Current Legislative Issues

This morning at 10 am EST, the Supreme Court announced it has upheld all but the Medicaid expansion mandate of the Affordable Care Act.  No matter your political view, this is a monumental decision for American healthcare.  See attached link for further information:
US Supreme Court Upholds Affordable Care Act


Have a Great Day!

Merrie J. Rheingans, MS, C-PNP
President and Legislative Committee Chair
Arizona Chapter
National Associations of Pediatric Nurse Practitioners

ANA President, Karen Daley, Testifies Before House Appropriations Subcommittee

On Thursday, March 29th, ANA President, Karen Daley, testified before the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies.  President Daley’s testimony focused on Title VIII programs, and funding nurse managed health centers.

Daley urged the committee to appropriate $251 million in FY 2013 for the Nursing Workforce Development programs authorized under Title VIII of the Public Health Service Act.  Additionally, she requested $20 million for the Nurse-Managed Health Centers authorized under Title III of the Public Health Service Act.

FY 2013- Title VIII Funding

Over the last 48 years, Title VIII programs have provided the largest source of federal funding for nursing education; offering financial support for nursing education programs, individual students, and nurse educators. These programs bolster nursing education at all levels, from entry-level preparation through graduate study and in many areas including rural and medically underserved communities. They are used to direct RNs into areas with the greatest need – including community health centers, departments of public health, and disproportionate share hospitals.

Funding for Title VIII programs has only received slight increases during the last couple of appropriations cycles. During these tough economic times, there is a desire to cut government spending.  However, as of January 2011, Baby Boomers began turning 65 at the rate of 10,000 a day.  With this aging population, there will be an increase in demand for nursing care in traditional acute care settings as well as the expansion of non-hospital settings such as home care and long-term care.  Nurses will be needed to address this growing health care need.

Between FY 2005 and 2010 alone, the Title VIII programs supported over 400,000 nurses and nursing students as well as numerous academic nursing institutions, and healthcare facilities.

President Daley’s request of $251 million in FY 2013 for the Nursing Workforce Development programs would be a slight increase over the $243 million appropriated in the omnibus for FY 2012.

Nurse-Managed Health Centers

Additionally, to attain an improved health status of individuals, families and the community a health care system must value primary care and prevention.  Daley shared with the committee that ANA believes the foundation for a wellness-based health care system is built utilizing community and home-based models of care which reduces the amount of financial expenditures and human suffering.  ANA believes that Nurse Managed Health Centers (NMHCs) are an efficient, cost-effective way to deliver primary healthcare services.

With more than 200 Nurse Managed Health Centers (NMHCs) in the United States these centers provide care to over 2 million patients annually.  NMHCs are effective in disease prevention and early detection, management of chronic conditions, treatment of acute illnesses, health promotion, and more.  These clinics are also used as clinical sites for nursing education. 

ANA’s requested $20 million for the Nurse-Managed Health Centers for FY 2013 which would provide an increase of $20 million, as the NMHC weren’t funded in FY 2012.~~ April Cante

Merrie Rheingans, MS, C-PNP
AzNAPNAP President-Elect and Legislative Committee Co-Chair

Unfortunately, SB1043 became a political football, on the last day of session, May 4th,  and in the process it did not move forward.  AzAAP leadership thanks each and everyone of you for the time taken to call and email legislator’s. Many were unaware of what the costs are in providing vaccines so the education you did was valuable.

Rep. Nancy Mclain, who sponsored our bill and worked on it to the very end is “heartbroken”.  Please send an email to Rep Mclain,  nmclain@azleg.gov  thanking her for such hard work and endless support for vaccine providers and children. She came up against her own party by supporting a mandate, against the powerful insurance industry. Also, Rep. Debbie McCune Davis ddavis@azleg.gov did a stellar job in keeping things on track.

LEGISLATIVE BRIGHT SPOT: the booster seat bill was transmitted to Governor Brewer last week. Many of you have already emailed the Governor’s office. We are hopeful she will sign it or allow it to pass-Sue Braga, Az AAP

Thank you for all you do for Arizona’s children and families.

Regards,

Merrie J. Rheingans, MS, C-PNP
AZ President-Elect and Legislative Committee Co-Chair

 

Feds Approve Plan to Add Children to KidsCare-April 17, 2012
There is a temporary thaw in the KidsCare freeze that has been keeping thousands of Arizona children uninsured due to budget cuts adopted by Governor Brewer and the state legislature. Last Friday, a plan was approved that will link 21,700 uninsured children with KidsCare coverage. The plan, called KidsCare II, came together thanks to the vision, leadership and financial commitment from the Obama administration and three Arizona hospital systems -- Phoenix Children's Hospital, the Maricopa Integrated Health System, and the University of Arizona Health Network. The hospitals are contributing their own funds that will be matched with federal dollars at a three to one ratio for KidsCare II.
The new coverage will be available for a limited number of qualified children who have applied for KidsCare and been put on the waiting list since the freeze. This coverage will last until the end of 2013. It will be up to us as voters and our state leaders to decide what's available for children's health coverage after that.
Families who are on the waiting list should complete a new on-line application to update their information and to see if they qualify.
Applications can be completed at www.healthearizona.org. For questions or assistance, families can call 1-800-377-3536.

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Information courtesy of Amy Kobeta, Children's Action Alliance
April 11, 2012

URGENT LEGISLATIVE ACTION NEEDED!! April 9, 2012

Please contact your legislators – 2 House members and 1 Senator  - and ask support for meaningful legislation and budget items regarding health and safety for children and appropriate reimbursement for providers. This legislative session is close to being done (could be this week) and these are important and unprecedented issues for AZ. See instructions below for legislator contact.

 

Bills

• HB 2739 NOW SB 1043: Vaccines; contracts; reimbursement; coverage; definition
• HB 2154 Child Restraint Systems (booster seats)  

 

Budget

• Provider Rate Increase
• DES/Child Protective Services
• Literacy Resources

Negotiations are happening this week and moving toward a final vote on the budget. Please ask your state representatives and senator to put these issues at the top of the list.

 

Please see details below and how to contact your legislator’s.

 

HB 2739 NOW SB 1043: Vaccines; contracts; reimbursement; coverage; definition

In our efforts to get appropriate private payer payment for vaccine acquisition and administration, we hit a wall after it passed the House and moved to the Senate. The Bill sponsor, Rep. Nancy McClain, was able to revive this legislative proposal but it is now going through the House process again before back to the Senate.

Please email/call your 2 representatives and ask them to vote YES for SB1043

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HB2154 Child Restraint Systems (booster seats)  

This bill also hit some political maneuvers in the Senate.

Please email/call  your Senators and ask them to vote YES on HB2154 Child Restraint Systems (booster seats)  .

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PROVIDER RATE INCREASE

Governor Brewer’s budget proposal includes a 3% provider rate increase.  Arizona’s AHCCCS providers have experienced a series of rate freezes and cuts since the beginning of the recession.  Some provider rates have been reduced by up to 15%.  These cuts have put strains on many pediatric practices in this state.   Some of these small businesses have had to reduce their staffs in light of these cuts.  A number of pediatricians expressed doubt about their ability to continue participation in AHCCCS when the last 5% rate cut went into effect on October 2011.  There are already low numbers of primary care physicians in Arizona, especially in rural areas.  The 3% provider rate increase will help relieve the financial pressure of pediatricians participating in AHCCCS, which will serve to maintain the stability and capacity of health care delivery. 

Please email or call your legislators and ask them to include the 3% provider rate increase in their budget.

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Arizona is losing $45.2 million in federal funds next year for the Department of Economic Security. These dollars have been paying for Child Protective Services work with abused and neglected children. Governor Brewer's budget calls for replacing these federal funds with state funds to sustain services. But the legislative budget that has been adopted by two committees puts ZERO state dollars in for this. Without this replacement funding, Child Protective Services will be cut severely which could put more children in danger.

Early Literacy Resources

Last year, the legislature passed a mandate that required all children reading at grade level by the end of 3^rd grade or they will be retained in 3rd grade. This year Governor Brewer allocated $50 million for literacy resources but the legislature’s budget proposes zero.

Please email/call your legislators and ask them to include funding for literacy/reading resources.

Find your legislator: click here. In bottom left corner of page, click "enter address, zip, find". On top left of next page you will see "Address was Found! It's: in Legislative District XX," then click "Click here for a list of State Senators and Representatives" and it will take you to the roster page where you click on HOUSE Roster. You will find the name of your 2 Representative's listed next to your district number. You can also click on SENATE Roster for your Senator

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Merrie J. Rheingans, C-PNP
Legislative Committee Co-Chair and President-Elect
Az NAPNAP

Please see the following video regarding legislative lobbying instructions:

http://www.youtube.com/watch?v=4wr3Ce9l28E&context=C384296dADOEgsToPDskJXBEJjz8JIfbx7Lz-mdisY