Results of the 2018 Arizona State Legislative Session

Arizona CapitolBills that successfully navigated the 2018 legislative process and were signed by the Governor generally become law ninety days following the end of the legislative session.  This is called the General Effective Date, and this year it falls on August 3. AHCCCS must take steps to implement these new laws, which often include updates to rules, contracts, policies, provider registration, claims processing, financial monitoring and reporting, the state plan, and in some instances even the waiver. Some laws are more complicated and time consuming to implement than others.

A variety of bills signed into law this year that will have long-lasting impacts to the Medicaid program and the state. Of the 1,206 bills that were introduced in both the House of Representatives and the Senate, 369 passed and 346 were signed into law by the Governor.

Some new laws aim to update or modernize existing statutes. Other bills overhaul or create entire programs or address a public health crisis such like the opioid epidemic. These will require an intense amount of work to turn into policies.

Here are a few new policies passed in the 2018 legislative session:

  1. HB 2235 formally recognizes and establishes scope of practice for dental therapists, a new provider type. Dental therapists will be permitted to provide about 30 services in total, including some extractions. This new provider type is being described as a big step forward for oral healthcare in the state, particularly for tribal partners.
  2. HB 2324 formally recognizes Community Health Workers, who have a long history in some Arizona communities across the state. These providers have also been referred to historically as Primatores. This newly recognized workforce will provide aid and support to members and communities across the state to better understand and manage their health. For those with chronic health conditions, a history of hospital readmissions, or even those experiencing significant cultural or language barriers, Community Health Workers will bridge the gap and enable better health outcomes, hopefully resulting in reduced costs long-term.
  3. SB 1450 renames the various Human Rights Committees to “Independent Oversight Committees” and transfers oversight responsibility from AHCCCS to the Arizona Department of Administration. This transition intends to create efficiencies by streamlining accountability for and engagement with the Independent Oversight Committees.
  4. SB 1520 & HB 2659 provide the State Fiscal Year 2019 budget and among other things, include:
    1. $10M in funds to provide behavioral health services in schools;
    2. Funding for a Suicide Prevention Coordinator at AHCCCS;
    3. Funds to increase hospital rates by 2.5% if specific performance metrics are met;
    4. Funds to increase Skilled Nursing Facility and Assisted Living rates by 3%;
    5. Funding for 12 full time employees within the American Indian Health Program; and
    6. The elimination of AHCCCS Prior Quarter Coverage.

Our favorite new law from 2018 is SB 1517, which officially establishes the Sonorosaurus as the official state dinosaur of Arizona. This bill successfully passed after an 11 year old boy wrote a letter to Governor Ducey seeking its addition as a state symbol after fossils had been found in Arizona. The Sonorosaurus now joins other notables such as the Saguaro Cactus Blossom, Palo Verde tree, Ridge-nosed Rattle Snake, Apache Trout, and even the Bola Tie as an official Arizona state symbol.

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Opioid Epidemic Now a Public Health Emergency in Arizona

Opioid epidemicWith the release of 2016 statistics from Arizona Department of Health Services (ADHS) regarding the steady increase of opioid-related deaths in Arizona­–­790 last year and a 74% surge since 2012—the epidemic is now elevated to a public health emergency. On average, two Arizona citizens die each day from opioid abuse.

On Monday, June 5, Governor Doug Ducey issued a statewide emergency declaration that seeks to coordinate state, local, and private-sector partners in an effort to collect data and develop targeted solutions.

In a press release, AHDS announced that it will take swift action to identify ways to:

  • prevent prescription opioid drug abuse through appropriate prescribing practices,
  • develop education guidelines for healthcare providers on responsible prescribing practices,
  • expand access to treatment, especially Medication Assisted Treatment (MAT), and
  • reverse overdoses through the distribution of Naloxone.

CVS Health announced in May that all 195 pharmacies in Arizona will sell Narcan, a brand of Naloxone, without a prescription.

Prior to the emergency declaration, state agencies and legislators had begun to address the growing opioid epidemic. In October 2016, Governor Ducey signed an executive order authorizing AHCCCS to adopt policies necessary to limit initial opioid prescriptions to seven-day supplies. AHCCCS applied for and received, as the Arizona Single State Agency for Substance Abuse Treatment, a $24.3 million formulary grant from SAMSHA, the Substance Abuse and Mental Health Services Administration, to combat opioid-related deaths.  The Arizona High Intensity Drug Trafficking Area, the Governor’s Office for Youth, Faith and Family, and state agencies ADHS and the Department of Child Safety and will collaborate with AHCCCS to implement targeted activities.

During the 53rd Arizona legislative session, lawmakers were instrumental to this effort as well. First, the Legislature passed HB 2493, a bill permitting pharmacists to dispense Naloxone or any other FDA approved opioid antagonist by standing order rather than a prescription. Dr. Sara Salek, AHCCCS Chief Medical Officer, will write the standing order. Secondly, lawmakers allocated funds in the SFY 2018 budget for five full-time positions at AHCCCS to contribute to the fight against the opioid epidemic.

The public can play an instrumental role in the effort to combat opioid-related deaths. Information about prevention, treatment, recovery resources, and many other ways to get involved is available at substanceabuse.az.gov.

 

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Dental benefit added for adult AHCCCS members

dentist and patientIn the budget approved by the 53rd Arizona Legislature for State Fiscal Year 2018, AHCCCS members who are at least twenty-one years of age will receive coverage for emergency dental services in an annual amount of not more than $1,000. The benefit is now in the process of being developed to incorporate services related to the alleviation of pain and infection. AHCCCS will then submit the plan to the Centers for Medicare and Medicaid (CMS), our federal oversight partners, for their approval. The anticipated effective date is October 1, 2017.

More details about the emergency dental benefit will be posted on the AHCCCS website as soon as they are available.

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