• SB1311 the healthcare workers assault bill, was passed by the legislature and at this writing is on the Governor’s desk for signature into law.

• The OR smoke bill, HB2434, was passed by the legislature and signed into law by the Governor.

• AzNA’s coalition healthcare workforce bill, HR2691, cleared the full House and through the Senate committees. It is being held for budget negotiations which are currently beginning in force at the legislature. (This is all good news, and your AzNA policy team is hard at work ensuring strong funding for Arizona’s nursing and healthcare workforce pipeline.)

• HB2098, establishing that psychiatric and mental health nurse practitioners may perform psychiatric assessments in pediatric patients, in addition to psychiatrists and physicians, was signed into law by the Governor.

• SB1234, continuation of the Arizona Board of Nursing, was signed into law with a 4-year continuation.

• SB1640, which defines the minimum age for CNAs as 16 years old, was signed into law, opening up the possibility for more CNA training programs in Arizona’s high schools.

• SB1654, which establishes the requirement to have seizure management plans in schools, passed through the full Senate and House, and is on its way back to the Senate for a final read and then to the Governor to be signed into law. Importantly, this bill includes registered nurse practitioners as authorized providers to establish seizure management plans and protects school nurses from civil liability related to seizure management plans.

• SB1637, which ensures the right of health professionals to practice the profession for which they are licensed in any form of business entity or employee-ship, passed the full Senate and House. It is headed back to the Senate for a final read and then on to the Governor to be signed into law.

• HB2429, which ensures confidentiality for healthcare professionals, including nurses, who engage in a wellness program for health professionals including substance abuse programs, has passed the full House and Senate. It is headed back to the House for a final read and then on to the Governor to be signed into law. This is a bill that was originally targeted to physicians. Your AzNA advocacy team collaborated with our physician colleagues to ensure that nurses will also have confidentiality protections that allow us to seek the care we need in order to care for our patients and communities.

• SB1568, which establishes a clear set of expectations and timelines for health profession regulatory board investigations, has passed the full Senate, House committees, and is currently being amended for an expected hearing on the House floor. This bill seeks to avoid protracted periods for licensing board investigations of complaints against healthcare professionals including nurses. Your AzNA policy team has been working in close collaboration with our fellow healthcare profession colleagues to ensure that Arizona’s healthcare professionals have fair and just treatment in the case of a formal complaint investigation, and that Arizona’s health profession regulatory boards can operate with clarity about investigation expectations. This bill, when signed into law, will be a win-win for Arizona’s healthcare workforce and the public we serve.

• AzNA’s Public Policy Agenda
• Find Your Legislators Here

• SB1311 and HB2635, the mirror assault bills, both successfully passed out of their respective originating chambers. At this point, we are awaiting one of the bills to be scheduled for a Health and Human Services committee hearing in the crossover chamber order to advance the bill toward passage. We anticipate a substantial update on these bills next week.

• AzNA’s coalition healthcare workforce bill, HR2691, awaits a hearing in the Senate Appropriations committee.

• The OR smoke bill, HB2434, passed out of the Senate Health and Human Services committee this week. Next step is Senate Rules committee, then on to the full Senate.

• SB1234, continuation of the Arizona Board of Nursing, was heard by the House Health and Human Services committee with significant testimony from AzNA’s own Kathy Busby. There was discussion about a floor amendment to shorten the continuation from eight years to a shorter timeframe based on concerns expressed by legislators. The bill passed out of Health and Human Services and is on the House Rules agenda for Monday, March 14.

• SB1640, which defines the minimum age for CNAs as 16 years old, passed the House Health and Human Services committee and awaits House Rules.

• SB1210, which proposes to update transportation requirements for people experiencing a mental health crisis, is on the calendar for third read (full Senate passage) on Monday, March 14. There is also a stakeholder meeting scheduled for this bill in the coming week. Kathy Busby will be attending to represent AzNA, at the organizer’s request.

• HB2161, which would give parents the right to access all healthcare records for a minor child, unless prohibited by law enforcement or the courts. The bill states that any employee of an institution may not withhold any information that is relevant to the physical, emotional, or mental health of the child, upon penalty of disciplinary action against the individual and/or legal action against a governmental entity or official (including public and charter schools) by parents. The bill’s language includes parental rights to access written and electronic records of a school district or school district employee. AzNA’s government affairs team has been asked to review language, and we are communicating with the bill’s sponsor as there are potentially troubling implications for school nurses in the bill’s language.

• AzNA’s Public Policy Agenda
• RTS Manual

Hello Arizona Nurses!

Our AzNA policy team had another busy week at the legislature with exciting hearings and lots of behind the scenes work to improve bills in process. Thanks to Christine Creen, Nichole Kuhns, Pat VanMaanen, Clay Mering, Dawna Cato, Leighanna Lawson, Jane Nakazato, Denise Link, Amber Porter, Selina Bliss, Georgina Rotzler, Hannah Challa, Sara Hererra, Jason Warren, Patricia Timmons, Jackie Martin, Rosemary Bolza, Rebecca Stoops, and Erin Luedtke for reviewing bills in the past week.

If you’re interested in getting involved, please email Dawna Cato at dawna@aznurse.org.

Recapping Week 4:

• AzNA supported HB2083 which will provide funding for diabetes outpatient self-management training prescribed by primary care practitioners. This bill passed out of the House Health & Human Services committee on 1/31 and the House Appropriations Committee on 2/2. Next up is the House Rules Committee before a full House vote and then on to the Senate.

• AzNA supported HB2227 which will provide a financial incentive to conduct 6-week postpartum visits for AHCCCS enrollees. This bill passed out of the House Health & Human Services committee on 1/31. Next up will be hearings in House Appropriations and House Rules, which have not been scheduled yet.

• One of AzNA’s flagship bills for this session, HB2434, passed unanimously out of the House Health & Human Services committee last week on 1/31. This bill would require smoke evacuation systems or devices to be used in all operating rooms to decrease the risk of exposure to staff. Kudos to Dan Wade, RN for providing compelling testimony to improve the safety of OR nurses and all OR workers.

Looking Ahead to a Busy Week 5:

• This week is already off to a great start with HB2434, AzNA’s smoke evacuation bill, passing unanimously out of the House Rules Committee on 2/7. Next stop is the Committee of the Whole before a full House floor vote and then on to the Senate.

• AzNA is monitoring several bills being heard in the Senate Health and Human Services committee this week on 2/9, and will sign in on several including:
• SB1052, which would disallow any government entity or business in Arizona from requiring any medical procedure including vaccines that have a potential implication that could cause death. AzNA is opposed to this bill, as it would essentially outlaw the ability to mandate any medical procedure as every procedure has the potential to cause bad outcomes that could lead to death. This bill would effectively disallow any school to require vaccinations, and would pose a direct threat to public health and safety.
• SB1514, which would mandate that a patient can have two visitors of their choice with them at all times in a healthcare facility, excluding surgical theatres. AzNA is opposed to this bill, as it may impede providers’ ability to provide safe and effective care in some situations, including in cases of suspected abuse, infectious disease emergency, or critical trauma.
• SB1639, which would require medical records integration for better tracking of controlled substances prescriptions. AzNA is supporting this bill, as it will improve safe access to care by providing an enhanced safeguard against abuse or unintentional overprescribing of controlled substances.
• SB1640, which clarifies that certified nursing assistants must be at least 16 years old. AzNA is supporting this bill, as it provides clarifying language that has the potential to open high-school based CNA programs to build the certified nursing assistant workforce, enhancing patient access to care.

What can you do this week to support AzNA’s public policy agenda?

Register for Healthcare Day at the Capitol next week on 1/16 and catch the Legislative Session Bill Report Zoom session on 2/8 (or the recording if you miss it live).

Don’t forget to practice armchair advocacy with just a few clicks of your mouse by using the Arizona Legislature’s RTS system. (Remember that although RTS stands for “Request to Speak” it doesn’t actually involve speaking!) We encourage you to sign in today and register your support or opposition of the bills that will be heard on 2/9.

• AzNA’s public policy agenda
• RTS manual here:
• Note that you must activate your RTS account at a designated kiosk in the state capitol (or in downtown Tucson at 400 W. Congress St.) before you use it the first time. If you need help with that, please email dawna@aznurse.org and we can assist

Stay tuned for more updates from the policy pulse in the coming weeks. Next week will be a big one with our other flagship bills addressing workplace assault and nursing workforce expected to be heard in committees. We’ll need the full force of our nursing community to weigh in to support these bills on their journey to improving nursing and healthcare for all Arizonans.

Heather Ross, DNP, PhD

AzNA Government Affairs Officer

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.

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.

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.

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.

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

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. 

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.

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

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. 

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. 

Last week was the last chance for bills to be heard in their house of origin; if a bill was not heard by a committee by the end of the week it is now considered dead - meaning there is no chance of being passed in its current form this session. Some topics of dead bills may still crop up in a "strike everything" bill. Fortunately, the primary bills AzNA has been pushing passed successfully out of committee at some point in the last few weeks.

You can read summaries of these bills and check where they are in the legislative process by visiting the AzNA Nurses List of Bills.

SB2068 (CNS prescribing) is awaiting final vote in the House before moving to the Senate;

SB1096 (Healthcare workforce database) has passed out of the Senate and is awaiting committee hearing in the House;

SB1134 (Kid's Care) has passed one committee but needs to be advanced by the Appropriations Committee. However, this may become part of budget negotiations;

HB2503 (Assault on health care workers) passed unanimously last week from the House Judiciary Committee and has momentum behind it.

Big Leaps Forward for the Assault Bill

Thank you to our nurses who provided testimony before the Judiciary Committee about their experiences being assaulted on the job. Not only has HB2503 advanced, but more attention to this issue has been generated. Watch our nurses testify during the hearing for 2503. Another bill, HB2041, which will require reporting of these incidents, passed successfully out of House Health and Human Services Committee this week.

Thank you to all of our nurses who took the AzNA Health Care Worker Assault Survey (Deadline March 1). Your answers will help educate legislators on the scope of work that needs to be done in this arena so that these bills can continue to move forward through the legislative process.

Immunization Issues

On another note, three bills (HB 2470, 2471 and 2472) which would expand exemptions to vaccinations and impose more hurdles and requirements on providing vaccinations, passed by a 5-4 vote out of House Health and Human Services after nearly 4 hours of testimony and discussion. AzNA is very concerned with these bills. You should already have received an email asking you to contact legislators to educate them on the dangers of lowering vaccination rates.

The Mid-February Shift

The legislative session is proceeding in its usual hectic manner at this time of year. This week is the last week to hear bills in the chamber in which they originated. Meeting agendas are very long.

So That's It? No New Bills?

New bills can no longer be created or introduced without special permission from leadership. However, existing bills can be used as 'strikers' - a bill which crosses out, or 'strikes', all of it's original text and substitutes completely new text. Amendments to existing bills can also be filed. These amendments do not necessary have to relate to the original text of the bill.

This dance to use existing bills to effectively introduce new legislation that missed the new bill deadline keeps AzNA's team on their toes.

What's up with the CNS and Workforce Bills?

HB2068, providing limited prescriptive authority to CNSs, is expected to be voted on by the House of Representatives as a whole in the coming days. AzNA met with several legislators who had expressed concerns. They were satisfied with the amendments AzNA made and are not expected to oppose the bill.

SB1096, providing funding for the health professionals workforce database, passed unanimously out of the Senate and is now waiting to be heard in the House in a few weeks.

Great News! How About Healthcare Practitioner Assault?

The assault on health care workers bill will be heard in the House Judiciary committee this week. HB2503 increases the criminal classification of aggravated assault committed on a health care practitioner while engaged in the practitioner's duties to a class 5 (second lowest) felony, from a class 6 (lowest) felony. AzNA will have ER Nurses who have been assaulted testify during the committee meeting regarding their experiences in the emergency room.

Get to Work!

We encourage you to contact your legislators and sign in in support of these bills.

Slow and Steady Progress

Three of our bills of importance have moved another step forward. Here's a refresher on what happened last week.

CNS

HB2068, allowing clinical nurse specialists (CNS) limited prescribing, passed the House Rules Committee on Monday and AzNA expects it to be voted on from the floor of the House this week.

Workforce Database

SB1096, the health care workers database, has passed through the Senate with a unanimous floor vote. Thank you to all our nurses who took time to email a letter of support to their Senators. The bill is now on its way to the House of Representatives and will repeat the approval process.

KidsCare

SB1134 which will remove the automatic freeze on Kid's Care enrollment when federal funds decrease and appropriate money for that purpose, passed out of the Senate Health and Human Services Committee by a 7-1 vote this week. AzNA is encouraged by the vote but expects there to be challenges ahead.

Get to Work!

We encourage you to contact your legislators and sign in in support of these bills.

Is That Ice-T?

Last week was very successful for AzNA!

What Happened?

We had a well attended & enthusiastic RN Day at the Capitol and made progress on two of our primary bills; SB1096 appropriating funding for the Healthcare Workers Workforce Database passed unanimously out of Senate Health & Human Services Committee and HB2068, giving Clinical Nurse Specialists prescriptive authority, passed unanimously out of House Health and Human Services Committee (despite opposition from a few doctor-related associations!).

Tell Me More About the CNS Bill

January 31st, HB2068 clinical nurse specialists; prescribing authority; was heard in the House Committee of Health and Human Services. You can watch the hearing on Capitol TV, The hearing is about 60 minutes long and worth watching.

During testimony, Kathy Busby, AzNA Lobbyist. Denise Gibson, RN, CNS, AzNA Governmental Affairs Director, and Heather Ross, RN, NP provided stellar support for the bill. The lobbyist for the doctors and osteopaths spoke against the bill, however this testimony did not deter all 9 of the legislators on the committee from all voting yes.

We will continue to work with the doctors to bring them to a level of comfort with their concerns.

Great News! What's Next for the CNS bill?

The bill will move to the next House committee (Rules), then to full house for approval. (Confused on how this all works? This is a great time to review how a bill becomes a law in Arizona.) We are optimistic that the bill will keep moving and may ask your assistance in contacting your legislators again for the full house vote, and then again when it moves onto the senate.

Everyone Loves a Strong Database

Last week, SB1096 health professionals data; repository; appropriation; passed unanimously out of the Senate Higher Education and Workforce Committee and is now on it's way to the Senate Rules Committee. SB1096 appropriates $50,000 to the Department of Health Services (DHS) to establish and maintain the Health Care Professionals Workforce Data Repository.

Why Is This Important?

Arizona lacks a comprehensive system to project the future of the nursing shortage. Proper data collection assures a strong and sustainable supply. Last year, AzNA was integral in the passing of 2018's HB2197 health professionals; workforce data; which laid the groundwork for this database.

Where Is the Workforce Bill at Now?

The next step is a vote by all Senators as early as this week! Each of the 30 Senators will vote and passage requires a majority.

Get to Work!

We encourage you to contact your legislators and sign in in support of these bills.

Last week committee hearings began in earnest while still juggling the governor's focus on water legislation.

KidsCare Progress

KidsWhat?

While none of the bills that AzNA is pursuing were heard last week, progress was made to protect KidsCare, Arizona’s Children’s Health Insurance Program (CHIP), which provides high quality health coverage to children in working families who earn too much to qualify for Medicaid/AHCCCS but struggle to afford private health insurance.

Bills Here, Bills There, Bills Everywhere

HB2513 and SB1134 were filed by Republican sponsors. It is not uncommon for the same bill to be introduced as both a Senate and a House Bill. HB2350 was filed by a Democratic sponsor. Democrats are also passionate about KidsCare and it's not unusual to have several bills on a similar topic.

The More the Merrier

These three bills bode well for the passing of laws that ensure the continuation of the program and aligns with AzNA's mission to promote a healthy Arizona.

AzNA at Work for Nurses

Advancing the Nursing Profession

This week, two of the bills AzNA is pursuing for the 2019 legislative session will be heard in committees:

Say it with us...

...Allow CNSs to practice to the full extent of their education and training.

HB2068 clinical nurse specialists; prescribing authority; provides limited prescriptive authority to CNSs. AzNA supports legislation that allows all APRN groups to practice to the full extent of their education and training. This bill will be heard Thursday in House Health & Human Services.

A Little Money Goes a Long Way

SB1096 health professionals data; repository; appropriation; would appropriate the sum of $50,000 to the Department of Health Services (DHS) to establish and maintain the Health Care Professionals Workforce Data Repository. Arizona lacks a comprehensive system to project the future of the nursing shortage. Proper data collection assures a strong and sustainable supply. Last year, AzNA was integral in the passing of 2018's HB2197 health professionals; workforce data; which laid the groundwork for this database. This year's bill works to solve funding needed to implement the 2018 bill and will be heard in Senate Higher Education & Workforce Development.

Get to Work!

We encourage you to contact your legislators and sign in in support of these bills.

Continued Work for Opioids

AzNA tracks bills based on our Public Policy Agenda. This agenda focuses on the health of all Arizonans and the professional practice and work environment of our Arizona nurses.

January 22, 2019

The first week of the first session of the 54th Arizona Legislature began this past week with the Governor outlining his priorities in the State of the State address and ending when he released his budget on Friday.

What's Up with Water?

Legislators are dealing with the Governor's draft legislation to handle the the water issue: in order to avoid the federal government stepping in and determining how Lake Mead water would be allocated when the level drops, Arizona has to formulate and pass a plan by January 31 - joining the already existing plans from California and Nevada. Due to this looming deadline, much of the legislature's time will be spent on negotiating and finalizing that legislation. Raise your glass of H2O!

Water is Vital in the Desert, but it Doesn't Dry Up Regular Business

During the first week of the session there were over 500 bills filed! These bills are now being assigned to committees, committees are beginning to hear them, and AzNA is closely tracking bills affecting nurses, nursing, healthcare, and the health of Arizonans. This is a great time get familiar with how a bill becomes a law in Arizona. It's not a simple as what you may have learned back in 4th grade.

What Else Should Nurses Know?

AzNA's staff, volunteers, and lobbyists are hard at work tracking any bills affecting nurses, nursing, healthcare, and the health of Arizonans. These bills are available in the Nurses List of Bills on the AzNA website. Each week, the Policy Pulse email you are currently reading will include updates to help summarize some key bills moving through the legislature. It is also helpful for you to access the Nurses List of Bills weekly to track any bills that you are passionate about.

AzNA tracks bills based on our Public Policy Agenda. This agenda focuses on the health of all Arizonans and the professional practice and work environment of our Arizona nurses.

January 15, 2019

Welcome to the 2019-Fifty-fourth Legislature - First Regular Session!

This week marks the beginning of the 2019 Arizona Legislative Session. While there is a lot of work that goes on at the State Capitol even before lawmakers gavel in, this week they and their staff finally settle in and hit the ground running. New lawmakers are moving into the Capitol, breathing a sigh of relief at what many feel is the official end to the long campaigning for the position and the official start of representing their constituents.

Leadership Updates

In the House, newly elected House Speaker Rusty Bowers, R-Mesa, will be heading up a chamber with a slim Republican lead of 31-29 after Democrats pick up four seats in the November 2018 election. This 31 member lead is significant because it takes 31 votes for final approval of any measure.

In the Senate, Karen Fann, R-Prescott, is the 2nd woman to be voted President of the Senate. She, along with Majority Leader Sen. Rick Grey, R-Sun City, and Majority Whip Sen. Sonny Borrelli, R-Lake Havasu City, will be heading up an Arizona Senate with a 17-13 Republican majority.

Gov. Ducey Kicks Off the Session

Governor Doug Ducey launched the 2019 Session on Monday, Jan. 14 with the first State of the State address of his second term in office. During his 39 minute speech, the Governor focused on common themes to his first term: responsible spending, reduced regulations and a commitment to education.

What's Going on That Impacts Nurses and Public Health?

AzNA's staff, volunteers, and lobbyists are hard at work tracking any bills affecting nurses, nursing, healthcare, and the health of Arizonans. These bills are available in the Nurses List of Bills on the AzNA website. Each week, the Policy Pulse email you are currently reading will include updates to help summarize some key bills moving through the legislature. It is also helpful for you to access the Nurses List of Bills weekly to track any bills that you are passionate about.

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

AzNA tracks bills based on our Public Policy Agenda. This agenda focuses on the health of all Arizonans and the professional practice and work environment of our Arizona nurses.

May 7, 2018-

It's finally over!

The Arizona Legislature adjourned the regular session for this year - sine die - at 12:26 AM on May 4.

In total, the 2018 Legislative Session lasted 116 days.

- 1206 Bills were introduced, 122 memorials and resolutions

- As of Friday, May 4, 369 bills had received final passage, of which 285 have been signed into law

- 16 bills were vetoed by Governor Ducey

- The Governor has until May 16th to take action on any remaining bills. Any he does not act upon will automatically become law.

- August 3 is the effective date for all non-emergency measures.

- Bills containing an emergency clause take effect immediately upon signature by the Governor.

As you are likely aware, most of the energy and discussion in the final days of sessions surrounded education. In order to pass the budget and vote on any remaining bills, the last several days were long and exhausting lasting until after midnight!

A Loss for Kid's Care

Unfortunately, the approved budget didn't include language to "fix" Kid's Care. Enrollment will not be automatically frozen if and when the federal government reduces the funding, even if by a very small percentage. This "fix" must be done next session if it is to make an impact. At this time, the federal budget includes a reduction in funding beginning October 1, 2019. AzNA will be part of this conversation and we will have our work cut out for us next session.

A Win for the Projected Nursing Shortage and the Healthcare Workforce Database

On a positive note, HB2197 Health professionals; workforce data, the bill that AzNA worked so hard on, passed unanimously. It has been forwarded to the Governor where we anticipate it will be signed. AzNA is very pleased that this bill passed unanimously out of every committee and as well as all votes by the legislature. This is an important milestone as it is the first step in addressing the supply and demand of nurses as Arizona enters the projected nursing shortage of 28,000 by 2025.

A Thank You for 2018

Thank you for being a dedicated reader and Nurse Advocate. AzNA looks forward to an exciting 2019 Legislative Session when we plan to introduce a bill which allows Clinical Nurse Specialists (CNS) to join other Arizona APRNs and practice to the full extent of their education and training.

Vote in Your Primary Elections

What should you do until 2019? One in every 54 eligible voters in Arizona is a Registered Nurse. Make sure you are registered to vote! Remember, 25 out of the 30 Arizona Legislative Districts are decided in the primary elections. The AzNA Political Action Committee (PAC) is in the process of vetting all candidates running for local legislative seats. They will be publishing a list of candidates that are "friends of nursing". Keep up to date.

Money Talks

With the veto of bills by the Governor to spur the legislators to pass a budget and with the looming, and then realized, walk out by educators, the budget was the center of discussion last week. There was some procedural movement on few bills such as the school safety bill, SB1519 protective orders; schools; appropriations, but no bills were sent to the Governor.

Okay. What's Next?

The concentration on the budget will continue this week. The legislative leadership and the Governor announced Friday that they had a "deal" on the education budget but it has not been put in the form of legislation. If there is a deal, and assuming they can/have worked out the remaining items of the budget, they can then pass a budget and move on to finish the remaining bills.

This includes HB2197 Health professionals; workforce data, the workforce database bill.

Drama Fit for HBO

Last week the legislature was absorbed in budget negotiations, with education funding being the major topic of consideration. The week ended with Gov. Doug Ducey vetoing 10 Arizona House bills in an attempt to force the legislature to finish the budget with his teacher pay raise included.

Part of the budget discussion includes the fate of the Kids Care bill which would provide flexibility to the legislature and not a hard and fast freeze if the federal contribution rate drops.

Hooray for AzNA

In addition, the Senate held a committee hearing for SB1519, which provides a process to temporarily remove guns from individuals who are believed to be dangerous. The evaluations for that process did not include psychiatric nurse practitioners but AzNA successfully added them to the bill. The bill is very controversial and it’s future is not certain.

Because it was foreseen that there may be tough budget talks, and the governor may veto some bills to send a message, HB2197 Health professionals; workforce data, the workforce development bill, was held in the Senate to avoid becoming a casualty of political collateral damage.

Pop the Bubbly

Budget, Budget, Budget

As the 53rd Legislature, 2nd Regular Session begins to wind down, the budget is the prime topic of discussion. Non-budget bills are moving slowly through the process until the budget is passed (hopefully sometime this week).

The Governor's school safety proposal to increase funds for on-campus police officers, introduced on March 19th, is still being discussed. We are unsure at this time whether it will be taken up in the regular session or warrant a special session like the opioid bill. One thing that we can be sure of; there will be a strong debate by both sides.

Dead, but Now Alive!

HB2127 children’s health insurance program died after it passed out of the house because it was never heard in a senate committee. This was an AzNA supported bill and we have not yet given up hope! The language in 2127 has been re-purposed and now appears in the striker SB1087 Notice of program suspension or termination: spending limit. This would add flexibility in the legislature to continue to fund Kid's Care when federal funding decreases and is being held up in the ongoing budget discussions.

Tag…You’re It!

These bills originated in the house, passed the house, then the senate, but need to go back to the house for final approval due to a senate amendment.

HB2323 schools: inhalers; contracted nurses adds nurses who are contracted (and not just employed) to the list of professionals who can administer inhalers at schools. If approved, it will head to the Governor’s office to be signed.

HB2549 controlled substances; dosage limit adds NPs with advanced pain certification as eligible to serve as medical directors of pain clinics. If approved, it will head to the Governor’s office to be signed.

Signed Into Law by Governor

HB2085 schools; emergency epinephrine administration adds NPs as prescribers of epinephrine to the statute allowing its administration at schools.

With the end of regular committee hearings, the Legislature is pushing through the bills that made it to the floor for a vote. Striker amendments appear regularly as legislators attempt to revive bills that would otherwise be dead this session.

In the midst of legislators trying to seal the deal on bills, there are also many negotiations and much maneuvering by legislators to keep their favored bills alive and moving forward or to stop those they oppose. Additionally, budget negotiations are ramping up. Bills that are unrelated to the budget are used as part of this negotiation process, being applied as leverage while trying to get the bill’s sponsoring legislator on board with items in the budget. It keeps everyone on their toes.

We are lucky to have two lobbyists working for AZNA to watch over nursing during this precarious time at the legislature.

Bills of Interest This Week

Last week was the final week to hear bills in committees at the Arizona Legislature. All bills must now have been heard in committees in both houses or they are dead for this legislative session - unless they become a striker. There are a few bills of interest that are already strikers. We are in the process of identifying them and will report them out next week in both the Nurses List and the Policy Pulse.

Along the same path of our APRN Full Practice Authority bill of 2017, a state Senate committee gave new hope to a proposal to license dental therapists in Arizona.

SB1470 sunrise process; health professionals; modifications, the sunrise process revision bill that AzNA was instrumental in negotiating a compromise among the stakeholders, passed unanimously in the House Government Committee. It is expected to have smooth sailing moving forward. The newly negotiated language will now be added to SB1034 as an amendment.

AzNA tracks bills based on our Public Policy Agenda. This agenda focuses on the health of all Arizonans and the professional practice and work environment of our Arizona nurses.

March 19, 2018-

The legislative session continues to roll along. Last week:

This week there was a flurry of activity around SB1470 sunrise process; health professionals; modifications which proposed substantial changes to the sunrise process - the process used to increase scope of practice as well as license new professional groups.

Various health professional groups were divided on this contentious bill. AzNA provided the voice of reason and testified at the committee hearing on our Neutral position. As a result, we were asked to draft a strike everything amendment. Stakeholders on all sides hoped our neutral position would provide common ground during the ensuing process, which it did.

After several drafts and meetings, an agreement has been reached. Because the original SB1470 language already passed out of the Senate, the House will now assign the amendment to a new bill number, rendering SB1470 dead. We will let you know the new number of the strike everything bill as soon as it is assigned.

HB2197 health professionals; workforce data advanced further in the Senate, sailing through two committees with unanimous votes in both. It will now proceed for final votes on the Senate floor. Once it passes the senate floor vote it heads to the governor’s desk to be signed into law.

Are you wondering why this bill keeps getting passed unanimously? Apparently, we are not the only ones concerned about the future supply of our healthcare workers! A 2016 local study identified a shortfall of physicians and nurses while also identifying important healthcare delivery trends emerging in AZ. It also helps that this bill has no financial commitment attached to it

AzNA tracks bills based on our Public Policy Agenda. This agenda focuses on the health of all Arizonans and the professional practice and work environment of our Arizona nurses.

March 12, 2018-

Last week was another busy week at the Capitol. Closed door meetings on the budget began and it looks as if, thanks to 11-year-old Jax Weldon, Arizona is on it's way to having an Official State Dinosaur.

An updated AzNA Nurses List (a list of bills AzNA is watching this session) can be found on the AzNA website. We have adjusted the list layout for ease of use - bills still alive and moving on top, bills that didn’t make it and are labeled “dead” on the bottom.

Bill of Interest This Week

SB1470 sunrise process; health professionals; modifications passed out of the Senate and continues its journey through the Arizona House of Representatives. This bill started as a somewhat benign effort to make a few revisions to the sunrise process but, while the bill was being heard in the Senate, a very extensive amendment that makes many changes to the process was added. AzNA supports some of these changes as we recognize that this process needs to be revised. However, there are a number of other provisions that are problematic, in particular because of their lack of clarity.

Most recently, the bill was heard in House Government Committee on March 8th in a 2 hour long contentious hearing. It passed narrowly out of the Committee with 4 yes, 3 no and 1 abstention, making it pretty clear that unless healthcare stakeholders meet and agree on some of the contentious areas, this bill may not pass a floor vote. A stakeholder meeting will happen this week.

Position: Neutral

AzNA, fearing unintended consequences from the aforementioned provisions, has adopted a neutral position and asked for a stakeholder process in which the problematic areas can hopefully be revised or deleted. It is possible that we might move to a SUPPORT position if the stakeholder meeting yields improved language for the areas of concern.

HB2197 health professionals; workforce data This bill continues to pass unanimously through every committee hearing. This week it will be heard in Senate Commerce and Public Safety. AzNA members and lobbyists have been meeting with members of this committee to explain the intent of this bill. We are hoping for another unanimous committee vote, but we don’t want to be greedy and will settle for a majority vote.

AzNA Position: Support

AzNA has been the primary driver behind this bill because Arizona lacks a comprehensive system to project the future of our nursing workforce. Proper data collection assures a strong and sustainable supply. Be on the lookout for a Call to Action/Letter writing campaign through our Phone2Action advocacy tool. If you haven't registered to receive text alerts, take a minute today!

March 6, 2018-

Some of you may have heard about SB1470 sunrise process; health professionals; modifications which makes substantial changes to the sunrise process. These changes are sweeping in their scope. While AzNA supports revisions to the sunrise process, in particular the criteria for review, presumptions and timing, we have several concerns:

• Some of the provisions lack clarity and may be interpreted to have unintended and unwanted consequences;
• This does not eliminate the sunrise process but compresses it into the regular legislative session which may make it more burdensome on applicants;
• One of the provisions may impact the Nursing Compact and potentially put Arizona out of compliance with the Compact.

AzNA Position: Monitor

AzNA will to work with all stakeholders in nursing, the legislature and the community to see if the concerns with the bill can be resolved.

AzNA tracks bills based on our Public Policy Agenda. This agenda focuses on the health of all Arizonans and the professional practice and work environment of our Arizona nurses.

March 5, 2018-

The Arizona House and Senate chambers held their first week of committee hearings on bills that had passed out of the other chamber. Calendars were light as time was spent in long meetings moving bills through the legislative process: voting out bills that had originated in each of the respective chambers, "first reading" in the receiving chamber, and assigning received bills to committees.

Last week was the second phase of our RN Advocacy Day plan. Over several days, nurses met with legislators from their home districts. The meetings were very productive and new relationships were established.

We are moving forward with our 'AzNA 90' Goal, “A Nurse Assigned to Each Legislator”, and you can take the 1st step by meeting with your legislator(s).

It’s easy to establish a relationship with your legislator by calling their office and scheduling an appointment. We make your message easy: give them a copy of our Public Policy Agenda which addresses all of the important messages related to our profession and patient safety. The AzNA staff is available to update you on bill progress or coach you on messaging.

Bill of Interest This Week

HB2197 health professionals; workforce data passed unanimously out of the House, however has now been assigned to two committees in the Senate: the Health & Human Services Committee ("Health") and the Commerce and Public Safety Committee ("Commerce"). This presents a problem as there are only 4 weeks for bills to be heard in committee of which one week has already passed and it may be difficult to persuade some Commerce Committee member of the merits of the bill. If the bill does not pass out of both committees, it will die before being heard by the Senate as a whole.

AzNA Position: Support

We will be spending a lot of energy in the next week to push this bill along. It is scheduled to be heard Wednesday in the Health Committee. Be on the lookout for a Call to Action/Letter writing campaign through our Phone2Action advocacy tool. If you haven't registered to receive text alerts, take a minute today!

Another long week as the Arizona House and Senate worked through lengthy floor calendars, voting bills out and over to the other chamber. This week, committee hearings will resume with the House hearing bills that the Senate passed and the Senate hearing bills that the House passed. Fortunately, AzNA anticipates most of the bills we have been closely following and supporting will proceed forward in the legislative process.

Bills of Interest This Week

HB2197 health professionals; workforce data provides for the implementation of a workforce database. AzNA has been the primary driver behind this bill because Arizona lacks a comprehensive system to project the future of our nursing workforce. Proper data collection assures a strong and sustainable supply. It passed out of the House unanimously and we expect it to be heard in the Senate Health and Human Services Committee in the next few weeks.

AzNA Position: Support

HB2549 controlled substances; dosage limit, which allows NPs with advanced pain certification to serve as medical directors of pain clinics, passed out to the House unanimously. We anticipate it being heard in the Senate Health and Human Services Committee in the next few weeks.

AzNA Position: Support

AzNA tracks bills based on our Public Policy Agenda. This agenda focuses on the health of all Arizonans and the professional practice and work environment of our Arizona nurses.

February 19, 2018-

This past week was a very busy and exhausting one.

It was the last week for bills to be heard by a committee in the chamber (House or Senate) in which they originated - if they didn't receive a hearing they are likely dead. Because of this deadline, the committees had very lengthy agendas and multiple controversial bills to hear. Many committee hearings lasted 5 hours or more. AzNA was present for all of the committee hearings impacting bills we are following, both for protection of AZ nurses and the health of our Arizona communities.

This week will be just as busy. Both chambers will hold lengthy floor sessions to vote on the bills that passed through a committee. Bills that pass during this floor session are sent forward to the other chamber, while bills that do not pass are dead for this year's legislative session.

Bills of Interest This Week

Below are a few follow up bills ("trailers") to the large opioid bill that was passed in special session in January. These bills clarify some of the sections in the opioid statute.

HB2548 health professionals; continuing education; opioids passed unanimously through House Health Committee and it clarifies that all health professionals who are authorized to prescribe schedule II controlled substances must complete three hours of opioid related, substance use related or addiction related education each during each license renewal cycle. This includes NPs and CNMs. We anticipate the Board of Nursing providing more guidance on this process if the bill is passed and signed into law.

AzNA Position: AzNA is closely monitoring this bill.

HB2549 controlled substances; dosage limit passed unanimously through House Health Committee and adds two items to the opioid bill that require certain medical practices with large opioid prescribing to be licensed as pain clinics. The addition to the bill allows 60 days for medical practices that meet the requirement to file for a clinic license. Pain clinics are required to have a medical director and the amendment to this bill allowed NPs with advanced pain certification to act as a medical director.

AzNA Position: Support

HB2633 pharmacists; controlled substances passed unanimously through House Health Committee and clarifies that it is not a pharmacist's responsibility to verify that a prescription written for greater than 90 morphine equivalent milligrams complies with the requirement that a board certified pain specialist had evaluated the patient. It is up to the prescriber to follow the law and not the pharmacist to police.

AzNA Position: Support

AzNA tracks bills based on our Public Policy Agenda. This agenda focuses on the health of all Arizonans and the professional practice and work environment of our Arizona nurses.

February 12, 2018-

The Legislative session is moving full throttle with lengthy committee hearings as next week is the last week for bills to be heard by a committee in the house in which they were introduced (their house of origin). If they don't receive a hearing and pass out of the committee, generally they are "Dead", though on occasion are revived, which we will review in the future.

One theme this session has been a push to reduce occupational licensing requirements, including the outright elimination of licensing boards. We are closely monitoring those bills and two (1184 and 1470) are included in this week's highlights.

S1184 state compact; temporary professional licenses would require that someone who is licensed in another state receive, within 30 days of application, a temporary license to work in Arizona for 18 months with some safeguards such as background checks. AzNA testified of our concern that this could interfere with the Arizona Nursing Licensure Compact that so many nurses enjoy in Arizona. While the bill passed unanimously out of the Senate Commerce Committee, the testimony of AzNA along with the input of other groups resulted in the sponsor agreeing to an amendment that will set up the structure of the temporary license process but will only apply to professions that will be added later after input by those professions. Thus we will work to make sure the Nursing Compact is not adversely impacted.

Progress: Made it out of the Senate Commerce Committee, must pass through the Senate Rules Committee in order for it to reach the Senate floor. As of this update, the SB 1184 is not on the agenda to be heard in the rules committee.

AzNA Position: Monitor.

S1470 sunrise process; health professionals; modifications would make a number of changes to the sunrise process which allows for the expansion of scopes of practice and the creation of new licensed professional groups (see 1377 below). NOTE: AzNA used the sunrise process for our CRNA legislation. This bill would essentially eliminate the current process and put it all in the regular legislative session with new standards on how these bills are to be reviewed.

Progress: Passed out of Senate Government Committee last week. On the agenda this week for Senate Rules Committee.

AzNA Position: Monitor for now. Still collecting information and input from our members.

S1377 dental therapy; licensure; regulation would allow the licensing of dental therapists, a new type of dental provider who would be supervised by a dentist but could perform basic dental treatments. This bill has faced fierce opposition from dentists and last year did not make it out of the Sunrise process. However, this year successfully made it through that process and has now passed narrowly out of Senate Health & Human Services Committee. The fight continues.

AzNA Position: We continue to monitor this bill. When a new professional role is introduced into the legislature, it often takes years to educate and build support. It is not unlike the experience we have had on our journey for full practice authority for our APRN’s

After the flurry of the previous week and the fast passage of the opioid legislation, the Arizona Legislature returned to its regular business last week. However, there was drama once again that disrupted some scheduled activities: the expulsion of Rep. Don Shooter of Yuma by the House of Representatives on a 56-3 vote. Shooter didn't go quietly into the night but the drama is over.

As for regular legislative business; some of the bills we are supporting have already passed out of their committee of origin and are moving forward. Below is a sample of two that are “on the move.”

HB2127 – Kid’s Care (Arizona’s CHIP program to provide coverage to eligible low income children who do not quality for AHCCCS) - Because the CHIP re-authorization by Congress last month provides for 100% funding through September 2019 but then drops over the next several years, this bill allowing Arizona flexibility to continue the program in the future is very important.

Progress: This bill has passed through the Health committee in the House, has also passed through the Rules committee and is waiting for a floor vote in the House. Once it passes through the House, it will follow a similar path in the Senate.

HB2087 – Family Caregiver Tax Credit - This bill was developed through the efforts of AARP and would establish a tax credit for qualifying expenses for the care and support of a qualifying family member (spouse, child, stepchildren, sibling etc) in the taxpayer’s home.

Progress: This bill has passed through the Ways and Means committee in the House, has also passed through the Rules committee and is waiting for a floor vote in the House. Once it passes through the House, it will follow a similar path in the Senate.