Category Archives: News Stories

Louisiana is 10th Fastest-Growing Economy in the Nation says Gov. in July 25 Statement

Gov. Edwards released a statement on Louisiana’s record high GDP of $256.45 billion, an annual growth rate of 3.8% in 2019Q1. According to the Bureau of Economic Analysis (BEA), Louisiana has the 10th fastest growing economy in the U.S., the Governor’s Office said on July 25.

“This latest ranking is further proof that Louisiana’s economy continues to grow and move in the right direction,” said Gov. Edwards. “Just this month, we have seen the largest unemployment decline since last year of any state, the lowest it has been in 11 years, personal income is at an all-time high and for the first time in a long time, our state debt is declining.”

“We are continuing to attract new business and industry while retaining and expanding our existing businesses and implementing programs in Louisiana to further strengthen our workforce.”

Louisiana’s GDP is at a new record high: $256.45 billion, compared to $247.2 billion in 2018Q1 and $255.5 billion in 2018Q4.

Non-durable goods manufacturing was the main contributor to growth, contributing 2.09 percentage points.

Retail trade contributed 0.82 percentage points and mining, quarrying, and oil and gas extraction contributed 0.80 percentage points.

In a related story, the Governor’s Office announced that Louisiana has the largest drop in unemployment rates of all states since last year.

Louisiana’s seasonally adjusted unemployment rate in June 2019 is 4.3 percent, which is a .7 of a percentage point decline since June of 2018, the largest such drop for any state.

Louisiana’s unemployment rate is the lowest it has been since January 2008.

La. No Longer “Incarceration Capital of Nation,” Says Gov. $12 Million in Savings

“Louisiana is no longer the incarceration capital of the nation, we have saved over $12 million which is more than double what was projected and are reinvesting those dollars into programs that are helping to reduce recidivism, improve public safety and support crime victims,” Gov. Edwards said in a July 19 press release.

“Everything we have put in place is based on data-driven policies that are successful in other southern states and are now having the same impacts in our state,” Edwards said. “It is still early in this process and there are more lessons to learn and more challenges to meet, but we are taking significant steps toward improving our criminal justice system.”

The comment followed the release of the Justice Reinvestment Reforms 2019 Annual Performance Report, presented to the Legislature in June. The report listed the following:
• Reduced Prison Population: Louisiana’s total prison population has continued to decrease. It has fallen from a peak of 39,867 individuals at the end of 2012 to 32,397 individuals as of the end of 2018. As an immediate result of reduction in nonviolent offenses, Louisiana no longer has the highest imprisonment rate in the nation.
• Sentence Length Down for Nonviolent Offenses: The State has seen significant decreases in sentence length for nonviolent offenses. Drug offenses have seen the largest decrease by the end of 2018 with a drop of 17%, followed by property offenses with an 8.3% decrease. The average sentence length for new felony admissions decreased from 76.6 months to 73.2 months (3.7%).
• Decrease in Use of Habitual Offender Enhancements: The use of Habitual Offender enhancements, which allow for increased penalties for crimes based upon the existence of previous convictions, decreased significantly (74.3%). This reduction is attributed to both prosecutorial and judicial discretion as well as legislative changes which limited the scope of its application.
• Reduction in Probation and Parole Population and Officers’ Average Caseloads: The State has seen a significant decrease in the total supervised population as well as the average caseload of Probation and Parole Officers; from 149 in 2016 to 123 by the end of 2018. The reduction is attributed to new incentives that allow people to earn time off supervision based upon compliance with supervision conditions.

The report can be found at http://gov.louisiana.gov/assets/docs/CJR/2019JRI-Performance-Annual-Report-Final.pdf.

Psychological science and practice has played an important part in the Governor’s reforms.

Dr. Susan Tucker, the 2019 recipient of the Award for Psychology in the Public Interest, has been a key figure for innovations in the state correctional system. She is Psychologist and Assistant Warden at the Bossier Sheriff’s Office.

Dr. Tucker has focused on treatment and research innovations that reduce recidivism and that are based in the fact that most inmates have a substance abuse problem and few get the right kind of treatment.
She launched the Steve Hoyle Intensive Substance Abuse Program to offer intensive treatment, skill development, educational opportunities, and post release support and care. Her approach has achieved a significant reduction in recidivism, from an expected first year rate of 18 percent to only 3 percent.

Tucker has earned state and national recognition for these achievements, including from the Vera Institute of Justice. Dr. Tucker was also commended by Louisiana legislators for her work and the related cost savings of $15 million by earned “good time credits” through participation and successes in the psychological programs designed by Tucker.

Defense Rests in Bellwether Case Against Opioid Drug Industries

The last arguments from the defense were heard in the $17.5B bellwether opioid crisis lawsuit against Johnson& Johnson, reported the Courthouse News Service last month.

The state Oklahoma sued Johnson & Johnson, Janssen, Teva Pharmaceutical Industries and OxyContin maker Purdue Pharma in 2017 on claims of fraud, unjust enrichment, public nuisance and violation of state Medicaid laws for allegedly pushing doctors to prescribe opioid painkillers while downplaying the addiction risks and overstating their benefits.

Purdue settled in March for $270 million. Israel-based Teva reached a similar settlement in May for $85 million – two days before the trial began, according to Court House News service.

Johnson & Johnson and its subsidiary are the only remaining defendants. In the  weeks before trial, the state dropped all claims except its public nuisance claim to prevent further delays caused by defense appeals, said Courthouse News.

“For its last witness during the seven-week bench trial, the defense called Dr. Terrell Phillips of Oklahoma City. He explained that many insurers and workers’ compensation laws reimburse doctors for only “reasonable and necessary” treatment that excludes physical therapy, counseling, injections and surgery. He said that leaves doctors with no choice but to prescribe opioids over the excluded treatment options.

“Phillips testified the situation leaves him effectively ‘handcuffed.’ He said patients with chronic pain are left improperly treated, leading to even depression and suicide.

Gov. Edwards Appoints Dr. Gina Gibson and Dr. Michelle Moore to LSBEP

On July 23, Governor Edwards announced that he appointed Dr. Gina Gibson of Lafayette and Dr. Michelle Moore of New Orleans to the Louisiana State Board of Examiners of Psychologists. Both were nominated by the Louisiana Psychological Association.

Dr. Moore received the top number of votes in a regular election held this past February to fill the opening left by the normal completion of service by Dr. Jesse Lambert. Dr. Gina Gibson (who has since changed her last name from Beverly) was nominated and ran in an April special election to fill an unexpected vacancy caused by the resignation of Dr. Leah Crouch.

Dr. Gibson is a neuropsychologist with the Department of Veterans Affairs, licensed in 2008. She lists her specialty as Counseling/Clinical Neuropsychology. Her training is from Louisiana Tech University and employment is with Dept. of Veterans Affairs and also private practice. She is a member of the National Academy of Neuropsychology and the American Academy of Clinical Neuropsychology.

In her statement, Dr. Gibson wrote that “there are numerous critical issues facing psychology, including revising the complaints process,” and “exploring the use of healthcare designations in place of specialty classifications.”

“Moving forward,” she wrote, “I believe that the board’s primary obligation is to the public consumers of our services and psychologists themselves. Examining these issues and finding balanced solutions that work to support and advance the profession should be at the forefront. My goals for the psychology board are to be an advocate for psychology as a progressive and critically important discipline that is well-suited to use our collective knowledge and training to help others and solidify our place in the current healthcare environment.”

Dr. Michelle Moore is an associate clinical professor at the LSU Health Science Center. She has served as Clinical Associate Professor of Psychiatry, LSU Health Sciences Center, New Orleans, LA, Department of Psychiatry, Section of Psychology, and Training Director of Clinical Psychology Internship Program.

From 2016 to present her research and scholarship has included: Working with ReNEW Charter School Network to provide needed clinical services to students either in special education or seeking evaluations for possible special education services; Primary Investigator and Mentor, AsianAmerican Mental Health among Medical Students; and Primary Investigator, Collaborating with Community Partners.

She is a member of the American Psychological Association; Association of Psychologists in Academic Health Centers; Louisiana Psychological Association; Southeastern Psychological Association; and Association of Psychology Postdoctoral and Internship Centers. “In my current role as Training Director for the internship program at LSU Health Sciences Center, School of Medicine,” Dr. Moore said in her statement, “I have the pleasure of directly training students and trainees who are the future of our profession. Being in this position, I would bring a unique perspective to the Board from the graduate program applications we review, the training of psychology interns and fellows and how we are preparing individuals for independent practice. […]”

Among other appointments announced in July 23 press release, the Governor also reappointed Bambi Polotzola of Opelousas, the executive director of the Governor’s Office of Disability Affairs, to the Statewide Independent Living Council. “Bambi has been a leader in disability issues for over a decade working with people with disabilities and their families as an educator and as a home and community-based service provider. She has served on state councils and boards of numerous disability-related non-profit organizations. Her work has primarily been centered in capacity building and systemic change that supports people with disabilities and their families to be fully included and valued members of their communities,” said the author of the announcement.

Winners in State Poster Research Announced LSU

Winners were named in the state-wide research poster presentation and competition, held at the Louisiana Psychological Association Scientific Poster Session, on June 14. The session was organized by Melissa Dufrene PhD, chair of the Early Career Psychologist Committee for the Association.

Tiffany Augustine, MA, Shaely Cheramie, MA, and Christoph Leonhard, PhD, authored the winning research presentation for the Evidence-Based Practice category for graduate students, titled “Making a difference in marginalized populations: mindfulness and adjudicated youth.”
The authors represented The Chicago School of Professional Psychology at
Xavier University of Louisiana, New Orleans.

The undergraduate winner for Evidenced-Based Practice was Anna Elysse Lee, with research titled, “Esketamine as an adjunct to psychotherapy, efficacy and possible side effects: Implications for therapists.” Ms. Lee represents Louisiana Tech University, Ruston, and her sponsor is Mary-Margret Livingston, PhD. In the category for Original Research, the graduate student entry winner was for the research, “Posttraumatic stress symptoms and gender: Independent and interactive associations with suicidal ideation among veterans with military sexual trauma.”

Authors were Chelsea R. Ennis, MS, from South Central Mental Illness Research, Education and Clinical Center (MIRECC), New Orleans; Taylor Ceroni, MA, also from MIRECC, Amanda M. Raines, PhD, from MIRECC, Southeast Louisiana Veterans Health Care System, New Orleans and School of Medicine, Louisiana State University, New Orleans; and C. Laurel Franklin, PhD, from MIRECC, Southeast Louisiana Veterans Health Care System, New Orleans, and Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans.

The undergraduate winner in the category for Original Research was Sarah Grace Guillaume for “Racial socialization of Black preschool-aged children: The influences of child sex and maternal arrest.”

Ms. Guillaume represented Tulane University, New Orleans, and was sponsored by Justin Carreras, PhD.

Heather’s Law May Help in Domestic Abuse

HB 36 became Heather’s Law and may help victims in domestic abuse situations so that law enforcement is alerted more quickly.

In present law provides that upon the issuance of a temporary restraining order or protective order in domestic abuse cases, the judge shall cause to have prepared a Uniform Abuse Prevention Order, shall sign such order, and shall immediately forward it to the clerk of court for filing on the day that the order is issued.

Present law further requires the clerk of the issuing court to transmit the Order to the judicial administrator’s office, La. Supreme Court, and to send a copy to the chief law enforcement officer of the parish where the person or persons protected by the order reside by facsimile transmission or direct electronic input as expeditiously as possible.

The new law:(1) Adds that the copy of the Uniform Abuse Prevention Order sent to the chief law enforcement officer shall be reviewed by the law enforcement agency upon receipt. (2) Requires the petitioner to be notified of the right to initiate criminal proceedings and to be informed that the granting of a temporary restraining order or protective order does not automatically file criminal charges against the defendant

New Crime of Harassing Referees Comes with Mandatory Anger Management

Representative Henry’s bill has been signed by the Governor into Act 355 and creates the crime of harassment of a school or recreation athletic contest official, and sets penalties which can include mandatory counseling for anger management.

The new law defines the crime as the harassment of a school athletic or recreation athletic contest official that occurs under either of the following circumstances and that includes verbal or non-verbal behavior by the offender that would cause a reasonable person to be placed in fear of receiving bodily harm: (1) While the school athletic or recreation athletic contest official is actively engaged in the conducting, supervising, refereeing, or officiating of a school-sanctioned interscholastic athletic contest or a sanctioned recreation athletic contest. (2) In the immediate vicinity of a school-sanctioned interscholastic athletic contest or a sanctioned recreation athletic contest and is based on the official’s performance in the conducting, supervising, refereeing, or officiating of a school-sanctioned interscholastic athletic contest or a sanctioned recreation athletic contest.

New law provides the following penalties for persons who commit the offense: (1) A fine of not more than $500, imprisonment without hard labor for not more than 90 days, or both. (2) Performance of 40 hours of court-approved community service work. (3) Mandatory participation in a court-approved counseling program which may include anger management, abusive behavior intervention groups, or any other type of counseling deemed appropriate by the court. Cost of the program shall be borne by the offender.

The new law creates the crime of entry or remaining on site of a school or recreation athletic contest after being forbidden which provides that no person shall without authority go into or upon or remain in or upon, or attempt to go into or upon or remain in or upon, any immovable property or other site or location that belongs to another and that is used for any school athletic contest or recreation athletic contest, including any area in the immediate vicinity of the site or location of the athletic contest, after having been forbidden to do so, either orally or in writing, by any owner, lessee, or custodian of the property or by any other authorized person.

New law provides that whoever violates the provisions of new law shall be fined not more than $500, imprisoned without hard labor for not more than six months, or both.

Changes Made to Law when Investigating Student Threats of Violence, Terrorism

The Governor signed House Bill 193 into law and revises last year’s effort to improve school safety. Representative Bacala’s measure revises procedures relative to students investigated for making threats of violence or terrorism.

Present law provides relative to a student reported to a law enforcement agency for a threat of violence or terrorism, and provides for a judicial hearing on whether the student should undergo a mental health evaluation. The current law requires that the student shall not be permitted to return to school until undergoing a formal mental health evaluation.

The changes passed and signed by the Governor instead instruct authorities that a student who is the subject of a complaint and investigation shall be permitted to return to school by the school administration if at any point prior to a hearing the threat is determined not to be credible by the school administration, law enforcement agency, or district attorney or by order of the court after a hearing.

While present law requires the law enforcement agency file a petition with the appropriate judicial district court for a mental health evaluation, the new law instead says that if the law enforcement agency determines that the threat is credible and imminent, it shall report it to the district attorney, who may file such a petition not later than seven days after receiving such report. It requires that a student be permitted to return to school if the district attorney decides not to file a petition or does not do so within that time period.

The new law defines that a “credible and imminent” threat means that the available facts, when viewed in light of surrounding circumstances, would cause a reasonable person to believe that the person communicating the threat actually intends to carry out the threat in the near future or has the apparent ability to carry out the threat in the near future.

Another revision passed by the Senate was to prescribe a 7day time limit on the district attorney’s authority to file a petition for the examination of a student who makes a threat and add a requirement that the student be allowed to return to school if the district attorney decides not to file a petition or does not do so within that time period.

The law now is “If a law enforcement agency, based on its investigation as required by R.S. 17:409.4(B)(1), determines that a student’s threat is credible and imminent, it shall report it to the district attorney, who may file a petition no later than seven days after receiving such report with the appropriate judicial district court for medical, psychological, and psychiatric examination as outlined in this Subsection.”

Trump Takes Swipe at Healthcare Monopoly: Orders Transparency in Hospital Costs

On June 24, President Trump signed an Executive Order on “Improving Price and Quality Transparency in American Healthcare to Put Patients First.” The Order requires the posting of standard charge information for services, supplies, or fees billed by hospitals, and special rates negotiated behind the scenes. “Providing access to this data will facilitate the development of tools that empower patients to be better informed as they make decisions related to healthcare goods and services.” And, “Access to this data will also enable researchers and entrepreneurs to locate inefficiencies and opportunities for improvement, such as patterns of performance of medical procedures that are outside the recommended standards of care,” the President wrote.

“To make fully informed decisions about their healthcare, patients must know the price and quality of a good or service in advance,” the President said. “With the predominant role that third-party payers and Government programs play in the American healthcare system, however, patients often lack both access to useful price and quality information and the incentives to find low-cost, high-quality care. Opaque pricing structures may benefit powerful special interest groups, such as large hospital systems and insurance companies, but they generally leave patients and taxpayers worse off than would a more transparent system.”

In 2017, the Administration issued a report titled “Reforming America’s Healthcare System Through Choice and Competition,” and was referenced in the June Ex. Order.

The report recommends developing price and quality transparency initiatives to ensure that patients can make wellinformed decisions about their care. “In particular,” the President wrote, “the report describes the characteristics of the most effective price transparency efforts: they distinguish between the charges that providers bill and the rates negotiated between payers and providers; they give patients proper incentives to seek information about the price of healthcare services; and they provide useful price comparisons for ‘shoppable’ services (common services offered by multiple providers through the market, which patients can research and compare before making informed choices based on price and quality).” Of inpatient care, 73 percent of the 100 highest cost services are shoppable and of outpatient, 90 percent of the 300 highest costs are shoppable.

“Improving transparency in healthcare will also further protect patients from harmful practices such as surprise billing, …”

“Making meaningful price and quality information more broadly available to more Americans will protect patients and increase competition, innovation, and value in the healthcare system.”

The President notes the Policy as follows: “It is the policy of the Federal Government to ensure that patients are engaged with their healthcare decisions and have the information requisite for choosing the healthcare they want and need. The Federal Government aims to eliminate unnecessary barriers to price and quality transparency; to increase the availability of meaningful price and quality information for patients; to enhance patients’ control over their own healthcare resources, including through tax-preferred medical accounts; and to protect patients from surprise medical bills.”

The Order also lays out the rules for making charges, including negotiated rates and rates worked directly with insurance companies, available to the public: “Within 60 days of the date of this order, the Secretary of Health and Human Services shall propose a regulation, consistent with applicable law, to require hospitals to publicly post standard charge information, including charges and information based on negotiated rates and for common or shoppable items and services, in an easy-to-understand, consumer-friendly, and machine-readable format using consensus-based data standards that will meaningfully inform patients’ decision making and allow patients to compare prices across hospitals.” […]

[…] “Within 180 days of the date of this order, the Secretaries of Health and Human Services, Defense, and Veterans Affairs shall develop a Health Quality Roadmap that aims to align and improve reporting on data and quality measures across Medicare, Medicaid, the Children’s Health Insurance Program, the Health Insurance Marketplace, the Military Health System, and the Veterans Affairs Health System. The Roadmap shall include a strategy for establishing, adopting, and publishing common quality measurements; aligning inpatient and outpatient measures; and eliminating low-value or counterproductive measures.”

Comments on Medscape, a popular physician and healthcare professional website and blog, were poignant.

Commenting was a psychologist. Dana Beezley-Smith| Psychologist ––Well, I for one am tickled pink. It’s a travesty that consumers have to purchase healthcare services without understanding what their portion of the expense will be. I wrote about this topic almost two years ago. (https://nationalpsychologist.com/2017/ 09/health-care-reform-update-pricetransparency-movementgrowing/104010.html) The devil’s in the details, of course, as proposed and final rulings will take some time, but if it plays out right, the entire provider
insurer-patient relationship will be transformed. No more secrets. Hospitals won’t like this, insurers won’t like this, but perhaps private physicians can prove they offer more value per dollar than giant hospital systems do. At the very least it encourages the consumer to ask more questions.

Popular comments included:

Dr. Chris Burritt| Psychiatry/Mental Health ––The Hospitals practically operate as cartels…pushback from them should be viewed as a sign of going in the right direction. I hope Trump stays the course – this should be a bipartisan effort!!

Dr. Yehuda Mond| Internal Medicine ––Politics aside, President Trump is the only president who has the guts to face on the pharma companies, call their bluff, and end the status quo. He’s the first to explain to the American people where the problem is and how it can be solved. We’re paying through the nose with unfettered billions of our tax and insurance dollars going straight to pharmaceutical companies. While this will not solve all our problems, if he is successful (ahem, so-called democrats), then it will reduce healthcare costs across the board. Please folks, put your unjustified hatred towards our president aside and show him your support.

Dr. Kathryn Duplantis| Plastic Surgery and Aesthetic Medicine –– president trump 2020! I wrote him a letter recently addressing the challenges that we doctors are facing including rising overhead, constant fighting with insurance companies to be paid and increasing liability! We are tired of all the big bosses running healthcare! I want doctors to be able to run their own practices and not deal with all the bosses that have driven up the cost of healthcare! My practice is all cash and will retire with a cash practice!

PTSD to Be Covered for Firemen, Police

After being amended on both the House and Senate Floors, Senator Gatti’s SB 107, which adds PTSD to injuries covered by workers’ compensation for certain public employees, passed. The House vote was 99 to 0 and Senate was 34 to 0.

Amendments included: Specify that the posttraumatic stress injury shall be caused by an event occurring in the course and scope of employment and which the preponderance of evidence indicates that the event was a substantial contributing factor; Remove the determination and factors of whether the evidence presented to determine if an employee has a posttraumatic stress injury has successfully rebutted the presumptions provided for posttraumatic stress injury; and Add that a posttraumatic stress injury that arises solely from a legitimate personnel action such as a transfer, promotion, demotion, or termination, is not a compensable injury under present law.

The newest digest indicates that while present law requires the state fire marshal to obtain workers’ compensation coverage for volunteer members who participate in the normal functions of the fire company, the new law will also now require upon the purchase of a new policy or renewal of an existing policy, that any workers’ compensation policy which provides coverage for a volunteer member of a fire company, pursuant to present law, will include coverage for posttraumatic stress injury.

The new law provides that any volunteer member of a fire company who is diagnosed by a psychiatrist or psychologist with posttraumatic stress injury, either during his period of voluntary service or thereafter, shall be presumed, prima facie, to have a disease or infirmity connected with his volunteer service.

Once diagnosed with posttraumatic stress injury the volunteer member affected or his survivors shall be entitled to all rights and benefits as granted by present law to one suffering from an occupational disease.

The new law also provides that, except as provided in proposed law, any local emergency medical services personnel, any employee of a local police department, or any local fire employee who is diagnosed by a psychiatrist or psychologist with posttraumatic stress injury, either during employment or thereafter, shall be presumed, prima facie, to have a disease or infirmity connected with his employment.

An employee of the division of state police who is diagnosed by a psychiatrist or psychologist with posttraumatic stress injury, either during employment or thereafter,
shall be presumed, prima facie, to have a disease or infirmity connected with his employment for purposes of workers’ compensation benefits.

Once diagnosed with posttraumatic stress injury the employee of the division of state police affected or his survivors shall be entitled to all rights and benefits as granted by state workers’ compensation law, as service connected in the line of duty, regardless of whether the employee is employed at the time of diagnosis.

The new law provides that a posttraumatic stress injury that arises solely from a legitimate personnel action such as a transfer, promotion, demotion, or termination, is not a compensable injury pursuant to present law. The law is set to become effective August 1, 2019.

Gov Edwards Comments: US News &World Report Ranks Louisiana 50th

For the second year in a row, U.S. News & World Report has placed Louisiana at the bottom in their rankings of states. In the report, Louisiana’s total rank of 50th was a result of ranking 45th in health care, 48th in education, 49th in the economy, 48th in infrastructure, 50th in opportunity, 43rd in fiscal stability, 50th in crime and corrections, and in 50th in natural environment.

Washington state ranked first followed by New Hampshire, Minnesota, Utah, and then Vermont.
At the bottom of the list rankings slightly higher than Louisiana, was Alabama at 49th, Mississippi at 48th, West Virginia at 47th, and New Mexico at 46th.

In a press release on May 14 governor Edwards said, “Unfortunately, this ranking doesn’t accurately reflect the progress Louisiana has made in recent years and how much better we are doing today, given the gains that we have made in many critical areas that directly impact people’s lives.

“Louisianans know how much better we’re doing now than when we were facing down a $2 billion dollar deficit just a few years back. By working together across party lines, we’ve stabilized our budget, turned deficits into a surplus, are investing more in education at all levels and focusing on our infrastructure for the first time in years. We have improved our health care by extending coverage to thousands of working adults, we no longer have the highest prison population in the country, and higher education funding is fully stable.

“It takes time for improvement to show up in data, and some of the U.S. News and World Report’s data sources are several years old, which is frustrating. But we know we’re doing far better than we were years ago and we fully expect that will show up in future rankings.”

Bill to Create Services for Trafficking Victims Passes Senate and Goes to House Health & Welfare Committee

SB 145 by Sen. Ronnie Johns was heard in committee, amended and passed to the Senate Floor where it was supported by favorable vote of 38 yeas and no nays. In the House it was referred to the Committee on Health & Welfare. It passed the Senate on April 29.

If it were to become law, the measure provides that, subject to appropriation by the legislature, the Dept. of Children and Family Services, working in collaboration with the Dept. of Health, and the Family in Need of Services Assistance Program, with the assistance of the La. Alliance of Children’s Advocacy Centers, to create a coalition to develop a human trafficking victim services
delivery model.

The proposed law further provides that the model is to be developed with consideration of the recommendations of and collaborating with the La. Human Trafficking Prevention Commission and Advisory Board, and provide a multidisciplinary and agency approach that coordinates resources and improves the statewide response and delivery of services to victims.

The new would designate that the human trafficking victim services delivery model is to provide a plan to address and promote the following goals including but not limited to:

(1) Safe and sufficient placements. (2) Available and adequate funding sources. (3) Stakeholder partnerships. (4) Coordinated response. (5) Appropriate and responsive services.

The Dept. of Children and Family Services is to promulgate any rules necessary to implement the provisions of proposed law, and that the Dept. of Children and Family Services is to provide a report on the development of the coalition’s services delivery model to the Senate and House
Committees on Health and Welfare by June 30, 2020, and annually thereafter until completion of the model.

Measure to Prohibit Cherry Picking by Insurance Venders Involuntarily Deferred

HB 237, a measure put forth by Rep. Chad Brown and supported by the Governor, to prohibit
discrimination by health insurance issuers in the individual market and small and large group
market based on health status, and from imposing any preexisting condition exclusion with respect to the plan or coverage, was involuntarily deferred in Committee on Insurance. The measure also took on six amendments.

The proposed law, if it would have passed, requires a health insurance issuer to include mental health and substance use disorder services, including behavioral health treatment, and preventive and wellness services and chronic disease management.

“Proposed law requires a health insurance issuer offering health insurance coverage in the
individual or group market to renew or continue in force the coverage at the option of the plan sponsor or the individual, as applicable, except that the issuer may nonrenew or discontinue health insurance coverage based only on a failure to pay premiums or contributions, an act or practice that constitutes fraud or an intentional misrepresentation of material fact under the terms of the coverage, or the issuer is ceasing to offer coverage in the market.”

The new law prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage from establishing rules for eligibility, including continued
eligibility, of any individual to enroll under the terms of the plan based on any of the following
health status-related factors in relation to the individual or a dependent of the individual:
(1) Health status.
(2) Medical condition, including both physical and mental illnesses.
(3) Claims experience.
(4) Receipt of health care.
(5) Medical history.
(6) Genetic information.
(7) Evidence of insurability, including conditions arising out of acts of domestic violence.
(8) Disability.
(9) Any other health status-related factor determined appropriate by the commissioner of insurance.

The proposed law prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage in La. from establishing lifetime limits on the dollar value of benefits for any participant or beneficiary.

Natural Chemical Helps Brain Adapt to Stress

Researchers at Vanderbilt University Medical Center have identified a natural signaling
molecule that activates cannabinoid receptors in the brain that play a critical role in
stress-resilience. The endocannabinoid family of signaling molecules that activate CB1
and CB2 cannabinoid receptors in the brain were investigated by Sachin Patel, M.D.,
Ph.D., the director of the Division of Addiction Psychiatry at Vanderbilt University
Medical Center. Patel indicated that finding ways to boost the signaling system could
represent a new treatment approach for many stress-linked disorders.

The endocannabinoids are endogenous ligands in the brain that activate CB1 and CB2.
While the endocannabinoids are a biochemistry topic too complex for this cursory look,
the effects of CB1 and CB2 have broad implications for the treatment and possible
prevention of disorders like major depression and PTSD. CB1 is found mostly in the
brain and central nervous system and to a lesser extent in other tissues. CB2 is mostly
found in peripheral organs and cells that service the immune system. CBD, which is now
generally available in several forms do not directly activated CB1 or 2; however, the
effects of CBD are foreshadowing the potential for treatment of not just mood disorders
but many other stress-related or stress-affected disorders, like diabetes, obesity,
memory, anxiety and neurodegenerative disorders.

Boosting this signaling system holds great promise. In fact, THC, the active compound
in marijuana, binds the CB1 receptor, which may explain why relief of tension and
anxiety is the most common reason cited by people who use marijuana chronically.
Patel and his colleagues previously have found CB1 receptors in the amygdala, a key
emotional hub in the brain involved in regulating anxiety and the fight-or-flight response.
They also showed in animal models that anxiety increases when the CB1 receptor is
blocked by a drug or its gene is deleted.

In the current study1 the researchers tested the effects of increasing or depleting the
supply of one endocannabinoid (2-AG) in the amygdala in two populations of mice: one
previously determined to be susceptible to the adverse consequences of acute stress,
and the other which exhibited stress-resilience. Augmenting the 2-AG supply increased
the proportion of stress-resilient mice overall and promoted resilience in mice that were
previously susceptible to stress, whereas depleting 2-AG rendered previously stressresilient mice susceptible to developing anxiety-like behaviors after exposure to acute
stress.

Taken together, these results suggest that 2-AG signaling through the CB1 receptor in
the amygdala promotes resilience to the adverse effects of acute traumatic stress
exposure and supports previous findings in animal models and humans suggesting that
2-AG deficiency could contribute to development of stress-related psychiatric disorders.
Marijuana use is highly cited by patients with PTSD as a way to control symptoms.
However, marijuana use in psychiatric disorders has obvious drawbacks including
possible addiction and cognitive side effects, among others. The Vanderbilt study
suggests that increasing production of natural cannabinoids may be an alternative
strategy to harness the therapeutic potential of this signaling system. For instance, once
levels of the endocannabinoids can be efficiently measured in humans, those identified
with low levels of the signaling system responsible for stress-related mood and anxiety
disorders could have their supply replenished without the complications of using
marijuana.

Rebecca J. Bluett, Rita Báldi, Andre Haymer, Andrew D. Gaulden, Nolan D. Hartley,
Walker P. Parrish, Jordan Baechle, David J. Marcus, Ramzi Mardam-Bey, Brian C. Shonesy,
Md. Jashim Uddin, Lawrence J. Marnett, Ken Mackie, Roger J. Colbran, Danny G. Winder,
Sachin Patel. Endocannabinoid signalling modulates susceptibility to traumatic stress
exposure. Nature Communications, 2017; 8: 14782

Governor Edwards Promotes Bi-Partisan Efforts and Announces Priorities

Governor Edwards announced his Legislative Agenda last month and said that he was excited to work in a bi-partisan manner, outlining key pieces of legislation that he would support. Included were a variety of health and education reforms.

Representative Chad Brown’s HB 237 would protect nearly 850,000 Louisianans with a preexisting condition by prohibiting health plans or health insurers from discriminating against a health insurance applicant based upon preexisting conditions or health status.

SCR 3 by Senator Blade Morrish and HCR 1 by Representative Nancy Landry provides for a
$1,000 pay raise for teachers or certificated personnel, a $500 pay raise for school support
or non-certificated personnel. Eliminating pay secrecy by prohibiting employers from taking actions against employees for inquiring about, discussing or disclosing their wages or another employee’s wages is another of the Governor’s objectives in SB 136 by Senator J.P. Morrell.

HB 391 by Rep. Franklin Foil establishes “The Veterans First Business Initiative”, a statewide
initiative designed to identify veteran owned businesses in Louisiana, create a veteran owned business designation that they can use, and produce a state database for Louisianans to search for various goods or services of veteran owned businesses.

To increase prescription drug transparency, the governor will support legislation sponsored by Sen. Fred Mills, SB 41, to provide the regulatory framework necessary for the Louisiana Department of Insurance, Louisiana Board of Pharmacy, and Louisiana State Board of Medical Examiners to respond to consumer and provider complaints against PBMs. Pharmacy Benefit
Managers (PBMs) are third party administrators, “middlemen,” contracted by health plans, employers, and government entities to manage prescription drug programs on behalf of health plan beneficiaries. The three regulatory bodies will have specific licensure requirements that must be met to be in good standing and operation in Louisiana.

For HB 243, Rep. Dustin Miller and the Governor hope to address opioid-related harm through policy change to establish an enhanced data reporting of fatal and non-fatal drug overdoses where opioids were suspected or present. This legislation will create mechanisms for rapid surveillance of overdoses in the state, and lead to data-driven decisions for targeted prevention, ntervention, and treatment in areas of the state with the most prevalent challenges.

“I am proud of the momentum we are experiencing in the state of Louisiana,” said the Governor. “We have turned the $2 billion deficit I inherited at the start of my administration into a budget surplus….”