Debate on whether to allow a health practitioner to treat an unseen partner of a patient with specific sexually transmitted diseases extended past three hours Tuesday without a vote.
The debate on the bill (LB528) introduced by Omaha Sen. Sara Howard started Monday and included several amendments offered by Sen. Bill Kintner of Papillion and Omaha Sen. Beau McCoy.
The bill would allow expedited partner therapy for the treatment of gonorrhea and chlamydia, permitting a physician, physician's assistant or advanced practice registered nurse who diagnoses a sexually transmitted disease to prescribe medication to that patient's partner or partners without examination.
"Because we are having such an epidemic of chlamydia and gonorrhea in our state, medical practitioners must have tools outside the traditional treatment models," Howard said.
It would be done in accordance with recommendations and guidelines by the Centers for Disease Control. Medication would be prescribed only for partners unable or unwilling to go in for treatment -- and only if they were named.
Chlamydia and gonorrhea are particularly dangerous to unborn babies, Howard said. The bill is an opportunity to prevent blindness and premature births.
In 2011, 317 Nebraska babies were born with chlamydia or gonorrhea.
That same year, Douglas County reported 3,366 cases of chlamydia and 866 cases of gonorrhea. For a number of years, the county has had twice the national rate for those STDs. Lancaster County reported 1,234 cases of chlamydia and 251 cases of gonorrhea.
The chlamydia rate in Lancaster County in 2011 was 426 per 100,000 population, higher than the 371 per 100,000 state rate and the highest rate in 13 years. The gonorrhea rate also is higher than the state rate.
Kintner tried and failed to push through an amendment to the bill that would require notifying parents of minors seeking treatment that an antibiotic had been provided.
Had it been adopted, Howard said, Nebraska would be the only state that required such notification, and many young people likely would not seek treatment.
People 15 to 24 years old are at greatest risk of these sexually transmitted diseases.
McCoy's first amendment, which would require a health practitioner to provide written information about the STDs to pass to partners, was adopted.
A second amendment that would have removed from the bill partner treatment for gonorrhea was withdrawn before the Legislature adjourned for the day. McCoy said there was a problem with drug-resistant strains of gonorrhea, and the Centers for Disease Control no longer recommends oral antibiotics to treat it.
Howard said Nebraska has had no reported cases of drug-resistant gonorrhea.
The state has to be careful with public policy, McCoy said, to ensure that while addressing a dire public health emergency it isn't also contributing to reinfection or spreading infections, especially to pregnant women.
He said he withdrew the amendment in light of the fact that the state Department of Health and Human Services would develop rules and regulations for the implementation of the bill.
Sen. Lydia Brasch of Bancroft said the bill was not good public policy.
Physicians have a relationship with patients they treat, and they are aware of pre-existing conditions and complications, she said. Making exceptions for STDs is not a good idea.
"We're not going to solve the problem, but what we're going to do is blindly treat someone on hearsay," Brasch said.
For a time, the debate dissolved into a discussion of love, particularly forbidden love, when Sen. Mark Christensen of Imperial questioned why a person would want to be with a partner who wouldn't go to the doctor to take care of an STD.
"You seriously going to stay with them? No common sense to that. I just cannot even fathom that," he said.
Several senators then tried to explain how those relationships work.
Debate on the bill is scheduled to continue Wednesday morning.