Week six of the 2017 legislative session is now behind us. This week I’ll take a quick look at President Trump’s nominee to head the Center for Medicaid and Medicare Services (CMS), then review Representative Fred Wood’s “Health Care Assistance Program” bill, and look at its implications for Idaho’s gap population. I have added new advocacy opportunities, and will discuss a few pieces of legislation in depth. This week I would like to extend special thanks to Rep. Melissa Wintrow for taking the time to provide me with comprehensive information on one of the bills I will highlight, H0146. 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
Last Thursday, Seema Verma underwent a confirmation hearing for appointment as administrator of the Center for Medicaid and Medicare Services (CMS), the trillion annual dollar agency responsible for managing health benefits for 100 million Americans, including the Children’s Health Insurance Program (CHIP). Verma is a private health care consultant and architect of the “Healthy Indiana Plan 2.0,” (HIP). The philosophical underpinnings of HIP, as co-stated by Verma, embody a “meld[ing] [of] two themes of American society that typically collide in our healthcare system, rugged individualism and the Judeo Christian ethic.” Verma noted that HIP was designed to give participants a sense of ownership, or “skin in the game,” related to their healthcare. Read Verma (and Roob’s) full article here. President Trump has referred to Verma as the person who “will transform our healthcare system for the benefit of all Americans.” In her confirmation hearing, Verma declined to answer questions directly related to her vision of Medicaid reform related to block grants or per capita caps. Verma did indicate that what she does support, "is the program working better, whether that is a block grant or per capita cap,” claiming further that, “there are many ways we can get there." Read source material for these statements here. Read the interim evaluation report of HIP 2.0 here. As of this writing, Verma’s official appointment is still pending.
On the State Level
On Monday, February 13th, the House Health and Welfare Committee voted unanimously to introduce Rep. Fred Wood’s (R-Burley) bill H0160 (reported printed and referred to Health and Welfare on 02/15/2017). H0160, or “The Health Care Assistance Program,” proposes to use $10 million of the state’s Millennium Fund to provide primary care and limited prescription coverage to Idaho’s gap population. Wood testified to the committee that funds are limited and, therefore, coverage would only extend to “a limited sub-group of adults and is not comprehensive care.” Wood further stated, in comments made after the meeting, that eligibility would be determined, “basically on a first-come, first-served basis.” Similar to Verma’s HIP 2.0 plan, patients under H0160 would be required to pay participating provider fees up to $20, thereby demonstrating an autonomous commitment to their healthcare process. Read the full text of this bill at the link provided in the IPHA Bill Tracker below.
Sen. Steven Thayn (R) Emmett and Rep. Ryan Kerby (R) New Plymouth, have also proposed legislation to address Idaho’s gap. Bill S1082, (known as the “Community Primary Care Program”) was reported printed and referred to Health and Welfare on 02/13/2017. S1082 is intended to improve the health of low-income Idahoans, while also helping them to develop economic self-sufficiency. There would be a 3-year lifetime enrollment limit according to this program. Reflective of Verma’s “rugged work ethic” stance on the national level, qualifying participants under S1082 would be eligible for an additional $400/year if they engage in “life skills training” (budgeting, conflict resolution, cooking, job seeking strategies, goal setting, parenting or other relationship building, and wellness), or “personal improvement plans.” This program would be funded by state appropriations to the CAT Fund. The full text of this bill is linked in the Bill Tracker below.
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.
Bills in Focus
H0146: Added Protections for Victims of Sexual Assault
H0146 (Rep. Melissa Wintrow, D-Boise), proposes to “codify standards for sexual assault victims’ access to medical examinations,” and, “sets standards for sexual assault evidence retention and preservation.” Further, this bill would ensure that victims are not denied medical exams based on their inability to pay for the same. Representative Wintrow will be presenting on this bill on Tuesday, Feb. 21 at 1:30pm in the House Judiciary and Rules Committee.
Representative Wintrow graciously offered me some clarification by email about H0146, a piece of legislation relevant not only to public health, but social justice in Idaho. She states:
Legislation that works to improve victims' rights is vital; right now, for every 1,000 sexual assaults, only 310 are reported to authorities, and only six perpetrators are convicted. This is a terrible miscarriage of justice and requires law makers to look at systems to better ensure justice.
Currently, there are massive inefficiencies within sexual assault reporting and investigation. There are currently many barriers for individuals when reporting a sexual assault. Victims are often ashamed and wonder if their story will be believed. Once a report to law enforcement occurred, there isn’t always a consistent way that evidence is treated or disposed of, thus the need for this legislation. These barriers contribute to the under-reporting of sexual assault cases in the United States and a lack of justice for victims. In order to continue holding perpetrators accountable, the state needs to help provide assistance to the people who need it most -- victims. I believe it is our responsibility as government officials to create the most accessible and transparent systems for victims of crime, especially in this case since sexual assault is so grossly underreported.
After passing H528 in 2016 (Idaho Code 67-2929), setting minimum standards for processing sexual assault evidence kits with ISP, a number of questions arose about establishing time standards for biological evidence preservation and destruction in our state. Law enforcement entities in Idaho have asked for direction from policy makers and legislators regarding the length of time they should preserve these kits.
Thus, a working group of stakeholders was formed with the goal to create statewide standards for sexual assault evidence kit preservation/destruction to ensure consistent practice throughout our state.
The committee reviewed best practices from other states, work products of national crime victim organizations, the Violence Against Women Act, and perspectives of a variety of stakeholder groups. Efforts were made to ensure diverse representation on the committee in order to increase effectiveness.
H0191: Greater Freedom for Pharmacists
H0191 gives pharmacists the ability to directly give patients certain low-risk medications (such as birth control) for conditions that “do not require a diagnosis, conditions that are minor and self-limiting, and conditions that have a simple CLIA-waived laboratory test which guides clinical decision making.” H0191’s Statement of Purposes notes that other states have seen good outcomes through implementation of similar bills. Read more about pharmacists as drug prescribers here.
HCR003: Idaho Caregiver Alliance (ICA) Update
The ICA presented before the Senate Health and Welfare Committee on Thursday, February 16th on behalf of their proposed, HCR003, a concurrent resolution designed to raise public awareness of the importance of Idaho caregivers, and recognize their enormous contributions to the State of Idaho. HCR003 was unanimously approved, with a “Do Pass” recommendation and will now be sent to the Senate floor. Read the ICA’s Idaho’s Family Lifespan Family Caregiver Action Plan in its entirety here. A link to HCR003 is provided in the Bill Tracker below.
Advocacy spotlight:
A chance to advocate on behalf of Tobacco 21, an initiative strongly supported by the IPHA, is at hand. A (tentative) full hearing in Senate State Affairs Committee (Room WW55, Garden Level), is scheduled for March 1st at 8 a.m. Talking points for this tentative public hearing have been provided by the American Lung Association, Idaho and can be found here. Read more about what’s happening in the Legislature with this here.
Upcoming Advocacy Days & Involvement Opportunities
February 21st: Rep. Melissa Wintrow will be presenting on H0126 at 1:30pm in the House Judiciary and Rules Committee. Please see my detailed description of this important piece of social justice/public health legislation above.
February 21st: Consortium for Idahoans with Disabilities, 1st floor, Capitol from 8 a.m. to 2 p.m. (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!
March 1st: Tobacco 21 (tentative) full hearing at 8 a.m. More information is forthcoming.
IPHA Bill Tracker
Bill No.
|
Description
|
Last Action
|
S1003
|
Nurse emeritus licenses; licensure renewal & reinstatement
|
02/14/2017 H-Read first time; referred to Health & Welfare
|
S1004
|
Board of Nursing member raise in compensation
|
02/17/2017 H-Rep. out of comm. w/ a Do Pass Rec.; filed for 2nd reading
|
S1009
|
DEQ; crop residue burning
|
01/31/2017 Read 1st time; referred to Environment, Energy, & Tech.
|
S1013
|
Marijuana/drug paraphernalia repeal
|
|
|
02/16/2017 H-Read 1st time; referred to JRA
|
S1024
|
Child protective act/definition revised
|
02/17/2017 S-Read 2nd time; filed for 3rd reading
|
S1031
|
Veterans transport fund grant program
|
02/09/2017 Read 1st time; referred to State Affairs
|
S1037
|
Dentists licensing provisions revised
|
02/15/2017 H-Read 1st time; referred to Health & Welfare
|
S1038
|
Dentistry Board/emergency proceedings
|
02/09/2017 Rep. out of committee; to 14th Order for amendment
|
S1046
|
Health savings acct/high deductible plan
|
02/06/2017 Rep. printed; referred to Commerce & Human Resources
|
S1050
|
Immunizations/exemption forms
|
02/08/2017 S-Reported printed; referred to Health & Welfare
|
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
|
02/17/2017 S-Read 2nd time; filed for 3rd reading
|
S1082
|
Community primary care program
|
02/13/2017 S- Reported printed; referred to Health & Welfare
|
H0002
|
Pharmacists reciprocal licensing
|
2/17/2017 H-Reported signed by Governor on this date
|
H0003
|
Pharma/tuberculin protein products
|
2/17/2017 H-Reported signed by Governor on this date
|
H0004
|
Pharmacists, tobacco cessation products
|
2/17/2017 H-Reported signed by Governor on this date
|
H0005
|
Controlled substances, opioids
|
2/17/2017 H-Reported signed by Governor on this date
|
H0006
|
Controlled substances
|
02/14/2017 H-Reported signed by Governor on this date
|
H0007
|
Massage therapists; change “establishment to school”
|
02/14/2017 S-Introduced; read 1st time; referred to Health & Welfare
|
H0008
|
Massage therapists; institute criminal background checks
|
02/17/2017 S-Rep. out of com. w/ a Do Pass rec.; Filed for 2nd reading
|
H0010
|
Chiropractic practice; licensure
|
02/17/2017 H-Rep. enrolled; signed by speaker; transmitted to Senate
|
H0011
|
Optometrists; licensure/provisions & revisions
|
02/09/2017 Sen. Introduced; read 1st time; referred to Health & Welfare
|
H0020
|
Vehicles; hybrid/plug-in fee reduction
|
02/17/2017 Sen. Passed: ayes 30, nays 2, excused 3;title approved to House
|
H0025
|
Tobacco permits, terminology
|
|
|
02/17/2017 Reported signed by Governor on this date
|
H0038
|
Mental health, cite ref added
|
02/17/2017 S-Introduced; read 1st time; 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
|
02/13/2017 S-Introduced; read 1st time; referred to Health & Welfare
|
H0042
|
Behavioral health, council board
|
01/24/2017 Reported printed and referred to Health & Welfare
|
H0043
|
Med. assistance/eligibility/emotional disturbance
|
02/13/2017 S-Introduced; read 1st time; referred to Health & Welfare
|
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
|
02/17/2017 Rep. out of committee w/ a Do Pass rec. Filed for 2nd read.
|
H0091
|
Immunization register/pro license board
|
02/17/2017 H-Rep. out of committee w/ a Do Pass rec. Filed for 2nd read.
|
H0115
|
Physicians, license background checks
|
02/17/2017 H-Rep. out of committee w/ a Do Pass rec. Filed for 2nd read.
|
H0128
|
Medicaid; payment agreements
|
02/09/2017 H-Rep. out of committee w/ a Do Pass rec. Filed for 2nd read.
|
H0146
|
Sexual assault evidence; med exam
|
02/13/2017 House - Reported Printed and Referred to JRA
|
H0160
|
Health care assistance program
|
02/15/2017 Reported printed and referred to Health & Welfare
|
H0191
|
Pharmacy/prescriptions authorization
|
02/17/2017 H-Reported printed and referred to Health & Welfare
|
HCR003
|
Lifespan Family Caregiver Action Plan
|
02/17/2017 S-Rep. out of comm. w/ a Do Pass rec.; 10th order; held one legislative day
|