Senate Health, Children, & Social Services Committee Meeting
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Senate Health, Children, & Social Services Committee Meeting Official Minutes 149th General Assembly First Session Committee Meeting Wednesday April 5th, 2017 2:30 p.m. Senate Hearing Room Meeting Attendance Committee Members: Present: Senator Bryan Townsend [email protected] 302-744-4165 Senator Nicole Poore [email protected] 302-744-4164 Senator Stephanie Hansen [email protected] 302-744-4138 Senator Ernie Lopez [email protected] 302-744-4136 Absent: Senator Catherine Cloutier [email protected] 302-744-4137 Other Legislators Present: Senator Bruce Ennis [email protected] 302-744-4310 Representative David Bentz [email protected] 302-744-4028 Staff: Annie Gould [email protected] 302-744-4059 Attendees: Organization: Phone: Dave Humes atTAcK Addiction 302-593-0949 Julie Price League of Women Voters 302-734-2561 Cheryl Heiks Connections 302-563-3273 Julie Wenger DFIL 302-545-8305 Pam Price Highmark BCBS 302-421-2172 Mike Malkiewicz DTLA 302-670-5307 Mary Davis Ned Davis Associates 302-670-5307 Drew Wilson Morris James 302-650-3971 Teresa Avery Autism DE Pat Maichle DDC 302-739-2232 Wayne Smith DE Healthcare Assoc. Jamie Mack Division of Public Health 302-744-4951 Joanne Finnegan DHSS 302-255-9880 Janneen Boyce Division of Social Services Takeya Perez Division of Social Services Nicholas Brock State Senate 302-744-4056 Lexi West Division of Research Jessica Stump Division of Research Anna Keleher State Senate 302-744-4063 Tanner Polce Lt. Governor David Mangler Division of Professional Regulation Agenda: SB 24 SB 35 HB 11 SB 44 SB 45 SB 48 HB 21 w/ HA 2 Senator Townsend brought the meeting to order at 2:34 p.m. Members approved the previously circulated minutes from the committee’s last meeting on January 25, 2017. SB 24 (Henry) AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO MEDICAL MARIJUANA SYNOPSIS- This Act removes the requirement that a psychiatrist be the physician who signs the written certification in support of an applicant's application for medical marijuana and adds anxiety to the list of debilitating conditions which a person can have to be eligible for medical marijuana. This Act also makes technical corrections to the statute. Nicholas Brock, Legislative Assistant to Senator Henry, introduced the bill stating that it expands upon HB 400 from the 148th General Assembly also known as “Bob’s Bill.” He provided the impetus for the bill and an explanation of the need. He stated that five other states have added PTSD to the list of conditions that would qualify someone to be eligible to receive medical marijuana. Jamie Mack, Policy Lead and Technical Advisor to the Director of the Division of Public Health, discussed a possible amendment that the Director’s Office has been working on with Senator Henry’s office. The amendment would address the concern that the Director’s Office has in expanding the prescribing capabilities beyond psychiatrists. Senator Hansen shared that she had a concern and a question about the bill. Her daughter, who is a psychiatrist and in that role works with members of the armed forces, recently shared with her a Yale Medical School study that showed that marijuana adversely affected veterans with PTSD. She said that she would be remiss if she did not share that with the committee and that she also likely would not support the bill given that the latest evidence shows that medical marijuana is harmful to veterans with PTSD. Jamie Mack assured Senator Hansen that there were several psychiatrists and physicians involved with drafting the bill and that the conversations were not over. The team would continue to look at the latest evidence. Nicholas Brock reminded the committee of the state’s opioid crisis and the role that medical marijuana could play in mitigating that crisis. Senator Poore asked for clarification on the timeline for the potential amendment from DHSS. She also thanked Senator Hansen for sharing the information from the Yale study. Jamie Mack said that the Director’s office hoped to have the proposed amendment language to Senator Henry’s office by the beginning of the following week. Senator Poore asked if the committee would be receiving any testimony from psychiatrists or physicians. Nicholas Brock stated that Rich Jester, an advocate who worked on HB 400, was not able to make it to the committee meeting, but that he had submitted written testimony. Senator Townsend said that he would be distributing the written testimony via email and also would provide hard copies to the committee members. Drew Wilson, on behalf of the Medical Society of Delaware, stated that the Psychiatric Society of Delaware and Medical Society of Delaware oppose the bill because of a lack of evidence and even evidence that medical marijuana could be more harmful than helpful for individuals with PTSD. He stated that this position was a departure from the Medical Society of Delaware’s neutral position on all preceding medical marijuana expansion bills. Pat Maichle, a representative of the Delaware Disabilities Council, stated that she could not speak to the effects on veterans or others with PTSD, but that medical marijuana has helped a number of children with autism who suffer from anxiety. Wayne Smith, on behalf of the Delaware Healthcare Association, stated that the association is opposed to SB 24 because of the evidence from the Yale study and others like it, which showed that cannabis could be harmful to veterans with PTSD. He noted that there are over 80 strains and there is not enough known about the effects of the different strains. He also said that the Association hoped that the amendment to the bill suggested by DHSS would include non- psychiatric professionals who have been through certain training programs focused on prescribing medical marijuana. SB 48 (Townsend) AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO NALOXONE SYNOPSIS - Under this Act, a pharmacist who dispenses naloxone under an established set of circumstances is not subject to disciplinary or other adverse action under any professional licensing statute or criminal liability, or liable for damages related to injuries or death sustained in connection with administering the drug, unless it is established that the pharmacist caused the injuries or death wilfully, wantonly, or by gross negligence. Senator Townsend, introduced the bill and explained that unlike the doctors who prescribe naloxone and the police officers who administer it, pharmacists do not currently have immunity in the Delaware Code. He then invited Dave Humes to provide testimony on the bill and stated that questions from the other senators and additional public comment would follow. Dave Humes, an advocate with aTAcK Addiction provided background on the opioid crisis in Delaware and the history of use of naloxone in Delaware. He stated that expanding the use of naloxone is critical to saving lives and provided figures to demonstrate how many lives were saved in Delaware in the last year through the use of naloxone. He explained that the bill was created after the Delaware Division of Public Health spoke with their counterparts in the Commonwealth of Pennsylvania regarding their successful implementation of allowing naloxone to be sold in pharmacies. Pharmacists in Delaware requested immunity as a condition of their support. He emphasized that all other individuals involved in the purchase/administration of naloxone are guaranteed immunity under the 911 Good Samaritan bill. Julie Wenger, from DFIL, who represents CVS, Walgreens, Rite Aid, and other supermarkets with full-service pharmacies, said that the organizations that she represents fully support the bill. She said that they look at this bill as a “loophole closer.” She also shared a story of a situation in which a young Delawarean passed away of an overdose because her friend could not get access to naloxone quickly enough. Mike Malkiewicz, Co-Chair of the legislative committee for the Delaware Trial Lawyers Association (DTLA), stated that DTLA is opposed to the bill to remain consistent with their opposition to any bill that guarantees immunity. He mentioned that there hasn’t been an explanation as to why Walgreens, Rite Aid, and CVS have insisted on this protection for their pharmacists, which makes the organization question if the drug is actually as safe as it is advertised to be. He hoped that the State of Delaware would not bend to corporate interests. Senator Townsend stated that he did not remember DTLA’s opposition to immunity clauses during the debates surrounding the 911 Good Samaritan bill, but he appreciates the group’s thoroughness and consistency is opposing any immunity bill, even one granting attorneys immunity. However, he believes that due to the grave nature and consequences related to overdoses that a carve out in the association’s immunity objection might be warranted. He then asked if any members of the committee had questions related to the bill. Having none, he announced that he would circulate both SB 24 and SB 48 for signatures. HB 11 (Bentz) AN ACT TO AMEND TITLE 31 OF THE DELAWARE CODE RELATING TO ELIGIBILITY FOR PUBLIC ASSISTANCE SYNOPSIS - This Act removes the prohibition against receipt of Temporary Assistance for Needy Families (“TANF” also referred to by the name Aid for Families with Dependent Children or “AFDC”) funds by persons convicted of a drug felony, so long as that person is otherwise eligible or TANF assistance. Even though federal laws such as PRWORA passed during the War on Drugs frequently prohibited access to public assistance for persons with drug felonies, these laws also gave states flexibility in determining eligibility for food aid and cash assistance for families with children when applicants had a criminal conviction.