Representative Rick Holman August 14, 2013
Interim Report from the Sixty-Third Session of the North Dakota Legislature.
The Health Services Committee had its first meeting on July 31. Issues assigned to this committee are:
· Examine ways to improve dental care access.
· Review the effectiveness of the Tobacco Control and Prevention agency.
· Study whether paramedics could have increased responsibility in health care.
· Study the effectiveness and cost of health insurance mandates.
· Receive a report from the Fire Marshall on the effects of reduced ignition propensity cigarettes.
· Receive a report from agencies regarding strategies to reduce the incidence of diabetes.
· Examine the success of out of state programs to train ND dentists, optometrists and veterinarians.
· Study the funding sources (state, county, local, etc.) for autopsies.
During the last session, legislation was proposed to allow expanded dental services by allowing other staff such as dental therapists to perform additional services in patient care under the supervision of a dentist. There are several areas in the state, especially with children, where there is limited access to dental care. Children on the Reservations, in particular, are often unable to receive the care needed, leading to more expense later on. The state’s dentists do provide services and have periodically set up large free clinics to examine and treat large groups of children and adults. The Ronald McDonald bus with state dentists providing free services also travels around the state to help fill the need. The reason for the study is that there still is an unfilled need in many rural areas. Resistance from the Board of Dental Examiners which licenses the caregivers centers on the danger of lesser trained persons providing care. Medicaid reimbursements being much less than that paid by other types of insurance add to the problem. We will continue to examine this issue, listening to both sides of the debate looking for ways to increase access while insuring the safety of care. More information on this issue can be found at the link called Committee Memorandum.
A similar issue which would also help health care access in rural areas would be the expansion of the role of paramedics. Often, those who work with ambulance services, have a lot of “down time” waiting for a call. This proposal would use these specially trained persons to assist in places such as patient care monitoring, home health visits, school programs and more. This, if set up in a way that would not impact emergency care has the potential of providing additional care and monitoring of patient health without significantly increasing cost. Ultimately, it could save money for local health units.
Years ago a lawsuit against tobacco companies provided funding for prevention and control of tobacco use. Initially, the ND Legislature used much of the available funding for other projects, but a vote of ND Citizens required the money to be used for its intended purpose. The Tobacco Control and Prevention Committee funds programs such as the Quitline, programs in schools, and advertising to point out the health hazards of smoking. Throughout the state, county coordinators work to limit the effects of tobacco use. More information on this issue can be found at the link called Committee Memorandum.
Each year, about 450 autopsies, at a cost of about $1000 each, are performed at a state supported facility in Bismarck and at the UND Medical School. During the session, increased need led to a proposal to double the size of the Bismarck facility. Since a large number of autopsies are generated in the eastern part of the state, counties, which bear the costs of transportation, would save money by using the UND facility. A compromise position led to additional funding for the Grand Forks facility with an interim study to seek the best solution.
Rep. Rick Holman. ND District 20