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Description
House Health Committee- March 30, 2022- House Hearing Room 1
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C
A
D
Lear
gant,
you
recognized
mr
chairman,
this
may
be
out
of
normal
protocol,
but
the
west
tennessee
and
middle
tennessee
weather
outlook
is
not
looking
too
good.
I
know
a
lot
of
us
have
family
members
back
home
constituents
and,
if
you
don't
mind,
I'm
gonna.
If
we
go
out
of
order
and
I'm
gonna
ask
representative
paul
cheryl
to
say
a
quick
prayer.
If
you
don't
mind.
E
Thank
you
chairman.
If
you
would,
if
you
have
a
hat
on,
would
you
mind
removing
it
as
we
pray?
Please
thank
you,
our
father
in
heaven,
god
we
humbly
bow
before
you.
We
come
to
you,
god
in
heaven,
our
father
at
this
time
through
your
son,
jesus
christ.
We
ask
these
things
in
jesus,
christ's
name.
According
your
will,
we
do
try
to
humbly
by
before
you
and
pray
and
ask
forgiveness
god
where
we
sin
fail,
do
wrong
in
our
lives.
E
We
thank
you
and
praise
you
so
much
for
forgiving
us
god,
as
we
come
together
here,
probably
a
very
unusual
time
to
do
this.
But
we
know
that
god,
your
god
of
the
universe,
and
we
know
that
god
you're
in
control,
we
hear
of
a
lot
of
bad
weather
coming
through
storms
and
things
coming
through
in
tennessee
and
other
places
in
the
united
states,
and
we
just
pray
and
ask
god
for
your
help
in
people's
lives
that
god,
you
just
help
us
all
to
look
to
you.
We
just
pray
now.
E
E
Thank
you,
mr
chairman.
I
just
like
to
recognize
there's
a
bunch
of
ladies
here
from
williamson
county
today.
I
asked
them
to
stand
and
they're
down
here
advocating
for
what
we
do
in
democracy,
letting
their
representatives
and
their
people
know.
Will
they
please
stand
there?
There
you
go
there.
They
are.
A
A
Item
number
14
house
bill,
2032,
roll
to
the
hill
calendar
item
number
15
house
bill;
946
roll
to
the
hill
of
the
calendar
item
number
six
house
bill:
two:
seven,
seven:
nine!
We
roll
to
the
hill.
The
calendar
item
number
seven
house
bill.
Two,
seven
seven
eight
will
be
rolled
to
the
hill.
The
calendar
and
item
number
nine
house
bill.
2535
will
be
rolled
to
the
hill
of
the
calendar.
A
F
Chairman
and
just
beforehand
we
were
comparing
the
two
amendments
and
I
had
indicated
that
we
might
go
with
one
six,
seven,
eight
seven.
I
actually
think
amendment
code,
one
six,
six,
two,
three
we'll
accomplish
our
goals
better
and
if
I
could
present
that
to
the
committee,
mr
chairman,
and
then
explain
why.
A
F
The
you
know
to
a
time
in
their
life
when
they
would
no
longer
need
these
programs,
so
the
intent
of
the
bill,
if
amendment
coded
16623
goes
on
is
the
we
would
not
grant
any
waivers
to
that.
Except
what
the
commissioner
currently
has
the
authority
to
be
able
to
do
and
part.
One
of
this
would
say
if
there
are
any
waivers-
and
these
are
very
very
rarely
used,
but
there
are
some
nuanced
circumstances
where
it
would
be
necessary
if
there
are
any
waivers.
F
Those
would
never
be
reported
back
to
us,
and
so
I
I
trust
the
commissioner.
They
seem
to
be
doing
a
very
good
job
with
this,
but
there's
just
nothing
in
the
statute
that
actually
controls.
For
that
to
say,
look
if
you're
working
you
should
be,
and
by
the
way,
if
you
do
any
waivers,
then
you
should
just
reporting
those
back.
G
F
So
and
you
and
I
always
get
deep
in
the
weeds-
and
I
appreciate
it
so
there's
a
there's-
a
distinction
between
exemption
and
waiver
apparently,
and
what
we're
talking
about
our
exemptions
here,
where,
if
say
in
an
area,
it's
it's
literally
a
tornado
hits
a
natural
disaster
hits
and
it's
impossible
for
someone
to
be
able
to
work
or
go
through
work
requirements.
Then,
obviously
that
would
be
a
situation
where
a
waiver
potentially
be
appropriate.
An
exemption
is
more
broad
where,
like
there
would
be
an
exemption,
say
statewide,
so
those
waivers
that
are
one-offs.
F
We
want
them
to
still
be
able
to
do
so.
If
you
have
a
again
a
unique
circumstance
say
you
have
someone
in
an
area
where,
literally
there
are
just
no
jobs
available,
I
mean
where
there's
just
nothing,
and
that
is
a
provable
fact.
Then
we
want
the
the
commissioner
to
have
that
type
of
flexibility,
but
not
to
do
just
a
full
exemption.
G
Thank
you,
and
I
appreciate
that
distinction,
and
I
guess
that's
where
my
concern
lies
is
the
taking
them
with
the
flexibility
department
to
make
a
a
judgment,
call
there
and
and
provide
exemptions
from
that
work
requirement
to
accommodate
different
circumstances
that
may
be
affecting
the
entire
state
or
an
entire
piece
of
our
population.
So
I
appreciate
the
the
response
and
thank
you,
mr
chairman,.
F
E
A
Seeing
none
we
are
voting
on
amendment
01
6623,
all
those
in
favor
say:
aye
aye
opposed
eyes
have
it.
We
are
back
on
the
bills,
amended
any
further
questions
for
the
sponsor
of
the
bill.
Seeing
none.
We
are
voting
on,
amen
on
house
bill
2096,
all
those
in
favor
say
aye
aye
opposed
eyes.
Have
it
bill,
goes
on
to
finance
ways
and
means
thanks
chairman
members
of
the
committee,
all
right.
Thank
you.
So
item
number
two
is
off
notice.
So
that
brings
us
to
item
number
three.
E
A
Thank
you
for
joining
us
now.
You,
you
have
an
amendment
on
this
zero
one.
Five,
three
one
five!
Is
that
correct,
correct?
Okay,
can
I
get
a
motion?
You
have
a
motion,
a
second
on
the
amendment.
Do
you
want
us
to
go
ahead
and
put
that
on?
Yes,
okay,
without
objection,
let's
vote
on
amendment
zero,
one,
five,
three
one,
five,
all
those
in
favor
say
aye
opposed
eyes.
Have
it
we
are
back
on
the
pills
admitted
you
you're,
recognized.
E
Thank
you
so
much
and
members
in
tennessee
we
already
it's.
It
is
against
the
law
to
do
a
telehealth
chemical
abortion.
So
we
realized
there
was
not
a
penalty
with
this.
So
what
this
does?
It
will
create
a
class
e
felony
and
it,
and
it
will
provide
a
basis
for
civil
malpractice
action
and
that's
all
we're
doing
is
adding
a
penalty.
A
A
A
A
A
H
Thank
you,
mr
chairman
and
committee
for
putting
the
amendment
on
the
bill.
It
was
actually
senator
reeves
and
the
he's
a
pharmacist.
He
helped
draft
the
amendment
and
the
bill
has
passed
the
senate
health
committee
and
it's
referred
to
senate
calendar
according
to
an
article
in
becker's
hospital
review.
As
of
march
11
of
this
year,
there
are
28
states
with
legislation
to
promote
iver,
ivermectin
access,
and
that's
what
this
bill
is.
H
It's
an
ivermectin
access
bill
last
week
in
subcommittee,
we
brought
up
new
hampshire
and
the
bill
in
new
hampshire
actually
allows
pharmacists
to
dispense.
The
ivory
mechan
bystanding
order,
and
the
bill
has
passed
the
new
hampshire
house
this
bill,
as
written
and
amended,
allows
a
pharmacist
to
provide
ivamectin
to
a
patient
who
is
at
least
18
years
old
pursuant
to
a
collective
pharmacy
practice
agreement
containing
a
non-patient-specific
prescriptive
order,
developed
and
executed
by
one
or
more
authorized
prescribers.
H
This
means
that
doctors
will
develop
the
proper
guidance
procedures,
such
as
the
proper
dosage
and
contraindications,
and
everything
needed
for
pharmacists
to
responsibly
dispense,
ivermectin
to
individuals
without
a
prescription,
but
still
have
proper
measures
of
a
prescriptive
order.
The
bill
requires
the
board
of
pharmacy
to
establish
procedures
for
providing
patients
with
a
screening
risk
assessment
tool,
providing
standardized
fact
sheet
and
providing
either
ivamectin
or
referral
to
a
pharmacy
that
dispenses
ibermectin.
H
This
bill
does
not
require
a
pharmacist
to
dispense.
Ivermectin
the
bill
includes
that
a
pharmacist
or
prescriber
acting
in
good
faith
is
immune
from
disciplinary
actions
or
civil
libert
liability.
Irvine
mechtin
was
first
licensed
for
human
use
in
1987
and
in
2015
its
inventors
actually
won
the
nobel
prize
for
saving,
so
many
human
lives
around
the
world.
As
of
today,
there
were
154
published
articles
on
ivermectin
studies
and
105
of
them
are
peer-reviewed
studies.
H
H
It
has
been
deemed
one
of
the
safest
drugs
ever
invented
on
the
world
health
organization's
list
of
essential
medicines,
and
in
order
to
get
a
clearer
and
unbiased
understanding
of
ivermectin
safety,
we
can
look
to
studies
published
prior
to
covid
and
one
such
study.
A
2016
study
in
the
journal
of
drugs
and
dermatology
titled
over
25
years
of
clinical
experience
with
ivermectin
an
overview
of
safety
for
an
increasing
number
of
indications.
H
H
The
limited
number
of
severe
adverse
events
were
found
to
be
from
dying
off
of
targeted
parasites,
not
from
the
ivermectin
itself.
It
has
a
robust
safety
profile
and
can
even
be
used
on
children
and
neonates
and
ivermectin
is
a
highly
anti-inflammatory
drug,
making
it
potentially
very
useful
for
many
other
medical
indications
with
that.
H
Mr
chairman
and
committee,
I
thank
you
for
hearing
this
bill
and
I
I
hope
that
you
will
pass
this
bill
so
that
the
next
covid
round
that
is
coming
tennesseans
can
be
better
prepared
and
and
well
able
to
use
this
for
early
treatment,
because
that
is
what
ivermectin
is
most
essential
effective
for
is
early
treatment,
and,
mr
chairman,
I
I
do
have
a
a
couple
of
folks
here
to
testify.
If
needed,
it's.
A
A
All
right
question
has
been
called
all
those
voting
on
previous
questions,
say:
aye
aye
opposed
eyes
have
it.
We
are
voting
on
the
bill.
All
those
in
favor
of
voting
of
house
bill
2746
as
amended,
say,
aye
aye
opposed
no
eyes
have
it.
Bill
goes
to
calendar
rules.
If
you'd
like
to
be
recorded.
As
I
know,
please
tell
the
clerk.
A
Thank
you,
you
are
recognized
and
there
is
an
amendment
14051.
Is
that
correct?
I
believe
that's
correct,
chairman
okay,
would
you
like
us
to
please?
Okay
without
objection,
let's
vote
on
amendment
one
four,
zero,
five,
one,
all
those
in
favor
say:
aye
aye
opposed
eyes.
Have
it
we
are
back
on
the
bills,
a
minute.
You
are
recognized.
E
Two
years
ago,
in
the
last
session,
I
brought
this
bill
and
your
committee
was
overjoyed
and
leaped
for
joy
and
after
much
discussion
passed
it
somehow
in
the
interim,
when
we
had
the
special
session,
this
bill
got
lumped
in
with
the
omnibus
bill
all
dealt
with
code,
and
it
ended
up
with
a
sunset
hanging
on
it,
which
was
never
the
intent
when
we
passed
the
bill.
So
all
this
bill
now
does
is
pull
the
sunset
off
of
it.
That
wasn't
supposed
to
be
there.
In
the
first
place,.
A
A
A
A
D
Thank
you.
Mr
chairman,
tennessee
has
had
a
certified
medication
aid
program
for
more
than
a
decade,
and
this
program
is
a
career
ladder
step
for
certified
nursing
aides.
This
bill,
as
amended,
allows
remote
learning
through
virtual
program
platforms
that
provide
flexibility
for
instructors
and
candidate
participation.
D
It
allows
cnas
with
a
year
of
continuous
work
experience
and
a
letter
of
recommendation
from
their
director
of
nursing
to
take
class
current
rule
requires
a
cna
to
have
one
year
of
experience
in
no
more
than
two
buildings.
It
adds
certified
occupational
therapy
assistance
as
a
qualified
candidate
for
the
course.
It
changes
the
exam
passing
grade
from
85
to
75
percent,
which
aligns
with
the
certified
nursing
assistant
test
passage
requirement,
and
it
authorizes
the
board
of
nursing
to
promulgate
rules
as
needed.
A
J
I
live
with
quadriplegia
every
day
and
muscle
spasms,
especially
as
night
for
me,
can
become
unbearable
and
does
lead
to
insomnia,
even
the
medication
I
currently
take,
and
I'm
asking
the
committee
for
some
relief
for
tendencies
for
quadriplegia
to
be
added
for
the
list
for
the
commissions
to
to
look
at.
So
with
that
I'll.
Take
some
questions,
mr
chairman.
J
K
A
A
I
I
I
Thank
you
and
thank
you
for
the
question.
I
I
really
think
the
department
of
health
is
the
there's
a
perfect
entity
to
do
it
because
they're
separated
again,
you
know.
I
know
some
people
probably
got
emails
on
this
bill
being
about
the
gun
about
the
ownership,
and
that's
it's
not
that
it's
about
the
health
effects
what's
happening
after
that
that
that
incident
happened.
As
you
know,
I
had
five
students.
My
high
school
high
school
700
students,
my
alma
mater
suffered
from
gun
violence
on
last
year
from
january
through
april.
I
What's
happened
with
those
families?
Well,
what's
happened
with
the
with,
with
the
you
know,
the
mothers
and
the
fathers?
It
really
is
strictly
about
the
health
effects
of
of
of
this
happening.
If,
if
there
was
a,
you
know
cancer
cluster
in
a
community,
that's
what
they
would
do,
look
at
it
from
a
site,
a
scientific,
epidemiological
kind
of
a
way.
So
it's
trying
to
take
it
away
from
those
polarizing
aspects
and
what
are
the
health
effects
of
that?
So
thank
you
for
that
question.
A
E
Well-
and
I
can
understand
the
reports,
but
I
don't
quite
understand
how
they
would
be
able
to
be
in
a
situation
to
give
you
a
recommendation
on
how
to
stop
the
violence
or
how
to
reduce
the
violence,
because
I
don't
think
they
have
the
manpower
for
one
thing
and
I
don't
think
they
have
the
expertise
for
another.
So
so
that's
my
concern
over
the
bill.
Thank
you.
I
Thank
you,
and,
and
and
and
that's
exactly
right,
we're
not
asking
them
to
solve
the
problem.
We're
asking
them
to
paint
the
picture
for
us
that
they
can
do
they.
They
can
say
from
a
health
standpoint.
What
can
happen
with
this?
We're
not
asking
them
to
take
away
anything
to
add
anything,
it's
strictly
to
give
us
the
data.
D
Recognize
thank
you
chairman,
good
afternoon
to
the
representative
from
knoxville.
Can
you
drill
down
into
this
and
give
us
the
specific
method
that
the
department
would
use?
How
would
they
correlate
getting
the
numbers?
Where
would
those
numbers
come
from
what
bureaucratic
process
would
that
entail?
For
that
to
happen,
you
recognize.
I
Thank
you.
I
I
can
give
it
a
a
good
overview
of
what
the
epidemiologists
would
do.
They
would
take
that
that
that
gun,
violence
that
gun
death
or
injury
and
start
to
peel
peel
back
what's
happened
if
it
happened
five
years
ago
to
a
26
year
old
that
had
two
kids:
what's
happened
to
those
two
kids
are
there
in
foster
care,
did
what
was
it
the
grandparent
that
took
them
up?
How
how
are
they
doing
socially?
I
If
it
just
happened
to
and
to
a
child?
How
are
the
parents
coping
with
this?
Are
they
are
they
engaged
or
are
they
are
they
working
again?
This
isn't
about.
This
is
about
the
health
effects.
What's
happening
happened
to
our
our
family
structure
after
this
tragic
event
happened,
so
that
again
it's
a
scientific
approach.
So
it's
not
about
the
event
so
much
as
the
results
of
that.
What's
what
kind
of
holes
remain.
D
Thank
you
chairman.
So
what
would
be
this
specific
steps,
as
I
guess
that's
where
I'm
having
trouble?
There's
got
to
be
something
built
into
this
legislation
that
gives
specific
direction
on
how
we
arrive
at
those
statistics
and
the
information
that
you're
wanting
to
come
back
out
of
this
legislation
to
the
department
to
give
you
the
information
you've
got
described
here
so,
okay.
I
I
I
Maybe
state
run
maybe
private,
and
then
you
got
johnny
over
here.
That
happened.
They
went
into
different
programs
and
five
years
later,
these
two
programs
were
very
effective.
This
one
that
this
person
went
into
this
child
went
into
wasn't
so
it's
it'll
rack
and
stack
all
of
the
things
that
happen.
We
don't
know
what's
happening
right
now.
We
don't
know
what's
going
on
again,
if
it
was
something
from
a
medicinal
standpoint,
you
would
know,
or
you
would
be
learning
that
this
puts
it
into
that.
I
I
Thank
you
so
there
there
would
be
a
person
that
has
we've
had
20
to
happen
this
year.
Okay,
so
they
would
start
with
person
one
event:
one
death,
one
shooting
one
and
say
where's:
where
are
they
and
again,
I'm
not
gonna
prescribe
to
them
to
go
back,
whether
it's
three
years
or
five
years,
but
we
that
that
data's
out
there
we've
just
not
correlated
it
or
collected
it
with
this
with
this
lens
zone.
So
if
it
happened
three
years
ago,
what
what's
happened
to
them?
You
can
talk
to
the
health
department
to
see.
I
What's
going
on,
you
can
talk
with
the
social
service.
Social
service
agencies
talk
to
law
enforcement
to
see
if
there's
there's
a
unfortunate
outcome
that
a
child
may
have
gotten
into
trouble.
So
this
child
end
up
a
pretty
good
kid
before
now,
he's
incarcerated
or
she's
incarcerated
or
she's
in
the
program
or
she's
at
the
university
of
tennessee
he's
and
he's
that
he's
at
the
university
of
memphis
so
taking
that
data.
So
that's
that
that's
that's
what
this
person
would
do.
It
would
be
their
job
to
do
that.
Okay,.
D
Later
again,
okay,
I
I'm
still
having
trouble
understanding
the
direction
of
the
legislation
and
it
sounds
like
it's
going
to
be
a
burdensome
thing
for
the
department
of
health
to
try
to.
I
know
your
intention
is
good.
It
sounds
like
it's
in
in
the
good
with
good
intentions,
but
I
think
this
creates
a
bureaucratic
nightmare
for
the
department
of
health
and
I
would
encourage
my
colleagues
to
vote
against
this.
G
G
G
Department
of
health
already
produces
a
trauma
health
report,
so
I
think
what
you're
looking
for
here
and
correct
me
if
I'm
wrong
is
basically
taking
all
this
data
that
the
department
of
health
collects,
and
we
often-
and
I
certainly
do
push
our
departments
to
have
some
interdepartmental
communications
and
coordination
to
address
crises
such
as
public
health
crisis.
So
the
department
of
mental
health
has
doubt
on
mental
health
and
mental
health
issues
are
direct
result
to
gun
violence,
and
so
all
this
stuff's
coordinated.
G
So
I
would
think
the
department
of
health
is
the
natural
body
to
not
only
I
don't
think
you're
asking
them
necessarily
to
collect
new
data.
It's
just
take
all
the
data
and
gather
it
in
an
interdepartmental
fashion
and
provide
it
to
this
body
so
that
we
can
make
informed
decisions
moving
forward,
and
I
think
that's
that's
a
great
idea.
That's
a
smart
idea
and
I
think
we
rely
on
that
type
of
data
or
should
to
make
data
informed
decisions
and
scientific
based
decisions
when
we
form
policy
up
here.
You
know
anything
from
blood
banks.
G
The
department
of
health
collects
information
on
blood
banks
and
when
you
have
gun
violence,
you
rely
on
blood
banks,
and
so,
if
there's
a
shortage
in
in
blood,
the
department
health
has
that
knowledge
and
has
that
information
and
that
data.
So
all
of
this
stuff
is
naturally
flowing
to
the
department
of
health
and
should
be
coordinated
in
an
intergovernmental
manner
to
provide
us
with
the
data
and
research
that
we
should
necessarily
rely
upon
in
forming
policy.
G
I
Thank
you
and
thank
you
for
that,
and,
and
thank
you
for
for
putting
it
in
in
that
way,
so
in
terms
of
what
would
be
new
for
the
health
department,
it's
it
is
that
it's
that
crosstalk
conversation
that
that
someone
who's
focused
solely
focused
on
doing
this
for
a
data
gathering
situation
would
be.
So.
Thank
you
for
that.
All
right.
L
I
So
if
you
look
at
the
report
yeah
it
talks
about
it
from
a
you
know,
a
pretty
pretty
much
a
numbers
standpoint
of
the
types
of
people
that
are
committing
crime
rates
and
things
of
that
nature,
but
it
doesn't,
it
doesn't
talk
about
it
from
the
the
health
effects
of
that
gun
bond.
It's
more
of
just
a
racking
stack.
We
had
20
this
year
and
30
the
year
before.
L
So
you
recognize
thank
you
chairman,
and
so
your
your
bill
says
that
it
terminates
in
july.
1St
of
2024
is
that
is
one
of
my
colleagues
stated
that
there
was
a
a
health
crisis
as
it
relates
to
gun
violence.
I
didn't
know
that
there
would
want
to
be.
Is
there
is
that
when
we
expect
the
end
to
be,
or
is
that
what?
What's
the
reason
for
the
termination
date
of
the
2024.
I
L
I
noticed
in
the
definition
it
says
that
it's
going
that
you're
going
to
deal
with
economic
hardships.
My
assumption
is:
that's
a
different
department,
maybe
in
economic
community
development
you
have
disabilities,
which
would
be
a
different
department.
Mental
health
would
be
a
different
department.
How
does
your
bill
make
sure
these
other
applicable
departments
are
reporting
the
data
so
that
the
department
of
health
can
assimilate
it
all?
I
guess,
including
the
tbi
report,.
I
It's
my
hope.
My
father
worked
for
the
department
called
the
welfare
department,
now
department
of
human
services
for
over
35
years
and
and
he
dealt
with
other
departments,
there
was
a
cross
conversation
hey.
I
have
a
patient
or
a
a
a
client
that
I
visited
that
looks
like
they
have
some
health
issues
associated
with
them.
So
it's
it's
my
thought,
hopefully
in
that
dream,
that
that
our
that
our
departments
are
already
in
communication
across
the
state
where
they're
all
state
employees,
so
if
they
have
to
reach
across
the
aisle
to
another
department.
I
L
Are
you
reckless
well,
I
think
part
of
the
reason,
unfortunately,
that
we
have
to
come
up
here
is
we
have
to
codify
things
in
order
to
make
sure
that
departments
sometimes
talk
to
each
other?
I
appreciate
your
father's
service
and
to
the
state,
but
I
I
do
I
do
have
concerns
that,
albeit
the
the
ideas
is
really
important
to
you,
I'm
just
not
certain
how
the
mechanism
can
actually
work
to
put
all
these
applicable
departments
together.
Thank
you
for
answering
my
questions.
All.
K
Thank
you,
mr
chairman.
Thank
you
mckenzie,
I'm
not
sure
about
which
department
is
qualified,
but
I
do
like
your
point
about
looking
at
the
consequences
of
violence
and
injury
and
what
happened
as
a
result
to
that
family
and
to
the
children
which
situations
did
they
do
better
in
and
if
they
did
not.
K
E
So
many
other
representatives
have
said
before
the
data
is
there.
You
know
the
economic
hardships
that
would
be
labor
and
workforce
development.
How
many
of
these
people
are
now
drawing
unemployment,
they've
lost
their
job
or
something
you
know.
So
all
the
data
is
there.
I
think,
as
you've
stated
you're
just
asking
the
department
of
health.
Let's
accumulate
all
this
data
together
and
put
in
one
report.
You
know,
I
don't
think
anyone
on
this
committee
should
be
scared
of
knowledge.
E
A
B
D
E
B
F
M
A
A
N
A
N
Mr
chairman,
what
this
bill
does
is
if
a
veteran's
family
presents
a
disability
determination
to
the
person
signing
a
death
certificate
of
loved
one,
they
will
have
to
use
that
determining
the
cause
of
death,
and
so
really
what
what
this
is
is
think
of.
A
veteran
is
an
example,
veteran
that
served
in
in
iraq
and
dealt
with
burn
pits
and
got
copd
and
then
came
back
here
and
then
got
coveted,
19
and
died.
N
If,
if
the
person
signed
that
death
certificate
didn't
know
that
that
person
had
that
veteran
ever
had
copd,
they
may
just
put
covet
19
on
that
death
certificate,
and
then
the
family
would
never
get
the
veterans
survival
benefits
so
had
that
that
person
signed
the
death
certificate
known
that
the
person
had
copd
that
would
have
conti
would
have
potentially
been
a
underlining
cause
of
death.
So
with
that
I'll
be
glad
to
answer
any
questions.
A
D
A
Thank
you
later,
thank
you,
and
I
would
like
to
second
those
comments
as
well.
So
without
any
objection
we
will
be
voting
on
house
bill.
Two
two,
two:
zero.
As
amended,
all
those
in
favor
say
aye
aye
opposed
eyes.
Have
it
bill
goes
on
to
counter
rules
all
right.
Thank
you.
That
brings
us
to
item
number
13.
A
C
C
It
seeks
to
help
us
get
a
better
definition
of
what
doulas
are
and
what
they
can
do
in
tennessee.
It
involves
having
the
department
of
health
to
collaborate
with
tenncare
to
study
existing
doula
certification
programs,
and
this
will
be,
I
think,
a
wonderful
way
to
increase
again
opportunities
to
increase
the
health
of
mothers
in
our
state.
C
E
N
C
A
A
A
A
O
A
One
five:
seven
one
four
that
rewrites
the
bill.
That's
that's
correct!
You
have
a
motion.
Second,
without
objection,
you
want
to
put
that
on
the
bill.
Okay,
without
objection,
let's
vote
on
amendment
zero,
one,
five,
seven,
one,
four
all
in
favor
say
aye
opposed
eyes
have
it.
We
are
back
on
the
bills
as
amended.
You
are
recognized
and.
O
O
We
can
make
make
some
changes
that
that
that
could
prevent
a
great
number
of
fatalities
they
climb
by
about
50
percent
a
year
tennessee's
the
40th
highest
in
fatality
drug
overdoses.
In
the
united
states
we
have
52
overdoses,
deaths
per
100,
000
people
per
year
and
and
the
average
in
the
united
states
is
30.,
so
per
100
thousand,
so
in
2017,
drug
abuse
and
overdose
cost
us
550
billion
in
health
cost
and
and
lost
productivity.
O
One
example
maryland
did
a
similar
program
like
this.
They
found
that
that
a
predominance
of
overdoses
happened
in
facilities
for
residents
like
hotels
and
motels,
so
they
actually
instituted
a
a
program
for
the
staff
that
that
taught
them
how
to
intervene
and
and
use
narcan,
so
they
they
dropped
their
fatalities.
So
with
that
explanation,
I
would
renew
the
motion.
L
I
had
a
question
I
recently
read
where
a
former
law
enforcement
agency
determined
that
they
would
characterize
every
overdose
death
as
an
accidental
death
which
would
stimulate
or
require
an
investigation
into
that
overdose
death
matter
of
fact,
I
think
that
law
enforcement
agency
was
up
towards
yours.
Does
yours
does?
Does
your
bill
define
that
that
we
would
that
every
overdose
death
would
be
investigated
as
if
it
were
one
or
would
we
be
collecting
data
without
a
an
actual
investigation
of
the
debt.
O
O
Yes,
sir,
thank
you
and
a
great
question.
We
do
not
address
that
in
this
bill.
This
is
a
permissive
voluntary
program.
We
have
two
of
these
programs
in
action,
one
in
davidson
and
one
in
knox
county,
and
so
that's
that's
where
the
fiscal
note
comes
from,
if
other
regions,
which
are
hoping
that
five
counties
will
will
become
a
regional
program
and
what
the
issue
is
is:
is
it's
difficult
to
study
these
these
results
and
statistics
because
they
are
protected
by
hipaa
laws?
O
So
what
this
would
do
is
allow
these
these
groups,
the
overdose
fatality
review
programs,
which
are
will
hopefully
be
regional.
It
allows
them
to
discuss
this
information
in
private
and
make
recommendations
according
to
statistics.
So
if
there's
no
mandate
about
it,
it
doesn't
do
anything
for
law
enforcement
across
the
state.
A
A
A
A
O
O
The
second
criteria,
the
health
care
provider,
is
giving
a
co-prescription
of
benzodiazepine
or
the
third
situation,
where
a
patient
presents
an
increased
risk
of
overdose
due
to
history
of
substance,
abuse
disorder.
So
what
what
this
would
do?
It
excludes
individuals
whose
opioid
prescriptions
are
part
of
a
palliative
care
treatment.
Are
those
prescriptions
that
are
written
by
a
veterinarian,
the.
So,
with
that
explanation
and
and
pending
questions,
sir,
I
would
renew
the
motion.
A
A
O
Thank
you,
mr
chairman.
We
are,
we
are
as
well
as
a
an
opioid
overdose
crisis,
we're
in
a
a
mental
health,
counselor
crisis.
77
percent
of
the
counties
in
the
u.s
have
a
severe
counselor
shortage
and
we
see
each
year
it's
a
very
difficult
profession.
Each
year
about
20
percent
of
those
jobs
are
are
vacated.
O
We
need
to
do
all
we
can
in
that
nature,
the
the
changes
that
we
are
making
today
in
the
first
section,
the
bill
refines
requirements
for
licensure
it
removes
required
hours,
which
is
in
the
regulations
for
the
regulatory
board,
removes
qualifications
which
are
in
another
section
of
the
chapter
section.
Two
of
the
bill
clearly
states
that
a
candidate
for
licensure
must
have
completed
supervised
field
experience.
O
It
removes
the
list
of
mental
health
providers
because
of
the
list
is
provided
in
the
regulations
of
that
body
and
the
term
master's
degree
is
changed
to
post
doctorate
degree
extends
one
year
for
temporary
licenses
right
now,
it's
three
years
or
until
the
board
grants
or
denies
a
license
so
that
it,
you
know
what
this
bill
does
is
increase
that
to
a
fourth
year.
With
that
explanation,
pending
questions,
I
will
renew
the
motion
all
right.
A
Amendment
zero
one,
four,
zero.
Four
seven!
Is
that
correct?
It
does,
sir
okay,
so
you
describe
the
amendment
without
objection.
Let's
vote
on
the
amendment,
all
those
in
favor
say:
aye
opposed.
I
just
have
it:
okay,
we're
back
on
the
bill
as
a
minute.
Do
we
have
any
questions
for
the
sponsor
of
the
bill?
A
Question
has
been
called
so
without
objection.
We
are
voting
on
house
bill,
two
five,
three
one
as
a
minute,
all
those
in
favor
say
aye
aye
opposed
eyes.
Have
it
bill
goes
on
to
finance
ways
and
mains
all
right,
your
other
two
bills
had
been
rolled
to
the
hill.
We
will
get
to
those
just
shortly.
We
got
one
other
bill,
and
so
I
will
we
are
on
item
number
19
house
bill
2641.
M
M
A
M
M
L
Order,
if,
if
the
bill,
if
the,
if,
if
the
amendment
rewrites
the
bill,
if
and
we're
taking
a
roll
call
vote,
the
big
challenge
you
have
is
it
could
be
misconstrued
that
you
support
the
bill
just
to
be
able
to
hear
the
amendment.
So
I
guess
the
point
is:
is
with
the
member
who
made
the
motion
allow
for
the
amendment
to
be
put
on
for
the
purposes
of
discussion,
regardless
of
a
vote
with
the
roll
call
vote
being
on
the
bill.
I'll
discuss.
M
A
A
Unfortunately,
that
amendment
had
a
fiscal
note
that
I
simply
cannot
resolve
at
this
time
and
so
what
this
amendment
does
is
it
essentially
does
three
things
and
has
three
goals,
one.
It
adds
currently
with
the
bill
that
we
passed
last
year
for
the
cannabis
commission.
We
added
a
nine
conditions
that
could
get
the
0.3
thc
oil
and
be
decriminalized
if
they
had
the
letter
of
attestation,
and
so
I'm
simply
adding
three
conditions
to
that.
One
is
trigeminal
neuralgia
currently
there's
between.
A
I
think
10
and
15
000
people
get
that
per
year,
so
that
maybe
roughly
is
maybe
300
tennesseans.
There
is
a
fda
approved
treatment
for
that,
but
there's
a
handful
of
those
that
do
not
respond
to
that
and
it's
referred
to
as
the
suicide
disease,
and
so
I
have
added
them
in
there.
There
are
studies
that
show
that
they
could
benefit
I've
added,
quadriplegia
and
paraplegia.
A
A
The
second
part
of
the
goal
of
this
it
defines
what
those
clinical
research
programs
are
they've
been
approved
by
the
federal
drug
administration,
that's
being
conducted
with
or
by
funds
provided
by
the
nida
or
they're
being
conducted
by
university,
medical
school,
pharmacy,
school
or
hospital,
and
then
the
last
thing
I've
done.
Is
it
directs
the
cannabis
commission,
which
we've
already
put
in
in
position
to
increase
patient,
to
determine
best
ways
to
increase
patient
access
to
clinical
research
programs?
A
Another
one
is
to
for
medical
use
of
cannabis
for
chronic
pain
or
intractable
pain,
to
have
them
just
study.
Hemp
derived
cannibal
cannabinoids
such
as
delta,
h,
delta,
thc
and
again
have
them
look
at
creating
a
fiscally
viable
patient
registry.
Because
the
fiscal
note
that
I
got,
I
simply
could
not
resolve
I've
worked
with
in
the
department
of
health
and
department.
Safety
are
neutral
on
this
amendment,
and
so
with
that
I'll
be
happy
to
take
questions
on
the
amendment.
M
L
L
It
doesn't
qualify
what
the
conditions
are
for
the
clinical
research.
So,
for
instance,
if
somebody
were
studying,
irritable,
irritable,
bowel
syndrome
and
the
effects
of
cannabis
on
someone
who
had
ibs
would
would
that
be
an
acceptable
treatment
under
the
idea
of
study
or
somebody
with
glaucoma
or
someone
with
ptsd.
A
A
So,
whether
it's
you
know
a
neuropathy
or
something
along
those
lines
or
it
could
be
glaucoma
or
something
along
those
lines
as
long
as
they
have
that
particular
disease
in
that
research,
and
it's
only
the
0.9
percent
oil
and
to
my
knowledge,
I
don't
know
how
many
studies,
if
many
are
out
there
on
just
0.9
oil,
that
many
would
qualify.
That's
why
the
next
section
I
have
asked
them
to
try
to
develop
ways
that
we
can
get
more
of
our
patients
into
research.
But
it's
just
point:
nine
percent
off.
L
L
L
A
K
A
A
K
Come
on,
I
would
think
that
the
falsehood
in
a
person
who
is
testifying
should
be
pointed
out
to
them
and
to
other
committee
members.
So
the
committee
members
are
the
ones
who
make
the
decision
who
they
want
to
trust
or
believe,
but
I
think
if
a
chairman
has
their
own
bill
and
they're
going
to
deny
a
person
to
testify
against
their
bill,
there's
a
bit
of
a
problem.
There.
M
M
K
I
want
to
re-emphasize
my
concern
that
we
should
not
be
denying
a
citizen
from
speaking
based
on
a
judgment,
and
especially
it
is
the
chairman's
bill
and
chairman
has
that
authority.
I
think
you
know
some
sort.
I
don't
know
if
there's
a
process
to
recuse
or
not.
I
think
that
is
important
as
far
as
the
overall.
K
K
Of
course
this
is
a
substance
plenty
available,
but
it
legitimizes
availability
and
I
think
there
is
a
problem
there
when
you
legitimize
it.
What
are
we
teaching
our
children
that
we
think
marijuana
is
okay,
children
will
extend
and
push
and
go
beyond
that
to
a
point
that
they
will
say.
Well,
it's
okay,
just
as
the
children
have
done
with
alcohol.
K
Well,
it's
not
for
minors
right
vaping!
You
know
it's
not
for
minors
e-cigarettes!
You
know
they
are
not
for
minors.
What
has
happened?
It
is
plenty
available
because
our
children
once
again
children
that
they
are.
We
love
them,
but
they
tend
to
push
the
envelope
and
go
beyond,
and
I
think
that
is
the
problem
with
the
legitimizing
availability
of
marijuana.
K
It
is
also
made
available
for
conditions
for
which
there
may
not
be
medical
evidence,
but
there
is
a
lot
of
internet
evidence.
Certainly,
and
when
that
happens,
it
leads
to
increased
usage
and
usage
in
inappropriate
circumstances.
This
part
is
encouraged
by
the
commission,
who
is
intimately
connected
with
the
industry
and
guess
what
industry
wants
to
sell
more.
There
is
a
problem
there,
so
other
states
have
done
that
they
have
paid
a
price
in
homelessness.
K
Dui
childhood
poisonings,
especially
increased
revenue,
but
the
costs
are
four
times
the
revenue
that
these
states
have
harvested
opia's
use
is
down
where
it
is
legitimized
guess
what
heroin
use
is
up.
Yes,
look
at
any
of
these
marijuana
research
is
not
going
to
denver
and
looking
at
a
pot
shop.
Marijuana
research
is
come
join
me
and
let
us
go
to
a
recovery
court
in
my
community
and
see
how
many
of
these
people
how
many
of
these
families
who
have
struggled
with
drugs,
it
all
started
with
marijuana
again.
K
J
Thank
you,
and
I
want
to
in
response
and
a
lot
of
the
facts
that
the
chairman
just
related,
was
a
lot
of
the
facts
that
the
witness
last
week
did,
which
one
of
the
local
news
stations
just
blew
holes
all
through
the
credibility,
the
misleading
facts,
the
misstatements
that
were
made-
and
I
think
that's
where
we
look
at
the
credibility
of
people
to
come
to
speak,
and
I
believe,
that's
when
the
chairman
exercised
his
right
to
do
that.
Well,
what
would
some
of
the
same
facts
that
was
just
mentioned
was
about
recreational?
J
It
was
about.
Smoking
was
just
nothing
this
bill
and
and-
and
chairman
williams
was
right
that
we're
not
we're
nowhere
near
on
the
bill,
so
I
hope
we'd
focus
back
with
the
intent.
What
we're
trying
to
do
here
and
to
relieve
the
pain
and
suffering
of
some
of
those
out
there
that
that
truly
needed.
Thank
you
term.
M
M
B
K
B
M
A
M
A
O
O
Dentistry
is
defined
in
tca
code
as
as
evaluation,
diagnosis,
prevention
and
treatment
of
non-surgical,
surgical
or
related
procedures
of
disease
disorders
and
conditions
of
the
oral
cavity,
maxillofacial
area
or
adjacent
and
associated
structures,
and
their
impact
on
the
human
body.
The
cdc
for
prevention
has
estimated
that
70
of
oropharyngeal
cancers
are
linked
to
hpv
human
papillomavirus.
O
O
There
is
a
law
defining
who
can
who
is
allowed
to
treat
the
14
to
17
year
old
children
without
parental
consent,
and
it
does
not
include
dentists.
It
includes
primary
care,
a
general
array
of
nurses,
advanced
practices,
nurses
that
that
have
supervision
by
mds,
but
it
was
never
intended
and,
and
then
code,
never
included
dentist.
O
So
if,
if
you
would
like
to
review
video,
this
bill
was
heard
in
the
senate
passed
and
the
video
makes
a
reference
to
that
you'd
see
the
lobbyist
mark
greene,
who
addresses
the
issue
and
responds
to
the
questions
by
senator
hensley,
regarding
where
the
dentist
intended
to
administrate
these
vaccines
to
children.
Mr
greene
repeatedly
said
yes,
but
only
with
parental
consent.
O
There's
no
place
in
the
law
no
place
in
this
bill
that
actually
defied
that
in
any
manner.
Unfortunately,
the
bill
has
been
unfairly.
I
guess
confused
with
house
bill
946
the
next
bill.
We're
going
to
hear
dentists
are
not
included,
nor
would
they
be
included
in
that
bill
at
all,
and
the
definition
of
health
care
officers
and
providers
per
code
is
limited
to
physicians.
A
A
O
O
I
I
want
to
quote
our
illustrious
member
dr
kumar,
when
he
was
naming
off
all
these
these
dangerous
activities
and
and
sex.
You
know
it
is
not
for
minors,
so
I
I
just
am
reflecting
your
your
voice,
sir.
The
program.
The
mission
of
the
programs
that
we've
had
in
the
state
is
to
prevent,
control
and
treat
the
spread
of
sexually
transmitted
diseases
stds
in
tennessee
nationwide
yearly,
we
had
last
year,
20
million
stds
newly
diagnosed
half
of
those
patients
were
between
the
ages
of
15
and
24..
O
It
caused
that
burden
cost
the
health
system
approximately
16
billion
dollars.
This
is
the
sixth
consecutive
year
that
we've
had
recorded
highs
in
new
cases
of
stds,
so
they've
been
going
up
for
six
years
currently
in
code
and
we're
talking
about
probably
30
years
old,
currently
in
code,
there's
a
specific
subsection
that
establishes
which
providers
may
treat
minors
with
stds,
including
physicians
and
the
advanced
practice
nurses
under
a
physician's
supervision.
O
Currently
the
law
reads:
health
care
officers
and
providers
licensed
in
the
state
under
what
I
just
had
referenced,
may
examine,
diagnose
and
treat
minors
infected
with
stds
in
the
house.
Bill
946
is
amended
will
update
the
current
public
health
policy
that
I
just
referenced,
allowing
consultation
by
public
health
officers,
along
with
physicians,
on
preventing
the
prevention
of
stds.
O
O
O
O
The
bill
was
not
introduced
on
behalf
of
a
drug
company
and
the
what
who
brought
us
the
bill
was
a
tennessee
charitable
care
network,
a
501c3
nonprofit
coalition,
so
the
the
current
law,
as
I
have
said
and
mentioned,
the
fact
is
that
for
30
years
the
current
law
has
allowed
minors
to
be
treated
for
sdb
stds
by
public
health
officials,
doctors,
nurse
practitioners
and,
and
all
those
folks
that
that
I
had
mentioned
previously
listed
in
code.
These
healthcare
professionals
provide
consultation
on
how
to
avoid
sexually
transmitted
diseases.
O
This
is
a
common
sense
bill.
That's
been
misinterpreted
for
fundraising
purposes
by
groups
outside
the
state
and-
and
I
want
to
mention
the
prevention
of
these-
these
providers
that
are
taking
care
of
these
folks
because
of
the
six
or
eight
words
that
are
missing
from
code
cannot
by
law,
address
these
preventive
measures;
preventive
preventive
measures
as
as
innocent
as
prac
practicing
abstinence.
O
Mine
got
cut
off
too
it
wasn't
me,
it
happens
all
the
time
and
I'm
so
sorry
to
be
I'm
so
sorry
to
be
lengthy.
But
I'm
trying
to
address
the
the
confusing
issues
that
have
come
up
about
this
bill
when,
when
at
at
the
basic
nature
of
the
bill,
is,
is
to
add
the
ability
of
these
providers,
as
I
have
discussed
in
code
to
be
able
to
discuss
prevention
and
be
within
lawful
ability
for
counseling
on
these
preventive
type
measures.
O
The,
as
I
say,
the
this,
this
new
language
says
that
health
care
officers
and
providers,
as
I've
mentioned
in
code
licensed
in
this
state,
may
examine,
diagnose
or
treat
a
minor
infected
with
stds
or-
and
this
is
the
new
portion
of
the
code-
that's
added
to
it,
provide
consultation,
examination,
diagnosis
or
treatment
to
a
minor
to
prevent
stds
this.
This
does
not
address
any
code
for
vaccination,
only
counseling.
O
The
truth
is
we
don't
want
to
have
to
think
about
young
people
related
to
the
treatment
or
prevention
of
stds,
but
being
able
to
provide
consultation
and
prevention
should
move
us
toward
treating
fewer
and
fewer
of
them,
and
that's
the
goal
with
that
explanation
and
pending
questions,
sir,
I
would
renew
the
motion
all
right.
Thank
you.
A
P
P
It
would
also
include
any
other
vaccines
indicated
for
the
prevention
of
stds
in
the
future
as
yet
unapproved.
It
would
also
include
controversial
hiv
prevention
drugs,
potentially,
which
pharmaceutical
companies
intend
to
push
on
high
school
students,
regardless
of
their
risk
regarding
vaccination
of
minors
without
parental
consent.
I
object
to
this
bill
on
the
following
grounds.
It
contravenes
federal
law.
It
would
put
children
at
risk,
as
adverse
events
may
go
unchecked
and
there
is
a
risk
of
duplicate
vaccination
by
other
medical
providers.
P
P
P
A
E
B
E
A
Thank
you.
I
appreciate
you
guys
submit
your
testimony.
We
will
be
back
next
week
now
that
everybody
in
the
member
committees
know
your
names.
Look
for
that
email
without
objection.
Go
back
in
session.
My
apologies
to
the
sponsor
of
this
bill
and
to
the
those
that
came
here
to
speak.
I
thought
that
we
would
be
able
to
get
to
all
this
on
time
today,
but
we
will
be
back
next
week.
So
without
objection.
We
are
adjourned.