Maine Medicine Weekly Update - 09/04/2018  (Plain Text Version)

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In this issue:
•  George J. Mitchell and Michael Botticelli to Keynote MMA's 165th Annual Session this Weekend in Bar Harbor
•  CMS Moves to Allow Step Therapy in Medicare Advantage Plans
•  Maine Legislature Acts on Several Child Protective Bills
•  Fewer Uninsured Hospitalizations Linked to Insurance Access Under ACA, Research Indicates
•  12/31/18 Deadline for All MDs Who Do NOT Prescribe Opioids
•  Maine Prescription Drug Monitoring Program User Survey: Extended Deadline Friday September 7
•  Diabetes and Gun Violence Resolutions Among Business at 165th MMA Annual Session, Sept. 7-9 in Bar Harbor
•  MMA Presentation on Healthcare Issues Considered by 128th Legislature Now Available
•  Upcoming Specialty Society Meetings
•  Hanley Center Offers New PELI Course Beginning in October - Enrollment Deadline: September 10
•  CMS National Training Program Workshop in Chicopee, MA - September 11
•  MICIS 3-hour Opioid CME Presentations - registration open for September 12 in Auburn
•  Hanley Center Offers Next Level Leadership Seminar Series and Advanced Practice Provider Leadership Institute - Enrollment Deadline: September 12
•  Recognizing & Responding to Opioid Overdoses - Training September 12
•  CMS National Training Program Workshop in New Hampshire - September 20-21
•  17th Annual Downeast Ophthalmology Symposium - September 21-23
•  MaineGeneral Offers X-waiver Training in Augusta - September 22
•  Maine Concussion Management Initiative has its final training program for 2018 on October 16
•  Children and Environmental Toxins: What Everyone Needs to Know - Friday, October 19
•  Maine AAP Sponsors SBIRT Training Sessions - Oct 20, Dec 8, Feb 2, Mar 2, Apr 6
•  Northern New England Society of Addiction Medicine 2018 Annual Conference & Meeting - Nov 2-3
•  Division of Disease Surveillance Annual Infectious Disease Conference - November 14
•  Family Nurse Practitioner - Ellsworth
•  Clinical Cardiology Opportunity
•  Internal Medicine Outpatient Physician
•  Nurse Practitioner - Nasson Health Care
•  Medical Director/Family Practice Physician - Relocate to Beautiful Southwestern Maine
•  Outpatient Internal Medicine Physician Bangor, Maine
•  Maine's Largest FQHC in need of Physician for Geriatric Program
•  Multiple Family Med Opportunities in Beloved Community Health Centers
•  Opportunities at the VA for Volunteer Physicians


Maine Legislature Acts on Several Child Protective Bills

Last Thursday the Maine Legislature killed LD 1919, which would have criminalized a failure to report suspected child abuse or neglect, and passed several other bills seeking to change the way the State of Maine deals with such cases.


Last Thursday the Maine Legislature killed LD 1919, which would have criminalized a failure to report suspected child abuse or neglect, and passed several other bills seeking to change the way the State of Maine deals with such cases.

LD 1919: Criminal penalties for failure of mandated reporters to report. In addition to the MMA's Gordon Smith, Dr. Genevieve Whiting and Dr. Syd Sewall testified to the Committee, and Dr. Deb Hagler also submitted written testimony. Of approximately 30 witnesses (not counting several legislators), only one favored criminalization. The Health & Human Services Committee voted “Ought Not To Pass” 8-2. On the floor of the House the vote was 72-53 against the bill, and it was defeated "under the hammer" in the Senate.

LD 1920: Record retention in unsubstantiated cases. There was much discussion about what a finding of “unsubstantiated” means and of various time periods. The current law allows the records to be kept for 18 months, and the bill, which was the subject of a 7-1 “Ought To Pass” Committee vote,  was amended to extend the time to 5 years. It passed both the House (68-50) and Senate.

LD 1921: Authorizing access to confidential criminal history records. Committee vote was unanimous “Ought To Pass.” It passed both House and Senate.

LD 1922: Ensuring that “best interest of the child” is a higher priority than “family reunification.” Discussion led to the conclusion that this bill would not really accomplish anything different from what is already happening. The vote was 5-3 “Ought Not To Pass." There was significant discussion in both House and Senate which resulted in a 26-4 vote for passage in the Senate. In the House, a motion that the bill not pass was defeated 46-74, after which the bill was passed.

LD 1923: This is a $23M funding bill with multiple sub-parts. Unanimous approval was given to the following parts:

  • Increase reimbursement for foster care
  • Purchase a new computer system
  • $5 per hour raise for caseworkers and $1 per hour raise for those obtaining a master’s degree
  • Pilot program to provide supportive and supervised visitation with relatives and evaluation of parental capacity
  • Clinical support and guidance of caseworker practice, including direct clinical consultation, training, and debriefing
  • The Department asked for 16 new Casework Supervisor positions and 2 new Regional Associate Director for Child Welfare positions, but no new caseworkers or case aides. Caseworkers have been stressing the need for increased numbers to lower a difficult caseload, and recently former Commissioner Hamilton has told OPEGA that 75 new caseworkers are needed. The Department representative, Acting Director of Child & Family Services Kirsten Capeless, said they need supervisors to help new caseworkers learn their jobs, so there is no sense hiring caseworkers until such administrative personnel are in place. By a 6-2 vote, the Committee approved an amended version of the bill that would give the Department what it asked for but add 16 caseworker positions and 8 case aide positions.
LD 1923 passed both the House and Senate (unanimously), then the House added an amendment that would appropriate $50,000 for a study of trauma-based cognitive behavioral therapy. The amendment was approved, and both chambers then passed the amended form of the bill.

 All in all, it was a good week for children and for the MMA at the Maine Legislature.