[{"_1":2,"_98":-5,"_99":-5},"loaderData",{"_3":4,"_25":26},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","routes/v2/article/layout",{"_27":28,"_29":30},"notFound",true,"relatedArticles",[31,74,86],{"_32":33,"_34":35,"_36":37,"_38":39,"_40":41,"_42":43,"_44":43,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":72},"mediaId",6366486,"mediaKeyId","2159489-be38a29ccfb308848773bdd7d1eb0873","parentId",2159489,"title","Committee advances ALTCS screening changes, nurse circulator rule and other measures; votes at a glance","audioSeconds",0,"startMs",3854000,"endMs","viewUrl","/Search/View?dp=1&key=2159489-be38a29ccfb308848773bdd7d1eb0873&start=3854&end=3854","thumbnailUrl","https://assets.pipeline.soar.com/2159489-be38a29ccfb308848773bdd7d1eb0873/thumbnail_3854000.jpg","articleUrl","/articles/6366486/Arizona/Committee-advances-ALTCS-screening-changes-nurse-circulator-rule-and-other-measures-votes-at-a-glance","mediaUrl","https://secure.pipeline.soar.com/6366486-99fafc17d83aeb495dd89d42b2e8aa7e/orig.mp4?Expires=1770101083&Signature=YjOq-Hk1robF-C0cGAt~kNSUCVL0jNatccJmil62r32i1r18nLx-FQ6XJsaehvlrs3rhdmG-bLjhdmAs15OPNqKAYyglh4DuTHOMc2vidXaglkpulr6vaPkJRoMFvIgmbyPktX1U8J3pcKJdIDvefU1JoWHQY-UIViOHDAbzVSbXMk3gp1MqqUhgPlmgCi3fxnb0w8bSYIXKToqUI5q4bp72VFEGigHC5YhHFmjKkReKnSErAfHQxNPZkDml6Y7L1ydZSYiwhIhY6k3cthrW4cvB1XUe9TKvKnApylnSeR99W3dA9mmRcFstNyq9uWh4ntP3XiPCP~F4IoKisSLaOg__&Key-Pair-Id=KUT5TJCACFTXG","author","Arizona State Legislature","date","2025-01-27T00:00:00Z","article","The Arizona House Health and Human Services Committee advanced six measures after presentations and testimony on workforce and rural access. Lawmakers passed or recommended passage for bills that would modify the Arizona Long‑Term Care System (ALTCS) screening process, require an RN circulator for most surgeries, restrict marijuana advertising near child‑focused locations, extend an acute‑care‑at‑home pilot, and alter licensing procedures for behavioral‑health professionals and behavior analysts.

Votes at a glance

- House Bill 2182 (ALTCS pre‑admission cognitive screening) — Passed in committee as amended, 12–0. Sponsor: Rep. Selena Bliss. The Bliss amendment (Jan. 24, 2025, 09:22 a.m.) removed a requirement that ACCESS conduct in‑residence interviews with caregivers, family, neighbors and medical providers; it maintained existing ALTCS pre‑admission screening procedures and added an effective date of July 1, 2027. ACCESS staff said redesigning the assessment tools and testing would carry a fiscal and operational cost; stakeholders including the Alzheimer’s Association supported the bill as a way to better identify cognitive decline in applicants.

- House Bill 2132 (Registered‑nurse circulator in operating rooms) — Passed as amended, 9–3. Sponsor: Rep. Bliss. The Bliss amendment (Jan. 23, 2025, 04:55 p.m.) exempts a hospital or outpatient center from the RN‑circulator requirement during an extraordinary number of emergency surgical cases resulting from unique or mass‑casualty events and defines “extraordinary.” Proponents, including perioperative nurses, argued a single dedicated RN per case is a patient‑safety standard; some hospitals and business groups warned the mandate could strain staffing and increase costs in understaffed facilities.

- House Bill 2179 (Marijuana advertising restrictions) — Passed, 12–0. Sponsor: Rep. Bliss. The bill restricts marijuana advertising and requires warning labels; it bars billboards within 1,000 feet of parks, playgrounds, child‑care centers, schools, substance‑use recovery facilities and churches and includes a Proposition 105 clause. Testimony included physicians and pediatricians who showed examples of ads they said targeted youth; hemp and paraphernalia businesses urged technical changes to avoid unintentionally encompassing lawful hemp products.

- House Bill 2180 (Acute‑care services at home pilot extension) — Passed, 11–1. Sponsor: Rep. Bliss. The bill extends the pilot program repeal date to Jan. 1, 2029. Mayo Clinic and other proponents said the program — hospital‑level remote monitoring and twice‑daily nursing or EMT visits in the patient’s home — has shown positive outcomes and high patient satisfaction; committee members asked for more outcome data tied to readmissions and costs.

- House Bill 2001 (Temporary license for behavioral‑health graduates) — Passed, 10–2. Sponsor: Rep. Breus. The bill would allow a temporary license, valid for 90 days after graduation, for applicants who have completed required graduate training and are working under qualified supervision while their associate‑level application proceeds; proponents said it avoids care interruptions for clients who otherwise lose their graduate‑intern clinician on graduation day.

- House Bill 2027 (State Board of Behavioral Analysts) — Passed, 10–2. Sponsor: Rep. Bliss. The bill moves the Committee of Behavior Analysts out of the Board of Psychologist Examiners and establishes a State Board of Behavioral Analysts (seven members), cites duties and sets a sunset date of July 1, 2034. Supporters said the change will reduce licensing delays and board quorum issues without increasing staffing or state costs.

Key details and committee discussion

ALTCS pre‑admission screening (HB 2182): ACCESS staff said updating the functional assessment tools to capture cognitive decline will require contractor support, extensive testing and fiscal resources; they estimated work to modify multiple assessment instruments and to model fiscal impacts. The Alzheimer’s Association, dementia‑care providers and owners of specialized facilities described cases where applicants were financially eligible for ALTCS but denied on functional measures and urged the committee to approve the amended approach to ensure cognitively impaired applicants receive appropriate assessment.

Circulator‑nurse requirement (HB 2132): Perioperative nurses testified that a dedicated RN circulator is best practice to maintain infection prevention, correct‑site verification and to detect subtle signs of patient deterioration; some hospital groups said the mandate could aggravate nursing shortages in some facilities and proposed an accreditation‑based exemption. The adopted amendment includes a narrowly drawn emergency exception.

Marijuana advertising (HB 2179): Pediatricians and prevention advocates emphasized ads that use cartoons or holiday themes visible to children; dispensary and hemp stakeholders sought technical fixes to avoid sweeping in lawful hemp products or constraining non‑marijuana businesses unintentionally. The bill sponsor signaled intent to work with stakeholders on clarifying amendments before floor action.

Other measures: HB 2180 (acute‑care at home) drew questions about the scale of current use, targeted diagnoses (pneumonia, cellulitis, COVID, sepsis and certain post‑op recoveries were cited) and insurer coverage for home‑based acute care. Supporters said Mayo Clinic has performed hundreds of admissions under the pilot and offered to provide outcomes and readmission data to staff. HB 2001 and HB 2027 address licensing processes and board structure; supporters said the changes would reduce avoidable delays and preserve continuity of care for clients of newly graduated clinicians.

What passed and next steps

All six bills received committee approval and will move to the House floor with sponsor commitments to work on technical amendments where stakeholders flagged concerns (notably HB 2132 and HB 2179). Sponsors and committee staff indicated they will supply fiscal notes, contractor reports (for ALTCS updates) and outcome data (for the acute‑at‑home pilot) before floor debate.

","mediaType","Video","parentTitle","01/27/2025 - House Health & Human Services","oneSentenceSummary","The Arizona House Health & Human Services Committee voted to advance six bills after presentations and testimony, including a modified ALTCS cognitive screening bill, a circulator‑nurse requirement for surgeries, marijuana ad restrictions, an acute‑at‑home extension and licensing reforms for behavioral health and behavior analysts.","taxTitle","2025 Legislature Arizona, Arizona","taxId",78572,"location","Arizona","headline","","shortSummary",{"_32":75,"_34":35,"_36":37,"_38":76,"_40":77,"_42":78,"_44":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":54,"_55":56,"_57":84,"_59":60,"_61":62,"_63":85,"_65":66,"_67":68,"_69":70,"_71":72,"_73":72},6366491,"Doctors tell lawmakers rural Arizona lacks specialists; transport costs, training gaps cited",1243,1778000,3021000,"/Search/View?dp=1&key=2159489-be38a29ccfb308848773bdd7d1eb0873&start=1778&end=3021","https://assets.pipeline.soar.com/2159489-be38a29ccfb308848773bdd7d1eb0873/thumbnail_1778000.jpg","/articles/6366491/Arizona/Doctors-tell-lawmakers-rural-Arizona-lacks-specialists-transport-costs-training-gaps-cited","https://secure.pipeline.soar.com/6366491-e170f84d5cb6746de6a115d0bce5dfc1/orig.mp4?Expires=1770101083&Signature=ECaFHm5XgX2hdwnXpsxHA9qljIu-jNmK6AoryWE~fhUYE0FLzjSRTrXmhseRrjJsWTCTJzuxgxoidiOHwC8E9wa7rh6WCa7PVINilW-qO9cC5kMthdfudoyYDei4pzfSg~ZasgHVPvplr~h8s40zwgw8H-PX7vNtSPOo7rVk3Rv3kgipXMTU1Y-i95n7F2eSPychEiLvSdxSsetEk0FopLFeV0Ud3xLJmKQMCkb6Fbdm7jf8--0J5K9VSFqkIGP4JTpKPlVHgUFdTvkMPj52nkC7dEP5TupAB5WsPakaIaW~rNPF-Nv5Hs-imnwjdxkwRpBj8zOyVOxFFdC5MZKmZg__&Key-Pair-Id=KUT5TJCACFTXG","Interventional cardiologists, rural physicians and policy advocates told the Arizona House Health and Human Services Committee that shortages of specialists in rural counties are causing delayed treatment, high transport costs and patient harm — and urged lawmakers to consider short‑term workforce fixes while expanding training pipelines.

Dr. Abdul Maiman, an interventional cardiologist who has practiced in rural Arizona for decades, told the committee that timely heart care is critical and that rural hospitals often lack the staffing and bed capacity needed for emergencies.

“Time is muscle,” Dr. Maiman said. “If we delay transfer, the patients are going to be not as good of an outcome as you would expect.” He said that air transport from Globe to Chandler can cost about $58,000 while insurers often reimburse a maximum of about $18,000, leaving large balances for patients or hospitals.

Local outcomes and capacity

Dr. Maiman described a rural practice that reduced the number of annual cardiac transfers from roughly 334 to fewer than 35 after adding local cath‑lab capacity and staff rotation. He told the committee many new graduates and fellows prefer tertiary centers with colleague backup rather than solo rural practice.

Policy options discussed

Jonathan Wolfson, chief legal officer at the Cicero Institute, described a policy route used by other states that creates a pathway for physicians trained overseas — who have passed equivalency exams and practiced in their home countries — to work in rural or underserved areas without repeating a U.S. residency. Wolfson said 10 states already have laws permitting such pathways and about a dozen states had similar bills in the current legislative session.

Dr. Maiman and Wolfson told lawmakers that safeguards in prior proposals included an initial period of direct supervision (for example, six months), retrospective case review and a commitment to work in an underserved community for a defined period.

Committee questions and context

Members asked about lifestyle and training pipeline issues. Representative Heap noted the long training path to sub‑specialization: college, four years of medical school, three years of internal medicine, three years of cardiology fellowship and additional fellowship for interventional cardiology — a sequence many students are reluctant to endure. Dr. Maiman and other speakers noted Arizona trains relatively few interventional cardiologists annually and said residency capacity and retention are chokepoints that will require federal and state attention.

Speakers urged a two‑track approach: expand long‑term U.S. residency slots and consider carefully structured short‑term pathways to place experienced internationally trained physicians in underserved areas under strict supervision and review.

","Interventional cardiologists and policy advocates told the committee patients in rural Arizona face delayed care, high transfer costs and too few specialists; speakers urged consideration of temporary licensing/pathways for internationally trained physicians alongside long‑term residency expansion.",{"_32":87,"_34":35,"_36":37,"_38":88,"_40":89,"_42":90,"_44":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":54,"_55":56,"_57":96,"_59":60,"_61":62,"_63":97,"_65":66,"_67":68,"_69":70,"_71":72,"_73":72},6366496,"Arizona health leaders warn of clinician burnout, urge systemwide well‑being drive",1145,591000,1736000,"/Search/View?dp=1&key=2159489-be38a29ccfb308848773bdd7d1eb0873&start=591&end=1736","https://assets.pipeline.soar.com/2159489-be38a29ccfb308848773bdd7d1eb0873/thumbnail_591000.jpg","/articles/6366496/Arizona/Arizona-health-leaders-warn-of-clinician-burnout-urge-systemwide-wellbeing-drive","https://secure.pipeline.soar.com/6366496-10de83d6887117f790a9233330fcfb5d/orig.mp4?Expires=1770101083&Signature=XIqQMJaqZ0RCLYL9n80M6nPMf32b49n91WAQVQBJD3HE6ep1iRqItv-6SIJXhdSreQrq~wodWAHGspPhjj~kLc5sOfi2kT33ZmZkMI7S6~Z6WGBoaf5E84~XjGjug~ahhiM8ul5mbmc7ckaHzH9HmSCa7aBs0PvkAw~hUF1g9-g9Iny0BTwqaq~pKdUtqMVBODa-INVOlgKz0ODgHs36nndGgvAN4yrYOGWY3Sjdxp8Y-t1I0Ak1agbxhFq8Ef52FOnYET2xECLvYf5yeFu5xleZnjsyrHrc3JirRqjJQAeoqheIq-u4cg83bhRyjhupHHky~uxMdEH2XvSerSE80w__&Key-Pair-Id=KUT5TJCACFTXG","At a meeting of the Arizona House Health and Human Services Committee, leaders of the Well‑Being Collaborative of Arizona Health Professionals told lawmakers the state faces a growing health‑workforce crisis driven by clinician burnout and called for leadership, team and system changes to retain staff and protect patients.

The collaborative’s executive director, Flo Spiro, and family physician Tiffany Panko, M.D., said more than half of clinicians nationwide report burnout and that Arizona’s rapid population growth will worsen shortages of physicians, nurses and behavioral‑health specialists.

“By burnout we don’t just mean having a bad day,” Dr. Tiffany Panko said. “The definition of burnout is really emotional exhaustion, depersonalization, and a lack of a sense of self‑efficacy.” She added that burnout is appearing early in training programs: “We’re seeing this in our young clinicians, our medical students, and our residents.”

Why it matters

The presenters linked workforce strain to patient safety and access: research shows clinician burnout raises the risk of medication errors and can delay diagnosis and treatment when clinicians leave practice. Spiro told the committee the collaborative is pushing three pillars of change — leadership development, inclusive and high‑performing teams, and organizational culture that prioritizes clinician well‑being.

What presenters told the committee

Spiro described the collaborative as a statewide, multidisciplinary group that includes health systems, public‑health organizations, professional associations, tribal partners and academic institutions. She said membership exceeds 350 individuals and roughly 50 organizations, and that the group is working on measurement and evidence for programs such as a leadership course called “Leading with Kindness.”

“We want resilient systems,” Spiro said. “We have resilient health‑care workers, but we need the systems to be resilient to support them.”

Panko said the collaborative will help state leaders identify policies and pilot programs that reduce burdens and stigma around mental‑health care for clinicians. She noted technology can help in some settings but also creates uncompensated burdens — for example, the volume of unremunerated electronic messages to outpatient clinicians.

Committee exchange

Members pressed presenters on concrete next steps. Rep. Willoughby, a nurse, said leadership matters: “I’ve had leaders in health care that I would follow through hell and high water.” Rep. Weniger asked whether technology and automation fit into the collaborative’s plan; Panko said technology is one of several topics for an upcoming summit, but that implementation must avoid adding uncompensated work.

Next steps and context

Presenters asked the committee to consider how state policy can support workforce well‑being, for example through funding for leadership development, mental‑health access for clinicians and programs that bolster rural networks. The collaborative said it will continue to work with state leaders, health systems and educators to pilot interventions and measure outcomes.

The collaborative’s presenters offered to provide the committee with the organization’s assessment tools and summit materials for follow‑up.

","At the Arizona House Health & Human Services Committee, the Well‑Being Collaborative said clinician burnout is driving workforce losses and urged policy and leadership changes to retain clinicians and protect patient safety.","actionData","errors"]

Article not found

Committee advances ALTCS screening changes, nurse circulator rule and other measures; votes at a glance

Doctors tell lawmakers rural Arizona lacks specialists; transport costs, training gaps cited

Arizona health leaders warn of clinician burnout, urge systemwide well‑being drive