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WEAMA April 2017 Legislative Update

April 13, 2017 8:05 AM | Anonymous

Prepared by Leslie Emerick, Lobbyist

Legislative Overview
Today is the 92nd day of the 105-day legislative session. The last bill cut-off for fiscal committees was on April 4th. The next deadline is April 12th for a bill to pass out of the opposite house with a vote on the floor of the House or Senate. Some of the bills listed in the fiscal committees are still on the list because they may be considered necessary to implement the budget. The last day of the regular session is April 23, 2017, but I suspect that we will have at least one Special Session of the legislature to hammer out the budget proposals between the House and the Senate!

The Senate’s $43 billion budget raises property taxes, with the most significant impact on the Puget Sound with high property values. Legislators from the west side of the state are not very happy with that proposal! The House has a $44.9 billion budget, include a B & O tax 20% surcharge on highest grossing businesses, exempts smaller businesses (under $250,000 a year) and a 7% capital gains tax from the sale of stocks, bonds and other assets. 

WEAMA has been tracking 31 bills this session and about half of them died at the first policy committee bill cut-off. I have met with key members of the House and Senate Health Care Committee over the session to discuss issues of importance to East Asian Medicine Practitioners (EAMPs). Here is a copy of the Weekly Bill Report.  WEAMA was anticipating running legislation in 2017, but we were successful in getting Labor and Industries to accept our request to add EAMPs as practitioners so running legislation was unnecessary to accomplish our goals! Our top priorities this session were:

Acupuncture as an Alternative to Opioids:
WA State is facing an Opioid epidemic and acupuncture can be a low-cost alternative to manage pain without pharmaceuticals. EAMPs can also treat chemical addiction to help wean patients off opioids. The Essential Health Benefits under the OIC allow for unlimited chemical dependency treatments for acupuncture. L & I is proposing rulemaking to add acupuncture for low-back pain.

Oppose Dry Needling/Acupuncture by practitioners who do not have adequate training for the therapeutic insertion of needles into the human body. Any practitioner who wishes to practice acupuncture needs national certification and adequate training to protect the public from harm.

The Chair of the Senate Health Care committee, Senator Ann Rivers invited WEAMA to present in an Opioid Abuse work session early in the legislative session. Danial Cook did an excellent job presenting Acupuncture as an Alternative to the Senate Health Care Committee on the topic of Opioid Abuse. We were given a rare opportunity to present for a full 15- minutes before the committee. If you are interested in seeing his testimony, please go to this link on TVW: Senate Health Care Committee
on January 17, 2017 10:00AM Work Session: Opioid abuse and treatment. Danial’s testimony starts at 1:07:00 on the slider at the bottom, left side of the screen. 

We are still pursing our options to best integrate acupuncture treatments into the Opioid crisis in our state on a number of fronts such as the Bree Collaborative and the Medical Directors group. There were a number of bills trying to preserve the Affordable Care Act (ACA) in WA State that did not make the bill cut-off, but with the failure of the Congressional efforts to overturn the ACA, it should not be an issue in the near future. I will attach our latest bill update to this report for your review. You can go to look at the bills by clicking on the hyperlink on the left side of the page. 

East Asian Medicine Advisory Committee/ Point Injection Therapy Rules Update
The next EAMAC meeting and public hearing for point injection is on April 28, 2017 at the Department of Health, Town Center 2, Room 158, 111 Israel Rd. S.E., Tumwater, WA. The committee meeting will begin at 9 a.m. These are public meetings and anyone can attend. It will be a business meeting first with a Rules Hearing on Point Injection Therapy starting promptly at 11:30 a.m. I have attached a copy of the filed CR-102 and the proposed rule language for your review. You can submit comments personally or send your comments to Curt Eschels (curtiseschels@gmail.com) at WEAMA to be incorporated into a comment document from WEAMA. 

If you want to send them directly to Vicki Brown at DOH or leave them on the rules comment website here.
Vicki Brown, Program Manager, East Asian Medicine Practitioner Programs
P. O. Box 47852
Olympia, WA  98504-7852
Voice:  360-236-4865  Fax:  360-236-2901
http://www.doh.wa.gov/hsqa/

NURSING CARE QUALITY ASSURANCE COMMISSION (NCQAC) Advisory Opinion
Fujio McPhearson, EAMP/ARNP, submitted a proposal to the Nursing Care Quality Assurance Commission (NCQAC) for a 200-hour class that would allow Advanced Registered Nurse Practitioners (ARNPs) to practice acupuncture, similar to a Medical Acupuncture program. WEAMA is opposed to this proposal and sent a letter to NCQAC to express our opposition. You can download the letter here:
 WEAMA testimony to NCQAC 
The NCQAC is in the process of developing an Advisory Opinion for this scope expansion with the advisement of WEAMA and Bastyr University. We are working with Bastyr to develop the appropriate number of hours required for a baseline dual licensure. WEAMA has set a meeting on April 14th to discuss their Advisory Opinion further. 

Labor & Industries (L & I) Update
L & I has agreed to move forward with rulemaking on acupuncture for low-back pain. Thanks to years of work on this issue and a fabulous literature review led by Lisa Taylor-Swanson and other dedicated WEAMA members! Here is a copy of the review We were finally successful in documenting an evidence based treatment for low back pain. It may take a while longer to gain permission to treat other work related injuries, but this is a huge step forward with the most common complaint.  Here is a copy of the review.  Acupuncture for Low Back Pain: A Systematic Review of Randomized Controlled Trials

WEAMA recently participated in the Industrial Insurance Medical Advisory Committee (IIMAC) meeting on January 26, 2017. It appears that the meeting went well and we are moving forward with the blessing of the committee towards rulemaking. L & I is trying to resolve an issue with the current WAC that prohibits acupuncture from being performed. They need to remove that language before we can proceed with new language that will allow EAMPs to treat patients. No date has been set yet for the rulemaking to begin, but hopefully sometime soon.

Background: The Industrial Insurance Medical Advisory Committee (IIMAC) was formed by the Washington State Legislature in 2007. Chapter 51.36 RCW (app.leg.wa.gov) authorizes the IIMAC to: "Advise the department on matters related to the provision of safe, effective, and cost-effective treatments for injured workers, including but not limited to the development of practice guidelines and coverage criteria, review of coverage decisions and technology assessments, review of medical programs, and review of rules pertaining to health care issues." Here is a link to the website: http://www.lni.wa.gov/ClaimsIns/Providers/ProjResearchComm/PAC/default.asp

Here is a link to the Proposed Rule Changes:Proposed Rule changes

Acupuncture and Medicaid
WEAMA has begun to research our options for becoming approved to serve the Medicaid population. We will need to develop a white paper outlining what we would like from the Health Care Authority and the legislature by June 2017. We are reviewing models and pilot projects from other states to possibly use as a model for Medicaid in WA. Meetings with the Governor’s office, the Health Care Authority, WSMA and a potential bill sponsor will happen over the summer interim. By this fall we should have a draft bill to share with stakeholders and legislators.

Here are two additional meeting announcements of interest to our members;

DOH Rules: Charge for searching and duplicating medical records. 
WAC 246-08-400 sets the maximum amounts medical providers may charge for searching and duplicating medical records.  RCW 70.02.010(37) requires the Department of Health to adjust these amounts every two years according to the change in the Consumer Price Index.  A copy of the proposed rule change is attached. A public hearing will be held May 25, 2017 at 11:00 A.M. at the Department of Health, Town Center 2, 111 Israel Road SE, Tumwater, Washington, 98501.

If you would like to submit written comments, you may post them to the Department of Health Rules Comment Site at https://fortress.wa.gov/doh/policyreview/.  You may also mail them to Sherry Thomas, Department of Health, PO Box 47850, Olympia, WA, 98504-7850.  Comments are due May 25, 2017.  If you have questions, please email Sherry Thomas at sherry.thomas@doh.wa.gov. 

Unintentional Poisoning Workgroup/Prescription Monitoring Program Meeting 

Location: WA State Department of Health, 310 Israel Road SE | Tumwater, WA 98501~
Point Plaza East | Room 152/153
Date and Time: 04/25/2017 | 1:00 pm – 4:00 pm
FOCUS: Non-Opioid Alternatives for Chronic Pain Treatment

 TOPIC  PRESENTER
Welcome/Introductions  
Legislative Updates  
Workgroup Progress Updates
- Prevention (DBHR; LNI) 
- Treatment (DBHR)
- Naloxone (UW)
- Data (DOH)
Group Leads

Julia Havens (DBHR) | Jaymie Mai (LNI)
Thomas Fuchs (DBHR)
Susan Kingston (UW)    
Jennifer Sabel (DOH)

Non-Opioid Pain Therapies
Cognitive Behavioral
Physical Therapy
East Asian Medicine Practitioners (Acupuncture)
 
Dr. Dawn Ehde (UW)
Brett Neilson, DPT (PTWA)
Fujio McPhearson (EAMP)
Discussion (Q&A)

Non-Opioid Treatment

Dr. Lofy
Analysis of Medicaid – Opioid OD risks Deborah Fulton-Kehoe (UW)