REFERENCE TITLE: appropriations; healthy communities program




State of Arizona

House of Representatives

Fifty-fifth Legislature

First Regular Session





HB 2885


Introduced by

Representative Bolding





Appropriating monies to the Arizona health care cost containment system.





Be it enacted by the Legislature of the State of Arizona:

Section 1. Appropriations; healthy communities health care program; requirements; exemption; delayed repeal

A. The sum of $2,167,000 is appropriated from the state general fund in each of fiscal years 2021-2022, 2022-2023 and 2023-2024 to the Arizona health care cost containment system to expand and operate the healthy communities health care program across this state with an emphasis on rural and urban underserved communities and tribal lands.

B. The Arizona health care cost containment system shall distribute the monies appropriated in subsection A of this section to a small business that is already engaged in operating the healthy communities demonstration program to improve health outcomes for high-risk patients in underserved communities. The program shall expand community service provider and physician enrollment in year one and expand availability of clinical services. Patients shall be enrolled over a rolling twelve-month period and outcomes shall be followed for a twelve-month period. The program shall conclude with a reporting period during which services will continue to be provided under existing reimbursement models.

C. The expanded healthy communities health care program must do all of the following:

1. Allow vulnerable persons encountered by community service providers or state and local agencies to be screened for eligibility and offered the opportunity to participate in the healthy communities health care program.

2. Manage insurance and program enrollment, referral and scheduling visits to primary care physician practices that accept both medicaid and medicare and to specialized clinicians.

3. Provide telehealth clinical care for diabetes, prediabetes, obesity, hypertension, hyperlipidemia and behavioral health conditions, including substance abuse, by licensed practitioners. The program is not limited to serving these conditions and may address other conditions such as sexually transmitted diseases.

4. Provide trained life coaches, compensated through the healthy communities health care program, to assist patients with removing barriers to health care, including transportation, and to address social determinants, cognitive challenges, clinical adherence, time management and community attachment.

5. Provide patients, community coaches and clinicians with a mobile-friendly application to empower the patients to develop self-management skills and habits regarding their own well-being, to improve clinical adherence and to improve communications with community service providers and health care professionals, at no charge to the patients or community service providers.

6. Provide access to advanced medical nutritional therapy and remote patient monitoring without requiring patients to purchase equipment.

7. Coordinate and provide access to reimbursable broadband communications to facilitate telehealth consultations, including medicaid smartphones and satellite communications, as appropriate.

D. The patient empowerment mobile-friendly application must do all of the following:

1. Comply with the health insurance portability and accountability act privacy standards (45 Code of Federal Regulations part 164, subpart E).

2. Conform to criminal justice privacy standards (42 Code of Federal Regulations part 2).

3. Be capable of providing secure live audio and video communication between mobile application users and their case managers, treatment providers or probation officer.

4. Be capable of allowing mobile application users to voluntarily disclose their location in real time, twenty-four hours a day.

5. Allow patients and their case managers access to a personalized treatment plan, to which patients, community service providers and clinicians may contribute and update progress.

6. Allow patients to receive and control access to their information, including revoking access from providers.

7. Support reporting of activity metrics by patients, coaches and treatment providers.

E. The monies appropriated in subsection A of this section shall be used for the following purposes:

1. Establishing and operating a community-based program office.

2. Employing community managers to expand healthy communities participation into more grass-roots community organizations, with one community manager for each of the three geographic service areas and a care educator dedicated to working with residents who are on community supervision or parole under the jurisdiction of the state department of corrections.

3. Training coaches to improve fidelity to the program model and ensure regulatory compliance.

4. Paying permissible, documented travel costs for community engagement and face-to-face coaching.

5. Implementing structured programs using evidence-based approaches.

6. Operating eligibility screening, referral and scheduling processes to ensure follow through and adherence.

7. Paying technology expenses not otherwise reimbursable under clinical models.

8. Developing, producing and distributing culturally appropriate communications materials and incentive programs to encourage community adoption.

9. Paying the costs of expense and outcomes management and reporting.

10. Paying the costs of data collection, analysis and reporting.

11. Integrating adjacent technology systems, including health current, medical records systems and other state information systems, as applicable.

12. Contributing to academic conferences and publications to distribute best practices learned through the program.

F. Clinical care delivery and coaching compensation shall be provided through existing reimbursement mechanisms and are not an allowable expense.

G. The recipient of the appropriated monies shall report on a quarterly basis, beginning six months after engagement expansion, on the following:

1. Job creation and retention supported by the healthy communities health care program to the commerce committees of the house of representatives and the senate.

2. Patients served, nonreimbursable costs per patient and estimated cost avoidance due to improved clinical outcomes to the health and human services committees of the house of representatives and the senate.

H. The appropriations made in subsection A of this section are exempt from the provisions of section 35-190, Arizona Revised Statutes, relating to lapsing of appropriations.

I. This section is repealed from and after December 31, 2024.