South Dakota’s 2022 Legislative Session opened Jan. 11 and continued through March 10, with the 37th legislative day held on March 28. Of the 551 pieces of legislation brought forward,75 had the potential to impact health care delivery in South Dakota.
During the nine-week session, the SDSMA worked on a wide range of issues to protect the practice of medicine and to enhance the delivery of medical care. Some highlights of the important issues the SDSMA was involved in include the following:
Promoting the art and science of medicine
The South Dakota State Legislature began its 2022 session with Gov. Kristi Noem’s State of the State address in which she spoke on several issues of interest to the SDSMA including increased spending for emergency medical services, addressing mental health and addiction, barring COVID-19 vaccination requirements, and pursuing stricter abortion regulations.
HB 1008, which would have allowed employees to bring claims against their employer for perceived injury due to vaccines required for work, was deferred to the 41st legislative day, meaning the bill was killed. The SDSMA opposed this anti-vaccination legislation.
HB 1242, An act to allow medical practice “based on conscience,” was deferred to the 41st legislative day. While sponsors of this type of legislation may believe that
healthcare workers are forced to perform procedures outside of their beliefs, it’s important to help legislators understand the relationship between a patient and a physician is based on trust, which gives rise to physicians’ ethical responsibility
to place patients’ welfare above their own self-interest or obligations to others, to use sound medical judgment on their patients’ behalf, and to advocate for their patients’ welfare. Furthermore, multiple federal health programs — such as Medicaid and CHIP — include conscience protections. The SDSMA opposed this bill.
HB 1267 would have allowed medical professionals to dispense ivermectin without a prescription. The bill was later amended to require a prescription. The SDSMA spoke in opposition on the grounds that the CDC and the FDA have issued advisories indicating that ivermectin is not authorized or approved for the prevention or treatment of COVID-19. The National Institutes of Health, World Health Organization, and Merck (the manufacturer of the drug) all state there is insufficient evidence to support the use of ivermectin to treat COVID-19. Additionally, ivermectin is a drug that, for appropriate use, can already be prescribed by medical professionals. The SDSMA opposed this bill, and it was killed in the Senate after passing in the House.
SB 211would have instituted a COVID-19 vaccine exemption into state law for religious objections and natural immunity. The bill passed the Senate 31-4 and the House 37-32; however, it was a different version of the bill. The bill failed due to lack of concurrence. The SDSMA opposed this legislation.
Protecting and improving public health
HB 1028, An act to update certain provisions related to the licensure of optometrists, was passed as amended and signed by the Governor on Feb. 15. The SDSMA effectively lobbied against the bill’s provision to allow optometrists to prescribe, administer and dispense oral therapeutics to children under age 12 and to prescribe, administer and dispense oral steroids without physician oversight.
HB 1038, An act to establish an opioid trust fund, was passed and signed into law by Gov. Noem. The legislation establishes a trust fund with dollars received from state and federal opioid settlement funds. The fund will provide resources to fight opioid abuse and to fund remediation programs for those struggling with addiction. The SDSMA supported this legislation.
HB 1056 adds physicians to the list of those who can access the patient registry for medical cannabis. The SDSMA lobbied in support of HB 1056 to ensure physicians can access/check the medical cannabis registry before prescribing narcotics or other drugs that have the potential for bad interaction with what a patient may be current taking. The SDSMA was integral in getting this legislation introduced.
HB 1068, An act to clarify the processing of sexual assault kits performed on individuals aged 16 and 17 passed unanimously in the House and Senate. The bill allows a minor to consent to a sexual assault kit without consent of a parent or guardian. The SDSMA supported this legislation.
HB 1292, An act to regulate delta-8-tetrahydrocannabinol for those under age 21, was passed by the House and Senate. This bill will make it unlawful for anyone to knowingly sell or distribute a product intended for human consumption containing delta-8 THC to a person under the age of 21. The SDSMA supported this legislation.
Ensuring access to and delivery of quality medical care
HB 1030 appropriates $690,150 to the SDDOH to reimburse three family physicians, four physician assistants and four nurse practitioners who complied with the requirements of state recruitment assistance programs. The SDSMA supported this legislation.
HB 1208, an act to prohibit chemical abortion drugs and to provide a penalty therefore was deferred to the 41st legislative day. This bill would have banned all drugs used in a medical abortion. While the SDSMA does not take a position on abortion, the SDSMA did speak in opposition to this bill as it made no exception for ectopic pregnancies.
HB 1223, An act to authorize the provision of informed consent by a pregnant minor passed the House of Representatives and the Senate. This bill allows a pregnant minor to provide consent for medical or dental procedures or services if a provider has tried and not been able to obtain consent from the minor’s parent or guardian, if the parent or guardian is unavailable, or if they withhold consent. The SDSMA supported this legislation.
SB 24, An act to prohibit cultivation of medical cannabis by a medical cannabis cardholder went to conference committee and passed the Senate 21-11 and House 50-19. The bill eliminates the need for a medical cannabis cardholder to obtain a prescription from a physician to grow their own medical cannabis. It also caps the number of plants a cardholder can grow at two flowering and two non-flowering, rather than a minimum of six plants as allowed by IM 26. The SDSMA strongly supported this bill.
SB 134 would have allowed independent practice of physician assistants. It failed in the Senate by a vote of 16-19. As proposed, the bill would have granted independent practice authority upon the completion of 1,040 supervised hours of practice. The prime sponsor of the bill offered several amendments on the Senate floor attempting to pass the bill including increasing the practice hours to 6,240. The SDSMA strongly opposed this legislation.
Advocating on other legislative priorities
HB 1004, An act to prohibit cardholder cultivation of medical cannabis, was deferred to the 41st legislative day. As proposed, this bill would have prohibited self-growth and self-cultivation of medical cannabis. The SDSMA supported this bill as there currently are no oversight and testing requirements for patients who “home grow.” Thus, leaving physicians with little to no information regarding what those patients are being exposed to.
HB 1088, An act to limit the delta-9 tetrahydrocannabinol concentration in medical cannabis and cannabis products that may be dispensed was withdrawn at the request of the prime sponsor. This bill would have limited the content of THC within medical cannabis products to 15 percent or less. Research indicates there is no medical benefit from cannabis with a THC level of more than 15 percent and in fact can be detrimental. The SDSMA supported this legislation.
SB 102 was tabled by the House Appropriations committee. It would have created a fund to expand Medicaid whether by the passage of a statewide ballot measure or by an act of the Legislature to provide benefits to people aged 18-65 whose income is at or below 133 percent of the federal poverty level. The SDSMA supported this legislation.
SB 186, An act to expand Medicaid eligibility, was passed by the Senate Health & Human Services committee but failed to pass the Senate. This bill would have provided Medicaid benefits to any person aged 18-65 whose income is at or below 133 percent of the federal poverty level. The SDSMA supported this legislation.