Will Humble Disease Control, Public Health, Wills Blog

AzPHA Data Brief: 2020 Arizona Life Expectancy Decreased Substantially More Than the US Average

View Our March 7, 2022 Data Brief on 2020 Arizona Life Expectancy:

In December 2021, CDC announced that life expectancy in the US had declined by about 2 years in 2020 compared to 2019, the largest single year decrease in more than 75 years and reflects the excess deaths in 2020 directly or indirectly related to the Covid pandemic.

Our new AzPHA Data Brief entitled Declines in Life Expectancy in Arizona: 2020 vs. 2019, explores how Arizona compares with the U.S. overall with respect to the decrease in life expectancy in 2020 vs. 2019. We chose this topic because of our previous reports that found that Arizona:

  1. has had the largest percent increase in all-cause mortality throughout the pandemic;
  2. is the only state in which COVID-19 has been the leading cause of death during the pandemic, and
  3. has the 2nd highest COVID-19 mortality rate in the U.S. averaged over the pandemic.

Not surprisingly, our analysis finds that life expectancy in Arizona decreased by substantially more than the US average during 2020; 2.8 years in Arizona vs 2.1 years nationally. 

The decrease in life expectancy was not uniform across demographics, with American Indians experiencing a decrease in life expectancy of about eight years.

Editorial Note: The reasons why Arizona’s 2020 life expectancy declined by substantially more than in the US overall are multifactorial, but the dominant reasons are the decisions made by Governor Ducey and former ADHS Director Christ during 2020 (particularly the lack of implementation and enforcement of mitigation measures like an enforced statewide face covering mandate and enforced mitigation in closed indoor environments like bars, restaurants and nightclubs).

For more on this topic be sure to read this article in the Arizona Republic by Stephanie Innes entitled: Why Is Arizona’s COVID-19 Death Rate So High?

Will Humble State Legislature, Wills Blog

Legislative Session Halftime Report

It was relatively quiet at the Arizona Capitol last week. Each chamber began the process of hearing the opposite chamber’s bills, Senate bills in House committees, and vice versa. AzPHA supported bill SB1272 which extends AHCCCS coverage to 12 months postpartum from its current 60 days, advanced out of the House Health Committee Monday. Like other bills that contain an appropriation, passing out of both chambers is just the first step in the process.

The next major session deadline is for those crossover bills to be heard in committee in the opposite chamber is Friday, March 25.

Last week’s Legislative Session highlight (from the point of view of good things) was the passage of HB 2157, which will significantly improve access to and the quality of home and community-based services for persons with disabilities. The American Rescue Plan Act provided Arizona up to $1.5B to enhance and improve community-based services for members of AHCCCS’ Long Term Care program (ALTCS).

AHCCCS had earlier developed their action plan to leverage those additional federal funds and CMS approved their plan back in January, but in AHCCCS needed legislative approval in order to implement the plan. Not that HB2157 has been passed and signed, they can begin implementation (once the statute kicks in).

Here’s a link to AHCCCS’ implementation plan which is of course written in dense AHCCCS/CMS language – but the takeaway is that they would bump up the per member per month capitation rates by 10% and then have some performance expectations tied to those funds in areas like:

  • Promoting stabilization, access to supportive services, and workforce retention/ consistency to improve member outcomes ($1B)
  • Expanding access to care from a “well-trained, highly-skilled workforce” ($217M)
  • Supporting individual self-sufficiency by connecting members to technological tools and resources that promote independence ($96M)
  • Using new technology to promote care coordination and seamless communication ($74M)
  • Funding local initiatives and community-specific programming to improve member health ($62M)
  • Empowering parents and families to provide care and meet the needs of their kids ($27M)
  • Assessing member engagement and satisfaction to better understand needs, prevent abuse and neglect, and identify opportunities for improvement ($5M)
  • Creating tools that strengthen quality monitoring and prevent abuse and neglect ($3.2M)

Bill Overview: Select Bills Progressing that AzPHA is Supporting

HB2157 supplemental appropriations; community-based services SIGNED

SB1272 AHCCCS; postpartum care; eligibility; Passed Senate 26-2

HB2144 health insurance coverage; biomarker testing Passed House 59-0

HB2060 supplemental nutrition assistance program; Passed House 44-15

HB2484 forcible entry; detainer; filing fee Passed House 59-0

HB2485 eviction dismissal; sealed records Passed House 50-8

HB2113 developmental disabilities; Down syndrome Passed House 59-0

HB2382 appropriations, health programs, disabilities Passed House 48-11

HB2033 juvenile offenders; monetary sanctions; repeal Passed House 58-1

HB2811 unlawful abortion medication; offense Failed House 28-31

SB1716 state hospital; governing board; governance Passed Senate 27-0

HB2111 appropriation; healthy families program – Passed house 40-17

Bill Overview: Select Bills Progressing that AzPHA Is Opposing

HB2086 ADHS; school immunizations; exclusions Passed House 31-28

SB1298 government mask mandate; prohibition Passed Senate 16-12

HB2125 electronic smoking devices; retail licensing – failed but on reconsideration for vote in 2 weeks

Senate Health Wednesday

HB2086 ADHS; school immunizations; exclusions OPPOSE

HB2622 AHCCCS eligibility, DCS – SUPPORT

Requires AHCCCS or its designee, subject to the approval of the Centers for Medicare and Medicaid Services, to annually renew the eligibility of a person under 26 years of age and who was in the custody of DCS when the person turned 18 without requiring additional information from the person until they turn 26 years old.

House Health Monday

SB1231  independent oversight committee; developmental disabilities SUPPORT

Directs DDD to allow the Committee up to 30 days to review new policies and major policy changes before DDD submits the policies or changes for public comment.

AzPHA Bill Tracking File 
Will Humble Disease Control, Wills Blog

Dr. Joe Gerald, MD, PhD Files His Final COVID-19 Epidemiological Report

View Dr. Gerald’s Final COVID Epidemiology Update (March 5, 2022)

Dr. Joe Gerald MD, PhD just published his final weekly epidemiology and hospital occupancy report. He’s been publishing these weekly for the last 2 years, providing the people of Arizona, journalists and policymakers refined data to inform their activities and to make policy decisions.

Dr. Gerald’s work has been essential and have been used to make policy and intervention decisions by county health departments, city governments, the judicial branch, K-12 schools, universities, community colleges, private businesses, non-profits, and private businesses & venues. His work has been essential for those of us doing advocacy.
Journalists across Arizona have used Dr. Gerald’s work to inform their reporting (helping them cut through the misinformation & spin coming from the governor, his staff & state health department directors). By doing so, his work was essential in keeping the people of Arizona to keep informed about what was really happening.
Dr. Gerald…  the people of Arizona salute you!
_______________________________________________________
Here’s introductory information from Dr. Gerald summarizing his final weekly report:

Good afternoon, all…

We continue to experience rapidly improving COVID-19 conditions. Arizona should fall below the 50 cases per 100K residents per week threshold in mid-March.  A few counties may lag behind, so there will be some geographic differences.  All-in-all, nothing but good news on the short-term horizon. I think the next opportunities for trouble will be May/June with the summer heat disrupting social behaviors, then August with resumption of K -12 and universities, and most likely November/December with the typical respiratory seasonal pattern.
Of course, a new variant could arise as well. While new outbreaks are expected, my hope is that we’ll see more muted seasonal patterns but that is not guaranteed.
A few things from this week. We’re getting a better idea of what the new ADHS Dashboard is going to look like after the change to weekly updating. Could be some hiccups before things get ironed out. I noticed the tally of cumulative deaths does not seem to be updating. Also, there appears to be considerable hospital non-reporting (~15%). Since the change, the total number of ward beds is down about 1200 and the total number of ICU beds is down about 240. The COVID-19 count occupancy will be more impacted than the percent occupancy. If non-reporting becomes worse, then non-response bias could be an issue for the new CDC Community Levels. Just keep an eye on it.
We’re almost certain to see more COVID-19 deaths from October 2021 – March 2022 than we did in the same period last year despite much greater vaccination and acquired immunity (See report Appendix). As it turns out, mooning COVID-19 before it was done left us with our pants down. The lack of a concerted, consistent, organized, effective policies to achieve high levels of vaccine immunity and widespread adoption of mitigation practices led us to this grim milestone. Not surprising, but disappointing and disillusioning.
Relatively low third-dose booster uptake, low levels of prior infection, and waning vaccine immunity among the elderly may lead to higher than expected hospitalizations and deaths in the coming months. Not to a degree that will stress hospitals but rather a lingering tale of woe to this most recent pandemic wave. For those >50 years who haven’t obtained a third shot booster, I would recommend doing so even though conditions are improving.
I want to thank everyone for their support over the past 2 years. Some specific mentions include my colleague Patrick Wightman who has steadfastly manhandled the data from ADHS. Also, a shout-out to Rob Bailey and Tim Flood at ADHS who have organized and overseen the work of our tri-university modeling group. Without them, our reports would not have been possible. They have done an incredible job managing, integrating, and distributing the myriad of data streams. Much thanks!!
Also to my UA, ASU, and NAU colleagues who have done their own work plus providing me ideas/suggestions for my reports. Of course, locally – Terry Cullen and Francisco Garcia who have helped with data and insights from Pima County. To the ICU/critical care physicians at Banner University Medical Center who have allowed me to listen in to their twice weekly COVID-19 huddles and kept me apprised of workload and clinical trends. Also, thanks to the MEZCOPH IT and media relations folks who have helped distribute and archive these reports. I’m sure there are others – I apologize for not recognizing your contributions.
This is the last planned report – so thank you to my readers for allowing me some of your precious time each week. I’m going to give a bit more free time.

Joe

Joe K. Gerald, MD, PhD
Associate Professor of Public Health Policy and Management
The Mel and Enid Zuckerman College of Public Health
The University of Arizona
Will Humble Disease Control, Wills Blog

AzPHA Weekly Legislative Update

Last week was “crossover week,” where the legislature holds very few Committee hearings and attempts to move as many bills as possible through the full chamber. At this point, any measures that haven’t received a hearing in committee in their chamber of origin can’t move forward unless the chamber suspends their own rules.

It is important to remember that no idea or bill is truly “dead” until sine die, as it can always be revived if the rules are waived. The House and Senate each heard over 200 bills in caucus this week and spent significant hours on the floor moving bills through the legislative process.

Here’s a synopsis of last week’s action.

 

Let’s start with the good stuff:

HB2144 health insurance coverage; biomarker testing Passed House 59-0

HB2060 supplemental nutrition assistance program; Passed House 44-15

HB2484 forcible entry; detainer; filing fee Passed House 59-0

HB2485 eviction dismissal; sealed records Passed House 50-8

HB2113 developmental disabilities; Down syndrome Passed House 59-0

HB2382 appropriations, health programs, disabilities Passed House 48-11

HB2033 juvenile offenders; monetary sanctions; repeal Passed House 58-1

HB2811 unlawful abortion medication; offense Failed House 28-31

 

Now for the bad things:

HB2086 ADHS; school immunizations; exclusions Passed House 31-28

SB1298 government mask mandate; prohibition Passed Senate 16-12

HB2161 OPPOSED Passed house transmitted to Senate

Committee Hearings of Interest this Week

House Health Committee Monday 2pm

SB1272 AHCCCS; postpartum care; eligibility; appropriations  SUPPORT

Allows AHCCCS to pursue eligibility for postpartum care for members for 1 year post-delivery up to 161% of federal poverty limit. Expanded eligibility currently ends at delivery. Still requires CMS approval. Update: Cleared House Health Committee 8-1 on 2/28

House Government and Elections Wednesday 9am

SB1009– state of emergency; executive powers OPPOSED

Passed Senate 16-13. Transmitted to House. Beginning on Ducey’s last day, caps the length of a Governor’s public health emergency declaration at 30 days but allows the Governor to extend the state of emergency for up to 120 days in 30-day increments. Terminates a state of emergency after 120 days, unless extended by the Legislature. Allows the Legislature to extend the state of emergency as many times as necessary in up to 30-day increments.

Senate Government Monday 2pm

HB2453 governmental entities; mask requirement; prohibition OPPOSED

Passed House 31-28. UPDATE: Passed Senate Government Committee 4-3. Prohibits the state or any political subdivision, including the judiciary, that receives or uses tax revenue (governmental entity) from imposing any requirement to wear a mask or face covering on the governmental entity’s premises, except where long-standing workplace safety and infection control measures that are unrelated to COVID-19 may be required.

Good Bills w Likely Floor Vote this Week

HB2125 electronic smoking devices; retail licensing

HB2111 appropriation; healthy families program Update: Passed House 40-17 on 2/28

SB1151 charging station; pilot program; appropriation

SB1210 mentally ill; transportation; evaluation; treatment Held in R Caucus

Bad Bills w Likely Floor Vote this Week

HB2043 employer liability; COVID-19 vaccine requirement

SB1567 vaccinations; prohibitions; evidence of immunity Held in R Caucus

HB2021 drug offenses, homicide, sentencing

SB1123 disruption; educational institution; concealed weapon

HB2787 Maricopa County; division; new counties

Full Legislative Update in last Sunday’s AzPHA Member Policy Update
Will Humble Disease Control, Wills Blog

New CDC ‘Community Levels’ Guidance Sets the Stage for Scaling Back Recommended COVID Mitigation Measures

Last Friday CDC released new recommendations for community masking to reduce the spread of COVID-19. The new recommendations now consider 3 key metrics: rate of new case detection, rate of new admissions to the hospital, and general ward occupancy. These recommendations are intended to apply to counties, not states. Currently, Maricopa, Coconino, Yavapai, and Santa Cruz Counties are rates as medium risk whereas all other counties are high risk.

You can visit the new CDC recommendations to see how the guidance applies to community spread in AZ right now. Among other things, it basically means that, in the opinion of CDC, indoor masking can responsibly scaled back in most indoor environments in the ‘moderate’ counties of Maricopa, Yavapai, Coconino & Santa Cruz. Universal masking is still recommended in congregate and healthcare settings.  

Here’s an excerpt of Dr. Gerald’s explainer of the new CDC guidelines from the Appendix of this week’s epidemiology & hospital occupancy report:

“… the CDC recommendations prioritize hospital utilization as the key metric to trigger masking. The advantage is that hospital utilization is easily measured and highly salient as a community metric. When hospitals are overwhelmed, we are all at risk whether we have COVID-19 or not.”

“The triggers would have fired at least 4 weeks prior to the observed peak. So, there would have been at least some opportunity for the incremental benefit of government mandated masking to moderate peak transmission and flatten the curve perhaps by 25 – 30%. While this would have blunted peak hospital utilization modestly, it would still “allow” large numbers of infections with the attendant risk of long-COVID and other post-infectious sequela.”

Editorial note: In other states, the new guidance may be used to inform the scaling back of statewide public health interventions. Because the governor and state health director are not now, nor have they been, using their public health emergency authority to require mitigation, the new CDC guidance will really only be useful for entities like K-12 schools, universities and private businesses to make decisions about masking requirements.

Will Humble Disease Control, Wills Blog

COVID-19 Cases & New Hospitalizations Drop: Omicron Has Nearly Completed Its Task of Infecting All Vaccine Holdouts

View Dr. Joe Gerald’s February 25 Epidemiology & Hospital Occupancy Report

From Dr. Gerald this week:

While Arizona continues to experience high levels of community transmission, we are experiencing rapid improvements that will meaningfully reduce risk of infection in March. Test positivity remains high but is also declining.

As of February 20th, new cases were being diagnosed at a rate of 170 cases per 100K residents per week. The risk of infection now falls below the CDC threshold for high transmission in Maricopa, Coconino, Yavapai, and Santa Cruz Counties. Residents in other counties should fall below high transmission this week.

During March more institutions and individuals will be drawing down their COVID-19 mitigations. For those who are healthy, vaccinated or recovered normalization will pose little risk. Those who have personal health conditions, family members with personal health conditions, or workers who interact with those who are vulnerable should continue to mitigate until transmission levels fall further. We are going to continue an awkward condition, where motivating the healthy to maintain their precautions to protect the vulnerable will become even more difficult.

COVID-19 hospital occupancy in the wards and ICUs is falling quickly. Even so, access to care continues to be constrained by COVID-19 occupancy, influenza cases, and the backlog of postponed care.

At least 27,931 Arizonans have lost their lives to COVID-19. Weekly totals in the low-400s are likely end soon as the Omicron surge resolved quickly.

Is BA.2 here in Arizona? Yes, it is present and now showing up in greater numbers (~10%). It should become the dominant variant over the coming month. The implication is that it will be a bit more difficult to push down transmission rates. https://pathogen.tgen.org/covidseq-tracker/

Other odds and ends…

Will Humble State Legislature, Wills Blog

Floor Votes Likely to Dominate Legislative “Crossover Week” 

This week is known as “Crossover Week” at the State Legislature. It’s one of the more chaotic weeks of the entire legislative session because all bills need to pass their chamber of origin and get transmitted to the other chamber in order to stay alive…  and that means there will be a ton of floor votes this week.

This upcoming week will be a busy one on the House and Senate floors. Several bills that we’re tracking and for which we’ve taken positions will have floor votes this week.  Many bills that we’ve taken a position on are now dead, so our tracking list is beginning to whittle down. But there are still lots of important bills in the hopper. Here’s a synopsis of last week’s action.

Let’s start with the good stuff from last week:

  • HB2125, the ‘good’ tobacco control bill unanimously passed through the House Health Committee. It still has a long way to go but the unanimity is encouraging.
  • SB1272, which will let AHCCCS cover postpartum care for members for 1 year post-delivery passed the Senate 26-2 and is headed for the House.
  • HB2157which will leverage $1.5B in mostly American Rescue Plan Act funds over the next 2 years to improve Home and Community Based Services for folks in their Long-Term Care Program passed the House 45-14 and is headed for the Senate
  • HB2033, which removes court-ordered fees and fines for juveniles (with some exceptions) passed through its committees 10-3 and will likely have a House Floor vote this week.
  • HB2111, which appropriates $10M for the DCS Healthy Families Program passed its House committees and will head to the floor this week.
  • HB2382, which appropriates $1M to ADHS for grants to statewide organizations dedicated to “promoting evidence based, inclusive health programs for people with intellectual and developmental disabilities” unanimously passed its committees and will head to the floor this week.

Now for the bad things:

  • HB2086, which will prevent future ADHS directors from doing a rulemaking to add the COVID-19 vaccine to the school required list passed the House Health and Education committees 5-4 and will go the floor this week.
  • HB2616, which prohibits this state or schools from requiring a person under 18 years of age to wear a mask without the parent’s written consent passed the House 31-28 and now goes to the Senate.
  • SB1164, which makes it a felony for a provider to perform an abortion after 15 weeks gestation passed the Senate 16-13 and was transmitted to the House.
  • HB2811, which will make it a Class 3 felony to manufacture, distribute, sell Mifepristone, Mifegyne, Mifeprex, RU-486, or other generic/non-generic drugs intended to cause/induce an abortion passed the Judiciary committee last week and will probably go to the floor this week.
  • HB2787, which will carve Maricopa County into 4 different counties passed the House Government and Elections committee 7-6 and will likely go to the House floor this week.
Senate Appropriations Committee Tuesday 9:00 am

There’s just one bill that we’re interested in that’ll be heard in committee this week. Senate Appropriations will hear SB1716 which would move governance of the Arizona State Hospital from the ADHS to a 5-member governing board appointed by the Governor.

This is a good solution to a longstanding problem, that the ADHS both runs and regulates ASH- never a good governance model. This move would transition accountability to a qualified governing board while the ADHS maintains its regulatory oversight.

SB1716 Arizona State Hospital; governing board – SUPPORT

Moves governance of the Arizona State Hospital from the Arizona Department of Health Services to a newly created Governing Board of 5 appointed members. ASH Superintendent would report to the Governing Board. Needs an amendment to appropriately compensate the Board.

Good Bills w Likely Floor Vote this Week

HB2125 electronic smoking devices; retail licensing SUPPORT

HB2144 health insurance coverage; biomarker testing SUPPORT

HB2060 supplemental nutrition assistance program; eligibility SUPPORT

HB2484 forcible entry; detainer; filing fee SUPPORT

HB2485 eviction dismissal; sealed records SUPPORT

HB2111 appropriation; healthy families program SUPPORT

HB2113 developmental disabilities; Down syndrome SUPPORT

HB2033 juvenile offenders; monetary sanctions; repeal SUPPORT

SB1151 charging station; pilot program; appropriation SUPPORT

SB1210 mentally ill; transportation; evaluation; treatment SUPPORT

Bad Bills w Likely Floor Vote this Week

HB2043 employer liability; COVID-19 vaccine requirement OPPOSED

HB2086 ADHS; school immunizations; exclusions OPPOSED

SB1567 vaccinations; prohibitions; evidence of immunity OPPOSED

HB2021 drug Offenses, homicide, sentencing OPPOSE

SB1298 government mask mandate; prohibition OPPOSED

HB2811 unlawful abortion medication; offense OPPOSED

SB1123 disruption; educational institution; concealed weapon OPPOSED

HB2787 Maricopa County; division; new counties OPPOSED

Dead Bills Removed from This Week’s List:

SB1153 state zero emission vehicle fleet SUPPORT

SB1391 state hospital transfer; AHCCCS NEUTRAL

HB2191 school immunizations; DHS; exclusions OPPOSE

HB2452 antidiscrimination; employment; vaccination status OPPOSED

HB2022 health emergencies; treatment; vaccinations; repeal OPPOSED

HB2029 vaccinations; evidence of immunity; prohibitions OPPOSED

HB2064 DHS; school immunizations; exclusions. OPPOSED

HB2534 feminine hygiene; exemption SUPPORT

HB2065 school immunizations; nonattendance; outbreak OPPOSED

HB2606 school districts; housing facilities; teachers SUPPORT

HB2674 municipal zoning; by right housing OPPOSE

SB1132 municipal bonds; environmental sustainability; prohibition OPPOSED

HB2403 appropriation; ADE; electric school buses SUPPORT

SB1413 pharmacists; prescriptions; refusal; prohibition OPPOSED

HB2311 school health program; appropriation SUPPORT

HB2155 health information organizations; research; disclosures SUPPORT

The complete list and explanation of all the bills for which AzPHA has taken a position were included in Sunday’s AZPHA Member Public Health Policy Update.
Will Humble Disease Control, Wills Blog

New COVID Cases Continue to Fall in All Age Categories as Hospital Conditions Continue to Improve

See Dr. Joe Gerald’s Weekly Epidemiology & Hospital Occupancy Report

Arizona continues to experience improving COVID-19 conditions. Even so, risk of infection remains high. Arizona should fall below the 100 cases per 100K residents per week threshold in early March.  A few counties may lag behind, so there will be some geographic differences.

The BA.2 Omicron variant is present in low numbers in Arizona (<5%). We can expect it to become the dominant variant over the coming months (not weeks like BA.1). The implication is that it will be a bit more difficult to push down transmission rates. https://pathogen.tgen.org/covidseq-tracker/ 

With fewer COVID hospital admissions over the last couple of weeks, COVID-19 hospital occupancy has been falling quickly. The census drop will continue as persons with previous COVID infections recover and are discharged or perish. Access to care continues to be constrained by COVID-19 occupancy and the backlog of postponed care.

At least 27,563 Arizonans have lost their lives to COVID-19. Weekly totals in the low-400s are likely for another couple of weeks. A large portion of those deaths could have been prevented if Governor Ducey, former Director Christ and Interim Director Herrington had used their authority to help, rather than impede the response over the last 2 years. Sadly, the opportunity to save those lives has come and gone.

Will Humble Professional Development, Wills Blog

UArizona Offering Master’s Degree in Research for Social Change in Program Design & Evaluation

COVID has turned our working environments upside down, and many of us may be looking for a way to transition to another role in our organizations or to gain new skills to improve our potential in the job market.

UArizona is offering a Master’s Degree in research for social change called Program Design & Evaluation.  This fully on-line graduate degree offers 7.5 week courses that are tailored for people who cannot meet for class at a specific time and need schedule flexibility.  The faculty bring a rich depth and breadth of expertise in community-based participatory and action research to each course.

This degree can be completed in 2 years and is price competitive with other online graduate degrees.  Many students approach their organizations to use tuition support or reimbursement programs to help with cost.

Enroll now to start classes this September! Enrollments will be every fall and spring. Please consider this opportunity for you, your staff or colleagues and share this email widely.   For more information, visit the program site. You can also contact the Director of Graduate Studies, Dr. Beth Meyerson at [email protected]“>DGSSI[email protected].

Will Humble Assurance & Licensure, Climate Change, Disease Control, Environmental Health, Medicaid, State Legislature, Tobacco, Wills Blog

Legislative Committee Agendas Are Packed This Week: Here Are This Week’s Priorities

This Friday is the deadline for bills to be heard in their body of origin, so we’re beginning to get a clearer picture of what is likely to move forward in this year’s legislative session. It also means that the committee agendas this week are absolutely packed.

The Senate Health and Human Services Committee has a couple dozen of complex bills, five of which we’ve taken positions on. One of those bills would move the Arizona State Hospital to AHCCCS. We took a neutral position on that. While that bill rightly tries to solve the conflict that has existed for decades in which the ADHS both runs and regulates ASH, we don’t think giving it to AHCCCS is the best solution. A better solution would be to spin ASH off as its own agency.

Over in House Health there is a good tobacco control bill being heard on Monday afternoon. 

The most bizarre bill of the session – one that would break Maricopa County into 4 pieces is being heard Wednesday in the House Government and Elections Committee.

Perhaps the most exciting development is the progress of SB1272 which would expand AHCCCS coverage to post-partum women for one year post pregnancy.

In additional good news, most of the bad bills that would have jeopardized immunization rates seem to be dying off. On the other hand, a barrage of bills that further marginalize LGBTQ+ communities continue to advance their way through the legislative process.

Committee Hearings this Week

House Health & Human Services 2pm Monday

HB2144 health insurance coverage; biomarker testing SUPPORT

HB2125 electronic smoking devices; retail licensing SUPPORT

HB2394 monitoring program for developmental disability homes SUPPORT

 

Senate Health & Human Services 8:30am Wednesday

SB1044 contracts; grants; exclusions; sex education OPPOSED

SB1641 health care institutions; civil penalties SUPPORT

SB1391 state hospital; transfer; AHCCCS NEUTRAL

SB1210 mentally ill; transportation; evaluation; treatment SUPPORT

SB1203 health care institutions; architectural plans SUPPORT

 

House Appropriations Committee 1:30pm Wednesday 

HB2111 appropriation; healthy families program SUPPORT

 

House Education Committee 2pm Tuesday

HB2086 ADHS; school immunizations; exclusions OPPOSED

 

House Commerce Committee 2pm Tuesday

HB2484 forcible entry; detainer; filing fee SUPPORT

 

House Government and Elections Committee 8am Wednesday 

HB2787 Maricopa county; division; new counties OPPOSED

Bill Summary & AzPHA Positions

Public Health Emergency

SB1009– state of emergency; executive powers OPPOSED

Passed Senate 16-13. Transmitted to House. Beginning on Ducey’s last day, caps the length of a Governor’s public health emergency declaration at 30 days but allows the Governor to extend the state of emergency for up to 120 days in 30-day increments. Terminates a state of emergency after 120 days, unless extended by the Legislature. Allows the Legislature to extend the state of emergency as many times as necessary in up to 30-day increments.

HB2022 health emergencies; treatment; vaccinations; repeal OPPOSED

No action yet. Still not assigned- probably dead. This bill eliminates public health emergency authority that currently allows the ADHS Director to mandate vaccinations in exposed persons in some circumstances

Vaccines

HB2029 vaccinations; evidence of immunity; prohibitions OPPOSED

No action yet. Still not assigned- probably dead.   Prohibits government entities from requiring a COVID vaccine as a condition of employment. Also prohibits them from contracting with any private business that requires vaccination. Has a conditional exemption for healthcare institutions.

HB2043 employer liability; COVID-19 vaccine requirement OPPOSED

Passed Senate Judiciary 6-4. Passed Rules. Heading to Senate Floor this Week. Makes employers liable for damages if the employer denies a religious exemption and requires a person to receive a COVID-19 vaccination and significant injury results from receiving the vaccine.

HB2064 ADHS; school immunizations; exclusions. OPPOSED

Double assigned to HHS and ED Committees. Hasn’t been heard. Probably dead. Prevents ADHS Director from ever adding COVID19 or HPV vaccines to the list required for school attendance

HB2065 school immunizations; nonattendance; outbreak OPPOSED

Double assigned to HHS and ED Committees. Hasn’t been heard. Probably dead. Removes the ability to exclude unvaccinated students from school during a school outbreak

HB2086 ADHS; school immunizations; exclusions OPPOSED

Passed House Health 5-4. Being heard in House Education 2/15. Prevents ADHS Director from ever adding COVID19 or HPV vaccines to the list required for school attendance

HB2191– school immunizations; DHS; exclusions OPPOSED

Double assigned to HHS and ED Committees. Hasn’t been heard. Probably dead. Prohibits ADHS from adding HPV, COVID-19 or any vaccine that is just emergency use authorized to list of vaccines required for school attendance.

HB2452  – antidiscrimination; employment; vaccination status OPPOSED

Still not assigned to committee. Probably dead. Prevents ‘discrimination’ against anybody because of the vaccination status.

SB1567– vaccinations; prohibitions; evidence of immunity OPPOSED

Passed Senate Health 5-4. Rules Committee then floor next. Prohibits businesses from requiring vaccinations of any kind and includes enforcement provisions including preventing the state from contracting with any entity that does so. Includes exemptions for certain healthcare facilities.

SB1052– medical procedures; prohibitions OPPOSED

Held by Senate Health last week.  Government entities and even schools would be unable to require vaccination if there is any threat of an adverse reaction that can result in death, even if the odds of that are for example 10,000,000 to one.

Family Planning

SB1044 contracts; grants; exclusions; sex education OPPOSED

Being heard in Senate Health 2/16. Prohibits ADHS from contracting with any entity that ‘provides or promotes abortion’ on their Personal Responsibility Education Program or the Sexual Risk Avoidance Education Grant Program grants. Adds Title X (if ADHS ever applies for that again).

Criminal Justice

HB2033 juvenile offenders; monetary sanctions; repeal SUPPORT

Passed Judiciary and Appropriations 10-3. Rules then Floor vote.  Removes statute relating to court-ordered fees and fines for juveniles, except for victim restitution and specific driving under the influence offenses. Appropriates $2,531,000 from the state General Fund for costs relating to juvenile treatment services and court services.

HB2021  Drug Offenses, homicide, sentencing OPPOSE

Passed House Judiciary 10-0. Floor next. Increases penalties for homicides that happen when there is also a drug offense.

Food Insecurity

HB2060– supplemental nutrition assistance program; eligibility SUPPORT

Passed House Judiciary and Rules 8-0. Floor next week.  Expands Supplemental Nutrition Assistance Program eligibility to individuals with felony drug convictions but still requires certain people to comply with probation conditions.

Housing

HB2606 – school districts; housing facilities; teachers SUPPORT

Assigned to House Ways and Means, no action yet. Permits all school districts to leverage district-owned property and facilities toward the development of housing for staff.  Current statute limits these “teacherages” to rural and tribal communities.  This bill would expand these abilities to urban and suburban districts.  It’s a technical change to existing statute, but should have promising health, educational and economic impacts.

HB2674 municipal zoning; by right housing OPPOSED

Being heard in House Commerce 2/15. Would prevent cities from implementing unreasonable zoning barriers that limit the production of affordable housing. Makes cities commit to policies that encourage affordable housing.

HB2484 forcible entry; detainer; filing fee SUPPORT

Being heard in House Commerce 2/15. Removes the answer fee or the requirement to file a fee deferral/waiver, which removes barriers for tenants and reduces work for the court.

HB2485 eviction dismissal; sealed records SUPPORT

Assigned to Commerce Committee. No action yet.  Would seal the eviction records for tenants whose cases are dismissed before an entry of judgment, or if a judgment is entered in favor of the tenant.  Essentially, in any case where there was no longer any legal merit to the landlord’s case, the eviction record would be sealed.

Maternal and Child Health

HB2111 appropriation; healthy families program SUPPORT

Passed House Health 7-2, being heard in House Approps 2/15. Appropriates $10 million from the state General Fund in FY 2023 to the Department of Child Safety for the Healthy Families Program.

HB2113 developmental disabilities; Down syndrome SUPPORT

Passed House Health 9-0. Needs Rules, then Floor.  Automatically qualifies persons with Down Syndrome for AHCCCS’ Long Term Care program (they currently need to go through a qualification process).

HB2311– school health program; appropriation SUPPORT

Assigned to House Education, no action yet. Requires school districts (and charters) to have evidence-based school health programs. Provides funding for such programs.

HB2616 mask mandates; minors; parental consent OPPOSED

Passed House Government Committee 7-6. Rules then Floor next. Prohibits this state from requiring a person under 18 years of age to wear a face covering or mask without the express consent of the person’s parent or guardian.

SB1298 government mask mandate; prohibition OPPOSED

Passed Government committee 4-3. Rules then Floor next. Prohibits the state or any political subdivision, including the judiciary, that receives or uses tax revenue from imposing any requirement to wear a mask or face covering on any Arizona resident, except where long-standing workplace safety and infection control measures that are unrelated to COVID-19 may be required.

Tobacco

HB2125 electronic smoking devices; retail licensing SUPPORT

Assigned to House HHS, no action yet. This is the ‘good’ tobacco control bill. Has a host of evidence based interventions including retail licensing with proper enforcement.

SB1245  tobacco; vapor; alternative nicotine; regulation OPPOSED

Passed Senate Approps, held in Commerce Committee. Regulates tobacco products but in a bad way that isn’t evidence based. It preempts local jurisdictions from doing more than state law. Includes a tobacco license though, with weak enforcement. Would be managed by the LLC.

HB2125 electronic smoking devices; retail licensing SUPPORT

Being heard in House Health 2/14. Conforms the minimum legal age for the sale of tobacco products or electronic smoking devices to the federal minimum age of sale for tobacco products. Makes, to a petty offence and a maximum fine of $100 an underage person who uses an ID to misrepresent the person’s age with the intent to induce the other person to sell, give or furnish a tobacco product or electronic smoking device. 

Access to Care

HB2144– health insurance coverage; biomarker testing SUPPORT

Being heard in House Health 2/14. Requires health insurance plans to begin covering biomarker testing. Important bill as emerging therapies rely on biomarker testing to target therapies. Medicaid is included!

HB2155 – health information organizations; research; disclosures SUPPORT

Assigned to House HHS. No action yet. Makes deidentified health information more available for research.

HB2100 health information organizations; confidentiality; data. SUPPORT

Assigned to House HHS, Held. This emergency measure would allow Health Current to receive, use and redisclose confidential information received for any purpose allowed by HIPPA. Ducey’s Executive Orders and Enhanced Surveillance Advisories currently address this privacy protection, but it needs to be codified in statute to ensure there are no gaps in the protection of this data or in healthcare information.

HB2161 parental rights; schools; educational records OPPOSED

Passed House Education 6-4. Passed Rules. Floor next. Expands statutory parental rights regarding the upbringing, education, health care and mental health of a parent’s minor child.

Special Needs & Disabilities

HB2382– appropriation; health programs; disabilities SUPPORT

Passed House HHS 9-0. Passed Approps 13-0.  Floor next. Appropriates $1 million to ADHS for grants to statewide organizations dedicated to “promoting evidence based, inclusive health programs for people with intellectual and developmental disabilities”.

HB2394 monitoring program for developmental disability homes SUPPORT

Being heard in House Health 2/14. Creates review committee for developmental disability group homes.

HB2157 supplemental appropriations; community-based services SUPPORT

Passed House Appropriations 11-1. Rules then Floor. Appropriates $1.4B of expenditure authority and $30M from Kids Care in FY 2022 for home and community-based services and funding formula requirements.  This will leverage $1.5B in mostly American Rescue Plan Act funds over the next 2 years to improve Home and Community Based Services for folks in their Long-Term Care Program.  $1B will go for badly needed investments to promote and stabilize access to supportive services, and workforce retention/ consistency to improve member outcomes ($1B)

Clean Energy & Climate/Environmental Health

SB1132– municipal bonds; environmental sustainability; prohibition OPPOSED

Assigned to Senate Nat. Resources, no action yet. Probably dead. Prohibits the use of municipal bonds for any project that is “green”. Defines anything green as basically anything to do with climate change, carbon emissions, or clean energy. Excludes other pollutants regulated by ADEQ.

HB2403– appropriation; ADE; electric school buses SUPPORT

Assigned to House Education, no action yet. Appropriates $1.5M for a pilot program for electric school buses

SB1150 electric vehicles; pilot program; appropriation SUPPORT

Passed Senate Transportation 6-3. Still needs Approps vote. Appropriates $500K from the General Fund to the Arizona Department of Administration (ADOA) for the Electric Vehicle-Ready Homes Pilot Program.

SB1151– charging station; pilot program; appropriation SUPPORT

Passed Senate Transportation 7-2. Appropriates $500K from the General Fund to ADOA to establish the Electric Vehicle Charging Station Pilot Program.

SB1152– zero emission vehicles; plans SUPPORT

Passed Senate Transportation 7-2. Still needs Appropriations. Requires ADOT to work in coordination with ADOA and ADEQ to develop a Zero Emission Vehicle Plan.

SB1153  state zero emission vehicle fleet SUPPORT

Assigned to Senate Transportation, still needs Approps, probably dead. Requires state agencies to buy zero emission vehicles when they buy new cars (when feasible).

SB1154 transportation electrification study committee SUPPORT

Passed Senate Transportation 7-2. Establishes the Transportation Electrification Study Committee

HB2226 fireworks use, limitations, prohibition SUPPORT

Passed Public Safety 13-1. Passed Rules. Floor next. Limits fireworks use to before 11pm except for a few holidays when the deadline is 1am.

HB2601 kratom products; definitions NEUTRAL

Passed House Government 9-1. Rules then Floor. Includes Kratom products in the definition of food and regulated under the pure food control statutes. Also specifies that a kratom product is contaminated with a dangerous non-kratom substance if the product contains any controlled substance prescribed by rules adopted pursuant to the Controlled Substances Act.

Women’s Health

HB2534 feminine hygiene; exemption SUPPORT

Assigned to Ways and Means, no action yet. Exempts feminine hygiene products from sales taxes.

SB1164– abortion; gestational age; limit OPPOSE

Passed Senate Judiciary 5-3. Floor next. Except in a medical emergency, prohibits physicians from performing an abortion after 15 weeks gestation as measured starting on the 1st day of the last menstrual period. Punishes the doctor with a felony and unprofessional conduct on her or his license. No exemptions for rape etc.

SB1272 AHCCCS; postpartum care; eligibility; appropriations  SUPPORT

Passed Senate 26-2. Transmitted to House. Allows AHCCCS to pursue eligibility for postpartum care for members for 1 year post-delivery up to 161% of federal poverty limit. Expanded eligibility currently ends at delivery.

Violence and Firearms

SB1123 disruption; educational institution; concealed weapon OPPOSED

Passed Senate Judiciary 4-3. Floor next. Prohibits the governing board of any university, college, or community college from prohibiting the possession of a concealed weapon by a concealed weapon permit holder, or the transportation or storage of a firearm.

State Agency Administration

SB1175– noncustodial federal monies; appropriation OPPOSE

Passed Senate 16-13. Transmitted to House. The legislature would need to appropriate federal funds that come through grants- including for example the maternal and child health block grant, WIC, SNAP, and many others.

SB1641 – health care institutions; civil penalties SUPPORT

Being heard in Senate Health 2/16. Raises the limit on ADHS healthcare institutions civil money penalties to $1K from $500.

SB1391 state hospital; transfer; AHCCCS NEUTRAL

Being heard in Senate Health 2/16. NO POSITION YET

This would move responsibility for operating the Arizona State Hospital from ADHS to AHCCCS.

SB1413 pharmacists; prescriptions; refusal; prohibition OPPOSED

Assigned to Senate Health Committee. Requires pharmacists to fill every prescription they receive. It would become unprofessional conduct to not fill a prescription, even if the pharmacist sees in the PMDP that the patient is doctor shopping or identifies a dangerous drug interaction.

HB2787 Maricopa county; division; new counties OPPOSED

Being heard in House Government & Elections Committee on 2/16. Would break Maricopa County into 4 separate counties.

Behavioral Health

SB1210 mentally ill; transportation; evaluation; treatment SUPPORT

Assigned to Senate HHS, no action yet. Stops the current practice of requiring that a police officer attend behavioral health ambulance transports.

SB1162 opioid prescriptions; intractable pain; exceptions SUPPORT

Passed Senate 27-0. Transmitted to House. Exempts patients with perioperative surgical pain, intractable pain or chronic intractable pain from statutory opioid prescription dosage restrictions. Contains good definitions of those words.

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