Will Humble Firearm Safety, Wills Blog

AzPHA Public Health Policy Update: March 26, 2018

Governor’s School & Firearm Safety Proposal

Last week the Governor proposed a conceptual initiative that would do several things related to school safety. I haven’t seen an actual bill, but the media release mentions the following items:

  • Increase behavioral health resources in schools

  • Increase school resource officer funding and training and increases the presence of law enforcement on school grounds

  • Severe Threat Order of Protection orders that would restrict firearm access for people who are a danger to themselves or others

  • Enhances some background checks by improving the completeness and accuracy of the criminal history database

  • Establishes a “Center for School Safety” with a centralized reporting tip line to report and investigate concerns of school safety

 

Federal Budget Drama is Finally Over

Last week the US House and Senate passed and the President finally signed a budget for this fiscal year. Here’s what the budget contains related to the federal public health agencies:

  • CDC: $8.3 billion, an increase of $1B from the FY17 level of $7.2 billion. Total funding includes $800 million from the Prevention and Public Health Fund. Specific allocations include: $350 million to address the opioid epidemic; $480 million for construction of a new BSL 4 lab at CDC; $160 million for the Preventive Health and Health Services Block Grant; and increases for several CDC programs.

  • HRSA: $7 billion, an increase of $550 million above FY17. This funding includes a $10 million increase for the Title V Maternal and Child Health Services Block Grant.

  • SAMHSA: $5 billion, an increase of $1.3 billion above FY17. It includes more than $1.7 billion to address opioid and heroin abuse—an increase of $1.5 billion above FY17. This includes $500 million for the state opioid response grants.

 

Legislative Session Update 

Committee Highlights Last Week

HB 2038 Drug overdose review teams; records was passed and signed last week.  Once it takes effect later this year, law enforcement agencies will now be required to provide 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.

HB 2084 Indoor tanning; minors; restricted use had been languishing in the Senate after passing the House by a 45-15 vote. Because of its lack of movement in the Senate it had appeared to be dead again this year.  However, this week it reappeared as a Strike All amendment in the House again as SB 1290.  It got a unanimous pass recommendation from the House Health Committee last Thursday- so it’s back in business.  It’ll still need another House Floor vote before going back to the Senate again.  If it passes and is signed, tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device” and tanning facilities couldn’t claim that using a tanning device is free from risk or has health benefits. We’ve signed on in support of this of course.

HB 2127 Children’s health insurance program had been languishing in the Senate and appeared dead. However, it was resurrected this week in the form of SB 1087 and was passed again by the House Health Committee last Thursday.  It still needs another House floor vote before it goes back to the Senate again.  It would remove 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. 

SB 1245 Snap Benefit Match earned a Do Pass recommendation from the House Appropriations Committee last week and is now ready for a House floor vote (and of course needs to make it through the budget process). It has passed through the Senate already.  This good Bill would appropriate $400K to ADES to develop a produce incentive program within the Supplemental Nutrition Assistance Program 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 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. 

SB 1261 Texting while driving has been languishing for the last few weeks, as it hasn’t been called up for a floor vote in the Senate.  Last week, the language from SB 1261 was added as an amendment onto HB 2159 traffic violations; traffic survival school.  This bill, with the addition of the texting language, is now in the House awaiting a final vote.  If anybody has influence with Speaker Mesnard now would be a great time to contact him and ask him to bring it to the floor.

Last week the Governor signed HB 2484 local food tax; equality which will ban Arizona cities and counties from taxing sugary drinks as a public health intervention. The bill doesn’t specifically mention taxes on sugary drinks, but states that any tax on food needs to be uniform.  products must be uniform. Right now, there aren’t any Arizona cities or counties that are taxing soda and other sugary drinks, and this new law will ensure that it stays that was. 

The APHA has a Policy Statement on the topic that states in part that: Research has shown that “Sugar-sweetened beverages are price elastic: it is estimated that every 10% increase in price would decrease consumption by 10%. A recent study revealed that a penny-per-ounce tax would reduce consumption by 15% among adults 25–64 years of age and prevent 2.4 million diabetes person-years, 95,000 coronary heart events, 8,000 strokes, and 26,000 premature deaths.”

SB 1445 AHCCCS Dental care, pregnant women cleared the House Health committee this week. The next stop is the House Appropriations committee (It previously was passed in the Senate).  This Bill would provide oral health coverage for pregnant Medicaid members.   Because it involves money, it’ll also need to get funded during the budget making process.

This is a priority Bill for AzPHA.  It would provide oral health coverage for pregnant Medicaid members.  The benefit would be limited to $1,000 and could be used for other than emergency dental procedures all adult Medicaid members became eligible for up to $1,000 in emergency dental services per year.  Lots of good public health reasons to support this one. 

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Committee Hearings this Week

HB 2324 Community health workers; voluntary certification and HB 2389 Syringe access programs; authorization are on the Monday, March 26 Senate Rules Committee on Rules Agenda at 1pm in Caucus Room 1 (no testimony is taken in Rules committees)

HB 2127 Children’s health insurance program is on the Tuesday, March 27 Senate Appropriations Committee Agenda at 2pm in Room SHR109

SB1445 AHCCCS Dental care, pregnant women is on the Wednesday, March 28 House Appropriations Committee Agenda at 1pm in Room HHR1

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Here’s a snapshot of where the various bills we’re working on are in the system. 

HB 2038 Drug overdose review teams; records (Signed into Law)

HB 2071 Rear-facing car seats (Stalled in Senate)

HB 2084 Indoor tanning; minors; restricted use (Now called SB 1290 as Striker) 

HB 2127 Children’s health insurance program (Now called SB 1087 as Striker)

HB 2197 Health professions, workforce data (Ready for Senate Floor Vote)

HB 2208 Prohibition, photo enforcement (Effectively dead)

HB 2228 Annual waiver, applicability (Needs Senate Rules Committee Approval)

HB 2323 Schools; inhalers; contracted nurses (Ready for Senate Floor Vote)

HB 2324 Community health workers; voluntary certification (Needs Sen. Rules Com. Approval)

HB 2389 Syringe access programs; authorization (Needs Sen. Rules Com. Approval)

HB 2484 local food tax; equality (Signed by Governor)

SB 1022 ADHS; homemade food products (On Governor’s Desk) 

SB 1083 Schools; recess periods (Needs House Floor Vote)

SB 1245 Snap Benefit Match (Needs Rules Committee & Budget Line)

SB 1261 Texting while driving (Now HB 2159 traffic violations; traffic survival school)

SB 1420 Medical marijuana; inspection; testing; appropriation (Needs House Rules)

SB 1445 AHCCCS Dental care, pregnant women (Needs House Approps and Rules Com)

SB 1377 Dental therapy, licensure, regulation (Failed in House now HB2235 in Senate as striker)

SB 1394 Abortion reporting (Ready for House Floor Vote)

 

Public Health-related bills that have been passed and signed so far:

HB 2038 Drug overdose review teams; records was passed and signed last week.  Once it takes effect later this year, law enforcement agencies will now be required to provide unredacted reports to the chairperson of a local Drug Overdose Fatality Review Team on request. 

HB 2484 local food tax; equality, which will ban Arizona cities and counties from taxing sugary drinks as a public health intervention.

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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 Official

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House Bills

HB 2038 Drug overdose review teams; records                

Passed and Signed

Law enforcement agencies will now 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.

HB 2071 Rear-facing car seats         

Stalled in 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.  No action has yet been taken in the Senate so this bill is effectively dead.

HB 2084 Indoor tanning; minors; restricted use

Stalled in Senate- now SB1290 in House

This bill had been languishing in the Senate after passing the House by a 45-15 vote. Because of its lack of movement in the Senate it had appeared to be dead again this year.  However, this week it reappeared as a Strike All amendment in the House again as SB 1290.  It got a unanimous pass recommendation from the House Health Committee last Thursday- so it’s back in business.  It’ll still need another House Floor vote before going back to the Senate again.  If it passes and is signed, tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device” and tanning facilities couldn’t claim that using a tanning device is free from risk or has health benefits. We’ve signed on in support of this of course.

HB 2127 Children’s health insurance program

Stalled in Senate- now SB 1087 in House

After passing the House, this bill had been languishing in the Senate and appeared dead.  However, it was resurrected this week in the form of SB 1087 and was passed again by the House Health Committee last Thursday.  It still needs another House floor vote before it goes back to the Senate again.  It would remove 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 Senate Floor Vote

This bill is looking good and ready for a final Senate floor vote.  It 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.  Over the long-term this bill would be helpful in providing better data with which to improve the distribution and capacity of the public health workforce in Arizona.

HB 2208 Prohibition, photo enforcement

Died in Senate

This one 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 but stalled in the Senate.  Honestly, it looks dead.

HB 2228 Annual waiver, applicability

Still Needs Senate Rules Committee

This 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 2323   Schools; inhalers; contracted nurses

Ready for Senate Floor Vote

This bill adds contracted nurses to the list of people who are authorized to provide emergency inhaler medication in case of respiratory emergencies. Some charter and independent schools don’t employ nurses directly but engage them through contracts. Ready for a final Senate floor vote.

HB 2324 Community health workers; voluntary certification

Still needs Senate Rules Committee

This Bill got a Do Pass recommendation from the Senate Commerce and Public Safety Committee last week (7-0-1).  As you’ll recall, the week before the Senate Health and Human Services Committee gave it a Do Pass recommendation. We’re getting a lot closer to the finish line. Our next hurdle will be the Senate Rules Committee followed by a floor vote in the Senate.  Because there are some changes in the language since it passed the House, it’ll need to go back to accommodate those differences after that.  But it is looking good! 

This Bill is a top priority for us. It asks the ADHS with developing a voluntary certification program for community health workers. The rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements.

HB 2389  Syringe access programs; authorization

Amended and Weakened- and Needs Senate Rules

This Bill was substantially amended in the Senate Government Committee last week.  The bill (as amended) passed the committee, but in its amended form will be much less helpful as a public health intervention.  The original bill essentially would have decriminalized needle exchange programs.  The amendment makes it such that needle exchange would only be decriminalized when and where the ADHS declares a public health emergency because of the rapid spread of infectious diseases. Hopefully we can get the amendment removed.  If we can’t and it passes and is signed as amended it’ll have very little public health utility.

HB 2484 local food tax; equality

Signed by Governor

Last week the Governor signed which will ban Arizona cities and counties from taxing sugary drinks as a public health intervention. The bill doesn’t specifically mention taxes on sugary drinks, but states that any tax on food needs to be uniform.  products must be uniform. Right now, there aren’t any Arizona cities or counties that are taxing soda and other sugary drinks, and this new law will ensure that it stays that was. 

The APHA has a Policy Statement on the topic that states in part that: Research has shown that “Sugar-sweetened beverages are price elastic: it is estimated that every 10% increase in price would decrease consumption by 10%. A recent study revealed that a penny-per-ounce tax would reduce consumption by 15% among adults 25–64 years of age and prevent 2.4 million diabetes person-years, 95,000 coronary heart events, 8,000 strokes, and 26,000 premature deaths.”

 

Senate Bills

SB 1022    DHS; homemade food products            

Sent to Governor

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. Being heard in the House Health Committee this week (Thursday).  Should have no problems at all.

SB 1083    Schools; recess periods

Ready for House Floor Vote

District and charter schools would be required to provide at least 2 recess periods during the school day for pupils in grades K-5 if this passes. 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. Hopefully there’s a floor vote on this shortly.

SB 1245 Snap Benefit Match

Needs House Rules Committee and Budget Line Item

This Bill earned a Do Pass recommendation from the House Appropriations Committee last week and is now ready for a floor vote (and of course needs to make it through the budget process). This good Bill would appropriate $400K to ADES to develop a produce incentive program within the Supplemental Nutrition Assistance Program 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. 

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. 

SB 1261 Texting while driving

Now HB 2159 and Moving Again in House

This has been languishing for the last few weeks because it hasn’t been called up for a floor vote in the Senate.  Last week, the language from SB 1261 was added as an amendment onto HB 2159 traffic violations; traffic survival school.  This bill, with the addition of the texting language, is now in the House awaiting a final vote.  If anybody has influence with Speaker Mesnard now would be a great time to contact him and ask him to bring it to the floor.

This 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, which hasn’t happened yet.  Not a good sign.

SB 1377 Dental therapy, licensure, regulation

Stalled in House now HB 2235

This bill failed to get a Pass recommendation from the House Health Committee last week (5-4), and is now HB 2235 as a striker.  It would have 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 House Floor Vote

This one 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.).  The bill was given a Do Pass recommendation last week by the House Judiciary & Public Safety Committee- although it was amended slightly by removing the requirement that physicians ask and report specifically why the woman is asking for the procedure

SB 1420 Medical marijuana; inspection; testing; appropriation

Needs House Rules Approval

This 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 and was given a Pass recommendation by the House Military, Veterans & Regulatory Affairs Committee this week.

SB 1445 AHCCCS Dental care, pregnant women

Needs House Approps and Rules Still

Last week SB 1445 AHCCCS Dental care, pregnant women was given a pass recommendation by the House Health committee. The next stop is the House Appropriations committee (It previously was passed in the Senate).  This Bill would provide oral health coverage for pregnant Medicaid members.   Because it involves money, it’ll also need to get funded during the budget making process.

This is a priority Bill for AzPHA.  It would provide oral health coverage for pregnant Medicaid members.  The benefit would be limited to $1,000 and could be used for other than emergency dental procedures (beginning October 1, 2017 all adult Medicaid members became eligible for up to $1,000 in emergency dental services per year).  Lots of good public health reasons to support this one. 

SB 1470  Sunrise process; health professions

Passed Senate 21 – 9; being amended

To be honest- this bill has been flying under the radar at least with me.  If it passes and is signed it’d make huge changes to the health professions scope of practice system we use today. The current sunrise process is a collaborative, inclusive process that allows time for consideration and review of the complicated health care delivery proposals.  The current process requires a Committee of Reference hearing, which allows a consideration of a proposed scope change and its potential patient safety and care implications.

SB 1470 would change the scope of practice system so that all a profession needs to do is prepare a written sunrise report right before the regular legislative session. It would allow the legislative standing committees (rather than Committees of Reference) to consider a sunrise proposal. During legislative session, long agendas and the fast pace limits the time to consider serious issues impacted by changes in scope of practice, including prescribing, complex health care procedures, complicated review, and reflection on curriculum, training and education.

We had a Public Health Policy Committee call last week and recommended to our Board that we take a position opposing the bill- which we did last week.  I testified that, rather than eliminating the pre-session hearings for scope of practice changes that they consider modifying the bill so that requests for new Scope changes go to the ADHS Director for a recommendation back to the Legislature. 

The Bill passed the House Government Committee last week.  There was reportedly a stakeholder meeting on the bill last week.  Being Held in the House Rules Committee.

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Public Health Bills that Failed

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.

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Remember to register for our April 11 Spring Conference: 

Together for Tomorrow: Protecting Arizona’s Children 

View Agenda &

 REGISTER TODAY!

 

 

 

Will Humble Medicaid, Social Determinants, Wills Blog

AzPHA Public Health Policy Update: March 19, 2018

AHCCCS Update: Coding the Social Determinants of Health

ICD-10 diagnosis codes that relate to the Social Determinants of Health can be a valuable source of information to improve health outcomes.  Social Determinants of Health codes can identify the conditions in which people are born, grow, live, work, and age like education, employment, physical environment, socioeconomic status and social support networks- data that can provide managed care organizations information with which to improve outcomes and reduce costs.

AHCCCS is recommending that providers routinely screen for and document the presence of social determinants (as appropriate within their scope of practice) and to document them in claims data. AHCCCS will begin to monitor claims for the presence of these codes after April 1, 2018. You can review the Social Determinant ICD-10 Codes on the AHCCCS website.

 

FDA Proposes Rulemaking to Reduce Nicotine Levels in Tobacco Products

The FDA issued an “advance notice of proposed rulemaking” last week to get input for them to develop new standards for the maximum nicotine level in cigarettes. They say they’re interested in reducing the level of nicotine in cigarettes to make them “minimally addictive or nonaddictive”.  

Those of you that are familiar with the evidence base in this area should take this opportunity to provide input to the FDA. It has the potential to be a big intervention in our decades long battle public health battle with tobacco.  Electronic comments can be submitted through June 14 at https://www.regulations.gov. 

 

AzPHA Comments on ADHS School Vaccination Rulemaking

The ADHS has an administrative rulemaking open to adjust their school and child care vaccine requirements. Our public health policy committee turned in a response last week (it had a short comment period- just a week).  You can see our comments on the proposed rules on our AzPHA Blog). 

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Legislative Session Update 

Committee Highlights Last Week

HB 2324 Community health workers; voluntary certification had another terrific week. The bill got a Do Pass recommendation from the Senate Commerce and Public Safety Committee last week (7-0-1).  As you’ll recall, the week before the Senate Health and Human Services Committee gave it a Do Pass recommendation. We’re getting a lot closer to the finish line. Our next hurdle will be the Senate Rules Committee followed by a floor vote in the Senate.  Because there are some changes in the language since it passed the House, it’ll need to go back to accommodate those differences after that. But it is looking good!  

This Bill is a top priority for us. It asks the ADHS with developing a voluntary certification program for community health workers. The rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements.

HB 2197 Health professions, workforce data also had a good week, getting a pass recommendation from the Senate Commerce and Public Safety Committee last week.  It 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.  Over the long-term this bill would be helpful in providing better data with which to improve the distribution and capacity of the public health workforce in Arizona.

HB 2228 Annual waiver, applicability received a pass recommendation from the Senate HHS Committee last week.  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, but this would place the exemption into statute.

HB 2389  Syringe access programs; authorization was substantially amended in the Senate Government Committee last week (not in a good way).  The amended bill passed the committee, but its amended form will be much less helpful as a public health intervention. The original bill essentially would have decriminalized needle exchange programs. The amendment makes it such that needle exchange would only be decriminalized when and where the ADHS declares a public health emergency because of the rapid spread of an infectious disease. Hopefully we can get the amendment removed.  If we can’t and it passes and is signed as amended it’ll have little public health utility.

SB 1245 Snap Benefit Match earned a pass recommendation from the House Health Committee last week.  Its next stop is the House Appropriation Committees.  This good Bill would appropriate $400K to ADES to develop a produce incentive program within the Supplemental Nutrition Assistance Program 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.  

SB 1377 Dental therapy, licensure, regulation failed to get a pass recommendation from the House Health Committee last week (5-4).  It would have 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 1420 medical marijuana; inspection; testing; appropriation received a pass recommendation by the House Military, Veterans & Regulatory Affairs Committee last week. This bill would require the ADHS to set up testing standards for medical marijuana and begin enforcing the standards beginning in 2019.

SB 1261 Texting while driving has been languishing for the last few weeks, as it hasn’t been called up for a floor vote in the Senate.  Last week, the language from SB 1261 was added as an amendment onto HB 2159 traffic violations; traffic survival school.  This bill, with the addition of the texting language, is now in the House awaiting a final vote.  If anybody has influence with Speaker Mesnard now would be a great time to contact him and ask him to bring it to the floor.

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Committee Highlights this Week

Monday, March 19th, Senate Commerce & Public Safety 2 pm, SHR 1

HB 2064:  medical marijuana; packaging; labeling

 

Wednesday, March 21st, House Appropriations 9 am, HHR1

SB 1245:  appropriation; SNAP; benefit match; produce

SB 1420:  medical marijuana; inspection; testing; appropriation

 

Thursday, March 22nd, House Health 9am, HHR 4

SB 1445:  AHCCCS; dental care; pregnant women

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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.  We’re keeping track of the hearing dates and times. 

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 2323 Schools; inhalers; contracted nurses

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 1445 AHCCCS Dental care, pregnant women

SB 1377 Dental therapy, licensure, regulation

SB 1394 Abortion reporting 

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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 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 Senate 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, and not yet scheduled in either of the Senate committees.

 

HB 2084 Indoor tanning; minors; restricted use

Passed House 45 – 15

Assigned to Senate HHS and Commerce & Public Safety Committees

Tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device”. Tanning facilities couldn’t advertise or distribute 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 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 had a good week, getting a Do Pass recommendation from the Senate Commerce and Public Safety Committee last week.  It 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.  Over the long-term this bill would be helpful in providing better data with which to improve the distribution and capacity of the public health workforce in Arizona.

 

HB 2208 Prohibition, photo enforcement

Passed the House 31-27-1

Assigned to the Senate Transportation Committee

This one 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- not on their agenda yet.

 

HB 2228 Annual waiver, applicability

Passed the House 58-0-1

Passed in the Senate HHS Committee

This 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 2323  Schools; inhalers; contracted nurses

Passed House 58 – 0 – 1

Assigned to Senate Education Committee

This bill adds contracted nurses to the list of people who are authorized to provide emergency inhaler medication in case of respiratory emergencies. Some charter and independent schools don’t employ nurses directly but engage them through contracts.

 

HB 2324 Community health workers; voluntary certification

Passed House 56 – 1 – 3

Assigned to HHS and Commerce & Public Safety Committees

This Bill had another terrific week. The Bill got a Do Pass recommendation from the Senate Commerce and Public Safety Committee last week (7-0-1).  As you’ll recall, the week before the Senate Health and Human Services Committee gave it a Do Pass recommendation. We’re getting a lot closer to the finish line. Our next hurdle will be the Senate Rules Committee followed by a floor vote in the Senate.  Because there are some changes in the language since it passed the House, it’ll need to go back to accommodate those differences after that.  But it is looking good!  

This Bill is a top priority for us. It asks the ADHS with developing a voluntary certification program for community health workers. The rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements.

 

HB 2389  Syringe access programs; authorization

Passed House 56 – 0 – 4

Assigned to the Senate Government Committee

This Bill was substantially amended in the Senate Government Committee last week.  The bill (as amended) passed the committee, but in its amended form will be much less helpful as a public health intervention.  The original bill essentially would have decriminalized needle exchange programs.  The amendment makes it such that needle exchange would only be decriminalized when and where the ADHS declares a public health emergency because of the rapid spread of infectious diseases. Hopefully we can get the amendment removed.  If we can’t and it passes and is signed as amended it’ll have very little public health utility.

 

Senate Bills

SB 1022    DHS; homemade food products            

Passed Senate 30-0

Assigned to House Health Committee

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. Being heard in the House Health Committee this week (Thursday).  Should have no problems at all.

 

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 if this passes. 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. Hopefully there’s a floor vote on this shortly.

 

SB 1245 Snap Benefit Match

Passed Senate 25 – 5

Assigned to House Health and Appropriation Committees

This Bill earned a Do Pass recommendation from the House Health Committee last week.  Its next stop is the House Appropriation Committees.  This good Bill would appropriate $400K to ADES to develop a produce incentive program within the Supplemental Nutrition Assistance Program 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.  

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 has passed the full Senate and will be heard this Thursday at 9 am in House Health.  

 

SB 1261 Texting while driving

Passed Transportation Committee- Ready for a Senate Floor Vote

This 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, which hasn’t happened yet.  Not a good sign.

 

SB 1377 Dental therapy, licensure, regulation

Passed Senate 22 – 8

Assigned to House Health Committee

This bill failed to get a Pass recommendation from the House Health Committee last week (5-4).  It would have 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.   Being heard this week (Thursday at 9 am) in the House Health Committee.

 

SB 1394 Abortion reporting

Passed Senate 17 – 13

Assigned to the Judiciary and Federalism, Property Rights & Public Policy Committees

This one 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.).  The bill was given a Do Pass recommendation last week by the House Judiciary & Public Safety Committee- although it was amended slightly by removing the requirement that physicians ask and report specifically why the woman is asking for the procedure.

 

SB 1420 Medical marijuana; inspection; testing; appropriation

Passed Senate 27 – 3

Assigned to House Military, Veteran and Regulatory Affairs Committee

This 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 and was given a Pass recommendation by the House Military, Veterans & Regulatory Affairs Committee this week.

 

SB 1445 AHCCCS Dental care, pregnant women

Passed Senate 27 – 3

Assigned to House Health & Appropriations Committees

Last week SB 1445 AHCCCS Dental care, pregnant women was passed by the Senate (27 – 3).  This Bill would provide oral health coverage for pregnant Medicaid members. It has moved on to the House and is assigned to the House Health Committee (which gave as similar bill a pass recommendation last year).  Because it involves money its also assigned to the House Appropriations Committee.  The benefit would be limited to $1000/year.  Lots of good public health reasons to support this one. 

This is a priority Bill for AzPHA.  It would provide oral health coverage for pregnant Medicaid members.  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. 

 

SB 1470  Sunrise process; health professions

Passed Senate 21 – 9

Assigned to House Government Committee

To be honest- this bill has been flying under the radar at least with me.  If it passes and is signed it’d make huge changes to the health professions scope of practice system we use today. The current sunrise process is a collaborative, inclusive process that allows time for consideration and review of the complicated health care delivery proposals.  The current process requires a Committee of Reference hearing, which allows a consideration of a proposed scope change and its potential patient safety and care implications. 

SB 1470 would change the scope of practice system so that all a profession needs to do is prepare a written sunrise report right before the regular legislative session. It would allow the legislative standing committees (rather than Committees of Reference) to consider a sunrise proposal. During legislative session, long agendas and the fast pace limits the time to consider serious issues impacted by changes in scope of practice, including prescribing, complex health care procedures, complicated review, and reflection on curriculum, training and education.

We had a Public Health Policy Committee call last week and recommended to our Board that we take a position opposing the bill- which we did last week.  I testified that, rather than eliminating the pre-session hearings for scope of practice changes that they consider modifying the bill so that requests for new Scope changes go to the ADHS Director for a recommendation back to the Legislature.  

The Bill passed the House Government Committee last week.  There was reportedly a stakeholder meeting on the bill last week.  We’ll stay tuned.

__

 

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.

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AzPHA Member Kelli Donley Publishes Again

COUNTING COUP is the latest novel by AzPHA member Kelli Donley, who works in public health in Phoenix. The book is about the Phoenix Indian School, and like Donley’s other novels, has a strong public health theme. Here’s a short description of her book, which you can order from Amazon:

Happily consumed with her academic career, Professor Avery Wainwright never planned on becoming sole guardian of her octogenarian Aunt Birdie. Forced to move Birdie—and her failing memory—into her tiny apartment, Avery’s precariously balanced life loses its footing. 

Unearthed in the chaos is a stack of sixty-year-old letters. Written in 1951, the letters tell of a year Avery’s grandmother, Alma Jean, spent teaching in the Indian school system, in the high desert town of Winslow, Arizona. The letters are addressed to Birdie, who was teaching at the Phoenix Indian School. The ghostly yet familiar voices in the letters tell of a dark time in her grandmother’s life, a time no one has ever spoken of. 

Torn between caring for the old woman who cannot remember, and her very different memories of a grandmother no longer alive to explain, Avery searches for answers. But the scandal and loss she finds, the revelations about abuses, atrocities, and cover-ups at the Indian schools, threaten far more than she’s bargained for. 

About the author: 

Kelli Donley is a native Arizonan. She is the author of three novels, Under the Same Moon, Basket Baby and Counting Coup. Inspiration for this novel was found hearing colleagues’ stories about childhoods spent at the Phoenix Indian School. Kelli lives with her husband Jason, children and small ark of animals in Mesa, Arizona. She works in public health, and blogs at: www.africankelli.com.

____________

Remember to register for our April 11 Conference: Together for Tomorrow- Protecting Arizona’s Children

View Agenda | Sponsorship Packet

 REGISTER TODAY!

Will Humble Vaccination, Wills Blog

AzPHA Letter to ADHS on Proposed Immunization Rulemaking for School Vaccination Requirements

March 15, 2018

 

Cara M. Christ MD

Director,

Arizona Department of Health Services

150 N 18th Avenue

Phoenix, AZ  85007

 

RE: Vaccination Rulemaking

Dear Director Christ:

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 AzPHA has examined the Arizona Department of Health Services (ADHS) proposed Rulemaking to revise the rules in 9 A.A.C. 6, Article 7, Required Immunizations for Child Care or School Entry.  We are generally supportive of the rule package as it appears to clarify and improve the requirements for personal, medical and religious exemptions, makes the rules more consistent with standard medical practices, and better allows for electronic records and record-keeping.

However, we believe that the Department is missing an opportunity to update the child care and school vaccine requirements so that they are consistent with the CDC’s Advisory Committee for Immunization Practices (ACIP) recommendations.  As you know, rulemaking packages are resource intensive and time consuming, and this may be the only opportunity for many years to update the Department’s vaccine requirements.

We urge the ADHS to update the requirements so that they (over time) are consistent with ACIP recommendations by adding a 2nd Varicella vaccine, the PCV 13 series, Rotavirus, and 2 Hepatitis A doses to the child care requirements.  We also urge you to add a 2nd Meningococcal vaccine, and the Meningococcal B at 16 years old to the school requirements.  We recognize that ARS 36-672 (C) prevents you from being able to add the Human Papilloma Virus Vaccine to the vaccine requirements.

We understand that the requirements may need to be phased in so that pediatricians and families have the time needed to become compliant with the new requirements. 

For example, the ADHS could write the final Rule such that the vaccines with the highest current coverage levels (as reported in ASIIS) are phased in over the next 18 months.  Vaccines with lower current coverage levels could be phased in at later dates. 

This approach would allow the Department to responsibly phase the vaccine requirements using coverage projections while being a good steward of future Department Rulemaking resources and at the same time secure a healthier future for Arizona children and families.

Sincerely,

Will Humble, MPH

Executive Director,

Arizona Public Health Association

Will Humble Firearm Safety, Wills Blog

AzPHA Public Health Policy Update: March 12, 2018

 

Firearm Safety Public Policy Changes in AZ?

There are rumors around the Capitol that the Governor’s Office is talking to stakeholders about potential firearm safety laws in Arizona. However, I haven’t seen or heard anything official. Here’s a piece from the Capitol Times that mentions the topic

The APHA and the American Journal of Public Health have opened up access to their collection of research papers, commentaries and essays on public health and firearms to non-members in an effort to share the surveillance and evidence that exists freely in hopes that it can be used to influence public policy. They’re hoping that it’ll contribute to “greater collaboration and smarter evidence-based policies that enhance firearm safety and prevent injury and violence”.

 

AHCCCS Awards Contracts to Provide Integrated Services
AHCCCS awarded managed care contracts to 7 managed care organizations last week.  They’ll be responsible for coordinating the provision of physical and behavioral health care services to 1.5 million Medicaid members starting October 1. Here are the awardees for the various regions:

  • Maricopa, Gila and Pinal Counties: Banner-University Family Care Plan, Care1st Health Plan Arizona, Health Choice Arizona (Steward Health Choice Arizona), Health Net Access, Magellan Complete Care of Arizona, Mercy Care, and UnitedHealthcare Community Plan.

  • Pima, Cochise, Graham, Greenlee, La Paz, Santa Cruz, and Yuma Counties: Banner-University Family Care Plan, Health Net Access, and UnitedHealthcare Community Plan (in Pima County only).

  • Mohave, Coconino, Apache, Navajo, and Yavapai Counties: Care1st Health Plan Arizona, Health Choice Arizona (Steward Health Choice Arizona).

 

Report: Federal, state public health funding ‘insufficient’
A new Trust for America’s Health (TFAH) analysis finds that federal and state spending on public health “is insufficient.” According to the report, available here, the CDC’s core budget – not including the Prevention and Public Health Fund – has been “essentially flat for the last decade.” Additionally, spending for public health by states has been declining.

 

Legislative Session News

HB 2324 Community health workers; voluntary certification was given a Pass recommendation by the Senate Health and Human Services Committee last Wednesday (5-2) (after passing the full House by a wide margin a few weeks ago).  We have a big test on Monday 3/12 in the Senate Commerce and Public Safety Committee. This Bill is a top priority for us. It asks the ADHS with developing a voluntary certification program for community health workers. The rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements.

HB 2197 Health professions, workforce data got a unanimous Do Pass recommendation (7-0) in Senate HHS. It passed the full House a few weeks ago by a wide margin.  It 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.  Over the long-term this bill would be helpful in providing better data with which to improve the distribution and capacity of the public health workforce in Arizona.

Meanwhile, HB 2389  Syringe access programs; authorization was scheduled to be heard in the Senate Government Committee last week but was tabled until this week’s agenda Wednesday at 2 pm.

______

 

Committee Highlights this Week

Monday- Senate Commerce & Public Safety – 2 pm, SHR 1

HB 2197:  health professionals; workforce data

HB 2324:  community health workers; voluntary certification

 

Monday- House Military, Veterans & Regulatory Affairs – 2 pm, HHR 3

SB 1420:  medical marijuana; inspection; testing; appropriation

 

Wednesday- House Judiciary & Public Safety – 2 pm, HHR4

SB 1394:  ADHS; reporting; abortions

 

Wednesday- Senate Government – 2 pm, SHR109

HB 2389:  syringe access programs; authorization

 

Thursday- House Health 9am, HHR 4

SB 1245:  appropriation; SNAP; benefit match; produce

SB 1377:  dental therapy; licensure; regulation

SB 1504:  developmental disability rates; appropriation

 

Thursday- Senate Education – 9am, SHR 1

HB 2088:  pupils; concussions; parental notification

HB 2323:  schools; inhalers; contracted nurses

________

 

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.  We’re keeping track of the hearing dates and times.

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 2323 Schools; inhalers; contracted nurses

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 1445 AHCCCS Dental care, pregnant women

SB 1377 Dental therapy, licensure, regulation

SB 1394 Abortion reporting 

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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

_____

 

House Bills

HB 2038 Drug overdose review teams; records                

Passed the House 57-0-2

Assigned to Senate Health and Human Services 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 Senate 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, and not yet scheduled in either of the Senate committees.

 

HB 2084 Indoor tanning; minors; restricted use

Passed House 45 – 15

Assigned to Senate HHS and Commerce & Public Safety Committees

Tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device”. Tanning facilities couldn’t advertise or distribute 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 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 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 will also be heard in Senate Health and Human Services Bill Wednesday afternoon.  It 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.  Over the long-term this bill would be helpful in providing better data with which to improve the distribution and capacity of the public health workforce in Arizona.

Being heard this week in Monday’s the Senate Commerce and Public Safety Committee.

 

HB 2208 Prohibition, photo enforcement

Passed the House 31-27-1

Assigned to the Senate Transportation Committee

This one 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- not on their agenda yet..

 

HB 2228 Annual waiver, applicability

Passed the House 58-0-1

Assigned to Senate HHS Committee

This 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 2323  Schools; inhalers; contracted nurses

Passed House 58 – 0 – 1

Assigned to Senate Education Committee

This bill adds contracted nurses to the list of people who are authorized to provide emergency inhaler medication in case of respiratory emergencies. Some charter and independent schools don’t employ nurses directly but engage them through contracts.

 

HB 2324 Community health workers; voluntary certification

Passed House 56 – 1 – 3

Assigned to HHS and Commerce & Public Safety Committees

This 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. Passed the Health and Human Services Committee last week and is up on Monday this week in the Senate Commerce and Public Safety Committee.

 

HB 2389  Syringe access programs; authorization

Passed House 56 – 0 – 4

Assigned to the Senate Government Committee

This important bill will also be heard Wednesday afternoon in the Senate Government Committee. It would decriminalize needle exchange programs.  It’s currently a felony to distribute needles to illegal drug users. Persons, employees and volunteers operating within the scope of the law can’t be charged or prosecuted for their activities. 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. 

Up this Wednesday in the Senate Government Committee- 2 pm in SHR 109.

 

Senate Bills

SB 1022    DHS; homemade food products            

Passed Senate 30-0

Assigned to House Health Committee

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. Being heard in the House Health Committee this week (Thursday).  Should have no problems at all.

 

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 if this passes. 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. Hopefully there’s a floor vote on this shortly.

 

SB 1245 Snap Benefit Match

Passed Senate 25 – 5

Assigned to House Health and Appropriation Committees

There was more good news with the passage of SB 1245 Snap Benefit Match by the Senate (25 – 5).  It’s assigned to House Health and Appropriation Committees too.  This good Bill would appropriate $400K to ADES to develop 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. 

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 has passed the full Senate and will be heard this Thursday at 9 am in House Health.   

 

SB 1261 Texting while driving

Passed Transportation Committee- Ready for a Senate Floor Vote

This 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, which hasn’t happened yet.  Not a good sign.

 

SB 1377 Dental therapy, licensure, regulation

Passed Senate 22 – 8

Assigned to House Health Committee

This 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.   Being heard this week (Thursday at 9 am) in the House Health Committee.

 

SB 1394 Abortion reporting

Passed Senate 17 – 13

Assigned to the Judiciary and Federalism, Property Rights & Public Policy Committees

This one 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.).  Up Wednesday this week in the House Judiciary & Public Safety at 2 pm.

 

SB 1420 medical marijuana; inspection; testing; appropriation

Passed Senate 27 – 3

Assigned to House Military, Veteran and Regulatory Affairs Committee

This 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.  Up this week in the House Military, Veterans & Regulatory Affairs – 2 pm, HHR 3.

 

SB 1445 AHCCCS Dental care, pregnant women

Passed Senate 27 – 3

Assigned to House Health & Appropriations Committees

This Bill would provide oral health coverage for pregnant Medicaid members. It has moved on to the House and is assigned to the House Health Committee (which gave as similar bill a pass recommendation last year).  Because it involves money its also assigned to the House Appropriations Committee.  The benefit would be limited to $1000/year.  Lots of good public health reasons to support this one. 

This is a priority Bill for AzPHA.  It would provide oral health coverage for pregnant Medicaid members.  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. 

 

SB 1470  Sunrise process; health professions

Passed Senate 21 – 9

Assigned to House Government Committee

To be honest- this bill has been flying under the radar at least with me.  If it passes and is signed it’d make huge changes to the health professions scope of practice system we use today. The current sunrise process is a collaborative, inclusive process that allows time for consideration and review of the complicated health care delivery proposals.  The current process requires a Committee of Reference hearing, which allows a consideration of a proposed scope change and its potential patient safety and care implications.

SB 1470 would change the scope of practice system so that all a profession needs to do is prepare a written sunrise report right before the regular legislative session. It would allow the legislative standing committees (rather than Committees of Reference) to consider a sunrise proposal. During legislative session, long agendas and the fast pace limits the time to consider serious issues impacted by changes in scope of practice, including prescribing, complex health care procedures, complicated review, and reflection on curriculum, training and education.

We had a Public Health Policy Committee call last week and recommended to our Board that we take a position opposing the bill- which we did last week.  I testified that, rather than eliminating the pre-session hearings for scope of practice changes that they consider modifying the bill so that requests for new Scope changes go to the ADHS Director for a recommendation back to the Legislature. 

The Bill passed the House Government Committee last week.  There is reportedly a stakeholder meeting on the bill this week.  We’ll stay tuned.

__

 

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.

____________

 

Register Today for our April 11, AzPHA Conference: Together for Tomorrow- Protecting Arizona’s Children

Agenda | Sponsorship Packet

 REGISTER TODAY!

 

 

Will Humble State Legislature, Wills Blog

AzPHA Public Health Policy Update: March 6, 2018

Legislative Session Update

Good news.  Last week SB 1445 AHCCCS Dental care, pregnant women was passed by the Senate (27 – 3).  This Bill would provide oral health coverage for pregnant Medicaid members. It has moved on to the House and is assigned to the House Health Committee (which gave as similar bill a pass recommendation last year).  Because it involves money its also assigned to the House Appropriations Committee.  The benefit would be limited to $1000/year.  Lots of good public health reasons to support this one. 

There was more good news with the passage of SB 1245 Snap Benefit Match by the Senate (25 – 5).  It’s assigned to House Health and Appropriation Committees too.  This good Bill would appropriate $400K to ADES to develop 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.  

______

 

Committee Highlights this Week

 

Senate Health and Human Services Committee- 2 pm Wednesday March 7

HB 2324 Community health workers; voluntary certification

This Bill is a top priority for us. It asks the ADHS with developing a voluntary certification program for community health workers. The rulemaking would include certification standards including qualifications, core competencies, and continuing education requirements.  The good news is that it’s being heard this week (Wednesday afternoon) in the Senate Health & Human Services Committee.

The members of the committee are Nancy Barto, Katie Hobbs, David Bradley, Kate Brophy McGee, Kimberly Yee,  Judy Burges, and Rick Gray.  Please contact these members today and let them know you support voluntary registration of community health workers.  You can also sign in using the RTS system.  Here’s some sample language to use:

“Thank you for hearing HB2324 (community health worker voluntary certification) in your HHS Committee next week. Community health workers establish and maintain trust, enabling them to serve as a liaison between health/social services and facilitating access to services and work to provide high quality and culturally competent service delivery- important tools to reduce costs and improve outcomes- especially for chronic diseases like diabetes.

Voluntary certification is an important next step in better using the CHW workforce in AZ’s managed care healthcare system.  While many providers currently employ and contract with CHWs, voluntary certification will provide an additional level of assurance that voluntarily certified CHWs meet a set of core competency requirements- allowing AZs provider network to elect to use this workforce to improve outcomes and reduce costs.”

 

HB 2197 Health professions, workforce data

This bill will also be heard in Senate Health and Human Services Bill Wednesday afternoon.  It 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.  Over the long-term this bill would be helpful in providing better data with which to improve the distribution and capacity of the public health workforce in Arizona.

 

Senate Government Committee – 2 pm Wednesday March 7

HB 2389  Syringe access programs; authorization

This important bill will also be heard Wednesday afternoon in the Senate Government Committee. It would decriminalize needle exchange programs.  It’s currently a felony to distribute needles to illegal drug users. Under this bill, persons, employees and volunteers operating within the scope of the law couldn’t be charged or prosecuted for their activities. 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. 

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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.  We’re keeping track of the hearing dates and times.

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 1445 AHCCCS Dental care, pregnant women

SB 1377 Dental therapy, licensure, regulation

SB 1394 Abortion reporting

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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 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 Senate HHS and Commerce & Public Safety Committees

Tanning facility operators would be prohibited from allowing a person under 18 years of age to use a “tanning device”. Tanning facilities couldn’t advertise or distribute 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 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 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 Transportation Committee

This one 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 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 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.

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.

 

HB 2389  Syringe access programs; authorization

Passed House 56 – 0 – 4

Assigned to the Senate Government Committee

This important bill will also be heard Wednesday afternoon in the Senate Government Committee. It would decriminalize needle exchange programs.  It’s currently a felony to distribute needles to illegal drug users. Persons, employees and volunteers operating within the scope of the law can’t be charged or prosecuted for their activities. 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

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. Being heard in the House Health Committee this week (Thursday).  Should have no problems at all.

 

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 if this passes.  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

Passed Senate 25 – 5

Assigned to House Health and Appropriation Committees

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. Being heard in Senate HHS Wednesday.

 

SB 1261 Texting while driving

Passed Transportation Committee- Ready for a Senate Floor Vote

This 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, which hasn’t happened yet.  Not a good sign.

 

SB 1377 Dental therapy, licensure, regulation

Passed Senate 22 – 8

Assigned to House Health Committee

This 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

Assigned to the Judiciary and Federalism, Property Rights & Public Policy Committees

This one 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

Assigned to House Military, Veteran and Regulatory Affairs Committee

This 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.

 

SB 1445 AHCCCS Dental care, pregnant women

Passed Senate

Assigned to House Health & Appropriations Committees

This is a priority Bill for AzPHA.  It would provide oral health coverage for pregnant Medicaid members.  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. 

 

SB 1470  Sunrise process; health professions

Passed Senate

Assigned to House Government Committee

To be honest- this bill has been flying under the radar at least with me.  If it passes and is signed it’d make huge changes to the health professions scope of practice system we use today. The current sunrise process is a collaborative, inclusive process that allows time for consideration and review of the complicated health care delivery proposals.  The current process requires a Committee of Reference hearing, which allows a consideration of a proposed scope change and its potential patient safety and care implications.

SB 1470 would change the scope of practice system so that all a profession needs to do is prepare a written sunrise report right before the regular legislative session. It would allow the legislative standing committees (rather than Committees of Reference) to consider a sunrise proposal. During legislative session, long agendas and the fast pace limits the time to consider serious issues impacted by changes in scope of practice, including prescribing, complex health care procedures, complicated review, and reflection on curriculum, training and education.

We haven’t taken a position on this yet- but we’ll talk about it on our Public Health Policy Committee call on Monday.  Seems like the risks outweigh the benefits on this one.

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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.

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APHA Legislative Update

On Feb. 9, President Trump signed the Bipartisan Budget Act of 2018. The new law raises the current spending caps for defense and nondefense discretionary spending in fiscal year 2018 and fiscal year 2019 by $165 billion and $131 billion, respectively. While APHA welcomed the increase in nondefense discretionary funding, the category of money that funds public health and other federal nondefense programs, the association is deeply disappointed that the bill also cut the Prevention and Public Health Fund by $1.35 billion over the next decade.

The bill used the cuts from the prevention fund in part to pay for reauthorizing community health centers, the National Health Service Corps and other expired health programs for two years. The bill also added an additional four years to the reauthorization of the Children’s Health Insurance program, bringing the total reauthorization for CHIP to 10 years. The bill passed the U.S. Senate by a vote of 71-28 and passed the House by a vote of 240-186.

After the bill passed, APHA issued a statement supporting the additional funding available for nondefense discretionary spending and urging Congress to work to ensure that some of the additional funding is directed to public health programs at the Centers for Disease Control and Prevention and the Health Resources and Services Administration.

The statement also expressed deep disappointment that Congress turned to cutting the prevention fund, a critical source of public health funding that currently makes up around 12 percent of the CDC’s entire budget. The Prevention Fund supports critical public health activities — including lead poisoning surveillance, vaccination initiatives and other programs — in every state and community across the country.

APHA members can send a message to their members of Congress urging them to ensure public health is adequately funded in FY2018.