State Legislature Bill Update
More than 700 bills have so far been proposed by members of the Arizona State Legislature so far. Our Public Health Policy Committee is busy sifting through them and looking for those that will have a public health impact. We’ve taken public positions on the www.azleg.gov website on more than 20 bills with links to public health. Below is a quick summary of those bills and the positions that AzPHA has taken.
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 Health & Human Services Committee last Wednesday.
HB 2024 Electronic Cigarettes. Smoke Free Arizona Act (Kavanaugh) – AzPHA Position: YES
Includes e-cigarettes in the definition of tobacco products and smoking for the purposes of the Smoke Free Arizona Act. Because the Act was voter approved- this modification to the law will require a 3/4 majority of both houses.
HB 2073 Vapor Products; Regulation (Shope) – AzPHA Position: Opposed
This bill would basically set up a regulatory program at the ADHS to inspect and license electronic cigarette manufacturers in Arizona and specify that only licensed electronic cigarette manufacturers can sell products in Arizona. It gives no regulatory authority to the ADHS to enforce that vape shops get licensed and they only must do it every 5 years. There are no penalties for noncompliance and penalties are against the purchaser instead of the retailer.
SB 1363 Tobacco Product Sales (Tobacco 21) (Carter) - AzPHA Position: YES
Tis bill would move the tobacco product (and e-cigarette) buy age to 21. Bill includes definitions and criteria as well as penalties for vendors that sell to people under 21.
Maternal & Child Health
SB 1088 Dental Care During Pregnancy (Carter) – AzPHA Position: YES
This bill would expand AHCCCS covered services to include comprehensive dental coverage during pregnancy and appropriate the required state match funding. This bill passed the Senate Health Committee 8-0 this week!
SB 1040 Maternal Mortality Report (Brophy-McGee) – AzPHA Position: YES
This bill would require the Child Fatality Review Team subcommittee on maternal mortality to compile an annual statistical report on the incidence and causes of "severe maternal morbidity" with recommendations for action. The current law requires a review of the data but no report. This bill passed the Senate Health Committee 8-0 this week!
HB 2125 Child Care Subsidies (Udall) – AzPHA Position: YES
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.
HB 2162 Vaccine Personal Exemptions (Hernandez) - AzPHA Position: Yes
This bill would remove the personal exemption option for parents to enroll in school when the child hasn’t had all the required school attendance immunizations.
HB 2352 School Nurse and Immunization Postings (Butler) – AzPHA Position: Yes
School districts and charter schools would be required to post on their websites whether a registered nurse is assigned to each school as well as required reports on immunization rates.
These bills 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.
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.
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. Penalties are a civil penalty (no driving points) with the first offense being between $75- $150 and the 2nd offense between $150 and $250. We are signed up in support of this bill.
HB 2069 Texting and Driving (Kavanaugh) - AzPHA Position: Supporting SB 1165
Makes texting while driving on a highway a nonmoving civil traffic violation. The penalty for the 1qst violation would be $100 and the second offense would be $300. If a crash is involved the penalty would be $500 but if someone died it would be $10K. subject to a civil penalty of $500, except that if the accident results in the death of another person, the civil penalty is $10,000.
HB 2165 Distracted Driving (Townsend) - AzPHA Position: Supporting SB 1165
A person who drives a vehicle while participating in an activity that willfully distracts the person from safely operating the vehicle is guilty of reckless driving, a class 2 (mid-level) misdemeanor. I’m not sure if texting and driving would qualify or not- it probably does.
HB 2172 Rear Facing Car Seats (Bolding) - AzPHA Position: YES
Kids under two years of age need to be in a rear-facing restraint system unless the child weights at least 40 pounds or is at least 40 inches tall.
HB 2246 Motorcycle Helmets (Friese) – AzPHA Position YES
Motorcycle riders over 18 would be required to wear a helmet unless they pay a fee that would be set by ADOT. Violations would be a $500 civil penalty, but no points or other sanctions.
HB 2075 Electronic Prescribing (Cobb) – AzPHA Position: Yes
Pushes the electronic prescribing requirement in last year’s Opioid Epidemic Act back to January 2, 2020 in all counties. Being heard in House Health & Human Services Committee Thursday Feb 24 at 9 am.
SB 1219 Domestic Violence Offenses & Firearm Transfer AzPHA Position: Yes
Persons that have been adjudicated and the court rules that they may not possess a firearm must surrender their firearms to a law enforcement agency. The law enforcement agency may then dispose of the firearm(s) in accordance with law. People that have an Order of Protection against them must also surrender their firearms, although the law enforcement agency must return the firearm when the Order expires (after a background check).
HB 2247 Bump Stocks (Friese) – AzPHA Position: Yes
This bill would outlaw the sale of bump stocks on firearms.
HB 2248 Firearm Sales (Friese) – AzPHA Position: Yes
This bill would require a background check for all sales at gun shows.
HB 2161 Order of Protection (Hernandez) AzPHA Position: Undetermined
A person who is at least 18 years of age and who is either a law enforcement officer, a “family or household member” (defined), a school administrator or teacher or a licensed behavioral health professional who has personal knowledge that the respondent is a danger to self or others is permitted to file a verified petition in the superior court for a one-year Severe Threat Order of Protection (STOP order), which prohibits the respondent from owning, purchasing, possessing or receiving or having in the respondent’s custody or control a firearm or ammunition for up to one year.
HB 2249 Mental Health and Firearm Possession (Friese) AzPHA Position: Undetermined
An immediate family member or a peace officer is authorized to file a verified petition with a magistrate, justice of the peace or superior court judge for an injunction that prohibits a person from possessing, controlling, owning or receiving a firearm. Any court may issue or enforce a mental health injunction against firearm possession, regardless of the location of the person. Information that must be included in the petition is specified. If the court finds that there is clear and convincing evidence to issue a mental health injunction against firearm possession, the court must issue the injunction. Information that must be included in the injunction is specified.
HB 2148 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.
SB 1119 Tanning Studios (Mendez) – AzPHA Position YES
Would require people under 18 that want to use a commercial tanning bed service to have permission from their parent or guardian.
SB 1247 Residential Care Institutions (Brophy McGee) – AzPHA Position: Yes
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.
HB 2004 Nuclear Management Fund (Kavanaugh) – AzPHA Position: Undetermined
Assesses the Palo Verde nuclear plant $2.55M and gives it to ADEM, ADHS and other jurisdictions to compensate them for off-site nuclear emergency response plan response activities. Being heard in House Appropriations Committee Wednesday Feb 23 at 2 pm.
HB 2280 Interfacility Ambulance Transports (Weninger) - AzPHA Position: Undetermined
A person may operate an "interfacility transfer ambulance service" by applying to the Department of Health Services for a certificate of operation with defined requirements. The requirement to transport a patient under medical direction to the nearest, most appropriate facility as defined by federal Medicare guidelines does not apply to an interfacility transfer ambulance service with a certificate of operation.
SB 1011 Information and Referral Service (Carter) – AzPHA Position: YES
Appropriates $1.5 million from the general fund in FY2019-20 to the ADES for a statewide information and referral service for health care services, community services, human services and governmental services.
AHCCCS Coverage & Private Insurance Coverage
HB 2347 Medicaid Buy-in (Butler) AzPHA Position: Undetermined
Would require AHCCCS to set up a program in which eligible people could pay a premium and receive Medicaid health insurance.
These bills Would appropriate funding so that Kids Care could continue after the federal match rate goes below 100% on October 1, 2019.
HB 2351 Medical Services Study Committee (Butler) – AzPHA Position: Yes
Establishes a 14-member Medical Services Purchase Program Study Committee to research and make recommendations for establishing and implementing a medical services purchase program. The Committee is required to submit a report of its findings and recommendations to the Governor
HB 2120 Chiropractic Coverage (Barto) - AzPHA Position: Undetermined
Would add chiropractic services to the list of reimbursable services under AHCCCS. Being heard in House Health & Human Services Committee Thursday Feb 24 at 9 am.
SB 1088 Dental Care During Pregnancy (Carter) - AzPHA Position: Yes
This bill would expand AHCCCS covered services to include comprehensive dental coverage during pregnancy and appropriate the required state match funding.
SB 1089 Telemedicine 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. Note: this is all Title 20 language and does not apply to Medicaid (AHCCCS).
Food Safety & Insecurity
HB 2178 Milk Manufacturing License Exemption - AzPHA Position: Undetermined
A restaurant wouldn’t be required to get a license to manufacture or distribute frozen desserts or frozen milk products if the product is manufactured or distributed and sold at the same facility for on-site consumption.
HB 2186 School Meals (Udall) AzPHA Position: Yes
Schools are required to provide a school meal to a student who requests it regardless of whether the student pays for a school meal or owes money for previous meals. Local education agencies are prohibited from taking a list of specified actions relating to unpaid school meal fees, including announcing or publicizing the names of students with unpaid school meal fees, requiring a student who cannot pay for a meal or who owes unpaid meal fees to work for a meal, and attempting to collect unpaid school meal fees from a student. Local education agencies are prohibited from using a debt collector to attempt to collect unpaid school meal fees.
Access to Care
HB 2218 State Loan Repayment (Blanc) – AzPHA Position: YES
Makes a supplemental appropriation of $500,000 from the general fund in FY2019-20 to the Department of Health Services to pay off portions of education loans taken out by physicians, dentists, pharmacists, advance practice providers and behavioral health providers participating in the primary care provider loan repayment program. An additional $500K would be appropriated to pay off education loans taken out by physicians, dentists, pharmacists, advance practice providers and behavioral health providers participating in the rural private primary care provider loan repayment program.
HB 2376 Associated Health Plans (Barto) AzPHA Position: Undetermined
An association health plan is authorized to operate in Arizona if the plan is following federal laws and regulations, and if the plan's governing documents require the plan to be actuarially sound and the plan is actuarially sound.
HB 2149 Cannabis Definition (Rivero) AzPHA Position: YES
Synchronizes the definitions of marijuana and cannabis in the state criminal code and the Arizona Medical Marijuana Act. There has been some confusion in certain counties- as medical marijuana patients have been prosecuted for possessing extracts and preparations of marijuana that they bought at dispensaries. The appeal of this prosecutions will be heard by the state supreme court. This would make it clearer in state law that extracts and preparations are included in the Act.