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General Assembly Sine Die, Part Three

Given the sheer volume of work done in the General Assembly every year, it is impossible to research every issue before the body. In the House alone 2,600 separate pieces of legislation were introduced in 2017. I have tried to touch on the highlights (and low points) of session which were not front and center in the news. Consider that while some of the bills and resolutions mentioned in both Part One [1] and Part Two [2] did not make their way through the process, they are a predictor of things to come and will be seen again.

Moving along in this third installment, there were no less than three resolutions for Conventions of States, HJ763, HJ547, and HJ551, all of which were tabled in committee but can be expected back in some form in the 2018 session. Redistricting bills were also left on the table.

Efforts on badly needed Certificate Of Public Need (COPN) reform fell completely flat and Virginians are the losers, yet again. The average tax paying citizen of the Commonwealth does not realize how much the current laws limit medical care or what is required to build a hospital, upgrade, or add new equipment to provide services for patients.

Current COPN laws give the General Assembly control of medical services including things like the building of neonatal units for sick infants, surgical facilities and can even limit the installation of a new MRI machine.  For those who think antiquated laws and for that matter, government run monopolies are a thing of the past, think again. It’s no surprise given this kind of control, that the process is inundated with politics and is broken. Hospitals are given free reign to object if they decide a new service in another facility will compete with those they already provide, a few miles away.  These objections are backed with intense effort by the powerful Virginia Hospital and Healthcare Association, who have blocked the passage of reform in the General Assembly for the past three years.

In February of 2012, a premature infant died in a hospital in Salem [3], Virginia, due to a lack of available services. These services had been requested numerous times by civic leaders, doctors and others.

Delegate John O’Bannon from Henrico led the charge this year with a practical COPN reform bill. HB2337 was well crafted to begin to address this failed solution to Virginia healthcare. It called for allowing operating rooms, NICUs and MRI facilities anywhere in Virginia where there are 200 or more people per square mile. COPN would be preserved in rural areas with far less people, and the bill fared well in the House. The Senate, however, was just was not hearing it.

For a comprehensive look at this issue which failed on the Senate side, check out my colleague D.J. McGuire’s stand-alone piece on the history (see COPN Reform Dies in State Senate, Again [4]).

So, in a last word on COPN reform for activists wanting to dance around the fire, angry at bills about Virginia Power and farmers, here’s an issue NOT controlled by your local government. It is totally dependent on your legislators and affects you directly — an issue you might pay attention to, especially in the upcoming Governors race.

On another subject, Senator Amanda Chase put forth two proposed constitutional amendments to begin their trip to the Virginia ballot. Senate Joint Resolutions 224 and 225 did not make stage one of their journey, but these are likely to return in a future session as well. The first resolution dealt with the qualifications of Governor and increased a potential candidate’s residency time. The other resolution addressed term limits and called for members of the Senate to retire after three full terms, and would limit members of the House of Delegates to six full terms.

Finally, in some really good news from the 2017 session and a long time in the making, is the passing of a bill carried by Senator Dave Marsden. His SB1027 is a high water mark and cause for celebration among all Virginians who have sought treatment that is considered unconventional for a serious illness. The bill will finally allow the manufacture of a medical drug in the form of an oil extracted from cannabis (marijuana), ensuring it becomes available here to treat patients with intractable epilepsy. While it is only for intractable epilepsy, it is a step in the right direction.

Despite pressure associated with the recreational use of cannabis, which actually has nothing to do with the medicinal oils extracted from the plant and does not make patients high, Senator Marsden shepherded several pieces of legislation through over the last few years. His 2015 bill, along with Delegate Dave Albo’s House companion bill, introduced language to prevent the prosecution of patients and caregivers who needed to obtain the oil for treatment, and was successfully passed. The effort started with three Virginia mothers and family members who began to appeal to the General Assembly in 2014. Read about their compelling story which details what life is like when a child can have daily epileptic seizures, 52 weeks a year (see NBC Dateline: Growing Hope [5]).

Apparently, even in 2017, just the word marijuana closes off conversation about the benefits to those suffering from a number of diseases. Senator Marsden, however, took this issue on and did his own research. He hung with the parents and patients until an acceptable remedy could be found over a succession of years. The Cannabidiol (CBD) oil does not have the effect of smoked marijuana, and law enforcement reports that abuse is not a concern. Much clinical evidence supports the potential benefit of cannabinoids and reasons are strong to accept they have a legitimate medical use. For the children in Colorado shown in the video, it has been a lifesaver and they are doing well.

The original protection bills by Marsden and Albo in 2015 had an emergency clause for families to immediately seek the drug in order to begin treatment. However, families were left without access to CBD within the state of Virginia. Some families of epileptics have been forced to live apart, with a husband or wife living with an ill child in a state where the drug is obtainable. The bill to allow manufacturing and distribution of the drug was introduced by the Senator in 2016 and ended its journey this year with a final enactment clause in the form of SB1027, allowing the production of the oil in Virginia. There are approximately 80 thousand people in Virginia with epilepsy and, nationwide, someone dies every ten minutes from this disease.

A similar bill carried this year by Delegate Glenn Davis, HB1637, which would have given relief to those suffering from Crohns, Alzheimers, and Parkinsons, was debated and defeated in committee. The issue has been sent to the Joint Commission on Healthcare Reform. Senator Jill Vogel also carried a medical marijuana bill, SB1298, which did not make it through the House. The verbiage was carefully written in an attempt to bring relief to Virginia citizens in a reasonable way and to quell objections.

To be fair, the objection to these bills is based on the premise that the General Assembly is not the proper party to determine what medical conditions qualify. The idea is that those decisions should be made by doctors based on ongoing trials and evidence, not legislators based on a brief synopsis during session.

With that said, referring back to the Marsden bill for intractable epilepsy, the prevention-from-prosecution clause already requires a written doctor’s order stating the patient has epilepsy not controlled by existing pharmaceuticals. Doctors are already making those calls. Kudos to Senators Marsden and Albo for hanging in there with these parents, to Senator Vogel, and to Delegate Glenn Davis for giving HB1637 his best effort.

It is understandable that the members of the Virginia General Assembly are not medical professionals, but Marsden’s bills are now on the books. With 29 states having passed full medical cannabis laws and another 15 with limited laws like Virginia, it’s time our lawmakers work together to ensure every suffering Virginian who, upon recommendation of their physician, has access to these oils.

The halls of the GA have been filled with really ill citizens and the message is they need help. Have it studied, convene a panel, and do what it takes. It really is an issue all our lawmakers should “take to raise.” The courage of all these families should be applauded but it is a shame it takes so much sacrifice to get the attention of our law makers. The focus by the GA this year on Opioid deaths was admirable but in states with robust medical marijuana laws, opioid deaths are down 25 percent.

Nationwide there are now 44 states and the District of Columbia that have enacted medical marijuana laws in conflict with federal law. This conflict needs to be addressed at the federal level. The states have recognized the immediate need for life-saving medicine and yet federal law continues to complicate research and access for patients. The Virginia delegation to Congress also has a responsibility to Virginians who are ill and may benefit from medical cannabis to do their part to pass laws that will end the federal prohibition of cannabis for medical use.

In my fourth and final installment, as the Governor takes his time with his magic pen, I’ll look at some little talked about, but great, legislation from the gentleman from Franklin County, Delegate Charles Poindexter, who took on the matter of Sanctuary Cities in Virginia. I’ll translate some budget speak, as well as a look at some “end of an era” moments in the GA of 2017.

The author would like to thank both Chuck Moss and Beth Collins for their help in this post and for a better understanding of the The Cannabidiol (CBD) bills for intractable epilepsy.