AzHHA is tracking more than 80 bills that may directly or indirectly impact hospitals in addition to advocating for our priority legislation.
Legislative update: 11th day of session begins with over 700 bills introduced
Today is the 11th day of legislative session and policymakers are hard at work as evidenced by the introduction of more than 700 bills and the release of Governor Ducey’s executive budget proposal. AzHHA is tracking more than 80 bills that may directly or indirectly impact hospitals in addition to advocating for our priority legislation.
Governor Ducey’s Executive Budget Proposal
Governor Ducey announced last week his executive budget proposal for fiscal year 2022. Unlike like previous years, there were no major provisions likely to affect hospitals. However, one non-healthcare related provision made headlines - tax cuts. The proposal would reduce taxes $200 million in fiscal year 2020 and reduce taxes an additional $200 million per year for the next two fiscal years. The proposal drew praise from republican legislators and business advocacy groups; however, it was roundly rejected by democratic legislators. Many Democrats believe the proposed tax cuts are intended to undermine Proposition 208 which increased taxes for high-income earners.
AzHHA Priority Legislation
AzHHA’s top legislative priority is to protect members from prospective frivolous lawsuits stemming from their response to COVID-19. Soon, legislation will be introduced to provide protections for businesses, healthcare providers, and healthcare institutions for action or omissions occurring between March 11, 2020 and December 30, 2022. Specifically, the bill will increase the burden of proof to “clear and convincing” of “willful misconduct or gross negligence” for actions or omissions in taken in “good faith.” This will apply to both COVID-19 and non-COVID-19 patients. This effort is supported by the Governor, the AZ Chamber of Commerce among other groups. However, it is strongly opposed by the Trial Lawyers and therefore may require significant effort to ensure its passage.
For years AzHHA has advocated for telehealth expansion. In 2019, AzHHA led the charge on coverage parity. Now, the Governor is seeking legislation to codify the telehealth provisions contained in several of his COVID-19 related executive order. Notably, the proposal would require non-ERISA commercial insurers reimburse for telehealth services at the same rate as in-person services and expand the definition of telehealth to permit the use of audio-only telephone encounters.
The bill contains one provision that requires further research. Specifically, it allows providers in any state to provide telehealth services so long as they hold a valid license in their home state and meet a few other minimal requirements. This could result in unintended consequences including reduced outpatient volume and lack of oversight for encounter quality of care.
The March of Dimes and other advocates are seeking legislation to expand the number of newborn screenings required by the state. In itself, expanding screening is a good thing; however, early drafts of the legislation placed hospitals at risk of bearing most or all of the costs. AzHHA is working with stakeholders to limit hospital financial risk by requiring insurers to increase their reimbursement rates anytime the Arizona Department of Health Services (ADHS) increases the newborn screening fee.
In previous years, legislation has been introduced to loosen school vaccination requirements or dissuade vaccinations by requiring recipients to receive an exhaustive list of possible side effects. This year, one anti-vaccination bill has already been introduced and we expect more to follow. AzHHA will strongly oppose any anti-vaccine bills or bills that seek to hinder or discourage vaccination.
Biden’s $1.9 trillion COVID-19 relief plan
In an announcement last week, President Biden unveiled a $1.9 trillion COVID-19 relief package plan which includes a number of provisions affecting hospitals and health systems. The plan consists of provisions to bolster the nation’s COVID-19 healthcare response by including additional resources for vaccines, treatment, personal protective equipment, testing, contact tracing and workforce development. Click here to view the American Hospital Association’s Special Bulletin which summarizes the provisions important to hospitals and healthcare systems. At this time, it is unclear if the proposed legislation will receive bipartisan support.
CMS issues memo clarifying expectations of State Survey Agencies and Accrediting Organizations during the pandemic
The Center for Disease Control and Prevention’s Center for Clinical Standards and Quality has released a memorandum to State Survey Agency Directors issuing hospital survey limitations that are immediately in effect for 30 days with the possibility for renewals. Flexibilities include hospital complaint surveys will be restricted to Immediate Jeopardy complaint allegations, hospital recertification surveys generally will be suspended and hospital enforcement actions for deficiencies that do not represent Immediate Jeopardy will have their termination extended for at least 30 days.
HHS invests in expansion of immunization information sharing
The Department of Health and Human Services (HHS) announced Tuesday a $20 million investment in several initiatives that will help increase data sharing between health information exchanges and immunization information systems. Funds, which were made possible through the Coronavirus Aid, Relief, and Economic Security Act, will allow the expansion of the Office of the National Coordinator’s Strengthening the Technical Advancement and Readiness of Public Health Agencies via Health Information Exchange (STAR HIE) program to help public health agencies track and identify patients who still need to receive their second COVID-19 vaccine dose and better identify those who may be high-risk who have not yet received a vaccination. The Office of the National Coordinator for Health Information Technology will also award funds to the Association of State and Territorial Health Officials and the Colorado Regional Health Information Organization to support immunization-related health information exchange collaborations.
COVID-19 vaccine update
ADHS this week opened registration for the second state-run COVID-19 vaccination site, Phoenix Municipal Stadium, as well as expanded registration to individuals ages 65-74. Vaccination of individuals ages 65-74 is only available at the two state-operated POD locations. Due to the limited supply of vaccine, Arizona counties will be utilizing the vaccine prioritization phased approach. According to the ADHS data, as of January 20, there have been 319,984 vaccines administered statewide. To find a vaccine site near you, click here or to schedule an appointment, visit podvaccine.azdhs.gov/.
Palliative care telehealth is available in Arizona
Patients experiencing acute or chronic COVID-19 symptoms and related complications have another resource available for their care. AzHHA launched the Palliative Care Telehealth program last month to give patients the option for care in their home while alleviating the current surge on our hospital systems.
Palliative Care Telehealth is a referral source for healthcare providers across Arizona to help their patients navigate through the complexities of COVID-19 related symptoms, or those chronic conditions exacerbated by COVID-19. Patients referred to this free service will be able to consult with a palliative care specialist for symptom management or goals of care. After the consultation, the palliative care specialist will collaborate with the referring provider on any changes to the plan of care.
This program is administered by AzHHA with a grant from the Arizona Department of Health Services. There is no charge to the patient or referring provider to use this service.
Please visit our website for more resources including patient and provider flyers and frequently asked questions: https://palliative.vsee.me/u/clinic.
February 10 & 11 - Cybersecurity tabletop exercise – free virtual presentation
AzCHER has joined the Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency (CISA) and the Federal Bureau of Investigation (FBI) to present a tabletop exercise on February 10 and 11, 2021 that is completely free to AzCHER members and partners. The target audience for this event includes information technology staff, emergency management staff, public information officers and healthcare executives. There is no limit to the number of participants who can attend from the same organization. To register for the February 10 exercise, click here. Or to register for the February 11 exercise, click here. The same exercise will be offered on Feb 10 and 11. Attendees should register for their preferred date.
February 10 - Advance Care Planning: Train the Trainer
This workshop prepares community representatives and volunteers to facilitate the 1 or 2-hour community Advance Care Planning workshop. Participants will learn the basic steps needed for effective advance care planning, Arizona regulations governing advance care planning, facilitation strategies and community/state/national resources. Click here to register.
Multiple dates – Introduction to POLST workshop
The one-hour Introduction to POLST workshop equips healthcare professionals with knowledge and resources to begin using POLST in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. Dates for the first quarter of 2021 have been announced. Click on the date to register for a workshop.