Week ten of the 2017 legislative session is now over. This has been a very busy week for public health in Idaho. As such, I will forego the national overview and focus this week’s update close to home. I will look at the proposed, “Idaho Accountable Community Care Act,” the Senate’s rejection of Medicaid expansion amendments to bill S1142 (Sen. Marv Hagedorn’s “Health Care Assistance Program”), and IPHA president, Ryan Lindsay’s, OpEd in the Idaho Statesman this week. I will also follow up on a few past pieces of legislation. 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 State Level

Rep. John VanderWoude (R-Nampa) announced this week that he will be introducing new legislation, “aimed at improving health care in Idaho by increasing the number of family medicine residency slots; creating a loan forgiveness program to help community health centers recruit doctors; and directing hospitals to help patients enroll in primary care instead of visiting emergency rooms, through a new Idaho Coordinated Care Program, which would be available to people in Idaho’s health coverage gap and also to some people already on Medicaid” (Betsy Z. Russell; read source material here). Named the, “Idaho Accountable Community Care Act,” (IACCA) draft legislation is based on the premise that, “health care is too expensive across the entire system, driven in large part by shortages in primary-care services that make people delay care until their health worsens or seek emergency room treatment regardless of urgency” (Bill Dentzer; read source material here). Majority Caucus Chairman, VanderWoude stated in a press release that, “with the election of President Donald Trump, now is the time to change Idaho’s health care system without interference from the federal government. Today, health care is expensive and inefficient. We have a solution to fix it.” The IACCA would initially be funded through the state, but is noted in Dentzer’s article (hyperlink above) to, “not preclude seeking funding from other sources including federal money.” Going further, the IACCA would also, “require hospitals to set up programs and procedures to redirect non-emergency patients to primary care providers instead of receiving expensive emergency room care.”

Meanwhile, Senate Bill 1142, which proposes to use $10 million from Idaho’s tobacco settlement proceeds to, “authorize primary care, limited prescriptions, and care coordination to Idaho's eligible population with income levels under 100% of the federal poverty guideline who are not eligible for Medicaid, the Advanced Payment of Tax Credit, and not currently eligible or enrolled in an employer sponsored or other government subsidized health care plan.” (SOP, S1142), has been amended and engrossed. Engrossment 1 was read a second time as amended on 03/17 in the Senate, and has been filed for a third reading. However, these changes will not include Medicaid expansion even after debate in the Senate over the same. Sen. Janie Ward-Engelking, D-Boise argued on 03/16 that the $10 million from the tobacco settlement fund could be used to leverage Medicaid expansion to the tune of $90 million that would serve Idaho’s 78,000 people in the health care “gap.” Sen. Hagedorn countered by saying the amended version of his plan would cover about 15,000 people in the gap, in addition to creating a pilot project for 250 of the most ill in that group, “to get some data on the success or failures of doing that managed care for that population.” Read source material here. As written, then, the 63,000 Idahoans who will be left without coverage under Hagedorn’s proposal will need to put their hope and healthcare needs on hold.

In an OpEd in the Idaho Statesman, IPHA President and assistant professor in the Department of Community and Public Health at Idaho State University, Ryan Lindsay, cautioned lawmakers about the ramifications of using monies from the Millennium Fund (the Master Tobacco Settlement) to close Idaho’s health care gap. In a statement reflecting thousands of uninsured Idahoans’ concerns, Dr. Lindsay advised that, “there simply are not enough Millennium Fund dollars to be a sufficient solution to providing health care coverage to the uninsured. Meaningful action is necessary to ensure health care coverage, but using tobacco use prevention funds to attempt partial coverage is a Band-Aid at best, and will only increase health care costs in the long run by undermining prevention efforts. We demand a better solution.”

Make your voice heard! 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

Update S1009

Keith Ridler of the AP reported on 03/16 that, “The Idaho Board of Environmental Quality voted to allow field burning during worse air quality thresholds for ozone that could start in 2018 if approved by the U.S. Environmental Protection Agency.” Read source material here. I have followed S1009 for several weeks now, and reported on the dangers of ozone and crop burning for rural Idahoans in previous blog entries. To read about the implications of this bill’s passage to air quality and health in Idaho, go here (entry “Idaho Air”).

Update H0043

JFAC unanimously approved funding for the Jeff D lawsuit settlement, as laid out in H0043, to cover its fiscal impact. To read the details about this decision, including eligibility criteria for children who will benefit from this funding, read source material here.

Coming up: RS25541 and RS25543

Two pieces of draft legislation are forthcoming which address faith healing. I’ll be keeping track of these and will present more information as it becomes available. Read more about what to expect here.

IPHA Bill Tracker

Bill No.	Description	Last Action
S1003	Nurse emeritus licenses; licensure renewal & reinstatement	03/08/2017 Senate – signed by Governor on this date
S1004	Board of Nursing member raise in compensation	03/01/2017 Senate – signed by Governor on this date
S1009	DEQ; crop residue burning	03/08/2017 Senate – signed by Governor  on this date
S1013	Marijuana/drug paraphernalia repeal	03/15/2017 H- U.C. to hold place on 3rd read. cal. 1 legislative day
S1024	Child protective act/definition revised	03/15/2017 H- U.C. to hold place on 3rd real. cal. 1 legislative day
S1031	Veterans transport fund grant program	03/15/2017 S- ret. from House passed; referred to enrolling
S1037	Dentists licensing provisions revised	03/08/2017 Senate – signed by Governor on this date
S1038	Dentistry Board/emergency proceedings	03/09/2017 S- read 1st time; referred to Health & Welfare
S1046	Health savings acct/high deductible plan	03/15/2017 Returned from House passed; referred to enrolling
S1050	Immunizations/exemption forms	02/08/2017 S-Reported printed; referred to Health & Welfare
S1058	Telehealth access; cost coverage	03/08/2017 S- failed: Ayes 10 Nays 24 Excused 1; to Sec. of Senate
S1060	Health care/cytomegalovirus	03/15/2017 S- Rep. signed by Speaker & ordered delivered to Governor
S1081	Immunization assessment bd/sunset revised	03/15/2017 House recvd. from Senate; Signed by Speaker; ret. to Senate
S1082	Community primary care program	02/13/2017 S- Reported printed; referred to Health & Welfare
S1090	Health Care, advance directives	03/15/2017 Read 2nd time as amended, filed for 3rd reading.
S1117	Self-funded insurance	03/15/2017 H- read 2nd time; filed for 3rd reading
S1131	Abortion, H&W dept. website posting	03/03/2017 Senate – reported printed; referred to State Affairs
S1142	Health Care Assistance Program	03/10/2017 S- rep. out of committee; ref. to 14th order for amendment
SCR113	Medical residencies; Idaho hospitals	03/15/2017 H – U.C. to hold place on 3rd reading calendar 1 leg. day.
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”	03/14/2017 H- Returned from Senate failed; filed in office of Chief Clerk
H0008	Massage therapists; institute criminal background checks	02/23/2017 H-Returned from Senate failed; filed in office of Chief Clerk
H0010	Chiropractic practice; licensure	02/22/2017 H-Reported signed by Governor on this date
H0011	Optometrists; licensure/provisions & revisions	03/15/2017 S- read 2nd time as amended in Sen.; filed 3rd reading
H0020	Vehicles; hybrid/plug-in fee reduction	02/28/2017 Reported signed by Governor on this date
H0025	Tobacco permits, terminology	02/17/2017 Reported signed by Governor on this date
H0038	Mental health, cite ref added	03/15/2017 H-Rep. enrolled; signed by Speaker; transmitted to Senate
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	03/15/2017 S- signed by President; returned to House
H0042	Behavioral health, council board	01/24/2017 Reported printed and referred to Health & Welfare
H0043	Med. assistance/eligibility/emotional disturbance	03/15/2017 H- Rep. enrolled; Signed by Speaker; Transmitted to Senate
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	03/15/2017 H- Rep. enrolled; Signed by Speaker; Transmitted to Senate
H0091	Immunization register/pro license board	02/23/2017 H-Failed; filed in office of Chief Clerk
H0115	Physicians, license background checks	03/15/2017 H- Rep. enrolled; Signed by Speaker; Transmitted to Senate
H0128	Medicaid; payment agreements	03/15/2017 H- Rep. enrolled; Signed by Speaker; Transmitted to Senate
H0146	Sexual assault evidence; med exam	03/15/2017 S-Read 2nd time; filed for 3rd reading
H0160	Health care assistance program	02/15/2017 Reported printed and referred to Health & Welfare
H0191	Pharmacy/prescriptions authorization	03/15/2017 H- Ret. from Senate passed; to JRA for enrolling
HCR003	Lifespan Family Caregiver Action Plan	02/24/2017 Senate – signed by President; returned to House