ARIZONA HOUSE OF REPRESENTATIVES

Forty-ninth Legislature –Second Regular Session

 

COMMITTEE ON HEALTH AND HUMAN SERVICES

 

Minutes of Meeting

Wednesday, March 17, 2010

House Hearing Room 4  --  9:00 a.m.

 

 

Chairman Barto called the meeting to order at 9:07 a.m. and attendance was noted by the secretary.

 

Members Present

 

Mr. Ableser                             Mr. Lopes                   Mr. Boone, Vice-Chairman (temporary)

Mr. Bradley                            Mr. Murphy                Mrs. Barto, Chairman

Mrs. Goodale                          Mr. Vogt

 

Members Absent

 

Mr. Court

 

 

 

Committee Action

 

SB1053 – DP (7-0-0-2)                                                           SB1152 – DP (7-0-0-2)

SB1091 – DP (7-0-0-2)                                                           SB1161 – DPA (7-0-0-2)

SB1111 – DP (7-0-0-2)                                                           SB1162 – DP (7-0-0-2)

SB1113 – DP (7-0-0-2)                                                           SB1305 – NOT ASSIGNED

SB1114 – DP (7-0-0-2)                                                           SB1315 – DISCUSSED & HELD

SB1116 – HELD                                                                    SCM1002 – DP (6-1-0-2)

 

Chairman Barto announced that due to Mr. Court’s absence, Mr. Boone has been appointed by the Speaker to serve as the temporary Vice-Chairman for today’s meeting.

 

CONSIDERATION OF BILLS

 

SB1161 – unemployment insurance; technical correction(now: death certificates; registration; deadline) – DO PASS AMENDED

 

Vice-Chairman Boone moved that SB1161 do pass.

 

Vice-Chairman Boone moved that the Barto seven-line amendment to SB1161 dated 3/16/10 (Attachment 1) be adopted.

 

Gina Kash, Majority Assistant Research Analyst, explained that SB1161 requires local registrars, deputy local registrars or state registrars to register death certificates within 72 hours after receiving a medical certification of death and instructs the medical examiner to sign the medical certification of death within 72 hours (Attachment 2).  The amendment allows naturopathic doctors to sign death certificates (Attachment 1).

 

Senator Linda Gray, sponsor, related that a constituent called her because she had not received a death certificate for her daughter even though it had been four months since she passed away.  Senator Gray opined that a family should have a death certificate for closure even if it states that the cause of death is pending. 

 

Janet Brown, representing self, spoke in favor of SB1161.  She testified that her daughter passed away on April 2, 2007 at 25 years of age.  Her daughter had knee surgery five weeks prior, and because she was so young and healing, and the death occurred suddenly, someone offered to pay for an autopsy.  She agreed because of concern about another child.  She was told it may take
90 days to receive the results, but after 90 days, she began wondering what was taking so long.  A friend suggested that she call Senator Gray, and within a few days she had a death certificate that did not state the reason, but it gave her some closure. 

 

Mark Barnes, Arizona Naturopathic Medical Association, spoke in favor of SB1161.  He stated that current law allows a nurse practitioner, medical doctor or doctor of osteopathy can sign a death certificate, but a naturopathic physician cannot.  It makes sense and it would be good from a public policy standpoint to allow naturopathic physicians to sign death certificates. 

 

Dr. Catherine Walker, Arizona Naturopathic Medical Association, spoke in favor of SB1161.  She testified that in the last 10 years she had over 30 cases where she was presented with a death certificate that she could not sign, and many times she was the only physician of record.  She related several situations in which that occurred.  She noted that anyone who signs death certificates goes through a program by the Centers for Disease Control to learn how.  She submitted that if nurse practitioners with two years of education can sign death certificates, naturopathic physicians with four years of medical school should also be allowed to do so. 

 

Vice-Chairman Boone announced the names of those who signed up in opposition to SB1161 but did not speak:

Richard Bohan, Legislative Liaison, Maricopa County Board of Supervisors

 

Vice-Chairman Boone announced the names of those who signed up as neutral on SB1161 but did not speak:

Duane Huffman, Chief Legislative Liaison, Arizona Department of Health Services

 

Dr. Philip Keen, representing self, spoke in favor of SB1161.  He stated that when there is a pending cause of death, it has to be resolved, which sometimes takes months.  There has been anecdotal information that people actually lost homes because they were not able to obtain a death certificate in a timely fashion.  In other states, a document is issued as an attestation that someone has died and a death certificate is provided later.  Death certificates are signed quickly in medical examiners’ offices and hospitals, but there is a problem if the death occurs in the home and the doctor is not present.  He said 72 hours is somewhat problematic, so to put the proper pressure on people, language could be adopted stating within 72 hours, except on holidays, to allow for occasions in which someone dies on a Friday but nothing happens until Tuesday morning.

 

Question was called on the motion that the Barto seven-line amendment to SB1161 dated 3/16/10 (Attachment 1) be adopted.  The motion carried.

 

Vice-Chairman Boone moved that SB1161 as amended do pass.  The motion carried by a roll call vote of 7-0-0-2 (Attachment 3).

 

SB1091 – CPS workers; investigations; group homes – DO PASS

 

Vice-Chairman Boone moved that SB1091 do pass.

 

Gina Kash, Majority Assistant Research Analyst, explained that SB1091 requires Child Protective Services (CPS) to accept, screen and assess reports of abuse or neglect in Level I, II and III behavioral health residential agencies licensed by the Department of Health Services (DHS) (Attachment 4).

 

Names of persons who signed up in support of SB1091 but did not speak:

Robin Quinn, representing self

Herschella Horton, Chief, Legislative Services, Department of Economic Security

Beth Rosenberg, Lobbyist, Children's Action Alliance

 

Chairman Barto stated that an Auditor General’s report addressed the difficulty of properly investigating behavioral health facilities for CPS children because of certain provisions in statute, so this bill solves that problem.

 

Question was called on the motion that SB1091 do pass.  The motion carried by a roll call vote of 7-0-0-2 (Attachment 5).

 

SB1162 – domestic relations committee; membership – DO PASS

 

Vice-Chairman Boone moved that SB1162 do pass.

 

Gina Kash, Majority Assistant Research Analyst, explained that SB1162 adds one member to the Domestic Relations Committee (DRC) who is a representative of a statewide coalition that combats sexual assault and assists victims of sexual assault (Attachment 6).

 

Vice-Chairman Boone announced the names of those who signed up in support of SB1162 but did not speak:

Danielle Rothleutner, Case Manager, representing self

Kendra Leiby, Arizona Coalition Against Domestic Violence

 

Question was called on the motion that SB1162 do pass.  The motion carried by a roll call vote of 7-0-0-2 (Attachment 7).

 

SB1053 – minors; electronic cigarettes; prohibition – DO PASS

 

Vice-Chairman Boone moved that SB1053 do pass.

 

Ingrid Garvey, Majority Research Analyst, explained that SB1053 prohibits a person from knowingly selling, giving or furnishing electronic cigarettes to a minor (Attachment 8).

 

Greg Stanton, Director of Legislative Affairs, Attorney General's Office, in favor of SB1053, stated that the need for this legislation was brought to him by the Tobacco Enforcement Unit.  An electronic cigarette is a battery-powered device that uses vapor to deliver nicotine to smokers.  It is a new product so it is not addressed in statute; therefore, he believes it is appropriate that the Legislature make a statement that this type of product is not appropriate for minors in the State of Arizona.

 

Vice-Chairman Boone announced the names of those who signed up in support of SB1053 but did not speak:

David Landrith, Vice President of Policy & Political Affairs, Arizona Medical Association Raymond Kronenbitter, Registered Nurse, Arizona Nurses Association

John Wayne Gonzales, Legislative Liaison, City of Phoenix

Rob Dalager, City of Phoenix Police Department

Paul Ahler, Executive Director, Arizona Prosecuting Attorneys' Council

 

Vice-Chairman Boone announced the names of those who signed up as neutral on SB1053 but did not speak:

Colby Bower, Director of Government Relations, American Cancer Society Cancer Action Network

 

Question was called on the motion that SB1053 do pass.  The motion carried by a roll call vote of 7-0-0-2 (Attachment 9).

 

SCM1002 – health care reform – DO PASS

 

Vice-Chairman Boone moved that SCM1002 do pass.

 

Gina Kash, Majority Assistant Research Analyst, explained that SCM1002 requests the United States Congress to ensure that any federal health care legislation contain an equitable distribution of Medicaid funding (Attachment 10).

 

Question was called on the motion that SCM1002 do pass.  The motion carried by a roll call vote of 6-1-0-2 (Attachment 11).

 

SB1315 – child care programs; fees – DISCUSSED & HELD

 

Vice-Chairman Boone moved that SB1315 do pass.

 

Vice-Chairman Boone moved that the Barto two-line amendment to SB1315 dated 3/11/10 (Attachment 12) be adopted.

 

Ingrid Garvey, Majority Research Analyst, explained that SB1315 specifies that child care facilities and child care group homes may pay annual licensing fees in installments
(Attachment 13).  The amendment makes a technical correction (Attachment 12).

 

Bruce Liggett, Executive Director, Arizona Child Care Association, spoke in favor of SB1315.  He speculated that no industry has been hit harder than child care in terms of the economy; many centers are operating at 30 to 40 percent capacity.  He reviewed the provisions of the bill, noting that the study of costs of the various functions, as recommended by the Auditor General, is to be done in April 2011, but there have been discussions with the Department of Health Services (DHS) about moving the date up a few months earlier.  DHS has some concerns about annual payments of fees, which will be addressed with an amendment, as well as inclusion of permissive authority for DHS to continue the EMPOWER program so it can be done when funds are available.

 

Mr. Liggett responded to questions concerning the definition of significantly lower in
Subsection R and adjustment of fees by DHS by refund or credit. 

 

Ms. Garvey advised that the exemption for DHS from rulemaking for one year is in Section 5 of the bill, and it is in session law, so it is only for the purposes of the bill.  She indicated that the language will be clarified.

 

In response to a question, Mr. Liggett explained that the fiscal note pertained to the bill as originally written with a provision to delete the 10 percent additional charges paid to the
General Fund; that language was removed, so there will be no impact to the General Fund.

 

Senator Sylvia Allen, sponsor, stated that she received many calls from small business owners in her district who are alarmed about the increase in fees.  This bill will allow DHS to conduct a study to determine the cost to regulate child care centers and calculate fees.

 

Chairman Barto asked who will be involved in the study and decide what regulations are needed.

 

Duane Huffman, Chief Legislative Liaison, Arizona Department of Health Services (DHS), neutral on SB1315, stated that DHS started a comprehensive review of the regulations that involves stakeholders across the child care community, and draft rules will be issued soon.  In relation to the study about cost, DHS is developing a system to track the time and effort that surveyors, administrative staff, etc., put into specific tasks, which will be used to determine where significant cost savings may be realized.  There have been discussions about having a third-party help with the review.

 

Chairman Barto remarked that someone in her district who runs a child care business in her home was recently visited by state inspectors who advised of a new regulation that lantana plants have to be covered with netting because they are poisonous.  She asked how the regulations are developed.

 

Mr. Huffman responded that most child care regulations are based on situations that arose in which a child was endangered. 

 

Mr. Lopes recalled that when he was at DHS, child care regulations, unlike hospital regulations, are not dictated by the federal government.

 

Vice-Chairman Boone announced the names of those who signed up in support of SB1315 but did not speak:

Don Isaacson, Valley of the Sun Young Men’s Christian Association

Kathleen Pagels, representing self

John Wayne Gonzales, Legislative Liaison, City of Phoenix

Dale Wiebusch, Legislative Associate, League of Arizona Cities and Towns

Kevin B. DeMenna, Arizona Child Care Association

 

Chairman Barto stated that after discussion with stakeholders about the number of changes that need to be made to the bill, she believes it is best to vote on the bill next week.

 

Mr. Vogt suggested the inclusion of a definition for significantly lower and clarification of the language relating to DHS adjusting fees to state that it will either be a refund or a credit.

 

Vice-Chairman Boone withdrew the motion that the Barto two-line amendment to SB1315 dated 3/11/10 (Attachment 12) be adopted.

 

Vice-Chairman Boone withdrew the motion that SB1315 do pass.

 

SB1152 – foster care children; rights – DO PASS

 

Vice-Chairman Boone moved that SB1152 do pass.

 

Gina Kash, Majority Assistant Research Analyst, explained that SB1152 provides that the Bill of Rights for Children and Youth in Foster Care Act does not provide any legally enforceable right or cause of action on behalf of any person (Attachment 14).

 

Senator Leah Landrum Taylor, sponsor, stated that this is merely a technical clarification.

 

Vice-Chairman Boone announced the names of those who signed up in support of SB1152 but did not speak:

Robin Quinn, representing self

 

Question was called on the motion that SB1152 do pass.  The motion carried by a roll call vote of 7-0-0-2 (Attachment 15).

 

SB1111 – child support; medical insurance – DO PASS

 

Vice-Chairman Boone moved that SB1111 do pass.

 

Ingrid Garvey, Majority Research Analyst, explained that SB1111 specifies that when an obligor in a child support case obtains private insurance, the case medical support order terminates, and if the private insurance terminates, the cash medical support order automatically resumes (Attachment 16).

 

Vice-Chairman Boone assumed the Chair.

 

Vice-Chairman Boone announced the names of those who signed up in support of SB1111 but did not speak:

Raymond Kronenbitter, Registered Nurse, Arizona Nurses Association

 

Question was called on the motion that SB1111 do pass.  The motion carried by a roll call vote of 7-0-0-2 (Attachment 17).

 

SB1113 – child support committee; membership – DO PASS

 

Mr. Murphy moved that SB1113 do pass.

 

Gina Kash, Majority Assistant Research Analyst, explained that SB1113 allows the division or section chief of the Attorney General’s Office to appoint a designee to the Child Support Committee (CSC) in lieu of the division or section chief (Attachment 18).

 

Question was called on the motion that SB1113 do pass.  The motion carried by a roll call vote of 7-0-0-2 (Attachment 19).

 

SB1114 – maternity; paternity; genetic testing – DO PASS

 

Mr. Murphy moved that SB1114 do pass.

 

Gina Kash, Majority Assistant Research Analyst, explained that SB1114 makes specific changes to paternity and maternity testing procedures and requires state and local agencies that have custody of a person who is the subject of another state’s genetic testing order to comply with the order (Attachment 20).

 

Question was called on the motion that SB1114 do pass.  The motion carried by a roll call vote of 7-0-0-2 (Attachment 21).

 

Without objection, the meeting adjourned at 10:20 a.m.

 

 

 

                                                                        _______________________________

                                                                        Linda Taylor, Committee Secretary

                                                                        March 25, 2010

                                                                                                                                   

(Original minutes, attachments and audio on file in the Chief Clerk’s Office; video archives available at http://www.azleg.gov)

 

 

 

 

 

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                        COMMITTEE ON HEALTH

                        AND HUMAN SERVICES

7

                        March 17, 2010

 

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