2023 Legislative Accomplishments

Overview
South Dakota’s 2023 Legislative Session opened January 10 and continued through March 9, with the 38th legislative day held on March 27. Of the 480 pieces of legislation brought forward, 61 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:

Promoting the art and science of medicine
The South Dakota State Legislature began its 2023 session with Governor Kristi Noem’s State of the State address in which she spoke on several issues of interest to the SDSMA including pregnancy & postpartum care and vaccine mandates.

HB 1235 would have established a personal exemption from any COVID-19 vaccination mandate, requirement, obligation, or demand on the basis that receiving a COVID-19 vaccination violates the person's conscience. Health care facilities would have been exempt from the law if compliance would result in violation of regulations issued by CMS or CDC. The bill failed in the House of Representatives 30-39 after passing the Health and Human Services Committee. The SDSMA opposed the bill.

SB 1 updates the process for adding new debilitating medical conditions for medical cannabis from an administrative rules process within the Department of Health to a legislative process. The bill also places into statute eight specific diagnoses that can be used to certify patient eligibility for medical cannabis. The SDSMA opposed the inclusion of glaucoma and post-traumatic stress disorder as qualifying conditions, due to the lack of evidence for cannabis as an effective treatment. An amendment removing glaucoma from the list was adopted by the House Health and Human Services Committee, and the bill passed both the Senate and House of Representatives by narrow margins.

SB 122 attempted to create opioid prescribing guidelines and require additional physical examinations and administrative documentation for physicians. The proposal was deemed restrictive and out of line with AMA and CDC guidelines. The Senate Health and Human Services Committee defeated the bill on a 6-0 vote with the SDSMA testifying in opposition.

SB 125 would have restricted any school, early childhood program, state agency, elected official, or state employee from adding new immunization requirements to state statute. Most of the proponent testimony during the Senate Health and Human Services Committee focused on the COVID-19 vaccine. The SDSMA opposed the bill, which failed in committee on a 7-0 vote.
SB 130 attempted to amend statute to include an exception for required school entrance vaccinations "because of a sincerely held religious or philosophical belief." The bill was defeated by the Senate Health and Human Services Committee with a 6-0 vote and was opposed by the SDSMA.

Protecting and improving public health
HB 1041 provides an exception to the definition of drug paraphernalia by exempting fentanyl test strips. The SDSMA testified in support during committee hearings and the bill received near unanimous, bipartisan support of the legislature for passage.

HB 1131 sought to prohibit state legislation or state agency rules from creating extreme risk protection orders, also known as red flag laws, and prohibit the enforcement of any federal law or rule pertaining to the same. The SDSMA opposed the legislation and testified against it in the House Judiciary Committee. The bill was defeated by a vote of 9-3.

HB 1162 allows licensed health professionals to dispense or distribute an opioid antagonist to an employer. Practically, the bill allows drug treatment centers to have on hand critical life-saving medications that can be used for someone experiencing an opioid overdose. Similar to HB 1041, another bill aimed at life-saving efforts related to drug use, support of the legislation was unanimous in its passage and was supported by the SDSMA.

HB 1216 was an effort to create and revise criteria for patient visits at certain medical facilities, including adding a physician evaluation component. Opponents, including the SDSMA, were concerned with new requirements for physician evaluation of patients for whom they are not currently serving as the primary practitioner, as well as facility visitation policies being set without regard to the impact of public health at large. The bill was defeated 9-2 by the House Health and Human Services Committee.

Ensuring access to and delivery of quality medical care
HB 1044 was tabled by the Joint Appropriations Committee. The bill would have appropriated $20 million to fund scholarships promoting behavioral health careers. The SDSMA supported this legislation, as well as other initiatives to expand patient access to quality mental health care.
SB 25 authorizes the disbursement of funds to physicians who have met criteria for recruitment assistance. The bill received unanimous, bipartisan support and passed both chambers overwhelmingly. The SDSMA supports this annual legislation.

SB 87 attempted to expand optometric scope of practice to permit injections around the eye, removal of lid lesions, and some laser surgeries. This scope expansion would have allowed optometrists to perform procedures without any experience on live patients and do so after completing a curriculum of just 32 hours. The bill was defeated 7-6 by the House Health and Human Services Committee after passing the Senate. The SDSMA opposed the bill and testified against it.

SB 149 would have created a Medicaid expansion fund to track the disbursements by the state related to the expansion of Medicaid. The SDSMA supported Medicaid expansion during the 2022 general election and supported this bill. The bill passed each chamber in slightly different form and a conference committee was unable to reach consensus. A separate fund isn’t necessary for the distribution of funds and instead will be part of the Department of Social Services’ budget.

SB 175 would have allowed independent practice of physician assistants. As proposed the bill would have granted independent practice authority upon the completion of 2,080 supervised practice hours. The bill allowed those practice hours to be completed under the supervision of another physician assistant, which isn’t allowed in any state. The SDSMA strongly opposed the legislation, and it failed in the Senate by a vote of 14-20.

Advocating on other legislative priorities
HB 1192 and SB 106 both sought to expand postpartum Medicaid coverage to one year, a change supported by the SDSMA. These bills were eventually tabled because the Department of Social Services expanded its ongoing budget to adopt the policy and cover the cost.

HB 1169 proposed to amend statute to state that before an abortion is justified as necessary to preserve the life of a mother, the attending physician, exercising reasonable medical judgment, must determine that by continuing the pregnancy the woman is at serious risk of death or of a substantial and irreversible physical impairment of one or more major bodily functions. The bill was tabled at the request of the sponsor. The SDSMA supported the bill.

South Dakota State Medical Association
2600 W 49th St Ste 100
Sioux Falls, SD 57105
Phone: 605.336.1965 | Fax: 605.274.3274

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