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A Look Back -- Policy Pulse for Nurses -- Final Wrap-up 2019

Posted By Administration, Wednesday, June 19, 2019

AzNA tracks bills based on our Public Policy Agenda focused on the health of all Arizonans along with the professional practice and work environment of our Arizona nurses.

 

June 18, 2019

 

#ThrowBackThursday

The 2019 Legislative Session ended May 28 and with that comes time to look back over what was accomplished by AzNA and AzNA lobbyists over the past 5 months. We invite you to read through the 2019 Legislative Summary Report.

 

 

 

 

Have a Great Summer! Keep in Touch!

Thank you for reading Policy Pulse every week. It's Goodbye for now, but don't worry! Policy Pulse will be back in your inbox starting January 2020, keeping you current on what is happening at the Arizona Legislature that impacts healthcare and nursing.

Special Thanks

 

AzNA wishes to extend a special thank you to the members of the AzNA Public Policy Committee for their hard work and dedication. AzNA runs on the power of our volunteers.

Want to get involved? Fill out a Volunteer Interest Form!

 

 

What Else Should Nurses Know?

 

During the 135 day legislative session, AzNA's staff, volunteers, and lobbyists were hard at work tracking the bills affecting nurses, nursing, health care, and the health of Arizonans. These bills are still available in the Nurses List of Bills on the AzNA website.

 

Each week during the Legislative Session, the Policy Pulse email you are currently reading included updates to help summarize some key bills moving through the legislature.

If you have questions about a specific bill, contact info@aznurse.org. We will triage your question to the appropriate person.

 

 

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That's All Folks -- Policy Pulse for Nurses -- Week of May 28, 2019

Posted By Wendy Knefelkamp, Wednesday, May 29, 2019

AzNA tracks bills based on our Public Policy Agenda focused on the health of all Arizonans along with the professional practice and work environment of our Arizona nurses.

 

May 28, 2019

 

Crossing the Finish Line

The Legislature wrapped up the session "sine die" at 12:58 AM Tuesday after approving an $11.8 billion budget.

 

Keeping Things Spicy

The last two weeks were very contentious as two Senators, Heather Carter (R-Cave Creek) and Paul Boyer (R-Phoenix), held out on voting for the budget.

 

They wanted Boyer's bill to pass, which helps survivors of childhood sexual abuse sue their abusers. Action on the budget was delayed as legislators battled one another both publicly and privately.

 

In the end, a compromise was reached. Legislators then met throughout the holiday weekend and the budget was passed in the wee hours of Tuesday morning.

 

What's In the Budget for Nurses?

A big sigh of relief - Kid's Care was funded, an AzNA priority. $1.6 million is designated to eliminate a freeze on the KidsCare program, which provides health care coverage to children in low-income families.

 

Not All Great News

The $50,000 needed to fund the workforce database was not included in the budget. That's ok for now. The project will proceed as DHS has to write rules, which will take about a year. Additionally, DHS has indicated there may be some other funding available in their own fiscal structure to begin the project.

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Dough, Moolah, Green -- Policy Pulse for Nurses -- Week of May 6, 2019

Posted By Wendy Knefelkamp, Thursday, May 9, 2019

May 8, 2019

 

Show Me The Money

Although there has not been much action at the Legislature in the past two weeks, any remaining bills are slowly being addressed while legislators start to negotiate a budget.

 

The bills that include money (appropriations) have been set aside and are considered in the budget negotiations. The Joint Legislative Budget Committee (JLBC) leads the negotiations. The budget process is expected to take longer than usual this year because of the revenue surplus.

 

Outcome Shaky - Teetering on the Fence

SB1096; health professionals data; repository, was one of the remaining bills whose future was unstable. That’s when AzNA's lobbyists (Rory Hays and Kathy Busby) got to work, visiting legislators that were on the fence.

 

The House majority leader, Rep. Warren Petersen, introduced an amendment to expand the behavioral health workforce (something desperately needed). This amendment was good enough to get the bill passed by unanimous vote through the House. Because of the new House amendment, the bill was sent back to the Senate who also voted unanimously to approve - and viola! SB1096 is now on the Governor’s desk to sign. The fence is still a bit shaky, but AzNA has good reason to believe that the Governor will sign.

 

That Seems Positive. Why The Concerned Face?

Here's the last hurdle: there are still some financial concerns because the money to support the database ($50,000) was stripped off the bill to allow it to move out of House Rules. That money still needs to be allocated somewhere in the budget. AzNA is optimistic this will happen; after all, $50,000 in a $144.2 Billon budget is a “drop in the bucket”! Hoping to come out on the right side of the fence.

 

Vaccine Bills: It’s Not Over 'Til It’s Over

The vaccine bills (HB 2470, 2471 and 2472) have been stalled in the house since February and have had no chance passing in their current form. However, with the shifting focus due to increased cases of measles across the nation, anything is possible. Legislators have until the close of the legislative session to change their minds. AzNA will keep you updated.

 

Should I Be Worried About Measles?

Arizona has avoided an outbreak so far, but according to Dr. Cara Christ, Director for the Arizona Department of Health Services, “Increased use of immunization exemptions [has] put Arizona at-risk for outbreak in 2019.”

 

Should I Get a Booster?

Maybe. Some adults born before 1989 may need to consider going back for an extra booster.

 

Sour Lemons

What an experience for a Gilbert, AZ high school student this legislative session as the Arizona Senate failed to move the lemonade bill forward. Garret Glover realized that unlike other states, Arizona did not have a “state drink.” He met with his elected official, Representative Warren Petersen and on February 13, 2019, HB2692; state drink; lemonade, was introduced by Rep. Petersen and sailed through the Arizona House with a 57-3 vote.

 

Unfortunately, the bill died when the Arizona Senate voted 18-12 against the bill. Comments from senators voting 'no' varied. AzNA hopes this brave teenager doesn’t sour from his experience. 

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Time to Party!

Posted By Debby Wood, Tuesday, April 23, 2019
Updated: Friday, May 10, 2019

AzNA tracks bills based on our Public Policy Agenda focused on the health of all Arizonans along with the professional practice and work environment of our Arizona nurses.

April 23, 2019

MISSION ACCOMPLISHED!

On April 16th Governor Ducey signed HB2068, the clinical nurse specialists; prescribing authority bill.

One giant step for Arizona nurses

The passage of this bill ends a 4-year journey to full practice authority (FPA) for our four APRN groups. Arizona like every state in the nation is working towards the APRN Consensus Model. In 2016 our legislative efforts failed, a “hard pill to swallow.” In 2017 we adjusted messages and strategies and were successful in passing FPA legislation for NPs, CNMs and CRNAs. Because the role of the CNS was not clear among legislators and even nurses, it took AzNA and our partners two additional years to secure prescriptive authority for CNSs.

Thank you’s all around!

Hundreds of advocacy hours were clocked by our Arizona nurses as well as national consultants. E-mails sent to legislators, face to face visits with legislators and stakeholder meetings all contributed to our success. A special shout out to Denice Gibson, AZNA’s Governmental Affairs Officer (and CNS), Kathy Busby, AzNA Lobbyist as well as our Executive Director, Robin Schaeffer for their tireless dedication and expertise to get the bill passed.

When can CNSs start prescribing?

The legislation, pursuant to law, will become effective 90 days after the close of the legislative session. We don't know the exact day as we don't know when the session will end at this point. Our “best guess” is mid to late August. The Board of Nursing is working to implement the legislation including determining educational requirements to comply with the legislation and guidance to CNS's who wish to apply for prescriptive authority. We will continue to inform our members as these issues are discussed and resolved.

HANDS-FREE ARIZONA!

HB 2318 the bill that would ban texting and driving statewide was signed by Governor Ducey on Monday, April 22nd. The law prohibits the following while driving; holding or supporting a wireless device, writing or reading any text-based communication or watching, recording or broadcasting videos. Arizona joins 47 other U.S. states that prohibit texting and driving.

So, when does this law take effect?

The law takes effect immediately, however, penalties will not begin until January 2021. Access this one-page information sheet to educate yourself and then start educating everyone around you.

 

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Drop Your Party Clothes at the Dry Cleaners

Posted By Debby Wood, Tuesday, April 16, 2019
Updated: Friday, May 10, 2019

AzNA tracks bills based on our Public Policy Agenda focused on the health of all Arizonans along with the professional practice and work environment of our Arizona nurses.

 

 

 

April 16, 2019

1-2-3-4

As we head towards the home stretch of the 2019 legislative session, bills now fall into one of four categories:

1. Signed or waiting to be signed by Governor

2. In last steps of approval or non-approval by legislators

3. Dead bills

4. Bills that have money (appropriations) attached and are part of future budget conversations this session

Pop The Cork!

HB2068, clinical nurse specialist; prescribing authority, moved through the Senate unanimously last week and was then sent back to the House for a final vote, which was also unanimous. The Governor just signed the bill late yesterday afternoon. Pour out the champagne!

I Say Data, You Say Base!

SB1096, health professionals data; repository; appropriation, has started to move again. As discussed last week, the $50,000 appropriation was stripped out of the bill to ensure the House Rules Chair would hear the bill. It passed Rules Monday and was discussed in both Caucuses yesterday (Tuesday).

Nice! Where to Next?

AzNA anticipates it moving through the House, with an amendment crafted to address last minute concerns, before proceeding back to the Senate for final vote. Don't forget to write your Representative for a Yes vote!

....And the Money?

The money to fund the database will be worked on in the budget later this legislative session or even next year; the money isn't needed until rules are developed by the Department of Health Services and that will take about a year.

Plumbers, Barbers, and.... Nurses?

On April 10, 2019, Gov. Doug Ducey signed HB2569, establishing reciprocity for occupational and professional license or certificate holders who come to Arizona from out-of-state. In a press release, Ducey celebrated the law as the first of its kind in the nation and mentioned nursing among the occupations in this quote:

“There’s dignity in all work,” said Governor Ducey. “And we know that whether you make your living as a plumber, a barber, a nurse or anything else, you don’t lose your skills simply because you moved here. The bill we signed today protects public health and safety while eliminating unnecessary and costly red tape.”

Remind Me How This Law Impacts Me as a Nurse

It doesn't. In an interview, Robin Schaeffer, Executive Director of AzNA, clarifies what the bill means for nurses in Arizona. "Here’s how it applies to nursing: It really doesn’t change much for us. The new law has a list of exemptions and an interstate compact is one of those exemptions. Arizona is a member of the Nurse Licensure Compact, an interstate agreement to recognize each other’s licensees...We’re supportive of the bill the governor signed; however, it doesn’t really change much for the nursing profession."

Get Those Legislative Skills Sharpened

Managing constant change in health care takes more than just hard work. It takes a solid understanding the legislative process and knowledge about intricacies of the health care system. That’s where State of Reform comes in. AzNA ED, Robin Schaeffer, will be participating in a panel during the first annual Arizona State of the Reform Health Policy Conference - AzNA members who wish to attend the conference can receive a 20% registration discount using the promo code AZNURSE during registration!

National Legislation for Cadet Nurses

ANA is pleased to support bipartisan, bicameral (both houses) legislation to honor Cadet Nurses who served during World War II by distinguishing them as honorary veterans, as well as providing them with burial privileges. U.S. Reps. Cheri Bustos (D-IL), Greg Gianforte (R-MT), Cindy Axne (D-IA) and Troy Balderson (R-OH) introduced the legislation on April 3, close to the birthday of former Rep. Frances Bolton (R-OH), who founded the U.S. Cadet Nurse Corps and was born on March 29, 1885. U.S. Senators Elizabeth Warren (D-MA), Susan Collins (R-ME), Angus King (I-ME), and Steve Daines (R-MO) re-introduced the U.S. Cadet Nurse Corps Service Recognition Act in the Senate.

"The Cadet Nurses answered the call of duty to fill a critical need during World War II," said ANA President Ernest J. Grant, PhD, RN, FAAN. "We are proud to support this bill to acknowledge and recognize these women for their selfless service to their country."

The U.S. Cadet Nurse Corps was established in 1943 during World War II to address nursing shortages. Former Cadet Nurses have been longtime advocates for being granted honorary veteran status – which this specific bill does. This legislation has garnered the support of organizations, including the American Nurses Association (ANA), the American Association of Colleges of Nursing, the Veterans of Foreign Wars, and the American Organization of Nurse Leaders.

You can encourage your members of Congress to pass this bill. Send your letter of support now.

 

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Double, Double Toil and Trouble

Posted By Debby Wood, Tuesday, April 16, 2019
Updated: Friday, May 10, 2019

April 9, 2018-

 

Extra Innings

Last week, Governor Ducey introduced a school safety bill (court orders to remove guns from ‘dangerous' persons and money for school programs) as well as a proposal to provide teachers with a raise (10% this year and two five year increases of 5%). These big proposals with a lot of money at stake threw the Legislature, which was trying to craft a budget, into turmoil.

 

Waiting Game

HB2197 Health professionals; workforce data is being held up in the various machinations of the budget negotiations and still needs to be voted on by the Senate and then would proceed to the Governor.

 

HB2549 controlled substances; dosage limit, which would allow NPs with advance pain training to act as medical director at pain clinics, has passed out of the Legislature is awaiting the Governor's signature.

 

Signed Into Law by Governor

SB1034 committee of reference; standing committee makes substantial amendments to the sunrise process to expand scope of practice has been signed into law. AzNA played a substantial role in the negotiations. 

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Quick Spin, Then Leap

Posted By Debby Wood, Tuesday, April 2, 2019
Updated: Friday, May 10, 2019

April 2, 2019

 

Is That the Finish Line I See?

Last week, AzNA saw great success with our CNS legislation, HB2068, clinical nurse specialists; prescribing authority. After in-depth conversations between practitioner groups, the physician groups moved from opposing the bill to a neutral position. At the Senate Health and Human Services Committee meeting Wednesday, the testimony was conciliatory and positive.

 

Keeping Me on the Edge of My Seat - What Happened?

HB2068 passed out of committee, 8-0. Take 20 minutes out of your day to watch how the testimony and discussion unfolded. It proceeded to the Rules Committee, Monday, April 1 and had no problems passing out of that committee since it had already cleared the House Rules Committee (which checks for the same legal and constitutional issues).

 

Refresh Me. What is Next?

The bill moves through the republican and democratic Senate caucuses, likely Tuesday, April 2 and then it will proceed to the Senate Committee of the Whole for passage. AzNA is optimistic at this time, but will continue to carefully watch and shepherd the bill through the process.

 

Shall We Dance?

There has been some resistance from a few House members regarding the $50,000 appropriation for the workforce database in SB1096; health professionals data; repository; appropriation. Although the bill passed out of the Appropriations Committee, three members of the committee voted no. One of those no votes belonged to the Chairman of the House Rules Committee, Rep. Kern.

 

I Thought There Was Dancing Involved...

A quick pivot is necessary. The bill needs to be heard and pass through Rules before it can move to the House floor. Because the substance of the bill is important to its implementation, AzNA has told Rep. Kern that the appropriation amount will be removed from the bill if he will allow it to proceed through the Rules Committee. The $50K will need to be added to the budget in other ways. Hoping to score perfect on these tricky moves.

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The Cookie is Starting to Crumble

Posted By Debby Wood, Tuesday, March 26, 2019
Updated: Friday, May 10, 2019

March 26, 2019

 

CNS Bill: Stakeholder Negotiations a Success

HB2068, clinical nurse specialists; prescribing authority, was not heard last week but is on the Senate Health and Human Services Committee agenda this week. Our AzNA lobbyist and public policy leadership team worked hard with the Arizona Medical Association (ARMA) to address and resolve their concerns. AzNA is pleased to report ARMA has agreed to an amendment and will now be neutral on the bill. This is great news. AzNA anticipates HB2068 passing out of the Health Committee and continuing to progress through the Senate.

 

Other Good News

SB1096; health professionals data; repository; appropriation; has successfully passed through the Senate and just cleared two House committees: Health and Appropriations. It is heading to the House Rules Committee this week. This bill has been trending well with legislators and AzNA anticipates continued success.

 

One Assault Bill Dead; One Moves Forward

HB2503, assault; healthcare practitioner; classification; which increases the penalty for assault on healthcare workers, is likely dead for the 2019 session. The Chair of the Senate Judiciary Committee, Eddie Farnsworth, had expressed his disagreement with the bill during RN Day at the Capitol in January. He has not scheduled it for hearing by the Committee. While the bill sponsor, Rep Shah, and others tried to persuade Rep. Farnsworth to schedule the bill, he would not. After the end of the 2019 legislative session, AzNA will work on new legislation for the 2020 session to address this problem.

 

HB2041, hospital assaults; testing; reporting; sanctions; passed out of the House and has already passed through the Senate Health and Human Services and Rules Committee. It requires reporting of assaults by the institutions. That data will then be studied to determine where there are problems in the system and where additional actions may be necessary. Since this bill has not met much resistance along the way, it has a chance of passing out of the Senate within the next few weeks. If this happens, the next stop is the Governor’s desk.

 

Six Feet Under
Any bill that is still active this session has already passed through either the House or the Senate and is moving through the other chamber. If a bill does not receive a hearing this week in these secondary committees, the bill is likely dead

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Just Keep Swimming

Posted By Debby Wood, Tuesday, March 19, 2019
Updated: Friday, May 10, 2019

March 19, 2019

 

The Death of a Bill is not Uncommon

As the session moves along, AzNA constantly modifies the list of bills we are following. Bills that do not progress are considered dead. They will still appear on our Nurses List of Bills, but will be moved the bottom of the document. During a legislative session it is not uncommon for over 50% of the bills to die.

 

Healthcare Workers Database Bill Moves One Step Closer to Passing

AzNA remains optimistic about SB1096, the healthcare workers database, which passed unanimously out of the House Health and Human Services Committee last week. It moves to the Appropriations Committee this week because the bill has a financial component ($50,000 to fund Arizona Department of Health Services who will administrate the database). Strategy is focused on educating members of the Appropriations Committee about the importance of our bill.

 

And We Wait...

Work continues as AzNA educates legislators about CNSs and the CNS prescribing authority bill, HB2068. The bill is not on this week’s Senate Health and Human Services Committee calendar, however Senator Brophy-McGee (chair) assures AzNA it will be on next week's calendar.

 

Assaults Bills Highlight Important Issue Nurses Deal with Daily

HB2041, hospital assaults; testing; reporting; sanctions; which requires reporting of assaults by the institutions. That data will then be studied to determine where there are problems in the system and where additional actions may be necessary. This bill passed out of the House and has already passed through the Senate Health and Human Services Committee. Since this bill has not met much resistance along the way, it has a chance of passing out of the Senate within the next few weeks. If this happens, the next stop is the Governor’s desk.

HB2503, assault; health care practitioner; classification; which would increase the penalty for assaulting health care workers, is still awaiting a hearing in the Senate Judiciary Committee after passing out of the House.

 

Why Next Week is So Important

Bills that passed through the house of origin are now in the opposite chamber. The week of March 25th is the last week for bills to be heard in the opposite chamber committee. Most committee agendas will be REALLY long! Our lobbyists are prepared for marathon days. If a bill doesn’t get heard in committee it will officially be dead. Bills that pass out of committee still have to go through a few more steps to survive. 

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We Like to Move It, Move It

Posted By Debby Wood, Tuesday, March 5, 2019
Updated: Friday, May 10, 2019

March 5, 2019

 

Our Patience was Tested...and Nurses Have Lots of Patience

Last week was a “wait and watch” week as members of the House and Senate met for hours each day to vote on all bills that made it through the committees. Although it seems straight forward, it is not. Here is why...

 

COW Keeps Bills Moooving

During the Committee of the Whole or COW (whole house or senate), legislators may offer amendments to bills from the floor. Floor amendments are proposed and voted on. If passed, the bill moves to the 'Third Read' Calendar.

 

Third Read's a Charm

Third Read Calendars are the last step for passage of a bill out of that chamber. Legislators make their final vote. A majority vote sends the bill to the opposite chamber. The bill dies without the majority vote.

 

How HB2068, the CNS bill, Rolled Out Last Week:

2/27 COW

A floor amendment was introduced by bill sponsor Representative Nancy Barto then was approved by the House. This moved the bill forward onto the Third Read Calendar.

 

Third Read

On Monday, March 4th, HB2068 got it’s Third Read and a subsequent vote – HB2068 passed out of the House with a 47-10 majority vote.

 

Next Up...

The bill will now be sent to the Senate where it will wait for the Senate President to assign it a committee (probably Health & Human Services). The work starts all over again in the Senate as the entire process repeats in that chamber: First Read, Committee Assignment, Rules, Second Read, Caucus, COW, Third Read, Floor Vote.

 

Then What?

If the bill successfully makes it through the Senate and there are no additional amendments, it will move on to the Governor for signing. If there are Senate amendments, it will need to go back to the House for amendment approval prior to being sent forward for the Governor.

 

Other news...

Vaccinations

The sponsors of the three vaccination bills have not been able to round up the votes needed for passage in the House, so have not yet brought these bills to the floor for a vote. The Governor has also stated that he will veto these bills if they reach his desk. AzNA continues to work to educate legislators on the impact these types of bills would have on community health.

 

Healthcare Worker Assault Bill

HB2503 successfully passed through COW and Third Read on Monday, March 4. This bill increases the penalty for assaulting a healthcare worker. It moves over to the Senate and will likely be assigned to the Judiciary Committee.

 

A special thank you to the over 350 nurses who filled out AzNA's Assault Survey! Your stories provide lasting support for the necessary changes needed to protect our nurses and other healthcare workers as they seek to provide proper patient care.

 

RIP

Many bills which are on the AzNA list for tracking did not receive a hearing in their chamber of origin and are dead. In order to facilitate easier understanding of which bills are still moving, AzNA will use the next few weeks to segregate the list, separating dead bills from bills that are still active this session. 

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