|
|
|
|
I’ve asked them for an independent and objective review of statutes and rules several times and their analyses are complete, helpful and prompt (and free).
|
|
|
|
I’ve asked them for an independent and objective review of statutes and rules several times and their analyses are complete, helpful and prompt (and free).
New bills proposed for psychiatric care of seriously mentally ill | 12news.com
Adults who rely on Arizona’s Medicaid program may get expanded coverage | KJZZ
Affordable Care Act enrollment hit record highs in Arizona, U.S. in 2023 (azpbs.org)
Emergency rooms in Arizona hospitals are extremely busy. Here’s why (azcentral.com)
Why is ban sought for menthol cigarettes? What Arizonans need to know (azcentral.com)
Arizona sober living scandal may have cost taxpayers $2 billion-plus (azcentral.com)
The health committees in the House and Senate have full agendas for the first time this legislative session. House Health meets Monday at 1:30pm and Senate at 1:30 Tuesday.
We’ve signed up in support of several bills in both committees next week. Several more aren’t in our wheelhouse and we haven’t taken a position. The bills that are bold are ones we’re supporting. The two that are in underlined are the bills I’ve selected to speak about at the podium this week.
Arizona Legislative Session Underway: Here’s Our Advocacy Approach
Let Legislators Know What You Think: Here’s How
Senate HHS (Tuesday 1:30pm Jan 30)
SB1020 | newborn screening; Duchenne muscular dystrophy | Shope |
SB1048 |child fatality review teams; duties | Shope |
SB1076 |marijuana funds; uses; enforcement | Shope |
SB1085 | pharmacists; independent testing; treatment | Shope |
SB1086 |assisted living facilities; referral agencies | Shope |
SB1100 | Arizona state hospital; private entity | Miranda | Neutral
SB1101 |appropriations; secure behavioral health facilities | Miranda
SB1154|dental board; dental hygienists | Shamp |
SB1163 |homeopathic medicine; integrated medicine; qualifications | Shamp
SB1178 |hospital interconnectivity; appropriation | Gowan |
SB1191 |developmental disabilities; Prader-Willi syndrome| Wadsack
|
House HHS (Monday 1:30pm Jan 29)
| HB2033 |department of health services; rulemaking | Cook |
| HB2050 |board of psychologist examiners | Bliss |
| HB2054 |SNAP eligibility; probation compliance | Dunn |
| HB2093 |emergency services; prudent layperson; definition | Parker B |
| HB2111 |licensed facilities; transfer; sale; prohibition | Willoughby |
| HB2112 |insurance coverage; hearing aids; children | Willoughby |
| HB2116 |fatality review; information; access | Willoughby |
| HB2137 infants; toddlers; developmental delays | Willoughby |
| HB2187 |health professionals; title use; prohibitions | Parker B |
| HB2402 |DCS; investigations; interviews; recording | Gress |
| HB2450 |remote pharmacies; pharmacy technicians; training | Montenegro |
| HB2451 |marijuana; advertising; restrictions | Montenegro |
| HB2454 kinship foster care; hearings; reports | Montenegro |
Note: Vitalyst put together this terrific compilation of categorized public health related bills this week. Rather than recreate their work I decided to just link to it above. Really good summary from Ana Roscetti.
Governor Hobbs has proposed a $16 billion budget, a decrease from last year’s $17.8 billion state spending plan. The economists at the JLBC think the deficit for the next two years is $1.7 billion, nearly twice the amount Hobbs’ $900 million estimate. The Governor’s Office estimates Arizona will pull in $823 million more revenue than the JLBC thinks the state will. The JLBC estimates baseline spending will decrease $1.5 million in the next fiscal year due to the cessation of one-time spending in last year’s budget.
Hobbs proposed cutting about $1 billion from the budget in a mix of cuts, sweeps and clawbacks and delays including clawing back $770 million in existing funding:
For the next fiscal year, the governor proposes cutting $737 million, including:
Hobbs made several proposals to improve ADHS’ healthcare licensing system after a series of articles in the Arizona Republic highlighting the impact that the lack of investment in and poor leadership at ADHS licensing programs during the Ducey Administration had – as well as the scathing Auditor General Reviews.
Governor Hobbs proposes an increase of $24.8 million in ADHS’ licensing programs including $1.9 million ongoing and $157,500 one-time to add 16 employees to follow up on complaints, general inspections, and enforcement. She’s also proposing $500K ongoing and $900K one-time to fund improvements to AZCARECHECK to improve transparency.
There’s also $500K earmarked for an independent assessment of AZ’s network of services for persons with a serious mental illness, and $485K for ADES Ombudsmen and $271K ongoing for an ombudsman for the AZ State Hospital.
The budget also includes a $10M item for AHCCCS to get more people to join behavioral health quality improvement initiatives.
2024 AzPHA Annual Conference:
The legislative session kicked off on paper last week – but this upcoming week is really the first set of committee hearings, including the first hearings of the Health and Human Services Committees.
The House Health committee will meet on Mondays at 2pm. Senate Health and Human Services will meet Tuesdays at 2pm. There are only four bills posted in each committee this week. We’ve signed up in support of a couple bills being heard this week including SB1037 which would allow adult Medicaid members to use their $1000 annual dental benefit for more tha just emergency procedures.
On the House side, we’ve signed in against HB2183 which would entitle parents with the right to receive from a health care entity equivalent access to any electronic portal or other health care delivery platform for their minor child.
While that might sound reasonable, we believe it would pose a risk to kids who are being abused – making even more difficult to get treatment – especially those being sexually abused. Also, other teenagers who are sexually active may be discouraged from seeking treatment if they know their parents have access to their medical records – causing unaddressed infections and increasing the spread of STIs.
AZPHA has taken positions on about 40 bills so far. A short synopsis of where we are on these bills is below:
House | ||
Bill # | Description | Position |
HB2002 | power plants; transmission lines; definition | No |
HB2003 | replacement lines; structures; commission hearings | No |
HB2004 | utilities; electronic filings; corporation commission | No |
HB2005 | Arizona power authority; DWR cooperation | No |
HB2130 | counties; maximum acreage; energy production | No |
HB2131 | residential utility consumer office; businesses | No |
HB2133 | solar panel disposal fund | No |
HB2035 | insurance; claims; appeals; provider credentialing | Yes |
HB2041 | school safety program; mental health | Yes |
HB2042 | food preparation; sale; cottage food | N/A |
HB2051 | joint training; surveyors; providers | Yes |
HB2079 | food handler certificate; volunteers; limits | Yes |
HB2081 | cremation | Yes |
HB2183 | parental rights; medical records | No |
HB2111 | licensed facilities; transfer; sale; prohibition | Yes |
HB2112 | insurance coverage; hearing aids; children | Yes |
HB2130 | counties; maximum acreage; energy production | No |
HB2137 | infants; toddlers; developmental delays | Yes |
HB2139 | medical records; minors; confidentiality; consent | No |
HB2192 | energy projects; grazing operations; compensation | No |
HB2221 | firearm purchases; waiting period; offense | Yes |
HB2223 | sentencing; concealed weapons permits; surrender | Yes |
HB2224 | TPT; exemption; firearm storage devices | Yes |
HB2226 | nursing care institutions; advisory council | Yes |
HB2228 | AHCCCS; complex rehabilitation technology | Yes |
HB2230 | AHCCCS; outpatient services | Yes |
HB2231 | nursing care institutions; medical directors | Yes |
HB2233 | firearms; ammunition; storage; civil penalty | Yes |
HB2238 | severe threat order of protection | Yes |
HB2239 | firearm sales; permit verification; requirements | Yes |
HB2240 | firearms dealers; firearms transfers; requirements | Yes |
HB2249 | residential care institutions; inspections | Yes |
HB2281 | solar royalties fund; county residents | No |
HB2315 | assisted living facilities; ownership; employees | Yes |
HB2468 | community fridge; liability; prohibition | Yes |
HB2471 | rulemaking; legislative approval | No |
HB2513 | AHCCCS; preventative dental care | Yes |
HB2560 | sober living; behavioral health; licensure | Yes |
Senate | ||
SB1002 | drug paraphernalia; testing; analyzing; repeal | Yes |
SB1002 | drug paraphernalia; testing; analyzing; repeal | Yes |
SB1003 | prohibition; photo radar | No |
SB1010 | vehicle mileage; tracking; tax; prohibitions | No |
SB1013 | government investments; products; fiduciaries; plans | No |
SB1014 | business; discrimination prohibition; social criteria | No |
SB1019 | appropriation; health innovation trust fund | Yes |
SB1024 | spina bifida, developmental disabilities | Yes |
SB1028 | medical assistance; drugs; prohibited arrest | Yes |
SB1037 | AHCCCS, comprehensive dental | Yes |
SB1045 | public restrooms; feminine hygiene products | Yes |
SB1067 | DCS; group homes; investigations | Yes |
SB1066 | solar royalties fund; county residents. | No |
SB1068 | secure behavioral health facilities; appropriations | Yes |
SB1100 | Arizona state hospital; private entity | Neutral |
SB1101 | secure behavioral health facilities; appropriations | Yes |
SB1102 | civil reintegration unit; state hospital | Yes |
SB1103 | state hospital; governing board; governance | Yes |
SB1157 | influenza response plan; updates; review | Yes |
The Arizona State Hospital is located on a 260 bed 93-acre campus in Phoenix providing inpatient psychiatric care to people with mental illnesses who are under court order for treatment. Treatment at ASH is considered “the highest and most restrictive” level of care in the state. Patients are admitted because of an inability to be treated in a community facility or because of their legal status.
The Civil portion of the hospital provides services to people civilly committed as a danger to self, danger to others, gravely disabled and/or persistently and acutely disabled. Forensic patients are court-ordered for pre- or post-trial treatment because of involvement with the criminal justice system due to a mental health issue.
The needs of patients at ASH can be complex and the patients are vulnerable, so it’s critical to ensure the facility uses best practice treatment and is following a rigorous set of regulations. To achieve fidelity to best practice standards, it’s critical that the governance structure ensures accountability and is free from conflicts of interests.
The existing governance structure is insufficient to ensure quality care is provided at ASH. The fundamental flaw is that ADHS both runs & regulates ASH.
The lack of independent regulation & oversight of the Arizona State Hospital results in poor accountability and can lead to unchecked substandard care when ADHS leadership soft-pedals regulatory oversight to give the appearance that the facilities are providing care that meets standards.
There is evidence that this occurred during the Ducey Administration. For example, in 2021, ADHS’ licensing division investigated multiple suicides and a homicide and concluded that no operating deficiencies led to those deaths. Suicides and homicides only occur when there are deficient practices.
AzPHA was a supporter of SB1710 during last year’s legislation because it was commonsense solution to governance problem that’s jeopardizing care at ASH by separating the operational functions of running ASH from the regulation of ASH. Sadly, there was a last second amendment that gutted all of the meaningful governance reform in that bill, and the Arizona Department of Health Services continues to both run and ‘regulate’ the Arizona State Hospital. See: Governance Reform of the Arizona State Hospital Goes Up in a Puff of Smoke
Fortunately, Senators Miranda and Shope continued to work with informed stakeholders, pursuing governance reform for our Arizona State Hospital. They even published a couple of op-eds in the Arizona Republic explaining their vision for improving care:
That ‘off-season’ work bore some important fruit. A series of bills were just posted to the State Legislature’s website this afternoon with a set of bipartisan plans sponsored by Senator Miranda and several other legislators (of both parties) to improve services and governance of the Arizona State Hospital and other psychiatric care resources.
AZPHA will be carefully following the progress of these bills and will be an active partner to help inform the debate as these important bills work their way through the legislative process this session.
4340 E Cotton Center Blvd, Phoenix, AZ 85040
*Subject to invitation acceptance by presenters
The Arizona Department of Health Services (ADHS) was charged with creating the Justice Reinvestment Program through the passage of Prop 207 (retail marijuana) in November 2020. The proposition legalized recreational marijuana use for adults 21 and older as well as created initiatives to increase safety and community resilience around arrest and incarceration, including the Justice Reinvestment Program.
The Office started by completing a statewide data and funding landscape analysis to decide which local communities were most impacted by drug enforcement, arrest, and incarceration. The analysis found priority communities across the state, where 18 listening sessions were held. Listening session participants expressed the following services would be beneficial for their communities:
The Office of Health Equity then released a competitive grant application open to qualified Arizona nonprofits to support Justice Reinvestment programming this year.
The awarded projects address all of the key focus areas outlined in the statute and in the community listening sessions and represent communities from across the state of Arizona. ADHS is proud to announce the following grant awardees:
Additional Justice Reinvestment funding will be made available in the near future. Earlier and new applicants are encouraged to apply. Visit the ADHS Office of Health Equity’s Justice Reinvestment Program page for updates.
Monday marks the beginning of the 2024 legislative session. Governor Hobbs will give her State of the State address in the House at 2pm on Monday. You can attend the speech live from the top floor of the House (take the stairs/elevator to the top floor and go to the Gallery’.
It’s usually pretty packed so your best bet is to watch it on Capitol TV. Several media outlets will no doubt be covering it live as well.
I expect the Governor to talk about statutory changes and resources needed to improve the performance of ADHS’ Licensing Division, who is responsible for assuring the health and safety of Arizonans residing in assisted living and skilled nursing facilities as well as medical facilities, clinics, residential group homes, sober living homes etc.
Look for proposals to:
Editorial Note: When you hear these proposals take note that they are a DIRECT result of the series by reporters Caitlin McGlade, Sahana Jayaraman and Melina Walling focusing unaddressed senior living violence and sexually assaults and a piece about how senior living facilities are often understaffed, endangering workers and residents.
It’s possible the governor may mention mental health care as well given the solid series of stories via Stephanie Innes about AZ’s behavioral health system – especially the Arizona State Hospital: Arizona is in a mental health crisis. Here’s what needs to improve.
About 200 bills have already been filed in the House, but only about 40 in the Senate so far. Those numbers will go up into the several hundred range in the coming days as legislators file their bills. You can find the inventory of bills in both chambers on the AZLEG website here: Introduced Bills.
So far we’re tracking about 12 of the pre-filed bills. That will dramatically increase in the coming days.
Bill # | Description |
HB2042 | food preparation; sale; cottage food |
HB2081 | cremation. |
HB2111 | licensed facilities; transfer; sale; prohibition |
HB2112 | insurance coverage; hearing aids; children |
HB2130 | counties; maximum acreage; energy production |
HB2137 | infants; toddlers; developmental delays |
SB1002 | drug paraphernalia; testing; analyzing; repeal |
SB1002 | drug paraphernalia; testing; analyzing; repeal |
SB1003 | prohibition; photo radar |
SB1024 | spina bifida, developmental disabilities |
SB1028 | medical assistance; drugs; prohibited arrest |
SB1037 | AHCCCS, comprehensive dental |
The days and times for the House and Senate Health & Human Services committees aren’t posted yet – but by this time next week you’ll be able to calendar those events.
Our Public Health Policy Committee has a discussion board on Basecamp and that’s also where we post information, research and documents related to public health policy. Let me know if you’d like to sign up for that Basecamp site at willhumble@azpha.org.
Our policy committee also has conference calls every other Friday at 2pm starting in mid January. Details are in our policy committee basecamp (email me at willhumble@azpha.org to get access to the members policy committee Basecamp).
Arizona Legislative Session Begins Monday, January 8: Here’s Our Advocacy Approach
Let Legislators Know What You Think: Here’s How
Learn How the Arizona State Legislature Works by Listening to this Consumable Podcast