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House | June 8, 2016 | Chamber | Judiciary I

Full MP3 Audio File

[BLANK_AUDIO] [BLANK_AUDIO] [BLANK-AUDIO] [BLANK-AUDIO] [BLANK-AUDIO] [BLANK-AUDIO] [BLANK-AUDIO] [BLANK-AUDIO] [BLANK-AUDIO] [BLANK_AUDIO] [BLANK_AUDIO] [BLANK_AUDIO] [BLANK_AUDIO] [SOUND] I'd like to call the Judiciary1 to order. There are a number of people here and we appreciate you coming, we have with us house pages, wells arms, would you stand up and tell us where you go to school and what grade you're in. >> I got a ten year [INAUDIBLE] >> Jeff Blunt. >> [INAUDIBLE] >> Where do you live? >> [INAUDIBLE] >> Alicia Thomas. >> [INAUDIBLE] >> We'd like to have you here, We also have the sergeant-at-arms protect from the unruly crowds,

Barry Moore, Will Clocker, and Bill Wright, thank you for being here. The first thing we're gonna take up is a resolution house joint resolution 1147 which is to confirm the honorable James Gale to a superior court he's the governor's nomination and I wanna recognize Mr. Marion Warren, Judge Marion Warren who is an expert on the judiciary he's had a [INAUDIBLE] and he's gonna speak on behalf of Judge Gale. >> [BLANK_AUDIO] Thank you Mr. Chairman May name is Marion Warren I'm the director of the North Carolina Administrative office of the court, Mr. Chairman, members plus the audience I bring greetings on behalf of the chief Justice of the North Carolina Supreme Court, the Honorable Matt Martin. In doing so I stand before you to introduce a man who if you were in the business community you would need no introduction but I'll also do so not only [INAUDIBLE] Mr. Chair to the nomination and confirmation in great appreciation to the governor [INAUDIBLE] In putting forth this nomination but to lend the Chief Justice's support to the confirmation of Judge Gail to the North Carolina business court for an additional term. Judge Gail came from, as most of us know in experience in our own lives adverse [INAUDIBLE] He overcame those adverse circumstances to attend Florida Presbyterian University College. After which he spent two years since understanding the business world, assessing risks and working as an insurance adjuster. After doing that for two years, he then attended the University of- >> [COUGH] >> Georgia. Where after completing his law degree studies, after three years he graduated- >> [NOISE] >> With highest honors as they had his perimeter Law Review with 58 decapa/g. Not bad for a boy from Alabama, they came up the hard way. The next thing he did was distinguish himself in Practice of Law. After having a longer distinguished career with one of the largest Law Firms in the state. And having been a Managing Partner of the same, he then accepted the call to become a Business Court Judge. He did so stepping into the large shoes being left in the void of no longer having Judge VInteniel/g to be a leader of the business court. But I stand here today, after one year of being the direct for the Chief Justice to the Administrated portion of the Judicial Branch, to tell you that there is no more qualified individual to lead the Business Court, as our current Chief Business Court Judge Jim Gale. I tell you that he has made a marked improvement in the efficiency of the court. In doing so, he has become an ambassador across the nation, for not only the North Carolina Business Court, but the Business Court Model. Unlike Delaware where that's merely a court of equity or chancellery. We have a proud judge here. [BLANK_AUDIO] We have a Trial Judge here. We have a Superior Court Judge that's handling the most difficult cases in the most arduous of circumstances and bringing forth justice, and rendering opinions that are now cited across the nation. In our earlier conversation with the chairman not only does he decide cases but he demonstrates leadership. I'll cite to you the North Carolina seed law case in which he rendered an opinion but then recommended to the highest court of the state to look at this. That's demonstrated leadership and that's what we need here in this state for our business course to take a 20 year, the one generation mark 1996 when it got started to 2016 take it to the next step the next level. And I will tell you with his leadership he's providing the template that we will use to help modernize and increase the efficiency of the judicial branch. Mr. Chairman I ask for a positive response on behalf of the chief justice and my personal recommendation of my friend Judge Jim Gale. Thank you for [CROSSTALK] >> We're delighted to have you here and would you be willing to answer any questions that member might have >> So most certainly, with the understanding that I can't comment on pending cases, other than that I'd be glad to answer any question anybody might have, and I very much appreciate the opportunity to be here. >> Any questions by anyone? If not do I hear a motion, Representative Barns >> A motion for favorable report, house joint resolution [INAUDIBLE] >> Further discussion, if not all in favor let it be know by saying aye, >> Aye.

>> Opposed no, aye have it Judge Gale thank for being here. Second bill is senate bill 734 State wide standing order, is anyone here to explain the bill? Miss Darden, will you explain the bill. You wanna do it? [BLANK_AUDIO] >> Thank you chairman Daughtry. I'm Randal Williams, the state health director and deputy secretary of health and human services. >> Senator Pate, he's also here. Do you wanna explain the bill sir? >> [INAUDIBLE] Senator Pate. >> Oh what an entrance. >> [LAUGH] >> Thank you Mr. Chair. Always welcome the senate and anything we do when you walk in the door you're welcome and you're able to get your business done- >> All right. >> [LAUGH] >> Just pass the bill. We've accepted the PCS I take it, Mr. chair. >> Representative Ark moves to that we have the PCS [UNKNOWN] unfavorable as to the original, favorable as to the PCS. All in favor let it be known by saying aye. >> Aye. >> Opposed no and the ayes have it. >> Thank you Mr. chairman. This bill is very important, we've bee following it along now ever since the beginning of the session. We are losing a lot of people to needless death by opioid overdoses. And some people just can not resist these painkillers, they use them for other purposes and I think we've come up, I won't say we've come up with the solution but Dr. Randal Williams who is our health director over in the department has come up with what I think is a very unique idea. Only two other states have adopted language liken this, and I would like with your permission to turn it over to Dr. Williams and let him explain this very, very important bill and live saving bill. >> Yes sir Senator >> Thank you chairman and thank you senator Pate I'm here today as result of listening to a lot people, secretary [INAUDIBLE] and I were down in Husky and Pit county on Friday and about two weeks I was up in [INAUDIBLE] and watauga. And no matter where we go, we go the legislature or working with our colleagues in the North Carolina medical society, and North Carolina medical board, the North Carolina Pharmacy board which we have done, collaborate with this we come to realization that probably the number one public health crisis in North Carolina right now if not the United States Is opioid overdose problem, we're losing more especially young people to opioid, to either car accidents or guns now in North Carolina. When I go out to the medical examiner which we over see and I work out there and watch autopsies, the last two I have been for very young people with overdoses. And in many situation now, as I'm sure you well aware that we have 91,000 prescription for opioid out there for every 100,000 North Carolinian. And so the Governor and the governor's task force is addressing that, but we're coming to you today with a very bold initiative our department is been around since 1877 And this is the first time we've ever done this we'll be the third state to do it we recognize nationally as [INAUDIBLE] space. But that is a bill that anyone in North Carolina can go into a pharmacy that chooses to participate we hope they all will and our friends at North Carolina medical board are doing everything they can to encourage that and in response to certain questions which is gonna be a simple one as do you have a loved one or a neighbor or a friend, or someone you're worried about that will get a prescription for [INAUDIBLE] usually intranasally you just squeeze it in the nose you don't inject it and [INAUDIBLE] will literally be life saving. Last year for the first time ever we had more [INAUDIBLE] than we did deaths one out of four of our autopsy in the state medical examiner system were drug overdoses it's literally overwhelming our system there. And if you thing about it I just don't know what could be more gratifying than to be in a situation we've seen this with our first responders we certainly [INAUDIBLE] around the state now there's normally someone in front of you whose lifeless and other than this drug they are going to die, but if you have that drug literally in 10 minutes they'll come back to life and so Example it's just like being a lifeguard, if your a lifeguard at the beach and somebody is drowning you don't ask any questions, you're just gonna save their life.

And once you save their life then you have to do all other things, but if you don't save their life then everything else is for is for [INAUDIBLE]. So I greatly appreciate your considerations, I greatly appreciate the She used to come talk with you and happy to answer any questions. >> Are there any question Representative [UNKNOWN]. >> Thank you [UNKNOWN] presentation and your correct decision, a very serious problem, very [UNKNOWN] problem that used be addressed. But something you do just said there kind of end Presenation there was [UNKNOWN] person's life and [UNKNOWN]. I'm just like a couple of question is about once this person's life and say what is the [UNKNOWN] in the story. Does that part of the story respected him a[UNKNOWN] get him some kind of help. Is there when a family member or co workers some use this [UNKNOWN] they have to report that they have used it, is there any [UNKNOWN] on the number of times that they [UNKNOWN] and I don't mean that [UNKNOWN]. >> [UNKNOWN] >> If you have to save 12 times I understand but it is any follow up but this is recurring problem that this person's life having to be [UNKNOWN] 3 months, this trigger something else and the system made we made it stop. saving our life and saving [INAUDIBLE] by getting them off of the marijuana or whatever it is that they're [INAUDIBLE]. >> Representative [INAUDIBLE] it's actually a great question because we know from our first responders that to your point that for many people this is a sentinel event. They were dead and so that is a high motivator for them to get therapy but if you do not institute the treatment we don't have data yet from this particular policy because we're only the third state to do it it just started in Pennsylvania in October we know from our first responders that if you do not institute the program there is a high degree recivitsm. They will just do this again. So one of the things we hope will come out of this bill is an incredible awareness of the need which you had this incredibly sentinel event and again somebody has to give it to you, a loved one or a coworker, that that is going to in time shared to be a great motivator for getting people into therapy. >> Follow up. If you don't mind you're holding that microphone a little too close. >> Thank you. >> Thank you and that's a good point, as retired law enforcement officer I've dealt with drug addicts all my life, it's very, very hard to get them off of that, and by them being dead and being [INAUDIBLE] it's going be of a menace thing in their life for a couple of days or week until that urge to get high again is there and then like you said is going to be a continuing cycle so I hope that the day we get that I'd like to see some kind of reporting process and that's some way of keeping up with this, and not necessarily we're trying to track people's private lives if you consider drug use products. So we will have some reliable data as to what's going, not just in that we're saving a life but now that we have said it like you said, what's the rest of the story, what are we gonna do now? >> Absolutely, and the staff is here, and we'll pass it along, and we'll do that again we consider a thought leader in the United States, of the 50 states and we would think that would have great utility for other people who come behind us, but appreciate your point is well made. >> Representative Martin. >>Thank you Mr. Chair. My understanding now under current law, a doctor can prescribe this either to the addict, or to someone in a position to help the addict. And this bill would enable you to give a standing order, I'm unclear on what exactly a standing order is what [INAUDIBLE] to that. >> Thank you representative Martin. Again the purpose of this- >> [INAUDIBLE] >> Okay yeah down here. >> Right there. >> Thank you, is that we've had such success with our first respondents that we think if we can push this out to anybody who can go get. And the barriers now are one you have to go to a doctor. And so many people don't wanna pay the money or are reluctant to go to a doctor and ask for a drug that's gonna be used on somebody else. Many doctors a little bit reluctant to say if you come in and you want to get the drug for your brother or a friend, there a little reluctant on that. So we wanna remove those barriers especially in our rural areas where there's might not be as easy access. So the real boldness of this bill is that you just go in and just identify that that's your concern,

the pharmacist will ask you some questions and if you, there about 10 questions. And of them can be just a simple as again is there is someone your concerned about, if you think this could help them with? Then you able to get it anonymously because we think that's one reason we're having so many deaths if people won't avail themselves of the therapy that is so [INAUDIBLE]. >> Follow up. Thank you Mr. Chair, so just to make sure I get it straight if this passes, you plan to issue such standing order. That standing order will enable- >> [INAUDIBLE] to go into the pharmacist and to enable the pharmacist to go ahead and distribute that medication. >> It would but I think in many cases your gonna see people who know the addict go in more. You gonna see family members, the estimates are that one out of four families in the United States has effected this in some way, maybe not within the family but with a neighbor or a coworker or someone. So what we're hoping is that they will avail themselves of that opportunity and have it on standby just in case they need it. >> Followup and a question on a different matter Mr. chair. On page 2 at the end the provision that exempts the director from any civil or criminal liability. Is that an expansion or clarification of the liability that they would already poses as an employee of the government? >> Miss Churchill will you answer that? >> It would be in addition to that specifically [INAUDIBLE] change to right now any practitioner is in the inference of a liability if the complied with the provisions on page [INAUDIBLE] 15 to 30 and this has given the state health director the same authority So it also [UNKNOWN] the health director [INAUDIBLE] in the same manner. >> Followup? >> Thank you Mr. chair. So in what way does that redemption from liability immunity from liability differ from the liability the director already has? >> [INAUDIBLE] if someone is harmed and [INAUDIBLE] then there could potentially be liability for the same. This would mean if the health director has acted in accordance with stage [INAUDIBLE] 15 through 30 [INAUDIBLE] There is no [INAUDIBLE] for health records [INAUDIBLE]. >> Representative Parr/g. >> My question is, I certainly understand the mercy aspect in what we're doing and for that I am in favor of the bill. [INAUDIBLE] My concern is along the The line where representative McNeil expressed and that it's morbid and it's [UNKNOWN] in the sense that if this is available on a broader basis will it actually increase because they've got their immunity [INAUDIBLE] So my question is, and I think you answered it a little bit earlier but there's no data on the expansion or contraction, this is more of a mercy issue. Trying to keep them alive so that they can deal with and get off the problem. But my fear is that this may increase abuse, in fact in severity. What programs are we gonna put in place to address those types of things? >> Yes sir. And we've looked at that. There always is a concern of what we call a moral hazard, which is, there are no consequences to your actions and that may promote your actions. But when we looked at this with new [UNKNOWN] again in other situations we don't see that to be true. It's a hard study to do, as you can imagine, so some of it is more observational than randomized, double blinded study. But we feel very good that from an observational study this has not been shown in places where it's been implemented to increase drug use. So we feel good about that, but again think back to Representative MC Neal's point, we all recognize that this is a lifesaving measure unless you go from there the nature of addiction is you're just having [UNKNOWN] so that the next focus is once you save that life, we've got put our emphasis on treating their addiction. >> So my concern too was the I guess is the magnitude [INAUDIBLE] maybe someone was fearful over drug overdose and would not use much drugs but now that this is available, the fact that [INAUDIBLE] if pushed down below [INAUDIBLE] will you be open to studies and [INAUDIBLE] that's not part of this but I'm very much concerned

that you follow up with these tracking mechanisms. [INAUDIBLE] >> Well clearly what I'll take from this meeting is [UNKNOWN] will see followup um if you don't see this it's just a one off that we do this and don't look at it . Again to your point one of the big issues we're seeing now is the use of fentanyl which is 20 times more potent than heroine, and again it kinda breaks your heart when you go to the medical examiner we've had more than I think 35 cases this year of people who thought they were getting heroine but they got fentanyl, and if you get fentanyl it's all over, I mean they're dead in two minutes. Now if you Narcan you could bring them back to life but to your point the mission create to this, the outcomes that just become progressively worse or just increasing and so we feel like we've got to do something to try to stop that. >> Representative Robinson >> Along the same lines, the antagonist, I think he said [INAUDIBLE] >> Yes sir. >> Can it be used in subsequent instances. >> Yes sir the way the drug works, it works on opioid receptors in the brains so it just knocks off the opioid, it doesn't hurt you if your're not on opioids if you get it and the person really wasn't having an overdose it doesn't hurt them. There are two samples per kit so you could use it again and three minutes if it's not enough to work the first time. And it works as many times as you would need it but again Representative McNeil the whole point is once you have this sentinel event where you Where you died and somebody had to bring you back to life we're hoping that will trigger a move to therapy. >> Follow up? >> Yes one other. Does that create any kind of dependency? >> No sir. >> Representative Steinburg. >> Yes thank you Mr. Chairman. I have a couple Couple of questions, comment first and that is that I understand the concerns of some of my colleagues but I commend you and those folks in research who have looked at this and who are absolutely focused on saving lives. I mean that's paramount regardless of The personal responsibility equation always comes into play. If we do this someone going to abuse it and use more drugs and so on and so forth. That's not our cause. I mean our call is and the call of certainly people in medicine is to save the life when they have the opportunity to save the life so Together and then I'll ask this question, I think it's already been answered, a question that Representative Robinson had and that is if this got into the wrong hands or somebody abused this particular drug, I mean just took it, thought it Thought it was something else, is there any chance that there will be any negative impact at all on that individual? >> No sir, again it's a benign drug if you're not on opioids, it just knocks off the opioids off the receptor. And again intuitively we all know anything you do has a risk and benefit so you can't do Anything and certainly in medicine we recognize that. For this particular drug the only real risk is that rarely its been associated in people with heart condition with some pulmonary oedema and ventricular [INAUDIBLE] but again and those people if you hadn't given them the drug they would have died. And then the other reaction Is that some people when they come out with their overdose they'll be very agitated and have certain bodily actions to that but again we always go back to that if we didn't use the drug they would pass away. So we feel like we can deal with those consequences once they develop. Follow-up? >> One quick follow-up. Is there any study that's been done that would indicate the level of success with the administration of this drug and I understand they would be dying if they wouldn't have it but How many times doesn't it work? >> Might defer to Allen/g. It's highly successful. Allen/g do you have a number for that, Allen/g Delapina/g? >> The only issue that's come up is that Sentinol/g has come on to the market, per se, it's more potent. So the Dosage of the new formulation of Narcan on the market is a higher dosage. So we've had the example of folks having to use multiple doses of Naloxone to do a save because the tolerance of the individual and the dosage of the opioid has become higher.

We got examples like in Wilmington area where Where we've got a particularly bad sentinel problem. >> Yeah you sure do. It's terrible. >> Any [INAUDIBLE] questions? Thank you. >> Thank you. >> Representative Neal. >> Thank you. I just have two and I'll just go ahead and ask both of them if I may. On page two starting on line four and five it says Of the use of reasonable care in administering the drug shall include the receipt of basic instruction and information on how to administer the opioid antagonist. And I was just wondering how that basic instruction is going to be provided. >> Yes sir. >> And my second part of my question is what is the cost [INAUDIBLE] who's paying for it? >> Yes sir again that for the cost what we're saying is there are three forms but we look at one most common uses the intranasal which is you just literally squat it in the nose, you can do the injection over the counter it's about $50 to $75 many people will pay for it out of pocket, it is covered by medicaid and the price there is $110 that we supply but we Look at the fiscal impact of this we actually anticipate we will save money on this even though we're making it more available because it's the third drug that's gone up to about $700 to $3700 you may have heard reports on that and we don't cover that through this act so when we Our fiscal analysis we actually think that we'll save money on this. >> Because of the time Representative Robinson moves to the bill the committee substitute senate bill 734 in favor to a reasonable bill [INAUDIBLE] Favor the motion let them say aye. >> Aye. >> Opposed no and the ayes have it, but there is a caucus that's going to meet there's a lot of people here who wanna speak on behalf of the next bill and I'll give you one minute per person to speak right now if you will. >> Thank you chairman Dandre. My name is Daniel Dose I'm with the North Carolina Justice Center, I'm also here on behalf of the North Carolina Second Chance Alliance. We have worked over the last year with the conference of DEAs to craft an expunction bill- >> Let the three women speak you wanted to speak they came along. >> [UNKOWN] and we think that it sort of protects community safety while expanding opportunities Get jobs and housing. Lynn Burk/g- >> Hello, everybody. I just wanna say something, I am an ex-offender myself. 20 years ago I went to prison and I didn't have an opportunity to get that expungement. But if I had, I believe honestly that I probably wouldn't have been in receipt of this, I wouldn't go back to prison because I Because I would have been able to find a job. It's very hard out here for anybody with a record, I don't care if you have one crime or a whole bunch to find a job. And I believe that this is an opportunity for people to get an expungement sooner, would help heal a lot of their families in this community and allow people to have hope to know that they they can change. And that the have, you know Support from the community to do that, so I just think it's very important. >> Anyone else? >> Good afternoon, my name is Laura Martin and I work here in Raleigh for a non profit called Step Up Ministry, we're a North Carolina non profit, we're home grown, and over the last 25 years we've helped thousands of people in this perk situation who have Who are searching for work, while they have a criminal background. I'd like to say I've met administrative assistants, truck drivers, lawyers, coaches, people that are vibrant parts of our community who also have convictions. And as a ministry that serves this population, we're here today to ask those of you who have the power and the authority Authority to make change to make it easier for people who would like an opportunity to support their families and to have economic community and participate here in our society to do somewhat equally so thank you for your time. >> Well thank you. Any one else? We have a [INAUDIBLE] well go ahead. >> Thank you Mr. Chair I'm Kimberly [INAUDIBLE] the Chief [INAUDIBLE] with the conference of the district attorney I'm here representing the conference also the director [INAUDIBLE] and to elect a district attorney Mr. [UNKNOWN] and [UNKNOWN] we support this bill, we feel like it's narrowly tailored and that It gives them extra benefit by giving people of the second chance and it allows us to have access to records that we don't currently have access to so we can better ensure that justice is served in our state. >> That's all the time we have we will not vote for the bill today but we will meet again i will be the first priority we'll vote

on. The meeting is adjourned thank you very much. [BLANK_AUDIO] [BLANK-AUDIO]