Posts Tagged ‘abortion’

Informed Consent Website Up & Running

November 26th, 2012

Last legislative session the Governor signed HB 2036- which amends state law regarding abortions. Some parts of the law are pending legal challenges, but the parts requiring us to develop a website were unaffected- and our new informed consent site just went up.  The website lists agencies and services that are available to assist women throughout their pregnancy, including information about adoption.  The information is listed to make it easy for women to find local resources.  Many of our public health programs are listed, like WIC, breastfeeding support, and home visiting programs.  The website also includes information describing fetal development and info describing various abortion methods and medical risks associated with the procedures. 

It’s important that providers are aware of the website because the law requires AZ health care providers to give a woman considering an abortion the opportunity to review the information. A “Potential Resources Submission Form” is posted in case agencies are interested in listing additional resources on the site.

Annual Abortion Report Published

September 18th, 2012

A couple of years ago a bill was passed that required our agency to do a comprehensive statistical report about abortion in Arizona. We published our second annual report this week… which includes data compiled from elective abortion procedures reports, complications from abortions reports and petitions filed authorizing abortions to minors. Facilities that provide the procedure are required to send us the required data elements every month (electronically). 

Over the last couple of years, we’ve been working hard to make sure that all providers are reporting as required by lawIn years past… we think we were missing data because of under-reporting by providers. This year’s report suggests that those efforts to boost reporting are paying off. During 2011 (calendar year) there were a total of 14,401 abortions compared to 11,438 abortions in 2010… which is a 26% increase in the number of reported abortions. I underlined the word “reported” because when you look inside the data, it appears that some of the increase is attributable to better reporting and enhanced surveillance. You can read the full report on our Vital Statistics website

Let’s tie this report to our Strategic Plan  for a second- particularly our mission to reduce teen pregnancy.  We already know that AZ has had one of the steepest declines in teen pregnancy in the last few years when compared to the other states.  In this report, we see that despite the increase in the overall abortion rate (at least partially attributable to better reporting), the abortion rates for women 15 to 19 years of age declined by 30% in the last 10 years- consistent with declines in the number of teen pregnancies in AZ.

Abortion Law

July 30th, 2012

Last year HB 2036, which relates to abortions in AZ, was passed and signed.  There are a host of changes that the new law makes- and many of the provisions kick in at different times.  The first things that we’re responsible for (beginning August 2nd)  include providing an informed consent form for unemancipated minors that are seeking an abortion.  The Parental Consent Form for Pregnant (Unemancipated) Minors is on our webpage along with a more general background information including a timeline regarding various implementation dates for the law.  The next deliverable for us is to develop a website that provides information about adoption services, details about pregnancy milestones etc.  We expect to have that website up and running by mid-October.

Abortion Clinic Licensing

July 13th, 2011

A new law was passed last legislative session (HB 2416) that expanded the definition of an abortion to include “any means” (the former definition was limited to surgical abortions) and changed the qualifications for who can perform the procedure.  For us, it meant that beginning July 21 (when the law was to take effect) we’d be responsible for ensuring compliance with the new provisions (including licensing an additional 12 or so abortion clinics).  We already license them; outpatient treatment clinics- so our job would be to ensure that they also comply with our abortion clinic rules.  However, earlier this year Planned Parenthood of AZ challenged some aspects of the new law-and at a hearing this week a judge held up the implementation of the new law pending an August 22nd hearing.

New Laws Related to our Mission

April 25th, 2011

The Legislature completed the Regular Session last week.  They’ve passed numerous bills.  The Governor has signed many of them, but some are still waiting for her consideration and signature.  Below are the new laws that have been signed by the Governor that are related to our mission:

  • HB 2585: Controlled Substances; Marijuana; Monitoring

This law requires the ADHS to share our list of current Medical Marijuana Registration Cardholders with the Arizona Board of Pharmacy’s Controlled Substances Prescription Monitoring Program database.  The Board will then add the data to their monitoring database, which includes data regarding the other controlled substances.  It would allow doctors (who are considering prescribing patients medication) to check if the patient is a medical marijuana registration card-holder.  The idea is to help doctors determine the best course of treatment for patients.  It basically would treat medical marijuana just like all the other controlled substances by including the information in the Pharmacy Board’s database.

This new law will allow baked food (not that’s not considered “potentially hazardous” as defined by our rules) to be prepared in a home kitchen and sold for commercial purposes beginning July 20.  It’ll provide self-employment opportunities to folks that might not otherwise be able to find work, and for supplemental income for others.  For example, the more than 900 or so group homes for folks that have developmental or intellectual disabilities would be able to start up a home cottage industry like a small oatmeal cookie business and sell their food to local grocers.  We’ll be helping to facilitate the use of healthy recipes as part of the program as well as set up an electronic registration database that we can use to communicate electronically with participants.

  • HB 2213: Intellectually Disabled Terminology

This bill was long overdue in Arizona.  The bill replaces the “the R-word” in state statutes with more appropriate terms.  A special shout-out to Special Olympics Arizona for making this happen.

The bill charges us with establishing rules and protocols to coordinate a state-wide stroke system of care.  We’ve already established some stroke centers in AZ and we’ll be developing various rules and protocols regarding the transportation of patients to hospitals based on several criteria.  These protocols help transport patients to the closest appropriate hospital for treatment based on the severity of the injuries.  Currently, there are no stroke specific guidelines for suspected stroke victims.

  • HB 2634: Health Care Institutions

This legislation will help kick off a serious effort at ADHS to better integrate behavioral health and primary care for patients by giving us exempt rulemaking authority (until July of 2013) to change our licensing rules (exempt rulemaking is the “diamond lane” for rules).  The bill directs ADHS to revise rules to reduce regulatory and monetary burdens and to facilitate the integration of healthcare.

  • SB 1248: Dual Licensure for Hospitals

This is another helpful law that will streamline our rules by enhancing integrated care by reducing the licensing burden on health care institutions. Right now, hospitals that provide psychiatric services need 2 licenses.  After we’re done revising our rules they’ll only need 1 license.

This new law expands the definition of abortion to include “any means,” among other changes to statute.  ADHS will now license about 12 additional abortion clinics as a result of the definition change.  These 12 clinics are already licensed as outpatient treatment clinics- so our job will be to ensure that they also comply with our abortion clinic rules.

  • SB 1025: Arizona State Hospital Fingerprinting Requirements

This new law prohibits people that have been convicted of certain criminal offenses from working at the AZ State Hospital. It also requires that all ASH employees and volunteers get a “Level 1” fingerprint clearance card in order to ensure compliance with the new restrictions.  The list of offenses that make an employee or volunteer ineligible are located in ARS 41-1758.07.  The new law states, “A state hospital employee or volunteer must have a valid fingerprint clearance card issued pursuant to section 41-1758.07 OR must apply for a fingerprint clearance card within seven working days after beginning employment or performing volunteer work.”  Level 1 Clearance Cards are good for 6 years. DPS routinely runs cardholders through their database to check for new convictions, and we’re automatically notified when there’s a conviction of one of the disqualifying offenses.

We’ll need to move quickly because the new law takes effect at the end of July.  We’ll be hiring a vendor to collect the fingerprints while our team is at work.  We’re also working a way to pay for collecting and running the prints so there won’t be an out-of-pocket expense.

  • Budget Highlights: SB1612: General Appropriations; SB1614: State Budget Procedures; SB1615: Consolidation of State Agencies; SB1616: Budget Reconciliation; SB1619: Health Budget Reconciliation

I won’t go into the details for these- but here are the basics:

1.     Mandatory furloughs are eliminated in 2011 and 2012.  Agencies can still use them to meet budget requirements.

2.     Employee/Employer retirement contribution rates go to 53%/47% from the current 50:50.

3.     The Arizona Biomedical Disease Research Commission will be transferred to the ADHS.

4.     Children’s Rehabilitation Services (CRS) is officially transferred to AHCCCS.

5.     Vital Records will become self-funded.

6.     County contributions for residents of the Sexually Violent Persons unit at the Hospital increases to 50% from the current 25%.

Abortion Clinic Inspections

August 30th, 2010

In 1999 a bill was passed to regulate abortion clinics.  Before the law could take effect, a lawsuit was filed that “stayed” the regulation of abortion clinics until a settlement agreement could be finalized with the Department and the plaintiffs.  Last year the settlement agreement was finalized and the Department was able to write rules for the regulation of abortion clinics.

The new rules are complete and have been filed with the Secretary of State’s office; they go into effect on November 1, 2010.  This has been a complicated process for the Office of Administrative Rules, the AG’s Office and the Office of Medical Facilities (OMF) in the Division of Licensing.  In order to allow abortion clinics to begin performing abortions on November 1, the providers of free standing abortion services will need to apply for a license by September 2, 2010 in order to be licensed by November 1, 2010 (by law, abortion clinics can’t qualify for a temporary license).   If a facility provides abortions and already has a license, they will need to apply for an amended license.   Our medical facility licensing folks will be providing training and surveys to all of the providers before November 1, 2010.

Special thanks go to Kevin Ray and Don Schmidt from the AG’s Office, Tom Salow and Valerie Grina from the Office of Administrative Rules, Alan Oppenheim and Mary Wiley from the Division of Licensing and Kathy McCanna and Connie Belden from our medical licensing shop.

New Vital Statistics computer application

August 16th, 2010

We have developed a new computer application and website to support the new abortion reporting requirements introduced with the passing of SB1304 into law.  This new law requires additional information to be provided to AHDS when abortions are performed or complications develop.  Currently, medical providers are required to report particular information to ADHS in an effort to collect Arizona specific data regarding abortion care. In the past this reporting has been manual via paper and we took this opportunity to automate this data collection by creating a reporting website for provider use.  In addition, we created a user registration site so that the management of users could be streamlined with self-service for account establishment and password management and we created an administration site for ADHS use.   Training has been developed and is available for new users. This project had an extremely short development cycle so it took a true team effort. Thanks to all who were involved!  The team consisted of both Vital Statistics and ITS personnel including  Beverlee Hall, Christopher Mrela, Richard Porter, Frank Caglio,  Madan Gopal, Ellen Rayer, Michelle St. Germain, Michael Conklin, Shandy Odell, Jeanie Milnes and Raghu Ramaswamy.

Abortion Reporting

May 12th, 2010

The Legislature passed (and the Governor signed) a new law this past session that expands the number of reportable fields for abortion procedures that occur in Arizona.  There are about 17 reportable fields and new reporting requirements for complications that occur as a result of the procedure.  All of the data is confidential and there are no personally identifiable patient fields that are reported. The law also requires the Department to write up an annual report summarizing the data that we collect.  The new law SB1304 will become effective at the beginning of July.

The law specifies that the data needs to be submitted electronically, which is an important provision because we have limited ability to do the data entry ourselves.  Out IT and Vital Statistics areas are busy getting the computer application up and running so that we’re ready to go on July 1.  We’ll also be coordinating the new reporting requirements with Licensure, as it will be in the process of setting up the inspection procedures over the summer, with the expectation that we will begin licensing and surveying the clinics starting November 1.

Tucson Women’s Clinic v. Eden

May 11th, 2010

Back in 1999, a law was passed and signed (ARS § 36-449.01 36-449.02 36-449.03) that required ADHS to license and inspect abortion providers if they provide 5 or more first-trimester abortions in a month or if they provide any 2nd or 3rd trimester abortions as an abortion clinic.  Hospitals were exempted.

The Tucson Women’s Clinic sued the ADHS director (Cathy Eden) to prevent the Department from implementing the inspection program, arguing that there were a number of problems with the new law.  The District Court decided that some of the new law was legal but some of it wasn’t.  The next stop in the case was the Appellate court, which reversed some of the District Court decisions and sent the case back (remanded the case) to District Court.  Some of the issues that they instructed the court to deal with included record access, the redaction of records, the Department’s ability to conduct unannounced inspections, and a regulation that required abortion providers to submit copies of fetal ultrasound prints to a private contractor and the Department.

After the remand, ADHS worked with the Tucson Women’s Clinic to negotiate a stipulated settlement which eliminated some of the requirements and added a regulation that provided the Department only strictly regulated access to patient records.  Eventually, a stipulation agreement was reached.  The US District Court approved the Stipulation of Settlement in September of 2008 and we began the process of writing a Rule to implement the 1999 statute.

A couple of weeks ago, the Governor’s Regulatory Review Council passed our rule package with the inspection requirements.  The new rules are posted in the Arizona Administrative Register, November 6, 2009 (15 AAR 1822).   Last week we filed a Motion to Vacate the previous court orders, which would allow us to begin licensing and inspecting abortion clinics.   Now that the court has approved our request, our licensing division is beginninglicensing and inspection programs to enforce the new rules on November 1, 2010.