5 Things in Arizona: Q&A with Rep. Salman, Prison Health Care, Medical Debt Ballot Initiative – State of Reform

In this month’s edition of “5 Things We’re Watching” in Arizona, we explore a recent ruling finding inadequate health care in Arizona prisons, a conversation with Rep. Athena Salman and an initiative heading to the ballot this fall that aims to reduce the medical debt burden for patients.

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Eli Kirshbaum
State of reform

1. Prison health care deemed ‘seriously inadequate’ by federal court

After years of allegations that health care for Arizona prisoners has failed to meet basic levels of adequacy, a US district court issued a ‘historic’ ruling late last month who ruled that health care in Arizona prisons was “grossly grossly inadequate” and “unconstitutional.” “Judge Roslyn Silver ordered the ACLU – one of the plaintiffs in the original 2012 lawsuit against the state’s prison health care system – to identify neutral experts she can consult to produce a final order to the prison officials to reform the prison health system.

Proponents have blamed the privatization of health care in Arizona prisons for its failures. Control of the system shifted from the state to the private sector in 2011, and over the following years jurisdiction drifted from one private company to another (during which time the system received several healthcare fines inadequate). “When you have this perverse funding system, it creates an incentive not to provide care and not to fully fill health care positions, because basically every unspent dollar is kept as profit,” says Corene Kendrick, associate director of the ACLU’s National Prison Project.

2. Q&A: Rep. Salman discusses post-Roe Arizona

With the annulment of Roe v. Wade, several conservative leaders in Arizona argue that a 1901 law banning virtually all abortions in the state has now been reinstated. In this Q&A session, Democratic Rep. Athena Salman talks about recent moves she’s seen in the legislature to restrict reproductive health care in Arizona, how some local jurisdictions might be more proactive than others in seeking to suing abortion care providers, and the opportunities she sees to protect that care in Arizona.

Due to the confusing state of current abortion policy in Arizona, Salman says abortion providers don’t provide care because they’re afraid of being sued for it. “Instead of focusing exclusively on the health, well-being, and ultimate desires of the pregnant person and how they wish to manage their pregnancy, physicians and providers must perform additional calculations in Arizona where they must ask the question, “If I provide this health care, will I go to jail? Will I lose my license?’”

3. What They’re Watching: Dawna Cato, PhD, Arizona Nurses Association

As CEO of the Arizona Nurses Association, Dawna Cato, PhD, focuses primarily on one policy area: the nursing workforce. With Arizona being one of the states with the worst healthcare workforce shortages, Cato is working with the state to implement policy that will help build this critical workforce and meet the growing demand for nurses as the pandemic continues.

This work includes the Arizona School Nurse Access Program, the RN Connect text messaging platform, and the Fallen Nurses Tribute. “[The Fallen Nurses Tribute] This is where we partner with an organization called Better Place Forest, and they go around and buy forest property, and they help us create a memorial in the name of the Arizona Nurses Association for all the healthcare heroes deceased.

4. Arizonans will vote on a ballot initiative to reduce medical debt in November

A proposed initiative to protect Arizonans from crippling medical debt reached nearly half a million signatures earlier this month, far exceeding the public support needed to put the initiative on the ballot in November. Proponents of the initiative, including the Arizona Public Health Association, believe it is a matter of economic justice. Opponents, including the Greater Phoenix Chamber, say it will be harder for lenders to collect debts and harder for Arizonans to access credit.

In addition to capping the interest rate on medical debt at 3%, the Predatory Debt Collection Act would increase the amount of home equity that is protected from foreclosure by medical debt collectors from $250,000 to $400,000. $, would increase this protection for vehicles from $6,000 to $15,000, and increase the amount of money in a bank account protected against garnishment from $400 to $5,000.

5. CDC designates several AZ counties with ‘high’ community COVID levels

The CDC recently identified 10 of Arizona’s 15 counties as having high community levels of COVID-19, as U.S. case rates are at their highest since February. The omicron BA.5 subvariant — which accounts for 60% of new COVID cases in the state — is largely responsible for the rise in cases, according to Acting ADHS Director Don Herington.

Named counties include Maricopa, where the case rate is 2.4% higher than the rest of the state (although the death rate is 7.1% lower). Maricopa County’s COVID vaccination rate is 6.7% lower than the statewide rate of 62.5%. COVID vaccination rates – which are well documented as the most effective way to protect against new variants – are fluctuating from county to county in Arizona, with 4 other counties falling below the vaccination rate at the statewide.

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