The NCSL Blog


By Mark Wolf    

The discussion was healthy and robust, even as the topic was how to deal with those who are not.

New Hampshire Representatives Neal Kurk and Cindy Rosenwald chat during a break in the roundtable discussion.NCSL’s Task Force on Innovations in State Health Systems gathered during the NCSL Capitol Forum for a roundtable discussion to exchange ideas and solicit feedback on health issues in their state.

Mississippi passed a pilot program to deal with unwanted pregnancy and required all public universities and community colleges to develop a plan of acion, reported Lonnie Edgar of the state’s joint PEER committee. In 2012, Mississippi recorded 5,644 teenage pregnancies, 3,913 of them among 18 and 19 year olds.

Senator Pat Miller of Indiana (R) said her state was dealing with people who have mental illness and drug addiction, many of them in jail or prison. A new law requires that they be enrolled in Medicaid before they are released from custody so they can continue their treatment.

Indiana has also approved a needle exchange program for several counties to deal with the spread of HIV and hepatitis. “It’s not a philosophical position we wanted to take but it’s one we needed to,” said Miller.

Representative April Weaver (R-Ala.)is sponsoring legislation to give “Good Samaritan” status to volunteers who want to help those caring for family members with chronic illnesses. “It came from church volunteers who want to help families but can’t because of liability,” said Weaver. “If you care for people in the home, the cost is much lower. It always passes the House but in the Senate the trial lawyers kill it.”

Florida, which is dealing with a shortfall of doctors, surveyed the state to discover which areas of practice are going to be needed, then created a program to pay each of the state’s teaching hospitals $100,000 for every residency they create in those areas. The initial idea was to create more medical schools but, said Representative Matt Hudson (R), co-chair of the task force, “if you don’t have residencies, it doesn’t matter and you wind up exporting all your well-trained individuals out of state.”

Hawaii lawmakers have been debating for a decade whether to allow psychologists to prescribe drugs. “Psychiatrists are up in arms,” said Representative Della Au Belam (D).

Utah is considering a proposal to expand Medicaid dental coverage to adults who are blind or otherwise disabled by using two dental schools, said Mark Anderson of the state’s Office of Legislative Research and General Counsel.

Maryland is dealing with the demise of its Certificate of Need board, which approves large medical projects said Representative Neal Kurk (R-N.H.). “We’re trying to figure out a non-Certificate of Need approach which will recognize that health isn’t free market. It’s not like buying TV sets. If a free market in health existed, the total cost of health care would rise.”

Following the state presentations, the task force members chose several topics for additional focus (in no particular order): Mental health/substance abuse, end-of-life, telehealth, health system payment and delivery reform, cost-effectiveness measures and volunteer health services to improve access.

Mark Wolf is the editor of the NCSL blog.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.