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TMA Position: Support– Part of TMA Legislative Package
Bill Summary: This bill prohibits advanced practice nurses and physician assistants from performing any invasive procedure involving the spine, spinal cord, sympathetic nerves or block of major peripheral nerves in a setting that is not a licensed facility unless under the direct supervision of a licensed physician who is actively practicing spinal injections and has current privileges to do so at a licensed facility. "Direct supervision" is defined as being physically present in the same building as the advanced practice nurse or physician assistant at the time the invasive procedure is performed. The supervising physician who violates this bill is subject to disciplinary action by the physician's licensure board including civil penalties of up to $1,000 per violation.
Bill Status: Off Notice
Senator Randy McNally put the bill in General Subcommittee this week after we could not get enough votes in the Senate General Welfare Committee to move the bill forward. This action effectively kills the bill for this session.
Three longtime TMA friends in the Senate would not make a commitment to support the bill which forced TMA lobbyists to assume they were “no” votes. Senator Diane Black sought a way to find compromise language. However, after TMA did propose some compromise language that we could support and her staff initially told us it seemed to be acceptable early on, we were notified just before the committee was scheduled to meet that she, in fact, would not accept the amendment. We believe in the intervening time that she had heard back that the CRNA’s who opposed the compromise.
Sen. Doug Henry claimed to be neutral on the bill but admitted in Committee that “he has only opposed TMA once in his career,” a statement that strongly implied this issue would be the second time. He kept requesting to hear from opponents of the legislation. That led TMA to realize that he too would not be willing to support the legislation due primarily, we believe, to his professional relationship with the Dean of Nursing at Vanderbilt.
Sen. Roy Herron, while uncommitted, seemed to be the only one of the three who may have been truly on the fence. He never gave us any indication one way or the other that he could support, or would oppose, the legislation but wanted to hear the testimony. After the committee hearing where testimony was presented, he still would not commit. Without knowing where Sen. Herron was, Sen. McNally was not ready to move forward.
Without one of these three commitments, there was no possibility of getting the bill out of Committee. It takes five votes. In the Senate, those who had agreed to support the TMA bill were the sponsor, Sen. Randy McNally, Committee Chairman Rusty Crowe, Senator Bo Watson, and Sen. Ophelia Ford. Senator Doug Overbey had always been a firm “no” vote and Senator Beverly Marrero , who for weeks had told TMA staff that she would support the legislation, changed her mind after hearing the testimony- we don’t really know what she heard.
On the House side, the Subcommittee members voted as follows (those who voted “Yes” supported the TMA position):
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Yes
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No
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No
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Yes
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Yes (sponsor)
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No
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Yes
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Yes
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No
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Yes
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Pass
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Yes
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Yes
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Yes
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We hope you will let supporters of the bill in both the House and the Senate know how much you appreciate their support of the TMA legislation and their commitment to ensuring that patients have access to safe and effective health care. These people put a lot on the line in support of organized medicine and the constituents they represent and need to know they are appreciated.
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