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.

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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

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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 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.

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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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