Legislative Update - Report from the Front Lines

North Dakota lawmakers gave their initial stamp of approval to nearly 600 bills before breaking for a three-day recess last Thursday, and a new state revenue forecast in mid-March will set the stage for the second half of the session.

For the last 37 days, lawmakers have been busy working on bills in their respective chambers. House and Senate lawmakers advanced a combined 599 bills – 70 percent of the 852 bills introduced – during the session’s first 38 days, while 249 bills failed and four were withdrawn. The vast majority of the bills will now be taken up in the opposite chamber which means it's time for cross-over.  That's when they start working on bills passed by the other chamber.

Most refer to the past two months as the “first half”.  AHA has always looked at session in thirds – first third sorting through the bills that survive to cross-over, second third giving the other chamber an opportunity to work, and then the important part of the legislative session - conference committee work.  This is when six legislators, 3 from each chamber, can meet to work through differences in each chamber’s work.  Last session, when our CPR in Schools funding bill had an opportunity to go to conference committee, we opted to encourage going with one chamber’s version, feeling we didn’t want to risk what we secured by that point.  This session, with several important areas of AHA interest in agency budget bills, we will be actively engaged in that 3^rd part of session committee work during April.

Here is how we have fared so far:

• Stroke System of Care (HB 1323):  This bill passed unanimously in House Human Services and the full House.  It was heard Wednesday, March 4 in Senate Human Services.  The bill is doing well due to: 1) stakeholder support of updating the century code to reflect important elements of system work; 2) survivor stories showing the impact of coordinated response and rehabilitation care; and 3) successful outcomes of our ND stroke work.  For example, the percent of acute ischemic stroke patients who arrived at the hospital within 2 hours of time last known well and for whom IV t-PA was initiated within 3 hours increased from 30.9% in 2010 to 80.9% in 2013.  This treatment improvement helps to reduce brain loss due to stroke by clearing out clots preventing blood flow to areas of the brain. That is significant!
• Funding Bills:  Our priority issues have been challenged by the revenue forecasts at the beginning of session.  Given oil production is up in North Dakota, we hope the new projections in March will help move these funding areas forward:
  • Senate Action:  The Senate continues with strong support for CPR being taught in schools, and has added language into the Department of Public Instruction agency budget to continue funding, and to extend the resources to the junior high level.  We appreciate DPI’s support of this continued invest also.
  • House Action:  The House opted to not add in new funding opportunities into the Department of Health budget, and made cuts into the Governor’s proposed budget.  However, we know our advocates have been impactful on the needs for the key heart and stroke funding priorities, and during conference committee work we may gain some traction.  So as HB 1004 makes it way to the Senate, we are focused on:
    • Cardiac System of Care funding:  With available grant funding coming to an end, the cardiac system needs a small base of funding to continue its work of public, EMS and hospital collaborative work to ensure timely, appropriate care for acute cardiovascular events.
    • EMS Database system:  Our EMS responders are working with outdated programs for capturing response runs, which no longer receive vendor support.  This is a request for mostly one time funding, and if successful, will provide our acute care field providers with improved health information and also our state with invaluable information related to field care.
    • Million Hearts Funding:  We know high blood pressure and tobacco use are driving cardiac and stroke events.  Yet no prevention funding is available to start addressing the leading risk factor – high blood pressure, and that funding support for smoking cessation access falls short of CDC guidance.

And of course there are a number of other bills we are watching and engaging on as appropriate.  It’s been a busy first half!

Our advocates have been instrumental in our progress to date.  I love hearing from legislators on committees and in the halls saying they are hearing from you.  Your voice does make a difference as we work the halls.  Keep up the great work as we navigate the next two core decision-making opportunities!