Senator Joey Hensley, MD: Tennessee 28th District Capitol Hill Week in Review

We will convene on January 12th to begin the 2021 session of the 112th General Assembly. Health care will be a top priority during the 2021 legislative session with the COVID-19 pandemic and a wide variety of other important issues to be discussed by the General Assembly. Lawmakers will look for ways to support healthcare systems, lower costs, increase access, and improve quality of care for all Tennesseans. Below is a look into some of the health-related legislation that the General Assembly plans to take up this session.

Vaccines – The Tennessee Department of Health has developed a preliminary structure for the allocation and distribution of COVID-19 vaccines. The vaccines require two doses injected 21 to 28 days apart. Tennessee’s COVID-19 Vaccination Plan was released on December 2 and includes four phases, with the first vaccines going to frontline hospital health care workers. This waive of vaccines will be followed by first responders, and staff and residents at long-term care facilities, such as nursing homes. Then the plan calls for the vaccines to be available to other high priority populations or those at high risk of complications from COVID-19. These include the remaining health care workers, people with high-risk comorbidities, and the elderly, before moving to other population groups in phases two, three and four.

Tennesseans have taken a highly active role in the Moderna and Pfizer vaccine trials. The state’s Financial Stimulus Accountability Group is looking at any needed funds to help ensure vaccines are distributed as efficiently and effectively as possible. The General Assembly will be actively monitoring the situation as the immunization plan unfolds. Governor Lee has voiced his support that Tennesseans have a choice in whether or not they should take the vaccine.

In related news, legislation has been filed to allow for vaccine exemptions based on religious objections or by right of conscience. Currently, Tennessee law allows for certain exemptions based on religious grounds for routine vaccinations, but the pandemic is not covered under the statute.

Health Care Safety Net Services / TennCare – The General Assembly will likely consider additional money in the 2021-2022 fiscal year budget to widen Tennessee’s Health Care Safety Net for adults in need of primary care, behavioral health, and dental services. State lawmakers made improvements in all of these areas during the 2019 and 2020 legislative sessions. The need for mental health services has particularly grown as a result of the pandemic. Proposals are also expected to increase access to preventative care and smoking cessation.

In addition, expansion of postpartum coverage for pregnant women could be on the legislative agenda this year. Last year, TennCare officials recommended a three-year pilot program to extend 12-month coverage after delivery for women who are currently ineligible under another program category.

Finally, lawmakers may look for availability of funds for the Department of Health’s Evidence-Based Home Visiting Program. The successful program offers an effective early-intervention strategy to improve the health and well-being of children and parents. Research demonstrates that young children of families enrolled in the program show improvement in health and development outcomes and increased school readiness. Since the pandemic, TennCare has added 83,000 new recipients, a six percent increase. This is in line with national trends resulting from the pandemic.

Telehealth Services – In August, the General Assembly passed major legislation expanding telehealth services. It required coverage of telehealth and telemedicine services, giving patients in Tennessee the option to receive medically necessary care at home and prevent the spread of the virus. The state’s health programs have greatly increased usage of telehealth services during the pandemic. Look for additional proposals regarding telehealth or the way the state delivers these services through TennCare and safety net programs to be proposed in 2021.

Certificate of Need - Legislation affecting Tennessee’s certificate-of-need requirements (CON) for health care facilities will likely be discussed again this year. CON is a legal document required in some states, including Tennessee, before proposed acquisitions, expansions or creations of healthcare facilities are allowed. In short, if a hospital or healthcare facility wishes to expand its capacity, whether that is the number of hospital beds it makes available or the types of imaging it can conduct, the facility must apply to a state board for permission through the CON process.

In recent legislative sessions, bills were filed both limiting CON requirements and eliminating them altogether. The Tennessee Health Services Development Agency (HSDA), which grants or denies CON applications is up for Sunset Review this year. Expect that debate to continue in 2021, including legislation which focuses on streamlining the process, removing unnecessary barriers and reducing costs. According to the National Conference of State Legislatures (NCSL), 35 states operate CON programs which greatly differ in their scope.