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House | March 25, 2015 | Committee Room | Health Committee Meeting

Full MP3 Audio File

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[SPEAKER CHANGES] Ladies and gentlemen at this time we will call this House Committee on Health to order. I'd like to thank our Sergeants-At-Arms who are here today. They are Young Bay, Bill Morris, and Jim Moran. Thank you gentlemen. We also have a couple of our pages that are with us today. If you would stand and be recognized when I call your name. We have Jaden Chees from Wake County, sponsored by Representative Gill, and Amy Clemens from Wake County, sponsored by Representative Stam. and I'm, where are you, are you here? Okay, there you are. We're glad to have you with us today and hope that you have a great week here at the General Assembly. Now ladies and gentlemen at this time, we'll-we'll start with our agenda. We're going to start with House Bill 286 and I will be presenting that bill. I'm going to ask Vice Chair Avila if she will come and take the chair and we'll start with House Bill 286. [SPEAKER CHANGES] You have the floor. [SPEAKER CHANGES] Well good afternoon again, ladies and gentlemen, Madam Chair. I am here to present House Bill 286, which is entitled Dental Hygienists Intra-Oral Local Anesthetics. And let me just start by assuring our members, at first glance this may seem like one of those scope of practice bills that legislators dread to hear. Let me start by saying that this has been worked out as an agreement between the North Carolina Dental Society, the North Carolina Dental Hygiene Association, the North Carolina Board of Examiners. I am not aware of any organized opposition to this bill. And just to, some of you probably know this, obviously this is an expansion of the scope of practice for the dental hygienists, but just as full disclosure, I am a dentist and a member of the North Carolina Dental Society. So maybe that gives you a little bit more comfort that the dentists and the dental society, the dental hygienists are in agreement about this. This, let me just start by telling you what the bill does. When you read Intra-Oral Local Anesthetic, let me just make sure that you understand what that means. Intra-Oral means in the mouth, and a local anesthetic is a medication that is applied, in layman's terms to get you numb. So those of you that have been to the dentist and had a procedure done and you were numb, you were applied a local anesthetic to do that. So what this act does is to authorize a properly trained dental hygienist who has completed the additional training that is required to administer the local anesthetic, in other words to give the injection in the mouth. It is only for those particular in the mouth, local anesthetic injections. I would just emphasize the importance of the training that is involved. If a dental hygienist does that, they will have received the training to administer it just like a dentist would have and they would be subject to the annual continuing education requirements required to continue to do that. I would also like to emphasize that this is done in 45 states, so this is not something new. But it is, to my knowledge, it is not controversial, there is no organized opposition, and Madam Chair, I would stand very ready to answer any questions and at the point, I would as a member be happy to offer a motion at the appropriate time. [SPEAKER CHANGES] Are there any questions? Representative Brown. [SPEAKER CHANGES] Thank you Madam Chair. Just a quick question as to the

The reasons why the dentists might be in favor of this is this is really a timesaver thing because I know that he has to come in there, administer the injection, and generally has to let you have time for that anesthetic to start working, and they usually leave, in my case, and then come back. Is that why this is wanted by them? [SPEAKER CHANGES] Exactly. It’s the ability to delegate that procedure to another healthcare professional that has been properly trained and is under the direct supervision of the dentist. Let’s make that clear, that when dental hygienists practice, they are under what is defined as the direct supervision of a licensed dentist, which means the licensed dentist is on the premises and has full control and direction over the procedure, so this would simply allow you as the patient not to have to wait for the dentist to come into the room. The hygienist could do it as long as the dentist authorized it to be done. [SPEAKER CHANGES] Madam Chairman? [SPEAKER CHANGES] Representative… Follow-up? Representative Dobson. [SPEAKER CHANGES] Thank you, Madam Chair. Two questions. One, on the training, if I may, would that be part of the curriculum as just an extra part of the curriculum that they receive as part of their dental hygienist degree, or would that be continuing education that they would do later? [SPEAKER CHANGES] It would be both, and so they would receive the training, but they would have to complete continuing education in order to be able to continue to be certified to do this. [SPEAKER CHANGES] Follow-up? [SPEAKER CHANGES] Follow-up. [SPEAKER CHANGES] So we would be adding an additional part to the curriculum, working with the community colleges or the four-year institutions, wherever they may receive their training, to add this new procedure? Because this is a pretty broad new authority I think, so how would that…? Do we know the answer to that yet, how that would work, implementing this new part of the curriculum? [SPEAKER CHANGES] I can speak to that in general, and I meant to say also that we do have a delegation here from the North Carolina Dental Society. We have representation from the Hygiene Society, from the North Carolina, Board of Examiners, so if we need to get into more specifics, I would be happy to defer and they are happy to speak. I think to answer your question, or to try to answer it, they currently would be receiving some form of training regarding local anesthetics and just the need for the medical emergencies in the office, the things that might would go with that, but under this training, they would actually receive the same type training that a dentist might receive – how to administer it; what you need to know about the human anatomy and where to administer it and things like that; what might be the side effects if there were problems, if a patient had some kind of a reaction to the local anesthetic. So they are currently receiving that to a degree, but they would receive the same type training that a dentist would receive, and they would continue that training with continuing ed., and if that’s not sufficient, I would be happy to defer, but that is my explanation for that. [SPEAKER CHANGES] Follow-up. [SPEAKER CHANGES] Thank you. One last follow-up. I appreciate that response, and maybe just a comment then a rhetorical question, if I may. This is broad authority. To me, this is a big new change to policy to implement this because I’ve been to the dentist for this type of thing, and it’s not what I would call minor. However, I think the fact that you’re the one presenting this gives it credibility to me, as a dentist, so I appreciate you bringing it forward, so I guess I’m asking rhetorically, you’re comfortable with giving this broad new authority to the dental hygienists within the dentist’s office? [SPEAKER CHANGES] That’s an excellent question, and I appreciate that. I would not be comfortable… I do want to put the emphasis on that there does need to be proper training for anyone, whether it’s any kind of a doctor, any kind of a nurse, any… whatever. As long as we are giving that training, and as long as the hygienist is under the direct supervision of a licensed dentist in this state, then yes, I would be comfortable with that, and the other dentists that I have talked to through the dental community would be comfortable as well. [SPEAKER CHANGES] Thank you, Madam Chair. [SPEAKER CHANGES] And I would just add that I have not had anyone contact me in opposition to the bill, and I do know a few dentists.

say. [SPEAKER CHANGES] Rep. Lucas. [SPEAKER CHANGES] Thank you, Madam Chair. Rep. Jones, to your right, thank you, sir. I have no problem with the bill and I know that you have many of the stakeholders, many of them present here who concur with this bill. The question I have is do you know of anybody who might be in the audience who may have a reason to oppose the bill? [SPEAKER CHANGES] Thank you for that question, Rep. Lucas, and I do not. [SPEAKER CHANGES] Thank you. One quick followup. [SPEAKER CHANGES] Followup. [SPEAKER CHANGES] I noticed that you did have in my packet of materials here, an amendment. DO you plan to offer the amendment? [SPEAKER CHANGES] Yes, sir, that’s my next order. [SPEAKER CHANGES] Thank you. And it is a technical amendment and that’s why I haven’t brought it forward before. I wanted to go ahead and take the questions. We have a very technical amendment that will add, but [SPEAKER CHANGES] Rep. Bishop. [SPEAKER CHANGES] Thank you, Madam Chairman. Rep. Jones, following up a couple of other representatives questions, you said that 47 other states do this. It’s obviously a change, it hasn’t been this way all along. Has there been some sort of change? Could you offer some perspective on whether there’s a new idea about the significance of this or why it’s now something that seems to be appropriate to be done. Or whether these other 47 states that allow it, is it an innovation? Why this change now? Why hasn't it always been this way? [SPEAKER CHANGES] Okay, well, there are 45 states that offer it and my only understanding is that there has been discussion among the stakeholder groups for some time about how this would be implemented, when it would be implemented. I don’t frankly know all the details. All I know is that the stakeholders have come together and decided that this is a good time and everyone is comfortable going forward with this. [SPEAKER CHANGES] Okay. [SPEAKER CHANGES] And as I said earlier, it’s no minor change. Nobody is flippant about it. Anytime you give an injection, as a doctor, I give injections, there’s always the opportunity that somebody out there could have an allergy, a problem, so please when I--I’m not saying this is a minor or flippant issue. It’s something that I think has been well thought out, well discussed within the providers community and they have agreement on it. So we’re bringing it forward at this time. [SPEAKER CHANGES] Followup? [SPEAKER CHANGES] Followup. [SPEAKER CHANGES] The training that hygienists will have to do this, will it be the equivalent of what the dentist has in terms of practical experience, i.e. the amount of practice they’ve had doing it before they’re in a private practice environment? [SPEAKER CHANGES] Yes, sir, that is exactly what I’m told. And just as a little aside, when we learned to do these things, the first people we’d do them on are each other, IVs and internal injections, so that kind of puts it in some perspective. [SPEAKER CHANGES] Sounds fine. Thank you, Madam Chairman. [SPEAKER CHANGES] Rep. Jones, staff has asked to expand a little bit on the question that Rep. Bishop had. [SPEAKER CHANGES] Thank you, Madam Chair. With regards to the timeframes that the states have moved to allowing this performance of the anesthesia by the dental hygienists, it actually dates back to as early as 1971 and several states had added it in the ‘80s, then another glob in the ‘90s, some more in the early 2000s, so it’s been a progression into those 45 states. [SPEAKER CHANGES] Thank you. [SPEAKER CHANGES] Rep. Dollar. [SPEAKER CHANGES] Thank you, Madam Chair and Rep. Jones. And you may have said this, I apologize for walking in late, but you may have said this prior to me walking in, but just to confirm it and I think just based on the questions...this bill, as I understand it, it is fully supported by the Dental Society, is that correct? [SPEAKER CHANGES] Yes, sir. [SPEAKER CHANGES] Okay, and all other various and a sundry professionals, bodies and associations that would otherwise be engaged, [SPEAKER CHANGES] The NC Dental Hygiene Association, The NC Board of Examiners. I am not aware of any dental or medical related organization that is against the bill. [SPEAKER CHANGES] Well, Madam Chair, I understand you have a technical amendment, but once that’s disposed of at the appropriate time, if a motion is needed, I’d be happy to offer it. [SPEAKER CHANGES] I think Rep. Jones was going to make a motion, but would you like to introduce your amendment at this time? [SPEAKER CHANGES] Yes, Ma’am. You have an amendment before you. It is an absolutely technical amendment. It makes no changes to the bill. You will note that the phrase, GS90-221A is replaced by GS90-2212A and staff just tell me that that is their

any numbering system. There’s just the two being put in there, so it is a purely technical change and, Madam Chair, if I may, I would move that the amendment be approved. [SPEAKER CHANGES] So moved. All those in favor, signal by saying Aye. [SPEAKER CHANGES] Aye. [SPEAKER CHANGES] All those opposed. Motion carries, thank you. Rep. Carney, you had a question? [SPEAKER CHANGES] Yes, thank you. Will a doctor or a dentist make the determination whether he or she will administer the anesthesia or the hygienist. [SPEAKER CHANGES] Yes, ma’am. [SPEAKER CHANGES] And I’m asking that in relevance to patients who have unusual medical histories, and the dentist would know that coming in. He or she would make that determination, whether they administer or the hygienist. [SPEAKER CHANGES] Yes, ma’am. That would fall under the direct supervision, so the procedure itself would continue to be done under the direction and control of the licensed dentist, so absolutely. The dentist could make that determination. [SPEAKER CHANGES] A followup, Madam Chairman? [SPEAKER CHANGES] Followup. [SPEAKER CHANGES] Will the patient be given the opportunity to determine whether they want the dentist or the hygienist? Will they have that option to determine who administers their anesthesia? This is a drastic change and so people coming in the office might wait, I don’t want a hygienist -- until people get comfortable with this, will they have that option? [SPEAKER CHANGES] As a dentist, I can’t imagine that a dentist office would tell a patient that you have no choice but that the hygienist do it and not the dentist. I don’t know that the law would mandate that. I think that’s one of those things that any time a patient goes into an office, they have control over the treatment that will be rendered and how it will be rendered. And the choice is always if it is not to their satisfaction, they’ll leave and go somewhere else. So the law is mandating that, however, as a doctor, I can’t imagine that a patient would come to my office and ask if I would do it...and I would say absolutely not, you’re gonna have it done by the hygienist or we’re not gonna see you. If so, that would be an office policy and the patient goes somewhere else, I guess. [SPEAKER CHANGES] Are there any additional questions from members of the committee? If not, Rep. [Dollar?], recognize you for a motion. [SPEAKER CHANGES] Chair move for an amendment be rolled into a new proposed committee substitute for House Bill 286 to be given a favorable report, unfavorable as to the original bill. [SPEAKER CHANGES] Thank you, Rep. [Dollar?]. Having heard the motion, all members in favor, please signify by saying Aye. [SPEAKER CHANGES] Aye. [SPEAKER CHANGES] All those opposed, no. The motion carries. Thank you very much. [SPEAKER CHANGES] Thank you, Madam Chair, members of the committee. Rep. Avila, thank you for taking the chair. And the next bill before us is House Bill 267, amend Respiratory Care Act. And Rep. Goodman, you’re recognized to present your bill. [SPEAKER CHANGES] Thank you, Mr. Chair. Ladies and gentlemen, this bill is one that we had in the last session in the House that passed with only one no vote. Unfortunately, it did not get through the senate, so this is essentially the same bill that we had before, but what it does, it makes changes and amends the Respiratory Care Act. If I could just go over it briefly, highlight it, and then if you have questions we’ll go into those. But it makes changes in Section 1 of the definition of the practice of respiratory care. In Section 2 it specifics the power of the NC Respiratory Care Board to conduct investigations, subpoena individuals and records, and take actions to discipline its licensees. It also includes the authority to designate one or more of its employees to issue and serve subpoenas and other papers on the board’s behalf. In Section 3 it outlines licensure requirements. In Section 4 it makes amendments to the provisional license of respiratory care practitioners. In Section 5 it adds to the limitations

The Board may place on a licensee, including assessment of monetary penalty, cost, or both. The Board may take actions on a licensee or applicant if any of the, there's a list of things that will allow the Board to take actions. You can read those for yourself. Section 5 makes changes allowing the Board to deny an initial application for a license without a hearing if the applicant fails to submit a complete application showing the individual has met the education and entry-level credential requirements. Section 5 also contains provisions allowing a licensee to voluntarily relinquish his or her license. Section 6 specifies that it is unlawful to hold oneself out to the public, advertise or represent in any manner that an individual is authorized to practice respiratory care without a license. Section 7 is a new section creating immunity from civil liability for any person or entity acting in good faith, without malice or fraud, for reporting, investigating, assessing, monitoring, or providing a medical expert opinion to the Board regarding a violation of the Respiratory Care Act. Section 8 adds a list of individuals to whom the Act does not apply. Section 9 provides new educational requirements. And Section 10 repeals language dealing with temporary licenses. We have Dr. Bill Croft, the Executive Director of the North Carolina Respiratory Care Board, here to answer any questions. Before we do that, though, I do have one technical amendment. They referenced the wrong statutory thing wrong. On Page 6, Line 32, we need to delete the phrase 90-633 and add 90-663 instead. [SPEAKER CHANGES] Representative Goodman, you are recognized to bring forth your amendment. Is that a motion? [SPEAKER CHANGES] I move for the amendment. [SPEAKER CHANGES] Is there any discussion on the Goodman Amendment? If not, all in favor signify by saying aye. [SPEAKER CHANGES] Aye. [SPEAKER CHANGES] All opposed, no. The ayes have it. We're back on the bill. Representative Goodman, would you like for Dr. Croft to speak? [SPEAKER CHANGES] I would. [SPEAKER CHANGES] Dr. Croft, if you would, just recognize yourself in the microphone for the benefit of the record, and you're recognized. You need to hold down the button. [SPEAKER CHANGES] My name is Bill Croft. I'm the Executive Director of the North Carolina Respiratory Care Board. I'll be happy to take any questions. [SPEAKER CHANGES] Members of the Committee, I've seen a couple of hands. We'll start with Representative Waddell. [SPEAKER CHANGES] Thank you, Mr. Chair. Just for a motion ?? [SPEAKER CHANGES] Representative Earle? [SPEAKER CHANGES] Thank you. It seems like a lot of changes. I was trying to see if there's anybody that's opposed to any of this? Because it seems like a lot of changes. [SPEAKER CHANGES] I have heard no opposition. Perhaps Dr. Croft might want to address that? [SPEAKER CHANGES] We don't know of any opposition. We have met with the North Carolina respiratory care managers, the Hospital Association, North Carolina ?? which is the agency that handles home care, and we have not received any concerns in that regard. As a matter of fact, one of the changes that we made to the credentialing requirements actually came as a recommendation from our liaison to the Hospital Association. So we made that adjustment in our amendment to meet that requirement. [SPEAKER CHANGES] Representative Brown. [SPEAKER CHANGES] Thank you, Mr. Chair. Just one quick question. It seems as though you're creating a new board. Who oversees respiratory care now? [SPEAKER CHANGES] Dr. Croft. [SPEAKER CHANGES] The Board was established in 2000 when the original bill passed. We've been operating as an occupational licensing board officially since 2002 after the rules were established. I'm not sure... [SPEAKER CHANGES] Is there a follow-up? If not, Representative Bishop, you're recognized. [SPEAKER CHANGES] Thank you, Mr. Chairman. My question is, I noticed in particular the expansion of grounds to suspend, revoke, or refuse a license. Does this impose any additional work on the Board? And is there a fiscal impact associated with that? Is there a fiscal

Note on the bill. [SPEAKER CHANGES] Representative Goodman? [SPEAKER CHANGES] We have not done a fiscal note. I don't know of any fiscal impact that there would be, but if, again I'll defer to Dr. Croft if there are any. [SPEAKER CHANGES] We don't anticipate any additional costs that we already aren't incurring. Since the board's been established, we've actually investigated over 600 concerns and have actually addressed about 90% of those in some form of action. This actual amendment actually clarifies many of those reasons a little more clearly in the statute. [SPEAKER CHANGES] Okay, I have Representative Dobson. [SPEAKER CHANGES] Thank you mister chairman. Section 7 talks about creating a new section creating immunity from civil liability for any person or entity acting in good faith. Has there been occasions where that would have been needed and what's the rationale for that new section? [SPEAKER CHANGES] Representative Goodman. [SPEAKER CHANGES] I'll defer that again to Dr. Croft. [SPEAKER CHANGES] Dr. Croft? [SPEAKER CHANGES] The answer is yes. There has been a case with civil liability that was imposed to the board and to the previous executive director. I have our council here because I wasn't with the board at the time. He could probably expand a little bit more on that if you would like, if you want to ask him anything directly. [SPEAKER CHANGES] Representative Rayne Brown, did you have another question? [SPEAKER CHANGES] Thank you mister chair. Just a point of clarification. So we had a board that came in in 2002. We're just merely changing the name? Is that correct? [SPEAKER CHANGES] Representative Goodman? [SPEAKER CHANGES] No, we're not changing the name. I think, I believe if I'm correct, the board is the same, will stay the same. [SPEAKER CHANGES] That is correct. There's no change in name or. [SPEAKER CHANGES] Dr. Croft, you're recognized. [SPEAKER CHANGES] Sorry. There's no change in name. I think just what might be confusing this is it that is says amend the Respite care practice act, but, but that's not changing the name of the respite care board in any manner. [SPEAKER CHANGES] Representative Goodman, would you like for staff to weigh in? Do you need for them to clarify, or? They are willing to do that. [SPEAKER CHANGES] Thank you, mister chairman. [SPEAKER CHANGES] Ms. Johnson? [SPEAKER CHANGES] Representative Brown, if you look on page one, the definition's board, the North Carolina Respite Care board, there's no changes made there. The board's name is actually the same. The board essentially carries out the respitory care practice act, and that might be where some of the confusion's coming from, but the board's name is not changing. [SPEAKER CHANGES] Representative Brown, you have a follow up question? [SPEAKER CHANGES] I do, mister chair. I think my confusion was on the summary, where it says regulates the care of respitory care and creates the North Carolina Respitory Care Board. I think that's where my confusion came in. Thank you. [SPEAKER CHANGES] Thank you. Representative Yarborough? [SPEAKER CHANGES] Representative, where does the funding for this board come from? [SPEAKER CHANGES] I will defer again to my expert in the back. [SPEAKER CHANGES] Dr. Croft? [SPEAKER CHANGES] As required by the statutory requirement when we originally established the board, all of the funds that we collect through licensing applications and licensing renewals each year as well as disciplinary costs are collected by the board, and then that's how we support the board's fundamental financial stability. And we go through an audit each year and we've submitted our latest audit this year with no concerns from the state auditors. [SPEAKER CHANGES] Representative Bishop, you're recognized. [SPEAKER CHANGES] What is the current licensing annual fee, if there is one? Is that changed in here, and, and have there been increases in it since the board's creation? [SPEAKER CHANGES] Representative Goodman, would you like for Dr. Croft to address that? [SPEAKER CHANGES] I would, thank you mister chair. [SPEAKER CHANGES] Dr. Croft? Can you answer that? [SPEAKER CHANGES] Yes I can. Just to make sure I'm clear, you're asking what the annual renewal fees or the initial fees? [SPEAKER CHANGES] I guess I'm interested, well, if you'd address both I'd appreciate it. [SPEAKER CHANGES] Okay. The initial fee for licensing is $175. The renewals are yearly at $75, and that's been that way, I think, since about 2008. [SPEAKER CHANGES] Follow up? [SPEAKER CHANGES] Follow up. [SPEAKER CHANGES] And no change in this legislation? I didn't catch that. Is there any change in the fees in this particular bill? [SPEAKER CHANGES] Dr. Croft is saying no. [SPEAKER CHANGES] Follow up, mister chairman? [SPEAKER CHANGES] Follow up. [SPEAKER CHANGES] Back on the question of the, what looks like sort of a whistle blower provision, this immunity from civil liability. Is this common in other occupational licensing board statutes? [SPEAKER CHANGES] Croft? [SPEAKER CHANGES] I'd like to defer to staff there. [SPEAKER CHANGES] Staff, can you address that question? [SPEAKER CHANGES] I could certainly provide the committee with information about the various other boards. There's quite a large number of occupational licensing boards in the state, and it varies amongst the boards. [SPEAKER CHANGES] Follow up, mister chairman? [SPEAKER CHANGES] Follow up. [SPEAKER CHANGES] I wonder if the gentleman from the board could address or explain

He said there has been precedent of this board having a civil controversy over… that would be obviated or eliminated by this. Could we hear a little bit more in detail? I don’t need the parties and so forth; I’d just like a little bit of description about what happened? [SPEAKER CHANGES] ??, do you have a brief answer for that? [SPEAKER CHANGES] Is it possible that I could have the Counsel discuss that? Because he was more intimate with all the details of that. I wasn’t with the board as executive director at the time. [SPEAKER CHANGES] Do you have someone else present that you would like to defer to? [SPEAKER CHANGES] Yes I do. Counsel Bill Shenton. [SPEAKER CHANGES] Sir, if you would come forward and just identify yourself for the committee, and you are recognized to answer that question. Do you need the question to be restated? [SPEAKER CHANGES] No sir, Mr. Chairman. Thank you. My name is Bill Shenton; I’m with the Poyner & Spruill Law Firm, and I’m here to respond directly to any questions that you all have about this bill. There was a circumstance in the past where the board and its executive director were sued both in the Industrial Commission and in Wake County Superior Court. Ultimately the case went to the Board of Appeals and there was no liability against the board, but Dr. Croft is simply referring to a fact that there was a circumstance where the board was sued. I think if that responds to the question, I’ll stop right there. [SPEAKER CHANGES] Are we good? Representative Insko. [SPEAKER CHANGES] Well actually, I would like to have more information on that same question, if I may. [SPEAKER CHANGES] You’re recognized for the floor. [SPEAKER CHANGES] And that is I guess that I’m surprised that our existing whistle-blower statutes don’t protect that board already. [SPEAKER CHANGES] Sir, you’re recognized again. If you would state your name. [SPEAKER CHANGES] Bill Shenton with the Poyner & Spruill Law Firm. Representative Insko, that was ultimately the determination in the courts, that there was no liability, and as I understand the purpose of this provision, it’s to sort of codify immunity in the statute, similar to other licensing boards already in place, as staff has indicated. [SPEAKER CHANGES] Are there further questions or comments from members of the committee? Seeing none, Representative Waddell, you are recognized for a motion. [SPEAKER CHANGES] Thank you, Mr. Chairman. I move that we roll the amendment into House Bill 267, give it a favorable report, and refer it to Finance, unfavorable to original. [SPEAKER CHANGES] Representative Waddell makes the motion that we roll the amendment into a new PCS for House Bill 267, favorable to the new PCS, unfavorable to the original, with a serial referral to Finance. Everyone in favor of the motion, signify my saying “aye”. [SPEAKER CHANGES] Aye. [SPEAKER CHANGES] All opposed, “no”. The ayes have it. Congratulations, Representative Goodman. [SPEAKER CHANGES] Thank you Mr. Chair and members of the committee. [SPEAKER CHANGES] Ladies and gentlemen, next we have House Bill 281. Representative Hall, you’re recognized to present your bill. [SPEAKER CHANGES] Thank you, Mr. Chairman, and Mr. Chairman – and good morning, committee – this is House bill 281, and this is a bill in an effort to speed and provide clarity and disclosure in the process of doping examinations on the part of the State Medical Examiner’s Office. Representative Cunningham, if you want to join me in case there are any questions that you would want to answer as well. Members, as you look at the bill itself, I want to make a note that we also have two amendments – one being sent forward by Representative Goodman, which I wholeheartedly concur with, as well as an amendment, if they would pass that out now, that I have, and I’d like to explain to you the bill, and what it does is make sure that the Department of Corrections, in an event that an inmate dies in custody under certain circumstances, will disclose the information that the state medical examiner requests from them, and so we have an amendment that will limit the information to what is requested by the State Medical Examiner’s Office. The original bill provided that the full file would be provided to the State Medical Examiner’s Office. On the request of the State Medical Examiner, they indicated they did not need the full file necessarily on every circumstance, but what they needed was to be responsive in their request for the contents related to the death, and so Mr. Chairman, I’d like to send forth my amendment at this time. [SPEAKER CHANGES] Representative Hall, you’re recognized to send forth your amendment. Do the members have the amendment before them? Representative Hall, you have the floor. [SPEAKER CHANGES] Again, the amendment on page 1, lines 13 and 14, would change it so that rather than providing, again, as I said

said the full file and all documents it would provide, for the purpose of determine cause and manner of death, the full and accurate copies of all records associated with deceased inmate, including any records made after the death as requested by the officer of the state medical examiner. So that does limit it to what they say they would need. I know of no opposition to this amendment. [SPEAKER CHANGES] Are there any questions from the committee on the amendment? If not, we'll take that, Representative Hall has a motion and Representative Hall moves for the passage of amendment H281-ASH4 Version 1. Any further questions, comments? ALl in favor of the amendment signify by saying aye, all opposed no. The aye's have it, the amendment passes. Representative Hall, would you like to proceed with the second amendment at this time? [SPEAKER CHANGES] Mr. Chairman, Representative Goodman has the second amendment so I'd like if you would yield to him. [SPEAKER CHANGES] Representative Goodman is recognized to sent forth an amendment. [SPEAKER CHANGES] Thank you, Mr. Chair. I'd like to amend the bill on page 1, line 20 by changing the line to read, correction or the state bureau of investigation records provided to the office of the chief medical examiner pursuant to this section shall not be public records as defined by GS132-1. If the records would not be public records in the custody of the division of adult correction or the state bureau of investigation. Mr. Chair, it basically says that these records will remain private and will not become public. [SPEAKER CHANGES] Members of the committee, you've heard the amendment. Are there any questions on the amendment? If not, we'll take that as a motion. Representative Goodman moves fort he passage of this amendment. All in favor of the Goodman amendment will signify by saying aye, all opposed no. The aye's have it, the amendment passes. Representative Hall. [SPEAKER CHANGES] Thank you, Mr. Chairman, and as the bill is now written the records are maintained as confidential unless through court proceedings the request is made. However, it does facilitate for the state medical examiner's office to do a timely review as well as receive information from the state department of justice who may have conducted an examination as well as the circumstances of the death. So I think it achieves what we want to have done to have a response for the family, for the prison system, to change any procedures it may need to have done, as well as for the information to be examined by the medical examiner in appropriate time. So I'd ask for your support and I ask for a approval of the bill to have the two amendments rolled into a proposed committee substitute unfavorable to the original bill. [SPEAKER CHANGES] Okay, I think the appropriate time is coming soon. Representative Dollar, in this case he does have a question. Representative Dollar, you're recognized. [SPEAKER CHANGES] Just one quick question, I think I had some indication that Health and Human Services was good with this legislation but I know it also impacts the Department of Public Safety. I just didn't know if there was a representative of DPS in the room that would have any comment on the bill. [SPEAKER CHANGES] Sir, if you would, state your name and position and you're recognized. [SPEAKER CHANGES] Ryan Combs, Legislative Liaison for the Department of Public Safety. Representative Dollar, we are supportive of this bill after Representative Goodman's amendment was added. [SPEAKER CHANGES] Ladies and gentlemen of the committee, are there any further questions? If not, Representative Hall, you're recognized for a motion. [SPEAKER CHANGES] Motion is to roll the two amendments into a proposed committee substitute. I'm not sure of the committee referral after this, Mr. Chairman. [SPEAKER CHANGES] There is no committee referral. [SPEAKER CHANGES] Okay, roll it into a committee substitute, unfavorable as to the original bill. [SPEAKER CHANGES] Members, you have heard the motion by Representative Hall, with no further questions, all in favor signify by saying aye, all opposed no. The aye's have it. The bill is given a favorable report. That concludes the business of this committee and this meeting is adjourned. Thank you all.