The 2017 Idaho Legislative Session has now concluded. It has been an interesting 80 day ride in terms of healthcare and public health related legislation.  There were some definite hits, with the passing of H0146 (Rep. Wintrow’s sexual assault evidence preservation bill), and HCR3 (the Idaho Caregiver Alliance’s concurrent resolution recognizing the importance of caregivers); and some notable misses with the failure of the Tobacco 21 (S1106), and passing of S1009 that will serve to impact air quality in Idaho. The biggest items on this writer’s agenda were the proposed pieces of legislation designed to address the uninsured in Idaho, none of which were successful and all of which had limitations therein. The 78,000 people in Idaho’s healthcare “gap” population are still waiting. Citizen support and formal advocacy efforts, especially by advocacy group “Close the Gap Idaho,” on behalf of these Idahoans were nothing less than heroic. However, the work of all concerned has just begun.

The failure of the AHCA marks a new opportunity for all state-level advocates to re-group and strengthen their voices for the expansion of Medicaid in the coming year. All must keep a close watch on both state and federal fronts to ensure a just outcome for those who have limited or no access to healthcare. It has been a privilege for me to have followed these efforts, and to keep IPHA members and supporters generally informed of a breadth of happenings this year. I thank the IPHA for allowing me the opportunity to serve as intern, and look forward to lending my voice to theirs as I move out into our community with my MSW.

If you have questions, comments, or suggestions regarding this blog, or for the future direction thereof, please feel free to contact me at: tiffenystees.policyintern@gmail.com. All suggestions will be forwarded to IPHA’s administration.

 

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

 

 

 

We have just passed week nine of the 2017 legislative session.  This week, I will take a look at the new “American Health Care Act" on the national level, and Sen. Marv Hagedorn’s health care coverage bill, S1142, here at home. 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

The American Health Care Act (AHCA), the GOP’s plan to replace the Affordable Care Act (ACA), has been unveiled. House Speaker Paul Ryan, has answers for those who have questions. On the Speaker’s official page, he states that, “[the Trump Administration’s] goal is to make sure every American has access to the coverage they want and can afford. And as we move to that better system, there will be a stable transition so the rug isn’t pulled out from under anyone. Our plan will protect the most vulnerable by strengthening Medicaid and giving power back to the states. What’s more, the advanceable, refundable tax credits will encourage competition and put consumers in the driver’s seat. That’s the kind of choice and control Americans deserve.” However, critics aren’t too sure about the tenability of the promised outcomes.

Not all of the AHCA’s details, such as absolute cost and coverage, are in yet. Glenza and Jacobs, of The Guardian write that, “The legislation has not been fully scored by the congressional budget office and debate in the House will proceed without members having a clear accounting of the mechanics of implementing it.” The American Medical Association, in a letter to congressional leaders, stated that they could not endorse the AHCA due to, “expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations,” and also referenced its provisions targeting Planned Parenthood, among other things. The American Nurses Association made their position known to lawmakers in a letter stating, “The American Health Care Act threatens health care affordability, access, and delivery for individuals across the nation. In its current form, the bill changes Medicaid to a per capita cap funding model, eliminates the Prevention and Public Health Fund, restricts millions of women from access to critical health services, and repeals income based subsidies that millions of people rely on. These changes in no way will improve care for the American people.” The American Hospital Association also wrote to express their views on the AHCA, on behalf of their members, that include 5,000 hospitals and health organizations, 270,000 affiliated physicians, and 2 million nurses and other caregivers. In a statement that echoed Glenza and Jacobs’ (cited above) the AHA wrote, “Any ability to evaluate The American Health Care Act, however, is severely hampered by the lack of coverage estimates by the Congressional Budget Office (CBO). Lacking that level of analysis and needed transparency, we urge that Congress should wait until an estimate is available before proceeding with formal consideration.”

As it is written, analysts estimate that millions of Americans insured through the ACA would be at risk of losing coverage, "with those in their 50s and 60s especially likely to find coverage unaffordable." Read source material here.

 On the State Level

Sen. Marv Hagedorn introduced Senate Bill 1142 this week; a bill closely resembling Rep. Fred Wood’s bill designed to address (in part) Idaho’s health care gap population. Sen. Wood withdrew his “Health Care Assistance Program (H0160) on February 28^th. S1142 will 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). The bill was reported by The Spokesman Review to have cleared Senate committee on Thursday, and will now head to the full Senate.

Close the Gap Idaho sponsored “A Plan not a Delay Procession,” on Thursday, March 9^th with a large, successful turnout of concerned citizens and advocates. However, there is still work to be done to help gain health insurance coverage for the over 78,000 Idahoans living in the gap. 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 S1060 – Cytomegalovirus Bill

The Idaho House voted to allot $15 thousand in funds to increase awareness of and educate the public on the dangers and prevention of the cytomegalovirus. The bill will now head to Governor Otter for signing. Read source material here. Read more about this dangerous virus, including information from the CDC, in my update during week five of the 2017 Idaho Legislative Session.

IPHA Bill Tracker

Bill No.	Description	Last Action
S1003	Nurse emeritus licenses; licensure renewal & reinstatement	03/02/2017 Senate – reported delivered to 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	03/02/2017 Senate – reported delivered to Governor  on this date
S1013	Marijuana/drug paraphernalia repeal	02/16/2017 H-Read 1st time; referred to JRA
S1024	Child protective act/definition revised	02/22/2017 H-Read 1st time; referred to JRA
S1031	Veterans transport fund grant program	02/09/2017 Read 1st time; referred to State Affairs
S1037	Dentists licensing provisions revised	03/02/2017 Senate – reported delivered to Governor on this date
S1038	Dentistry Board/emergency proceedings	02/09/2017 Rep. out of committee; to 14th Order for amendment
S1046	Health savings acct/high deductible plan	02/28/2017 House – read 1st time; referred to State Affairs
S1050	Immunizations/exemption forms	02/08/2017 S-Reported printed; referred to Health & Welfare
S1058	Telehealth access; cost coverage	03/01/2017 Reported out of committee; to 14th order for amend.
S1060	Health care/cytomegalovirus	02/28/2017 House – read 1st time; referred to Health & Welfare
S1081	Immunization assessment bd/sunset revised	03/02/2017 H- U.C. to hold place on 3rd reading calendar 1 legislative day
S1082	Community primary care program	02/13/2017 S- Reported printed; referred to Health & Welfare
S1090	Health Care, advance directives	02/23/2017 Reported out of committee; to 14th order for amend.
S1117	Self-funded insurance	03/03/2017 Senate; rep. out of com. w/ Do Pass rec. Filed for 2nd read.
S1131	Abortion, H&W dept. website posting	03/03/2017 Senate – reported printed; referred to State Affairs
S1142	Health Care Assistance Program	03/07/2017 Reported printed; referred to Health & Welfare
SCR113	Medical residencies; Idaho hospitals	03/03/2017 House – read first time, 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”	02/24/2017 S-Read 2nd time; filed for a 3rd reading
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	02/23/2017 S-Reported out of committee; 14th order for amendment
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	02/24/2017 S-Read 2nd time; filed for 3rd reading
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	02/23/2017 S-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	02/22/2017 S-Read 2nd time; filed for 3rd 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	03/02/2017 S-Read 2nd time; filed for 3rd reading
H0091	Immunization register/pro license board	02/23/2017 H-Failed; filed in office of Chief Clerk
H0115	Physicians, license background checks	03/03/2017 S-Read 2nd time; filed for 3rd reading
H0128	Medicaid; payment agreements	03/02/2017 S-Read 2nd time; filed for 3rd reading
H0146	Sexual assault evidence; med exam	02/28/2017 S-Introduced; read 1st time; referred to J & R
H0160	Health care assistance program	02/15/2017 Reported printed and referred to Health & Welfare
H0191	Pharmacy/prescriptions authorization	03/02/2017 S-Introduced; read 1st time; referred to Health & Welfare
HCR003	Lifespan Family Caregiver Action Plan	02/24/2017 Senate – signed by President; returned to House

Week eight of the 2017 legislative session has now concluded.  I’ll begin this week’s update by taking a look at President Trump’s address to Congress, and his comments on repeal and replacement of the Affordable Care Act (ACA). After taking a quick look at what is happening with close the gap issues here at home, I’ll highlight a few bills newly added to the IPHA bill tracker. 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.

*CORRECTION NOTE* Last week I spoke about Senator Lee Heider testifying on behalf of HCR003. The testifying Senator was actually Senator Fred Martin (R) of District 15, Ada County.

On the National Level

President Trump, in his address to Congress on February 28^th, continued to admonish lawmakers to repeal and replace the ACA. In comments nearly identical to others he has made, the President stated, “We should help Americans purchase their own coverage through the use of tax credits and expanded health savings accounts. But it must be the plan they want, not the plan forced on them by our government.” The President, who in his campaign stated that under his administration all Americans would be “beautifully covered” by “much less expensive and much better” health insurance, appears to be moving away from these campaign promises by touting the larger Republican idea of everyone having access to coverage. The difference is more than linguistic. It means that Americans would have the opportunity to buy their own coverage, in whatever manner, or from whatever entity, they choose. Naturally, this presupposes that those with serious pre-existing conditions, and other low income Americans, could afford the same (or make enough money to fund an HSA, or qualify for tax credits).

All of the directional uncertainty related to “repeal and replace” within the Trump Administration has started to reflect in a shifting attitude toward the ACA by former skeptics. A recent Kaiser Health Tracking Poll found that 48% of respondents showed a more favorable attitude toward the ACA, reflecting the highest approval rating ever recorded in the 60 polls conducted by Kaiser since 2010 (N = 1,160). Read survey methodology here.

On the State Level

February 28^th was also eventful on the state level. House Health & Welfare Chairman, Rep. Fred Wood (R – Burley), withdrew his “Health Care Assistance Program” (H-0160) bill, a $10 million measure designed to partially address Idaho’s health care gap problem. Wood stated, “I don't think there will be any legislation coming forward this year regarding the gap population,” (Lewiston Tribune reporter, Bill Spence cited in The Spokesman Review). However, on Friday, March 3 a new bill closely resembling Rep. Wood’s bill was reintroduced in the Senate by Sen. Marv Hagedorn. More to come on this in the near future.

A reminder that Close the Gap Idaho is sponsoring “A Plan not a Delay Procession,” on Thursday, March 9^th from 12:30 to 1:30 p.m. on the First Floor Rotunda. They are asking that advocates wear WHITE to show solidarity, and to add visual impact as supporters engage in procession through the Capitol. 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: Update

On Monday, February 27^th ,the House voted in unanimous support of  H0146, (Rep. Melissa Wintrow, D-Boise). H0146 moved on to the Senate the following day (28^th) where it was read for the first time and referred to Judiciary and Rules. Again, H0146 proposes to “codify standards for sexual assault victims’ access to medical examinations,” and, “sets standards for sexual assault evidence retention and preservation.”

Update: Tobacco 21

Tobacco 21 failed by a narrow margin in the Senate State Affairs Committee on Friday. Opponents of Tobacco 21 believed that such legislation would limit the rights of young people, who are considered old enough to do other things such as “join the military and vote.” Read source material here.

 S1131: Amendment Regarding Medical Abortion

S1131 (Senate State Affairs Committee) proposes to amend section 18-609 of Idaho code to require the Department of Health and Welfare to provide, on their website, “(f) 14-20 Information directing the patient where to obtain further information and assistance in locating a health care provider whom she can consult about chemical abortion, including the interventions, if any, that may affect the effectiveness or reversal of a chemical abortion, and informs the patient that if she wants to consult with such health care providers, she should contact those health care providers before she takes he abortifacient.” The amendment also includes language requiring information be provided that includes a woman’s right to observe heartbeat monitoring over just the stated “hear[ing] of the heart tone.” Senator Lori Den Hartog (R-Meridian) is the contact on this bill. Read more about “abortion reversal” here. Read what the American Congress of Obstetricians and Gynecologists report on “abortion reversal” here.

S1117: Self-Funded Insurance

S1117 proposes to amend section 41-4010 of Idaho Code to, “make it easier to create self-funded health insurance plans,” and “adds to the current law giving authority to the director of insurance to extent by up to 12 months the time period a self-funded plan has to meet the minimum surplus requirements (Sen. Steven P. Thayn, R-Emmett). Read about the advantages and disadvantages to employers on self-funding here.

SCR113: Formally Acknowledging Our Physician Shortage

SCR113 was approved in the Senate on March 2^nd, and was sent to the House, and has been referred to Health and Welfare. SCR113’s purpose is to, “bring attention to the pressing need for Idaho physicians and the shortage of residency programs to develop new physicians. It encourages hospitals to expand residency programs in existing fields as well as create residency programs for medical specialties that Idaho hospitals currently do not offer, such as general surgery and pediatrics.” (SOP, Sen. Chuck Winder, sponsor)

Upcoming Advocacy Days & Involvement Opportunities

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

March 9th: Close the Gap Idaho invites the public to attend "A Plan not a Delay Procession" Thursday, March 9th from 12:30 to 1:30 p.m. on the First Floor Rotunda at the State Capitol. Please wear WHITE to show your support, and to add visual impact to this advocacy opportunity.

IPHA Bill Tracker

Bill No.	Description	Last Action
S1003	Nurse emeritus licenses; licensure renewal & reinstatement	03/02/2017 Senate – reported delivered to 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	03/02/2017 Senate – reported delivered to Governor  on this date
S1013	Marijuana/drug paraphernalia repeal	02/16/2017 H-Read 1st time; referred to JRA
S1024	Child protective act/definition revised	02/22/2017 H-Read 1st time; referred to JRA
S1031	Veterans transport fund grant program	02/09/2017 Read 1st time; referred to State Affairs
S1037	Dentists licensing provisions revised	03/02/2017 Senate – reported delivered to Governor on this date
S1038	Dentistry Board/emergency proceedings	02/09/2017 Rep. out of committee; to 14th Order for amendment
S1046	Health savings acct/high deductible plan	02/28/2017 House – read 1st time; referred to State Affairs
S1050	Immunizations/exemption forms	02/08/2017 S-Reported printed; referred to Health & Welfare
S1058	Telehealth access; cost coverage	03/01/2017 Reported out of committee; to 14th order for amend.
S1060	Health care/cytomegalovirus	02/28/2017 House – read 1st time; referred to Health & Welfare
S1081	Immunization assessment bd/sunset revised	03/02/2017 H- U.C. to hold place on 3rd reading calendar 1 legislative day
S1082	Community primary care program	02/13/2017 S- Reported printed; referred to Health & Welfare
S1090	Health Care, advance directives	02/23/2017 Reported out of committee; to 14th order for amend.
S1117	Self-funded insurance	03/03/2017 Senate; rep. out of com. w/ Do Pass rec. Filed for 2nd read.
S1131	Abortion, H&W dept. website posting	03/03/2017 Senate – reported printed; referred to State Affairs
SCR113	Medical residencies; Idaho hospitals	03/03/2017 House – read first time, 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”	02/24/2017 S-Read 2nd time; filed for a 3rd reading
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	02/23/2017 S-Reported out of committee; 14th order for amendment
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	02/24/2017 S-Read 2nd time; filed for 3rd reading
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	02/23/2017 S-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	02/22/2017 S-Read 2nd time; filed for 3rd 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	03/02/2017 S-Read 2nd time; filed for 3rd reading
H0091	Immunization register/pro license board	02/23/2017 H-Failed; filed in office of Chief Clerk
H0115	Physicians, license background checks	03/03/2017 S-Read 2nd time; filed for 3rd reading
H0128	Medicaid; payment agreements	03/02/2017 S-Read 2nd time; filed for 3rd reading
H0146	Sexual assault evidence; med exam	02/28/2017 S-Introduced; read 1st time; referred to J & R
H0160	Health care assistance program	02/15/2017 Reported printed and referred to Health & Welfare
H0191	Pharmacy/prescriptions authorization	03/02/2017 S-Introduced; read 1st time; referred to Health & Welfare
HCR003	Lifespan Family Caregiver Action Plan	02/24/2017 Senate – signed by President; returned to House

The 2017 legislative session is moving along, with week seven having just ended. This week I will look at reactions to the White House’s proposal for replacement of the Affordable Care Act (ACA), and look at outcomes from the latest JFAC committee meeting here at home. I will follow up on a couple of bills I’ve been tracking and, again, encourage all readers to look at the new advocacy opportunity presented by Close the Gap Idaho (as well as other advocacy and involvement opportunities) listed below. 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

Reactions from health policy experts continue to flow in, in response to the GOP’s proposal for repeal and replacement of the ACA. Analysts say that this plan would “substantially cut funding for states in providing free insurance to low-income adults through Medicaid [and] would change how tax credits are distributed by giving all Americans not covered through work a flat credit by age, regardless of income” (read source material here). The replacement plan heavily emphasizes tax credits and health savings accounts (HSAs) which disproportionately benefit those who need it the least: middle to higher income Americans. To read more about HSAs and their implications to our economy and lower income people, go here. Read about Idaho’s HSA proposed legislation for state employees (S1046) here, or read the full bill located in the IPHA Bill Tracker below.

There have been additional suggestions for making health care plans more affordable to the public in the wake of an ACA repeal. One such proposal involves trimming the so-called fat from what insurers are required to offer. GOP leaders suggest that “shrinking the list of services that insurers are required to offer in individual and small group plans would reduce costs and increase flexibility.” One service, specifically, came to light during Seema Verma’s confirmation hearing two weeks ago (Verma is slated to run the Centers for Medicare & Medicaid Services in the Trump administration). Namely, Verma and others propose that coverage for maternity services should be optional in health plans as a potential cost cutting measure. Currently, the ACA requires that this and other vital areas of healthcare coverage are required to be offered by insurers. Changes under Tom Price (and potentially Verma’s) leadership may serve to weaken those requirements. Read source material for this and previous paragraph here. Read about the ten essential benefits under the ACA that may suffer cuts here.

On the State Level

The legislative hearing scheduled to cover H0160, the “Health Care Assistance Program” bill, was canceled (by the committee chair) on Monday, February 20^th. I will continue to monitor HB160’s progress, and welcome all those who are doing the same to keep me in your informational loop (email address listed above). 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.

The Joint Finance-Appropriations Committee met on February 20^th, and unanimously approved  current budget year changes including: “a $5 million reduction in general funds to the Catastrophic Fund, because of fewer cases than expected in fiscal year 2016; a nearly $400,000 reduction in general funds for non-emergency transportation under Medicaid, due to the state’s new, lower-cost contract with Veyo; and an additional $128,600 to the Department of Health & Welfare’s Physical Health Services division for an expanded access program that’s providing a limited number of Idaho children with intractable epilepsy with the experimental drug Epidiolex, which contains CBD oil, or cannabidiol, a derivative of marijuana.” Read source material (Russell’s full article) here.

 Bills in Focus

H0146: Update

On Tuesday, February 21^st, the House Judiciary, Rules and Administration Committee voted to advance H0146, (Rep. Melissa Wintrow, D-Boise), out of committee with a “Do Pass” recommendation. H0146 was read a second time on February 24, 2017, and a third reading has been filed. To recap from last week’s update, H0146 proposes to “codify standards for sexual assault victims’ access to medical examinations,” and, “sets standards for sexual assault evidence retention and preservation.” I had the opportunity to watch Representative Wintrow present on this bill, and watched testimony given in support of the same. There was overwhelming forensic, and legal support for H0146. Law enforcement officials testified to the necessity of preserving evidentiary rape kits for the proposed 55 year time period in order to give victims the opportunity to come forward at later dates, and also to increase the likelihood of catching “serial rapists,” tying them back to earlier crimes as well.  

Success! HCR003: Idaho Caregiver Alliance (ICA) Update

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, was unanimously passed in the Senate on Tuesday, February 21^st. Senator Fred Martin (R) spoke to the resolution on a personal level, having had experience with caregiving himself. The Senator noted that it was a piece of legislation that reflected the “honor[ing of] thy father and thy mother,” citing biblical text to reflect how many Idahoans will or do provide care for their parents (and other loved ones). The “Next Steps” piece of the ICA’s Idaho’s Lifespan Family Caregiver Action Plan will now bring to bear as the value and necessity of the population it impacts has been officially recognized. Read The Plan in its entirety here. A link to HCR003 is provided in the Bill Tracker below.

H0091 Update

H0091, a bill requiring all providers and all immunizations (except for flu shots) be recorded in the state’s Immunization Reminder Information System (IRIS), failed in the House on February 23^rd. The ostensible purpose of this bill was to ensure that a child would not inadvertently receive duplicate immunizations, but was noted by opponents to also extend to adults. As it stands, and will now remain, those who do not want their information shared or reported have the ability to opt out. Read what those opposed to this bill had to say during testimony here, and the perspective of others who were opposed here. Read about the importance of accurate immunization record keeping here

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 3^rd 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 27^th: Alzheimer's Association Idaho, the Capitol. Be visible and wear purple to show your support on their advocacy day!

March 3rd: Tobacco 21 (tentative) full hearing at 8 a.m. Room WW55, Garden Level of the Capitol.

March 9th: Close the Gap Idaho invites the public to attend "A Plan not a Delay Procession" Thursday, March 9th from 12:30 to 1:30 p.m. on the First Floor Rotunda at the State Capitol. Please wear WHITE to show your support, and to add visual impact to this advocacy opportunity.

IPHA Bill Tracker

Bill No.	Description	Last Action
S1003	Nurse emeritus licenses; licensure renewal & reinstatement	02/24/2017 H-Passed; title approved to Senate
S1004	Board of Nursing member raise in compensation	02/24/2017 Reported enrolled; signed by President; to H for Speaker sig.
S1009	DEQ; crop residue burning	02/24/2017 Passed House; title approved to Senate
S1013	Marijuana/drug paraphernalia repeal	02/16/2017 H-Read 1st time; referred to JRA
S1024	Child protective act/definition revised	02/22/2017 H-Read 1st time; referred to JRA
S1031	Veterans transport fund grant program	02/09/2017 Read 1st time; referred to State Affairs
S1037	Dentists licensing provisions revised	02/24/2017 H-Passed; title approved to Senate
S1038	Dentistry Board/emergency proceedings	02/09/2017 Rep. out of committee; to 14th Order for amendment
S1046	Health savings acct/high deductible plan	02/23/2017 S-Read 2nd time; filed for 3rd reading
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	02/22/2017 S-Read 2nd time; filed for 3rd reading
S1081	Immunization assessment bd/sunset revised	02/23/2017 H-Referred to Health & Welfare
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”	02/24/2017 S-Read 2nd time; filed for a 3rd reading
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	02/23/2017 S-Reported out of committee; 14th order for amendment
H0020	Vehicles; hybrid/plug-in fee reduction	02/23/2017 H-Delivered to Governor on this date at 11:10 a.m.
H0025	Tobacco permits, terminology	02/17/2017 Reported signed by Governor on this date
H0038	Mental health, cite ref added	02/24/2017 S-Read 2nd time; filed for 3rd reading
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	02/23/2017 S-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	02/22/2017 S-Read 2nd time; filed for 3rd 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	02/23/2017 S-Introduced; read 1st time; referred to Health & Welfare
H0091	Immunization register/pro license board	02/23/2017 H-Failed; filed in office of Chief Clerk
H0115	Physicians, license background checks	02/23/2017 S-Introduced; read 1st time; referred to Health & Welfare
H0128	Medicaid; payment agreements	02/23/2017 S-Introduced; read 1st time; referred to Health & Welfare
H0146	Sexual assault evidence; med exam	02/24/2017 H-U.C. to hold place on 3rd read. calendar 1 legislative day
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	02/24/2017 Senate – signed by President; returned to House

 

 

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 13^th, 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 16^th 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 1^st 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 21^st: 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 21^st: 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 27^th: Alzheimer's Association Idaho, the Capitol. Be visible and wear purple to show your support on their advocacy day!

March 1^st: 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

 

 

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.

We have now passed week four of the 2017 legislative session. This week I will continue moving forward with my national ACA watch, look at a few new pieces of legislation up close, follow up on previously covered items, and explore some advocacy opportunities in greater detail. 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

The numbers are in. The Washington Post reports that approximately 9.2 million people signed up for health care coverage last week through HealthCare.gov, roughly 500 thousand fewer than last year. The Trump administration halted all outreach activities six days prior to the close of the enrollment period, partially accounting for the steep decline in numbers. Tom Price, Trump’s candidate as Secretary for Health and Human Services, has proposed one of the many (and most comprehensive) replacement plans for the Affordable Care Act (ACA) to date. To read more about Price’s plan, JAMA offers insight and overview as to its content and implications.

Further consequences of the repeal of ACA were discussed in the 2017 Idaho Legislative session. Program Director of Idaho’s Catastrophic Health Fund (CAT), Kathryn Mooney, testified before the House Health and Welfare Committee that indigent care costs could jump by 20 million dollars annually with the repeal of the ACA. Mooney remarked that numbers have been steadily declining over the past four years thanks to the state health exchange, but notes that all of this could change drastically in the near future. William L. Spence, of the Lewiston Tribune, reports that, “the Catastrophic Health Fund [program] has returned more than $40 million to the state general fund since 2012, in part because people who previously relied on indigent care can now afford to buy subsidized insurance.” Read Spence’s full article here.

Roger Christensen, chairman of the Catastrophic Health Fund, told the JFAC committee on February 1^st, that cases requiring CAT assistance are up by 7.5%, and expressed concern particularly surrounding the area of Idaho’s indigent mental health needs, noting that CAT's requested 18 million dollar budget is made less predictable by the current uncertainty surrounding health care in general. Read source material here.

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.

Looking Forward

Significant Medicaid budget changes are coming next year that will transform Idaho children’s mental health services. These changes will not result in large state spending, but will effectively result in tripling services for children with serious mental health issues. Read more here.

Medicaid Administrator, Matt Wimmer's, January 31^st JFAC testimony is available at the link provided.

We are ABLE!

H0041 will allow Idahoans with disabilities that have ABLE accounts (accounts falling under the federal Achieving a Better Life Experience Act (ABLE) in other states to save monies for qualified disability expenses (e.g. education, transportation, housing, etc); monies that will not factor in to determining fiscal eligibility for state or local assistance programs (so long as that same activity is in line with what qualifies for federal assistance eligibility). Currently, Idaho does not have an ABLE account program. Read the full bill text in the IPHA Bill Tracker below, or the statement of purpose in the link provided above.

Protections for the LGBTQ Community

Bill H0062 proposes to prohibit state funding for “conversion therapy,” defined as a therapy that “seek[s] to change an individual’s sexual orientation or gender identity." H0062 also prohibits a licensed professional counselor from engaging in the same. For more information on what “conversion therapy" is and its deleterious effects, visit the Human Rights Campaign’s website here

Funding Formula

A study conducted in 2015 by the Office of Performance Evaluations, found that the current Idaho Public Health District funding formula is inconsistently linked to program needs within various districts. H0080 seeks to revise this formula to better meet district needs, and be more responsive to population and poverty numbers. Read the full text of the bill below, and the statement of purpose at the link provided in this text.

J-1 Visas for Physicians

H0081 proposes amendments to the current Idaho Conrad J-1 Visa Program that allows qualified Idaho healthcare organizations to place foreign trained physicians in federally designated shortage areas. Among other things, H0081 would grant Idaho healthcare organizations not located in such areas the ability to apply for J-1 slots. In view of Idaho’s identified doctor shortage (addressed again in Governor Otter’s State of the State this year), this will be a bill to watch.

Eye on S1009

My watch on Bill S1009 continues this week, as it passes through the Senate in a 29-5 vote, and now moves to the House. To read more about the current activity surrounding this bill go here

As was stated last week, some agencies supporting stronger, more protective air quality regulations include, the American Medical Association, American Lung Association, American Academy of Pediatrics, American Thoracic Society, and the American Heart Association. For further reading on the subject of ozone levels, air quality, and the impact of both on human health go here. For more about S1009, and its trajectory through this legislative session, go here

Following Up…

The Idaho Caregiver Alliance is hard at work and making progress. On Thursday, February 2, Sarah Toevs presented the Idaho Lifespan Family Caregiver Action Plan to the House Health and Welfare Committee.  The ICA plan outlines recommendations for how Idaho might improve that support and ensure that families can continue to fill their important caregiving role.  The plan was well received by the committee with Chairman Fred Wood indicating that the committee would do all it could to support the plan. Following the presentation, Rep. Christy Perry (R-11) presented a draft concurrent resolution that stated the legislature's recognition of the issues facing family caregivers and their support for the plan.  The committee agreed to print the resolution, now HCR 3.  The resolution will return to the committee for a hearing at which time members of the public can provide comment. A presentation of the plan is also scheduled for Thursday, February 16 in the Senate Health and Welfare Committee.

Advocacy spotlight:

AARP’s lobby day at the capitol is rapidly approaching (February 7^th), and will be bringing awareness to the Idaho Legislature about the importance of issues facing those over 50. Wear red to show your support. Read about AARP’s priorities as outlined to the Trump administration here

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 5^th highest state in the nation for suicides, making this event vital for attendance by mental health advocates, and the public alike.

Upcoming Advocacy Days & Involvement Opportunities

February 7th: AARP Idaho, 1st floor, Capitol

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	01/16/2017 Reported printed; referred to Commerce & HR
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
S1037	Dentists licensing provisions revised	02/02/2017 Reported printed; referred to Health & Welfare.
S1038	Dentistry Board/emergency proceedings	02/02/2017 Reported printed; referred to Health & Welfare.
H002	Pharmacists reciprocal licensing	02/03/2017 Read second time; filed for third reading
H003	Pharma/tuberculin protein products	02/03/2017 Read second time; filed for third reading
H004	Pharmacists, tobacco cessation products	02/03/2017 Read second time; filed for third reading
H005	Controlled substances, opioids	02/03/2017 Read second time; filed for third reading
H006	Controlled substances	02/03/2017 PASSED: ayes 32; nays 0; excused 3; title approved, refer to H.
H007	Massage therapists; change “establishment to school”	01/17/2017 Reported printed; referred to Health & Welfare
H008	Massage therapists; institute criminal background checks	01/17/2017 Reported printed; referred to Health & Welfare
H0010	Chiropractic practice; licensure	02/01/2017 Reported out of committee; referred to Health & Welf.
H0011	Optometrists; licensure/provisions & revisions	01/17/2017 Reported printed; referred to Health & Welfare
H0020	Vehicles; hybrid/plug-in fee reduction	02/03/2017 Rep. out of committee w/ ‘do pass’ recommendation; Filed for 2nd read.
H0025	Tobacco permits, terminology	02/03/2017 Read 2nd time; filed for 3rd reading.
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	01/24/2017 Reported printed and 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	01/24/2017 Reported printed and referred to Health & Welfare
H0044	Secure treatment facility act	01/24/2017 Reported printed and referred to Health & Welfare
H0045	Dieticians/licensing revised	02/03/2017 U.C. to hold place on 3rd reading calendar until 02/06/2017.
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

Week three of the legislative session proved to be a very busy one in terms of public health. Several new bills were introduced and have now been added to our tracking list. This week we will again look at the future of the ACA and Close the Gap. We will follow up on bill S1009, and will look at some highlights from this week’s Health and Welfare listening session. 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

This week, Republican Sens. Susan Collins of Maine and Bill Cassidy of Louisiana unveiled their proposed replacement for the Affordable Care Act (ACA). The so-called Cassidy-Collins plan would give states options to keep the ACA as is, enact their own insurance expansion, or completely opt out of federal assistance. The Cassidy-Collins plan is the latest in a growing body of other bills proposed by the GOP as potential answers to the looming healthcare crisis, pending repeal without replacement of the ACA; a repeal that will affect 20 million Americans. Read more about this latest proposal, and others here.  Read Trump’s seven point healthcare reform proposal here, and for more information on the implications and ramifications of his Medicaid “block grant” funding proposal go here and  here.

On our Idaho home front, House Health and Welfare Chairman, Fred Wood, assured a packed room on January 27 (during the joint Health and Welfare listening session) that lawmakers are, “working on the gap issue.” Rep. Wood told those in attendance that he heard them, “loud and clear,” stating also that “if it were that easy” to fix Idaho’s healthcare gap issue “it would have been done by now.” Read the source material here

Advocacy group, Close the Gap Idaho, noted in a Facebook post on Friday the 27^th that the Trump administration has cancelled all outreach ads, email reminders, phone calls and other promotion related to the final five days of the open enrollment period. Close the Gap Idaho reminds citizens that it is important for people to know they can still be enrolled and covered for 2017. They urge all those who might be affected to visit to Healthcare.gov to learn how they might still enroll before January 31st.

Health & Welfare Listening Session

January 27th's joint listening session was well attended, with many people unable to be heard due to the large turnout. Testimony was given on a variety of subjects ranging from safety and efficacy complaints about Veyo (a non-emergency medical transport service for the state that contracts individual drivers) to faith healing and health care choice by Health Freedom Idaho. Mike Berlin, from Boise State University and the Idaho Alzheimer’s Planning Group, testified regarding the “broken system of care” affecting Idahoans with Alzheimer’s and their families, and Boise physician, Dr. Kara Kuntz, testified in support of the Idaho Caregiver Alliance’s, Idaho Lifespan Caregiver Action Plan. Read all source materials, and more about the session through the in-text links provided.

 Update on S1009

Bill S1009 (discussed in depth in last week’s post) passed the Senate Committee Hearing on Wednesday, January 25^th and now heads to the Senate floor.  If passed, it will move to the House Environment, Energy, and Technology Committee before final approval. Austin Hopkins, from the Idaho Conservation League (ICL), notes that this bill will greatly impact air quality and the health of Idahoans. In a statement disseminated to this writer the position of the ICL is clear, “Farming is an integral part to Idaho, but farming practices that endanger public health should not be authorized by regulating agencies such as the Department of Environmental Quality.  We need a collaborative approach to identify and develop solutions that rely on the best available science and truly protect human health."

Other agencies supporting stronger, more protective air quality regulations include, the American Medical Association, American Lung Association, American Academy of Pediatrics, American Thoracic Society, and the American Heart Association. For further reading on the subject of ozone levels, air quality, and the impact of both on human health go here. For more about S1009, and its trajectory through this legislative session, go here

Following Up…

As discussed in Week One’s post, Senator Dan Foreman (R-Moscow) planned to introduce a bill during this session classifying abortion as murder (with the sole exception of when a mother's life is in danger), carrying penalties and charges for both mother and doctor.  His statements can be read here. However, advocacy group, Right to Life Idaho, will not be supporting this measure. To read more on their position, go here.

H0044: Secure Care for More Vulnerable Clients

House bill H0044 was printed and referred to Health and Welfare on 01/24/2017.  This legislation will enable the DHW to maintain and operate a secure treatment wing  at the Southwest Idaho Treatment Center (SWITC) for more vulnerable clients with intellectual or developmental disabilities needing a higher level of care. To learn more about  some of the changes regarding SWITC over the past years  go here

Upcoming Advocacy Days & Involvement Opportunities

February 7th: AARP Idaho, 1st floor,  Capitol

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!

IPHA Bill Tracker

Bill No.	Description	Last Action
S1003	Nurse emeritus licenses; licensure renewal & reinstatement	01/16/2017 Reported printed; referred to Commerce & HR
S1004	Board of Nursing member raise in compensation	01/13/2017 Reported printed; referred to Health & Welfare
S1009	DEQ; crop residue burning	01/27/2017 Read second time; filed for third reading
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
H002	Pharmacists reciprocal licensing	01/27/2017 Read second time; filed for third reading
H003	Pharma/tuberculin protein products	01/27/2017 Read second time; filed for third reading
H004	Pharmacists, tobacco cessation products	01/27/2017 Read second time; filed for third reading
H005	Controlled substances, opioids	01/27/2017 Read second time; filed for third reading
H006	Controlled substances	01/17/2017 Introduced; read first time; referred to Health & Welfare
H007	Massage therapists; change “establishment to school”	01/17/2017 Reported printed; referred to Health & Welfare
H008	Massage therapists; institute criminal background checks	01/17/2017 Reported printed; referred to Health & Welfare
H0010	Chiropractic practice; licensure	01/27/2017 Introduced; read first time; referred to Comm. & HR
H0011	Optometrists; licensure/provisions & revisions	01/17/2017 Reported printed; referred to Health & Welfare
H0020	Vehicles; hybrid/plug-in fee reduction	01/20/2017 Reported printed and Referred to Transportation & Defense
H0025	Tobacco permits, terminology	01/27/2017 Introduced; read first time; referred to local Gov. & Tax
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	01/24/2017 Reported printed and 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	01/24/2017 Reported printed and referred to Health & Welfare
H0044	Secure treatment facility act	01/24/2017 Reported printed and referred to Health & Welfare
H0045	Dieticians/licensing revised	01/24/2017 Reported printed and referred to Health & Welfare

 

The 2017 Idaho Legislative Session is now in full swing, and our journey is now underway. With the inauguration of President Trump on 01/20/2017,  the journey should prove an interesting one in terms of healthcare policy.  This week we'll look at the implications of the incoming administration, explore a few items of proposed legislation in depth, and look at opportunities to get involved during advocacy days. Thanks to all who contacted me over the past week. Your feedback was most welcome! Again, 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.

A New Era

Almost directly after his inauguration,  President Trump issued a one page, executive order in the first official step toward dismantlement of the Affordable Care Act (ACA). The New York Times reported that the order's, "broad language gave federal agencies wide latitude to change, delay or waive provisions of the law that they deemed overly costly for insurers, drug makers, doctors, patients or states." Hence, the thrust of the ACA law is effectively removed by this act even prior to an act of Congress moving to repeal it. Read the full text of the NYT's report here

What does this mean for Idaho? Your Health Idaho Director, Pat Kelly, told the Idaho House Health and Welfare Committee on 01/18/2017 that, "depending on what the [ACA] repeal would look like," Idaho's health insurance exchange stands to lose $220 million in tax subsidies. As such, 82,650 Idahoans would stand to lose their tax credits which currently assist them in offsetting costs of current health insurance coverage. At present, no alternative to the ACA exists, as was noted in an interview with Kimberlee Kruesi of the Associated Press by Rep. Ilana Rubel (D-Boise). Rep. Rubel stated that, "it's imperative the public know what's at stake under a possible repeal of Obamacare." Read the source material for this paragraph here.

Idaho College of Osteopathic Medicine (ICOM) Residences Update

Last week in his State of the State address, Governor Otter welcomed the ICOM, a (currently unaccredited) for-profit medical school, stating that they had secured 78 residency positions at healthcare facilities across the state. These same residencies were to be instrumental in increasing access to healthcare for all Idahoans as reported in the same address. However, a new report from Associated Press', Rebecca Boone, indicates that said residency spots do not as yet exist, and that the board responsible for their approval, "has denied the first step in creating them." To read Boone's full report at the location of this writer's access to the same, click here.

Upcoming Advocacy Days & Involvement Opportunities

January 25th: Regarding S1009 - DEQ will be presenting its proposal to the Senate Health and Welfare Committee on Wednesday, Jan 25, at 3 pm. A follow-up hearing by the House Environment, Energy and Technology Committee is likely next week. This legislation will weaken the restrictions on field burning, in place to protect air quality. For more information on this bill, see the piece written below ("Idaho Air").

January 27th: Public hearing - Close the Gap! Health and Welfare listening session from 8 to 11 a.m. (plan to arrive at 7 a.m. to sign in). All are encouraged to attend, participate, and speak out on this vital issue.

The disability community is strongly encouraged to attend and speak out about closing the gap, non-emergency Medicaid transportation, mental health services through Optum Idaho, and more! For more information contact the Idaho Council on Developmental Disabilities at 208-334-2178.

February 7th: AARP Idaho, 1st floor,  Capitol

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!

Looking ahead...

The leadership team of the Idaho Caregiver Alliance (ICA) is working on a draft Concurrent Resolution for presentation to the legislature. The intent of the resolution is to broaden awareness of the issues facing unpaid family caregivers. It will also raise awareness of the recommendations for supporting caregivers in the ICA's Lifespan Family Caregiver Action Plan.  For more information about the ICA, its mission, and the Action Plan visit their site here.

Bills in Spotlight

Idaho Air

The Idaho Department of Environmental Quality (DEQ) has proposed bill, S1009 (01/1/2017 Reported printed; referred to Health and Welfare), that addresses the issues of crop residue burning vis a vis required National Ambient Air Quality Standards (NAAQS) in rural Idaho. Idaho Code 39-114 requires the DEQ to evaluate air quality conditions before approving crop burn days. Currently, air quality levels are not to exceed (or be projected to exceed within 24 hours) 75% of the NAAQS  in order for a burn day to be in compliance with the same.  In the S1009's language, "the program is difficult to manage because 75% of the current NAAQS for ozone is close to background ozone concentrations in rural Idaho." Hence, S1009 proposes to raise, "the ozone evaluation threshold from 75% to 90%." The initial rate will remain the same for the 2017 burn season, increasing on February 28, 2018, the expected date of the EPA's approval of the increase.

The subjects of air quality and ozone levels are very complex. Counter-intuitively, ozone levels in rural areas may often be higher than in urban ones, "because ozone levels are generally higher downwind of ozone precursor sources, at distances of hundreds or even thousands of kilometers..."(Jeannie Allen, writing for NASA's Earth Observatory here). Hence, what happens in our urban areas affects what can or does happen in our rural ones. In the case of S1009, the "can and what" is crop residue burning. The DEQ offers an excellent explanation of what crop burning is here and offers a link dedicated to daily air quality reports and forecasts here.  The impact of ozone on human health is discussed in Allen's article, cited above, and also on the EPA's website here. 

In the Spirit of Clean Air

From the AP: "Two years ago, lawmakers passed a transportation funding plan that raised vehicle registration fees and the gasoline tax by 7 cents. Electric and hybrid vehicles faced higher registration fees because lawmakers argued those owners don't pay as much at the pump." House bill 20 proposes to reduce the extra $75 registration fee to gasoline hybrid owners as, according to Rep. Steven Harris, these drivers "already pay the appropriate gas tax at the pump." Monies collected from these fees go toward maintaining Idaho's roads and bridges. Read source material here

H0004: It's Legit to Quit!

The Board of Pharmacy is proposing legislation through bill H0004 (01/17/2017 reported printed; referred to Health & Welfare) amending the practice of pharmacy in a way that will increase the public's access to tobacco cessation products "in certain scenarios." Under H0004, pharmacists will also be required to obtain advanced training and engage in certain protocols when prescribing or screening a patient for the appropriateness of tobacco cessation products.

In other tobacco related legislation, H0025 proposes to change language relating to tobacco permits, amending Idaho Code 63-2555. H0025 would simply use the word "permit" over "registration certificate" in the body of the code.

This is a good place to pause and remind readers that the IPHA supports tobacco cessation in the interest of the public's good health. Initiatives such as the Tobacco 21 Resolution receive the endorsement of the IPHA in moving toward healthier bodies and communities!

S1013

S1013 addresses a conflict issue between two statutes in the Idaho Code relating to the charging of juveniles with possession of marijuana, and proposes to, "help...avoid confusion in the system as a whole" by repealing section section 18-1502c of the law.

IPHA Bill Tracker

Bill No.	Description	Last Action
S1003	Nurse emeritus licenses; licensure renewal & reinstatement	01/16/2017 Reported printed; referred to Commerce & HR
S1004	Board of Nursing member raise in compensation	01/13/2017 Reported printed; referred to Health & Welfare
S1009	DEQ; crop residue burning	01/19/2017  Reported Printed; referred to Health & Welfare
S1013	Marijuana/drug paraphernalia repeal	01/20/2017 Reported printed; referred to JR
H002	Pharmacists reciprocal licensing	01/17/17 Reported printed; referred to Health & Welfare
H003	Pharma/tuberculin protein products	01/17/2017 Reported printed; referred to Health & Welfare
H004	Pharmacists, tobacco cessation products	01/17/2017 Reported printed; referred to Health & Welfare
H005	Controlled substances, opioids	01/17/2017 Reported printed; referred to Health & Welfare
H006	Controlled substances	01/17/2017 Reported printed; referred to Health & Welfare
H007	Massage therapists; change “establishment to school”	01/17/2017 Reported printed; referred to Health & Welfare
H008	Massage therapists; institute criminal background checks	01/17/2017 Reported printed; referred to Health & Welfare
H0010	Chiropractic practice; licensure	01/17/2017 Reported printed; referred to Health & Welfare
H0011	Optometrists; licensure/provisions & revisions	01/17/2017 Reported printed; referred to Health & Welfare
H0020	Vehicles; hybrid/plug-in fee reduction	01/20/2017 Reported Printed and Referred to Transportation & Defense
H0025	Tobacco permits, terminology	01/20/2017 Reported Printed and Referred to Revenue & Taxation