Legislative and Advocacy Committee

General Assembly – July 23, 2021 – Destin, FL

Legislative Report Richard Bridges, MD – Chairman, Legislative and Advocacy Committee

On Thursday, June 10, 2021, the Regular Legislative Session adjourned sine die. Our legislative committee met before and during the session to set priorities and define specific positions on bills that we were following. We worked effectively on issues with other organizations, both healthcare and non-healthcare, and communicated with the State Medical Society, LA Chapter of the American Academy of Pediatrics and Medicine Louisiana on several bills. The committee met on several occasions and asked for opinions and guidance by email when needed when emergent issues arose. Outlined below is a summary of major topics from this session listing specific legislative instruments that the Legislative and Advocacy Committee and the LAFP Board of Directors determined had a significant impact on family medicine.

During the Regular Session, the medical community was engaged with significant legislation:

For LAFP and our membership, the session was dominated by non-fiscal legislation, but we would be remiss in not sharing the passage of five bills pushed by legislative leaders with the backing of the business community.

The first four bills are a package including a constitutional amendment that must pass a vote of the people prior to any taking effect: • SB 159 by Sen. Bret Allain (R-Franklin) is a Constitutional Amendment which would remove the requirement of a federal income tax deduction and would cap the maximum individual income tax rate at 4.75 percent. It will appear on the October 9 ballot. • SB 161, also by Sen. Allain, eliminates the federal income tax deduction and phases in lower franchise tax rates gradually as certain positive economic and tax revenue triggers are met. • HB 278 by Rep. (R-Lafayette) eliminates the federal income tax deduction and lowers individual income tax rates with similar tax revenue triggers. • HB 292 by Rep. Neil Riser (R-Columbia) reduces the number of tax brackets for corporate income taxes, lowers rates and eliminates the federal income tax deduction.

HB 199 by Speaker (R-Gonzales) creating the State and Local Streamlined Sales and Use Tax Commission will also be on the October 9 ballot. If approved by the voters, this commission will be tasked with the promulgation of rules aimed at simplifying electronic filing and remittance of local sales taxes. It will also serve as the entity to perform audit functions for out-of-state businesses and develop rules to streamline the audit process for companies with a physical presence in Louisiana.

For physicians, the 2021 session focused on two controversial issue areas: scope of practice and noncompete clauses. Incredibly, LAFP members delivered more than 5,000 messages through email and text to legislators on the following bills. We thank you for your advocacy on behalf of your profession!

On scope of practice, we had four pieces of legislation that we focused on: • HB 495 by Rep. (R-Baton Rouge) would have granted full practice authority to advanced practice registered nurses. This legislation was the most contentious bill of the entire session and finally died on the calendar with the legislature adjourned. LAFP and other physician groups fought hard to educate legislators as to the dangers associated with the bill. As the legislature adjourned, the Louisiana Association of Nurse Practitioners has already challenged its membership to continue advocating and promised to return next year. It is incredibly important for our membership to remain engaged and work to educate your legislators on our concerns. Legislative and Advocacy Committee Report, continued

General Assembly – July 23, 2021 – Destin, FL

• HB 442 by Rep. Larry Bagley (R-Stonewall) would have changed how all physician assistants practice by removing physician involvement from any requirement of oversight. This bill died on the house floor with a 39 to 39 tie vote. • HB 181 by Rep. (D-Opelousas) was intended to provide mental health nurse practitioners the ability to admit patients to inpatient mental health hospitals among other items. The bill was amended to only allow these items to occur if authorized by a collaborative practice agreement. The bill has fully passed the legislature and awaits action by the Governor. • HB 187 by Rep. Larry Bagley (R-Stonewall) allows nurse practitioners and physicians assistants to order home health. While LAFP did oppose the bill, it is reflective of changes made by CMS during COVID-19. The bill passed the legislature and awaits action by the Governor. • HCR 94 by Rep. Stuart Bishop (R-Lafayette) and SCR 73 by Sen. Patrick McMath (R-Covington) was requested by LSMS in response to many legislators who sought a different way to review scope of practice increases. The resolution would have required all healthcare professional licensing boards to review processes utilized in other states and report back to the Health and Welfare Committees which ones would work for them and which ones would not work. After being egregiously mischaracterized in House Health and Welfare, the legislation was defeated by a vote of 2 to 10.

Noncompete clauses in physician contracts was the subject of two bills. Both bills addressed certain aspects of the clauses and were successful leaving the House before meeting increased opposition on the Senate side. Although HBs 483 by Rep. Mark Wright (R-Covington) and 561 by Rep. Larry Bagley (R-Stonewall) stalled out in the Senate Commerce Committee, Representative Wright has filed HCR 125 which directs a joint subcommittee of the House and Senate Commerce Committees to study various aspects of noncompetition agreements relative to physicians in the state and to report the findings of the joint committee to the legislature prior to the convening of the 2022 Regular Session of the Legislature of Louisiana. Then, with less than thirty minutes left before Sine Die, Representative Bagley introduced HR 223 which directs a joint committee of the House Committee on Commerce and the House Committee on Health and Welfare to study the issue and report their findings to the House of Representatives. LAFP continues to tirelessly champion our members and the medical profession. We will be there as your voice, and we thank you for putting your trust in your membership.

White Coat Day The Physician Coalition of Louisiana invited our members to the Louisiana State Capitol for a Day of Advocacy on Wednesday, April 21, 2021. Attendees kicked the morning off with breakfast and registration at the Lt. Governor's apartment before heading to the Capitol to meet with legislators.

THANK YOU to the great group of 120 physicians, residents and medical students who joined us at the Capitol for this week's White Coat Wednesday! Those attending had the opportunity to attend committee meetings and visit with their legislators. We were pleased to expand the event by offering some additional opportunities and joining forces with some of our specialty society groups. This event was a valuable and successful day for the LAFP.

The Louisiana Family Medicine Residency Programs around the state set up various screening booths during the White Coat Day in the State Capitol Rotunda. Including:

• Glucose Screening East Jefferson Family Medicine Residency Program • Blood Pressure Check Lake Charles Family Medicine Residency Program • Vision Screening Monroe Family Medicine Residency Program • BMI Screening Bogalusa Family Medicine Residency Program • Vaccination Screening Baton Rouge General Family Medicine Residency Program Legislative and Advocacy Committee Report, continued

General Assembly – July 23, 2021 – Destin, FL

• Sleep Apnea Kenner Family Medicine Residency Program • Skin Cancer Screening Lafayette Family Medicine Residency Program • Overall Health Profile Alexandria Family Medicine Residency Program

The day as a whole was a great success, and we greatly appreciate all of our members who took the time to participate and help strengthen the voice of Family Physicians in Louisiana. If you were unable to attend this year, be on the lookout for 2022 dates!

Individual Involvement – Family Physician of the Day I want to express my gratitude to the members of the legislative committee for their time, advice, and expertise. It was a very active and involved group this year. Thanks also to those LAFP members who volunteered time as Family Physician of the Day, which had the highest number of member participants in our tenure at that facility. There is no way to overstate the value this program brings to our Academy, and to the House of Medicine in general, in terms of our profile, our reputation, and our mission. The time those members give when leaving their practices, on behalf to our colleagues and our profession, is precious and is appreciated as such. Legislators and Capitol staff continue to provide feedback on how much they appreciate our presence through the Family Physician of the Day program. The following members volunteered their time during the 2021 Legislative Session:

Richard Bridges, MD Devin Petrone, MD Nathan Sugarman, MD Chris Foret, MD Julissa Placencio, MD Wayne Gravois, MD Vincent Shaw, MD

LAFP also extends warm thanks and appreciation to our nursing staff at the Capitol, Pat Rusk, RN and Lee Ann Albert, RN, who are there every day whether or not a doctor comes in.

Your LAFP Legislative Affairs Committee The following LAFP members serve on the Legislative and Advocacy Committee:

Richard Bridges, MD - Chair Chris Foret, MD Marguerite Picou, MD Youssef Abdullah, MD Indira Gautam, MD M. Tahir Qayyum, MD Chris Achee, MD Monica Gillie Jason Schrock, MD Pheobe Askie, MD Wayne Gravois, MD Nicholas Seeliger, MD Jule Griebrok-Assercq, MD Emily Holt, DO Lacey Shreve Lauren Bartholomew, MD Michael Jennings, MD Jane Singh, MD Houston Bonnyman, MD Prabhdeep Khunkhun, MD Zeb Stearns, MD Eldridge G. Burns, MD Alan LeBato, MD Deidre Stelly, MD James Campbell, MD Lindsay Liles, MD James A. Taylor, Jr., MD Lisa Casey, MD Jayesh Madrecha, MD Christopher Van Hise, MD Lacey Cavanaugh, MD Cynthia Brown-Manning, MD Kenneth Brown, MD Mark Dawson, MD Edith Chimezie Mbagwu, MD Kenneth Brown, MD (Ex-officio) Phillip Ehlers, MD Joseph Nida, MD Stephen Finney, MD Bryan Picou, MD

Respectfully submitted, Richard Bridges, MD 2020-2021 Legislative and Advocacy Committee Chair