►
Description
House Health Subcommittee - March 23, 2021 - House Hearing Room 2
A
Right,
thank
you
and
before
we
get
started,
do
any
of
the
members
have
any
personal
orders?
A
Okay,
are
you
carrying
it?
Okay,
my
understanding
is
that
chairman
kumar
is
carrying
house
bill.
778
you're
recognized
have
a
motion
a
second.
D
This
bill
solves
a
problem
that
we
have
in
the
sense
that,
when
tenncare
approved
pharmacies
provide
covet
vaccination,
the
federal
law
requires
that
they
should
be
registered
with
10
care,
and
that
is
not
common.
So
this
bill
will
establish
a
statewide
collaborative
practice,
agreement
between
the
department
of
health
and
the
pharmacist,
so
they
can
continue
to
provide
that
service.
A
All
right,
thank
you.
We
have
an
amendment
amendment
zero,
zero,
four,
four
one
zero.
Is
that
correct?
Yes,
okay,
you
have
a
motion
in
a
second
that
rewrites
the
bill.
Is
that
the
the
explanation
you
gave
us
was
that
actually
the
amendment
explanation?
That
is
true.
Okay,
any
questions
on
the
amendment
representative
smith.
You
recognize.
C
Thank
you,
chairman
and
chairman
one
of
the
things
I
asked
the
department
when
they
came
and
worked.
This
bill
is
pharmacists,
I
know,
are
giving
covid
vaccines,
but
have
we
had
this
mechanism
in
place
for
flu
vaccines
for
other
shingles
vaccines
and
other
things
like
that?
Is
this
something
that
will
apply
only
to
covid,
or
will
this
be
something
that
applies
to
all
other
vaccines?
D
Chairman
kumar,
are
you
recognized?
Thank
you,
mr
chairman.
The
way
this
is
written,
it
applies
only
to
covet
vaccines.
A
All
right
any
further
questions
on
the
amendment:
okay,
seeing
none.
We
are
voting
on
amendment
zero,
zero,
four,
four
one:
zero,
all
those
in
favor
say:
aye
opposed
okay
eyes
have
it.
We
are
back
on
the
bill
as
amended
any
further
questions
or
comments,
seeing
none.
We
are
voting
on
house
bill
778,
all
those
in
favor
say
aye
aye
opposed
eyes.
Have
it
bill
goes
on
to
full
health.
A
A
E
To
mr
chairman,
what
this
bill
does
I
always
hate
when
people
start
the
presentation
that
way
what
this
bill
does
well,
we
know
we're
eventually
going
to
get
there.
This
this
bill
clarifies
who
is
able
to
use
the
term
anesthesiologist
and
the
basis
behind
this
is
the
recent
recognition
by
the
dental
board
of
the
term.
Dental
anesthesiologists,
you
know,
there's
already
codified,
who
is
an
anesthesiologist
people
are
starting
to
outside
of
that
code.
A
All
right,
thank
you.
So
without
objection
we
will
go
out
of
session
and
we
have
looks
like
four
folks
that
would
like
to
testify.
So
without
objection
we'll
go
out
of
session,
we
have
julie
griffin
with
the
tma.
B
Can
you
all
hear
me,
okay,
julie,
griffin,
tennessee,
medical
association?
I
really
applaud
the
sponsor
of
this
bill
for
bringing
the
legislation.
It
is
a
confusing
time
in
health
care.
B
A
F
Many
diagnosis,
but
first
let
me
say
thank
you
to
mr
chairman
and
members
of
this
committee
for
letting
me
speak
to
you
this
morning.
I'm
the
proud
parent
of
a
handicapped
son.
He
has
been
diagnosed
as
profound
mentally
global
developmental
delays
autistic
and
he
is
non-verbal.
So
we
have
no
communication.
F
I
am
unable
to
communicate
or
explain
things
to
him
as
they
occur
at
an
early
age.
He
had
one
very
bad
experience
with
the
dentist
filling
a
cavity
with
no
anesthesia.
It
was
traumatizing
for
him
in
every
way.
Every
attempt
to
visit
a
dentist
thereafter
was
met
with
very
aggressive
behavior,
and
at
this
point
you
can
think
about
a
bull
in
a
china
shop.
Flailing
arms
kicking
whatever.
F
F
F
F
F
So
as
a
caring
mother,
I
called
two
of
my
personal
friends
who
were
medical,
anesthesiologists
and
begged
them
to
come
and
sedate
my
son,
so
he
could
have
a
dental
checkup
and
they
both
apologized
and
explained
to
me
that
they
work
for
an
anesthesiology
group
and
that
group
has
privileges
at
specific
hospitals,
but
not
a
dentist
office.
So
they
were
committed
to
this
group
that
was
not
able
to
provide
the
service
that
I
needed.
F
So
I
knew
what
I
needed.
I
just
didn't
know
how
to
find
it.
So
I
went
on
the
internet
and
I
searched
dentist
anesthesiologist
and
by
the
way,
that
term
is
not
confusing
to
me
one
bit.
I
knew
what
I
needed
and
I
found
this
group
called
national
office
based
anesthesiology
ologist
and
I
called
them
immediately
and
so
for
the
last
three
years,
I've
used
them
in
providing
the
necessary
dental,
checkup,
cleaning,
cavity,
filling
and
all
the
other
things
afforded
to
all
humans.
F
I
have
found
dentist
anesthesiologists
to
be
professional,
caring,
very
dedicated
to
their
service.
There
need
to
be
more
of
these
to
care
for
the
thousands
of
patients
who
need
this
kind
of
service.
They
enable
the
dentist
to
focus
on
his
work
and
not
the
anesthesia
portion,
and
this
also
saves
money
because
there
are
no
hospital
costs.
G
D
D
I
don't
think
this
legislation
will
prevent
those
dental
anesthesiologists,
as
they
are
called
at
this
time
from
practicing.
They
may
practice
under
a
slightly
different
name,
but
they
will
definitely
continue
to
practice
and
provide
the
care,
and
that's
our
duty
too,
to
continue
to
have
that
cover
care
available
to
your
child
and
people
in
similar
situations.
G
Dr
kumar,
are
you
familiar
with
question.
D
Thank
you,
mr
yes,
I
would
need
help
answering
it.
I
don't
know
if
this
bill
is
going
to
prevent
those
people
from
calling
themselves.
Dental
anesthesiologists,
that's
a
question
for
legal,
but
what
I'm
saying
is
whether
they
practice
under
that
name
or
another
name.
They
will
definitely
continue
to
practice
and
provide
the
care.
F
F
G
F
Come
to
the
office
and
provide
the
anesthesia
services
needed
for
whatever
is
process
is
taking
place
and
in
my
my
son's
case
it
was
the
dentist
and
he
needed
to
have
his
teeth
cleaned.
He
hadn't
had
him
cleaned
in
two
years.
Yes,
he
would
walk
into
a
dental
office
and
smell
and
see
that
chair,
that
is
specific
to
a
dentist's
office
and
he
will
go
berserk.
G
And-
and
that
is
my
understanding
I
think
of
most
of
these-
they
operate
out
of
a
central
office
and
they
go
to
different
places
to
practice,
and
I
think
that's
one
of
the
great
benefits
is
that
they
get
to
go
to
areas
that
typically
aren't
supported
by
a
brick
and
mortar
anesthesiology
prisons.
So
you're.
F
Exactly
right,
mr
chairman,
and
that
is
a
huge
pro
huge
deal
to
me
because,
like
I
said
in
my
testimony,
we
should
all
have
the
privilege
of
choosing
the
dentist
we
want
to
go
to
and
if
I
only
could
go
to
this
place
that
pros
that
served
dental
anesthesiologist
and
the
dentist
I
wanted.
As
my
dentist
was
not
a
part
of
that
office
or
that
complex,
then
I
I
would
still
be
out
of
luck
and
I
would
still
not
be
able
to
have
the
dental
procedures
process
done
with
anesthesiologists.
G
G
H
H
H
H
To
a
state
that
doesn't
recognize
our
earned
credentials,
and
I
appreciate
and
agree
with
dr
kemp's
statement
on
this
matter
as
for
me,
I'm
a
dentist
anesthesiologist
I've
resided
in
practice
in
middle
tennessee
since
2012.,
and
I'm
not
here
to
represent
a
trade
organization
or
a
lobbying
group,
I'm
here
to
represent
my
practice
and
my
patience,
and
if
you
hear
nothing
else
today
from
me,
please
hear
this.
If
it's
this
bill
is
allowed
to
pass
as
written,
it
will
have
unintended
consequences
that
affect
real
people,
including
dental
professionals
and
their
patients.
H
I've
waited
years
for
the
board
of
dentistry
to
update
our
rules
and
regulations
and
by
defining
our
specialty
at
the
state
level,
we'll
finally
be
able
to
be
approved
for
tin
care
services,
where
some
children
are
currently
waiting
over
six
months,
with
a
backlog
of
patients
requiring
anesthesia
and
across
the
state,
hospitals
and
surgery.
Centers
are
cutting
dental
services
in
favor
of
more
lucrative
procedures
in
rural
communities.
H
After
my
undergraduate
education,
I
completed
four
more
years
to
earn
my
doctor
of
dental
medicine
degree.
I
then
continued
my
education
with
three
postdoctoral
years
of
residency
training
at
an
accredited
program
for
dental
anesthesiology
at
stony,
brook
university
medical
center
in
long
island.
So
our
training
was
completed
in
tandem
with
medical
residents
trained
by
physician,
anesthesiologist
and
dentist
anesthesiologist.
H
We
provided
anesthesia
at
a
level
one
trauma
center
for
every
type
of
surgery,
general
surgery,
orthopedic,
neurosurgery,
pediatric,
from
appendectomies
to
organ
transplants.
We
took
24-hour
call,
we
served
on
trauma
teams,
we
served
on
code
teams
and
difficult
airway
teams.
Our
training
was
extensive,
but
our
training
is
also
highly
specialized
for
dentistry,
it's
not
identical
to
medical
counterparts,
but
please
keep
in
mind
that
differences
in
training
does
not
mean
inferior
training.
H
H
I
built
my
practice
by
educating
and
providing
anesthesia
services
for
over
a
hundred
dental
offices
and
treating
thousands
of
patients
who
could
have
been
seen
otherwise.
So
if
this
bill
moves
forward
as
written,
it
would
indicate
that
my
training
is
somehow,
even
though
I
completed
it
in
parallel
with
medical
residents.
Somehow
I'm
less
than
my
physician
colleagues
and
not
worthy
of
the
title,
dentist
anesthesiologist,
not
only
that
this
bill
would
state
that
my
training
is
somehow
inferior
to
a
dentist
that
completed
training
over
50
years
ago,
even
before
residencies
had
accreditation
standards.
H
H
H
The
u.s
bureau
of
labor
statistics,
the
u.s
department
of
education
and
even
the
american
society
of
anesthesiologists
recognized
the
term,
and
it
was
implied
last
week
that
the
asa
doesn't
recognize
the
term
and
isn't
aware
of
it,
but
from
the
asa's
own
website.
This
morning,
I've
printed
off
practice
guidelines
from
2018
that
were
published
in
the
journal,
anesthesiology
the
asa's
official
journal,
and
not
only
does
that
publication
recognize
our
american
society
of
dentist
anesthesiologists,
but
they
also
surveyed
our
members.
H
Tennessee
already
recognizes
all
other
dental
specialties
and
their
practices
and
the
modifiers
before
those
recognized
terms,
including
oral
pathologists,
oral
radiologists
and
oral
surgeons.
So
do
those
titles
and
modifiers
that
are
already
in
use
today
cause
confusion
or
do
they
provide
clarity,
and
will
this
bill
set
a
precedent
to
strip
titles
from
other
dental
specialties?
There's
a
simple
way
to
fix
this,
and
that's
by
using
the
existing
clause
that
mentions
a
dentist
who
completed
a
residency
program
from
1963
to
1977
can
use
the
term
anesthesiologist
to
include
all
dentists
who
meet
this
level
of
training.
H
I
H
No,
I
haven't
our
my
my
license
is
is
through
our
the
dental
board,
and
so
I
provide
anesthesia
for
dental
services,
and
so
when
a
dentist
calls
me
to
say,
hey,
can
you
please
come
in?
I've
got
a
patient
who
can't
be
seen
any
other
way,
that's
who
I'm
there
to
see,
and
they
know
who
they're
coming
chairman
boyd.
Thank
you,
mr
chairman,.
I
H
I
H
My
mind
it
makes
it
incredibly
clear.
There's
there
hasn't
been
any
confusion.
The
only
confusion
comes
in
the
fact
that
there's
so
few
of
us
here
in
tennessee,
and
I
wish
that
there
were
more
of
us
because,
like
we
heard
there
are
lots
of
patients
who
need
this
service,
and
so
if
we
were,
if
there
were
more
of
us,
then
I'm
sure
that
any
confusion
would
be
cleared
up
very
easily.
D
Thank
you,
mr
chairman.
I
have
a
question
for
our
legal
eagles.
Considering
that
dr
yasirski
has
had
a
recognized
or
approved
residency
in
anesthesia,
he
is
entitled
to
use
the
terminology
dentist.
Dental
anesthesiologist.
Isn't
he
is
he
not
because
he
has
had
a
full
residency.
J
Presidency,
matt
king
from
the
office
of
legal
services,
chairman
kumar,
the
the
subdivision
that
speaks
to
having
completed
a
residency
anesthesiology
falls
beneath
another
subdivision
that
speaks
to
physicians.
So
it's
a
two-part,
so
they'd
have
to
be
a
physician,
a
licensed,
physician
who's,
completed
a
residency
in
anesthesiology
and
has
practiced
primarily
limited
to
anesthesiology.
J
D
J
Chairman,
I
wouldn't
want
to
speculate
on
other
titles.
However,
the
only
thing
the
bill
would
prohibit
is
just
the
use
of
the
one-term
anesthesiologist.
It
doesn't
speak
to
any
other
prohibition.
J
D
Well,
thank
you
for
clarification,
so
it
does
not
clarify,
since
your
residency
at
stony
brook
was
after
77,
so
this
bill
will
take
away
your
ability
to
call
yourself
a
dental,
anesthesiologist,
correct,
and
so
you
may
you
will
have
to
choose
another
title.
That
explains:
is
dental
anesthetist
or
something
like
that
and.
H
That's
that's
the
yes,
sir.
That's
the
point
that
that's
really
tough
is
that
when
we're
dealing
with
malpractice
and
liability
coverage,
insurance
carriers,
cms
center,
medicare
and
medicaid
services,
the
only
term
that's
recognized
is
dennis
anesthesiologist
and
that's
at
a
national
level,
and
so
there's
not
a
there's.
No
such
term
as
dentist,
anesthetist
or
or
anything
else
you
can
come
up
with
there.
Just
isn't
something
else
that
recognizes
what
we
do
in
our
level
of
training.
Dr
kumar.
D
I
would
just
close
end
by
saying
that
anesthesiology
to
me
means
more
than
just
putting
people
to
sleep.
It
has
other
disciplines
in
it,
such
as
critical
care,
which
is
very,
very
important
in
a
hospital
setting
and
pain
treatment
and
so
on.
So
I
think
anesthesiologists
rightfully
can
claim
that
their
specialty
covers
so
much
of
it
and
people
who
are
limited
to
only
dental
anesthesiology
may
not
call
themselves.
D
G
K
H
It
limits
a
few
things,
one.
It
doesn't
take
away.
My
general
anesthesia
permit.
Okay,
so
you
know
I
can
still
see,
go
to
a
dental
office
and
see
patients
who
can
afford
to
pay
anesthesia
fees
at
the
dental
office,
but
what
it
doesn't
do
is
it
doesn't
allow
me
to
you
know
if
I,
if
I
don't
have
the
this
designated
specialty
in
tennessee,
that
the
dental
board
has
already
attempted
to
recognize,
then
I
won't
be
able
to
have
accurate,
mpi
numbers
which
go
along
with
insurance
billing.
H
I
wouldn't
be
able,
like
I
mentioned,
and
to
be
able
to
see
10
care
patients,
so
90
of
the
kids
at
these
dental
offices
that
I
go
to.
I
can't
see
because
they
have
to
wait
and
go
to
a
surgery
center
or
the
hospital,
but
I'm
able
to
see
the
kids
with
wealthy
parents
who
can
pay
for
the
treatment,
and
so
not
only
it.
G
H
There's
that's
just
a
plan.
It
turns
into
this
play
of
semantics,
but
the
problem
is:
when
you
take
away
the
actual
term,
dentist
anesthesiologist,
that's
the
defined
term
by
cms.
That's
the
defined
mpi
taxonomy
code
is
dentist
anesthesiologist
you,
if
you
start
saying
well
in
tennessee
everywhere
else,
we're
dennis
anesthesiologist
but
tennessee,
you
have
to
say
you're
a
dental
specialist
in
the
field
of
anesthesia.
It
just
doesn't
work
and
that's
what's
kind
of
funny
about
this.
Is
that
there's
a
carve
out
for
a
dentist
who
finished
a
residency
50
years
ago?
H
But
if
you
just
change
that,
if
you
change
that
to
be
able
to
say
someone
who
finished
a
post-doctoral,
accredited
anesthesia
residency
perfectly
fine
and
then
all
of
a
sudden
where
everybody's
happy-
and
we
can
continue
to
see
the
patients
that
we've
been
able
to
see
and
provide
more
care
for
patients.
So
that's
that's
where
it
comes
to
to
be
kind
of
frustrating
to
watch
it
from
this
side.
Thank
you,
you're
welcome.
Thank.
G
You,
mr
chairman,
representative
freeman,
you
wanted
to
be.
L
Recognized.
Thank
you
chairman.
My
question
deals
with
with
that
those
codes
and
and
the
billing
do
you
get
paid
the
same
amount
to
perform.
The
anesthesiology
as
someone
who
was
an
anesthesiologist
and
in
a
hospital
setting
is,
is
the
is
the
the
cost
to
to
10
care
and
insurance
is,
at
the
same
time.
H
The
the
cost
is
actually
because
we're
able
to
provide
it
safely
and
in
a
timely
way
in
the
dental
office,
you
lose
you
actually
don't
have
to
charge
facility
fees
which
are
thousands
of
dollars
for
every
procedure.
That
goes
so
when
a
child
goes
for
tin
care
to
go
to
a
surgery
center
or
to
vanderbilt
or
any
hospital
across
the
state
that
sees
these
patients,
then
they
actually
get
charged
for
the
anesthesia
and
then
also
a
higher
facility
fee
as
well.
H
H
The
issue
right
now
is
that
I
I,
until
the
dental
board's
rules,
are
finalized
to
recognize
our
specialty
in
tennessee.
I'm
not
billing.
Under
the
term
dentist
anesthesiologist,
I'm
billing
as
a
general
dentist
who
provided
a
service
and
right
now,
like
I
said
all
of
my
patients
are
fee
for
service.
H
Ms
kiefer
has
to
pay
out
of
pocket
to
be
able
to
have
our
services
done,
but
she's
willing
to
do
that,
because
it's
a
tenth
of
the
cost
of
going
to
the
hospital,
and
so
if,
if
this,
if
the
bill
is
allows
us
to
be
called
dennis,
anesthesiologists
and
the
dental
board's
rules
can
go
through
as
they've
approved.
Then
that
would
allow
me
to
then
build
insurance
and
and
hopefully
be
credentialed
through
tenncare
as
well.
G
Representative
freeman,
any
anybody
else
have
any
questions
of
our
dental
anesthesiologist.
If
none
thank
you
for
your
testimony.
Yes,
sir.
G
Okay,
we
now
say.
G
Okay,
thank
you
very
much,
dr
uzersky.
We
appreciate
you
being
here.
Sorry,
we
we
missed
you
last
week,
we've
got
a
request
from
tasha
alexander
tennessee
association
of
nurse
anesthetists,
and
then
we've
been
asked
to
have
julia
griffin
back
up
from
the
tma.
So
no
objections
introduce
yourself
please
for
the
record.
M
He'll
outline
the
concerns
of
the
tennessee
association
of
nurse
anesthetists
to
house
bill
1350..
My
name
is
tasha
alexander.
The
genesis
of
this
bill,
as
as
it
has
already
been
presented,
is
that
two
healthcare
provider
groups
could
not
find
common
ground
on
what
to
call
in
the
use
of
the
term
anesthesiologist.
M
Not
fighting
over
one
group
not
fighting
over
when
whether
one
group
gets
to
use
a
word
that
describes
a
specialty
or
not
tana,
considered
all
perspectives
on
this
bill,
including
member
input.
Other
state
experiences,
as
well
as
the
short-term
impact
and
the
long
view
the
primary
concerns
expressed
by
our
members
were:
how
could
this
impact
our
profession
in
the
future?
And
how
does
this
bill
serve?
Patients
first
and
foremost,
tana
and
its
members
are
committed
to
the
overarching
priority
of
patient
care.
M
The
state
of
tennessee
has
a
system
of
licensing
and
regulating
health
care
providers
through
its
regulatory
boards.
These
regulatory
boards
are
vested
with
the
responsibility
to
protect
the
public,
including
including
determining
the
appropriate
standards
of
practice
in
an
effort
to
ensure
the
qualified
professional
conduct,
whether
that
be
a
physician,
a
nurse
or
a
dentist.
M
Tennessee
by
law
and
rule
already
sets
forth
rules
and
requirements
for
practitioners
related
to
informing
and
protecting
the
public.
The
very
statute
that
this
bill
amends
outlines
in
detail
the
requirements
for
a
health
care
provider
to
display
and
inform
a
patient
about
his
or
her
licensure
and
specialist
designation
in
facilities.
M
Licensure
for
healthcare
providers
in
tennessee
is
based
on
meeting
the
qualifications
of
the
profession,
I.e,
physician
nurse
dentist,
pharmacist,
etc.
Not
the
descriptor
term
for
a
specialty
state
law
should
not
restrict
the
use
of
the
descriptor
term
anesthesiologist
or
any
other
descriptor
term
to
a
single
profession.
M
Many
other
health
care
professions
recognize
the
use
of
descriptor
terms
for
specialties,
orthopedic,
physician
assistants,
radiology
assistants,
psychiatric
nurse.
Those
are
some
examples
from
the
tennessee
code.
Today,
one
group
is
asking
the
legislature
to
restrict
the
descriptor
term
for
its
specialty,
but
what
group
will
be
next
and
what
precedent
are
we
setting
for
patients
in
the
future?
M
Transparency
and
accountability
in
healthcare
should
help
inform
patients
in
the
public
and
promote
patient
safety
and
choice.
Informing
the
patients
includes
recognizing
specialties
within
professions.
Prohibiting
the
use
of
the
descriptor
term
does
nothing
to
inform
the
patient
or
encourage
transparency
in
an
already
confusing
health
care
system
or
promote
profession.
M
Accountability
tana
holds
its
healthcare
colleagues
in
the
highest
regard,
and
we
sincerely
hope
that
the
discussions
will
continue
outside
this
committee
room
to
address
this
issue,
but
we
are
very
concerned
that,
if
it
does
not
that
this
bill
could
impact
other
interested
health
care
professionals-
and
we
don't
want
to
see
that
happen.
For
these
reasons,
tana
and
its
members
respectfully
ask
that
you
vote
no
on
house
bill
1350..
G
None
well,
we
appreciate
your
your
statements
and
thank
you
for
being
here.
We
will,
if
there's,
no
objection,
I've
I've
been
told
that
judah
griffin
from
the
tennessee
medical
association
does
not
want
to
to
be
recalled.
G
E
And
mr
chairman,
I
I'd
like
to
say
that
I
think
I
think
you
may
have
through
the
testimony
if
you
were
listening
to
some
of
this.
You
know
when
I
first
got
this:
it's
like
hey.
Here's,
a
beef
between
two
highly
qualified
people
over
what
their
title
that
they're
gonna
wear
is.
E
But
then,
as
you
dig
deeper,
and
you
listen
to
this
and
you
listen
to
the
testimony,
I
kind
of
got
a
little
bit
different
perspective
on
it,
and
it
is
that
one
business
is
trying
to
expand
its
marketplace
based
upon
a
title
that
has
been
rightfully
earned
by
someone
else,
and
that
is
what
I
would
ask
we're.
Not
here.
E
E
It's
a
trade
dispute
and
I
think
it's
a
legitimate
thing
for
this
legislature
to
to
to
consider-
and
the
last
point
I'd
like
to
make-
is
that
this
does
not
in
any
way
diminish
the
services
that
the
good
doctor
and
and
and
his
patients
that
he
provides
and
they
receive
there's
there's
obviously
and
that
he
serves
an
important
role
enough
and
I
would
I
would
not
be
bringing
this
legislation
if
I
thought
that
that
would
diminish
and
take
away
from
that.
But
to
me
it's
kind
of
like
and
I'm
a
simple
man.
E
I
look
at
things
and
and
y'all
remember
when
hope,
when
it's
a
little,
when
I
was
a
little
kid,
it's
a
big
deal
to
me
when
hostess
changed,
remember:
ding,
dongs,
the
chocolate
cakes
and
they
changed
from
ding
dongs
to
king
dons,
the
names
and
I
was
just
crushed
because
I
thought
man
they
took
my
favorite
snack
food
away,
but
yeah
they're
the
same
thing,
so
you
can
change
names
of
items
and
they
still
provide
the
same
benefit.
The
same
satisfaction,
the
same
service.
L
Thank
you
chairman.
Thank
you
chairman.
I
I
think
I
was
with
you
until
the
ding-dong
comment
yeah,
but
I
I
guess
my
main
question
is
because,
because
I
feel
like
you
said
it,
it
was,
it
is
a
trade
dispute
over
name
and
then
you
said
it
was
something
about
expanding
services.
And
then
you
said
you
don't
want
to
take
the
service,
so
I
just
want
to
make
sure
that
I'm
fully
understanding
the
intent
you
just
want
them
to
change
their
name
right,
but
not
reduce
the
services.
So
so
in
actuality
it.
L
E
G
Representative
freeman,
I
think
chairman
boyd,
you
wanted
to
be
next.
I
Yeah,
thank
you,
mr
chairman,
and
chairman
vaughn.
I
appreciate
you
bringing
this
bill
and
I've
learned
a
lot
about
it.
I
didn't
come
into
this
with
any
preconceived
idea
of
what
it
was
going
to
be,
but
after
hearing
this,
I'm
I'm
hearing
it.
The
conversation
eventually
shifted
to
who
was
who
had
the
most
training
or
who
was
the
most
qualified
and
and
and
certainly
if
I
was
having
a
serious
surgery
in
a
hospital
I'd
want
I'd
want
to.
I
Let
someone
like
dr
terry
to
to
do
that,
but
I
don't
think
that
the
dentist,
the
dental
anesthesiologists,
are
suggesting
that
they
can
do
that.
We've
heard
about
an
apparent
confusion
that
doesn't
seem
to
exist.
I'm
not
aware
that
anybody,
I've,
never
accidentally
got
really
close
to
a
surgery
and
then
realized
I'd
accidentally
set
it
up
with
a
dental
anesthesiologist.
That's
never
happened.
I
We've
learned
that
it's
a
that
the
american
dental
association,
that
it's
a
national
accreditation
and
we
continue
in
this
body
to
index
things
to
national
accreditations,
but
here
we
are
in
tennessee
kind
of
time,
taking
a
step
backwards
on
that
and
then
finally,
I
would
actually
say
my
colleague
from
davidson
county
said
is:
is
this
a
a
trademarked
or
copyrighted
word?
Well,
apparently
we're
about
to
do
that.
Apparently
we
we
are
given
license.
We
we
are
giving
a
copyright
to
the
word
anesthesiologist
and
folks.
I
I
don't
know
that
we
have
to
it's
a
big
word
and
it's
big
enough
for
two
different
professions
to
share
it,
and
I
think
that
the
distinction
is.
If
you
are
an
anesthesiologist,
then
you
are
a
medical
doctor
that
performs
surgeries
in
a
hospital
or
some
sort
of
ambulatory
surgical
center.
And
if
you
are
a
dental
anesthesiologist,
I
think
the
distinction
is
obvious
with
the
word
dental,
so
I'm
I'm
mean
this
as
much
as
I
can.
I
hate
to
oppose
your
bill,
but
I'm
I'm
going
to
be
a
strong
no
on
this
one.
E
You
don't
want
to
see
someone
who
has
established
a
lesser
and
when
I
say
lesser,
not
less
important
but
lesser
in
work,
lesser
in
accomplishment
to
be
able
to
rise
up
to
take
what
you
have
to
what
you
have
grabbed
and
what
you've
rightfully
earned
and
pull
it
back
down.
E
So
more
people
can
use
it
just
by
adding
a
modifier
on
and,
like
I
said
last
week,
my
profession
engineers
have
allowed
everyone
in
the
world
to
call
themselves
an
engineer,
and
I
wish
we
had
done
this
sooner,
because
there
is
a
distinction,
we're
just
asking
that
distinction
be
upheld
and
then,
if
somebody
else
needs
to
provide
another
qualifier,
another
title
for
their
services
be
a
sedation
dentist,
be
whatever
you
need
to
do.
Adequately
describe
your
services,
but
you
don't
get
to
claim
someone
else's
work
and
that's
where
this
stems
from.
K
E
Frankly,
speaker,
I
don't
know
this
ev
this
for
sure,
but
according
to
the
testimony
that
I
heard
our
our
that
we
had
and
heard
today
is
that
yes,
they
would
they
just
would
not
expand
their
marketplace,
would
not
expand
as
a
result
of
it.
That's
my
understanding
and.
K
G
Okay,
chairman
boyd
you're
recognized.
I
Thank
you,
mr
chairman,
and
when
leader
marsh
I'm
sorry,
speaker
marcia
asked
that
question.
It
was
my
understanding
when
I
heard
the
testimony
a
minute
ago
that
these
folks
were
having
to
pay
cash
now
for
this
type
of
dental
anesthesiologist,
because
it
had
not
yet
been
established
for
insurance
purposes,
and
so
I
I'm
just
bringing
that
up,
because
that's
my
recollection
of
what
I
heard
matthew
testified
a
minute
ago.
G
Yes
and
chairman
vaughn
you're
recognized
no.
I
haven't.
G
A
Also,
I
reached
out
to
dentaquest,
and
they
had
informed
me
that,
regardless
of
the
outcome
of
this
bill,
you
know
they
could
call
themselves
dental
anesthesiologist
to
the
fourth
power.
It's
not
going
to
change
their
policy.
Ultimately,
it
is
about
mobile
anesthesia
services
that
is
at
at
the
heart
of
this
and
according
to
dentaquest,
two
of
their
of
these
anesthesia
dentists
chose
not
to
be
credentialed
or
not
to
get
contracted
so
with
tenncare.
A
So
that's
that's
something
that,
in
my
investigation
of
what's
going
on
with
this
that
that
I
think
the
committee
needs
to
know.
I
also
want
to
address
a
few
things.
Our
committee
committee
recently
received
an
email
from
a
lobbyist
on
behalf
of
the
anesthesia
dentist,
with
the
suggestion
of
the
mandatory
language
and
in
it
the
email
said.
Dentist
anesthesiologists
are
proud
to
be
dentists
and
do
not
pretend
to
be
otherwise
and
indeed
they're
willing
to
meet
tmas
or
tsa's
concerns
head
on.
A
A
They
are
licensed
dentists
with
advanced
training
anesthesiology,
and
I
want
to
point
to
our
code
title
63,
a
person
who
shall
be
regarded
as
practicing
medicine
with
the
meaning
of
this
chapter,
who
treats
or
professes
to
diagnose,
treat,
operates
on
or
prescribes
for
any
physical
ailment
or
any
physical
injury
to
or
deformity
of
another,
and
then
it
has
beyond
that.
Anesthesiologist
is
defined
as
a
physician,
not
a
dentist,
a
physician,
that's
a
medical
doctor
who
has
completed
residency
and
anesthesiology,
and
then
we've
we've
heard
that
the
rest
of
that
by
legal
services.
A
I
want
to
point
out:
we've
talked
about
transparency
and
accountability,
and
that's
what
this
is
about
and
on
the
website
for
the
dentist
that
that
testified.
It
says
the
anesthesia
procedures
mirror
those
received
in
hospitals
and
surgery
centers.
So
going
back
to
the
definition
about
practicing
medicine
mirror
those
in
hospitals
and
surgery
centers,
including
airway
protection,
yada
yada,
you
can
take
comfort
in
knowing
you
or
your
child
will
be
continuously
monitored
by
our
highly
trained
anesthesiologist.
A
Not
dental
anesthesiologist
anesthesiologist
go
down
further.
They
say
our
anesthesiologist
will
personally
call
you
the
night
before
the
procedure
to
answer
any
questions
you
may
or
may
not
have
about
your
procedure
so
in
transparency
and
accountability.
Yes,
that
is
that
is
out
there
last
point:
I
want
to
make
received
another
email.
That
said,
they
need
formal
recognition
to
comply
with
dinaquest
policy
and
otherwise
continue
to
otherwise,
but
would
not
be
continued
to
be
eligible
to
perform
deep
sedation
on
tenncare
patients.
A
Again,
they
can
get
credentialed,
tenncare
and
danaquest
said
that
it's
not
an
issue
with
adequacy
for
the
network.
They
can
go
through
a
process
to
get
credentialed.
Thank
you
to.
G
According
to
the
staff
here
they
say
that
that
heretofore,
with
the
passage
of
this
bill,
no
one
except
medical
anesthesiologists
will
be
able
to
use
that
term.
So
the
veterinary
anesthesiologist
will
be
the
next
ones
here.
L
Sorry,
sorry
for
the
continuing
question.
Thank
you,
chairman
back
to
this
confusion,
thing
just
to
fully
beat
it
to
death.
I've
got
several
friends
who
are
doctors,
I've
got
medical
doctors,
I've
got
phd
doctors,
I've
got
psychiatrists,
I've
got
dentists
and,
to
me
the
the
the
qualifier
there
is:
are
they
an
md?
Are
they
a
dds?
Are
they
a
phd
and
this
confusion?
Question
keeps
coming
up,
so
is
a
dental
anesthesiologist?
L
G
And
chairman
vaughn
I'd
be
glad
to
ask
that
yes,
the
clarifications
there
dmd
and
dds
doctor
of
dental
surgery
and
doctor
of
medicine
and
dentistry
do
designate,
and
so,
when
you
look
it
up
in
the
phone
book,
it's
it's
obvious.
Is
that
what
your
question
was.
E
C
J
C
And
so
I
want
to
make
sure
that
I
understand
that
this
is
the
definition
of
practicing
medicine
with
the
with
the
the
area
of
specialty
for
anesthesiology
and
what
I'm
getting
more
talk
about,
confusion,
confusion,
I'm
getting
more
confused
as
I
hear
the
conflicting
testimony
that
if
your
bill
takes
this
and
puts
it
into
another
section
of
code,
are
you
making
it
more
more
vulnerable
or
are
you
protecting
anesthesiology
because,
as
it
relates
to
the
practice
of
medicine
and
the
healing
arts,
I
would
think
that
if
it's
limited
to
one
section
limited
to
the
practice
of
medicine
for
mds,
that
that
would
be
an
advantage
to
physicians
as
opposed
to
putting
it
in
another
section
of
code
but
I'll.
J
Cheerleader
smith,
I
think
yes,
it
is
correct
that
the
definition
that
has
been
referenced
in
636
204,
the
lead-in
language
says
as
used
in
this
section.
That
is
the
section
that
deals
with
the
practice
of
medicine.
J
However,
the
bill,
as
we've
been
discussing,
prohibits
people
from
using
that
term
or
another
term
to
imply
that
they
are
an
anesthesiologist
unless
they
meet
the
qualifications
that
are
laid
out
in
the
bill,
their
physician
with
those
qualifications
or
they're.
One
of
those
dentists
with
the
past
presidency.
C
And
so
what
I'm
hearing
is
this
panel
is
about
to
make
a
decision
as
to
whether
we
are
redefining
anesthesiology
period,
because
if
it's
already
encode
and
it's
been
there-
and
I
do
understand
that
there
are
national
organizations
that
are-
are
expanding
it.
But
you
know
one
of
the
things
I've
learned
in
healthcare
after
having
a
career
in
it
for
30
years
is
that
we
chase
dollar
signs.
C
This
is
about
the
payer
model
and
it's
getting
while
I,
as
I
drove
here
this
morning,
I
heard
a
commercial
on
sedation
dentistry
and
it's
very
lucrative,
and
I
think
I
just
heard
the
testimony
that
this
particular
dentist
chose
not
to
be
in
network
for
tenncare
and
dentaquest.
E
With
that
assessment,
thank
you,
mr.
E
And
again,
I
think
you
crushed
them.
We
wouldn't
be
here
if
this
was
just
a
beef.
This
is
a
this
is
a
money
question
this
is
about
this
is
about
dollars,
and
so
who
and
again
the
practice.
The
these
people
provide
a
great
service,
obviously
he's
obviously
very
this
particular
provider.
That's
here
obviously
provides
a
wonderful
service
and
nobody's
denying
that.
But
what
we're
talking
about
is.
Are
we
going
to
allow
this
an
expansion
of
this
practice
and
then
this
body
deciding
that
dentist
anesthesiologists
are
okay.
G
And-
and
let
me
make
clear-
probably
the
people
you
heard
advertising
on
the
radio
are:
are
relative,
anesthesiology
the
they
use
that
in
almost
every
operatory,
in
an
oral
surgeon's
office,
which
is
a
totally
different,
there's
no
intubation
or
anything.
It's
a
totally
different
and
highly
regulated
portion
of
the
dental
practice.
So
so
the
these
folks
that
that
dr
uzursti
are
not
not
advertising
on
on
radio
they're
they're,
not
going
to
do
that.
C
Again,
thank
you,
but
again
just
making
my
point
that
you
know
there
is
a
difference
between
anesthesia
services
and
being
intubated
and
there's
quite
a
difference,
but
but
that's
where
the
public
doesn't
know
that,
and
so
I
you
know
again,
I'm
just
I'm
just
trying
to
make
sure.
I
understand
what
we're
voting
on
today,
but
thank
you,
mr
chairman,.
G
Have
a
call
for:
are
there
any
objections
to
calling
for
the
question?
If,
if
none,
then
we
will
be
voting
to
send
this
bill
to
full
committee,
all
those
in
favor
say
aye
all
those
opposed
noes
have
it.
I'm
fear
that
the
bill
has
failed,
and
I
I
would
encourage
everybody
to
to
go
ahead
and
and
maybe
get
together
and
we'll
have
our
own
summer
study
and
see
if
we
can
come
up
with
a
some
sort
of
a
decision
between
the
factions.
E
G
Stick
around
is
patsy
pardon
me
chair,
lady
yeah,
chair
lady
hazelwood.
You've
asked
to
be
allowed
to
do
a
real,
quick,
important
bill
that
may
save
the
world
by
tomorrow
morning.
B
B
The
dsp
providers
bring
their
salaries
up
to
15.
When
we
reach
that
point,
then
what
we
would
seek
to
do
is
to
tie
those
salaries
into
state
employees
and,
if
state
employees
get
a
two
percent
raise.
These
folks
would
get
a
two
percent
raise.
We
don't
want
to
do
that
until
the
the
minimum
is
at
a
reasonable
amount.
These
people
are
highly
highly
underpaid
for
the
work
that
they
do.
B
A
lot
of
that
is
due
not
only
it's
a
stressful
job,
it's
emotionally
and
physically
challenging,
and
then,
when
you
add
that
to
the
fact
that
we
pay
them
so
very
little,
it
really
it's
it's
an
issue
that
we
need
to
address
and
the
point
of
tying
it
to
state
salaries.
B
It
used
to
be
that
way
years
ago,
and
in
a
budget
crunch,
we
chose
to
cut
these
people
back
and
we've
left
them
behind
ever
since.
So
all
I'm
trying
to
do
is
is
bring
them
up
to
something
not
up.
We
can't
pay
them
what
it's
worth
for
the
work
that
they
do,
but
we
can
pay
them
as
something
more
reasonable.
Okay,.
G
Thank
you,
representative
jernigan.
Our
pardon
me,
chairman,
jernigan
you're
recognized
thank.
N
You
I'm
incredibly
supportive
of
this
bill,
I'm
probably
maybe
the
only
one
on
this
committee-
that's
actually
used
dsps
and
who
have
come
into
my
home
and
that
if
you
get
a
really
good
one,
the
quality
of
life
that
they
provide
for
a
person
isn't
measurable
and
they
they
need
to
be
paid
for
what
they're
worth
and
we're
getting
to
a
point
where
people
turning
65
years
old
every
day
is
around
10
000
for
the
next
10
years.
So
we're
getting
to
a
point
to
where
they're
going
to
be
incredibly
in
demand.
N
We
need
quality
folks,
we
need
to
pay
them
for
what
they
do,
because,
especially
our
seniors
and
our
disabled.
They
deserve
no
less
and
thank
you
chair
lady,
for
bringing
this
bill.
Do.
G
G
G
G
B
E
G
E
Yes,
sir,
mr
chairman,
this
bill
creates
a
c-o-n
carve
out
for
retired
energy
workers,
the
people
it's
completely
funded
by
the
federal
government.
What
happens
is
that
the
population
has
grown.
These
are
folks
who
were
exposed
to
radiation
in
oak
ridge
back
in
the
day,
and
this
allows
service
providers
for
this
very
specialized
type
of
care
to
administer
the
services
that
these
folks
need.
C
And
chairman,
just
for
clarity
and
for
the
record,
this
is
a
very
small
population,
probably
less
than
maybe
30
000
people,
because
in
the
world
or
certificate
of
knee
when
you
choose
the
term
carve
out,
people
seem
to
tighten
up
a
little
minute,
but
this
is
a
very
specific
population
for
department
of
energy
workers
that
is
not
going
to
be
open
to
the
general
public.
Is
that
correct?
So,
yes,.
E
G
For
the
comments
or
questions
of
the
amendment
we'll
vote
on
the
amendment,
all
those
in
favor
of
placing
the
amendment
on
the
bill
say
aye.
Any
opposition
so
approved
we're
back
on
the
bill
as
amended.
G
G
G
For
motion
and
second
on
the
amendment
have
motion
and
second
on
the
amendment,
if
you'd
like
to
explain
the
amendment.
E
Yes,
sir,
this
bill.
This
comes
to
us
from
our
friends
at
the
tennessee
hospital
association.
What
we're
attempting
to
do
is
codify
one
of
the
executive
orders
that
governor
lee
brought
forth
during
the
pandemic.
E
What
it
does
is,
it
will
allow
for
nursing
graduates
who
have
not
yet
sat
for
their
rn
exam
or
their
nclex
exam
to
still
be
supervised
by
accredited
people
within
the
hospital
setting,
and
so
what
it
does
is.
While
these
folks
are
studying
to
take
their
boards,
they
can
work
in
the
hospital
under
very
defined
set
of
circumstances,
and
it
is
consistent
with
what
we've
the
practice
we've
had
over
the
past
few
months
and.
G
D
You,
mr
chairman,
this
has
been
a
common
practice
and
I
still
remember
nurses,
who
had
finished
their
training
but
waiting
to
take
their
boards
wearing
a
badge
called
gn
graduate
nurse
and
they
worked
with
us
in
a
very
satisfactory
way.
It
was
also
in
the
setting
of
the
same
hospital
same
word
where
they
had
been
doing
their
learning,
because
nursing
is
so
clinically
intensive
that
there
is
not
a
whole
lot
of
transition
involved
and
I
think
that's.
I
was
surprised
that
that
practice
had
been
discontinued
and
I
think
it
does
our
profession
well
needing.
E
For
that,
and
and
I'm
glad
you
brought
that
up
dr
kumar,
what
this
is
is
this
is
a
portion
of
kind
of
a
workforce
development
program
for
medic,
the
medical
industry,
we've
seen
how
we've
been
shorted,
not
just
with
nurses.
But
again
we
spoke
to
you
about
the
laboratory
personnel
we've
now
we're
talking
about
I'll,
be
back
with
the
doctors
with
regards
to
that.
But
this
is
workforce
development,
training
for
the
medical
profession
and
we
think
it's
something
that's
sorely
needed.
G
For
the
comments
or
questions
of
the
sponsor,
if
not
we'll
be
voting
on
the
amendment
to
places
on
the
full
bill,
all
those
in
favor
say:
aye
aye,
any
opposition
back
on
the
bill
is
amended.
We
have
comments
or
questions
chair,
lady
smith,.
C
I
would
just
say
that
this
is
what
I
did
when
I
graduated
from
ut
knoxville,
and
this
does
not
prohibit
a
university
hospital
or
a
private
hospital
from
having
or
a
any
other
entity
from
creating
their
own
type
of
specialized
training
within
an
entity
so
that
they
can
be
better
placed
in
an
intensive
care
unit
or
a
floor.
And
so
I
applaud
you
for
this,
because
this
has
worked
in
practice.
Just
like
dr
kumar
had
said.
Thank
you.
G
For
the
comments
or
questions,
if
not
we'll
be
voting
to
send
this
bill,
as
amended
to
the
pardon
me
chairman,
terry
you're
recognized,
I.
G
G
O
Sorry
about
that,
am
I
on
all
right,
kathleen
murphy
with
the
tennessee
nurses
association,
and
I
know
I've
spoken
with
a
few
of
y'all
about
our
concerns
around
this
program.
First,
we
would
like
to
say
that
we're
trying
to
work
an
amendment
out
with
the
tennessee
hospital
association.
O
There
are
a
few
areas
of
this
bill
that
we
think
needs
guard
rails
around
it,
not
just
to
protect
the
registered
nurse
or
the
graduate
student,
the
student,
the
graduate
nurse,
but
also
to
protect
the
patient
and
protect
your
constituents
who
are
under
our
care.
So
one
area
is
that
we
would
like
to
see
this
tied
to
graduation
in
some
way,
so
this
would
allow
under
the
current
amendment
this
would
allow
nurses
the
graduate
nurse
to
take
time
off
from
school.
O
O
Maybe
yes,
maybe
no,
but
that
guard
rail
is
not
in
this
legislation
currently,
and
we
feel
pretty
strongly
that
that's
important
that,
if
you're
going,
if
we're
going
to
bring
this
this
program
back
and
enter
into
it
here
in
tennessee,
we
need
it
tied
to
their
graduation
date
in
some
way.
So
it
is
not
an
unended
issue.
Secondly,
and-
and
most
importantly,
is
this
needs
to
have
in
the
legislation
a
one-to-one
ratio.
The
supervising
rn
needs
to
only
supervise
one
graduate
nurse
at
a
time,
because
the
nurse
will
have
their
own
patients.
O
The
graduate
nurse
could
have
their
own
patients
and
exponentially
will
stretch
out
the
rn's
responsibilities.
We
don't
want
to
put
the
rn
at
liability
and
risk.
We
do
not
want
to
put
that
graduate
student
at
risk
and,
most
importantly,
we
want
to
make
sure
that
our
patients,
your
constituents
yourself,
your
family
members,
are
taken
care
of
here
in
tennessee.
I'm
happy
to
answer
any
questions,
and-
and
I
would
I
hope,
that
we
are
able
to
work
out
an
amendment.
I
think
that
this
could
be
worked
out
pretty
easily.
O
A
Thank
you
and
just
for
clarification
there.
There
are
two
issues,
even
as
amended
that
you
see
with
the
bill.
One
is
that
there's
a
the
timeline
from
time
of
graduation
and
I've
known
nurses
personally,
who
have
waited
a
period
of
time
before
they
tried
to
get
their
nursing
license
and
so
they're
out
of
practice,
and
so
I
agree
with
you
heartily
on
that
issue.
Secondly,
the
issue
about
one-to-one
supervision.
G
We
have
further
comments.
Your
questions,
speaker,
marshall,
recognized
thank.
K
O
So
the
bill,
I'm
sorry,
thank
you.
Thank
you
chairman,
as
amended.
What
would
happen
is
once
the
graduate
nurse
gets
their
approval
to
take
the
nclex
test,
so
that
means
once
they've
passed
their
background
check
once
their
transcripts
have
been
submitted.
All
of
that
when
the
board
of
nursing
says
you
are
good
to
go
to
sit
for
the
test,
that's
when
that
120
days
starts
clicking.
O
So
that
means
that
I
could
have
graduated
with
a
degree
in
nursing.
We
won't
say
how
many
years
ago,
but
a
few
years
ago,
right-
and
I
could
just
now
start
down
this
path
right,
say
I
had
a
different
opportunity.
I
went
to
some
sort
of
pharmaceutical,
something
or
other
or
I
went
home
and
worked
in
my
family
business
for
a
while
before
starting
practicing
nurse,
then
under
this
program,
as
written
as
amended,
I
could
enter
into
this
graduate
program
and
that's
our
concern
is
well.
O
We
we
want
nurses
to
feel
comfortable,
and
so
the
student
nurses
association
they
they
have
a
representative
on
our
government
affairs
committee
and
they
have
voiced
great
concern.
Great
fear.
They
do
not
want
to
be
put
in
the
position
of
graduating
and
then
going
immediately
to
the
floor
without
some
sort
of
well
first
being
tested
for
licensure,
but
also
without
these
guard
rails
of
where
they
may
have
patients,
but
they
may
have
other
people
as
well
under
this
rn,
and
they
don't
want
to
take
that
risk.
It's
very
scary
to
them.
O
So
so
we
are
asking
you,
we
are
nurses,
we
know
what
we
can
handle.
Please
please
listen
to
us
and
hear
us
when
we
say
these
are
concerns
for
us
doing
our
job
to
protect
the
patients.
G
Okay,
speaker.
O
This
would
allow
nurses
to
graduate
sorry
graduate
nurses
to
get
onto
the
floor
120
days
faster,
potentially,
but
I
think
that
the
shortage
of
nursing
well
again
speaking
kind
of
away
from
this
bill.
The
shortage
of
nursing,
can
be
fixed
in
in
a
lot
of
different
ways
and
should
be
fixed
in
a
lot
of
different
ways.
C
Thank
you,
mr
chairman,
and
one
thing
I
just
wanted,
and
you
may
not
have
the
answer
to
this,
but
what
I'm
hearing
validates
something
you
know
when
I
got
my
bsn,
I
had
two
years
of
clinical
nursing
before
I
walked
across,
so
I
had
been
on
med
surg
floors.
I'd
been
in
surgery
suites,
I
delivered
babies,
I've
been
in
the
er,
and
so
for
two
years
I
did
clinical
and
so
120
days
is
really
not
going
to
make
that
much
difference.
C
Your
clinical
people
should
have
an
assurance
in
that
degree,
and
and
if
we've
got
a
if
I'm
hearing
this
correctly
and
we've
got
a
problem
with
degree
meals
and
we're
just
churning
out
people
very
quickly
for
some
kind
of
franchise.
That's
a
problem
but
I'll.
Let
you
all
work
this
out,
but
I
think
it's
a
good
idea.
Thank
you
for.
G
The
comments
or
questions
of
the
witness,
if
not
let
me
recognize
the
sponsor,
is
this
an
issue
that
you
have
discussed.
Yeah.
Oh
you're,
stay
there
just
a
minute.
Is
this
an
yeah?
Is
this
an
issue
that
that
you've
discussed
there.
E
Has
been
discussions
on
it?
Obviously
people
don't
always
agree.
One
thing,
one
point
that
I'd
like
to
make
in
rebuttal
is:
is
that
if
a
nurse
is
scared
to
be
120
days
on
the
floor,
then
she
doesn't
have
to
participate
in
this
program.
She
can
stay
at
home
and
study
for
for
nclex,
and
so
I
don't
think
that
from
that
standpoint,
if
a
graduate
nurse
is
not
confident
enough
to
go
onto
the
hospital
floor,
they
know
that
better
than
anybody
so
there's
nobody
forcing
them
to
go.
But
what
this
does?
E
G
G
G
It's
not
a.
I
was
told
going
into
this
that
there
was
a
given
that
you
were
going
to
consider
that
amendment
where
we
to
send
it
to
the
full
committee,
but
that's
not
obvious
so
well,.
A
Thank
you
chairman.
I'm
willing
to
work
with
the
sponsor
and
and
those
on
this
if
it's
the
will
of
the
committee
to
move
it
forward
and
work
on
the
amendment
beforehand.
I'm
I'm
I'm
okay
with
that.
Obviously
it's
the
will
of
the
committee
to
do
that,
but
I
I
do
want
those
issues
addressed.
G
Okay,
the
no
objections
we'll
move.
The
previous
question
voting
to
send
this
bill
as
amended
with
hopes
of
collaboration
to
the
full
committee,
all
those
in
favor
say
aye.
Any
opposition
so
approved.
G
Is
he
still
here,
yeah
he's
right
there?
Oh,
oh
I'm
sorry
yeah,
chairman
boyd,
you
are
recognized
on
item
six
750..
We
have
motion
second.
I
Thank
you,
mr
chairman.
This
is
a
incredible
bill.
This
creates
a
obesity
task
force
and
I
think
it's
ironic
that
I
just
carried
a
bag
of
chick-fil-a
in
here.
As
as
I
get
ready
to
present
this
bill-
and
I
don't
know
how
I
was
picked
for
this
this
bill,
but
it
what
it
does
members
is,
it
creates
a
a
task
force
that
there
are
people
that
come
from
the
medical
industry.
I
This
is
not
a
taser
study
and
just
to
clarify
this
is
not
to
study
what
causes
obesity,
and
this
is
not
to
study
necessarily
the
effects.
This
is
looking
more
at
the
whether
or
not
it
would
be.
There
would
be
cost
efficiency
for,
for
maybe
tenncare
or
medical
insurance
in
general
to
treat
obesity
rather
than
the
symptoms
of
obesity
and
so
I'll
I'll.
Take
any
questions.
Mr
chairman,
we
have
a.
G
Chairman
terry
you're
recognized
question
on
the
bill.
No
objections
we'll
be
moving
this
bill
forward
to
full
committee,
all
those
in
favor
say
aye
any
opposition
so
approved.
Thank
you,
mr
chairman.
G
1045
by
dr
kumar
has
been
rolled
one
week
item
eight
house
bill
829
by
dr
kumar.
P
Thank
you,
mr
chairman
house,
bill
180
was
brought
to
me
by
the
tennessee
firefighters
association,
and
this
would
require
a
mental,
our
health
care
providers
that
are
caring
for
patients
that
display
threats
of
suicide
or
bodily
harm.
G
That
what
he
just
okay,
the
there's,
an
amendment
on
the
bill
that
makes
the
bill
which
you've
just
described
it.
We
have
a
proper
motion
and
second
on
the
amendment.
Yes,
all
those
in
favor
of
the
amendment
say
aye
any
opposition,
we're
back
on
the
bill
as
amended.
I
think,
which
you
just
described
to
us.
K
P
They
they
don't
have
to
it,
directs
them
to
a
to
mental
health
facility
or
counseling
and
gets
them
the
proper
help.
In
the
past,
we've
had
some
first
responders
that
have
sort
of
fell
through
the
cracks
and
have
gotten
not
really
gotten
the
help
they
deserve.
G
For
further
questions
or
comments
of
the
bill,
we've
not
we'll
be
voting
to
send
this
to
full
committee.
All
those
in
favor
say
aye.
Any
opposition
are
so
approved.
We've
taken
10,
I
think,
parkinson's
left.
So
I
guess
we
will
call
for
a
motion
to
adjourn
and
let
me
let
me
make
an
announcement
that
oh
or
we
run
out
of
time.
G
A
couple
of
announcements,
all
the
bills
that
we
didn't
get
to
today,
plus
item
8,
which
we
chose
didn't
have
enough
time
with
we
will
move
until
next
week
and
if
we're
going
to
have
the
final
calendar
next
week
for
all
of
those
that
want
to
bill
on
on
the
calendar,
you've
got
to
put
it
on
notice
by
tomorrow
at
3
30..