Week five of the 2017 legislative session proved, once again, to be very busy in terms of public health. Ten new pieces of legislation were added to our IPHA bill tracker this week, and five will receive focused treatment, including an update about the Idaho Caregiver Alliance’s Lifespan Family Caregiver Action Plan. This week’s update will continue looking at health care news on the national front, and tie this back to news in Idaho. As always, if you have questions, comments, or suggestions regarding issues or items that you would like to see followed here, please feel free to contact me at: tiffenystees.policyintern@gmail.com.

On the National Level

On Friday, February 10^th (by a vote of 52 to 47) the Senate approved the nomination of Representative Tom Price to be secretary of health and human services under the Trump administration. Price has been a leader in the movement to repeal the Affordable Care Act (ACA), and a strong proponent of curtailing the growth of Medicare and Medicaid. His “Empowering Patients First Act of 2015” (HR 2300), which he proposed as replacement for the ACA, can be read in full here. For a clear synopsis of HR 2300 go here. Among other things, Price favors “high risk pools” for difficult to insure individuals. This will be an item to watch as Dr. Price moves forward into his position, as such pools affect millions of Americans with preexisting conditions. To read more about “high risk pools” and why they have proved problematic in states offering the same, visit the Kaiser Family Foundation here.

On the State Level

On Tuesday, February 7^th, Governor Otter spoke to members of the Idaho Press Club at a breakfast meeting. Lis Stewart, of the Idaho Press, reports that the governor told members in attendance that what Idaho does in relation to the ACA conundrum has, “a lot [to] do here...on what goes on in Washington D.C.” and indicated that he wanted to be cautions moving forward with any plan of action that might be affected with an ACA repeal. She notes that, “Otter added Idaho is pushing for Congress to allow universal waivers to federal programs and statutory requirements, such as Medicaid. A waiver means that the state can develop a different kind of program than is required by the federal government, or enact stricter regulations, while still meeting the mission of the statute.” Indeed, this reflects the mission of Dr. Price in giving states more control over the future of health care in their individual areas. Read Ms. Stewart’s full article here.

As Idaho has failed to come up with a workable solution for the nearly 78,000 citizens who have fallen into the notorious health insurance “gap” to date, the future of those experiencing lack of coverage in Idaho is uncertain. For easy to implement guidelines in contacting Idaho lawmakers regarding health care coverage issues facing our state, Close the Gap Idaho has an excellent template and instructions here. Use it, or pass it on.

H0043

Last week I discussed forthcoming Medicaid budget changes (next year) that will transform Idaho children’s mental health services, effectively resulting in tripling services for children with serious mental health issues. This week Idaho Health and Welfare Director, Dick Armstrong, reiterated to legislative budget writers that a top budget priority this year is a redesign of the children’s mental health program. Armstrong claims that plans are, “the result of the Jeff D lawsuit which began in 1980," in which, "it took [them] years of court wrangling to come up with something [they] could have come up with decades earlier.” Read source material here.

Speaking to these changes, H0043 begins the process. From the bill’s Statement of Purpose:

This bill directs the Department of Health and Welfare to provide coverage for children under age 18 with serious emotional disturbance with family incomes up to 300% of the federal poverty level. The purpose of the legislation is to enable these children to recover from past trauma and build resiliency so that they can become adults who participate meaningfully and productively in society. This legislation allows the Department to comply with the Jeff D. settlement agreement (U.S. District Court Case No.4:80-CV-04091-BLW) in a manner that most efficiently leverages state general funds.

HCR003: Idaho Caregiver Alliance (ICA) Update

The ICA has made great progress in the past week. HCR003 will be read for a third time in the House on Monday, February 13^th, and is the 12^th item on the docket. HCR003 raises public awareness of the importance of Idaho caregivers, and gives recognition to their enormous contributions to the State of Idaho. Read the ICA’s Idaho’s Lifespan Family Caregiver Action Plant in its entirety here.

Immunization Legislation

This week, two pieces of legislation affecting immunization in Idaho were introduced. First, bill S1050 proposes to grant parents (or guardians) the ability to “opt out” of certain childhood immunizations normally required before a child starts school (pursuant to Idaho Code § 39-4801). The law, “would clarify that a parent or guardian…sign a statement in objection in any form and present it to the school [emphasis added].” This amends previous language requiring a parent or guardian to use an official form furnished by “the State Board of Health and Welfare, a school or another entity.”

Second, S1081, “resets the Sunset date for the Immunization Assessment Board from 2017 to July 1, 2019.” To better understand the Board, go here.

To read about Idaho State vaccine requirements, the NVIC has a helpful overview here. The National Institute of Health offers a JAMA published article regarding statistical correlation between vaccine refusal and vaccine preventable disease(s) numbers. To better understand those opposing vaccine requirements, Health Freedom Idaho opines about the debate from their organization’s perspective here.

 S160 – Cytomegalovirus

From S160’s Statement of Purpose:

 The purpose of the bill is to ensure the women of Idaho and their doctors have access to the most accurate and up-to-date information available regarding cytomegalovirus (CMV) prevention, infection, and treatment. Appropriate dissemination of this information will foreseeably prevent the infection of numerous babies inutero [sic], thereby saving the State of Idaho millions of dollars in the care and treatment of various disabilities that are associated with congenital CMV infection.

The Centers for Disease Control and Prevention offers a clear overview of what the cytomegalovirus and congenital CMV infection are, here.

Advocacy spotlight:

February 15^th is suicide prevention advocacy day the Capitol, sponsored by the American Foundation for Suicide Prevention, Idaho. Idaho has moved from the 9^th to the 6^th highest state in the nation for suicides, making this advocacy day vital for mental health advocates, and the public to show their support. Read more about Idaho’s suicide statistics on this SPAN fact sheet here.

Upcoming Advocacy Days & Involvement Opportunities

February 15th: Suicide prevention advocacy day at the Capitol sponsored by the American Foundation for Suicide Prevention, Idaho. For more information about this and the AFSP go here

February 21st: Consortium for Idahoans with Disabilities, 1st floor, Capitol (for more information visit CID on Facebook here

February 27th: Alzheimer's Association Idaho, the Capitol. Be visible and wear purple to show your support on their advocacy day! IPHA Bill Tracker

Bill No.	Description	Last Action
S1003	Nurse emeritus licenses; licensure renewal & reinstatement	02/09/2017 Read second time; filed for third reading
S1004	Board of Nursing member raise in compensation	02/03/2017 Read first time; referred to Health & Welfare
S1009	DEQ; crop residue burning	01/31/2017 Read first time; referred to Environment, Energy, & Tech.
S1013	Marijuana/drug paraphernalia repeal	01/20/2017 Reported printed; referred to JR
S1024	Child protective act/definition revised	01/25/2017 Reported printed; referred to JR
S1031	Veterans transport fund grant program	02/09/2017 Read 1st time; referred to State Affairs
S1037	Dentists licensing provisions revised	02/09/2017 Rep. out of committee with a Do Pass Rec.; filed for 2nd read.
S1038	Dentistry Board/emergency proceedings	02/09/2017 Rep. out of committee; to 14th Order for ammendment
S1046	Health savings acct/high deductible plan	02/06/2017 Rep. printed; referred to Commerce & Human Resources
S1050	Immunizations/exemption forms	02/07/2017 Introduced; read first time; referred to JR for printing
S1058	Telehealth access; cost coverage	02/09/2017 Reported printed; referred to Commerce & Human Resources
S1060	Health care/cytomegalovirus	02/09/2017 Reported printed; referred to Health & Welfare
S1081	Immunization assessment bd/sunset revised	02/10/2017 Introduced; read first time; referred to JR for printing
S1082	Community primary care program	02/10/2017 Introduced; read first time; referred to JR for printing
H0002	Pharmacists reciprocal licensing	2/09/2017 Reported enrolled; signed by Speaker; transmitted to Senate
H0003	Pharma/tuberculin protein products	02/09/2017 Reported enrolled; signed by Speaker; transmitted to Senate
H0004	Pharmacists, tobacco cessation products	02/09/2017 Reported enrolled; signed by Speaker; transmitted to Senate
H0005	Controlled substances, opioids	02/09/2017 Reported enrolled; signed by Speaker; transmitted to Senate
H0006	Controlled substances	02/09/2017 Ret. signed by President; ordered transmitted to Governor
H0007	Massage therapists; change “establishment to school”	02/09/2017 Reported out of comm. w/a Do Pass Rec; Filed for 2nd read.
H0008	Massage therapists; institute criminal background checks	02/09/2017 Sen. Introduced; read first time; referred to Health & Welfare
H0010	Chiropractic practice; licensure	02/01/2017 Reported out of committee; referred to Health & Welf.
H0011	Optometrists; licensure/provisions & revisions	02/09/2017 Sen. Introduced; read 1st time; referred to Health & Welfare
H0020	Vehicles; hybrid/plug-in fee reduction	02/08/2017 Sen. Introduced; read 1st time; referred to Transportation.
H0025	Tobacco permits, terminology	02/09/2017 Reported enrolled; signed by Speaker; transmitted to Senate
H0038	Mental health, cite ref added	01/24/2017 Reported printed and referred to Health & Welfare
H0039	Medicaid; H&W agreements	01/24/2017 Reported printed and referred to Health & Welfare
H0040	Hosp, mentally ill, release notice	01/24/2017 Reported printed and referred to Health & Welfare
H0041	Individuals w/ disabilities/ABLE accts	02/09/2017 House read 2nd time; filed for 3rd reading
H0042	Behavioral health, council board	01/24/2017 Reported printed and referred to Health & Welfare
H0043	Med. assistance/eligibility/emotional disturbance	02/09/2017 Read second time; filed for third reading
H0044	Secure treatment facility act	01/24/2017 Reported printed and referred to Health & Welfare
H0045	Dieticians/licensing revised	02/06/2017 U.C. to be returned to Health & Welfare Committee
H0062	Youth mental health; conversion	01/27/2017 Reported printed and referred to Health & Welfare
H0080	Public Health Districts/Funding/bd of trustees	02/01/2017 Reported printed and referred to Health & Welfare
H0081	Health care, J-1 visa waiver program	02/01/2017 Reported printed and referred to Health & Welfare
H0091	Immunization register/pro license board	02/02/2017 Reported printed and referred to Health & Welfare
H0128	Medicaid; payment agreements	02/09/2017 Introduced; read first time; referred to JRA for printing
HCR003	Lifespan Family Caregiver Action Plan	02/09/2017 Rep. out of committee with Do Pass rec.; Filed for 2nd read.