With Republicans taking control of 18 state legislative chambers in 12 states, along with 23 of 37 contested governors' races, political philosophies in state legislatures and assemblies across the country are changing dramatically.
What isn't changing for many states is that budget deficits continue to loom. According to the Center on Budget Policy and Priorities, 39 states have projected budget gaps of $112 billion for FY2012, which rise to $140 billion after estimates are updated. So what is the outlook for neurology at the state legislative level? One answer to that is to ask another question: Does the legislation come with a cost? If so, the chances of passage aren't likely.
That said, the AAN will continue to be active at the state level and will seek out opportunities where neurology can have a significant impact at the state level in 2011, including tracking the following priorities:
Ensuring Access to Antiepileptic Drugs (AED): The Academy's position on this issue states the organizations opposition to the substitution of anticonvulsant drugs (AEDs) for the treatment of epilepsy unless the prescribing physician is notified and approves. The Academy continues to work with the Epilepsy Foundation on this vital issue, which had success in 2010 in Idaho, which joined Georgia, Hawaii, Louisiana, Tennessee and Utah in some form of having AED substitution protection
Sports Concussion: With its recent position statement on sports concussion, the Academy will encourage states to pass legislation based on AAN recommendations, which include student athletes needing approval from a neurologist or physician properly trained in the diagnosis and treatment of concussion. The Academy expects to partner with other organizations that have similar priorities on this issue.
Stroke Care: The Academy released a position statement on stroke care in April 2010 that outlines what policymakers should consider when designating a hospital as a primary stroke center. The position statement also discusses rural issues, telestroke, stroke systems of care, and reimbursement.
Scope of Practice: Threats to the physician scope of practice continue. Neurology is no exception, as other groups look to expand into diagnostic testing such as needle electromyography (EMG) or limit what trained physicians can do by enacting new restrictive regulations.
Liability Reform: The Academy supports caps on noneconomic damages for plaintiffs of no more than $250,000 and tighter standards for expert witness reviews. With many state legislatures under new leadership, there may be opportunity to either insert or enhance liability reform.
While it is well known the Academy relies on its members to use their voice at the federal level, their voice at the state level is even more essential.
The Academy recently formed a group called the State Neurology Insider Program (SNIP). The goal of this program is to attract members who are willing to not only keep an eye out for legislative issues pertaining to neurology at the state level, but to also find members who are willing, if necessary, to visit their state capitol to educate legislators or testify on an issue before a committee.
If you're interested in becoming a key contact or seek any more information on these issues, contact Tim Miller at firstname.lastname@example.org.