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Senate | June 19, 2013 | Committee Room | Finance

Full MP3 Audio File

Ladies this is Admiral ?? , take your seats and we will get have to our meeting started. We have a full load of bills today and we need to, need to get going if you will take your seats. And now be a good time to put your electronic devices to silent or to vibrate only, so that we will not be disturbed by that. I would like to introduce ?? who are here today, ?? if you please raise our hands when I call your name and we will recognize you. Emma mans, from ??, she, Emma where are you , well hand in the pose. Emma was sponsored by Senator highes. And Alison Walton, also of ??,also sponsored by Senator highes. Alison, in the corner. J.C Barringer, from ??, no sir correct? Looks like ??. Sponsored by Senator alwin. Drake barton, from stela. Sponsored by senator Briam. Gordon maa from Kaey, sponsored by senator Stayne. Senators, you really need to pay attention to who these ?? are. Taiwan Desanda from Rileys, sponsored by Senator Blue. Parker lee from ?? sponsored by senator sanderson. And take Zack grei from Chappel hero, sponsored by Senator Tinord. I do believe that the bill we recently passed about writing incursive, is one of the best bills we have passed through and here you should see this. [SPEAKER CHANGES] Senator page [SPEAKER CHANGES] Page is regarded to have you with this today. [SPEAKER CHANGES] Senator page [SPEAKER CHANGES] Recognize some of your ?? [SPEAKER CHANGES] I didn’t vote for the ?? of ?? for the multiplication table. [SPEAKER CHANGES] Lets not go there. Sargent sevan sudae, steve Watson, Bill fitcher, Ashley mickens and Ed Kesrin. We certainly appreciate the work that those gentlemen do and all the sergeants in arms do for us. We will have four bills in our agenda today. And the first bill we will take up is House bill 467, senator Robinson if you’d like to come forward and the house bill sponsors. We’ll have a pcs for house bill 467. Is there a motion to? Senator Harmen recommends a move that we take up the pcs ?? to instruction only. And Senator Robinson, you recognize this represents a take off. [SPEAKER CHANGES] Thank you so much Mr.Chair. And I wanna thank representative ?? who is here and ?? here. Some ?? for House bill 467 and actually we had a companion bill, senate bill 59087 and they has met crossover, so that’s wonderful. And I also wanna thank ?? senators highes and ?? for working with me, this is heck of a ?? to get it down. But I appreciate them working with me and I’ll do the other. The ?? ?? who are here to here the talk as well the ??. This bill actually requires and women is here know that whom u get a ?? and a ??, we got whoever owes back in once in a whole life ?? in terms of who might get contact of doctoral, based on the findings of ??. However ?? are, may the gets ??, and researches show that there are about one in four women have ??, that likely may have some acmonologists one may not might do it doctors may wanna do, do that we talk about. So that the ?? and the breasts could possibly be cancerous and we have seen recently with Anjelina Jolie and other people who-

Representative: …family histories that, hopefully, some of that could be prevented by what we are doing in terms of an awareness bill. This is an awareness bill, so that the results would be to go to the woman and say that you have some breast tissue, and it could indicate that there are some abnormalities here, etc…, that you may want to contact your physician as we have sent the results there. So that is what it says. Senator Parmen wants to say something. Speaker: Senator Parmen, you are recognized. Representative: Thank you Mr. Chairman. Senator Robinson I think this is a very good bill and I know that you all put a lot of work into it. At the appropriate time, Mr. Chairman, I would like to make a motion. Speaker: Okay, I will not recognize you for that right now because there are some visiting experts that would like to have an opportunity to speak. Offer a microphone to Representative Bearclaw, if you would like to speak and then we will hear from members of the public, who are hear to speak, and then we will take question form the membership, and then we will get to your motion. Representative: Thank you Mr. Chairman. I will not take but a moment. The senator has laid out the groundwork. I think you may wonder why a man in the army might be standing up here fighting for this bill. I am a husband of a survivor, and when I heard about this bill, it is very important to us, so I worked hard on it in our house, and I know in your house. I will leave the other comments here to the folks with an interest and an expertise. Speaker: I believe there are some medical personnel and other interested people who are coming forward. Please limit your remarks to three minutes. Please tell us who you are and who you represent. Public: I am a radiologist specializing in breast imaging, from Greensborough, NC. I am here representing radiologists, women, and advocating for women who have had the diagnosis of breast cancer, and also women who have dense breasts. As Senator Robinson mentioned, breast density, when we read on a mammogram, is categorized into one of four levels of density ranging from fatty to very dense. We know that 40-50% screened now with mammograms have dense breasts. We also know, from scientific evidence, that these women are at increased risk of developing breast cancer and if diagnosed with breast cancer, have a decreased prognosis. This fact is compounded by more dilemmas and that dilemma rests in the hands or eyes of the radiologist. Breast cancer is white density on mammogram is white. It is much more difficult to detect breast cancer. So I firmly support this bill. I think that women need to know. I think I represent most radiologists in breast imaging when we say we support this bill. For women and their doctors to know that when they have dense breasts, to heighten their awareness of breast exams, and it will also lead them to more discussion with their family doctor’s, and hopefully looking into what breast density means. There are more tests that can be done to help these women, but I think, most importantly, women need to know what breast density is for their own exams. Thank you very much for this opportunity. Speaker: Thank you doctor. Are there other people to speak on this issue? Please come forward, give us your name and who you represent. Public: My name is Gina Waters. I am from Gilford County. I am a survivor. I was diagnosed with triple negative [xx] invasive breast cancer in June of 2010. I found the lump myself. Even though I had been for all my mammograms, my oncologist said that this had been in me for two years. The tumor was three centimeters when I found it, and it was growing at a 99% rate. By the time I got my [xx] in and received my first chemotherapy treatment, it was two weeks, and in two weeks, it had doubled in size: to six centimeters. After 16 treatments of chemotherapy, over a 20 week period, unfortunately, the tumor did not shrink at all. I had a mastectomy in September, 2010, and they discovered that the tumor had spread to one of my lymph nodes, despite all the treatments. I then took a chemotherapy and had 33 treatments of radiation over a 6 ½ week span. I am a 2 ½ year survivor of stage

[SPEAKER] 3B Cancer. I learned about dense breasts a few months all my treatments ended. Come to find out I had the third level of breast density and my tumor was not visible on the mammogram, even on the day I was diagnosed. I've share what I've learned about this issue with everyone I know who will listen. A dear friend of mine from Pearson County heeded my advice and she called her radiologists office and requested a copy of the written report of her mammogram. And it was sent to her house. And she was shocked to discover when she found it in a mailbox that she had the highest level of density. She then had an informed conversation with her doctor who ordered further testing and they found breast cancer at its earliest stage. She had a mastectomy four months ago and will need no chemotherapy or radiation treatment. Her chance of reoccurrence is one percent. In my case, however, there’s a seventy-five percent chance that I could have a reoccurrence in the first five years. I compare our two stories to point out the importance of the awareness of breast density and the impact it can have on a woman’s life. Some might say, it’s a coincidence that our two stories can be contrasted in as recent as four months ago. I believe that it’s proof that we must take a change. You see, it took my friend more than a year to act on my advice. Consider the outcome if she’d never made that choice. Women all across our state appreciate your support for bill 467. Your support will save lives. Thank you. [SPEAKER CHANGES] Thank you very much for your comments. If you will identify yourself and who you represent, please. [SPEAKER CHANGES] Yes. My name is Addie Jeffrey, and I’m a volunteer with the Commission on the Status of Women in Gilford County in Greensboro, for the City of Greensboro. On Monday afternoon, I just wanted to mention that I was vacationing with my family in Florida laying on the beach. And I was notified that this bill would be heard for today. So, instead of being on the beach I would rather be here with all of you today. So, anyway, eight months after a clean mammogram, I found a lump. And my doctor ordered a diagnostic mammogram and an ultra sound and asked me to return in six months. I didn't want to worry so I asked for a biopsy immediately which diagnosed invasive breast cancer that was almost the length of an Iphone. My oncologist later told me that I had probably had breast cancer for at least three years. So I wanted to know, how could this be? After all, I had had a clean mammogram just eight months before. I then learned about dense breast tissue and that my density may have obscured cancer on previous mammograms because the cancer, as you can see here on the left, is dense breast tissue. It shows up as white and so does the breast cancer. The image on the other side is of fatty breast. I also learned that having dense breast is a risk factor for developing breast cancer. I learned all of this after I was diagnosed with breast cancer, not before. Unlike Gina’s friend from Pearson County, I went through five months of chemo, four surgeries and six weeks of radiation that took one year of treatment. Since my diagnosis two years ago during the time that I was undergoing treatment, I along with a group of very committed volunteers with the City of Greensboro Commission on the Status of women started working on breast density awareness. At the time only Connecticut had a law that women needed to be informed about this. As of that time, now nine other states have enacted this law. Five states have enacted the law this year. So some people have asked why do we need a law for one of many risk factors for breast cancer. Well, this is the only risk factor that is related to the screening process. According to the American Cancer Society, one in eight women will develop invasive breast cancer during their life time. This year 39,000 women will die from the disease. A friend of mine told me a little while back that we are drowning in a sea of pink and we don’t even know what to ask. This law will help to educate the women of North Carolina about the risk factors and their options. You will save lives if you pass House Bill 467. I appreciate your time. Thank you. [SPEAKER CHANGES] Thank you for your testimony. I believe there are a couple of, . . . another doctor. Please state your name, sir, and who you are with. [SPEAKER CHANGES] Good morning, I’m Dr. Bruce Schroder from Greenville. And I’m a breast imaging specialist. I've been doing it for about twenty years and I’ll have to say that over the years I've found many breast cancers. I’m proud of that and guess I've saved many lives. But also, I've missed a lot of breast cancers and more than I care to admit. You know, we've

A very good job in radiology and mammography and telling women to get out and get your mammogram, come every year and we’re going to keep you alive. And I guess we’ve done that and women have certainly listened and they show up. But when they get that letter that we’ve already talked about and it says you’re good, see you in a year. They jump up and down and breathe a sigh of relief and say, I don’t have breast cancer, there’s no way I have breast cancer I did what you said. That’s just simply not the case. And as Dr. ?? said, breast cancer is white on a mammogram. Breast tissue is white on a mammogram. It’s like trying to find a snowball in a blizzard. And actually dense breast tissue actually increases your chance of breast cancer. When I lecture on this I use a picture from The Perfect Storm move. And I say that not only does dense breast tissue increase your risk of getting breast cancer but it prevents us from finding it and that’s a perfect storm. So I support this bill. This is a good bill, it protects women. It gets information out there and it is a notification awareness bill. Id o think that there’s another piece that needs to be done and doesn’t necessarily think we can do it now. Because I don’t want to jeopardize the hard work that everybody’s gone through, but I think we have an obligation and if we’re going to notify women that they need more testing we have an obligation to make sure they have access to it. And it turns out the North Carolina CON law can prevent access to mammography. I know if I mention CON lawmakers are going to run for cover, duck under their desk and turn off their cellphone. Nobody wants to talk about this. This isn’t the usual CON this is not cat scanners, MRIS and operating rooms. Talking about breast cancers. And this is informational. It turns out when CON was enacted a long time ago they put a 500000 cap on it. Probably to control CT scanners. That Makes sense, CT scanners were $1 million and nanomachines were 40,000. You couldn’t get a CT scanner. Fats forward to today, you can buy a used not so good CT scanner for a couple hundred thousand, everybody who wants one has one. So it hasn’t’ been effective. But mammography equipment which has gone through great advances and digital mammography has been proven to be effective in UNC and that study is quoted worldwide, North Carolina can be very proud. Those machines cost $300,000 to $400,000. You can’t have a mamma machine and the ultra sound that dense breast tissue need without jumping through the hoops of CON Now I don’t want to jeopardize this bill and I don’t know that we can bite off more than we can chew at one point right now but I want to make you aware that as we go forward we need to find portu7itesi to protect access to the service not just tell people they need it. Thank you [SPEAKER CHANGES] Thank you, Dr. ??. Any other speakers from the public? Seeing none, I appreciate all of the remarks that we have heard. Senator Allran? [SPEAKER CHANGES] Thank you Mr. Chairman. This seems like a great bill with no downside whatsoever. But the only question I have is this is a really wonderful thing for what it does to help women know more. But what’s confusing me is where do the doctors fit in? Because they already knew all this. I mean they already had this knowledge it’s the women patients that didn’t have the knowledge so do the doctors have an obligation to do something? [SPEAKER CHANGES] ?? to answer. We can get one of the doctors. Do you want to say something? [SPEAKER CHANGES] Dr. Fulgum is with us, Representative Fulgum. And Dr. and one of the bill cosponsors, sir if you’d like to address that question. [SPEAKER CHANGES] Thank you, Mr. Chairman. Knowledge’s power and this is an example of, as the mammography expert said. Women were following the instructions, thought they were doing the right thing and this condition prevents the effective nature of this diagnostic test being the same degree in all women. All women are not the same. And this bill evens out that knowledge gap and that’s all it does. He’s absolutely right, about the access being a different issue. But this is giving the knowledge to the women who need that knowledge because they’re different. They’re not getting the same degree of diagnostic accuracy because they have an impossible situation. This clears that up to the extent that we can clear it up legislatively and I recommend it. [SPEAKER CHANGES] Mr. Chairman., let me get back to the question that I asked. The doctors already knew about this. So were helping women know more so that they dn do something. But don’t doctors who know this already have some sort of obligation they aren’t doing anything with the doctors and that’s my question.

?? where do the doctors fit in terms of having an obligation to share information that they already knew anyway, as opposed to just, this is a great bill but I don't see how it changes anything in regards to the doctors, trusted [SPEAKER CHANGES] Perhaps the doctor at the rear of the rooms who has already testified could just more light on that. [SPEAKER CHANGES] It does help to hear me thank you. Since nineteen ninety three, the FDA has required that radiologists across the country state in their mammogram report. the degree of breast density that is done on every mammogram in every state and every city in every county and every primary care doctor getting that report does know the woman’s stress density but you’ve already heard testimony that probably eighty or more percent of women polled don't know their breast density and when push comes to shove the transmission of that knowledge probably does need to come from radiology and then that should inspire women to have a more detailed discussion with their primary care doctor. I think that especially in this healthcare environment. Primary care doctors. time becomes more limited their patients, numbers increase, and somehow that information has not been conveyed, and were now twenty years since that's been sent out, so I think it is time to have a bill or a law, and we appreciate all the support you may give us in enacting this. Thank you [SPEAKER CHANGES] Thank you Senator Bingham. [SPEAKER CHANGES] Thank you Mister Chairman I wanted to forth an amendment on CO ends, No I'm joking out. I just wanted to move for a favorable report Mister Chairman. [SPEAKER CHANGES] Senator Parmon already beat you to that and I'll recognize her shortly but we’ll make you the third. Senator McKissick. [SPEAKER CHANGES] I am, first I want to commend Senator Robinson, Representative Faircloth, and all others who participated in bringing this bill forth in consideration. The thing I was wondering was this I was looking at the language that is suggested and I was wondering if there's any problems with making a little bit stronger because what it reads right now is that they are encouraging patients to have to talk to their physicians and it really gets encouraged not even make a stronger say highly recommend that you talk to your physicians about this. I mean to send the strongest possible message to those that are getting these notifications. Is there any reason why we couldn’t amend it to make it a little bit stronger than what it states right now because I want folks to see a red flag raised, a brilliant red flag. [SPEAKER CHANGES] ?? [SPEAKER CHANGES] Senator, thank you for that. The house language up was a little bit stronger. The senator worked on it and she had some pressures I understand so maybe she can clear that up for you. I don't mind setting for an amendment to put the words in their highly recommend unless it’s going to present some challenges because this is. I did not recognize the seriousness of this problem until I heard the testimony today having heard it I think we really do need to make this a brilliant red flag, not just a subtle message. [SPEAKER CHANGES] Senator Robinson. [SPEAKER CHANGES] Senator McKissick thank you for that and I do say that Representative Faircloth and we worked on their this and some of the other ladies here in the Senate as well too but we’ve gone back and forth with the language to try to accommodate different folks and you know how that is in terms of this environment. So I would say that might be good but I think we’d like to leave the bill like it is right now and then later on we want to move and some other pieces. I don’t know Mister Chair if you want to do that on the floor or something. I want it passed today though. I don’t want you to do anything to keep it from being passed. [SPEAKER CHANGES] No at all I was thinking about doing a handwritten amendment right here in this room or we can do it on the floor. I believe on the floor would be the best, and then have to go back to the House for concurrence and there will be plenty of opportunity. [SPEAKER CHANGES] That is not a problem. I’ll prepare one for the floor if it has the blessings of the sponsors and one quick follow-up. Assuming somebody gets this notice and they go

the doctors. Do doctors generally understand what the options are in terms of what they need to do as a second step once they discover this dense breast tissue? Imean, in terms of treatment options or further diagnosis, is it common knowledge, or do we need to suggest people seeing a certain type of specialist that might be more aware? And I'm just looking for insight. You guys know more about this than I do. [SPEAKER CHANGES] Thank you, Senator McKissick. The diagnosis is not made if the breast density is too dense. Given that, there are other ?? mammography that was mentioned, M.R.I. scans. Those are more expensive, they're more time-consuming, and so on. They are not indicated as primary screening tools. In most cases, these women with highly dense breasts at the stage 4 situation, are probably wasting their time to have mammography to begin with. So they probably should be going to these highly expensive, more diagnostic procedures to begin with. So they know that from the very beginning, and they don't have the false sense of security by doing something that for less dense breasts would be okay. So given that knowledge, they can make that decision with their physician up front. So that is well thought-through already, so there's no question about those alternatives being available. [SPEAKER CHANGES] Thank you. I appreciate that. [SPEAKER CHANGES] Further questions from members of the committee? Senator Tarte, and then Senator Wade. [SPEAKER CHANGES] Thank you, Mr. Chair. More a personal comment, and first of all Dr. ??, I appreciate you. You are truly part of one of the noble professions. The medical one, not the current one. Relative to this bill, I mean, everybody that cares, and it touches everybody personally in lots of ways, and I say that my sister-in-law is a breast cancer survivor, and what makes this really tough, my 34-year old niece has breast cancer and had surgery this week. And I've known her since birth, and this touches so many families, and it is so important we stay on. Any caring human being is not going to be against this, I get that. But it is so near and dear, it touches families, and it has such an impact. And I'm going to pontificate for a second. I mean, we have a M.I.S. system, an I.T. where we have a 400 million overrun, and we pull eight million from funding for cancer research from U.N.C. hospitals? That's just not right. That's where we need to invest and put our money. This is so important. So I really commend you guys for what you did. This is awesome. And I just want to keep my niece in our prayers. Thanks. [SPEAKER CHANGES] Senator Wade. [SPEAKER CHANGES] Yes. ??, I just wanted to thank you for bringing this before us at the Guilford delegation. You opened all our eyes to what we needed to do, and I just want to thank you and everyone that came with you that night and presented in Greensboro. And I will thank the Greensboro city council for putting it on their legislative agenda and bringing it forth to our delegation. So thank you again for all your hard work. [SPEAKER CHANGES] Senator Parmon moves favorable to the P.C.S., unfavorable to the original bill. All those in favor will please say aye. All opposed may say no. And a favorable report is given to P.C.S. for House Bill 832. [SPEAKER CHANGES] 467. [SPEAKER CHANGES] We haven't made any progress at all here today, have we? We've got three bills to go, folks. P.C.S. to House Bill 832. Is there a motion to consider the P.C.S. for explanation only? Okay, it's a little bit inconvenient to take up 832 right at the moment, Representative Avila. We're still doing some working the back room to get adequate copies, so we'll take up House Bill 371 at this time. Representative Bryan, Representative Conrad, who's presenting this bill? Alright sir, please go ahead. [SPEAKER CHANGES] Thank you, senators. This hopefully will be short. You'll see before you House Bill 371. There's probably a summary, as well. This is a fairly simple bill to amend the Chiropractic Practice Act to authorize the state Board of Chiropractic Examiners to certify their clinical assistants. It comes at the request of the Board of Chiropractic Examiners

and has passed unanimously through a couple of committees on the House side and in the House where I think we had one no vote I should say. The standards for the chiropractic assistance we're going to cover safety indications, contraindications for care as well as protocol. [SPEAKER CHANGES] Excuse me Representative. We have a motion for a favorable report unless you'd like to go forward with additional explanation. [SPEAKER CHANGES] I would love for that. Thank you. [SPEAKER CHANGES] Senator Hise, I recognize you for a motion. [SPEAKER CHANGES] ?? for a favorable vote for the bill. [SPEAKER CHANGES] You've heard the motion. Any further questions. Senator McKissick. [SPEAKER CHANGES] Quick question and it's simply this and I commend you for bringing it forward but was this brought to us by the chiropractors and I assume that's where it's coming from. I take it these people that are working in their offices have not been certified previously. [SPEAKER CHANGES] That's correct and in fact a number of other states have been using this certification process. I think it actually helps with insurance and some other things so they're trying to create a little uniformity. [SPEAKER CHANGES] Excellent. So the Chiropractic Association and everybody is all behind this 100%? [SPEAKER CHANGES] That is correct and in fact some of the folks, Buck Lattimore and others may be here if you'd like for any of them to comment. [SPEAKER CHANGES] Well I don't need a comment. If they're all on board. The last question is in terms of implementation. What's the time frame for it? [SPEAKER CHANGES] I think the Chiropractic Board is authorized to adopt rules. I mean it will be, they're going to have some various rules and I'm trying to look for the actual effective date. That would be July 1, 2014. [SPEAKER CHANGES] Thank you. [SPEAKER CHANGES] Okay, we've had a motion for a favorable report. House Bill 371, all those in favor say aye. All opposed say no. And the motion carries and the bill has a favorable report. Thank you very much. [SPEAKER CHANGES] Thank you Senator. [SPEAKER CHANGES] We're now ready I believe for House Bill 832, PCS. Representative Avila. Is there a motion to consider the PCS? Senator Robinson. Go ahead Representative Avila. [SPEAKER CHANGES] Thank you Mr. Chairman and members of the Committee. What House Bill 832 does, it also had a Senate companion bill, Senate Bill 500, which was sponsored by Senator Hartsell, is to expand the ability of citizens in the State of North Carolina to receive preventative vaccinations through their local pharmacies. What it does in broad strokes is to create a definition of an immunizing pharmacist. It also relocates the description of the practice of pharmacy for one general statute area to another. [SPEAKER CHANGES] xcuse me, Representative Avila. We have a motion for a favorable report if you would like to have us go forward with that or you can continue with your remarks. [SPEAKER CHANGES] I'm just disappointed you didn't stop me sooner. By all means. [SPEAKER CHANGES] Senator Rabin. Senator Rabin, I recognize you. You did not hear that through the microphone but Senator Rabin made that motion but I'm going to recognize Senator Wade first because she has her hand up. [SPEAKER CHANGES] I do have a question on this. Maybe it is in here but I didn't see, if the pharmacist does the vaccination and there's a reaction do they have a physician they refer to or do they have an agreement with someone? [SPEAKER CHANGES] There will be, in Section 4 creates an area or section where a lot of the protocols and the procedures are going to be developed and one thing I do want to make a strong point of is the thank you that's owed to everybody that's mentioned in that section of the bill, from the Medical Society, the pharmacists, the nurses, the public health, all of these have come together. This is not the first year that this has been brought up and tried to be worked through but it's come to fruition because family physicians and everybody coming together and realizing the importance of being able to offer this expanded preventive vaccination and availability for our citizens. [SPEAKER CHANGES] Follow up. So there will be something worked out where they should go ??. Thank you. [SPEAKER CHANGES] Senator Kinnaird. [SPEAKER CHANGES] Thank you, Mr. Chair. I'm glad that we did get to hear this explanation because this has been very controversial for years.

?? to hear that everybody's gotten together and we're moving forward on it. So thank you for working on it. [SPEAKER CHANGES] Senator McKissick. [SPEAKER CHANGES] And I want to thank Representative Avila as well for bringing this forward. Just want to get two points of clarification. It's my understanding that for flu vaccines they can still be administered to people under 18 years of age or as for other immunizations you'd have to be 18 or older and have a doctor's order. [SPEAKER CHANGES] Yes, sir. [SPEAKER CHANGES] OK. And that goes down, is it, to 14? It didn't say anything in the bill about that. [SPEAKER CHANGES] I think the influenza's 14, all the others are 18 and above. These are for adults. [SPEAKER CHANGES] Now, help me with one issue, and that's simply this: I know it says you've got to be 18 and with a doctor's order. But if the doctor's entering an order for it, I assume the patient's going to see the doctor first. Why wouldn't the doctor just do the immunization? [SPEAKER CHANGES] That's not the requirement. And that's why the development of the protocol and the procedures that they'll use in order to make sure that the medical side knows about the administration of the vaccine. [SPEAKER CHANGES] Quick follow up. And so you don't have to have a doctor. So it will be adopted to specify what the pharmacist can do then. [SPEAKER CHANGES] Right. [SPEAKER CHANGES] Thank you very much. [SPEAKER CHANGES] Further questions from members of the committee? Hearing none. Senator Rabon, you're recognized for your motion. You can try it through the mic. [SPEAKER CHANGES] It's unusual that I forget the microphone. We'll have to let Senator Brunstetter know that. May I make a motion for a favorable, please? [SPEAKER CHANGES] That would be a favorable to the PCS, unfavorable to the original bill, and this will go to the floor. All those in favor will say aye. All opposed may say no. The motion carries. Thank you very much, Representative Avila. I'm sorry you didn't get to talk longer. [SPEAKER CHANGES] Oh, I appreciate it. And thank you, members of the committee. [SPEAKER CHANGES] And now, our final bill today is House Bill 830, "Adopt State Symbols." Representative Susan Martin is here to explain this bill to the health care committee. [SPEAKER CHANGES] Thank you. Thank you. First I'd like to explain, and thank you for your indulgence in having this in this committee. We are having a special event today where we are having a resolution on the House floor to honor the life and memory of Vollis Simpson, who is the artist and creator of the whirligigs, which we adopted earlier in May as the state folk art, and are hoping the Senate will concur and move the bill along. And that delegation is coming, and Senator Apodaca is indulging me and taking pity on me for having to work with Senator Newton in my district and trying to move this to the House floor so the group can go. If you'd like to hear about the other state symbols, I'd be happy to share all those with you. We have a- although I'm only responsible for the whirligig. [SPEAKER CHANGES] Representative Martin, I believe there are several members of this committee who have some very insightful questions into this bill, but I'm going to recognize Senator McKissick, who is going to be very short with his recommendations. [SPEAKER CHANGES] Move for a favorable report. [SPEAKER CHANGES] Having heard that- [SPEAKER CHANGES] No, no. Mr. Chair, I have- [SPEAKER CHANGES] Senator Kinnaird, you are recognized. [SPEAKER CHANGES] I think that you are depri- by all these others, fossil, frog, salamander, I'm glad about the whirligig, that's wonderful. We have, in Fearrington Village and Chatham County, we have some of those and they're wonderful. In fact, I think they have four of them. What I'm complaining about is every year some fourth grader comes to one of us and says, "We don't have a state marsupial, and would you please make it-," and of course this is Virginia and I'm not sure we want that. And so we get to run a bill naming a state something-or-other and then we please all the fourth graders. So, I think when we do this en masse we are depriving those of us who might like the state art medium, to no longer be able to say to those fourth graders, "We got your bill through." So my question is, why are all these on there in addition to the whirligig, which is all we needed? [SPEAKER CHANGES] Thank you for that question. It was brought to us in caucus that we would do this as omnibus to protect the efficiency of the process. However, there were different individuals and classes who contributed the different pieces that came together in a bill, particularly the fossil, which is a shark tooth, came from Pat McElraf's class. And Representative Avila had a very impressive high school stude-

who presented the proposal on the salamander and frog, and they did a great job. So, I appreciate that, and that is a important part of the process. [SPEAKER CHANGES] Thank you. [SPEAKER CHANGES] And Senator Conrad, we have not gotten into the Human Genome change yet, and I'm sure there'll be a few interests along this way. Senator Hise? [SPEAKER CHANGES] I just wanted to say real quick, well in general these kinda bills we take up at our own risk, but saying forward, but I would say that I have been quite entertained this morning by reading the blogs and even some of the news organizations about the diabolical nature of this bill, and the unplanned committee substitute that we were getting ready to drop on all of healthcare, all across the state, to make everyone kinda nervous, and as you said, it is not subbed and remains about a whirlygig, so- [SPEAKER CHANGES] Laughter is important for your health, so we need to have a sense of humor here. [SPEAKER CHANGES] I don't see any whitecoats in the audience today, they did not march on Raleigh, so- [SPEAKER CHANGES] That was a good idea. [SPEAKER CHANGES] We are ready to go forward with this motion, who made the motion? Oh, someone did, Senator McKissick, I recognize you for your motion. Move for a favorable report? Having heard that, any further question from members of the Committee? Hearing none, all those in favor of adopting this please say aye, all opposed no, the Bill will be going to our floor. Thank you very much, Representative Martin. This meeting is now adjourned.