This report is updated weekly. You can view the most current status at capitol.tn.gov.

Criminal Law - 2

SB1113 / HB1182 DHS to investigate reports of elder abuse within 24 hours. Category Criminal Law Sponsors Sen. James F. Kyle Jr. / Rep. Jr. Description Requires the department of humans services to initiate investigation of reports of elder abuse or neglect within 24 hours, instead of as soon as practical. Fiscal Note (Dated: March 10 2013) Increased State Expenditures - $594,000/One-time - $6,909,100/Recurring. Senate Status 03/20/2013 - Senate Health & Welfare Committee deferred to 03/272013. House Status 03/19/2013 - House Health Subcommittee deferred to 01/01/2014. SB1852 / HB1768 Abuse of disabled adults - enhanced penalty. Category Criminal Law Sponsors Sen. / Rep. Courtney Rogers Description Enhances the penalty for knowingly abusing, neglecting or exploiting an adult who is unable to manage his or her resources or carry out the activities of daily living due to mental or physical dysfunctioning or advanced age to a Class D felony instead of a Class E felony. Amendment HOUSE CRIMINAL JUSTICE AMENDMENT 1 (013692) creates an elder abuse task force. Members of the task force are one senator appointed by the Speaker of the Senate, one representative appointed by the Speaker of the House of Representatives, the executive director of the Commission on Aging and Disability, the commissioner of Commerce and Insurance, a district attorney general selected by the District Attorneys General Conference, and the executive director of the Tennessee Bureau of Investigation. The task force will assess the current status of elders in Tennessee and make recommendations to the General Assembly and the governor. Members of the task force serve without compensation, but may be reimbursed for expenses. The Department of Human Services shall provide administrative support to the task force. HOUSE CRIMINAL JUSTICE COMMITTEE AMENDMENT 2 (013548) requires the clerk of the court to notify the Department of Health upon each conviction of knowingly abusing an adult. A copy of the judgment must be sent to the department. Requires the department to place the person on the registry of persons who have abused, neglected, or misappropriated the property of a vulnerable individual. Requires the department to notify the individual that he has been placed on the registry. The person may challenge the accuracy of the report. Fiscal Note (Dated February 4, 2014) Increase State Expenditures – $18,200/Incarceration* Senate Status 03/20/2014 - Set for Senate Judiciary Committee Regular Calendar 03/25/14. House Status 03/19/2014 - House Criminal Justice Committee recommended with amendments 1 and 2. HOUSE CRIMINAL JUSTICE AMENDMENT 1 (013692) creates an elder abuse task force. Members of the task force are one senator appointed by the Speaker of the Senate, one representative appointed by the Speaker of the House of Representatives, the executive director of the Commission on Aging and Disability, the commissioner of Commerce and Insurance, a district attorney general selected by the District Attorneys General Conference, and the executive director of the Tennessee Bureau of Investigation. The task force will assess the current status of elders in Tennessee and make recommendations to the General Assembly and the governor. Members of the task force serve without compensation, but may be reimbursed for expenses. The Department of Human Services shall provide administrative support to the task force. HOUSE CRIMINAL JUSTICE COMMITTEE AMENDMENT 2 (013548), which requires the clerk of the court to notify the Department of Health upon each conviction of knowingly abusing an adult. A copy of the judgment must be sent to the department. Requires the department to place the person on the registry of persons who have abused, neglected, or misappropriated the property of a vulnerable individual. Requires the department to notify the individual that he has been placed on the registry. The person may challenge the accuracy of the report. Sent to House Finance.

Government Organization - 4

SB368 / HB827 Creation of conflict of interest policies. Category Government Organization Sponsors Sen. / Rep. Judd Matheny Description Requires each board, commission, committee, or other governmental entity to adopt and implement rules and regulations to create a conflict of interest policy for board members. Specifies that the policy shall mandate annual written disclosures of financial interests, other possible conflicts of interest, and an acknowledgement by board members that they have read and understand all aspects of the policy. Fiscal Note (Dated: March 22 2013) Not Significant. Senate Status 01/31/2013 - Referred to Senate Government Operations. House Status 02/07/2013 - Referred to House Government Operations. SB390 / HB802 Health related boards to assess a fee on licenses Category Government Organization Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Requires each regulatory board and health related board to assess a state regulatory fee on licensees. Fiscal Note (Dated: March 17 2013) Other Fiscal Impact - To the extent any health-related regulatory board does not currently assess a regulatory fee, there will be a recurring increase in state revenue of an unknown amount. Any such recurring increase is unknown because such regulatory fees shall be established as part of the general appropriations act pursuant to Tenn. Code Ann. § 4-3-1011(b)(2). Otherwise, the fiscal impact of this bill is considered not significant. Senate Status 03/26/2013 - Taken off notice in Senate Health & Welfare Committee. House Status 04/03/2013 - Taken off notice in House Health Committee. SB717 / HB583 Restructuring of certain agencies. Category Government Organization Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Revises various provisions governing the structure of Tennessee commission on historic preservation, the state historian and historical commission, and the drycleaner environmental response board. Amendment SENATE AMENDMENT 1 (006750) rewrites the bill. Changes the composition, membership, and terms of the Tennessee historical commission. Changes certain responsibilities regarding the board of accountancy. Changes the "geologists fund" to the "geologist and soil scientist regulatory fund." Deletes provisions regarding the agricultural hall of fame, board of governors and the drycleaner environmental response board. (11 pp.) SENATE AMENDMENT 2 (006798) adds new language immediately preceding Section 2 of the bill. Requires the historical commission to have an executive director who shall be appointed by the governor. Requires the commission to submit to the governor three candidates. Authorizes the executive director to create positions and employ personnel needed to conduct affairs. Allows for all reimbursement of travel expenses that are in accordance with the regulations of the department of finance and administration and approved by the attorney general. HOUSE AMENDMENT 1 (004789) rewrites the bill. Section 1 changes the membership of the Historical Commission from 24 members to 18 and specifies that there will be five members from each grand division and three at large members. Specifies that no two members can be appointed from the same county. Allows the governor to appoint the chairman of the commission instead of the chairman being selected by the commission and staggers terms of members of commission. Vacates current membership upon effective date of this act. Section 2 revises provision related to the Board of Accountancy. Adds specific duties of the executive director role of the board for more clarity. Allows the executive director to be subject to "performance review and other general requirements" of state employees. Allows the commissioner, after consultation with the board, to dismiss the executive director for cause. Sections 3 and 4 revise provisions related to the Advisory Committee for Geology and Soil Scientist Advisory Committee. This amendment combines the funds for these two committees. Section 5 allows the governor to appoint the chair of the Health Services and Development Agency instead of board election. Section 6 through 38 deals with the Dry Cleaner Environmental Response Board. This amendment deletes the Dry Cleaner Environmental Response Board and gives the duties of the board to the commissioner of the department of environment and conservation. Allows the commissioner to appoint an advisory committee when needed. Fiscal Note (Dated: March 19 2013) Increase State Expenditures - $2,810,300/One-Time - Net Impact - $154,100/ Recurring - Other Fiscal Impact - The Governor's proposed FY13-14 budget accounts for the Criminal Justice Coordinating Council transferring from the Department of Finance and Administration to the Department of Correction, in an amount equal to $227,500. Senate Status 04/18/2013 - Senate passed with amendments 1 and 2. House Status 04/19/2013 - House passed with amendment 1. SB843 / HB311 Civil penalties that TN departments may assess. Category Government Organization Sponsors Sen. Bill Ketron / Rep. Description Requires departments of this state prior to assessing any civil penalty against a person whose business or activities are regulated by the department to issue by mail a written citation that includes the nature and location of the violation, the requirements necessary to remedy the violation, the time for abatement of the violation which shall be no less than twenty business days, and the civil penalties that shall be assessed if the person fails to remedy the violation within the time for abatement. Allows the department to proceed to assess civil penalties if the person fails to remedy the violation. Amendment House Business and Utilities Subcommittee amendment 1 (004667) makes the bill. Requires a department who finds that a person or business is not in compliance with a law, rule, or regulation made within the last two years to issue a written citation if the person or business has not previously violated such law, rule, or regulation. A time of abatement shall be provided for the person or business to remedy the violation. The person or business may object to the citation and have a hearing. This act does not preempt any federal laws, nor prohibit the immediate application of criminal penalties. Fiscal Note (Dated: March 11 2013) Decrease State Revenue - $45,300/General Fund - $5,500/Agriculture Regulatory Fund - $52,500/Tennessee Regulatory Authority - $368,700/ABC Fund - Increase State Expenditures - $2,000/One-Time/ABC Fund - $58,900/Recurring/ABC Fund $10,000/General Fund - Decrease Local Revenue - Exceeds $27,200 - Increase Local Expenditures - $19,100* - Other Fiscal Impact - The Department of Health's Division of Regulatory Boards will experience a decrease in fee revenue from assessed civil penalties resulting in a loss of revenue to the boards of $261,921; however, any decrease in revenue can be offset by subsequent increases in issuance and renewal fees for boards, agencies, and commissions. - According to the Department of Health, this legislation may jeopardize $1,300,000 in federal funds provided to the Office of Health Care Facilities through a contract with the Centers for Medicare and Medicaid Services to conduct surveys on health facilities. - According to the Department of Environment and Conservation (TDEC), certain federal acts require that state law maintain a level of severity, at least equal to federal law. According to TDEC, it anticipates that the following acts and related funding would be jeopardized: Underground Storage Fund, Federal Clean Water Act, Environmental Protection Fund, Safe Drinking Water Act, Safe Water Programs, Drinking Water Regulation, Clean Water Act Grants, State clean Water Program Regulations, Solid Waste Disposal Act, State Hazardous Waste Programs, Clean Air Act, State Air Programs, State Air Implementation. Jeopardizing federal funding received from these Acts could result in a loss in federal revenue exceeding $4,400,000. Senate Status 03/19/2013 - Taken off notice in Senate Commerce & Labor Committee. House Status 04/03/2013 - Taken off notice in House Business & Utilities Committee.

Government Regulation - 3

SB377 / HB821 Filing of emergency rules by an agency. Category Government Regulation Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Authorizes the joint government operations rule review committee to request an agency to file an emergency rule. Fiscal Note (Dated: February 23 2013) Not Significant. Senate Status 01/31/2013 - Referred to Senate Government Operations. House Status 02/06/2013 - Referred to House Government Operations. SB388 / HB812 Public rulemaking hearing for proposed rule. Category Government Regulation Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Establishes that hearings are not required when the proposed rule is posted to the administrative register web site within five business days of receipt, together with a statement that the agency will adopt the proposed rule without a public hearing unless within thirty days, instead of sixty days, after the first day of the month subsequent to the filing of the proposed rule a petition for a public hearing on the proposed rule is filed by twenty-five persons who will be affected by the rule. Prohibits an agency that has filed an emergency rule from filing a proposed rule on the same subject without first holding a public hearing. Fiscal Note (Dated: February 18 2013) Not Significant. Senate Status 01/31/2013 - Referred to Senate Government Operations. House Status 02/06/2013 - Referred to House Government Operations. SB463 / HB1051 Programs for older Tennesseans. Category Government Regulation Sponsors Sen. / Rep. Steve McDaniel Description Makes the provision of a home care ombudsman by area agencies on aging subject to appropriations. Deletes an outreach program to Medicare eligible Tennesseans. Removes the prohibition on the commission on aging and disability to exercise any control or authority over the administration of programs for home and community based long-term care that are operating on the basis of federal waivers in effect on June 19, 2001. Fiscal Note (Dated: March 25 2013) Increase State Expenditures - $835,600. Senate Status 03/06/2013 - Senate Health & Welfare Committee deferred to 03/13/2013. House Status 02/20/2013 - Referred to House Health Subcommittee.

Health Care - 17

SB98 / HB470 Accounting of long-term care expenditures. Category Health Care Sponsors Sen. Lowe Finney / Rep. Lois M. DeBerry Description Requires the bureau of TennCare to report to the general assembly and make available to interested persons a separate accounting of long-term care expenditures for nursing facility services and home and community-based services made under the CHOICES long-term health care program, including prior fiscal year actual expenditures and projected current fiscal year expenditures no later than February 1 of each year. Fiscal Note (Dated: February 3 2013) Not Significant. Senate Status 01/30/2013 - Referred to Senate Commerce & Labor Committee. House Status 02/05/2013 - Referred to House Health Subcommittee. SB530 / HB78 Order issued concerning a nursing home within 12 days. Category Health Care Sponsors Sen. Steven Dickerson / Rep. Description Changes the amount of time an order must be issued following an administrative hearing concerning a nursing home from 10 to 12 days. Deletes authorization for a demonstration project that was supposed to be completed and reported on by 2006. Fiscal Note (Dated: March 20 2013) Not Significant. Senate Status 02/05/2013 - Referred to Senate Health & Welfare Committee. House Status 01/30/2013 - Referred to House Health Subcommittee. SB746 / HB865 Contracts between residents and assisted-care living facilities. Category Health Care Sponsors Sen. / Rep. Description Requires assisted-care living facilities to enter into a contract with each resident which sets forth the services and accommodations to be provided by the facility, the rates of charge, the rights, duties, and obligations of each resident, and other matters deemed appropriate by both parties. Fiscal Note (Dated: March 10 2013) Increase State Expenditures - $41,100/FY13-14/Board for Licensing Health Care Facilities - $73,600/FY14-15 and Subsequent Years/ - Board for Licensing Health Care Facilities. Senate Status 03/20/2013 - Taken off notice in Senate Health & Welfare Committee. House Status 03/26/2013 - Taken off notice in House Health Subcommittee. SB804 / HB937 Prohibits Medicaid expansion under new federal health care law. Category Health Care Sponsors Sen. Brian K. Kelsey / Rep. Jeremy Durham Description Prohibits the state from establishing, facilitating, implementing, or participating in any new expansion of the medical assistance program, also known as Medicaid, pursuant to the Patient Protection and Affordable Care Act. Amendment HOUSE AMENDMENT 2 (012781) rewrites this bill to prohibit the governor from making any decision or obligating the state in any way with regard to the expansion of optional enrollment in the medical assistance program, pursuant to the Patient Protection and Affordable Care Act, unless authorized by joint resolution of the general assembly. SENATE AMENDMENT 8 (013864) provides that if a special session is called it should be at the members' expense. Fiscal Note (Dated: February 26 2013) Forgone State Revenue - $418,207,600/TennCare/FY13-14 - $1,000,100,900/TennCare/FY14-15. Senate Status 03/06/2014 - Senate passed with amendment 8, which provides that if a special session is called it should be at the members expense. House Status 03/17/2014 - House non-concurred in Senate amendment 8 (013864). SB818 / HB686 Defines "medical directive" to mean the same as "advance directive". Category Health Care Sponsors Sen. Lowe Finney / Rep. Sherry Jones Description Includes "medical directive" as an alternative term for "advance directive". Fiscal Note (Dated: March 3 2013) Not Significant. Senate Status 02/08/2013 - Referred to Senate Judiciary. House Status 02/06/2013 - Referred to House Civil Justice Subcommittee. SB1865 / HB1884 Nursing homes - informal dispute resolution program. Category Health Care Sponsors Sen. Doug Overbey / Rep. Vance Dennis Description Establishes an independent informal dispute resolution program (IIDR) for nursing homes. Requires the IIDR program contract with at least two independent contract organizations to conduct the IIDR process for nursing homes. Creates policies and procedures for notifying, requesting, and reviewing IIDR process. Requires the department to report on December 1st of each year to the general assembly. Fiscal Note (Dated March 8, 2014) Increase State Expenditures – Exceeds $10,000 Decrease Federal Expenditures – Exceeds $10,000 Other Fiscal Impact – According to the Department of Health, contracting with independent review organizations could result in an increase expenditures ranging from $2,000 to $250,000. Senate Status 03/10/2014 - Senate Health & Welfare Committee recommended. Sent to Senate Calendar Committee. House Status 03/18/2014 - Taken off notice in House Health Subcommittee. SB1871 / HB2174 Appeals process-ineligible for TennCare nursing facility services. Category Health Care Sponsors Sen. Doug Overbey / Rep. Barrett Rich Description Establishes an appeals process for a resident who is involuntarily discharged from a TennCare nursing facility or for someone who is determined not financially or medically eligible for TennCare nursing facility services, and details how both appeal processes are to move forward. Amendment Senate Health & Welfare Committee amendment 1 (013965) rewrites the bill. Provides that a resident's appeal to a nursing home facility's notice to involuntary discharge must be completed within 90 days of the notice of appeal, but may be continued if agreed to by the patient and the nursing home. The timeframe may also be extended without the consent of the facility by a presiding administrative judge, but only after it has been shown that the resident faces a substantial threat of irreparable damage or injury if continuance is not granted. Provides that where a patient has applied for TennCare nursing facility benefits and it has been determined that the patient is not financially or medically eligible for such benefits, there shall be hearing conducted and a final order within 90 days from the date of appeal. If an individual is successful in an appeal and establishes that they should have been determined to be eligible, the resident shall be deemed eligible from the date of submission of the application or pre-admission evaluation, and payment shall be made back to the initial date of such submission. Specifies the process for an appeal in which a final administrative order is not issued by the 90th day following the bureau's receipt of a request to appeal the denial of a PAE for any long term support or service. Fiscal Note (Dated March 10, 2014) Increase State Expenditures - $105,000 Increase Federal Expenditures - $105,000 Senate Status 03/10/2014 - Senate Health & Welfare Committee recommended with amendment 1 (013965), which rewrites the bill. Sent to Senate Finance. House Status 03/20/2014 - Set for House Health Subcommittee Final Calendar 03/25/14. SB1872 / HB1783 Nursing home - privilege tax and contracting requirement. Category Health Care Sponsors Sen. Doug Overbey / Rep. Michael Harrison Description Present law requires any managed care organization (MCO) to contract with any licensed nursing facility that is certified by the centers for Medicare and Medicaid services, that provides Medicaid nursing facility services pursuant to an approved preadmission evaluation (PAE) or that provides Medicare skilled nursing facility services and is willing to contract with the MCO to provide that service under the same terms and conditions as are offered to any other participating facility contracted with an MCO to provide that service under any policy, contract or plan that is part of the TennCare managed long-term care service delivery system. This requirement is scheduled to expire on June 30, 2015. This bill removes the expiration date on the forgoing requirement and extends for one year the nursing home annual assessment fee. Fiscal Note (Dated February 27, 2014) Other Fiscal Impact – Prevents the loss of $82,300,000 in state revenue and $153,280,364 in federal matching funds. Revenue recognition in the amount of $82,300,000 is included in the Governor’s proposed FY14-15 budget. Senate Status 03/10/2014 - Senate Health & Welfare Committee recommended. Sent to Senate Calendar Committee. House Status 03/19/2014 - House Finance Subcommittee deferred to 03/26/14. SB1873 / HB2175 Managed care organizations - payment to nursing facilities. Category Health Care Sponsors Sen. Doug Overbey / Rep. Barrett Rich Description Requires managed care organizations to comply with changes made by TennCare to a nursing facility's Medicaid per diem rate within 30 days of the date of the changes. Requires that all claims be paid based upon the rate that TennCare established for the date of service, regardless of the date the claim was submitted. Payments other than the daily rates must be paid by a managed care organization to a contracted nursing home no later than 60 days from the receipt of those funds by TennCare. Fiscal Note (Dated March 12, 2014) NOT SIGNIFICANT Senate Status 03/19/2014 - Taken off notice in Senate Health & Welfare Committee. House Status 03/18/2014 - Taken off notice in House Health Subcommittee. SB1875 / HB1784 Extends moratorium-issuance of certificates of need. Category Health Care Sponsors Sen. Doug Overbey / Rep. Michael Harrison Description Extends the current moratorium on the issuance of certificates of need (CONs) for new nursing home and skilled nursing facility beds until June 30, 2015. Fiscal Note (Dated January 29, 2014) Forgone State Revenue - $222,500/FY14-15/Nursing Home Bed Tax State Expenditures – Cost Avoidance – $2,002,200/FY14-15 Federal Expenditures – Cost Avoidance – $3,801,300/FY14-15 Senate Status 03/10/2014 - Senate Health & Welfare Committee recommended. Sent to Senate Finance. House Status 03/19/2014 - House Finance Subcommittee deferred to 03/26/14. SB1908 / HB1950 Annual Coverage Assessment of 2014. Category Health Care Sponsors Sen. Doug Overbey / Rep. Michael Harrison Description Enacts the "Annual Coverage Assessment of 2014" to assess on each covered hospital an annual fee. The annual coverage assessment shall be four and fifty-two hundredths percent (4.52%) of a covered hospital's annual coverage assessment base. Amendment House Health Committee amendment 1, Senate Health & Welfare Committee Amendment 1 (013120) rewrites the bill to enact the Annual Coverage Assessment Act of 2014, which establishes an annual coverage assessment on hospitals of 4.52 percent of a covered hospital's annual coverage assessment base and is required to be paid in equal quarterly installments. The Bureau of TennCare will send a notice of payment and a return form to each covered hospital 30 days prior to the payment date. A penalty of $500 a day is imposed on a hospital that does not pay the assessment by the due date. The covered hospital is also subject to disciplinary action under the licensing laws applicable to the hospital. A covered hospital is prohibited from increasing charges or adding surcharges based on or as a result of the annual coverage assessment. A TennCare managed care organization is prohibited from implementing across the board reductions in rates that are in existence on July 1, 2014, for hospitals and physicians by category or type of provider, unless mandated by the CMS. A Maintenance of Coverage Trust Fund (the Fund) consisting of all annual coverage assessment collections and investment earnings credited to the assets of the Fund is established. Assessment payments, investment earnings, and federal matching funds are required to be available to the Bureau and only expended for benefits and services that would been subject to reductions or eliminations from the FY13 – 14 TennCare budget; for refunds to hospitals for payments of assessments or penalties to the Bureau through error, mistake, or a determination that the payment was invalidly imposed; and for reimbursements to hospitals to offset losses for services provided to TennCare enrollees (assessment payments only). The implementation of the annual coverage assessments is dependent upon approval of additional hospital payments by CMS and a determination by CMS that the payments will not reduce federal participation in the TennCare program. Critical access hospitals, state mental health hospitals, rehabilitation and long term care acute hospitals, St. Jude Children's Research Hospital, and the state and local government hospitals are exempt from the annual coverage assessment. Beginning September 1, 2014, and on a quarterly basis thereafter, TennCare is required to report the status of the determination and approval by CMS, the balance of the Fund, and the extent to which the funds have been used, to both of the Finance, Ways and Means Committees, the Senate Health and Welfare Committee, and the House Health Committee. (19 pp.) Fiscal Note (Dated February 27, 2014) Increase State Revenue - $449,800,000/FY14-15/ Maintenance of Coverage Trust Fund Increase State Expenditures - $449,800,000/FY14-15/ Maintenance of Coverage Trust Fund Increase Federal Expenditures - $826,559,200/FY14-15/ Maintenance of Coverage Trust Fund Revenue recognition in the amount of $449,800,000 is included in the Governor’s proposed FY14-15 budget. Corresponding non-recurring appropriations in the amount of $1,276,359,500 ($449,800,000 in state funds and $826,559,500 in federal matching funds) are also included. Senate Status 03/10/2014 - Senate Health & Welfare Committee recommended with amendment 1 (013120), which enacts the "Annual Coverage Assessment Act of 2014. Imposes an annual coverage assessment, defined as a covered hospital's net patient revenue as shown in its Medicare cost report for its fiscal year that ended during calendar year 2008 on file with the CMS as of September 30, 2009, subject to certain qualifications, on each covered hospital. Provides that the coverage assessment shall not be effective until the bureau of TennCare has provided proper written notice to the Tennessee Hospital Association. Provides that the annual coverage assessment established for this statute shall be 4.52 percent of a covered hospitals annual coverage assessment base. Outlines the process and timeline for how such annual coverage assessments shall be paid and collected, and where the funds generated shall be deposited. Provides that payments may be made from the annual coverage assessment payments received by the bureau to covered hospitals to offset losses incurred in providing services to TennCare enrollees. Specifies other requirements to assist the bureau in enforcing the provisions of this statute. Sent to Senate Finance. House Status 03/20/2014 - Set for House Finance Subcommittee 03/26/14. SB1974 / HB1827 Health care providers - inquiry into patient's firearm use. Category Health Care Sponsors Sen. Frank Niceley / Rep. Rick Womick Description Prohibits health care providers or employees of a health care facility from inquiring about a person's ownership, possession or use of firearms as a condition for receiving health care or refusing to provide health care because the person declines to answer such questions. Amendment House Civil Justice Committee amendment 1 (013279) deletes all language after the enacting clause. Prohibits any health care provider or employee of a licensed health care facility to refuse to provide health care to a person because of the person's refusal to answer questions concerning such person's firearm ownership, possession, or use. Specifies that nothing in this act shall interfere with a healthcare provider's independent medical judgment in diagnosing and treating patients or carrying out the duties of Tenn. Code Ann. Title 33 concerning mental health and substance abuse and intellectual and developmental disabilities. Authorizes a healthcare provider or employee of a healthcare facility to discuss or provide educational materials on gun safety. Fiscal Note (Dated February 7, 2014) NOT SIGNIFICANT Senate Status 03/17/2014 - Taken off notice in Senate Health & Welfare Committee. House Status 03/19/2014 - Taken off notice in House Civil Justice Committee. SB2237 / HB1811 Nursing home facility - bed conversion. Category Health Care Sponsors Sen. Jim Tracy / Rep. Ryan Williams Description Permits a nursing home facility to convert a licensed nursing home bed to a reserved nursing home bed right if certain conditions are met, including that the licensed nursing home bed has been voluntarily removed from the license of the nursing home. Requires a nursing home facility to pay a filing fee for such a conversion equal to the minimum filing fee for a certificate of need application. Allows a nursing home facility to implement one or more of its reserved nursing home bed rights as a licensed nursing home bed without a certificate of need in certain situations. Provides that a reserved nursing home bed right shall be null and void upon failure of the nursing home to meet certain requirements outlined in the statute. Fiscal Note (Dated March 19, 2014) Other Fiscal Impact – It is unknown how many vacant licensed nursing home beds will be converted to reserved nursing home beds or when such a conversion will take place; therefore an exact fiscal impact cannot be determined. If all vacant beds are converted, there would be an increase in state expenditures of $1,457,800 and an increase in federal expenditures of $2,715,200. Senate Status 01/29/2014 - Referred to Senate Health & Welfare Committee. House Status 02/04/2014 - Referred to House Health Subcommittee. SB2292 / HB1920 Organ donation consent forms and advance directives as voluntary acts. Category Health Care Sponsors Sen. Jim Summerville / Rep. Joshua G. Evans Description Prohibits health care providers, institutions, and insurances from requiring the issuance, execution, or revocation of an organ donation consent form or advance directive as a condition for being insured for, or receiving health care. Fiscal Note (Dated: February 9, 2014) NOT SIGNIFICANT Senate Status 03/17/2014 - Senate Health & Welfare Committee recommended. Sent to Senate Calendar Committee. House Status 03/17/2014 - House passed. SB2327 / HB1719 Nursing home quarterly statement of residents funds. Category Health Care Sponsors Sen. Randy McNally / Rep. Michael Harrison Description Requires a nursing home, upon request of a resident's guardian, trustee, or conservator, provide a quarterly statement of the principal amount of deposits owned in any interest bearing account owned by the resident. Fiscal Note (Dated March 15, 2014) NOT SIGNIFICANT Senate Status 01/29/2014 - Referred to Senate Health & Welfare Committee. House Status 01/29/2014 - Referred to House Health Subcommittee. SB2429 / HB2342 Nursing homes - divide and relocation of licensed beds. Category Health Care Sponsors Sen. Thelma Harper / Rep. Harold Love Jr. Description Authorizes an existing licensed and operating nursing home to divide and relocate a portion of its licensed beds to not more than two new locations (each being a "qualified partial relocation"), with not more than 260 beds to be relocated pursuant to each qualified partial relocation, if the existing nursing home facility meets all of the following criteria: (1) The existing nursing home facility is licensed by the department for at least 400 beds on the effective date of this bill; (2) The existing nursing home facility has operated for at least 45 years at its current location; (3) The existing nursing home facility is located in Davidson County; (4) Any qualified partial relocation facility is located in the same county as the existing nursing home facility; and (5) An application for the qualified partial relocation of the beds is filed with and approved by the health services and development agency. An application for a qualified partial relocation of a nursing home facility that does not seek to increase the number of licensed beds from the number of beds to be relocated must be reviewed by the department of health and considered by the agency and will not be considered new nursing home beds. The present law criteria for certificates of need and skilled nursing facility beds will not apply to an application for a qualified partial relocation of a nursing home facility filed with the agency pursuant to this bill. This bill states that it will not affect a certificate of need project filed before the effective date of this bill. Amendment Senate amendment 1 (013476) authorizes an existing licensed nursing home that meets certain criteria to relocate less than all of its licensed beds but no more than 140 licensed beds to a new location. Requires the existing facility to take action to reduce its licensed bed capacity to no more than 120 beds so that after the certification of the partial replacement facility, the combined number of licensed beds relocated from the existing nursing home to the partial replacement facility and the remaining beds at the existing nursing home do not exceed 260 licensed beds. Fiscal Note (Dated February 12, 2014) Other Fiscal Impact – The proposed legislation could result in a nursing home reaching full occupancy of current licensed beds. If the legislation directly results in the facility reaching full capacity, the Bureau of TennCare could incur additional expenditures that, while currently responsible for such costs, the Bureau is not currently experiencing. It is difficult to determine the exact fiscal impact directly related to the passage of the legislation and the fiscal year in which the full impact will be realized. If the facility reaches full occupancy for its currently licensed beds, the TennCare program will expend approximately $3,621,900 in state funds and $6,745,700 in federal funds for costs of approximately 181 filled beds. Senate Status 03/17/2014 - Senate passed with amendment 1 (013476), which authorizes an existing licensed nursing home that meets certain criteria to relocate less than all of its licensed beds but no more than 140 licensed beds to a new location. Requires the existing facility to take action to reduce its licensed bed capacity to no more than 120 beds so that after the certification of the partial replacement facility, the combined number of licensed beds relocated from the existing nursing home to the partial replacement facility and the remaining beds at the existing nursing home do not exceed 260 licensed beds. House Status 03/20/2014 - Set for House Health Subcommittee Final Calendar 03/25/14. SB2458 / HB2389 Nursing Care Facilities Category Health Care Sponsors Sen. / Rep. Richard Floyd Description Revises the requirements for a nursing home's certificate of need for qualified partial relocation of nursing homes by adding that a qualified partial relocation of a nursing home also refers to a request to relocate up to 20 license nursing home beds from one nursing home to another home, if the following conditions are met: (1) the current location and the proposed location of the nursing home beds are in the same county; (2) the nursing home from which the beds will be located is licensed for over one 100 beds; (3) the nursing home at which the beds are currently located and the nursing home to which the beds will be relocated are under common ownership or control; and (4) the site of the nursing home to which the beds will be relocated is on the campus of a rehabilitation hospital. Fiscal Note (Dated February 13, 2014) NOT SIGNIFICANT Senate Status 03/20/2014 - Senate passed. House Status 03/17/2014 - House passed.

Judiciary - 1 SB2042 / HB1504 Statute of limitations for commencing wrongful death action. Category Judiciary Sponsors Sen. Brian K. Kelsey / Rep. John J. Deberry Jr. Description Creates a two year, rather than one year, statute of limitations for commencing wrongful death action. Fiscal Note (Dated February 16, 2014) NOT SIGNIFICANT Senate Status 01/29/2014 - Referred to Senate Judiciary Committee. House Status 03/20/2014 - Set for House Civil Justice Subcommittee 03/26/14.

Labor Law - 2

SB699 / HB1321 Employers cannot use certain credit reports for employment purposes. Category Labor Law Sponsors Sen. Reginald Tate / Rep. Karen D. Camper Description Prohibits an employer from using the credit report or credit history of an employee or applicant for employment to deny employment, discharge an employee or determine compensation of the terms, conditions or privileges of employment. Permits the credit report or credit history of the employee or applicant to be used if information in the credit report is substantially job-related and disclosed in writing to the employee or applicant. Allows the commissioner of labor and workforce development to assess a civil penalty to an employer who violates this section. Fiscal Note (Dated: March 14 2013) Increase State Revenue - Exceeds $500. Senate Status 03/19/2013 - Senate Commerce & Labor Committee deferred to next meeting. House Status 03/20/2013 - Taken off notice in House Consumer & Human Resources Subcommittee. SB2126 / HB1954 Revises provisions concerning employment litigation in Tennessee. Category Labor Law Sponsors Sen. Jack Johnson / Rep. Vance Dennis Description Removes from the definition of a discriminatory practice the provision to Aid, abet, incite, compel or command a person to engage in any of the acts or practices declared discriminatory. Specifies that no individual employee or agent of an employer will be liable for any violation of human rights that an employer committed. Provides that the sum of the amount of compensatory damages awarded for future pecuniary losses, emotional pain, suffering, inconvenience, mental anguish, loss of enjoyment of life, and other non-pecuniary losses, may not exceed, for each complaining party: (A) In the case of an employer who has eight or more but fewer than 15 employees at the time of the cause of action, $25,000; (B) In the case of an employer who has more than 15 employees but fewer than 101 at the time the cause of action arose, $50,000; (C) In the case of an employer who has more than 100 and fewer than 201 employees at the time the cause of action arose, $100,000; (D) In the case of an employer with more than 200 employees but less than 501 at the time the cause of action arose, $200,000; and (E) In the case of an employer with more than 500 employees at the time the cause of action arose, $300,000. Provides that damage limits will not apply to back pay, interest on back pay, front pay or any equitable relief. Specifies that no employee may be discharged or terminated solely for refusing to participate in or for refusing to remain silent about illegal activities who report those illegal activities to an individual or entity other than the employee's employer or the employer's corporate affiliate prior to the termination of the employment. Specifies that the statutory law governing discharge for refusal to participate in or remain silent about illegal activities or use of agricultural product repeals and supersedes common law with respect to any claim that could have been brought. Fiscal Note (Dated February 28, 2014) NOT SIGNIFICANT Senate Status 03/20/2014 - Set for Senate Commerce & Labor Committee Final Calendar 03/24/14. House Status 03/20/2014 - Set for House Consumer & Human Resources Subcommittee 03/26/14.

Professions & Licensure - 3

SB976 / HB1211 Prescribing restriction for nurse practitioners, physician assistants. Category Professions & Licensure Sponsors Sen. Randy McNally / Rep. David Shepard Description Prohibits a nurse practitioner or physician assistant from prescribing schedules II, III, and IV controlled substances unless such prescription is specifically authorized by the formulary or approved after consultation with the supervising physician. Establishes a nurse practitioner or physician assistant may only prescribe or issue an opioid or benzodiazepine for a maximum 30 day non-refillable course of treatment unless specifically approved after consultation with the supervising physician. Fiscal Note (Dated: March 1 2013) Not Significant. Senate Status 03/26/2013 - Taken off notice in Senate Health & Welfare Committee. House Status 03/26/2013 - Taken off notice in House Criminal Justice Subcommittee. SB1629 / HB1425 Online applications - various health-related professions. Category Professions & Licensure Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Authorizes the use of online applications for all occupations regulated by the division of health related boards and for all occupations regulated by any board, commission, committee, agency or other governmental entity created in title 63, title 68, chapter 24 and title 68, chapter 140, part 3. Requires department annual health care facility and pharmacy survey inspection reports to be available to the public pursuant to the conditions of making medical records public. (Part of Administration Package) Fiscal Note (Dated March 6, 2014) Increase State Expenditures $795,000/FY14-15/Health Related Boards $50,000/FY15-16 and Subsequent Years/ Health Related Boards According to the Department of Finance and Administration, expenditures in the amount of $745,000 one-time and $50,000 recurring are included in the Governor’s proposed FY14-15 budget. Senate Status 03/20/2014 - Set for Senate Finance, Ways & Means Committee Regular Calendar 03/25/14. House Status 03/19/2014 - House Health Committee recommended. Sent to House Government Operations. SB1982 / HB2040 Annual report regarding hospice services. Category Professions & Licensure Sponsors Sen. Lowe Finney / Rep. Description Requires the board for licensing health care facilities to prepare and present an annual report regarding hospice services on or before January 15 of each year. Also requires the board to make the report available on its website. Fiscal Note (Dated March 9, 2014) NOT SIGNIFICANT Senate Status 03/19/2014 - Taken off notice in Senate Health & Welfare Committee. House Status 03/20/2014 - Set for House Health Subcommittee Final Calendar 03/25/14.

Property & Housing - 1

SB2343 / HB2418 Fine for committing certain offenses related to smoke detectors. Category Property & Housing Sponsors Sen. Bill Ketron / Rep. Description Increases the fine for committing certain offenses relating to smoke detectors from a fine up to fifty dollars to a fine of one hundred dollars. Fiscal Note (Dated March 7, 2014) NOT SIGNIFICANT Senate Status 01/29/2014 - Referred to Senate Judiciary Committee. House Status 03/18/2014 - Taken off notice in House Criminal Justice Subcommittee.

Public Finance - 1

SB2543 / HB2458 Budget procedures. Category Public Finance Sponsors Sen. Randy McNally / Rep. Charles M. Sargent Description Authorizes grant payments under the grant assistance program for nursing home care to be made either monthly or quarterly. Requires the commissioner of finance and administration to assign the state employee staff responsible for administration of state insurance coverage. Fiscal Note (Dated March 5, 2014) NOT SIGNIFCANT Senate Status 02/10/2014 - Referred to Senate Finance, Ways & Means Committee. House Status 02/12/2014 - Referred to House Finance Subcommittee.

Taxes Business - 1

SB191 / HB185 Extends nursing home bed tax. Category Taxes Business Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Extends the levy of the nursing home tax of $2,225 per licensed bed per year from June 30, 2013, to June 30, 2015. (Part of Administration Package) Fiscal Note (Dated: February 15 2013) Other Fiscal Impact - Prevents the loss of $82,300,000 in state revenue and $156,250,700 in federal matching funds. - Revenue recognition in the amount of $82,300,000 in state revenue is included in the Governor's proposed FY13-14 budget. Senate Status 04/08/2013 - Taken off notice in Senate Finance, Ways & Means Committee. House Status 04/18/2013 - Taken off notice in House Finance Subcommittee.

Tenncare - 3

SB429 / HB79 Annual actuarial study of TennCare - payments to providers. Category Tenncare Sponsors Sen. Doug Overbey / Rep. Curtis Halford Description Requires the annual actuarial study of TennCare to include an analysis of the effect of reduction of payments to providers on the provision of care. Fiscal Note (Dated: February 10 2013) Increase State Expenditures - Exceeds $25,000 - Increase Federal Expenditures - Exceeds $25,000. Senate Status 02/05/2013 - Referred to Senate Health & Welfare Committee. House Status 02/05/2013 - Referred to House Insurance & Banking Subcommittee. SB556 / HB397 Enterprise fraud program within the office of inspector general. Category Tenncare Sponsors Sen. Doug Overbey / Rep. Description Establishes an enterprise fraud program office within the office of inspector general to implement a fraud, waste, and abuse detection and prevention system across state agencies and programs. Requires the enterprise fraud program to initiate a project within one hundred twenty days of the effective date of this act to implement state-of-the-art fraud detection technology. Fiscal Note (Dated: March 16 2013) Increased State Expenditures - $9,000,000/FY14-15 - $1,500,000/FY15-16 and Subsequent Years - Other Fiscal Impact - Reduced state expenditures will occur in future fiscal years due to implementation of the automated fraud detection system. Due to many unknown factors, including the time required to develop the system, the identity of participating agencies, and the types of fraud targeted it is not possible to quantify the eventual recovery of investment that might occur as a result of implementing the system. Senate Status 03/27/2013 - Taken off notice in Senate Government Operations Committee. House Status 03/27/2013 - Taken off notice in House Insurance & Banking Subcommittee. SB1387 / HB82 Prohibits TN from participating in Medicaid expansion. Category Tenncare Sponsors Sen. Brian K. Kelsey / Rep. Jeremy Durham Description Establishes the "TennCare Fiscal Responsibility Act ". Prohibits Tennessee from participating in any Medicaid expansion authorized under the federal Patient Protection and Affordable Care Act. Fiscal Note (Dated: March 17 2013) Forgone State Revenue - $418,207,600/TennCare/FY13-14 - $1,000,100,900/TennCare/FY14-15 - Other Fiscal Impact - According to the Bureau of TennCare, the bill could jeopardize $6.34 billion federal Medicaid matching funds by prohibiting the state from extending eligibility to children up to 133 percent of the federal poverty level. If the state does not extend coverage eligibility for children up to 133 percent of the federal poverty level, then the state will not be compliant with 42 U.S.C. 1396a and could lose Medicaid funding pursuant to 42 U.S.C. 1396c. Senate Status 02/26/2013 - Referred to Senate Commerce & Labor Committee. House Status 02/05/2013 - Referred to House Insurance & Banking Subcommittee.

Tort Liability - 1

SB1463 / HB1881 Health care liability action: prohibited criteria. Category Tort Liability Sponsors Sen. Mark S. Norris / Rep. Vance Dennis Description Prohibits, without competent expert testimony establishing the appropriate standard of care, the development or implementation of any guidelines by a public or private health insurer, defined in the section as a "payor", or the use of any payment or reimbursement criteria under federal laws to establish a legal basis of negligence or compliance with the standard of care provided by any health care provider in a health care liability case. Fiscal Note (Dated February 5, 2014) NOT SIGNIFICANT Senate Status 01/15/2014 - Referred to Senate Judiciary Committee. House Status 02/04/2014 - Referred to House Civil Justice Subcommittee.

Workers Compensation - 1

SB1645 / HB1440 Revises various workers' compensation provisions. Category Workers Compensation Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Revises various provisions relative to workers' compensation. Defines specialty practice group. Alters distribution of proceeds from certain penalty payments. Alters provisions regarding specific documented findings by the court. Alters penalties and procedure for noncompliance with insurance requirements. (11 pp.) (Part of Administration Package) Amendment SENATE COMMERCE & LABOR COMMITTEE AMENDMENT 1 (013628) provides technical corrections. Changes "issue of surgery" to "issue of surgery and diagnosis." Changes "15 days" to "15 calendar days." Replaces commissioner of labor and workforce development with administrator of the division of workers' compensation. Clarifies that the effective date will be in Section 8 of the bill and not in Section 9. HOUSE CONSUMER & HUMAN RESOURCES COMMITTEE AMENDMENT 1 (013778) Rewrites the bill. Deletes section seven of the original bill that proposed rewriting of the authorization to provide additional workers' compensation benefits, and the criteria for receiving additional workers' compensation benefits, both of which shall take effect on July 1, 2014 under current law, for certain injuries occurring on or after July 1, 2014; the addition of a new language that replaces the Commissioner of Labor and Workforce Development with the Administrator of the Division of Workers' Compensation as the individual responsible for the rules and regulations for drug-free workplace programs; and several technical corrections. Fiscal Note February 7, 2014 NOT SIGNIFICANT Senate Status 03/04/2014 - Senate Commerce & Labor Committee recommended with amendment 1 and amendment 2. Sent to Senate Calendar Committee. House Status 03/20/2014 - House Calendar & Rules Committee deferred to 03/27/14. Executive Status 02/27/2014 - Workers' Compensation Advisory Council recommended with expression of the council's concerns in particular regarding section 7.

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