The Senate adjourned sine die on Thursday evening and the House adjourned on Friday at 12:10 p.m. ending the legislative session. This week’s update delivers a summary of the public health issues discussed during the week. Keep an eye out for a special end of session wrap up next week.

Public Health Districts Appropriations

On Tuesday, House Bill No. 549 was reported delivered to the Governor. The legislation is the fiscal year 2017 appropriation for the Idaho Public Health Districts and provides for $9,289,500 to be transferred from the General Fund to the Public Health Trust Fund. House Bill No. 549 full bill text can be found here.

Assisted Living Legislation

Senate Bill No. 1341 was reported delivered to the Governor on Tuesday. The purpose of the bill is to assure that all Residential or Assisted Living Facilities are only cited for violations that are specified in an applicable law or rule. The bill will help with challenges associated with interpretation of regulations. This legislation is recent progress of the Idaho Alzheimer’s Planning Group’s objective to create a more conducive regulatory environment for Assisted Living Facilities so that Idahoans suffering from Alzheimer’s disease and related dementias can access these facilities. SB 1341 full bill text can be found here.

Right to Try Act

House Bill No. 481 was signed into law on Wednesday. The purpose of this legislation is to allow patients with a terminal diagnosis the right to try an investigation drug that has completed basic safety testing through the FDA, thereby dramatically reducing paperwork, wait times, bureaucracy, and most important, potentially saving lives. This legislation releases liability from physicians, hospitals, insurers, and any other person and clears the way for patients to work with manufacturers under the recommendation of a physician to try an investigational medication. Patients will accept full responsibility, including financial responsibility, for their decisions to try to save their own lives. HB 481 full bill text can be found here.

Unborn Infants Dignity Act

Democratic members of the House State Affairs Committee boycotted Thursday morning’s meeting. Senate Bill No. 1404a was on the agenda. The legislation, called “Idaho Unborn Infants Dignity Act” seeks to “protect the dignity of preborn children to abortion by making illegal to harvest their organs and tissue for any purpose, including experimentation.” The bill was reported out of Committee with Do Pass Recommendation, passed the floor of the House, and was reported as enrolled and signed by President. SB 1404a full bill text can be foundhere.  

Health and Welfare Public Health Services Appropriations

House Bill No. 566 was reported delivered to the Governor on Thursday. The legislation is the fiscal year 2017 appropriation to the Department of Health and Welfare for the Division of Public Health Services. It includes $7,771,900 from the General Fund, $41,993,400 from dedicated funds, and $63,285,100 from federal funds for a total of $113,050,400 and 233.34 FTP. The bill also includes three sections of legislative intent language that are incorporated department wide and two sections specific to the division.

Biosimilar legislation signed into law

On Thursday, Governor Otter signed a bill that would require pharmacists to notify physicians when they change out prescribed medication for a biosimilar medication. HB 483 full bill text can be found here.

Medicaid redesign

There was a lot of excitement this week surrounding the “gap population”. Although discussion on a bill was promised for Monday, as stated in last week’s update, the print hearing was cancelled.

Lawmakers quiet on status of health care bill, leaving opponents to make noise – Idaho Statesman

On Tuesday, there was no word on a possible new bill and about 85 Close the Gap supporters rallied at the Capitol. They held signs comprising of slogans such as, “Close the Gap, 78,000 can’t wait” and “Save Idaho Lives.” The House Health & Welfare Committee posted an amended agenda for an 8:30 a.m. meeting on Wednesday, with two agenda items: RS24759C2 Health Care Study Committee - Rep. Lynn Luker RS24760C3 Health Care Grant Program - Rep. Lynn Luker. The Close the Gap network released an email stating,

We just received depressing news: The House of Representatives will NOT be moving forward with the Idaho Accountability Waiver Act – the bill that would have closed the coverage gap. Instead, the PCAP lite ($5 million one-time token to health centers) and interim committee bills are scheduled for print hearings tomorrow morning at 8:30 a.m. These bills will not close the coverage gap and would merely kick the can down the road. They are a waste of time, money, and lives. The network needs to ensure that legislators know we do not support these bills; we want a full solution to the coverage gap this session. The legislature just let 78,000 Idahoans down and need to be held accountable.

On Wednesday morning the Committee voted 8-3 in favor of legislation to create a study committee to research health coverage and a possible waiver for the state’s gap population and a bill to give a $5.4 million grant next year, plus another $5 million the following year, to community health clinics in Idaho to gather data on the gap population and provide additional services to the population. Legislators opposing the bills stated that it was not a viable solution. Representative John Rusche (D-Lewiston) said, “I don’t think that anybody should be deceiving themselves that we’re really doing something to provide health coverage for the low income.” Later that day, the House passed the gap coverage study committee legislation after a tense debate. House Concurrent Resolution 63 full text can be found here. This concurrent resolution would establish a legislative interim committee to study and make recommendations regarding health care for the gap population (persons under 100% of the federal poverty guidelines).

House passes gap coverage study committee 39-30 after tense debate – The Spokesman Review

The House also passed the ‘gap’ grant bill. This proposal establishes a two-year cooperative grant program through the Department of Health and Welfare to the Community Health Center Network of Idaho. The purpose of the grant program is 1) to collect demographic and health data on the Idaho gap population (persons under 100% of the federal poverty guidelines), and 2) to provide outreach to and augmentation of primary health care services to the gap population provided through federally qualified health centers throughout the state. House Bill No. 644 full bill text can be found here.

House passes gap coverage study committee 39-30 after tense debate – The Spokesman Review

Following the passing of the two bills, Close the Gap sent out an email update with their stance,

This morning, the House Health & Welfare Committee passed two bills, HB 644and HCR 63, and sent them directly to the House floor without accepting public testimony. HB 644 creates a one-time $5.4 million grant to community health centers to study the gap population and provide services, and HCR 63 creates an interim committee to study and make recommendations for the “gap population.” Read more about today’s events here and here. Neither of these bills close the coverage gap. Instead, they merely postpone a full solution for another year. Idaho families will continue to be left out of our health care system; 78,000 will continue to struggle with medical costs, bankruptcies, poor health, and preventable tragedies. It is extremely disappointing that the alternative waiver proposal was ignored by leadership and not allowed a hearing today.

On Thursday morning the Senate Health & Welfare Committee voted unanimously to kill HCR 63. The Senators expressed that the resolution contained statements that they disagreed with and it would delay any coverage for the gap population until 2018. Additionally, the Committee sent House Bill No. 644 to 14^th Order for amendments. Senator Marv Hagerdorn (R-Meridian) proposed amendments that would add language to seek a waiver to expand Idaho’s Medicaid program to provide a managed-care option to serve those who make less than 100% of the poverty level. The amendments can be found here. Later in the morning the Joint Finance-Appropriations Committee voted 13-6 to approve $5.4 million in funding next year as a trailer bill for HB 644. Full text of the funding bill can be found here. Thursday afternoon the Senate voted 27-8 in favor of HB 644. The amended bill then went back to the House for possible concurrence in the Senate amendments. After a bill-signing ceremony on Thursday, Governor Butch Otter expressed his support for beginning the Medicaid expansion waiver application process as soon as possible.

Senate Health & Welfare kills interim study committee on ‘gap’ waiver – The Spokesman Review

Senate H&W sends HB 644 to 14th Order for amendments – The Spokesman Review

Senate debate: ‘Another year is a long time to wait to do the right thing’ – The Spokesman Review

Senate approves gap coverage waiver bill, 27-8 – The Spokesman Review

Legislature Down to the Wire on Medicaid Plan – Times-News

Three GOP members of the House Health & Welfare Committee submitted formal letters committing to vote against any legislation that comes before the committee next year until a waiver program to cover the gap population is presented and voted on in the full House.

Five House GOP reps pledge not to vote for any bills next year ‘til Medicaid waiver – The Spokesman Review

One Friday morning the House voted 55-12 to not concur in the Senate amendment to HB 644, thus killing the health care legislation. After the vote, House Speaker Scott Bedke (R-Oakley) announced the he will appoint a bipartisan working group to start meeting this spring to find “a solution for the gap population”. Later in the afternoon, Idaho Democrats held a press conference at the Capitol to discuss their opinions on the legislative session. When the topic of Representative Bedke’s work group was brought up, House Minority Leader John Rusche (D-Lewiston) said, 

"Well, good for him. We know how much results the tax working group had, right? Nothing. This issue has been studied to death with professionals who know health care policy, health care financing. The complications of not covering health care for the low-income are clear. I laid ‘em out for my district: We can expect three deaths and spend another $1.75 million over the next year."

In a joint statement Representative Rusche and Senate Minority Leader Michelle Stennett, (D-Ketchum) stated,

"We fought long and hard for healthcare fairness, to protect those in the insurance gap from being financially destroyed by an illness. Closing the gap also saves Idaho lives and millions of dollars. The fact that House Republicans – after four long years – were unable to see the plight of the 78,000 was very disappointing. We will be calling on Gov. Otter to proceed by executive decision or call a special session, likely best done after the GOP primary elections."

House kills health care bill on party-line vote, adjourns; full story- The Spokesman Review

Bedke plans working group on gap coverage plan during interim - The Spokesman Review

Our View: Legislative Session More Than a Dud – It Was a Dangerous Failure – Times-News

As Idaho health proposal dies, focus turns to Otter – Idaho Statesman

Bills/Rules of Note

For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill No	Description	Last Action
S1393	Approp, catastrophic hth care, orig	03/21/2016 Senate - Reported delivered to Governor at 2:40 p.m. on 03/21/16
H0482	Boards/qualifications/consumr membr	03/22/2016 House - Delivered to Governor at 10:45 a.m. on March 22, 2016
H0516	Abortion, ultrasounds	03/22/2016 House - Delivered to Governor at 10:45 a.m. on March 22, 2016
H0533	Hospital districts, board trustees	03/22/2016 House - Delivered to Governor at 10:45 a.m. on March 22, 2016
H0549	Approp, public hlth districts, orig	03/22/2016 House - Delivered to Governor at 10:45 a.m. on March 22, 2016
H0550	Approp, drug policy office, orig	03/22/2016 House - Delivered to Governor at 10:45 a.m. on March 22, 2016
H0332	Residential care, license renewal	03/22/2016 House - Reported Signed by Governor on March 22, 2016
H0333	Optometrists, license renewal	03/22/2016 House - Reported Signed by Governor on March 22, 2016
H0334	Physical therapy license renewal	03/22/2016 House - Reported Signed by Governor on March 22, 2016
S1295	Public assistnc/provider penalties	03/22/2016 Senate - Signed by Governor on 03/22/16
S1296	Background checks/fed pilot project	03/22/2016 Senate - Signed by Governor on 03/22/16
S1326	Suicide preventn/diretor authority	03/22/2016 Senate - Signed by Governor on 03/22/16
H0500	Medicare reimbursement rate	03/23/2016 House - Reported Signed by Governor on March 23, 2016
H0528	Sexual assault evidence kits	03/23/2016 House - Reported Signed by Governor on March 23, 2016
HCR063	Health care study committee	03/23/2016 Senate - Introduced, read first time; referred to: Health & Welfare
S1323	State independent living council	03/23/2016 Senate - Reported delivered to Governor at 11 a.m. on 03/23/16
S1341	Residential care, citations	03/23/2016 Senate - Reported delivered to Governor at 11 a.m. on 03/23/16
S1399	Approp, edu bd, hlth ed prgrm, orig	03/23/2016 Senate - Reported delivered to Governor at 11 a.m. on 03/23/16
S1403	Approp, H&W chld wlfr DDS srv, orig	03/23/2016 Senate - Reported delivered to Governor at 11 a.m. on 03/23/16
S1293	Ed, parental rights in education	03/23/2016 Senate - Signed by Governor on 03/23/16
H0554	Worker's compensation, firefighters	03/24/2016 House - Delivered to Governor at 10:36 p.m. on March 24, 2016
H0557	Ed/youth athletes/concussion monitr	03/24/2016 House - Delivered to Governor at 10:36 p.m. on March 24, 2016
H0566	Approp, H&W public hlth srvcs, orig	03/24/2016 House - Delivered to Governor at 10:36 p.m. on March 24, 2016
H0331	Alcoholic bevs, powdered alcohol	03/24/2016 House - Delivered to Governor at 3:04 p.m. on March 24, 2016
S1265	Insuranc premium tax/high risk pool	03/24/2016 House - Received from Senate; Signed by Speaker; Returned to Senate
S1322	Epinephrine auto-injectors	03/24/2016 House - Received from Senate; Signed by Speaker; Returned to Senate
H0483	Pharmacy, communicatn, bio products	03/24/2016 House - Reported Signed by Governor on March 24, 2016
S1382	Nursing, definition revised	03/24/2016 Senate - Reported delivered to Governor at 10:45 a.m. on 03/24/16
S1390	Approp, Idaho state police, orig	03/24/2016 Senate - Signed by Governor on 03/24/16
S1391	Approp, H&W medicaid, orig	03/24/2016 Senate - Signed by Governor on 03/24/16
S1201	Approp, catastrophic health, reduce	03/25/2016 House - Received from Senate; Signed by Speaker; Returned to Senate
S1253	Child protection, caregivers	03/25/2016 House - Received from Senate; Signed by Speaker; Returned to Senate
S1404	Unborn infants dignity act	03/25/2016 House - Received from Senate; Signed by Speaker; Returned to Senate
S1413	Approp, H&W indirect support, orig	03/25/2016 House - Received from Senate; Signed by Speaker; Returned to Senate
H0650	Approp, H&W, hlthcr plcy int, trail	03/25/2016 House - Reported Enrolled; Signed by Speaker; Transmitted to Senate
H0644	Health grant program/med underservd	03/25/2016 House - UC not to concur; objection

This week’s legislative update delivers an overview of some public health issues we’ve been following and information regarding legislation for the health care coverage gap.  

Rape Kit Legislation

On Tuesday, the Senate passed House Bill No. 528 on a 35-0 vote. House Bill No. 528 seeks to create and codify systems used by law enforcement, health care facilities, and the Idaho State Police (ISP) Forensics Laboratory in the processing of sexual assault evidence kits in the State of Idaho. It also creates a system of tracking and reporting to require an annual audit and report about the collection of evidence and testing given to the Idaho State Legislature on an annual basis. Currently there are not statutes that address sexual assault kit evidence collection in our state. This legislation would provide a consistent process to better support victims, law enforcement, health care facilities, and the forensics laboratory. HB 528 full bill text can be found here.

Fire Fighter cancer bill

House Bill No. 554 passed the Senate on Thursday and is on its way to the Governor. The legislation amends existing law to “provide that compensation shall be payable for disability or death resulting from certain firefighter occupational diseases, to provide a presumption of proximate causation between specified diseases and employment as a firefighter, to provide for rebuttal of the presumption, to provide for the demonstration of causal connection, to provide that the presumption shall not apply under certain circumstances and to clarify that employment shall be within the State of Idaho.” Currently, without a presumption in the law, it’s extremely difficult for firefighters to prove that their jobs led to the cancers, as they develop over long periods of time and could be related to any number of carcinogens. HB 554 full bill text can be found here.

Abortion legislation

House Bill No. 516 passed the Senate on Thursday. The bill would require women seeking abortions to be provided with a state-compiled list of providers who could provide them with free ultrasounds, and told they have a right to a free ultrasound and to hear a fetal heart monitor. The bill has already passed the House and is on its way to the Governor.

HB 516 full bill text can be found here.

Assisted Living Legislation 

Senate Bill No. 1341 passed the House on Thursday. The purpose of the bill is to assure that all Residential or Assisted Living Facilities are only cited for violations that are specified in an applicable law or rule. The bill will help with challenges associated with interpretation of regulations. This legislation is recent progress of the Idaho Alzheimer’s Planning Group’s objective to create a more conducive regulatory environment for Assisted Living Facilities so that Idahoans suffering from Alzheimer’s disease and related dementias can access these facilities. SB 1341 full bill text can be found here.

Senator Schmidt gives up health insurance

On Thursday Senator Dan Schmidt (D-Moscow) spoke to reporters at a news conference outside the Idaho Senate chamber and announced that he’s giving up his state-paid health insurance. Senator Schmidt explained that this decision is a “nudge”; he is trying to “nudge” folks to feel a sense of urgency and of doing the right thing. He told reporters, “I have state taxpayer-funded health insurance, because I am a state legislator,” he said. “I get that benefit, and this Legislature can’t give that benefit to 78,000 Idahoans who can’t afford it.”

“Sen. Schmidt gives up his state-paid health insurance out of ‘sense of fairness,’ due to coverage gap” - Spokesman Review

'Shame on us:' Idaho senator gives up health insurance - KTVB

Health insurance coverage

On Monday, The Senate voted to bar Senate Bill No. 1205, the Healthy Idaho plan, from passing out of the Senate Health & Welfare Committee. The vote was 28-7 to “excuse the committee” from reporting the bill. SB 1205 full bill text can be found here.

Drama in the Senate today, as pressure mounts to consider ‘Healthy Idaho’ plan – Spokesman Review

Faith leaders make case for health coverage ­- Spokesman Review

Senate defeats bid to call ‘Healthy Idaho’ coverage bill out of committee, on party-line vote – Spokesman Review

Two proposed bills regarding health insurance coverage for the gap population were on the House Health & Welfare Committee for Thursday morning but were pulled. Instead, the committee plans to consider the issue again on Monday with a new proposal. Committee Chairman Representative Fred Wood (R-Burley) said they will have a meeting on Monday morning and will take up an RS or two on this topic. He is not sure what they may look like at this time, but committed that they will have a hearing and will send it directly to the 2^nd Reading Calendar so there will be time to get it across to the Senate.

House Health & Welfare delays consideration of health care legislation to Mon., pending new plan – Spokesman Review

UPDATE: The print hearing originally scheduled for tomorrow morning in the House Health & Welfare Committee has been tentatively rescheduled until Tuesday at 9:00am.

Health coverage in the news

Albion Woman's Health Falters in the Medicaid Gap – Times-News Magic Valley

Idaho lawmakers advance new health care plan, kill tax cut bill – Idaho Statesman

Lawmakers: Health Care Fix in the Works – The Associate Press

Guest column: Time to take on healthcare crisis – Post Register

Bills/Rules of Note

If there are specific Bills or Rules that you would like Molly to track, please let her know. For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill No	Description	Last Action
H0335	Controlled substances, sched II	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0336	Pharmacy board terms	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0337	Prescriptions, med examiners/dbase	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0338	Legend drug possession	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0339	Controlled substance storage	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0340	Pharm brd, contraceptives	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0373	Legend drugs, clinic donat/dispense	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0374	Control subs prescription database	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0375	Health care task force	03/14/2016 House - Delivered to Governor at 10:50 a.m. on March 14, 2016
H0533	Hospital districts, board trustees	03/14/2016 Senate - Read second time; filed for Third Reading
S1250	Adv practic registerd nurse compact	03/14/2016 Senate - Reported delivered to Governor at 10:40 a.m. on 03/14/16
S1251	Nursing licensure compact	03/14/2016 Senate - Reported delivered to Governor at 10:40 a.m. on 03/14/16
S1382	Nursing, definition revised	03/15/2016 House - Read First Time, Referred to Health & Welfare
S1387	Pharm board, durable med equipment	03/15/2016 House - Read First Time, Referred to Health & Welfare
H0341	Patient freedom of info act	03/15/2016 House - Returned Signed by the President; Ordered Transmitted to Governor
H0557	Ed/youth athletes/concussion monitr	03/15/2016 Senate - Introduced, read first time; referred to: Health & Welfare
H0516	Abortion, ultrasounds	03/15/2016 Senate - Read second time; filed for Third Reading
H0566	Approp, H&W public hlth srvcs, orig	03/15/2016 Senate - Read second time; filed for Third Reading
S1270	Approp, H&W benefit payments, add'l	03/15/2016 Senate - Signed by Governor on 03/15/16
S1271	Approp, H&W medicaid, chg	03/15/2016 Senate - Signed by Governor on 03/15/16
S1391	Approp, H&W medicaid, orig	03/16/2016 House - Passed: Ayes 39 Nays 30 Abs/Excd 1, title approved, to Senate
S1390	Approp, Idaho state police, orig	03/16/2016 House - Passed: Ayes 59 Nays 9 Abs/Excd 2, title approved, to Senate
S1393	Approp, catastrophic hth care, orig	03/16/2016 House - Passed: Ayes 69 Nays 0 Abs/Excd 1, title approved, to Senate
S1323	State independent living council	03/16/2016 House - Read second time; Filed for Third Reading
S1341	Residential care, citations	03/16/2016 House - Read second time; Filed for Third Reading
H0500	Medicare reimbursement rate	03/16/2016 House - Reported Enrolled; Signed by Speaker; Transmitted to Senate
H0483	Pharmacy, communicatn, bio products	03/16/2016 House - Returned from Senate Passed; to JRA for Enrolling
H0528	Sexual assault evidence kits	03/16/2016 House - Returned from Senate Passed; to JRA for Enrolling
H0332	Residential care, license renewal	03/16/2016 House - Returned Signed by the President; Ordered Transmitted to Governor
H0333	Optometrists, license renewal	03/16/2016 House - Returned Signed by the President; Ordered Transmitted to Governor
H0334	Physical therapy license renewal	03/16/2016 House - Returned Signed by the President; Ordered Transmitted to Governor
S1201	Approp, catastrophic health, reduce	03/16/2016 House - U.C. to place at bottom of third reading calendar one legislative day
H0554	Worker's compensation, firefighters	03/16/2016 Senate - Read second time; filed for Third Reading
S1295	Public assistnc/provider penalties	03/16/2016 Senate - Reported signed by the Speaker & ordered delivered to Governor
S1296	Background checks/fed pilot project	03/16/2016 Senate - Reported signed by the Speaker & ordered delivered to Governor
S1326	Suicide preventn/diretor authority	03/16/2016 Senate - Reported signed by the Speaker & ordered delivered to Governor
S1293	Ed, parental rights in education	03/16/2016 Senate - Returned From House Passed; referred to enrolling

Maniacs license plate

House Bill No. 413 passed the House on Tuesday. Earlier that day it had failed 35-35 but after a Motion to Reconsider it passed 34-32. The legislation aims to create a special license plate to benefit Orofino schools honoring the Orofino High School Maniacs. Opponents of the bill have said the mascot, whose name was removed from the bill through an amendment, is insulting to people with mental illnesses. State Hospital North, the state mental hospital, is located in Orofino. HB 413 full bill text can be found here.

Maniacs license plate bill killed on 35-35 tie in House, but reconsideration pending – The Spokesman Review

‘Maniacs’ plate revived on reconsideration – The Spokesman Review

Senator Schmidt resigns from CAT board

Senator Dan Schmidt (D-Moscow), a physician, announced on Wednesday that he’s resigning from the board of the Catastrophic Health Care Fund. The board administers the fund that covers catastrophic medical bills for Idahoans who can’t pay. Senator Schmidt explained that although he is proud of the work he’s done on the board, he couldn’t continue to serve on a program board he fundamentally believes should not exist. He also said his resignation is not a protest; he characterizes it as an attempt to further the conversation.

Schmidt resigns from CAT board – The Spokesman Review

Youth athlete – concussion bill

House Bill No. 557 was introduced last week and reported out of the House Health and Welfare Committee with Do Pass Recommendation on Thursday. This legislation amends Section 33-1625, Idaho Code, to add provisions relating to youth athletes and concussion guidelines recommended by the Centers for Disease Control and Prevention, the National Football League, and its youth arm, USA Football, to protect youth athletes from the risk of concussion. Additionally, the term "biannually" is changed to "biennially" to reflect the original intent to require a review of the guidelines every two years. HB 557 full bill text can be found here.

Rape kit legislation

House Bill No. 528 passed the House last week and its appropriation bill was introduced this week. On Thursday JFAC voted to provide the necessary funding for the Idaho State Police; the funding will add two DNA forensic scientists and one forensic evidence specialist. House Bill No. 528 seeks to create and codify systems used by law enforcement, health care facilities, and the Idaho State Police (ISP) Forensics Laboratory in the processing of sexual assault evidence kits in the State of Idaho. It also creates a system of tracking and reporting to require an annual audit and report about the collection of evidence and testing given to the Idaho State Legislature on an annual basis. Currently there are not statutes that address sexual assault kit evidence collection in our state. This legislation would provide a consistent process to better support victims, law enforcement, health care facilities, and the forensics laboratory. HB 528 full bill text can be found here.

Medicaid budget passes the Senate

The budget for the Medicaid program for next year passed the Senate on Thursday afternoon. Senate Bill No. 1391 shows a 3.4% increase in state general funds next year and 6.2% in total funds. SB 1391 full bill text can be found here.

Suicide prevention legislation

Two pieces of legislation regarding the Idaho suicide prevention plan passed the House on Friday. Senate Bill No. 1326 clarifies that the Department of Health and Welfare's Mission includes services for the prevention of suicide and House Bill No. 566 is the fiscal year 2017 appropriation to the Department of Health and Welfare for the Division of Public Health Services. House Bill No. 566 includes $7,771,900 from the General Fund, $41,993,400 from dedicated funds, and $63,285,100 from federal funds for a total of $113,050,400 and 233.34 FTP. The bill also includes three sections of legislative intent language that are incorporated department wide and two sections specific to the division. SB 1326 full bill text can be foundhere and HB full bill text can be found here.

Medicaid expansion in the news

Economist: Medicaid expansion would boost economy – Post Register

Guest column: Access to health care for all – Post Register

2 months and 21 cases in the Medicaid gap – Post Register

Idaho lawmakers head into final stretch; health care still untouched – Idaho Statesman

Bills/Rules of Note

If there are specific Bills or Rules that you would like Molly to track, please let her know. For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill No	Description	Last Action
S1323	State independent living council	03/07/2016 House - Read First Time, Referred to Health & Welfare
S1231	Chiropractic practic/prescrib drugs	03/07/2016 House - U.C. to be returned to Health & Welfare Committee
H0500	Medicare reimbursement rate	03/07/2016 Senate - Read second time; filed for Third Reading
S1341	Residential care, citations	03/08/2016 House - Read First Time, Referred to Health & Welfare
H0528	Sexual assault evidence kits	03/08/2016 Senate - Read second time; filed for Third Reading
H0549	Approp, public hlth districts, orig	03/08/2016 Senate - Read second time; filed for Third Reading
H0550	Approp, drug policy office, orig	03/08/2016 Senate - Read second time; filed for Third Reading
H0413	License plates, Orofino hs mascot	03/09/2016 Senate - Introduced, read first time; referred to: Transportation
S1270	Approp, H&W benefit payments, add'l	03/09/2016 Senate - Reported delivered to Governor at 11:30 a.m. on 03/09/16
S1271	Approp, H&W medicaid, chg	03/09/2016 Senate - Reported delivered to Governor at 11:30 a.m. on 03/09/16
S1322	Epinephrine auto-injectors	03/10/2016 House - Reported out of Committee, Recommend place on General Orders
H0583	Telehealth services, reimbursement	03/10/2016 House - Reported Printed and Referred to Health & Welfare
H0566	Approp, H&W public hlth srvcs, orig	03/11/2016 House - Passed: Ayes 52 Nays 15 Abs/Excd 3, title approved, to Senate
S1296	Background checks/fed pilot project	03/11/2016 House - Passed: Ayes 62 Nays 0 Abs/Excd 8, title approved, to Senate
S1295	Public assistnc/provider penalties	03/11/2016 House - Passed: Ayes 63 Nays 1 Abs/Excd 6, title approved, to Senate
S1326	Suicide preventn/diretor authority	03/11/2016 House - Passed: Ayes 64 Nays 0 Abs/Excd 6, title approved, to Senate
H0554	Worker's compensation, firefighters	03/11/2016 House - Passed: Ayes 65 Nays 3 Abs/Excd 2, title approved, to Senate
S1390	Approp, Idaho state police, orig	03/11/2016 House - Read First Time, Filed for Second Reading
S1391	Approp, H&W medicaid, orig	03/11/2016 House - Read First Time, Filed for Second Reading
S1393	Approp, catastrophic hth care, orig	03/11/2016 House - Read First Time, Filed for Second Reading
H0557	Ed/youth athletes/concussion monitr	03/11/2016 House - Read second time; Filed for Third Reading
S1250	Adv practic registerd nurse compact	03/11/2016 House - Received from Senate; Signed by Speaker; Returned to Senate
S1251	Nursing licensure compact	03/11/2016 House - Received from Senate; Signed by Speaker; Returned to Senate
H0341	Patient freedom of info act	03/11/2016 House - Reported Enrolled; Signed by Speaker; Transmitted to Senate
S1293	Ed, parental rights in education	03/11/2016 House - Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
H0332	Residential care, license renewal	03/11/2016 House - Returned from Senate Passed; to JRA for Enrolling
H0333	Optometrists, license renewal	03/11/2016 House - Returned from Senate Passed; to JRA for Enrolling
H0334	Physical therapy license renewal	03/11/2016 House - Returned from Senate Passed; to JRA for Enrolling
S1265	Insuranc premium tax/high risk pool	03/11/2016 House - U.C. to be placed on General Orders
S1201	Approp, catastrophic health, reduce	03/11/2016 House - U.C. to hold place on third reading calendar until Monday, March 14, 2016
H0482	Boards/qualifications/consumr membr	03/11/2016 Senate - Read second time; filed for Third Reading
H0483	Pharmacy, communicatn, bio products	03/11/2016 Senate - Read second time; filed for Third Reading
S1382	Nursing, definition revised	03/11/2016 Senate - Read second time; filed for Third Reading
H0533	Hospital districts, board trustees	03/11/2016 Senate - Reported out of Committee with Do Pass Recommendation; Filed for second reading
S1294	Pharmacists, immunizations	03/11/2016 Senate - Reported signed by the Speaker & ordered delivered to Governor
S1387	Pharm board, durable med equipment	03/11/2016 Senate - Retained on calendar
H0335	Controlled substances, sched II	03/11/2016 Senate - Signed by President; returned to House
H0336	Pharmacy board terms	03/11/2016 Senate - Signed by President; returned to House
H0337	Prescriptions, med examiners/dbase	03/11/2016 Senate - Signed by President; returned to House
H0338	Legend drug possession	03/11/2016 Senate - Signed by President; returned to House
H0339	Controlled substance storage	03/11/2016 Senate - Signed by President; returned to House
H0340	Pharm brd, contraceptives	03/11/2016 Senate - Signed by President; returned to House
H0373	Legend drugs, clinic donat/dispense	03/11/2016 Senate - Signed by President; returned to House
H0374	Control subs prescription database	03/11/2016 Senate - Signed by President; returned to House
H0375	Health care task force	03/11/2016 Senate - Signed by President; returned to House

JFAC approves funding for the suicide prevention plan

Last Friday was an exciting day for public health in Idaho. Lawmakers backed a budget for public health services under the state Department of Health & Welfare that includes $971,100 in state funds and 4 new positions to carry out the state’s suicide prevention plan. The Joint Finance and Appropriations Committee approved funding for the first four priorities of the Suicide Prevention Plan. This funding was recommended by the Health Quality Planning Commission and will support the creation of a state office for suicide prevention, sustainable funding for the suicide hotline, “Sources of Strength” training for Idaho students, and a public outreach campaign to reduce stigma and encourage help-seeking behavior. This funding is extremely important, as Idaho’s suicide rate is higher than that of the United States as a whole. The Suicide Prevention Plan can be read here.

Hospital district bill

House Bill No. 533 was reported out of the House Health and Welfare Committee with do pass recommendation on Tuesday. The legislation will allow the board of trustees of a hospital district to unanimously appoint up to two additional members to serve as trustees for the purpose of adding necessary and specialized skills to assist board deliberations and decision-making. HB 533 full bill text can be found here.

Immunizations

Senate Bill No. 1294 was reported out of the House Health and Welfare Committee with do pass recommendation on Tuesday. The bill, proposed by the Idaho State Pharmacy Association, seeks to allow pharmacists to prescribe and administer immunizations to children 6 years or older, the current limit is 12 years or older. SB 1294 full bill text can be found here

Abortion bill

The House passed House Bill No. 516 on Tuesday. As mentioned last week, the bill would require women seeking abortions to be provided with a state-compiled list of providers who could provide them with free ultrasounds, and told they have a right to a free ultrasound and to hear a fetal heart monitor. HB 516 full bill text can be found here.

House passes abortion ultrasound bill after stormy debate – Spokesman Review

Idaho House backs abortion ultrasound bill – Local News 8

Abortion-Targeting Ultrasound Bill Passes Idaho House – Boise Weekly

Rape kit legislation

The House unanimously passed House Bill No. 528 on Wednesday. The legislation seeks to create and codify systems used by law enforcement, health care facilities, and the Idaho State Police (ISP) Forensics Laboratory in the processing of sexual assault evidence kits in the State of Idaho. It also creates a system of tracking and reporting to require an annual audit and report about the collection of evidence and testing given to the Idaho State Legislature on an annual basis. Currently there are not statutes that address sexual assault kit evidence collection in our state. This legislation would provide a consistent process to better support victims, law enforcement, health care facilities, and the forensics laboratory. HB 528 full bill text can be found here.

Relating to the Right to Try Act

House Bill No. 481 passed the House on Monday, was sent to the Senate Health and Welfare Committee, and then passed out of committee with do pass recommendation. The purpose of this legislation is to allow patients with a terminal diagnosis the right to try an investigation drug that has completed basic safety testing through the FDA, thereby dramatically reducing paperwork, wait times, bureaucracy, and most important, potentially saving lives. This legislation releases liability from physicians, hospitals, insurers, and any other person and clears the way for patients to work with manufacturers under the recommendation of a physician to try an investigational medication. Patients will accept full responsibility, including financial responsibility, for their decisions to try to save their own lives. HB 481 full bill text can be found here.

Funding for behavioral health crisis centers

The Joint Finance and Appropriations Committee backed funding for two additional behavior health crisis centers on Wednesday during the budget setting for the state Department of Health & Welfare’s Mental Health Services. Lawmakers had a hard time deciding whether or not to open a center in Twin Falls or one in the Boise area, so they compromised and decided to partially fund two. Both centers would open partway in the coming year.

State budget writers approve funding 2 crisis centers – Idaho Statesman

JFAC backs new crisis centers next year for both Twin Falls, Boise - Spokesman Review

Firefighter cancer coverage legislation

House Bill No. 554 passed the House Commerce Committee on Thursday after a two hour long hearing. The legislation amends existing law to “provide that compensation shall be payable for disability or death resulting from certain firefighter occupational diseases, to provide a presumption of proximate causation between specified diseases and employment as a firefighter, to provide for rebuttal of the presumption, to provide for the demonstration of causal connection, to provide that the presumption shall not apply under certain circumstances and to clarify that employment shall be within the State of Idaho.” Currently, without a presumption in the law, it’s extremely difficult for firefighters to prove that their jobs led to the cancers, as they develop over long periods of time and could be related to any number of carcinogens. HB 554 full bill text can be found here.

Firefighters’ cancer coverage bill wins House panel support– Spokesman Review

Nurse licensure compact and advanced practice nurse licensure compact

Senate Bill No. 1251 and Senate Bill No. 1250 were both reported out of the House Health and Welfare Committee with do pass recommendation. The licensure compact bills seek to adopt new language to align Idaho’s compact agreement adopted by the National Council of State Boards of Nursing to recognize those holding a valid nursing license in another compact state to obtain an Idaho license.  The Nursing Compact has been in place since 2001 for RNs and LPNs.  The Advanced Practice Nursing Licensure Compact is new for APNs. SB 1250 full bill text can be found here and SB 1251 full bill text can be found here.

EMS compact

Senate Bill No. 1281 was reported out of the House Health and Welfare Committee with do pass recommendation on Friday. The legislation seeks to add to existing law to establish the EMS Personnel Licensure Interstate Compact. SB Full bill text can be found here. 

Medicaid expansion

In his weekly newsletter, John Rusche (D-Lewiston) said the House Health and Welfare Committee was fairly quiet this week. There continues to be undercurrents of interest in low-income healthcare, but he does not think a bill will be available for discussion or vote until the week after filing closes.

Medicaid Expansion in the news

Falling between the gaps of health insurance - KMVT

GOP Eyeing Health Care Fix – Twin Falls Times-News

Dunn letter: Health care – Idaho Statesman

Idaho legislative leaders: Medicaid expansion still in talks– Idaho Statesman

Bedke, Hill say health care ‘gap’ discussions still ongoing – Spokesman Review

Bills/Rules of Note

If there are specific Bills or Rules that you would like Molly to track, please let her know. For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill No	Description	Last Action
S1295	Public assistnc/provider penalties	02/29/2016 House - Read First Time, Referred to Health & Welfare
S1253	Child protection, caregivers	02/29/2016 House - Read First Time, Referred to Judiciary, Rules, & Administration
H0331	Alcoholic bevs, powdered alcohol	02/29/2016 Senate - Introduced, read first time; referred to: State Affairs
H0482	Boards/qualifications/consumr membr	03/02/2016 Senate - Introduced, read first time; referred to: Commerce & Human Resources
H0483	Pharmacy, communicatn, bio products	03/02/2016 Senate - Introduced, read first time; referred to: Health & Welfare
H0516	Abortion, ultrasounds	03/02/2016 Senate - Introduced, read first time; referred to: State Affairs
S1293	Ed, parental rights in education	03/02/2016 Senate - Read second time as amended, filed for Third reading
H0332	Residential care, license renewal	03/02/2016 Senate - Read second time; filed for Third Reading
H0333	Optometrists, license renewal	03/02/2016 Senate - Read second time; filed for Third Reading
H0334	Physical therapy license renewal	03/02/2016 Senate - Read second time; filed for Third Reading
S1322	Epinephrine auto-injectors	03/03/2016 House - Read First Time, Referred to Health & Welfare
S1326	Suicide preventn/diretor authority	03/03/2016 House - Read First Time, Referred to Health & Welfare
H0528	Sexual assault evidence kits	03/03/2016 Senate - Introduced, read first time; referred to: Judiciary & Rules
S1231	Chiropractic practic/prescrib drugs	03/04/2016 House - Read second time; Filed for Third Reading
S1294	Pharmacists, immunizations	03/04/2016 House - Read second time; Filed for Third Reading
H0554	Worker's compensation, firefighters	03/04/2016 House - Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
S1250	Adv practic registerd nurse compact	03/04/2016 House - Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
S1251	Nursing licensure compact	03/04/2016 House - Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
H0566	Approp, H&W public hlth srvcs, orig	03/04/2016 House - Reported Printed; Filed for Second Reading
HCR034	Community water fluoridation	03/04/2016 House - Returned from Senate Failed; Filed in the office of the Chief Clerk
H0413	License plates, Orofino hs mascot	03/04/2016 House - U.C. to hold place on third reading calendar until Monday, March 7, 2016
H0533	Hospital districts, board trustees	03/04/2016 House - U.C. to hold place on third reading calendar until Monday, March 7, 2016
S1201	Approp, catastrophic health, reduce	03/04/2016 House - U.C. to hold place on third reading calendar until Monday, March 7, 2016
S1341	Residential care, citations	03/04/2016 Senate - Read second time as amended, filed for Third reading
H0500	Medicare reimbursement rate	03/04/2016 Senate - Reported out of Committee with Do Pass Recommendation; Filed for second reading
S1270	Approp, H&W benefit payments, add'l	03/04/2016 Senate - Returned From House Passed; referred to enrolling
S1271	Approp, H&W medicaid, chg	03/04/2016 Senate - Returned From House Passed; referred to enrolling

This week’s legislative update delivers an overview of public health issues that were discussed during the week.

Immunizations

Senate Bill No. 1294 passed the Senate on Tuesday after some debate. The bill, proposed by the Idaho State Pharmacy Association, seeks to allow pharmacists to prescribe and administer immunizations to children 6 years or older, the current limit is 12 years or older. Lawmakers had safety concerns about the legislation but the bill ultimately passed on a 29-5 vote.

SB 1294 full bill text can be found here

JFAC Increases Idaho’s Health Education Programs Budget

On Thursday morning JFAC voted 19-1 to increase Idaho’s Health Education Programs budget. Overall, the budget reflects a 5.6% increase in state general funds, and matches the governor’s recommendation. The increase includes five new seats for first-year Idaho students in the WWAMI Medical Education Program, two in the University of Utah medical school program, and six additional first-year residents at the Kootenai Health Family Medicine Residency program. The five new seats bring the WWAMI program to a total of 40 students per year, the addition of two students to the University of Utah medical school program brings it up to 10 Idaho students a year, and the six additional first-year residents at the Kootenai Health Family Medicine Residency program brings that program up to 18 students. In a state that doesn’t have a medical school, these programs are of utmost importance.

HB 516 passed the House State Affairs Committee

House Bill No. 516 passed the House State Affairs Committee on Thursday. The bill would require women seeking abortions to be provided with a state-compiled list of providers who could provide them with free ultrasounds, to be told they have a right to a free ultrasound, and to hear a fetal heart monitor. Many people spoke out in support or against the bill and the hearing lasted for two and a half hours. Supporters of the bill say it would make women more likely to decide against abortion. Representative Melissa Wintrow  (D-Boise) said, “I have no problem if a group wants to organize and provide free health care services. That’s within everybody’s rights.” But she continued that the “state should not be requiring that advertising” to be provided when a patient goes to their licensed health care provider. The legislation makes no exception for victims of rape or incest. Representative Pete Nielsen (R-Mountain Home) said, “Now, I’m of the understanding that in many cases of rape it does not involve any pregnancy because of the trauma of the incident. That may be true with incest a little bit.”  Although during the hearing he was contradicted by Angela Dwyer of Stanton Healthcare, a crisis pregnancy center, he stood by his comments. After the hearing, Nielsen said pregnancy doesn’t happen with rape as often as it does with consensual sex, because of the trauma involved. He explained that’s the information he’s been given through the years but he doesn’t know if it’s totally accurate. Betsy Russell’s account of the Committee meeting can be found here.

HB 516 full bill text can be found here.

“Abortion ultrasound bill headed to Idaho House” – Idaho Statesman

Assisted Living Legislation passed the Senate Health and Welfare Committee

Senate Bill No. 1341 was reported out of the Senate Health and Welfare Committee to 14^th Order for amendment. The purpose of the bill is to assure that all Residential or Assisted Living Facilities are only cited for violations that are specified in an applicable law or rule. The bill will help with challenges associated with interpretation of regulations. This legislation is recent progress of the Idaho Alzheimer’s Planning Group’s objective to create a more conducive regulatory environment for Assisted Living Facilities so that Idahoans suffering from Alzheimer’s disease and related dementias can access these facilities.

SB 1341 full bill text can be found here.

The Idaho College of Osteopathic Medicine

Thursday was an exciting day for medical education. Governor Butch Otter announced that the Idaho College of Osteopathic Medicine has made a commitment to locate on the Idaho State University Meridian Health Care Center campus. Governor Otter continued, “Preference will be given to Idaho students.” Idaho currently ranks 49^th in the country for its number of doctors per-capita. Efforts to increase these numbers, such as the programs previously mentioned in addition to the new medical school, are much needed.

Private osteopathic med school proposed for ISU’s Meridian campus – The Spokesman Review

Otter: Public-private partnership for new med school ‘an exciting day for state’ – The Spokesman Review

More on proposed new medical school; dean says it’s a ‘done deal’ – The Spokesman Review

Governor announces plans for Idaho medical school – KTVB

Idaho’s first-ever medical school approved by state board – The Washington Times

Department of Health and Welfare Budget

The Joint Finance-Appropriations Committee considered the Health and Welfare budget on Friday morning.  The budget for Medicaid reflects a 3.4% increase in stage general funds; and a 6.2% increase in total funds. The budget includes an increase of $1.5 million, $442,000 of that in state general funds, in the “personal needs allowance” for disabled and elderly people on Medicaid. The budget, at $519.6 million in state general funds and $2.23 billion total, will need approval from both houses and the governor’s signature to become law. In addition, JFAC supported a budget for public health services that includes $971,100 in state funds and 4 new positions to carry out the state’s suicide prevention plan. The money and new positions will be used to carry out a coordinated approach to suicide prevention that includes funding for the Idaho Suicide Prevention Hotline, funding for youth programming, a public awareness campaign, training, and much more. The budget reflects a 14.5% increase in state funds, but just a 2.4% increase in total funds.

Medicaid expansion in the news

“Group says proposed bill would eliminate Idaho's health care gap” – Moscow-Pullman Daily News

What’s Next in Idaho’s Health Care Debate? – Idaho Public Radio

Krell letter: GOP opinion wrong – Idaho Statesman

“Idaho health care debate may have turned a corner” – Idaho Statesman

Idaho lawmakers stall on Medicaid alternative, but talk expansion – KBOI

Idaho's lone alternative to Medicaid expansion isn't dead, but it may be on life support – The Republic

Working poor: 1 in 3 Idaho households struggles to pay for the basics – Idaho Statesman

Bills/Rules of Note

If there are specific Bills or Rules that you would like Molly to track, please let her know. For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill No	Description	Last Action
H0518	Mental illness, admit, detention	02/22/2016 House - Referred to Judiciary, Rules, & Administration
S1231	Chiropractic practic/prescrib drugs	02/23/2016 House - Read First Time, Referred to Health & Welfare
S1264	Pharmacy, durable medical equipment	02/23/2016 Senate - Failed: Ayes 17 Nays 17 Excused 1; to Secretary of Senate
S1250	Adv practic registerd nurse compact	02/24/2016 House - Read First Time, Referred to Health & Welfare
S1251	Nursing licensure compact	02/24/2016 House - Read First Time, Referred to Health & Welfare
S1294	Pharmacists, immunizations	02/24/2016 House - Read First Time, Referred to Health & Welfare
S1265	Insuranc premium tax/high risk pool	02/25/2016 House - Read First Time, Referred to Health & Welfare
HCR034	Community water fluoridation	02/25/2016 Senate - Reported out of Committee with Do Pass Recommendation; to 10th order; held one legislative day
H0331	Alcoholic bevs, powdered alcohol	02/26/2016 House - Passed: Ayes 42 Nays 24 Abs/Excd 4, title approved, to Senate
H0500	Medicare reimbursement rate	02/26/2016 House - Read second time; Filed for Third Reading
H0516	Abortion, ultrasounds	02/26/2016 House - Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
H0413	License plates, Orofino hs maniacs	02/26/2016 House - Retained on General Orders
H0482	Boards/qualifications/consumr membr	02/26/2016 House - U.C. to hold place on third reading calendar until Monday, February 29, 2016
H0483	Pharmacy, communicatn, bio products	02/26/2016 House - U.C. to hold place on third reading calendar until Monday, February 29, 2016
S1201	Approp, catastrophic health, reduce	02/26/2016 House - U.C. to hold place on third reading calendar until Monday, February 29, 2016
S1270	Approp, H&W benefit payments, add'l	02/26/2016 House - U.C. to hold place on third reading calendar until Monday, February 29, 2016
S1271	Approp, H&W medicaid, chg	02/26/2016 House - U.C. to hold place on third reading calendar until Monday, February 29, 2016
S1295	Public assistnc/provider penalties	02/26/2016 Senate - Passed: Ayes 33 Nays 2 Excused 0; title approved; to House
S1253	Child protection, caregivers	02/26/2016 Senate - Passed: Ayes 34 Nays 0 Excused 1; title approved; to House
H0341	Patient freedom of info act	02/26/2016 Senate - Read second time; filed for Third Reading
S1293	Ed, parental rights in education	02/26/2016 Senate - Read second time; filed for Third Reading
S1322	Epinephrine auto-injectors	02/26/2016 Senate - Reported out of Committee with Do Pass Recommendation; Filed for second reading

This week’s legislative update delivers more information regarding PCAP, an overview of public health issues that were discussed, and bills of interest during the week.  

PCAP funding killed in committee

Representative Fred Wood’s (R-Burley) bill to fund the Governor’s Primary Care Access Program was defeated abruptly. The House State Affairs Committee refused to introduce this legislation on Monday morning. The bill sought to provide a funding source for the program from the Millennium Fund, which comes from a nationwide tobacco settlement. 

House State Affairs rejects partial PCAP funding bill – Spokesman Review

Their bill is dead until they can find a funding source – Spokesman Review

Idaho health care proposal ‘dead’ – Idaho Statesman

What happened and what’s next? – Idaho Statesman

Medicaid Expansion in the news

Opinion article – Idaho Statesman

Advocates say Medicaid expansion would be better – Idaho Business Review

Board of Nursing Legislation 

Three bills proposed by the Idaho Board of Nursing were scheduled for hearing in the Senate Health & Welfare Committee Monday afternoon.

Nurse Licensure Compact and Advanced Practice Nurse Licensure Compact

Senate Bill No. 1251 and Senate Bill No. 1250 are two licensure compact bills that seek to adopt new language to align Idaho’s compact agreement adopted by the National Council of State Boards of Nursing to recognized those holding a valid nursing license in another compact state to obtain an Idaho license.  The Nursing Compact has been in place since 2001 for RNs and LPNs.  The Advanced Practice Nursing Licensure Compact is new for APNs. 


SB 1250 full bill text can be found here

SB 1251 full bill text can be found here

Revision to the Definition of Nursing

The statement of purpose of Senate Bill No. 1252 states, “the current statutory definition of the ‘practice of nursing’ is antiquated. The Idaho Board of Nursing, the agency charged with regulating nurses and the practice of nursing, seeks to amend the statute to more accurately reflect the functions nurses perform and what the practice of nursing means.”

SB 1252 full bill text can be found here

Caregiver Presentation

The Idaho Caregiver Alliance (ICA) presented findings from Caregiver Task Force to the House Health and Welfare Committee on Tuesday. The Task Force was created in response to House Concurrent Resolution 24 passed during the 2015 session.  A similar presentation will be made to the Senate Health and Welfare committee on Tuesday, February 23^rd at 3:00 pm; interested constituents are invited to attend.

ICA Presentation

ICA Executive Summary

ICA Report

Abortions and Ultrasounds

On Wednesday a bill was introduced that would require women seeking abortions to be provided with a state-compiled list of providers who could provide them with free ultrasounds, and told they have a right to a free ultrasound and to hear a fetal heart monitor. The House Bill No. 516 seeks to amend existing law to “provide that the Department of Health and Welfare shall compile a list of providers that perform free ultrasounds, and shall state that a patient has the right to obtain a free ultrasound, view an ultrasound image and hear heart tone monitoring and to provide that no abortion shall be performed unless the woman is informed that ultrasound imaging and heart tone monitoring are available.”

HB 516 full bill text can be found here

House Health & Welfare Chairman speaks to JFAC

During beginning of the session, chairmen of various legislative committees presented to JFAC on what should be funded in the state budget in the areas they manage. House Health & Welfare Chairman Fred Wood (R-Burley) spoke to the Joint Finance-Appropriations Committee on Wednesday. Chairman Wood spoke to bring attention the 78,000 Idahoans who now make too little to qualify for subsidized insurance through the state exchange, but get no other help because Idaho hasn’t expanded Medicaid to cover adults who don't qualify for nursing home care. Wood expressed,  “at some basic level, the House Health & Welfare Committee unanimously agreed what is currently happening is just unfair and wrong. It’s as simple as that.” Chairman Wood also spoke about what he called the weakest component of the health care system in Idaho”.  He said the most urgent need of all Idahoans in the health care arena is behavioral services. He advised full funding for Idaho’s suicide prevention hotline, its state suicide prevention plan, and as many crisis centers as the committee feels comfortable with funding.

Betsy Russell’s account of the Committee meeting can be found here

Unborn Infants Dignity Act

Senate Bill No. 1349 was introduced in the Senate State Affairs Committee Friday morning. The legislation proposed by David Ripley of Idaho Chooses Life seeks to ban fetal tissue from being donated after an abortion, either for organ donations or medical research. The purpose of the bill states, “This legislation protects the dignity of preborn children, lost to abortion, by making it illegal to harvest their organs and tissue for any purpose, including experimentation. It strengthens ethical standards for proper medical research, and the legislation reinforces the principle that the mother has a right to provide for the respectful disposition of her baby's remains.”

SB 1349 full bill text can be found here

Bills/Rules of Note

If there are specific Bills or Rules that you would like Molly to track, please let her know. For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill No	Description	Last Action
H0482	Boards/qualifications/consumr membr	02/15/2016 House - Reported Printed and Referred to Health & Welfare
H0483	Pharmacy, communicatn, bio products	02/15/2016 House - Reported Printed and Referred to Health & Welfare
H0484	Primary care access program	02/15/2016 House - Reported Printed and Referred to Health & Welfare
S1231	Chiropractic practic/prescrib drugs	02/15/2016 Senate - Read second time; filed for Third Reading
S1265	Insuranc premium tax/high risk pool	02/15/2016 Senate - Read second time; filed for Third Reading
S1322	Epinephrine auto-injectors	02/15/2016 Senate - Reported Printed; referred to Health & Welfare
S1250	Adv practic registerd nurse compact	02/16/2016 Senate - Read second time; filed for Third Reading
S1251	Nursing licensure compact	02/16/2016 Senate - Read second time; filed for Third Reading
S1326	Suicide preventn/diretor authority	02/16/2016 Senate - Reported Printed; referred to Health & Welfare
H0500	Medicare reimbursement rate	02/17/2016 House - Reported Printed and Referred to Health & Welfare
S1271	Approp, H&W medicaid, chg	02/18/2016 Senate - Passed: Ayes 29 Nays 6 Excused 0; title approved; to House
S1270	Approp, H&W benefit payments, add'l	02/18/2016 Senate - Passed: Ayes 32 Nays 3 Excused 0; title approved; to House
H0335	Controlled substances, sched II	02/18/2016 Senate - Read second time; filed for Third Reading
H0336	Pharmacy board terms	02/18/2016 Senate - Read second time; filed for Third Reading
H0337	Prescriptions, med examiners/dbase	02/18/2016 Senate - Read second time; filed for Third Reading
H0338	Legend drug possession	02/18/2016 Senate - Read second time; filed for Third Reading
H0339	Controlled substance storage	02/18/2016 Senate - Read second time; filed for Third Reading
H0340	Pharm brd, contraceptives	02/18/2016 Senate - Read second time; filed for Third Reading
H0331	Alcoholic bevs, powdered alcohol	02/19/2016 House - Bill as Amended Referred to JRA for Engrossing
H0516	Abortion, ultrasounds	02/19/2016 House - Bill Previously Held at Desk, Referred to State Affairs
H0518	Mental illness, admit, detention	02/19/2016 House - Reported Printed and Referred to Health & Welfare
H0413	License plates, Orofino hs maniacs	02/19/2016 House - Retained on General Orders
S1201	Approp, catastrophic health, reduce	02/19/2016 House - U.C. to hold place on third reading calendar until Monday, February 22, 2016
S1349	Unborn infants dignity act	02/19/2016 Senate - Introduced; read first time; referred to JR for Printing
H0373	Legend drugs, clinic donat/dispense	02/19/2016 Senate - Read second time; filed for Third Reading
H0374	Control subs prescription database	02/19/2016 Senate - Read second time; filed for Third Reading
H0375	Health care task force	02/19/2016 Senate - Read second time; filed for Third Reading
S1264	Pharmacy, durable medical equipment	02/19/2016 Senate - Read second time; filed for Third Reading
S1206	Approp, H&W indirect support, add'l	02/19/2016 Senate - Reported signed by the Speaker & ordered delivered to Governor
S1207	Approp, H&W psych hosp, add'l	02/19/2016 Senate - Reported signed by the Speaker & ordered delivered to Governor
S1216	Approp, blind com, add'l	02/19/2016 Senate - Reported signed by the Speaker & ordered delivered to Governor

This week’s legislative update delivers an overview of public health issues discussed during committee presentations, more information regarding PCAP, highlights from the Health and Welfare joint listening session, and bills of interest during the week.  

Committee Presentations

On Monday Caroline Keegan and Megan Williams from the Idaho Academy of Nutrition and Dietetics gave a presentation titled, “Annual Report and Summary of Work with the Idaho State Healthcare Innovation Plan (SHIP)” to the Senate Health and Welfare Committee. The Committee also heard from Lance McCleve and Ryan Langrill from the Office of Performance Evaluations regarding the “Evaluation Report: Design of the Idaho Behavioral Health Plan”.  

Tom Hanson and Kathie Garrett from the National Alliance on Mental Illness – Idaho, Ross Edmunds from the Department of Health and Welfare, and Dennis Boughman from Lifeways presented “Behavioral Health in Idaho” to the Senate Health and Welfare Committee on Tuesday.

On Wednesday, the Director of the Idaho Department of Health and Welfare, Dick Armstrong, presented the Department’s budget to the House Health and Welfare Committee.

Yvonne Ketchum from the Idaho Primary Care Association, Mike Baker from Heritage Health, and Heidi Traylor from Terry Reilly Health services presented “Idaho's Community Health Centers” to both the House and the Senate Health and Welfare Committees on Thursday.

Presentations are archived here

Primary Care Access Program Hearing

Governor Otter’s Primary Care Access Program (PCAP) received a hearing on Thursday in the House Health and Welfare Committee. Director Armstrong made the preliminary presentation of RS24492; as there was not yet a proposed piece of legislation. The House Health and Welfare Committee introduced the bill later that day and the bill was printed without discussion as a courtesy to the Governor.

Full bill text is now available here

PCAP in the News

SB1205 Provides Common Sense Medicine – Idaho Politics Weekly

IDAHO HEALTHCARE BUDGET PRESENTED – BYUI Scroll

Otter health plan no substitute for Medicaid expansion – Idaho Statesman

 Joint Listening Session

The Senate and House Health and Welfare Committees came together on Friday morning to hold a joint listening session. The public was invited to come and speak about issues related to Idaho’s Health and Welfare system. Testimony was limited to three minutes to give plenty of folks the opportunity to have their voice heard. More than 30 people spoke during the hearing and at least 75 had signed up in hopes of testifying. In short summary: No one that testified wanted PCAP – it was said that the $30 million program will not provide enough value, there was an immense amount of support for expanding Medicaid – which was expressed through heartfelt stories, child foster care and adoption was brought up - a number of foster parents voiced their disappointment in both the process and outcome of custody and adoption, and mental health services were also discussed – mainly in connection to Medicaid expansion and the fact that chronic mental illness is prevalent in the “gap” population.

Betsy Russell provided live updates all morning:

• Crowd gathers for public hearing this morning in Lincoln Auditorium
• Testimony: 'I don't see the justice,' 'Access to health care,' 'Conditions are horrific'
• Testimony: ‘She needed coverage,’ ‘Please hear us,’ ‘The money goes to other states’
• Testimony: Medicaid expansion, mental health needs, foster care questions, reimbursements
• Testimony: Medicaid expansion, mental health needs, foster care questions, reimbursements
• Testimony: 'Close the gap,' 'Better off at home,' 'Penalty for parents'
• Testimony: ‘It’s heartbreaking - we need to make some changes’
• Hearing wraps up; Heider says message was ‘loud and clear’

Medicaid Expansion in the News

The Health Care Gap in Idaho – Idaho Public Radio

7 Investigates: How to get a healthier Idaho – KTVB

Bills/Rules of Note

If there are specific Bills or Rules that you would like Molly to track, please let her know. For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill No	Description	Last Action
S1211	Catastrophic heath care program	02/08/2016 House - Read First Time, Referred to Local Government
H0373	Legend drugs, clinic donat/dispense	02/08/2016 Senate - Introduced, read first time; referred to: Health & Welfare
S1264	Pharmacy, durable medical equipment	02/08/2016 Senate - Reported Printed; referred to Commerce & Human Resources
H0453	Medical lab science practice act	02/10/2016 House - Reported Printed and Referred to Health & Welfare
H0374	Control subs prescription database	02/10/2016 Senate - Introduced, read first time; referred to: Health & Welfare
H0375	Health care task force	02/10/2016 Senate - Introduced, read first time; referred to: Health & Welfare
S1199	Approp, medical boards, add'l	02/10/2016 Senate - Signed by Governor on 02/10/16
H0482	Boards/qualifications/consumr membr	02/12/2016 House - Introduced, read first time, referred to JRA for Printing
H0483	Pharmacy, communicatn, bio products	02/12/2016 House - Introduced, read first time, referred to JRA for Printing
H0484	Primary care access program	02/12/2016 House - Introduced, read first time, referred to JRA for Printing
S1201	Approp, catastrophic health, reduce	02/12/2016 House - U.C. to hold place on third reading calendar until Monday, February 15, 2016
S1206	Approp, H&W indirect support, add'l	02/12/2016 House - U.C. to hold place on third reading calendar until Monday, February 15, 2016
S1207	Approp, H&W psych hosp, add'l	02/12/2016 House - U.C. to hold place on third reading calendar until Monday, February 15, 2016
S1216	Approp, blind com, add'l	02/12/2016 House - U.C. to hold place on third reading calendar until Monday, February 15, 2016
S1322	Epinephrine auto-injectors	02/12/2016 Senate - Introduced; read first time; referred to JR for Printing
S1231	Chiropractic practic/prescrib drugs	02/12/2016 Senate - Reported out of Committee with Do Pass Recommendation; Filed for second reading
S1265	Insuranc premium tax/high risk pool	02/12/2016 Senate - Reported out of Committee with Do Pass Recommendation; Filed for second reading

Regulation of Contraceptives

On Monday Alex Adams, Executive Director, Idaho State Board of Pharmacy, presented House Bill No. 340 to the House Health and Welfare Committee. The bill aims to repeal an archaic 1937 chapter for the regulation of non-prescription contraceptives. It has not been updated since 1982 and is not enforced. It does not have any impact on prescription contraceptives. Representative John Rusche (D-Lewiston) made a motion to send H 336 to the floor with a DO PASS recommendation. Adams also presented House Bill No. 335, 336, 337, 338, and 339 on behalf of the Board of Pharmacy.

HB 340 full bill text can be found here

Orofino Maniacs License Plate

Last Friday, Representative Paul Shepherd (R-Riggins) introduced a bill to create the "Friends of the Orofino Maniacs" license plate in the House Transportation Committee. House Bill No. 413 seeks to put the word MANIAC into Idaho Code and the a license plate depicting the Orofino maniac mascot will be officially sanctioned and issued by the State of Idaho. Orofino is the location of State Hospital North, the state mental hospital; Orofino High School has had “Maniacs” as its school mascot since the 1920s. On Tuesday, the House Transportation Committee heard from advocates for the mentally ill and people who suffer from mental illnesses that an “Orofino Maniacs” specialty license plate would be offensive. The committee voted to send the bill the House’s amending order to remove its four references to the word “maniacs,” but still authorize a special plate with the emblem.

The Idaho Federation of Families for Children’s Mental Health believes this legislation is harmful. They sent out a newsletter earlier this week stating:

The issue is that the word maniac and the logo of the mascot adds to a false stereo-type of people with mental illness and adds to the stigma they face. Mania is a recognized mood disorder characterized by abnormally elevated and aroused energy levels, effusiveness and/or irritability. By allowing the Orofino Maniacs name and their mascot logo to be place on Idaho's license plates, it will signal that Idaho officially sanction of the use of a word and image that is hurtful, insulting, discriminatory and stigmatizing to every Idahoan who lives have been touched by mental illness. This is more than political correctness and trying to ban a word we find offensive.  Stigma is one of the major barriers for people to seek help and treatment whether for mental illness or to prevent suicide!

Full bill text HB 413 full bill text can be found here

Medicaid Expansion

If you missed my special update regarding the Medicaid expansion hearing, it can be found here.

Medicaid Expansion in the news

Tax cuts sweep House; broader policy moves swept under rug - Idaho Statesman

Otter’s health care plan would cover Idaho’s poorest — until something goes wrong – Idaho Statesman

Week of February 5, Indigent Health Care – Idaho Reports

Local doctor fights to break Medicaid gap – NPG of Idaho

Doctor: Not expanding Medicaid has led to nearly 1,000 deaths in Idaho – Idaho Statesman

Idaho doctor: Legislative inaction has killed 1,000 Idahoans – Idaho Business Review

Idaho Senate panel listens to Medicaid expansion hearing – KBOI2

Legend Drugs

Ross Edmunds, Administrator of the Division of Behavioral Health, presented House Bill No. 373 to the House Health and Welfare Committee on Wednesday.  The legislation proposes changes to the Legend Drug Act to designate the Department's Regional Behavioral Health Centers and State Charitable Institutions as "qualifying charitable clinic(s) or center(s)" under the Legend Drug Act. This change would then allow the Regional Behavioral Health Centers to accept donated medications including unused Patient Assistance Program Medications. These donated medications may then be dispensed to indigent clients with a valid prescription order. The bill was reported out of committee with do pass recommendation and passed the House on Thursday.

HB 373 full bill text can be found here

Controlled Substance Prescription Database

House Bill No. 374 was reported out of the House Health and Welfare Committee with Do Pass Recommendation and filed for a second reading on Wednesday. HB 374 seeks to authorize certain supervised individuals (delegates) to access the Prescription Monitoring Program (PMP) database, to limit the number of delegates to be supervised, and to require Board of Pharmacy registration by each delegate.

HB 374 full bill text can be found here 

Health Care Task Force

Also on Wednesday, House Bill No. 375 was reported out of the House Health and Welfare Committee with Do Pass Recommendation and filed for a second reading. The first purpose of HB 375 is to remove the single reference to the Health Care Task Force by amending Section 56-1054, Idaho Code. Secondly, the bill repeals Section 1, Chapter 280, Session Laws of 2006, which renamed the Health Insurance Premium Task Force the Health Care Task Force.

HB 375 full bill text can be found here

Bills/Rules of Note

If there are specific Bills or Rules that you would like Molly to track, please let her know. For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill #	Description	Last Action
S1196	Sexual orientation, gender identity	01/20/2016 Senate - Reported Printed; referred to State Affairs
S1204	Medicaid, eligibility expansion	01/25/2016 Senate - Reported Printed; referred to Health & Welfare
S1205	Medical assist/eligibility standard	01/25/2016 Senate - Reported Printed; referred to Health & Welfare
H0331	Alcoholic bevs, powdered alcohol	01/28/2016 House - Reported out of Committee, Recommend place on General Orders
H0416	Chip plan B, eligibility requirmnts	02/01/2016 House - Reported Printed and Referred to Ways & Means
H0421	Health insurance exchange	02/01/2016 House - Reported Printed and Referred to Ways & Means
S1231	Chiropractic practic/prescrib drugs	02/01/2016 Senate - Reported Printed; referred to Health & Welfare
H0332	Residential care, license renewal	02/02/2016 Senate - Introduced, read first time; referred to: Commerce & Human Resources
H0333	Optometrists, license renewal	02/02/2016 Senate - Introduced, read first time; referred to: Commerce & Human Resources
H0334	Physical therapy license renewal	02/02/2016 Senate - Introduced, read first time; referred to: Commerce & Human Resources
H0341	Patient freedom of info act	02/02/2016 Senate - Introduced, read first time; referred to: Commerce & Human Resources
H0335	Controlled substances, sched II	02/04/2016 Senate - Introduced, read first time; referred to: Health & Welfare
H0336	Pharmacy board terms	02/04/2016 Senate - Introduced, read first time; referred to: Health & Welfare
H0337	Prescriptions, med examiners/dbase	02/04/2016 Senate - Introduced, read first time; referred to: Health & Welfare
H0338	Legend drug possession	02/04/2016 Senate - Introduced, read first time; referred to: Health & Welfare
H0339	Controlled substance storage	02/04/2016 Senate - Introduced, read first time; referred to: Health & Welfare
S1251	Nursing licensure compact	02/04/2016 Senate - Reported Printed; referred to Health & Welfare
S1252	Nursing, definition revised	02/04/2016 Senate - Reported Printed; referred to Health & Welfare
S1216	Approp, blind com, add'l	02/05/2016 House - Read second time; Filed for Third Reading
H0374	Control subs prescription database	02/05/2016 House - Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
H0375	Health care task force	02/05/2016 House - Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
H0413	License plates, Orofino hs maniacs	02/05/2016 House - Reported out of Committee, Recommend place on General Orders
S1201	Approp, catastrophic health, reduce	02/05/2016 House - U.C. to hold place on third reading calendar until Monday, February 8, 2016
S1206	Approp, H&W indirect support, add'l	02/05/2016 House - U.C. to hold place on third reading calendar until Monday, February 8, 2016
S1207	Approp, H&W psych hosp, add'l	02/05/2016 House - U.C. to hold place on third reading calendar until Monday, February 8, 2016
H0340	Pharm brd, contraceptives	02/05/2016 Senate - Introduced, read first time; referred to: Health & Welfare
S1264	Pharmacy, durable medical equipment	02/05/2016 Senate - Introduced; read first time; referred to JR for Printing
S1265	Insuranc premium tax/high risk pool	02/05/2016 Senate - Introduced; read first time; referred to JR for Printing
S1211	Catastrophic heath care program	02/05/2016 Senate - Passed: Ayes 32 Nays 1 Excused 2; title approved; to House
S1253	Child protection, caregivers	02/05/2016 Senate - Reported Printed; referred to Judiciary & Rules
S1199	Approp, medical boards, add'l	02/05/2016 Senate - Reported signed by the Speaker & ordered delivered to Governor

Special Update: Medicaid Expansion Hearing

I attempted to attend the hearing of Senate Bill No. 1204 and Senate Bill No. 1205 in the Senate Health and Welfare Committee meeting on Tuesday afternoon. However, hundreds of other people had the same idea. There were so many people that only those who were testifying and a few others were allowed into the meeting room. Two other meeting rooms had to be opened as overflow rooms.

To begin the meeting, Chairman Lee Heider (R-Twin Falls) told the room, “We’re certainly happy that all of you have come today. We have two options. There’s one that I would like to pursue, and that is to have this be an informational hearing only. Let me explain why I feel that way.” He explained that Governor Otter and the Department of Health and Welfare have proposed the Primary Care Access Program to address the issue of Idahoans who fall into the insurance coverage gap. Chairman Heider acknowledged that the Medicaid expansion bills deal with the same population and if the legislators have to choose, it would place them in “an awkward situation as a committee, to vote against one of our colleagues or against [the governor]”. He expressed that the informational hearing will gather information but there wouldn’t be a motion on either of the bills. Chairman Heider assured the audience that the bill is not dead and remains in the “care” of Senator Schmidt.

Senator Dan Schmidt (D-Moscow) expressed his thanks for the discussion and told the committee that he’d like both SB 1204 and SB 1205 to be considered together. Senator Schmidt stated that his goal for the discussion was to have an “open and frank conversation”.  

The committee heard testimony from Dr. Ted Epperly, president and CEO of the Family Medicine Residency of Idaho, first. Dr. Epperly, who worked on both of the Governor’s Medicaid redesign task forces, outlined the two bills. He expressed his hope that the committee will send SB 1205, the Healthy Idaho Plan, to the full Senate with do pass recommendation. Dr. Epperly stated,

“This plan represents three years of hard work by Idaho experts on the governor’s work group, and it represents a tremendous opportunity to save Idaho taxpayer dollars, by leveraging federal dollars back to the state, and eliminating wasteful county and state programs that would no longer be necessary, not to mention the greater reason to do this, which is saving and improving Idaho lives, of low income Idahoans who fall into the coverage gap, and because of this live sicker and die younger.”

Dr. Epperly emphasized that a “usual source of care,” and “some source of insurance coverage” drive better outcomes for patients. SB 1204 and SB 1205 would provide both of those things while PCAP would only provide the first but not the second. In addition, PCAP would not allow Idaho to eliminate the current state Catastrophic Care program and the county indigency program while both SB 1204 and SB 1205 would.

Dr. Kenneth Krell, director of critical care at Eastern Idaho Regional Medical Center in Idaho Falls, provided unsettling testimony to the committee. He spoke about the Idahoans who fall in the coverage gap and explicated, “I see those patients on a near-daily basis through the emergency room who present with end-stage disease,” he continued, “dying, often, because those disease processes are now at an end state and have resulted in organ failure that often results in death or really irreparable damage.” He discussed Jenny Steinke, a patient who died from asthma; Jenny’s case is what really “crystalized” the issue for him. Dr. Krell told the committee, “And I kept asking myself, how could this be? How could, in a state like Idaho where we care about each other, could I be seeing deaths and really damaging illness on a nearly daily basis as a result of failure to expand Medicaid that cost tangible lives? It’s difficult to understand.” He cited statistics from a study in the New England Journal that compared states who accepted Medicaid expansion with a neighboring state that hadn’t. The study found that the failure to expand Medicaid cost 19.7 lives per 100,000 population. When extrapolated, it adds up to about 324 lives a year, meaning nearly one patient dies per day in this state as a result of not having Medicaid expansion. Dr. Krell acknowledged that, “It’s been said that perhaps it’s an ideological difference, that we just don’t want to accept federal dollars. But if that were true, I don’t see that we would see many in the Legislature accepting federal dollars for federal farm subsidies.” He concluded, “That the Idaho Legislature is unfortunately responsible for those deaths. Our intransigence in failing to pass Medicaid expansion for the last three years has probably resulted in over 1,000 deaths in this state. Please help us. I would ask you to please stop the killing. Thank you.”

Boise Mayor David Bieter testified, “I think this is the most important public policy decision in the state of Idaho by far”. He clarified, “I think every Idahoan believes that when we see suffering, we have a moral obligation to do what we can to eliminate that”. Mayor Bieter told legislators, “This is something you can do now. I really urge you to pass this bill.”

Chairmen Heider asked if anyone had come to testify against the bills. Fred Birnbaum, from the Idaho Freedom Foundation, argued that he believes the savings are based on “thin air” and we don’t know what future congresses will do.

In support of the bills, Shelly Gluch shared a personal story. She told the committee that her family couldn’t afford their medical care. She said her husband is chronically ill; they owe $60,000 in medical debt and are “stuck tight in a terrible cycle”.

Jim Baugh, executive director of Disability Rights Idaho, addressed the committee in support of the legislation. He said, “The single most important thing you can do to fix Idaho’s very severely stressed mental health system would be to adopt one of these two programs. People with severe and persistent mental illness need more than primary care; they need specialty care, hospitalization, and they need coordinated care.”

Chairman Heider ended the hearing without any motion or vote as promised. He thankedSenator Schmidt for bringing, printing, and hearing the bills and also thanked the public for coming and listening to the information-gathering session. Senator Schmidt thanked the committee for their time and acknowledged that there were so many people at the hearing that, “You could fill a couple days with the testimony that is here to speak before you.”

More information: 

• The Idaho Statesman interviewed some of the hundreds of folks who came out in support of closing the coverage gap. You can watch their video here.
• Kaiser Health News article
• KBOI article
• For more information about the coverage gap and related legislation follow Close the Gap Idaho on Facebook.

This week’s legislative update delivers an overview of public health issues discussed in the Governor’s budget revisions, more information regarding PCAP, unexpected news about Medicaid expansion, and other topics of interest during the week.  

Governor’s Budget Revisions

Governor Otter made revisions to his executive budget and submitted the changes to JFAC on Monday. The changes included the deletion of a $2.9 million reversion that had been expected from the Department of Health & Welfare (but now is on hold pending the study for in-home care services mentioned last week) and recognition of the $11 million in additional savings in the CAT fund.

PCAP Funding

House Speaker Scott Bedke (R-Oakley) doesn’t completely agree with Governor Butch Otter’s proposed funding mechanism for PCAP. Instead of using $30 million from cigarette and tobacco taxes, Representative Bedke suggested that the money come from the Millennium Fund and savings from the Catastrophic Health Care Fund. Full story.

Director Armstrong Presents on PCAP

Department of Health and Welfare Director Richard Armstrong presented the Primary Care Access Program to the Senate Health & Welfare Committee on Tuesday. During his presentation, Director Armstrong described how the program would work, provided examples, and explained how it is not an “entitlement program”. He mentioned, “this is all our money, this is state of Idaho, and we can drive the program as we see fit.” Director Armstrong also briefed the House Health & Welfare Committee on Wednesday. Betsy Russell’s account of the Senate Committee meeting can be found here.

CAT Fund Savings Bill

The Senate voted in favor of Senate Bill No. 1201 on Wednesday. The legislation proposes to transfer $29 million in savings from the Catastrophic Health Care fund back to the state’s general fund. Up until recently, the fund’s costs had been rising significantly. Three years ago, Idaho established the Your Health Idaho insurance exchange, which enabled about 100,000 Idahoans to enroll in health insurance plans. After the establishment of the insurance exchange, CAT fund costs have decreased significantly.

S1201 full bill text can be found here

New Recovery Center Funding

On Tuesday, The Idaho Legislature's Joint Millennium Fund Committee recommended funding four new community recovery centers. The centers are intended to provide a safe, supportive environment for people who are recovering from substance abuse and behavioral issues. As stated above, Representative Scott Bedke recently proposed to use the Millennium Fund money to pay for the Governor's Primary Care Access Program (PCAP) proposal.

Millennium Fund panel backs recovery center funding – The Spokesman-Review

Committee barely OKs recovery center proposal - The Lewiston Tribune

Comprehensive Plan for Suicide Prevention

The Idaho Council on Suicide Prevention presented a comprehensive plan for suicide prevention to the House Health and Welfare Committee on Thursday. The presentation was titled “Success Through Collaboration”. The Council stated that suicide is a prevalent public health problem in Idaho. The moving presentation provided facts about suicide in the state and descriptions of “what works”. The Health Quality Planning Commission (HQPC) followed the Idaho Council on Suicide Prevention with a similar presentation. It was referred to as a “tag team approach”. In 2015 SCR 104 charged the HQPC to prepare an implementation plan for a comprehensive suicide prevention program. A team was assembled to select prevention methods most likely to succeed and the infrastructure necessary to improve coordinated efforts across Idaho. The HQPC provided data, recommendations, and initiatives to the committee. Both presentations, the questions that followed, and commentary can be listened to through the Idaho Legislature Digital Media Archive.

Medicaid Expansion Hearing

The Idaho Legislature will hold its first-ever hearing on Medicaid expansion next week. Senate Health and Welfare Committee has scheduled a public hearing on Tuesday for the two personal bills introduced by Senator Dan Schmidt (D-Moscow). The hearing will include time for the public to present testimony in support or opposition of the two bills.

S1204 full bill text can be found here

S1205 Full bill text can be found here

News articles about the hearing:

Medicaid Expansion to Get Hearing in Senate Committee – Twin Falls Times-News

Idaho Legislature schedules Medicaid expansion hearing – KTVB

Medicaid expansion plan gets first-ever hearing in Idaho – Idaho Statesman

Bills/Rules of Note

If there are specific Bills or Rules that you would like Molly to track, please let her know. For full bill text and more information regarding bills this session, please go to the Idaho Legislature Bill Center

Bill No	Description	Last Action
H0331	Alcoholic bevs, powdered alcohol	01/28/2016 House - Reported out of Committee, Recommend place on General Orders
H0332	Residential care, license renewal	01/29/2016 House - U.C. to hold place on third reading calendar until Monday, February 1, 2016
H0333	Optometrists, license renewal	01/29/2016 House - U.C. to hold place on third reading calendar until Monday, February 1, 2016
H0334	Physical therapy license renewal	01/29/2016 House - U.C. to hold place on third reading calendar until Monday, February 1, 2016
H0335	Controlled substances, sched II	01/19/2016 House - Reported Printed and Referred to Health & Welfare
H0336	Pharmacy board terms	01/19/2016 House - Reported Printed and Referred to Health & Welfare
H0337	Prescriptions, med examiners/dbase	01/19/2016 House - Reported Printed and Referred to Health & Welfare
H0338	Legend drug possession	01/19/2016 House - Reported Printed and Referred to Health & Welfare
H0339	Controlled substance storage	01/19/2016 House - Reported Printed and Referred to Health & Welfare
H0340	Pharm brd, contraceptives	01/19/2016 House - Reported Printed and Referred to Health & Welfare
H0341	Patient freedom of info act	01/29/2016 House - U.C. to hold place on third reading calendar until Monday, February 1, 2016
H0375	Health care task force	01/27/2016 House - Reported Printed and Referred to Health & Welfare
H0416	Chip plan B, eligibility requirmnts	01/29/2016 House - Introduced, read first time, referred to JRA for Printing
H0421	Health insurance exchange	01/29/2016 House - Introduced, read first time, referred to JRA for Printing
S1196	Sexual orientation, gender identity	01/20/2016 Senate - Reported Printed; referred to State Affairs
S1199	Approp, medical boards, add'l	01/29/2016 House - U.C. to hold place on third reading calendar until Monday, February 1, 2016
S1201	Approp, catastrophic health, reduce	01/29/2016 House - U.C. to hold place on third reading calendar until Monday, February 1, 2016
S1204	Medicaid, eligibility expansion	01/25/2016 Senate - Reported Printed; referred to Health & Welfare
S1205	Medical assist/eligibility standard	01/25/2016 Senate - Reported Printed; referred to Health & Welfare
S1206	Approp, H&W indirect support, add'l	01/29/2016 House - Read First Time, Filed for Second Reading
S1207	Approp, H&W psych hosp, add'l	01/29/2016 Senate - Passed: Ayes 32 Nays 0 Excused 3; title approved; to House
S1211	Catastrophic heath care program	01/25/2016 Senate - Reported Printed; referred to Local Government & Taxation
S1231	Chiropractic practic/prescrib drugs	01/29/2016 Senate - Introduced; read first time; referred to JR for Printing

This Week’s Presentations House Health and Welfare: Monday Idaho Time Sensitive Emergency System Council, School-Based and Therapy Services, Health Care Policy Initiatives, Medicaid Enhanced Plan Benefits, Consumer Directed Services, Certified Family Homes, Licensure to Practice, and Telehealth Services Tuesday Residential Care, Optometrists, Physical Therapy, Patient Freedom of Information Act, and Your Health Idaho Annual Report Wednesday Primary Care Access Program Thursday Licensure to Practice, Telehealth Services, Idaho Council on Suicide Prevention, and Health Quality Planning Commission Friday Health Care Policy Initiatives, Medicaid Enhanced Plan Benefits, Consumer Directed Services, and Certified Family Homes Senate Health and Welfare: Monday Rules of the Idaho Time Sensitive Emergency System Council, Medicaid Enhanced Plan Benefits, Consumer-Directed Services, Rules Governing the Food Stamp Program in Idaho, Idaho Telecommunication Service Assistance Program Rules, Rules Governing the Emergency Food Assistance Program, Rules Governing the Low Income Home Energy Assistance Program, and Weatherization Assistance Program in Idaho Tuesday Rules of the Board of Medicine for the Licensure to Practice Medicine and Surgery and Osteopathic Medicine and Surgery in Idaho, Rules Relating to Telehealth Services, and Primary Care Access Program Wednesday Food Safety and Sanitation Standards for Food Establishments (The Idaho Food Code), Behavioral Health Sliding Fee Schedules, Behavioral Health Development Grants, Behavioral Health Programs, Alcohol and Substance Use Disorders Services, and Alcohol and Substance Use Disorders Treatment and Recovery Support Services Facilities and Programs Thursday  Rules of the Idaho Licensing Board of Professional Counselors and Marriage and Family Therapists, Rules of the State Board of Acupuncture, Rules of the Genetic Counselors Licensing Board, Rules of the State Board of Chiropractic Physicians, Rules of the Board of Drinking Water and Wastewater Professionals, Rules for the Licensure of Occupational Therapists and Occupational Therapy Assistants, Rules of the Idaho State Board of Psychologist Examiners, and Amending to revise restrictions relating to prescribing, dispensing, independently administering, distributing, directing or suggesting to patients certain drugs, substance or products.