Last week the President released the Executive Branch’s FY18 proposed budget… called“A New Foundation for American Greatness.” The proposal outlines the administration’s funding priorities for the upcoming fiscal year… but it’s Congress that has the authority to actually set the budget.  

In a nutshell, the President’s budget requests an additional $54B in military spending next federal fiscal year (about a 9% increase) and proposes paying for the increase with cuts to other domestic discretionary programs (including core public health programs) by the same amount ($54B). 

Obviously, if it were to be enacted by congress as proposed, it would mean pretty substantial reductions in public health spending at the national, state and local level as the cuts would significantly impact public health grant funds to state (and local) health departments here in Arizona. 

Below is a breakdown of the proposed cuts to the CDC & HRSA and here’s a link to the President’s proposed budget:

https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/budget/fy2018/budget.pdf 

Centers for Disease Control & Prevention

The executive budget proposes cutting the CDC’s budget by 17% (from $7.2B to $5.9B) with large specific cuts to several programs.  I’ve broken down the proposal by public health service category below.

Chronic Disease Prevention and Health Promotion

The proposal completely eliminates several line items in the CDC’s budget including:

• tobacco prevention and cessation ($204M cut);
• nutrition, physical activity and obesity ($50M cut);
• heart disease ($103M cut);
• diabetes ($140M cut); and many other line items.

The proposed budget reduces the CDC’s Immunization and Respiratory Disease program by 10%; from the current $782M to $701M.

The proposal calls for cut by 17% funding for HIV/AIDS, Viral Hepatitis, STIs and TB Prevention programs; from the current $1.1B to $934M. In addition, the budget calls for decreases HIV/AIDS Prevention and Research Program by $147M.

A cut of 11% is proposed for Emerging and Zoonic Infectious Diseases; going from $579M to $514M.

The Executive budget completely eliminates the Preventive Health and Health Services Block Grant. Arizona currently over $1.85 million in FY16 from this Block grant, which allows AZ to address our unique public health needs in innovative and locally defined ways.

The budget does propose the creation of a $500M fund called the America’s Health Block Grant to provide flexibility for each state to implement specific interventions to address its population’s unique public health issues. States could theoretically use this funding to support interventions such as tobacco prevention and control; diabetes; heart disease and stroke; nutrition, physical activity and obesity and arthritis.  However, this new Block Grant is slated to be funded via the Prevention and Public Health Fund, which is completely eliminated by the American Health Care Act as passed by the House of Representatives.

Birth Defects, Developmental Disabilities, Disability and Health

The proposed budget eliminates 18 current categorical programs in the birth defects center and directs the CDC to focus its birth defects and developmental disabilities portfolio on core public health activities that “align with CDC’s mission and have proven interventions to make an impact on America’s health.”  It calls for 26% cut to the total programs in this category going down from the $135M to $100M.

Public Health Scientific Services are slated to be cut by $30M to $460M from the current $491M; Occupational Safety and Health is slated for a dramatic 41% cut to $200M from the current $338M.  Public Health Preparedness and Response is slated for a 9% cut ($136M), bringing preparedness funding down to $1.2B including a cut of $107M to the Public Health Emergency Preparedness Cooperative Agreement.

Environmental Health

The budget proposes eliminating the Amyotrophic Lateral Sclerosis Registry and reducing the Environmental and Health Outcome Tracking Network by $9M.  Environmental programs are slated to be cut to $157M, a decrease of $59 million from the current $217M.    

Injury Prevention and Control

Eliminates the elderly falls program and the injury research control centers. It does plan for level funds for opioid abuse and overdose prevention at $74M but cuts total injury prevention by 8% going from to $216 million from the current $235M.

Health Resources & Services Administration (HRSA)              

The executive budget proposes cutting HRSA’s budget to $5.5B from the current $6.15B with large specific cuts to several programs among rural health and primary care.  I’ve broken down the proposal by public health service category below.

Primary Health Care

The budget proposes the elimination of HRSA primary care programs for area health education centers; training diversity; training in primary care medicine; oral health training; public health and preventive medicine programs and other workforce programs.

HRSA workforce programs would be cut by 33% from $1.15B to $771M. I couldn’t tell from the line item whether this represents the match funding for state loan repayment programs for primary care incentives in rural areas or not.

Overall, this category of the HRSA budget would be $5B. There are proposed increases in mandatory funding for Community Health Centers by $89M.

Rural Health

The proposed budget eliminates the rural hospital flexibility (FLEX) grants and the state offices of rural health grants (like our Arizona Center for Rural Health). The Rural Hospital Flexibility Grants and State Offices of Rural Health are discontinued “to prioritize programs that provide direct services”. 

The total HRSA rural health budget would be cut by 50% with whatever funding remaining targeted toward the Rural Health Outreach Network and Quality Improvement Grants, Rural Health Policy Development, and Telehealth.

Maternal and Child Health Bureau

The proposed budget envisions cutting this Bureau within HRSA by $35M to $1.2B. It increases funding for the Title V Maternal and Child Health Block Grant by $30M and increases funding for the Healthy Start program by $10M but eliminates the sickle cell demonstration program; autism and other developmental disorders; heritable disorders; universal newborn hearing screening and emergency medical services for children.

Ryan White HIV/AIDS Program is slated for a $59M cut from the current $2.3B; eliminating the AIDS Education and Training Centers Part F and the “special projects of national significance”

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Remember, these proposed FFY 18 budget cuts by the President are just that, proposed.  Congress is the branch of government that’s authorized to set spending levels, so it’ll be important for us to continue to follow the budget conversations over the coming months and add our voices to others that will be advocating for the protection of important public health programs.

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107 years ago Arizona’s founders protected ordinary voters with a state constitution that guaranteed AZ residents the power of referendum, recall and initiatives.

Many of the bold moves to improve public health policy have come via citizens initiatives. A few examples are:

• The Smoke Free Arizona Act;
• The TRUST Commission for tobacco education and prevention;
• First Things First;
• Proposition 204 (from 2000) which extended Medicaid eligibility to 100% of federal poverty

This legislative session, Arizona’s legislative and executive branches passed and signed two bills (HB2244 and HB2404) that will impair our ability to use voter initiatives to improve public health in the future.

• HB 2404 prevents signature gatherers from getting paid by the signature (for voter initiatives), making it more difficult to provide the work incentive needed for gatherers to be efficient.  This will be a barrier to getting the large number of signatures needed to put citizens initiatives on the ballot in the future.

• HB2244 changes the citizen’s initiative compliance standard from “substantial compliance” to “strict compliance” with the requirements for putting initiatives on the ballot. This new law will make it easier to reject petitions if there are any errors on the document.

Fortunately, a new non-partisan political committee called The Voters of Arizona www.votersofarizona.com is challenging these new limits on voter initiatives. Their goal is to collect 75,000 signatures by August 12 in an effort to keep these new laws on hold (called a referendum) until the Arizona voters have an opportunity to weigh in during the November 2018 election.

As an ordinary Arizona citizen, you can help preserve the current voter initiative process. To learn more about the referendum effort or to collect signatures visit www.votersofarizona.com

If you’d like to help gather signatures for this important effort you can click here.

“This is part of what Arizona is supposed to be about, what we always have been about. The people serve as a check on the government and in particular, the Legislature. It’s pretty clear to me that this Legislature is doing what it can to try to take that power away from the public so we’re not going to let them get by with it.“

– Grant Woods, Co-Chair, Voters of Arizona

The Arizona State Legislature’s 2017 Regular Legislative Session ended yesterday.  We had some solid gains in terms of public policy that influences public health.  We also had some missed opportunities and some losses (especially when it comes to future voter initiative possibilities), but on the whole, lots of good things happened.

A big thank you to Eddie Sissions and all of the members of the AzPHA Public Policy Committee for their work tracking and advocating for and against bills this session.  Thank You!

Access to Care

Emergency Dental Care

The biggest public health win came inside the Budget.  Arizona will shortly be providing all of the matching funds needed to ensure that all adult Medicaid members have access to emergency dental services (up to a cap of $1,000 per person per year).  Adult Medicaid members that are members of AHCCCS’ Arizona Long Term Care System had emergency dental services restored last year, so this year’s action fills the last gap in dental emergency care for adults.  Kids that have their insurance through AHCCCS have comprehensive dental coverage that includes preventative services. 

Primary Care Loan Repayment

The state budget authorized an additional $350K per year to go into the state’s loan repayment program, bringing the total funds to $1M per year… which will potentially qualify Arizona for up to an additional $1M in federal funds.  These new resources are timed perfectly to take advantage of the revamping of the program over the last few years.  In a nutshell, this program gives primary care and other front line health practitioners an opportunity to get significant relief for their student loan debt by practicing in rural and underserved AZ.

Newborn Screening

The state budget includes a measure allowing the Arizona Department of Health Services to increase their newborn screening fees by $6 per test so the AZ State Lab can afford to test babies for Severe Combined Immune Deficiency syndrome.  Babies born with Severe Combined Immunodeficiency look normal at birth but they can’t fight infections. They often die before 1 year of age without medical treatment.  But if SCID is caught at birth (before the onset of infection) a bone marrow transplant can successfully treat the disorder.  It’s especially important to test for SCID in Arizona because the disorder is much more common in certain populations in Arizona: 1/2,000 among Navajo’s and Apache’s and about 1/20,000 among Latinos.

Clarifying Certified Registered Nurse Anesthetist Practice

Nurse anesthetists are a kind of registered nurse who is skilled in the administration of anesthesia and pain management.  They are a key practitioner all across Arizona, especially in rural areas.  Some disconnects with respect to the supervision of nurse anesthetists and prescribing and administration authority had been causing access to care problems especially in rural AZ.

In a nutshell, SB 1336 outlines medication orders and prescribing authority for nurse anesthetists and makes it clear that a physician isn’t liable for anesthetic administration by a nurse anesthetist.  It also modifies the definition of “presence” (relating to supervision) of these folks, and outlines medication orders and prescribing authority.  This new law got through the process with some hard work and compromise by folks who kept their eye on the access to care ball in AZ.

Outpatient Occupational Therapy for Adult Medicaid Members

AHCCCS currently provides coverage for occupational therapy services in an inpatient hospital setting to all of their members (when medically necessary), for outpatient members under 21, and for adults that are enrolled in the Arizona Long Term Care System portion of AHCCCS.  The state budget funds AHCCCS so that it can start providing coverage for occupational therapy as an outpatient health service for all their enrollees (when it’s medically necessary).

Involuntary Commitment Procedures

Existing state law has procedures for civil commitment of a person for mental health treatment if a court finds enough evidence that the person (as a result of mental disorder), is a danger to self or others, or has a disability in need of treatment but won’t or can’t accept voluntary treatment.  The court can then order the patient to undergo treatment.

Last year, the State Supreme Court amended the rules for enforcement of Tribal Court Involuntary Commitment Orders to allow the enforcement of tribal court orders upon the acceptance by the clerk of the filing of the tribal court order rather than upon the certification of the order.  In other words- some tribal members had delays in getting treatment because of the new rules. 

HB2084 will allow a mental treatment facility to admit a patient for involuntary treatment for a mental health disorder pending the filing of a tribal courts involuntary commitment order, providing a mechanism for a more smooth access to care- especially for tribal members. 

Tools for Schools

Asthma Management

Schools will be better able to help kids with asthma to manage their symptoms next school year thanks to the passage of HB 2208.  It will let trained school staff to administer (or help administer) an inhaler for a student in respiratory distress.   The new law also outlines the training required and provides immunity from civil liability (lawsuits).

The old statute allowed kids to have & use inhalers if it was prescribed by a doctor and the school had an annual written documentation from the parent or guardian authorizing the student to have and self-administer their inhaler.  The new law will let trained school district and charter school staff to help the child to use their inhaler. 

UA’s Western Region Public Health Training Center has Stock Albuterol Inhaler Training for School Personnel available on their website already… and the e-learning course provides the training needed for schools to implement this new law. 

Sunscreen Use at Schools & Camps

Schools, parents and kids will be better able to protect children from damaging UV rays as a result of the passage of HB 2134 which will make it clear that kids can take and use sunscreen at school and camps… and that school, preschool and camp staff can help them put it on. 

Why was this needed, you ask?  The FDA regulates sunscreen as an over-the-counter drug.  School districts set their own policies concerning the administration of “medication” (including over the counter sunscreen) to kids.  Some school districts and camps prohibit the administration of “over-the-counter drugs” (e.g. sunscreen) unless a parent provides written consent and an order from a physician.  This new law will make it clear for schools, camps, and day cares that it’s OK for kids to have and use sunscreen.  It’ll also give schools, camps and day cares protection from lawsuits.

Injury Prevention

Distracted Driving

Arizona will shortly join the 47 other states that have laws on the books restricting the use of smart phones while driving.  SB 1080 will ban brand-new teen drivers from using their smart phone while driving for the first 6 months of their license (if they’re under 18).  Using the phone in an emergency will still be OK.  Tickets can only be issued if the driver committed another violation.  The new law allows sound only smart phone functions under specified conditions.  Prior to this, the only other limitation in AZ to this kind of distraction was for school bus drivers. 

Drug Overdose & Poisoning Prevention

HB 2493 sets up a drug overdose review team at the ADHS (much like the child fatality review team).  It’ll be a 21-member consisting of nine heads of various government entities (or their designees) and 12 members appointed by the ADHS Director to:

• Develop a data collection system regarding drug overdoses;
• Conduct an annual analysis relating to drug overdose fatalities;
• Develop standards and protocols;
• Provide training and technical assistance to local Teams;
• Develop investigation protocols for law enforcement and the medical community;
• Study state and local laws, training and services in order to recommend policies to decrease drug overdose fatalities; and
• Educate the public regarding drug overdose fatalities.

Looks like a good opportunity to get some better surveillance, standards, protocols, and explore new laws that could help with the ongoing opioid painkiller epidemic.

Safety Net

HB2091 was passed at the very end of the Session and will (assuming it’s signed) remove the requirement that SNAP (food stamp) recipients file fingerprints prior to becoming eligible for benefits.  This had been a barrier for seniors to participate in the program because of perceived stigma.

HB2372 was also passed in the waning minutes of the Session and (if signed) will extend the Temporary Assistance for Needy Families program to 2 years lifetime participation from the current 1 year.

New Laws Posing Public Health Challenges

Changes to the Voter Initiative Process

Many of the bold moves to improve public health policy have come via the citizens initiative process that’s written into Arizona’s constitution.  A few examples are the Smoke Free Arizona Act; the Tobacco, Revenue, Use, Spending and Tracking Commission (Proposition 303 from 2002) for tobacco education and prevention; First Things First; and Proposition 204 from 2000 which extended Medicaid eligibility to 100% of federal poverty for childless adults and creating the AZ Area Health Education Centers.  Future citizens initiatives geared to improve public health will be more difficult to get on the Arizona ballot as a result of the passage of 2 new laws:  HB 2404 & HB 2244.

• HB 2404 prevents signature gatherers from getting paid by the signature (for voter initiatives), making it more difficult to provide the work incentive needed for gatherers to be efficient.  This will make it more difficult to get the large number of signatures that are needed to get citizens initiatives on the ballot in the future.

• House Bill 2244 changes the citizens initiative compliance standard to “strict compliance” with all of the requirements regarding the entire process of getting on the ballot.  The previous criteria meant that citizens initiatives needed to be in “substantial compliance” with the requirements.  This new law does require the Secretary of State generate a rule handbook with the requirements. 

A group of folks will be organizing to collect 75,000 signatures by August 12 in an effort to keep these new laws on hold (called a Referendum) until the voters of Arizona have an opportunity to weigh in during the November 2018 election.  We’ll stay in touch with the groups organizing this effort and we’ll keep our AzPHA members informed regarding how they can participate in the signature gathering process.

Family Planning

One component of the state budget requires the Arizona Department of Health Services to apply to become the Title X family planning grantee in Arizona. Federal Title X funds provide about $5M in family planning resources statewide.  When I was the ADHS Director we never applied to be the Title X grantee because the Arizona Family Health Partnership (an Arizona nonprofit) did such a good job administering the grant.

The challenge that this new law poses is that if ADHS is successful becoming the Title X grantee, they’dbe prohibited by state law (ARS 35-196.05) from contracting with Planned Parenthood of Arizona to provide the family planning services- and many many Arizonans rely on Planned Parenthood a their access point for family planning.

Missed Opportunities

There were several missed opportunities to improve public health that were proposed but failed to get through the legislative process:

• Voluntary Certification for Community Health Workers
• Comprehensive oral health coverage for pregnant Medicaid members
• Requirements for recess time for physical activity in schools
• Requirement for hospitals to offer influenza vaccines to seniors in hospitals
• Regulation of tanning bed studios
• Changing the age at which folks can but tobacco products and e-cigarettes to 21 from 18

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Note: according to state law, most of these changes won’t come into effect until 90 days after the end of the legislative session- which is in mid August.  

I’ll be doing a webinar at 12 noon on May 25 summarizing this year’s legislative session.  Tiffany has sent out a couple of notices inviting people to register- and we’ll send out a couple more.

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Our Public Policy Committee will continue to meet over the phone on an ad-hoc basis the rest of the year to talk about policy at the federal level and issues that may relate to AHCCCS waiver requests.  We will also be following efforts to collect signatures to suspend implementation of the voter initiative laws until voters have an opportunity to approve or deny the laws at the ballot box in November 2018.  Our materials will continue to be posted on Basecamp.  For information about participating in the committee activities contact [email protected]

From all indications, it looks like this year’s legislative session is about to wrap. Most of the bills besides the budget bill have been through the legislative process and either have been passed and signed or have died. The last bolus of work is to pass and sign a state budget for the next fiscal year.  That will happen in the next few days- maybe even before the end of the week.  

We’re still hopeful that the budget will include funding for adult emergency dental services for all Medicaid members. Right now kids that have their insurance through AHCCCS get comprehensive dental coverage- which is a good thing.  

Adult Medicaid members that are part of the Arizona Long Term Care System have coverage for emergency dental treatment up to $1,000 per year, but other adult Medicaid members don’t have any dental care coverage- which leads to poor oral health outcomes.  We’re crossing our fingers that the financial match will be provided for this in the final state budget.

Here’s a summary of where we are with the various bills that relate to public health this legislative session:

Good New Public Health Laws

Asthma Management

HB 2208 was passed and signed a few weeks ago.  Once it becomes effective later this summer, it will authorize trained school districts and charter schools to administer (or help administer) an inhaler for a student in respiratory distress.   The new law also outlines the training required and provides immunity from civil liability (lawsuits).

The old statute allowed kids to have & use inhalers if it was prescribed by a doctor and the school had an annual written documentation from the parent or guardian authorizing the student to have and self-administer their inhaler.  The new law will let trained school district and charter school staff to help the child to use their inhaler.  The new law will also protect the school from lawsuits.

Lucky for Arizona, we’re ready to implement this already thanks to AzPHA members Dr. Lynn Gerald at the UA’s Mel and Enid Zuckerman College of Public Health and Dr. Doug Taren at the UA’s WesternRegion Public Health Training Center. The Training Center has Stock Albuterol Inhaler Training for School Personnel available on their website already.  

The e-learning course provides the training needed for schools to implement this new law.  Thank you Dr.’s Gerald & Taren for your leadership in this area of public health!

Sunscreen Use at Schools & Camps

HB 2134 will become law 90 days after the end of the legislative session. It’ll  make it clear that kids can take and use sunscreen at school and camps… and that school, pre-school and camp staff can help them put it on. 

Why was this needed, you ask?  Well, the FDA regulates sunscreen as an over-the-counter drug.  School districts set their own policies concerning the administration of “medication” (including over the counter sunscreen) to kids.  Some school districts and camps prohibit the administration of “over-the-counter drugs” (e.g. sunscreen) unless a parent provides written consent and an order from a physician.  
 
This new law will make it clear for schools, camps, and day cares that it’s OK for kids to have and use sunscreen.  It’ll also give schools, camps and day cares protection from lawsuits.  Hooray.

Involuntary Commitment Procedures

The Governor signed HB2084 which will allow a mental treatment facility to admit a patient for involuntary treatment for a mental health disorder pending the filing of a tribal courts involuntary commitment order.  We advocated for this bill because it provides a mechanism for a more smooth access to care- especially for tribal members.  Now that it’s been signed, it’ll become law 90 days after the legislative session ends.

State law already has requirements and procedures for civil commitment if a court finds enough evidence that the person (as a result of mental disorder), is a danger to self or others, or has a disability in need of treatment but won’t or can’t accept voluntary treatment.  The court can then order the patient to undergo treatment.

Currently, an order from an Arizona tribal court is recognized by the other courts in AZ and enforceable by any court of record in this state, subject to the same procedures, defenses and proceedings for reopening, vacating or staying as a judgment of the court. 

Current statute says a patient committed to a state mental health treatment facility by a tribal court order is subject to state jurisdiction.  Last year, the State Supreme Court amended the rules for enforcement of Tribal Court Involuntary Commitment Orders, to allow the enforcement of tribal court orders upon the acceptance by the clerk of the filing of the tribal court order rather than upon the certification of the order.  In other words- some tribal members had delays in getting treatment because of the new rules. 

This new law will fix that delay in treatment, which is a good thing for public health we think.

Nurse Anesthetists  

SB 1336 was passed and signed a couple of weeks ago.  In a nutshell, the new law outlines medication orders and prescribing authority for nurse anesthetists and ill make it clear that a physician isn’t liable for anesthetic administration by a nurse anesthetist.  It also modifies the definition of “presence” (relating to supervision), and outlines medication orders and prescribing authority for a nurse anesthetis.  

AzPHAsupported this Bill and submitted information to the committee providing information about how this bill would be good for access to care in rural AZ- which had been facing challenges as a result of the existing laws.

Teen Texting & Driving

SB 1080 was signed by the Governor last week and will ban brand-new teen drivers from using their smart phone for the first 6 months of their license – if they’re under 18.  Using the phone in an emergency will still be OK.  Tickets can only be issued if the driver committed another violation.  It allows anaudible tool like Mapquest under specified conditions.

The only other limitation in AZ to this kind of distraction is for school bus drivers.  Arizona will now join 48 other states that restrict smart phone use!

Drug Overdose Review Team

HB 2493, which sets up a drug overdose review team at the ADHS (much like the child fatality review team) will also become law later this summer.  The new law sets up a21-member consisting of nine heads of various government entities (or their designees) and 12 members appointed by the ADHS Director.

The Mission for the Team is to:

• Develop a data collection system;
• Conduct an annual analysis relating to drug overdose fatalities from the preceding year;
• Aid in the development of local Teams;
• Develop standards and protocols;
• Provide training and technical assistance to local Teams;
• Develop investigation protocols for law enforcement and the medical community;
• Study state and local laws, training and services in order to determine if changes are needed to decrease drug overdose fatalities and, as appropriate, take steps to implement these changes; and
• Educate the public regarding drug overdose fatalities.

Looks like a good opportunity to get some better surveillance, standards, protocols, and explore new laws that could help with the ongoing opioid painkiller epidemic.

Good Public Health Bills Not Yet Passed

Emergency Dental Coverage for Medicaid Members

We’re still hopeful that the budget will include funding for adult emergency dental services for all Medicaid (AHCCCS) members. Right kids that have their insurance through AHCCCS get comprehensive dental coverage- which is a good thing. 

Adult Medicaid members that are part of the Arizona Long Term Case System have coverage for emergency dental treatment up to $1,000 per year, but other adult Medicaid members don’t have any dental care coverage at all- which has led to all sorts of bad oral health outcomes among adult Medicaid members (they had emergency dental coverage before the Recession- but that funding was a casualty of the recession).  We’re crossing our fingers that the financial match will be provided for this in the final state budget.

Newborn Screening for SCID

SB 1368, which would authorize the ADHS to collect the newborn screening fees needed to add Severe Combined Immune Deficiency syndrome to the list of newborn screening tests passed through the Senate and the was unanimously approved by the House Health Committee. 

Babies born with Severe Combined Immunodeficiency look normal at birth but they can’t fight infections. They often die before 1 year of age without medical treatment, but if caught at birth,  before the onset of infection, a bone marrow transplant can successfully treat the disorder.  It’s particularly important to test for SCID in Arizona because the disorder is much more common in certain populations in Arizona: 1/2,000 among Navajo’s and Apache’s and about 1/20,000 among Latinos. 

Bills Good for Public Health that Died

Community Health Workers

Sadly, HB 2426, which would have set up a pathway for Community Health Workers in AZ, appears to be dead for this year.  Had it passed, it would have set up a pathway for Community Health Workers in AZ to voluntarily become certified… which would be a big step forward for this important health profession.  It would have  expanded  the use of CHWs in Arizona’s healthcare system in part by making it easier to get reimbursement for their services.

The Arizona Community Health Workers Association did a great job of organizing and is in a solid position to keep the momentum going next legislative session.  

Influenza Vaccines in Hospitals

HB 2090 which would have required hospitals to offer influenza vaccines to seniors during the cold and flu months appears dead for whatever reason.  It would’ve provided an additional access point for getting a flu vaccine among a high risk population- but alas- it won’t become law this year (although hospitals could of course elect to offer the vaccines if they want).

Physical Activity

HB 2082, which would have required that schools have some recess time went down in flames.  To be honest, I think it would have passed but didn’tbecause of a heated remark made by the Bill’s sponsor made on social media about the school voucher bill that the Governor signed.  Here’s the story about it in the AZ Republic.   Lesson: relationships are important.

Tanning Beds

HB 2194 which would have prohibited kids under 18 from using tanning beds and prevents studios from claiming that tanning beds are risk-free is effectively dead for this year, again. 

Bills Bad for Public Health that Luckily Died

Traffic Safety Cameras

Let’s face it. Getting a ticket in the mail for speeding or running a red light is no fun.  But evidence suggests that photo enforcement of red lights is an effective public health intervention, which is why we advocated against HB2525.  It would have banned traffic safety cameras in AZ.  While it passed out of the House, it stalled and died in the Senate. 

It’s sure to be back next year.  My advice to some towns that are over-using photo enforcement is to tone it down- or you’ll end up ruining it for everybody.