to intervention” legislation that will facilitate regular screenings to identify areas of need and a tiered model of intervention. Another bill helps struggling students who suffer alcohol or drug dependency by authorizing “Recovery Schools.” These schools have been very successful in putting students recovering from addiction back on the right path while continuing their studies.
The General Assembly approved a package of bills to prevent sexual misconduct by teachers with their students. The legislative package follows a comprehensive report from Tennessee Comptroller Justin Wilson that revealed deficiencies in hiring practices for school personnel that could allow predators to slip through the cracks and a high-profile Tennessee case where a Maury County teen was taken across country by her teacher.
In higher education, the budget approved by lawmakers this year provides $119 million in additional funding as Tennessee continues the Drive to 55 Initiative to get 55 percent of Tennesseans equipped with a college degree or certificate by the year 2025. This effort is bolstered by the Tennessee Promise and Reconnect programs, which give all Tennesseans access to higher education tuition-free programs that have become models that other states are looking to emulate.
The General Assembly acted to reconstitute the University of Tennessee Board from 27 to 11 members to operate more efficiently and effectively like the state’s other four-year universities that were reorganized in 2016. Named the Focus Act, the new law also created seven-member advisory boards at primary UT campuses to submit recommendations regarding operating budgets, tuition and fees, strategic plans, campus life, academic programs and other matters related to the institution.
Welfare reform was on the General Assembly’s 2018 agenda. Legislation to reduce fraud and abuse and to strengthen the integrity of Tennessee’s Families First program passed final consideration. It calls for Tennessee to join a multi-state cooperative to identify dual recipient participation in the state’s programs. It also strengthens investigations of multiple Electronic Benefit Transfer (EBT) card replacements, as well as providing other tools which will help the state investigate fraud and abuse.
Similarly, the legislature approved a measure that encourages self-sufficiency for those receiving TennCare by requiring enrollees who are able-bodied adults between the ages of 18 and 64 and don’t have children under the age of six to work, volunteer or further their education. The bill does not set policy; rather, it directs TennCare to negotiate with the federal government. Per policies set by the Center for Medicaid Services, the requirements proposed would not apply to individuals with disabilities, elderly beneficiaries, children and pregnant women, as well as those who are caregivers or are undergoing job training or education, among other categories.
Several major bills were approved by the General Assembly to improve the health of Tennesseans, including legislation to help struggling hospitals develop a business plan so they can continue to provide needed care to individuals in their communities. The pilot program uses the Department of Economic and Community Development, as hospitals are vital to the economy of local communities. The rural hospital transformation program will help these hospitals assess viability, identify new delivery models, develop strategic partnerships and implement changes to operate more efficiently in an ever-evolving healthcare marketplace.
Another key health bill approved this year establishes a statewide ST-Elevation Myocardial Infarction (STEMI) system of care in Tennessee to get patients suffering with a heart-related emergency to a highly qualified hospital quickly to save lives. Likewise, a new law has passed requiring the Tennessee Emergency Medical Board to establish protocols to get stroke patients in Tennessee to the best hospital with the best treatment capabilities to foster better outcomes and save lives.
The Suicide Prevention Act passed this session establishes a Tennessee Suicide Mortality Data Review and Prevention Team in the Department of Health to address the growing number of adult suicides in Tennessee. Each day, three people in Tennessee die by suicide, and that rate is increasing.
This legislation calls for the team to gather suicide data identifying causes and factors in order to direct limited prevention resources in the most effective way possible. Similarly, legislation establishing a Palliative Care and Quality of Life Council was approved to look at issues experienced by patients who are facing serious or life-threatening illnesses and barriers to care to ease suffering. Quality of care is also behind mental health parity legislation that passed this year which ensures that behavioral and drug treatment benefits are applied fairly and that insurance carriers are accountable to consumers and small business owners.
Elderly and Disabled Tennesseans
In order to care for some of Tennessee’s most vulnerable citizens, the budget adopted this year provides an additional $11 million to raise the Department of Intellectual and Developmental Disabilities (DIDD) hourly rate of reimbursement for professionals providing care for those who have intellectual, developmental and age-related disabilities. Similarly, $7.3 million in new funds were appropriated for the state’s CHOICES program, which serves developmentally and intellectually disabled Tennesseans.
Legislation passed by the General Assembly this year helps aging caregivers by adding a person with a developmental disability who is on the waiting list for services and whose older custodial parent or caregiver has reached the age of 80 to the Employment and Community First (ECF) Choices program. Family caregivers are also the impetus of a new law aiding respite care service programs that provide limited adult day care in a manner similar to a “mother’s day out” program for young children. Another law aiding elderly Tennesseans that was approved requires the Tennessee Commission on Aging and Disability to design and maintain a resource mapping of all federal, state and nongovernmental resources that support the health, safety, and welfare of adults who are 60 or older.
A new law passed this year helps persons with disabilities have as much independence in their decision-making as possible when a court is considering conservatorships or other actions to protect their best interest. Research supports that when people are empowered to make their own decisions, to the maximum extent possible, they are better able to recognize abusive situations and surround themselves with healthy relationships.
Finally, major legislation was approved this year that modernizes Tennessee’s laws pertaining to elder abuse to make it easier for law enforcement to recognize and prosecute crimes against the elderly. The bill draws a distinction for aggravated abuse of an elderly individual and increases penalties for the offense. It also increases fines for those who commit elder neglect with the money going into a special fund that may be used to help victims.
The bill is part of the legislature’s ongoing efforts to address crimes against the elderly with major legislation approved during the past two General Assemblies, including a new statute protecting elderly and vulnerable adults from financial exploitation.
MARK NORRIS is a state senator (R-Collierville) for Tennessee and Senate Majority Leader. He chairs the Senate Rules Committee and serves as second vice-chair for the Senate Calendar Committee. He is also a member of the Senate Ethics Committee; Finance, Ways and Means Committee; State and Local Government Committee; and Joint Pensions and Insurance Committee. He may be reached at (615) 741-1967 or via email to firstname.lastname@example.org.