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ARIZONA HOUSE OF
REPRESENTATIVES
Forty-eighth
Legislature –Second Regular Session
COMMITTEE ON HEALTH
Minutes of Meeting
Wednesday, March 5, 2008
House Hearing Room 4
-- 9:00 a.m.
Chairman Stump called the meeting to order at 9:07 a.m. and
attendance was noted by the secretary.
Members Present
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Mrs. Barto
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Mr. Lopes
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Mr. Murphy, Vice-Chairman
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Mr. Bradley
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Ms. Lopez
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Mr. Stump, Chairman
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Ms. Burns J
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Mrs. Mason
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Mrs. Groe
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Ms. Young Wright
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Committee Action
HB 2581 – DISCUSSED AND HELD HB 2697 – DISCUSSED
AND HELD
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HB 2823 – DPA (9-0-0-1)
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HB 2269 0 DPA – S/E (6-3-0-1)
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HB 2682 - DPA – S/E (9-0-0-1)
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HB 2848 – NOT ASSIGNED
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Presentation on Phoenix
Children’s Hospital
Annie Mooney, Director of
Public Affairs, Phoenix Children’s Hospital, introduced Dr. Meyer.
Dr. Bob Meyer, President and
CEO, Phoenix Children’s Hospital, narrated a slide show on Phoenix
Children’s Hospital’s history and current status and needs in regards to
technology, expansion and funding (Attachment 1).
Presentation on the Pros
and Cons of State-level Universal Access
Mr. Lopes introduced a proposal from
the state of New Mexico for fair, affordable and equal access insurance. He introduced
Dr. Jonathan Weishich, The Biodesign Institute, Dr. Burris “Duke” Duncan,
Professor of Pediatrics at Arizona Health Sciences Center and Dr.
Byron Schlomach, Economist, Goldwater Institute, and provided two handouts:
Quantitative and Comparative Analysis of Reform Options for Extending Health
Care Coverage in New Mexico (Attachment 2) and a 2008 Summary Report on the
Arizona Health Security Act (Attachment 3).
Dr. Weishich distributed a packet
of handouts on various health system reports and articles (Attachment 4) and
responded to comments and questions along with Dr. Duncan and Dr. Schlomach.
CONSIDERATION OF BILLS
HB 2581 - pharmacy audits; requirements; limitations
S/E: pharmacy audits; timely
pay – DISCUSSED AND HELD – S/E
Chairman Stump announced that HB
2581 would have an informational hearing only.
Dan Brown, Majority Research
Analyst, explained that HB 2581 establishes standards for pharmacy audits
conducted by or on behalf of insurance entities (Attachment 5). The proposed six-line
Stump S/E amendment to HB 2581 dated 03/03/08 10:08 AM (Attachment 6) would
require the Department of Insurance to promulgate rules related to the timely
pay statutes as they relate to pharmacy audits.
Mindy Rasmussen, Arizona
Pharmacy Alliance, spoke in support of HB 2581 and explained that pharmacy
audits often result in reimbursement that equals hundreds of thousands of
dollars. She further explained that Pharmacy Benefit Managers (PBMs) manage
prescription drug benefits to over eighty percent of the three billion
prescriptions dispensed every year. Ms. Rasmussen expressed support for pharmacy
audits and introduced two handouts on Pharmacy Audit Integrity Act (Attachment
7) and AMCP Pharmaceutical Payment Methods (Attachment 8).
Mark Boesen, Director of
Pharmacy Operations, Apothecary Shop Pharmacies of Arizona, spoke in
support of HB 2581 and the striker.
Jay Kaprosy, CVS Caremark,
spoke against HB 2581 and pointed out that thousands of prescriptions that are processed
on site every day without incident. He said the issues brought forward today
involve the business practices of the pharmacists who choose to accept certain
PBM’s and that the issues have not been fully addressed in the stakeholder
meetings.
HB 2823 - patient care; presumptions – DPA
Vice-Chairman
Murphy moved that HB 2823 do pass.
Matt Flannery, Majority
Research Intern, explained that HB 2823 moves the location in statute of
language that prohibits surrogate decision makers from withdrawing the
artificial administration of food or fluid (Attachment 9).
Vice-Chairman
Murphy moved that the proposed three-page Stump amendment to HB 2823 dated 03/04/08
1:36 PM be adopted (Attachment 10).
Matt Flannery, Majority
Research Intern, explained that the three-page Stump amendment (Attachment
10) adds a “notwithstanding” clause to provision and requires the court to
provide a temporary order directing compliance with law that prohibits
surrogate decision makers from withdrawing the administration of artificial
food or fluid.
Chairman Stump welcomed students
and doctors from Midwest University, JT Steele University and members from the
Arizona Osteopathic Medical Association.
Marlene Romirez-Oliva,
representing Ramirez family, Jesse Ramirez, Jr., self, spoke in support of
HB 2823, testifying that her brother was severely injured with major head
trauma. Ten days after the accident the doctors pulled his foods and fluids to
determine his outcome. He was moved to Hospice care to receive further medical
treatment but not rehabilitation care. Her family trusted the doctors in this
decision, not knowing the medical ethics that were being violated at the time.
His diagnosis being hydration and starvation, he was refused antibiotics and
nutrition. With no living will, the family was forced to go to court to
determine who would make the medical decisions for Jesse. Mrs. Romirez-Oliva
concluded that his prognosis is promising now but no family should have to
endure what they went through to save her brother’s life.
Chairman Stump recognized those
in favor of HB 2823:
David Landrith, Vice President of
Policy & Political Affairs, Arizona Medical Association
Ron Johnson, Arizona Catholic
Conference
Rory Hays, Arizona Nurses
Association
Peter Gentala, Arizona Center for Policy
Laura Hahn,
Executive Vice President, Arizona Academy of Family Physicians
Chairman Stump recognized an
individual who was neutral on HB 2823, not wishing to speak:
Amy Love,
Administrative Office of the Courts
Question was
called on the motion that the proposed three-page Stump amendment to HB 2823
dated 03/04/08 1:36 PM (Attachment 10) be adopted. The motion carried.
Vice-Chairman
Murphy moved that HB 2823 as amended be adopted. The motion carried by a roll
call vote of 9-0-0-1 (Attachment 11).
HB 2697 - body art
establishments; licensure – DISCUSSED AND HELD
Vice-Chairman
Murphy moved that HB 2697 do pass.
Vice-Chairman
Murphy moved that the proposed nine-page Lopes S/E amendment to HB 2697 dated
03/03/08 2:17 PM (Attachment 12) be adopted.
Matt Flannery, Majority
Research Intern, explained that the S/E amendment (Attachment 12) to HB
2697 establishes licensure requirements for body artists and body art
establishments (Attachment 13). He further explained the S/E amendment and
answered questions.
Vice-Chairman
Murphy moved that the proposed four-line Lopes amendment to the Lopes S/E
amendment (Attachment 12) to HB 2697 dated 03/04/08 1:22 PM (Attachment 14) be
adopted.
Mr. Flannery explained that the
four-line Lopes amendment (Attachment 14) clarifies that although body piercing
includes ear piercing, ear piercing does not include puncturing of the outer
lobe of the ear with a pre-sterilized, single use stud and clasp ear piercing
system.
Representative David Shapira,
Sponsor, explained the purpose of the two amendments and answered Members’
questions.
Sean Dowdell, Arizona Tattoo
and Piercing Association, Owner, Club Tattoo, self, spoke in favor of HB
2697 and the amendments. He mentioned two cases of Mercer contracted from a
Tempe Tattoo business and the potential for the spreading of communicable
diseases like Hepatitis A, B, C and HIV if proper hygienic procedures were not
enforced through licensure. He responded to questions and comments.
Pete Wertheim, City of Peoria,
Intergovernmental Affairs Coordinator, Department of Health Services (DHS),
registered as neutral on HB 2697 and explained that the design of the bill and
amendments was similar to the food code system established in Arizona where DHS
sets minimum standards for regulation of food establishments and the local
health offices do the regulatory oversight. With this bill the business will
have licenses that will require training and standards that are set through
rule making by the Department of Health. He answered questions.
Mrs. Barto asked Mr. Wertheim
what the cost of time and money would be to his office. Discussion ensued.
Ms. Burns asked Mr. Wertheim if
the Department of Health could do safety inspections right now under their
current powers of protecting the public health. Discussion ensued.
Rory Hays, Maricopa County,
commented that a temporary solution would be ok but some fee authority would
need to be put in place because the counties may not have the ability to do
even a temporary fix in the interim. She answered questions.
Representative Shapira explained the
Sunrise process as part of Title 32 portion of statutes which licenses health
professionals, but body artists are not health professionals and therefore they
would be regulated under Title 36.
Dan Brown, Majority Research
Analyst, clarified the Sunrise process, stating that it is used to
determine how to regulate somebody who might be considered a health
professional, explaining that athletic trainers, massage therapists and
cosmetologists all fall under Title 32.
Darlene Justus, self,
spoke in favor of HB 2697 and the amendments, stating that it was her hope to see
regulations applied because too many infectious diseases could be contracted by
unsanitary conditions in certain tattoo parlors.
Chairman Stump announced that in
fairness to the bill it should go through the Sunrise process and therefore he would
withdraw the bill.
Chairman Stump moved
to withdraw the proposed four-line Lopes amendment to the Lopes S/E amendment
to HB 2697 dated 03/04/08 1:22 PM (Attachment 14), the proposed nine-page Lopes
S/E amendment to HB 2697 dated 03/03/08 2:17 PM (Attachment 12) and HB 2697 do
pass. The motion carried.
HB 2682 - technical correction; hearing evaluation
S/E: physician assistants;
qualifications - DO PASS AMENDED – S/E
Vice-Chairman
Murphy moved that HB 2682 do pass.
Vice-Chairman Murphy moved that the
proposed five-page Barto S/E amendment to HB 2682 dated 02/28/08 3:48 PM be
adopted (Attachment 15).
Dan Brown, Majority Research
Analyst, stated that the Barto S/E amendment (Attachment 15) to HB 2682
(Attachment 16) would allow the Board of Physician Assistants to consider
licensed applicants who were the subject of disciplinary action in other
jurisdictions, if the applicant’s act of conduct was subsequently corrected,
monitored, and resolved to the satisfaction of the Board.
Mrs. Barto, Sponsor, was available to answer questions.
Question was called on the motion
that the proposed five-page Barto S/E amendment to HB 2682 dated 02/28/08 3:48
PM be adopted (Attachment 15). The motion carried.
Vice-Chairman Murphy moved that HB
2682 as amended do pass. The motion carried by a roll call vote of 9-0-0-1
(Attachment 17).
HB 2269 - DHS; behavioral health; copying fees – DO
PASS AMENDED – S/E
Vice-Chairman
Murphy moved that HB 2269 do pass.
Vice-Chairman
Murphy moved that the proposed seven-line Stump S/E amendment to HB 2269 dated 03/03/08
12:49 PM be adopted
(Attachment 18).
Dan Brown, Majority Research
Analyst, explained that the Stump S/E amendment
(Attachment 18) to HB 2269 would prohibit nurses from performing surgical
abortions (Attachment 19).
Rory Hays, Arizona Nurses’
Association, spoke against the Stump S/E amendment to HB 2269 (Attachment
18) stating that she looks forward to working with the sponsor and that she is
pleased with his intent to place the bill into Title 36.
Chairman Stump read into record a
person against HB 2269 who did not speak:
Shannon Harper,
Planned Parenthood, Arizona
Chairman Stump read into record persons
for HB 2269 who did not speak:
Dr. Michael
Uring, self
Ron Johnson, Arizona Catholic Conference
Cathi Herrod, Center for
Arizona Policy, spoke in favor of HB 2269 and supported Rory Hays’ request
that it be put in Title 36.
Shannon Harper, Planned
Parenthood, Arizona, against HB 2269, announced that she could not testify
on the bill because of a pending court case.
Vice-Chairman Murphy read
statements from the following individuals who could not attend:
Dr. Michael
Urig, Chief of Service Department of OBGYN, Banner Good Samaritan Medical Center
Dr. Clint
Leonard, Morning Star Obstetrics and Gynecology
Dr. William A. Shavira,
OBGYN
Question was
called on the motion that the proposed seven-line Stump S/E amendment to HB
2269 dated 03/03/08 12:49 PM be adopted
(Attachment 18). The motion carried.
Vice-Chairman
Murphy moved that HB 2269 as amended do pass. The motion carried by a roll
call vote of 6-3-0-1 (Attachment 20).
Without objection, the meeting adjourned at 12:01 p.m.
____________________________________
Sarah K. Griffith, Committee Secretary
March 12, 2008
(Original minutes, attachments
and audio on file in the Office of the Chief Clerk; video archives available at
http://www.azleg.gov/)
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COMMITTEE
ON HEALTH
2
March 5,
2008
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