Will Humble Uncategorized, Wills Blog

AzPHA Public Health Policy Update: February 27, 2018

Last week was pretty busy with lots of floor votes on many of the public health bills- the highlights were full chamber approvals of HB2324 (voluntary certification of community health workers), HB2389 (syringe access), and SB1083 (recess in schools).

Unfortunately the community health worker bill got assigned to both the Health and Human Services and the Commerce & Public Safety Committees in the Senate this week. That’s a tough break- especially the PS/Commerce assignment.  The syringe access bill got a Government Committee assignment- which is encouraging I think.

Yesterday the House Education Committee voted 9-0 to give SB 1083 Schools; recess periods a Do Pass Recommendation.  The Bill passed through the Senate a couple of weeks ago.  It would require public and charter schools to provide at least 2 recess periods during the school day in grades K-5. There was a lot of community support at the hearing yesterday, which is encouraging.

The following public health related bills passed their committee of origin and have gone over to the other chamber. Some have been assigned to committees in the new chamber, but some haven’t yet.  Where available, I’ve listed the committee assignments in the detail section below.  Hearings will begin next week.

HB 2038 Drug overdose review teams; records                

HB 2071 Rear-facing car seats

HB 2084 Indoor tanning; minors; restricted use      

HB 2127 Children’s health insurance program

HB 2208 Prohibition, photo enforcement (we’re against this one)

HB 2228 Annual waiver, applicability (tribes)

HB 2324 Community health workers; voluntary certification

HB 2389 Syringe access programs; authorization

SB 1022 ADHS; homemade food products            

SB 1083 Schools; recess periods

SB 1377 Dental therapy, licensure, regulation

SB 1394 Abortion reporting

This week is light in terms of committee hearings.  That’ll pick up a lot next week.

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Remember to stay engaged and voice your opinion via the www.azleg.gov commenting system.  Click the following links for: Request to Speak account registration form; a Step-by-step use of the Request to Speak platform; and to Locate your Elected Officials 

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House Bills

HB 2038 Drug overdose review teams; records                

Passed the House 57-0-2

Assigned to Senate Health and Human Services (HHS) Committee

Under this proposed Bill, law enforcement agencies would be required to provide unredacted reports to the chairperson of a local Drug Overdose Fatality Review Team on request.  All information and records acquired by a Team are confidential and not subject to subpoena, discovery or introduction into evidence in a civil or criminal proceeding or disciplinary action.  We’re signed up in support of this one of course.

 

HB 2071 Rear-facing car seats         

Passed House 33-25-1

Assigned to HHS & Commerce and Public Safety Committees 

This Bill would require kids under 2 years old to be in a rear-facing restraint system unless the child weights at least 40 pounds or is at least 40 inches tall.  We’ve signed up in support of this bill.  Dual assigned in the Senate.

 

HB 2084 Indoor tanning; minors; restricted use

Passed House 45 – 15

Assigned to HHS and Commerce & Public Safety Committees

Under this proposal, tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device”. Tanning facilities are prohibited from advertising or distributing promotional materials that claim that using a tanning device is free from risk or will result in medical or health benefits. We’ve signed on in support of this of course. Bummer that it’s dual assigned in the Senate.

 

HB 2127 Children’s health insurance program

Passed House 46-12-1

Assigned to HHS & Appropriations Committees

This Bill removes the trigger that automatically freezes the KidsCare program if FMAP (the federal contribution) drops below 100%.  It allows the state to freeze it if costs are more than the state or federal allotment. The bill does not require the state to appropriate any money for a state share.  We’ve signed up in support of this bill because it provides a pathway to keep KidsCare if the federal government drops its contribution level. 

 

HB 2197 Health professions, workforce data

Passed House 60 – 0

Assigned to HHS and Commerce & Public Safety Committees

This Bill would require AZ health licensing boards to collect certain data from applicants (beginning January 2020) to get better data about health professions workforce distribution and needs.  The data would be confidential.  

 

HB 2208 Prohibition, photo enforcement

Passed the House 31-27-1

Assigned to the Senate Transit Committee

This Bill would prohibit cities and other jurisdictions from having photo enforcement of red light and speeding violations.  While nobody likes getting a ticket in the mail, the data suggest that photo enforcement saves lives and prevents injuries (especially red-light photo enforcement).  We’ve signed up in opposition to the bill.  This bill passed the House 31-27 last week and is moving on to the Senate Transportation Committee.

 

HB 2228 Annual waiver, applicability

Passed the House 58-0-1

Assigned to Senate HHS Committee

This Bill would direct AHCCCS to exempt tribes from their directed waiver requests to CMS asking permission to implement work requirements for some Medicaid members.  The recently submitted Waiver request includes an exemption for American Indians, however, this would place the exemption into statute.

 

HB 2324 Community health workers; voluntary certification

Passed House 56 – 1 – 3

Assigned to HHS and Commerce & Public Safety Committees

This Bill is a top priority for us. It would charge the ADHS with developing a voluntary certification program for community health workers.  The Department rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements. We’ve signed up in support of this bill. Tough break this week because it’s assigned to both the HHS and Commerce and Public Safety Committees. 

 

HB 2389  Syringe access programs; authorization

Passed House 56 – 0 – 4

Assigned to the Senate Government Committee

Under this Bill, organizations in Arizona may establish and operate a needle exchange program.  Persons, employees and volunteers operating within the scope of the law may not be charged or prosecuted for their activities. It’s currently a felony to distribute needles to illegal drug users. While many people thought that this should be included in the Opioid Special Session, it was not.

We’ve signed up in support of this bill because this type of program is evidence-based and reduces the spread of bloodborne diseases as well as engaging in intravenous drug users into treatment. 

 

Senate Bills

SB 1022    DHS; homemade food products            

Passed Senate 30-0

Assigned to House Health Committee

Under this Bill, ADHS would be required to establish an online registry of food preparers that are authorized to prepare “cottage food products” for commercial purposes. Registered food preparers would be required to renew the registration every three years. This is a sensible addition to the current cottage industry food law and we’ve signed up in support.

 

SB 1083    Schools; recess periods

Passed Senate 26-3-1

Assigned to and Passed House Education Committee 9-0 on Monday

District and charter schools would be required to provide at least 2 recess periods during the school day for pupils in grades K-5.  We’ve signed in support of this bill because there is good evidence that opportunities for physical activity at school are associated with improved health, behavior, and academic achievement of students.  Here is a good evidence review from the CDC entitled The Association Between School-based Physical Activity and Academic Performance. Great couple of weeks for this bill.

 

SB 1245 Snap Benefit Match

Ready for a Floor Vote in the Senate

This Bill would appropriate $400K to ADES to develop the infrastructure for a produce incentive program within the Supplemental Nutrition Assistance Program (SNAP) for members to buy Arizona-grown fruits and vegetables.  It would also provide matching funds to SNAP-authorized vendors as an incentive to participate in the fruits and vegetable program.  It passed the Health and Human Services Committee and the Appropriations Committee. We’ve signed up in support of this Bill. Still needs a Senate floor vote.

 

SB 1261 Texting while driving

Passed Transportation Committee- Ready for a Senate Floor Vote

This bill would prohibit drivers from “using a portable wireless communication device to read, write, or send an electronic message while driving” (unless the car is stopped).  The first violation would be a petty offense with a fine between $25 and $99.  It has passed its committees and is ready for a floor vote, hopefully that happens this week.

 

SB 1377 Dental therapy, licensure, regulation

Passed Senate 22 – 8

Not yet assigned to House Committees

This Bill was introduced last week and would set up a new licensed class of dental professionals called a Dental Therapist.  Their scope of practice would be somewhat less than a DDS, but they could do some procedures like filling cavities. This has been a somewhat controversial bill as there are stakeholders of both sides that are quite passionate about their position on this Bill. 

 

SB 1394 Abortion reporting

Passed Senate 17 – 13

Not yet assigned to House Committees

This Bill would require the ADHS to collect and report additional data regarding abortions that are performed in AZ. The data would be collected and reported by providers and would include the reason for the abortion (economic, emotional health, physical health, whether the pregnancy was the result of rape or incest, or relationship issues etc.).

 

SB 1420 medical marijuana; inspection; testing; appropriation

Passed Senate 27 – 3

Not yet assigned to House Committees

This Bill would require the ADHS to set up testing standards for medical marijuana and begin enforcing the standards beginning in 2019.  We’re supporting this legislation.  It passed the full Senate last week.

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Public Health Bills that Failed to Thrive

HB 2064 Medical marijuana; packaging; labeling              

Dead for now

This Bill proposes that medical marijuana dispensaries be prohibited from selling a marijuana product that’s packaged or labeled in a manner that’s “attractive to minors”. Due to voter protection, this legislation requires the affirmative vote of at least 3/4 of the members of each house of the Legislature for passage.  Dead for now.

 

HB 2109 Tobacco possession; sale; age; signage                

Sadly, dead for now

This Bill would prohibit furnishing a tobacco product to a person who is under 21 years of age. The definition of “tobacco product” is expanded to include “electronic smoking devices”. We’ve signed up in support. It received a Do Pass recommendation from the House Health Committee three weeks ago but the Commerce chair hasn’t put it on the agenda, so it’s effectively dead for now. Kudos to Rep. Boyer for sponsoring this.

Will Humble Medicaid, Wills Blog

AzPHA Public Health Policy Update: February 21, 2018

Good Article about Community Health Workers from Rep. Carter

Representative Heather Carter wrote a very informative opinion piece in

the Capitol Times about how community health workers reduce healthcare costs and improve outcomes. Check it out!

 

AHCCCS Contract Award Schedule

Seven health plan contractors submitted bids to provide integrated physical and behavioral health services to the majority of AHCCCS members a few weeks ago. Awards will be announced by March 8 and implementation will begin October 1. Here’s the contract integration timeline.

 

Bidders include:

Banner – University Family Care Plan

Care1st Health Plan Arizona, Inc.

Health Choice Arizona, Inc. (Steward Health Choice Arizona)

Health Net Access, Inc.

Magellan Complete Care of Arizona, Inc.

Mercy Care

UnitedHealthcare Community Plan

 

Prior Quarter Coverage Waiver Open for Public Comments

AHCCCS is proposing a change in benefits for Medicaid members that would limit retroactive coverage to the start of the month of the person’s application.  Currently benefits are retroactive for the 3 months prior to the application.  AHCCCS is asking for comments from members, families, stakeholders and the public on the proposed change. Comments can be submitted by email to publicinput@azahcccs.gov.

Here’s the draft Prior Quarter Coverage Amendment.

 

The CDC has Recently posted Immunization Schedules online.

For Healthcare Professionals:

Immunization Schedules for Children & Adolescents

Immunization Schedules for Adults

 

For Everyone: Easy-to-Read Schedules

Children Birth through 6 years old

Pre-teens and Teens

Adults

 

Legislative Session Update

The following bills passed their house of origin and will be going over to the other chamber. Hearings in the other chamber will begin next week.

HB 2038 Drug overdose review teams; records                

HB 2071 Rear-facing car seats         

HB 2127 Children’s health insurance program

HB 2208 Prohibition, photo enforcement (we’re against this one)

HB 2228 Annual waiver, applicability (tribes)

SB 1022 ADHS; homemade food products            

SB 1083 Schools; recess periods

 

Priorities for this Week

Last week our top priority was to get SB 1445 AHCCCS Dental care, pregnant women and SB 1245 Snap Benefit Match through the Senate Health and Human Services and Appropriations committees.  Fortunately, both received pass recommendations. Both still need to be heard by the Senate Rules Committee before going to the Senate floor.

HB 2324 Community health workers; voluntary certification passed through the House Rules Committee and is now ready for a floor vote.  HB 2389  Syringe access programs; authorization also received a pass recommendation from the House Health and the Rules Committees and is also ready for a floor vote.

So far we have one priority up for next week:

 

House Education Committee: Monday 2/26 2pm (HHR1)

SB 1083    Schools; recess periods

Under this Bill, district and charter schools would be required to provide at least 2 recess periods during the school day for pupils in grades K-5.  We’ve signed in support of this bill because there is good evidence that opportunities for physical activity at school are associated with improved health, behavior, and academic achievement of students.  Here is a good evidence review from the CDC entitled The Association Between School-based Physical Activity and Academic Performance.

 

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Remember to stay engaged and voice your opinion via the www.azleg.gov commenting system.  Click the following links for: Request to Speak account registration form; a Step-by-step use of the Request to Speak platform; and to Locate your Elected Officials

Below are the bills that we’re tracking and advocating for or against.  They’re in order of Bill number.  I included a colored comment to show where the bill is in the process.

 

House Bills

HB 2038 Drug overdose review teams; records                

Passed the House 57-0-2 – Going to Senate

Under this proposed Bill, law enforcement agencies would be required to provide unredacted reports to the chairperson of a local Drug Overdose Fatality Review Team on request.  All information and records acquired by a Team are confidential and not subject to subpoena, discovery or introduction into evidence in a civil or criminal proceeding or disciplinary action.  We’re signed up in support of this one.

 

HB 2064 Medical marijuana; packaging; labeling              

Ready for a Floor Vote

This Bill proposes that medical marijuana dispensaries be prohibited from selling a marijuana product that’s packaged or labeled in a manner that’s “attractive to minors”. Due to voter protection, this legislation requires the affirmative vote of at least 3/4 of the members of each house of the Legislature for passage.  We’re supporting this bill. It’s ready for a floor vote in the House.

 

HB 2071 Rear-facing car seats         

Passed House 33-25-1 – Going to Senate

This Bill would require kids under 2 years old to be in a rear-facing restraint system unless the child weights at least 40 pounds or is at least 40 inches tall.  We’ve signed up in support of this bill.  This Bill cleared the House Transportation & Infrastructure Committee last Wednesday.

 

HB 2084 Indoor tanning; minors; restricted use

Passed House Health, Waiting for Rules Committee

Under this proposal, tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device”. Tanning facilities are prohibited from advertising or distributing promotional materials that claim that using a tanning device is free from risk or will result in medical or health benefits. We’ve signed on in support of this. It received a Do Pass recommendation from the House Health Committee last week but failed to get on the Rules Committee agenda- so this is likely dead.

 

HB 2109 Tobacco possession; sale; age; signage                

Waiting on a Hearing in Commerce Committee

This Bill would prohibit furnishing a tobacco product to a person who is under 21 years of age. The definition of “tobacco product” is expanded to include “electronic smoking devices”. We’ve signed up in support. It received a Do Pass recommendation from the House Health Committee three weeks ago but the Commerce chair hasn’t put it on the agenda, so it’s effectively dead.

 

HB 2127 Children’s health insurance program

Passed House 46-12-1 – Going to the Senate

This Bill removes the trigger that automatically freezes the KidsCare program if FMAP (the federal contribution) drops below 100%.  It allows the state to freeze it if costs are more than the state or federal allotment. The bill does not require the state to appropriate any money for a state share. 

 

We’ve signed up in support of this bill because it provides a pathway to keep KidsCare if the federal government drops its contribution level. 

HB 2197 Health professions, workforce data

Ready for a Floor Vote in the House

This Bill would require AZ health licensing boards to collect certain data from applicants (beginning January 2020) to get better data about health professions workforce distribution and needs.  The data would be confidential.  This bill passed all of its committees and is ready for a floor vote.

 

HB 2208 Prohibition, photo enforcement

Passed the House 31-27-1 – Going to the Senate

This Bill would prohibit cities and other jurisdictions from having photo enforcement of red light and speeding violations.  While nobody likes getting a ticket in the mail, the data suggest that photo enforcement saves lives and prevents injuries (especially red-light photo enforcement).  We’ve signed up in opposition to the bill.  This bill passed the House 31-27 last week and is moving on to the Senate.

 

HB 2228 Annual waiver, applicability

Passed the House 58-0-1 – Going to the Senate

This Bill would direct AHCCCS to exempt tribes from their directed waiver requests to CMS asking permission to implement work requirements for some Medicaid members.  The recently submitted Waiver request includes an exemption for American Indians, however, this would place the exemption into statute.

 

HB 2324 Community health workers; voluntary certification

Ready for a Floor Vote in the House

This Bill is a top priority for us. It would charge the ADHS with developing a voluntary certification program for community health workers.  The Department rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements. We’ve signed up in support of this bill.  It received a Do Pass recommendation from the House Health Committee two weeks ago and the Rules Committee this week. It’s ready for a floor vote.

 

This would be a very good week to reach out to your State Representatives and Senator and let them know you support this measure as it will go to a Floor vote soon.  You can find their contact information at www.azleg.gov.

 

Senate Bills

SB 1022    DHS; homemade food products            

Passed Senate 30-0 – Going to the House

Under this Bill, ADHS would be required to establish an online registry of food preparers that are authorized to prepare “cottage food products” for commercial purposes. Registered food preparers would be required to renew the registration every three years. This is a sensible addition to the current cottage industry food law and we’ve signed up in support.

 

SB 1083    Schools; recess periods

Passed Senate 26-3-1 – Going to the House

Under this Bill, district and charter schools would be required to provide at least 2 recess periods during the school day for pupils in grades K-5.  We’ve signed in support of this bill because there is good evidence that opportunities for physical activity at school are associated with improved health, behavior, and academic achievement of students.  Here is a good evidence review from the CDC entitled The Association Between School-based Physical Activity and Academic Performance.

 

SB 1245 Snap Benefit Match

Ready for a Floor Vote in the Senate

This Bill would appropriate $400K to ADES to develop the infrastructure for a produce incentive program within the Supplemental Nutrition Assistance Program (SNAP) for members to buy Arizona-grown fruits and vegetables.  It would also provide matching funds to SNAP-authorized vendors as an incentive to participate in the fruits and vegetable program.  It passed the Health and Human Services Committee and the Appropriations Committee. We’ve signed up in support of this Bill. 

 

SB 1261 Texting while driving

Passed Transportation Committee- Ready for a Floor Vote

This bill was introduced last week and would prohibit drivers from “using a portable wireless communication device to read, write, or send an electronic message while driving” (unless the car is stopped).  The first violation would be a petty offense with a fine between $25 and $99.  It has passed its committees and is ready for a floor vote.

 

SB 1377 Dental therapy, licensure, regulation

Passed HHS, Education & Rules Committee – Ready for a Floor Vote

This Bill was introduced last week and would set up a new licensed class of dental professionals called a Dental Therapist.  Their scope of practice would be somewhat less than a DDS, but they could do some procedures like filling cavities. This has been a somewhat controversial bill as there are stakeholders of both sides that are quite passionate about their position on this Bill. 

 

SB 1394 Abortion reporting

Ready for a Floor Vote

This Bill would require the ADHS to collect and report additional data regarding abortions that are performed in AZ. The data would be collected and reported by providers and would include the reason for the abortion (economic, emotional health, physical health, whether the pregnancy was the result of rape or incest, or relationship issues etc.).  It has passed its committees.

 

SB 1420 medical marijuana; inspection; testing; appropriation

Passed Governance & Rules Committees – Ready for a Floor Vote

This Bill would require the ADHS to set up testing standards for medical marijuana and begin enforcing the standards beginning in 2019.  We’re supporting this legislation.  It received a Do Pass recommendation from the Senate Government Committee last week.

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Will Humble Uncategorized, Wills Blog

AzPHA Public Health Policy Update: February 14, 2018

The Legislative Committees are in full swing and agendas are full.  Several of the priority public health bills have been successful so far, but there’s a long way to go still. 

Last week the following bills passed their house of origin and will be going over to the other chamber:

HB 2038 Drug overdose review teams; records                

HB 2071 Rear-facing car seats         

HB 2127 Children’s health insurance program

HB 2208 Prohibition, photo enforcement (we’re against this one)

HB 2228 Annual waiver, applicability (tribes)

SB 1022 ADHS; homemade food products            

SB 1083 Schools; recess periods

 

Priorities for this Week

Our top Action priority this week is in the Senate Health and Human Services Committee Wednesday at 2 pm when SB 1445 AHCCCS Dental care, pregnant women will be heard along with SB 1245 Snap Benefit Match.  On Thursday in House Health HB 2389  Syringe access programs; authorization will be heard.

Remember to stay engaged and voice your opinion via the www.azleg.gov commenting system.  Click the following links for: Request to Speak account registration form; a Step-by-step use of the Request to Speak platform; and to Locate your Elected Officials

 

Wednesday

Senate Health and Human Services: 2pm

SB 1445 AHCCCS Dental care, pregnant women

This is a priority Bill for AzPHA.  It would provide oral health coverage for pregnant women who receive their health insurance coverage through AHCCCS.  The benefit would be limited to $1000 and could be used for other than emergency dental procedures (beginning October 1, 2017 all adult Medicaid members became eligible for up to $1000 in emergency dental services per year).  Lots of good public health reasons to support this one. 

Members of the committee are Nancy Barto, David Bradley, Kate Brophy McGee, Judy Burges, Rick Gray, Katie Hobbs, and Kimberly Yee.  You can contact these members directly by email (here is the list) and you can also sign in using the RTS system.

 

SB 1245 Snap Benefit Match

This Bill would appropriate $400K to ADES to develop the infrastructure for a produce incentive program within the Supplemental Nutrition Assistance Program (SNAP) for members to buy Arizona-grown fruits and vegetables.  It would also provide matching funds to SNAP-authorized vendors as an incentive to participate in the fruits and vegetable program.  We’ve signed up in support of this Bill.  It hasn’t been scheduled for a committee hearing yet.

 

SB 1394 Abortion reporting

This Bill would require the ADHS to collect and report additional data regarding abortions that are performed in AZ. The data would be collected and reported by providers and would include the reason for the abortion (economic, emotional health, physical health, whether the pregnancy was the result of rape or incest, or relationship issues etc.). 

Thursday

House Health Committee: 9 pm

HB 2389  Syringe access programs; authorization

Under this Bill, organizations in Arizona may establish and operate a needle exchange program.  Persons, employees and volunteers operating within the scope of the law may not be charged or prosecuted for their activities. It’s currently a felony to distribute needles to illegal drug users. While many people thought that this should be included in the Opioid Special Session, it was not.

We’ve signed up in support of this bill because this type of program is evidence-based and reduces the spread of bloodborne diseases as well as engaging in intravenous drug users into treatment.  Hearing is in the House Health Committee Thursday morning (2/15). 

 

Below are a list of the bills that we’re tracking and advocating for or against.  They’re in order of Bill number.  I included a colored comment to show where the bill is in the process.

 

House Bills

HB 2038 Drug overdose review teams; records                

Passed the House 57-0-2

Under this proposed Bill, law enforcement agencies would be required to provide unredacted reports to the chairperson of a local Drug Overdose Fatality Review Team on request.  All information and records acquired by a Team are confidential and not subject to subpoena, discovery or introduction into evidence in a civil or criminal proceeding or disciplinary action.  We’re signed up in support of this one.

 

HB 2064 Medical marijuana; packaging; labeling              

Hearing in House Commerce Committee Tuesday

This Bill proposes that medical marijuana dispensaries be prohibited from selling a marijuana product that’s packaged or labeled in a manner that’s “attractive to minors”. Due to voter protection, this legislation requires the affirmative vote of at least 3/4 of the members of each house of the Legislature for passage.  We’re supporting this bill. It’s being Held right now by the Commerce Committee.

 

HB 2071 Rear-facing car seats         

Passed House 33-25-1

This Bill would require kids under 2 years old to be in a rear-facing restraint system unless the child weights at least 40 pounds or is at least 40 inches tall.  We’ve signed up in support of this bill.  This Bill cleared the House Transportation & Infrastructure Committee last Wednesday.

 

HB 2084 Indoor tanning; minors; restricted use

Passed House Health, Waiting for Rules Committee

Under this proposal, tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device”. Tanning facilities are prohibited from advertising or distributing promotional materials that claim that using a tanning device is free from risk or will result in medical or health benefits. We’ve signed on in support of this. It received a Do Pass recommendation from the House Health Committee last week.

 

HB 2109 Tobacco possession; sale; age; signage                

Waiting on a Hearing in Commerce Committee

This Bill would prohibit furnishing a tobacco product to a person who is under 21 years of age. The definition of “tobacco product” is expanded to include “electronic smoking devices”. We’ve signed up in support. It received a Do Pass recommendation from the House Health Committee two weeks ago but so far the Commerce chair hasn’t put it on the agenda.

 

HB 2127 Children’s health insurance program

Passed House 46-12-1

This Bill removes the trigger that automatically freezes the KidsCare program if FMAP (the federal contribution) drops below 100%.  It allows the state to freeze it if costs are more than the state or federal allotment. The bill does not require the state to appropriate any money for a state share.  

We’ve signed up in support of this bill because it provides a pathway to keep KidsCare if the federal government drops its contribution level. 

 

HB 2197 Health professions, workforce data

Waiting for a Hearing in Rules Committee

This Bill would require AZ health licensing boards to collect certain data from applicants (beginning January 2020) to get better data about health professions workforce distribution and needs.  The data would be confidential.

 

HB 2208 Prohibition, photo enforcement

Passed the House 31-27-1

This Bill would prohibit cities and other jurisdictions from having photo enforcement of red light and speeding violations.  While nobody likes getting a ticket in the mail, the data suggest that photo enforcement saves lives and prevents injuries (especially red-light photo enforcement).  We’ve signed up in opposition to the bill.  This bill passed the House 31-27 last week and is moving on to the Senate.

 

HB 2222 Feminine hygiene products, requirements

Waiting for a Hearing in Rules Committee

This Bill would require the Arizona Department of Corrections to offer female inmates an unlimited supply of feminine hygiene products free of charge. We signed up in support, that the Bill received a Do Pass recommendation in committee (5-4).

 

HB 2228 Annual waiver, applicability

Passed the House 58-0-1

This Bill would direct AHCCCS to exempt tribes from their directed waiver requests to CMS asking permission to implement work requirements for some Medicaid members.  The recently submitted Waiver request includes an exemption for American Indians, however, this would place the exemption into statute.

 

HB 2324 Community health workers; voluntary certification

Waiting for a Hearing in the Rules Committee

This Bill is a top priority for us. It would charge the ADHS with developing a voluntary certification program for community health workers.  The Department rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements. We’ve signed up in support of this bill.  It received a Do Pass recommendation from the House Health Committee last week.

This would be a very good week to reach out to your State Representatives and Senator and let them know you support this measure as it will go to a Floor vote soon.  You can find their contact information at www.azleg.gov.

 

HB 2348 Vehicle emission standards

Held in Energy and Natural Resources Committee

Existing AZ law requires Arizona vehicle emission standards to be consistent with federal law.  This Bill would require ADEQ to adopt the California clean air emission standards beginning on January 1, 2018.  It would just apply to the sales of new cars.

 

HB 2443  Medical services purchase, premiums

Waiting for a Hearing in the Health Committee- but not on agenda this week so it’s probably dead

The Bill would essentially allow Arizonans that don’t normally qualify for Medicaid to buy Medicaid health insurance.  It would ask AHCCCS to write the rules and regulations for the program including setting a premium that ensures people buying in would pay full freight.  If approved, it would allow people to buy in beginning on October 1, 2019. 

The bill is also contingent on CMS approval.  Here’s a link to a really good document that discusses the merits of a Medicaid buy-in system.  

 

Senate Bills

SB 1007  Motorcycle operation; riding between lanes          

Waiting for a Hearing in Transportation Committee

Under this proposal, motorcycle operators would no longer be prohibited from passing in the same lane occupied by the vehicle being overtaken and from operating a motorcycle between the lanes of traffic if they’re wearing a helmet.  We decided to take a position against this one in our Public Health Policy Committee last week. No action this week.

 

SB 1022    DHS; homemade food products            

Passed Senate 30-0

Under this Bill, ADHS would be required to establish an online registry of food preparers that are authorized to prepare “cottage food products” for commercial purposes. Registered food preparers would be required to renew the registration every three years. This is a sensible addition to the current cottage industry food law and we’ve signed up in support.

 

SB 1083 Schools; recess periods

Passed Senate 26-3-1

Under this Bill, district and charter schools would be required to provide at least 2 recess periods during the school day for pupils in grades K-5.  We’ve signed in support of this bill. 

 

SB 1245 Snap Benefit Match

To be heard in Senate HHS Wednesday

This Bill would appropriate $400K to ADES to develop the infrastructure for a produce incentive program within the Supplemental Nutrition Assistance Program (SNAP) for members to buy Arizona-grown fruits and vegetables.  It would also provide matching funds to SNAP-authorized vendors as an incentive to participate in the fruits and vegetable program.  We’ve signed up in support of this Bill. 

 

SB 1250 Food Producers, Ordinances

Failed 2-5 in Governance Committee

This Bill would make it clear that cities, towns and counties can’t restrict food producers including community gardens from producing food products with some exceptions and inspection authority.

 

SB 1261 Texting while driving

Passed Transportation Committee- awaiting Rules

This bill was introduced last week and would prohibit drivers from “using a portable wireless communication device to read, write, or send an electronic message while driving” (unless the car is stopped).  The first violation would be a petty offense with a fine between $25 and $99. 

 

SB 1377 Dental therapy, licensure, regulation

Passed HHS, Awaiting Education Committee

This Bill was introduced last week and would set up a new licensed class of dental professionals called a Dental Therapist.  Their scope of practice would be somewhat less than a DDS, but they could do some procedures like filling cavities. This has been a somewhat controversial bill as there are stakeholders of both sides that are quite passionate about their position on this Bill. 

 

SB 1394 Abortion reporting

To be heard in Senate HHS Wednesday

This Bill would require the ADHS to collect and report additional data regarding abortions that are performed in AZ. The data would be collected and reported by providers and would include the reason for the abortion (economic, emotional health, physical health, whether the pregnancy was the result of rape or incest, or relationship issues etc.).

 

SB 1420 medical marijuana; inspection; testing; appropriation

Passed Governance Committee 4-3, Waiting for Rules Committee

This Bill would require the ADHS to set up testing standards for medical marijuana and begin enforcing the standards beginning in 2019.  We’re supporting this legislation.  It received a Do Pass recommendation from the Senate Government Committee last week.

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Will Humble Uncategorized, Wills Blog

AzPHA Public Health Policy Update: February 6, 2018

 

New Bills this Week

Before we get to the committee agendas for this week- here are a few new bills that were proposed.

SB 1261 Texting while driving

This bill was introduced last week and would prohibit drivers from “using a portable wireless communication device to read, write, or send an electronic message while driving” (unless the car is stopped).  The first violation would be a petty offense with a fine between $25 and $99.  It’s being heard at 2 pm today (Tuesday) in the Senate Transportation and Technology Committee.

SB 1377 Dental therapy, licensure, regulation

This Bill was introduced last week and would set up a new licensed class of dental professionals called a Dental Therapist.  Their scope of practice would be somewhat less than a DDS, but they could do some procedures like filling cavities. This has been a somewhat controversial bill as there are stakeholders of both sides that are quite passionate about their position.  We haven’t taken a position at this time.  It’s on the agenda in the Senate Health and Human Services Committee this Wednesday. 

SB 1394 Abortion reporting

This Bill would require the ADHS to collect and report additional data regarding abortions that are performed in AZ. The data would be collected and reported by providers and would include the reason for the abortion (economic, emotional health, physical health, whether the pregnancy was the result of rape or incest, or relationship issues etc.). This one is being heard in the Senate Health & Human Services Committee Wednesday at 2 pm.

HB 2348 Vehicle emission standards

Existing AZ law requires Arizona vehicle emission standards to be consistent with federal law. This Bill would require ADEQ to adopt the California clean air emission standards beginning on January 1, 2018.  It would just apply to the sales of new cars.

HB 2512 Water program amendments

This Bill would provide a pathway for counties to exempt themselves from existing water use and extraction requirements.  It could post water supply issues in some parts of the state in coming years.

 

Committee Hearings this Week

This is a busy time of year in the Legislature.  Committees are in full swing and agendas are full. Below is a summary of the committee hearings… I’ve pasted a quick summary of the Bills that are being heard this week.  After that is a listing of the other bills that haven’t been heard in their committees yet.

Remember to stay engaged and voice your opinion via the www.azleg.gov commenting system.

 

Monday

House Military, Veterans, and Regulatory Affairs Committee

HB 2222 Feminine hygiene products, requirements

This Bill would require the Arizona Department of Corrections to offer female inmates an unlimited supply of feminine hygiene products free of charge. We signed up in support.  This Bill received a Do Pass recommendation in the Military, Veterans, and Regulatory Affairs Committee yesterday (5-4).

 

Tuesday 

Senate Transportation Committee @ 2 pm, HHR 1

SB 1261 Texting while driving

This bill was introduced last week and would prohibit drivers from “using a portable wireless communication device to read, write, or send an electronic message while driving” (unless the car is stopped).  The first violation would be a petty offense with a fine between $25 and $99.  We signed up in support.

 

House Energy, Environment and Natural Resources @ 2pm

HB 2512 Water program amendments

This Bill would provide a pathway for counties to exempt themselves from existing water use and extraction requirements.  

HB 2348 Vehicle emission standards

Existing AZ law requires Arizona vehicle emission standards to be consistent with federal law.  This Bill would require ADEQ to adopt the California clean air emission standards beginning on January 1, 2018.  It would just apply to the sale of new cars.

 

Wednesday 

Senate Government, Wednesday @ 2 pm, SHR 109

SB 1250 Food Producers, Ordinances

This Bill would make it clear that cities, towns and counties can’t restrict food producers including community gardens from producing food products with some exceptions and inspection authority. We’ve signed up in support.

 

Senate Health and Human Services, @ 2pm

SB 1377 Dental therapy, licensure, regulation

This Bill was introduced last week and would set up a new licensed class of dental professionals called a Dental Therapist.  Their scope of practice would be somewhat less than a DDS, but they could do some procedures like filling cavities. This has been a somewhat controversial bill as there are stakeholders of both sides that are quite passionate about their position on this Bill.  We haven’t taken a position at this time.  

SB 1394 Abortion reporting

This Bill would require the ADHS to collect and report additional data regarding abortions that are performed in AZ. The data would be collected and reported by providers and would include the reason for the abortion (economic, emotional health, physical health, whether the pregnancy was the result of rape or incest, or relationship issues etc.).

 

House Judiciary & Public Safety @ 2 pm HHR 4

HB 2038 Drug overdose review teams; records                

Under this proposed Bill, law enforcement agencies would be required to provide unredacted reports to the chairperson of a local Drug Overdose Fatality Review Team on request.  All information and records acquired by a Team are confidential and not subject to subpoena, discovery or introduction into evidence in a civil or criminal proceeding or disciplinary action.  We’re signed up in support of this one.

 

Public Health Bills that Progressed Last Week

HB 2324 Community health workers; voluntary certification

This Bill is a top priority for us. It would charge the ADHS with developing a voluntary certification program for community health workers.  The Department rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements. We’ve signed up in support of this bill.  It received a Do Pass recommendation from the House Health Committee last week.

This would be a very good week to reach out to your State Representatives and Senator and let them know you support this measure as it will go to a Floor vote soon.  You can find their contact information at www.azleg.gov.

HB 2109 Tobacco possession; sale; age; signage                

This Bill would prohibit furnishing a tobacco product to a person who is under 21 years of age. The definition of “tobacco product” is expanded to include “electronic smoking devices”. We’ve signed up in support. It received a Do Pass recommendation from the House Health Committee last week.

HB 2084 Indoor tanning; minors; restricted use

Under this proposal, tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device”. Tanning facilities are prohibited from advertising or distributing promotional materials that claim that using a tanning device is free from risk or will result in medical or health benefits. We’ve signed on in support of this. It received a Do Pass recommendation from the House Health Committee last week.

HB 2208 Prohibition, photo enforcement

This Bill would prohibit cities and other jurisdictions from having photo enforcement of red light and speeding violations.  While nobody likes getting a ticket in the mail, the data suggest that photo enforcement saves lives and prevents injuries (especially red-light photo enforcement).  We’ve signed up in opposition to the bill.  It received a Do Pass recommendation from the House Judiciary and Public Safety Committee last week.

SB 1420 medical marijuana; inspection; testing; appropriation

This Bill would require the ADHS to set up testing standards for medical marijuana and begin enforcing the standards beginning in 2019.  We’re supporting this legislation.  It received a Do Pass recommendation from the Senate Government Committee last week.

 

Bills Waiting in the Wings

House Bills

HB 2064 Medical marijuana; packaging; labeling              

This Bill proposes that medical marijuana dispensaries be prohibited from selling a marijuana product that’s packaged or labeled in a manner that’s “attractive to minors”. Due to voter protection, this legislation requires the affirmative vote of at least 3/4 of the members of each house of the Legislature for passage.  We’re supporting this bill. It’s being Held right now by the Commerce Committee.

HB 2071 Rear-facing car seats         

This Bill would require kids under 2 years old to be in a rear-facing restraint system unless the child weights at least 40 pounds or is at least 40 inches tall.  We’ve signed up in support of this bill.  It cleared the House Transportation & Infrastructure Committee last Wednesday.

HB 2127 Children’s health insurance program

This Bill removes the trigger that automatically freezes the KidsCare program if FMAP (the federal contribution) drops below 100%.  It allows the state to freeze it if costs are more than the state or federal allotment. The bill does not require the state to appropriate any money for a state share.  

We’ve signed up in support of this bill because it provides a pathway to keep KidsCare if the federal government drops its contribution level.  This one cleared the House Health Committee a couple of weeks ago.

HB 2197 Health professions, workforce data

This Bill would require AZ health licensing boards to collect certain data from applicants (beginning January 2020) to get better data about health professions workforce distribution and needs.  The data would be confidential. No news on this one.

HB 2228 Annual waiver, applicability

This Bill would direct AHCCCS to exempt tribes from their directed waiver requests to CMS asking permission to implement work requirements for some Medicaid members.  The recently submitted Waiver request includes an exemption for American Indians, however, this would place the exemption into statute.

HB 2389  Syringe access programs; authorization

Under this Bill, organizations in Arizona can establish and operate a needle exchange program.  Persons, employees and volunteers operating within the scope of the law may not be charged or prosecuted for their activities. It’s currently a felony to distribute needles to illegal drug users.

We’ve signed up in support of this bill because this type of program is evidence-based and reduces the spread of bloodborne diseases as well as engaging in intravenous drug users into treatment. No hearings scheduled yet.

HB 2443  Medical services purchase, premiums

The Bill would essentially allow Arizonans that don’t normally qualify for Medicaid to buy Medicaid health insurance.  It would ask AHCCCS to write the rules and regulations for the program including setting a premium that ensures people buying in would pay full freight.  If approved, it would allow people to buy in beginning on October 1, 2019.  

The bill is also contingent on CMS approval.  Here’s a link to a really good document that discusses the merits of a Medicaid buy-in system.  It has not yet been assigned to a committee.

 

Senate Bills

SB 1007  Motorcycle operation; riding between lanes          

Under this proposal, motorcycle operators would no longer be prohibited from passing in the same lane occupied by the vehicle being overtaken and from operating a motorcycle between the lanes of traffic if they’re wearing a helmet.  We decided to take a position against this one in our Public Health Policy Committee last week. No action this week.

SB 1022    DHS; homemade food products            

Under this Bill, ADHS would be required to establish an online registry of food preparers that are authorized to prepare “cottage food products” for commercial purposes. Registered food preparers would be required to renew the registration every three years. This is a sensible addition to the current cottage industry food law and we’ve signed up in support.  This bill as passed through both of it’s assigned committees over the last couple of weeks.

SB 1083 Schools; recess periods

Under this Bill, district and charter schools would be required to provide at least 2 recess periods during the school day for kids in grades K-5.  We’ve signed in support of this bill.  It got a Do Pass recommendation from the Education Committee a couple of weeks ago and both Caucuses support it- a good sign.

SB 1245 Snap Benefit Match

This Bill would appropriate $400K to ADES to develop the infrastructure for a produce incentive program within the Supplemental Nutrition Assistance Program (SNAP) for members to buy Arizona-grown fruits and vegetables.  It would also provide matching funds to SNAP-authorized vendors as an incentive to participate in the fruits and vegetable program.  We’ve signed up in support of this Bill.  It hasn’t been scheduled for a committee hearing yet.

SB 1445 AHCCCS Dental care, pregnant women

This is a priority Bill for AzPHA.  It would provide oral health coverage for pregnant women who receive their health insurance coverage through AHCCCS.  The benefit would be limited to $1000 and could be used for other than emergency dental procedures (beginning October 1, 2017 all adult Medicaid members became eligible for up to $1000 in emergency dental services per year).  Lots of good public health reasons to support this one.

 

Federal Budget Drama Update

The House Appropriations Committee released the next Continuing Appropriations Act (H.J. Res 128) designed to update current continuing resolution that expires Thursday.  The proposed CR extends funding for the federal government through Mar. 23. Here’s what’s in it:

  • Community Health Centers: Provides $3.6 billion in FY18 and FY19.
  • National Health Service Corps: Provides $310 million in FY18 and FY19.
  • Family to Family Information Centers: Provides $6 million for FY18 and FY19.
  • Census: Provides $51 million to prepare for the 2020 census.
  • Medicaid Disproportionate Share: Eliminates the Medicaid DSH reductions scheduled for FY18 and FY19. The DSH reduction of $4 billion for FY20 remains and adds a total of $6 billion in additional DSH reductions to offset the cost of eliminating the FY18 and FY19 reductions.
  • Sexual Risk Avoidance Program (formerly Abstinence Education program): Provides $75 million in FY18 and FY19.
  • Personal Responsibility Education Program: Provides $75 million in FY18 and FY19.

The House is expected to vote tonight.  After that, the Senate will probably modify the bill and send it back to the House. All this needs to be done before midnight on Friday to avert another federal government shutdown.

 

Will Humble Medicaid, Wills Blog

AzPHA Comment Letter to CMS Regarding AHCCCS Work Requirement Directed Waiver

February 5, 2018

 

Seema Verma

Administrator,

The Centers for Medicare and Medicaid Services

7500 Security Boulevard

Baltimore, MD 21244

 

RE: Arizona (AHCCCS) 1115 Waiver Application

Dear Administrator Verma:

I write on behalf of the Arizona Public Health Association (AzPHA) – one of Arizona’s oldest and largest membership organizations dedicated to improving the health of Arizona citizens and communities. An affiliate of the American Public Health Association, our members include health care professionals, state and county health employees, health educators, community advocates, doctors, nurses and students.

The Arizona Health Care Cost Containment System (AHCCCS) has requested permission through an 1115 Waiver Application to implement changes to its 1115 demonstration in response to its state legislation, (Senate Bill 1092). Through their amendment, AHCCCS requests to implement employment and community engagement requirements as a condition of Medicaid eligibility and bi-annual verification of compliance with employment and community engagement requirements as well as other changes in family income or other eligibility factors.  They have also asked for the authority to limit lifetime coverage for “able-bodied adults” to five years unless an individual is considered exempt by the state.

Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that are found by the Secretary to be likely to assist in promoting the objectives of the Medicaid program. The purpose of these demonstrations, which give states additional flexibility to design and improve their programs, is to demonstrate and evaluate state-specific policy approaches to better serving Medicaid populations.

A core tenant of these waivers is to conduct a robust evaluation of demonstration projects to properly gauge their effectiveness.  We urge the Centers for Medicare and Medicaid Services to stay true to this commitment and withhold approval of the waiver.

until after AHCCCS submits an evaluation design that will satisfactorily measure the effectiveness of this waiver application in meeting the health and wellness needs of our nation’s vulnerable and low-income individuals and families. 

Because a comprehensive evaluation plan has not been submitted with this waiver application, it is unclear how the Administration will evaluate the plan’s effectiveness and meet the intent of the 1115 waiver requirements. 

For example, the application provides no insight into how AHCCCS will evaluate program impact on health outcomes and track and report on the number of individuals whose eligibility is discontinued due to failure to demonstrate compliance with the Waiver’s work/job training requirements.

It is unclear whether AHCCCS will track and report on the number of individuals who seek and obtain exemptions from the work requirement and how population impacts will be disaggregated by sociodemographic characteristics including age, sex, race, ethnicity and geography. The application does not discuss whether they will use external metrics such as hospital uncompensated care reports to provide early indicators of any potential provider impacts on changes in coverage that may result from the waiver.

AHCCCS identifies basic proposed evaluation methods such as the rate of employment, job seeking, education and employment support and development activities for able-bodied adults and state that they will track and report on the average household income.  However, their discussion does not constitute an evaluation plan. CMS guidance states that evaluations must assess program impact on health outcomes – a topic which is not addressed in the AHCCCS Waiver application.

We are aware the Secretary of Health and Human Services and the CMS Administrator are receptive to the kind of waiver request that AHCCCS is requesting, and that Section 1115 demonstrations are generally approved for an initial five-year period and can be extended for up to an additional three to five years, depending on the populations served. 

However, because of the large and challenging system changes that will be required by AHCCCS and members under this request, we strongly urge CMS to withhold any approval until the Administration submits a credible and robust evaluation strategy and plan.

We also urge CMS to limit any approval to 3 years, pending the results of an objective evaluation of the impact that these changes will have on vulnerable and low-income individuals and families.

Additionally, we urge CMS to ask AHCCCS for a complete and evidence-based rationale for how a 5- year limit on lifetime benefits could possibly further the mission of meeting the health and wellness needs of our nation’s vulnerable and low-income individuals and families. Many chronic medical conditions such as diabetes and asthma require continual chronic disease management.  Without connection to care these conditions become more challenging and more expensive. With a 5-year limit on benefits, former members will be disconnected from care, resulting in poor outcomes and increased compensated and uncompensated care.

Additionally, there are many unknowns about how the Administration will implement the 5-year limit. For example, how will the Administration keep track of exempt member months over time and how will they be able to apply and allocate those months toward the 5-year limitation? What mechanisms will be used to allow members to supply the needed data, and how will the communication loop be implemented and maintained.

Sincerely,

 

Will Humble, MPH

Executive Director,

Arizona Public Health Association