TESTIMONY OF THE MAINE MEDICAL ASSOCIATION

IN OPPOSITION TO

L.D. 1072, AN ACT TO PROMOTE WORKFORCE EDUCATION ON ALZHEIMER’S DISEASE AND DEMENTIA

Joint Standing Committee on Health Coverage, Insurance & Financial Services
Room 220, Cross State Office Building, Augusta, Maine
Thursday, March 21, 2019, 1:00 p.m.                                              

Good Afternoon Senator Sanborn, Representative Tepler, & Members of the Joint Standing Committee on Health Coverage, Insurance & Financial Services.  My name is Andrew MacLean, Interim CEO of the Maine Medical Association (MMA), and I am pleased to be here today to speak in opposition to L.D. 1072, An Act to Promote Workforce Education on Alzheimer’s Disease and Dementia.

The MMA is a professional organization of more than 4300 physicians, residents, and medical students in Maine whose mission is to support Maine physicians, advance the quality of medicine in Maine, and promote the health of all Maine citizens.

I know that Representative Craven has a deep personal commitment to improving our health care system’s response to patients with Alzheimer’s disease and dementia, as well as their families and caregivers.  She and I have had a brief chance to discuss this bill and it is not an easy one for MMA to oppose. 

But, I must express several concerns about the bill.

Sections 1 through 3 in the bill propose amendments to Maine’s comprehensive health information privacy statute, 22 M.R.S.A. §1711-C, a state statute that is similar to, but pre-dates, the federal HIPAA Privacy Rule.  I think I understand the intent of this part of the bill – to authorize clinicians to disclose protected health information about patients with Alzheimer’s disease or dementia – but, I am not sure that it is necessary or appropriate to add yet another exception to the general requirement of written authorization from the patient to this statute to enable communication with the family.

Section 4 in the bill would impose new obligations on health care practitioners and hospitals to provide families with specific information about Alzheimer’s disease and dementia.  While this is well-intended, MMA traditionally has advocated against legislating the details of “consent to treatment” or “informed consent” by disease or part of the body.  Proposals like this concern us because they add to the substantial administrative burden of compliance with a complex web of federal and state laws governing the delivery of health care in our country.  This administrative burden does add cost to our delivery system.

Lastly, Section 6 through 10 in the bill would require the licensing boards for physicians and nurses to amend their rules to require 2 hours of continuing medical education (CME) specifically on Alzheimer’s disease and dementia.  As I mentioned during my testimony earlier in this session on L.D. 558 regarding the opioid prescribing CME, MMA has concerns about legislative directives to the physician licensing boards on specific CME topics because we believe that physicians should be permitted to use their judgment to choose CME that meets their medical specialty and type of practice.

In place of the bill, the MMA is willing to work with Representative Craven, the Alzheimer’s Association, the Maine Hospital Association, and other stakeholders on a communication strategy to improve awareness of Alzheimer’s disease and dementia in the medical community.

Thank you for considering the views of the MMA on L.D. 1072.  I would be happy to respond to any questions you may have.