It’s Switchover Time at the Legislature

The week before last was the deadline for bills to be heard in their chamber of origin- and much of last week’s action was on floor votes (called Third Read).  When a bill clears the House or Senate (having a 3rd reading with a recorded vote of the body) it’s transmitted to the other body of the legislature (the switchover). At that point, it gets 1st and 2nd read and assigned to a committee (s). Then it’s up to the chair to schedule the bill.

If heard, then it gets voted on and gets thru that body. If there are no changes, it’s sent back to its original body who then transmits it to the Governor. If there are changes the bill, goes back to the originating body to decide if they accept the changes. If they do, they’ll be a final read and recorded vote before transmitting to the Governor. If they don’t agree then it goes to conference committee. It can be a “simple” conference where the choice is the House or the Senate version. Most are free conference committees in which there are 3 members per body who serve.

Conference committees usually don’t take testimony.  The meetings are open but there’s usually only announcements from the floor to know when the group meets.  If there’s finally agreement, it goes back for acceptance of the conference report and a final vote by each side before it goes to the Governor.

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Lots of action last week with lots of 3rd read floor votes in the Senate. The House isn’t as far along in finishing 3rd reads.  This week we'll mostly be watching the 3rd Read votes.  We'd really like to get the hand free cell use bill, the syringe services bill, the GME bill and the e-cigarette smoke free AZ act bill through their chambers this week. Here's our document with all the particulars on bills this week.

Public health can breathe a little sigh of relief now that the Governor made it clear that he doesn’t   intend to sign any bill that would lower vaccination rates. We're already gambling with the lives of infants, people with disabilities, and immune optimized folks because of the erosion in our immunization rates and any of the 3 anti-vaccine bills this year (HB 2470, HB 2471, or HB  2472 would have done just that. 

We need public health policy decisions that improve vaccination rates, not decisions that put vulnerable people at even more risk.  With the Governor’s statements this we can now focus more of our efforts on the other (mostly good) public health policy bills out there.

 

Bills that Passed through the House or Senate

Access to Care & Healthcare Workforce

SB 1088 Dental Care During Pregnancy (Carter) – AzPHA Position: YES

Passed the Senate 27-3.  This bill would expand AHCCCS covered services to include comprehensive dental coverage during pregnancy and appropriate the required state match funding. Good oral health is well established to improve birth outcomes including reducing pre-term birth while also preventing the transmission of caries from mom to infant after birth.  This priority bill was passed by the Senate this week and has been transferred to the House. Note that since this bull would have a needed appropriation it will need to be included in the final state budget.

SB 1089Telemedicine Insurance Coverage (Carter) – AzPHA Position: Yes

This Bill would put into law specific standards requiring non-Medicaid insurance companies to cover telemedicine.  There are criteria and standards in the law regarding contracting standards. Requires that coverage for telemedicine healthcare services if the service is covered when delivered in-person.   This bill would be good for access to care especially in rural Arizona which is why we’re supporting it. Passed 30-0.

SB 1174 Tribal Area Health Education Center

Health Education System consists of five area health education centers each representing a geographic area with specified populations that currently lack services by the health care professions.  The current regional centers include: 1) Eastern Arizona AHEC; 2) Greater Valley AHEC; 3) Northern Arizona AHEC; 4) Southeast Arizona AHEC; and 5) Western Arizona AHEC/Regional Center for Border Health.  This bill adds an area health education center that would focus on tribal areas and the Indian health care delivery system. Passed 30-0.  

SB 1355 Native American Dental Care

Passed Senate 25-5.  Requires AHCCCS to seek federal authorization to reimburse the Indian health services and tribal facilities to cover the cost of adult dental services.

** Kids Care: The Kids Care Reauthorization bills have all languished in their chamber of origin, however, we have good reason to believe that reauthorizing Kids Care including the appropriation needed to pay the state match (10%) will be negotiation in the state budget bills.

 

Licensing & Vital Records

SB 1247 Residential Care Institutions (Brophy McGee) AzPHA Position: Yes

Passed the Senate 30-0. This good bill will require more robust staffing background checks for facilities that provide services for children and will remove the “deemed status” designation for child residential behavioral health facilities.  Under current law, facilities in this category (e.g. Southwest Key) can be accredited by a third party (e.g. Council on Accreditation) and avoid annual surprise inspections by the ADHS.  This intervention will provide more oversight to ensure background checks are done and that the facilities are compliant with state regulations. 

 

SB 1211 Intermediate Care Facilities (Carter) AzPHA Position: Yes

Passed the Senate 30-0. Like SB 1247, this bill closes a licensing loophole.  This good bill will require more robust staffing background checks for facilities that provide services to people with disabilities at intermediate care facilities.  These facilities would also require a license to operate from the Arizona Department of Health Services beginning on January 1, 2020.  Under current law these facilities (Hacienda de los Angeles and similar facilities run by the ADES are exempt from state licensing requirements)

 

SB 1245 Vital Records- Death Certificates (Brophy McGee) AzPHA Position: Yes

This bill will make it clear that both state and county Registrars can provide certified copies of death certificates to licensed funeral home directors upon request.  There’s been some confusion about this authority and this bill would clear it up.   Passed the Senate 30-0.

Tobacco & Nicotine

SB 1009 Electronic Cigarettes, Tobacco Sales (Carter) – AzPHA Position: YES

Expands the definition of tobacco products to include e-cigarettes. Among other things, it'll make it clear that it's illegal to sell e-cigarettes to minors. The penalty for selling to minors remains at $5K. Passed the Senate 30-0.

Surveillance & Social Determinants

HB 2125 Child Care Subsidies (Udall) – AzPHA Position: YES

Passed House 46-13.  Makes a supplemental appropriation of $56 million from the Federal Child Care and Development Fund block grant in FY2018-19 to the Department of Economic Security for child care assistance. Another bill, HB 2124 would allocate the money as follows: $26.7 million for provider rate increases, $14 million to serve children on the waiting list, and $13.1 million to increase tiered reimbursement for infants, toddlers and children in the care of DCS. HB 2436 is a similar bill. Passed 46-13 and has moved over to the Senate.

HB 2488 Veteran Suicide Annual Report (Lawrence) AzPHA Position: Yes

Requires ADHS to annually compile a report on veteran suicides beginning January 1, 2020. The data in the report would be shared across the public health system and with the VA and will hopefully include surveillance results that are actionable to prevent veteran suicides.

SB 1040 Maternal Mortality Report (Brophy-McGee) – AzPHA Position: YES

This bill would require the Child Fatality Review Team subcommittee on maternal mortality to make recommendations on improving information collection. Passed the Senate 30-0.

Bills that Still Need to Have a Final (3rd Read) First Chamber Vote

SB 1165 Texting and Driving Prohibition (Brophy McGee) – AzPHA Position: YES

This bill prohibits using a hand-held cell phone while driving.  There are some common-sense exemptions for example if the person is using it hands free etc.  Violations are a civil $ penalty (no driving points) with the first offense being between $75- $150 and the 2nd offense between $150 and $250.  The bill would provide a state overlay so the cell phone use laws would no longer be different from jurisdiction to jurisdiction. We’re signed up in support of this bill.  This bill still needs to go to Committee of the Whole and get a Senate 3rd read.

HB 2718 Syringe Services Programs (Rivero) AzPHA Position: Yes

Decriminalizes syringe access programs, currently a class 6 felony. To qualify, programs need to list their services including disposal of used needles and hypodermic syringes, injection supplies at no cost, and access to kits that contain an opioid antagonist or referrals to programs that provide access to an opioid antagonist.  Approved by the International Affairs Study Committee this week.  Did not receive a hearing in Rules yet, we’ll work with stakeholders to get it heard in Rules.

SB 1354 Graduate Medical Information & Student Loan Repayment (Carter) AzPHA Position: Yes

This bill appropriates $50M from the General Fund to AHCCCS, UA Health Science Center, ADHS and the to address the state-wide shortage of physicians and nurses.  The bill has several elements with a rural focus. Elements include $20M for Graduate Medical Education in critical-access hospitals and community health centers in rural areas and $4M for the ADHS’ health practitioners loan repayment system. Many elements will be very good for access to care in rural AZ.  Bill still needs a final vote in the Senate and of course – since it’s a money bill it’ll need to go through the budget process.

SB 1060 (Strike-all Amendment) Electronic Cigarettes. Smoke Free Arizona Act (Carter) – AzPHA Position: YES

Includes e-cigarettes in the definition of tobacco products and smoking for the purposes of the Smoke Free Arizona Act.  Allows smoking in retail stores that sell electronic smoking devices exclusively and have an independent ventilation system.  Because the Act was voter approved- this modification to the law will require a 3/4 majority of both houses.  This bill still needs to go to Committee of the Whole and get a Senate 3rd read.

SB 1456 Vision Screening- AzPHA Position: Yes

This bill would require schools to provide vision screening services to students in grades prescribed by future ADHS rules, kids being considered for special education services, and students who are not reading at grade level by the third grade. Appropriates $100,000 from the state General Fund to the ADHS for the tracking and follow up.  This bill still needs to go to Committee of the Whole and get a Senate 3rd read.

HB 2471 Informed Consent (Barto) - AzPHA Position: Opposed

This bill would add a requirement that physicians provide to parents and guardians the full vaccine package insert and excipient summary for each vaccine that will be administered.  Physicians already provide a Vaccine Information Summary to parents and guardians for each vaccine administered, which is noted in the medical record.  This new requirement would mandate provision of the 12-15 page insert, which is not presented in a format that incorporates health literacy principles.  Bill is likely dead but we’re remaining vigilant and will work with Stakeholders like TAPI to hold it back in the House.

HB  2472 Vaccinations- Antibody Titer (Barto) - AzPHA Position: Opposed

These bills would mandate that doctors inform parents and guardians that antibody titer tests (which involve a venous draw) are an option in lieu of receiving a vaccination and that there are exemptions available for the state requirements for attending school.   Bill is likely dead but we’re remaining vigilant and will work with Stakeholders like TAPI to hold it back in the House.

HB 2470 Vaccination Religious Exemptions (Barto) - AzPHA Position: Opposed

This bill would add an additional exemption to the school vaccine requirements into state law.  Currently there are medical and personal exemptions.  The bill doesn't include any verification of the religious exemption from a religious leader, just a declaration from the parent that they are opposed to vaccines on religious grounds.  Bill is likely dead but we’re remaining vigilant and will work with Stakeholders like TAPI to hold it back in the House.

Good Bills that are Effectively Dead

Unless a miracle happens- this is the last time you’ll see me mention the bills below in my policy updates

SB 1363  Tobacco Product Sales (Tobacco 21) (Carter)

HB 2162  Vaccine Personal Exemptions (Hernandez)

HB 2352 School Nurse and Immunization Postings (Butler)

HB 2172  Rear Facing Car Seats (Bolding)

HB 2246  Motorcycle Helmets (Friese)

SB 1219  Domestic Violence Offenses & Firearm Transfer

HB 2247  Bump Stocks (Friese)

HB 2248  Firearm Sales (Friese)

HB 2161  Order of Protection (Hernandez)

SB 1119 Tanning Studios (Mendez)

HB 2347  Medicaid Buy-in (Butler)

HB 2351  Medical Services Study Committee (Butler)