Legislative Update: Strange bedfellows? / by AzHHA

Today is the 116th day of legislative session and hopes of an imminent budget breakthrough have largely been dashed.

Regular readers will recall that a copy of the senate republicans’ super-secret budget spreadsheet was leaked to the press last week. It received a chilly response from the governor, house republicans, and democrats alike - though for very different reasons.

Not to be outdone, the house democrats released their own budget proposal yesterday. It closely resembles the governor’s plan with several major additions, including:

  • Fully fund K-12 Additional Assistance                                       

    $203.3 million in FY20

  • Provide critical funding for roads and infrastructure throughout Arizona

    $100 million in FY20

  • Provide funding for affordable housing solutions statewide       

    $30 million in FY20

  • Provide additional funding for Arizona's most vulnerable populations

    $40 million in FY20

While the house democrats’ budget provides the governor with major wins like funding KidsCare and a sizeable deposit to the state rainy day fund, many capitol insiders believe it’s unlikely that Ducey will abandon his party. Doing so would only buy him 29 of the 31 votes necessary to pass the house.

It is important to note the house democrats’ budget includes funding for rural broadband and rural prenatal telemedicine equipment but excludes funding for graduate medical education.

Below, please find an update on select legislation.


AZHHA PRIORITY LEGISLATION

SB1089: INSURANCE; TELEMEDICINE

Sponsored by Senator Heather Carter (R-Cave Creek), SB1089 is intended to expand telemedicine coverage. The bill requires commercial health insurers to cover medical services provided by telemedicine if they cover the same service when provided in person.

STATUS: Signed into law on April 18th.

SB1352 Health Care Directives Registry; Transfer

Sponsored by Senator Heather Carter (R-Cave Creek), SB1352 is intended to improve healthcare provider access to health care directives like living wills. The bill moves the Arizona Health Care Directive Registry from its current location at the Secretary of State to the state’s Health Information Exchange organization Health Current.

AzHHA strongly supports the bill. Increase provider access to health care directives is consistent with the policy priority of improving end of life care.

STATUS: The bill passed house caucus on April 30th, it awaits a vote on the House floor.

SB1354: GRADUATE MEDICAL EDUCATION; APPROPRIATION

Sponsored by Senator Heather Carter (R-Cave Creek), SB 1354 is intended to make a significant dent in the physician shortage affecting Arizona - especially in rural and medically underserved areas. As amended, the bill appropriates: 1) $20 million to AHCCCS for Graduate Medical Education (GME); 2) $11 million to U of A Medical School; 3) $10 million for costs related to nurse training and to encourage retired doctors to return to practice; 4) $4 million to Arizona Department of Health Services (ADHS) for the primary care provider loan repayment program; and, 5) $5 million to the Board of Medical Student Loans program. (SB 1354 passed Senate Appropriations 9-0; passed Senate 28-2; passed House Appropriations 10-1).

Arizona has not appropriated state general funds for GME in approximately a decade. In 2018, AHCCCS provided more than $239 million in GME payments to Arizona hospitals. Of that amount, $205 million in federal matching funds were triggered by $88 million from local, county, tribal jurisdictions, hospitals and universities. If passed, more than $66 million ($20 million state funds + $46 million federal funds) will be available for medical residencies and rotations in rural and medically underserved areas.

STATUS: Pending budget negotiations. See above.

OTHER LEGISLATION

HB 2041: HOSPITAL ASSAULTS; TESTING; REPORTING; SANCTIONS

Sponsored by Representative Mark Finchem (R-Oro Valley), HB2041 is intended as a state-level response to the nationally recognized issue of healthcare workplace safety. The bill: 1) Allows hospital employees, volunteers, and others who have been assaulted petition a court to require the assailant get a blood test; and, 2) Requires a hospital to report an assault to the Arizona Department of Health Services within 72 hours of an assault.

UPDATE: The bill was amended by removing the statutory reporting requirement and replacing it with nonbinding language expressing the legislature’s intent to encourage hospitals to keep and report statistics on workplace safety to public policy researchers. AzHHA is now neutral on the bill.

UPDATE: The bill was signed into law on April 17th.

H2122: DO-NOT-RESUSCITATE ORDERS; MINORS; PARENTAL CONSENT

Sponsored by Representative Nancy Barto (R-Cave Creek), HB2122 is intended to prohibit health care providers from placing Do-Not-Resuscitate (D-N-R) orders on minors against the will of the parents or guardians. As amended the bill: 1) Prohibits providers from implementing a D-N-R order without the written or oral consent of both parents or guardian of a minor; 2) If the parent or guardian orally consents to implement a D-N-R order, two witnesses other than the parent, guardian or physician must be present and willing to attest to the consent; and, 3) Prohibits a health care provider from withholding care even if, using reasonable medical judgement, they believe that care will harm the patient and/or cause unnecessary pain or suffering.

UPDATE: The bill was signed into law on April 30th.