Arizona House of Representatives Committee on Regulatory Affairs Meeting Minutes - February 15, 2023
Summary
Minutes of the regular meeting of the Arizona House of Representatives Committee on Regulatory Affairs, Fifty-sixth Legislature - First Regular Session, held Wednesday, February 15, 2023, chaired by Representative Hendrix. The committee action table records HB2625 DP 6-0-0-1, HB2622 DP 4-3-0-0, HB2630 FAILED 3-3-1-0, HB2166 DP 7-0-0-0, HB2094 DPA/SE 5-2-0-0 and HB2558 DP 6-0-0-1. Attachments include the agenda, which lists bill short titles such as tobacco; alternative nicotine; vapor products and dietitian nutritionists; licensure, and the Request to Speak report listing positions and comments registered on each bill. The attachments close with a letter urging support for HB2558, describing it as a title protection only bill.
Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used
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“Arizona House of Representatives Committee on Regulatory Affairs Meeting Minutes - February 15, 2023.”
Original at www.azleg.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/committee-265e0bc9d764ef7a/
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ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature - First Regular Session
COMMITTEE ON REGULATORY AFFAIRS
Report of Regular Meeting
Wednesday, February 15, 2023
House Hearing Room 5 -- 2:00 P.M.
Convened 2:06 P.M.
Recessed 3:53 P.M.
Reconyened 4:00 P.M.
Adjourned 4:49 P.M.
Members Present Members Absent
Representative Bravo
Representative Gutierrez
Representative Hernandez
Representative Payne
Representative Pefia
Representative McGarr, Vice-Chairman
Representative Hendrix, Chairman
Agenda
Original Agenda — Attachment 1
Request to Speak
Report — Attachment 2
Committee Attendance
Report — Attachment 3
Committee Action
Bill Action Vote
HB2625 DP 6-0-0-1
HB2622 DP 4-3-0-0
HB2630 FAILED 3-3-1-0
HB2166 DP 7-0-0-0
HB2094 DPA/SE 5-2-0-0
HB2558 DP 6-0-0-1
MINUTES RECEIVED
CHIEF CLERK'S OFFICE
2-/F- PR
Attachments
4,5,6
7,8
9,10
11, 12
13, 14, 15
16, 17, 18
A a
Julie R¥berg, Compfittee Secretary
February 17, 2023
(Original attachments on file in the Office of the Chief Clerk; video archives available at http:/Avww.azleg.gov)
COMMITTEE ON REGULATORY AFFAIRS
February 15, 2023
REVISED - 2/13/23 REVISED - 2/13/23 REVISED - 2/13/23
Convenes 10 pn
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature - First Regular Session Kecesecl 2LF fr?
i Wweantenze Los frre
COMMITTEE ON REGULATORY AFFAIRS
DATE Wednesday, February 15, 2023 ROOM HHR5 TIME 2:00 P.M.
Members of the public may access a livestream of the meeting here:
https://www.azleg.gov/videoplayer/?clientID=6361 162879&eventID=2023021073
Members:
Representative Bravo Representative Payne Representative McGarr, Vice-Chairman
Representative Gutierrez Representative Pefia Representative Hendrix, Chairman
Representative Hernandez A
Bills Short Title Strike Everything Title
(EP HB2094 D p ‘ ~ ‘2chnical correction; tax debt; enforcement S/E: mobile food vendor; operation; rules
-.+ . _ RA,RULES
8-0-2
é
4) **HB2166 p yp DHS; licensure; group homes
(Dunn: Fernandez)
5 S, RA, RULES
/ 0-0-0 MHS , RUL
> *HB2542 cosmetology licensure interstate compact
———_ tan)
RA,RULES
(G) HB2558 p 2 dietitian nutritionists; licensure.
(Hernandez A: Shah)
C-o.¢..) RA: HHS, RULES
__ ————_ Parker B)
RA,RULES
Attachment Tf |
Page 1 of 2
Bills Short Title Strike Everything Title
HB2622 D fp cost sharing; health coverage; report
—— (Hendrix)
4,9-Q-c¢ RA, RULES
@ HB2625 y fj? residential care institutions; inspections
(Carter)
Lor 0: 7. PA. RULES
“3 > HB2630 tobacco; alternative nicotine; vapor products
Failed (Payne)
2.2-/-E ®& RULES
#% If out of primary committee
On previous agenda
ORDER OF BILLS TO BE SET BY THE CHAIRMAN
JY
92/09/2023
02/13/2023
People with disabilities may request reasonable accommodations such as interpreters, alternative formats, or
assistance with physical accessibility. If you require accommodations, please contact the Chief Clerk's Office at
(602) 926-3032 or through Arizona Relay Service 7-1-1.
Page 2 of 2
Information Registered on the Request to Speak System
House Regulatory Affairs (2/15/2023)
HB2094, technical correction; tax debt; enforcement
Testified as neutral:
Robin Hillyard, COUNTY SUPERVISORS ASSN OF AZ
Testified as opposed:
Tom Dorn, City Of Phoenix; Mark Barnes, PINAL COUNTY; Salvador Reza, representing self; Marshall Pimentel,
LEAGUE OF ARIZONA CITIES & TOWNS
Support:
Diane Ortiz-Parsons, representing self; Patty Munozcano, representing self
Oppose:
Steve Ramos, representing self; Judith Robbins, representing self; Mariana Spier, representing self; Mary Ann
Graffagnino, representing self; Karen Syversen, representing self; Wes Oswald, representing self; Margaret Baca,
representing self; Tom Savage, LEAGUE OF ARIZONA CITIES & TOWNS; SUSAN ARNOLD, representing self; Karen
VanAllen, representing self; Janet Senf, representing self; Penny Boone, representing self; Margaret Winchell,
representing self; Francesca Pardes, representing self; William S. James, representing self; Kathleen Collins,
representing self; Steve Gorman-Hackstadt, representing self; Dorothy Reed-Inman, representing self; Eileen
Hollowell, representing self; Melinda lyer, representing self; Kathryn Anderson, representing self; Charlotte Lis,
representing self; Bruce Flocken, representing self; Elizabeth Lyons, representing self; Loretta O'Connor,
representing self; Mary Lisa, representing self; Joseph Alexander, representing self; Ginna Carico, GOODYEAR, CITY
OF; Roger Blain, representing self; Gary Townsend, representing self; Karina Sampson, representing self; Carmen
Terrell, representing self; Micheal Slattery, representing self; Jerrold Borchardt, representing self; Nancy Lecrone
Nonini, representing self; Nora Welsh, representing self; RITA DEPUYDT, representing self; Dale Wiebusch,
"SCOTTSDALE, CITY OF"; Nora Plonsky, representing self; Lisa Koenig, representing self; Lora Lida Walradt,
representing self; John Walradt, representing self; Srinivas Manne, representing self; HELI NIELSON, representing
self
All Comments:
Salvador Reza, Self: Takes away protection from neighborhoods. Endangers public health by taking away
commissary health regulations; Steve Ramos, Self: oppose striker if any; Judith Robbins, Self: This bill is a clear
violation of ethics when the sponsor directly benefits from the legislation devised. This is why government is seen
as corrupt. Vote no on 2094 to say NO to corruption. Kevin Payne should clearly be censured for this violation.;
Mariana Spier, Self: NO for the striker; Mary Ann Graffagnino, Self: We need strong regulations on food trucks to
protect the health of all.; Janet Senf, Self: | oppose the striker.; Penny Boone, Self: Food truck regulations should
NOT be relaxed as this bill would do. | oppose.; Margaret Winchell, Self: conflict of interest; Eileen Hollowell, Self: |
oppose the striker which would greatly benefit the sponsor but is bad for the public; Melinda lyer, Self: | oppose
the striker. This could create neighborhood issues, and is also a textbook example of self-dealing; Charlotte Lis,
Self: Regulations are important for our safety. Lenders show not be allowed to put forth bills that affect them.;
Attachment x
Loretta O'Connor, Self: The annual request from Rep Ptomaine. NO.; Ginna Carico, GOODYEAR, CITY OF: Concerns
with the strike-everything amendment.; Gary Townsend, Self: Payne, who owns a food truck, sponsored the same
bill in 2019, which did not pass.; RITA DEPUYDT, Self: 1 oppose the Kevin Payne striker regarding food truck
regulations.; Lisa Koenig, Self: The ammendments to this bill are self serving to its sponsor, who owns a food truck.
Vote no.; Lora Lida Walradt, Self: Unethical bill put up by food truck owner who would benefit from it. Will damage
public health & safety by relaxing regulations.; John Walradt, Self: LD-8. This is simple. | don't want a food vendor
operating on my neighbor's property next to mine.
HB2166, DHS; licensure; group homes
Support:
Brandy Petrone, AZ ASSN OF PROVIDERS FOR PEOPLE WITH DISABILITIES; LISA FARR LD4 - STATE Committeeman,
representing self; Emily Raymond, AZ ASSN OF PROVIDERS FOR PEOPLE WITH DISABILITIES
All Comments:
Brandy Petrone, AZ ASSN OF PROVIDERS FOR PEOPLE WITH DISABILITIES: AAPPD supports HB 2166 with the strike
everything amendment. AAPPD is opposed to the bill as introduced.; Emily Raymond, AZ ASSN OF PROVIDERS FOR
PEOPLE WITH DISABILITIES: We were opposed to the underlying bill, but are supportive of the Strike Everything
amendment
HB2558, dietitian nutritionists; licensure.
Testified in support:
Erika Barrera, representing self; Glenna Renee McCollum-Cloud, representing self
Support:
Gibson McKay, representing self; Briauna Ramirez, representing self; kathyrn busby, Arizona Nurses Association;
Michelle Berman, representing self; Paul Berman, representing self; Richard Berman, representing self; Kala
Narramore, representing self; Roger Blain, representing self; Maya Schmitt, representing self; Donna Shannon,
representing self; Caleb Rosales, representing self; Nicole Reeder, representing self; Raquel Cidone, representing
self; Logan Whitfill, representing self; Jay Tomkus, AZ Academy Of Nutrition And Dietetics; kathy Dixon,
representing self; Jennifer Doley, representing self
Oppose:
John Matthews, representing self; Jeff Mulder, representing self; Daniel Salerno, representing self; Eugene Slutskiy,
representing self; Geline Coulbourne, representing self; Stephen Harris, representing self; Basil Fernimos,
representing self; Bill Brown, representing self; Kim Miller, representing self; Lori Huff, representing self; Laurie
Foster, representing self; Sandy Williams, representing self; Mary Ann Johnston, representing self; Mary Kay
Ruwette, representing self; bruce emmons, representing self; Cheryl Rosado, representing self; Peter Anello,
representing self; Raymond Darragh, representing self; Denny Thomason, representing self; Crystal O, representing
self; Lady Surprise, representing self; Brent Meadows, representing self; Jeff Specter, representing self; Maria
Lopez, representing self; Carol Stines, representing self; Elouise Flagg, representing self; Eric Lovelis, representing
self; Wendy Jonessee, representing self; Amanda Monize, representing self; Jennifer Waller, representing self;
Terry Stines, representing self; Catherine Day, representing self; Vivian Figueroa, representing self; Barb
Hinderland, representing self; john shepard, representing self; Pam Gravely, representing self; Danielle Earl,
representing self; Joelene Williamson, representing self; Wayne Sapp, representing self; Donna Malik, representing
self; Sheilia Stoddard, representing self; J M, representing self; Andrea Wolverton, representing self; Bonnie Lund,
representing self
All Comments:
Glenna Renee McCoilum-Cloud, Self: This Bill protects those who are vulnerable when sick. Medical Nutrition
Therapy is not just "diet counseling” but rather a assuring critical care for those who need nutritional therapy
when burned severely, post-surgery, & critical care to survive!; Briauna Ramirez, Self: Licensure is important for
the safety of the public and consumer.; Kala Narramore, Self: Licensure protects the public from unknowingly
receiving nutrition counseling from unqualified people and prevents dietitians from being confused with these
unqualified people.; Roger Blain, Self: This bill would even the playing field and allow AZ dietitians and nutritionists
to compete with out of state providers. Without licensure, Arizona's practitioners are at a considerable financia!
disadvantage to those in other states.; Donna Shannon, Self: Licensure helps consumers identify nutrition
professionals qualified to provide Medical Nutrition Therapy. Regulation increases the safety of Arizonans by
mitigating unethical and unsafe practices.; Jennifer Doley, Self: Licensure for Registered Dietitian Nutritionists is
necessary to protest the public from fraudulent and dangerous practices form unqualified nutrition professionals.
There are currently NO protections in place; licensure is therefore needed.; John Matthews, Self: adding more
restrictions will make it harder to comply; Daniel Salerno, Self: no!; Stephen Harris, Self: Do we really need 9 pages
of additional regulations over nutritionist licensing?; Bill Brown, Self: These licensing requirements are needlessly
burdensome and infringe on our freedoms.; Sandy Williams, Self: Absolute NO. We shouldn't be restricted from
utilizing the services we need from who we prefer.; Maria Lopez, Self: As a State Committeeman and Precinct
Committeeman, | am opposed to this bill due it its excessive government encroachment.; Terry Stines, Self: This is
restricting our freedoms even more; Catherine Day, Self: PC letting you know how | the people feel; john shepard,
Self: I'm a PC and oppose this bill. We need more freedom in healthcare.; Danielle Earl, Self: Navajo County PC;
Bonnie Lund, Self: Stop strangling American freedom!
HB2622, cost sharing; health coverage; report
Testified in support:
Marc Osborn, AMERICA'S HEALTH INSURANCE PLANS (AHIP), Blue Cross Blue Shield Of Arizona
Support:
Wendy Briggs, CIGNA CORPORATE SERVICES LLC; Jay Kaprosy, CIGNA CORPORATE SERVICES LLC; Chad Heinrich,
Arizonans For Affordable Health Coverage; Jaime Molera, Aetna Inc. A Subsidiary Of CVS Pharmacy Inc.; Stan
Barnes, UNITED HEALTHCARE SERVICES, INC.; Chuck Bassett, Blue Cross Blue Shield Of AZ
Oppose:
Stuart Goodman, Susan G. Komen Center For Public Policy; Amanda Rusing, AZ MEDICAL ASSN; Julie Hoffman ,
representing self
All Comments:
Julie Hoffman , Self: Patient advocacy orgs will not support a scarlet letter list of diagnoses that plans allege burden
all other members. An ER trauma admit could cost more than the lifetime $ of a person w well controlled diabetes.
Cost sharing shaming is a new low bar
HB2625, residential care institutions; inspections
Testified in support:
will humble, AZ PUBLIC HEALTH ASSOCIATION
Oppose:
Don Isaacson, LEADINGAGE ARIZONA; Karen Barno , representing self; Marie Isaacson, ARIZONA LEADINGAGE;
Jaime Roberts, representing self; JD Butler, ARIZONA LEADINGAGE; Dan Selby, representing self
All Comments:
will humble, AZ PUBLIC HEALTH ASSOCIATION: In my professional experience running ADHS during the Brewer
Administration leads me to believe the health and safety risks in some residential facilities warrant an annual
inspection by state staff and that deemed status licensing is inappropriate.
HB2630, tobacco; alternative nicotine; vapor products
Testified in support:
Gibson McKay, ARIZONA SMOKE FREE BUSINESS ALLIANCE; Amanda Gray, Arizona Petroleum Marketers
Association; Jobe Dickinson, Other
Testified as opposed:
Nicole Olmstead, American Heart Association; JoAnna Strother, AMERICAN LUNG ASSOCIATION IN ARIZONA
Support:
Mark Miller, representing self; rani sweis, representing self; Sufian Awawdeh, representing self; Bashar Dababneh,
representing self; Rani Sweis, representing self; Trish Hart, AZ FOOD MARKETING ALLIANCE; kathyrn busby,
Arizona Nurses Association; Andrew Williams, representing self; Domitila Mendez, representing self; Kyle Geiken,
representing self; Duncan Earle, representing self; Demetrius Bonds, representing self; Chris Bean, representing
self; Laura Rodriguez, representing self; Emilio Amezquita, representing self; Albert Lopez, representing self; Eryka
Lee, representing self; Summer McClelland, representing self; Xavier Moreno, representing self; Alex Dunham,
representing self; Terryl Moe, representing self; Christopher Speers, representing self; Isaac Sapien, representing
self; Christopher Johnson, representing self; Isaiah Arias, representing self; Anthony Walkenbach, representing
self; Markie Peterson, representing self; Stacie DeWeese, representing self; Amadeo Lopez, representing self; Julia
Rogge, representing self; Robert Olander, representing self; Dylan Walters, representing self; Michael Cunningham,
representing self; David Kopilovitch, representing self; Brad Falaschi, representing self; Ryan Roberts, representing
self; Brandon Dominguez, representing self; Joshua Barnard, representing self; Michael Damiano, representing self;
David Morganflash, representing self; Patrick Shore, representing self; Seth Raymer, representing self; Tyler
Gilchrist, representing self; Christopher Nunez, representing self; Devin Gusich, representing self; Travis Crouch,
representing self; Brian Mayse, representing self; Sean O'Meara, representing self; James Smaltz, representing self;
Sylvester Jones, representing self; Brandon Bittner, representing self; Cristobal Roman, representing self; Xavier
Arias, representing self; Leticia Ramirez, representing self; Matt Montgomery, representing self; Rebecca Basinski,
representing self; Geoff Habicht, representing seif; Amir Hakak, representing self
Neutral:
Guy Bentley, representing self; Lora Lida Walradt, representing self
Oppose:
Brian Hummell, American Cancer Society Cancer Action Network; Peggy Glenn, representing self; kathleen mayer,
representing self; Dave Long, representing self; Susan Cannata, AMERICAN ACADEMY OF PEDIATRICS - AZ
CHAPTER; Pat VanMaanen, representing self; Steve Ramos, representing self; Karen McClelland, representing self;
Mary Pradelt, representing self; Laura Dearing, The Arizona Academy Of Family Physicians; Janet Larkin,
representing self; Rebecca Smith Gross, representing self; Judith Robbins, representing self; Peggie Jo Vincent,
representing self; marilyn duerbeck, representing self; Maria Salvucci, representing self; Kevin Brown, representing
self; Kelley Murphy, CHILDREN'S ACTION ALLIANCE; Beatriz Urrea, representing self; Amy Arnold, representing self;
Lisa Olson, representing self; Karen Syversen, representing self; Wes Oswald, representing self; Sallie Kladnik,
representing self; Christina Mollica, representing self; Dianne Post, Self, STATE CONFERENCE NAACP; Elizabeth
Putnam-Hidalgo, representing self; Elizabeth Goodman, American Heart Association; Ginna Carico, GOODYEAR,
CITY OF; Robert Larson, representing self; Robert Fisher, representing self; Brent Gibbs, representing self; Elizabeth
Schauer, representing self; Sharon Ehrlich, representing self; Gail Kamaras, representing self; Kimberlee McClure,
representing self; Edna Weigel, representing self; George Ehrlich, representing self; Athol Sutton, representing self;
Sherrilynn James, representing self; Jane Atkins, representing self; Francis Copple, representing self; Frederick
James, representing self; Rebecca Shook, representing self; Christopher Cerrato, representing self; Lisa Maczura,
representing self; Cynthia Couture, representing self; ALICE BUCK, representing self; Kathleen Dubbs, representing
self; Susan Collins, representing self; DEBRA GORDON, representing self; Denise Hudson, representing self; Allison
Jackson, representing self; Angela Buer, representing self; Carol Maas, representing self; Mariette Francis,
representing self; GARY LEW OLIVER, representing self; Jacqueline deSa, representing self; Nancy Santori,
representing self; Eric Harris, representing self; Kathleen Pettycrew, representing self; Barbara Larson,
representing self; Margaret Adams , representing self; Jerrold Borchardt, representing self; Jeffrey Fortney,
representing self; Mary Fortney, representing self; Vickey Finger, representing self; Marilyn Coyle, representing
self; Suzanne Mead, representing self; Julie Golding, representing self; Crystal Bazarnic, representing self; Linda
Paul, representing self; Stephen Coyle, representing self; Emily Norton, representing self; Brenda White,
representing self; Kathleen Butler, representing self; Margaret Lacey, representing self; Debbie Odle, representing
self; Jean Meconi, representing self; Sheila Green, representing self; Jennifer Hanley, representing self; Paula Van
Derven, representing self; Kathleen Woessner, representing self; Kathleen Sauer, representing self; Kathy Fraser,
representing self; Marcia Tingley, representing self; Diane Lings, representing self; Barbara Hutchinson,
representing self; Charles Turner, representing self; Jo Ann Caruthers, representing self; Bryna Koch, representing
self; Marie Thearle, representing self; Rebecca Haynes, representing self; Stephanie Romero, representing self;
Teresa Akrish, representing self; Sharon Lee, representing self; Joan Murphy, representing self; Michelle Helmken,
representing self; Kathleen Schanus-Gohl, representing self; Carolyn Lowther, representing self; Sandra Rizzo,
representing self; Diane Klock, representing self; Elizabeth Kelchner, representing self; Donita Ramos, representing
self; Mary Grove, representing self; Jackie Rich, representing self; Becky Sayler, representing self; frene Arango,
representing self; Christine McLachlan-Comer, representing self; jeff green, representing self; Christine Keitges,
representing self; Jennifer Jones, representing self; Sharon Regen, representing self; Jeri Dow, representing self;
Nelson Morgan, representing self; Lori Taniguchi, representing self; Marilyn Murov, representing self; Christine
Whitley, representing self; Ilene Riffle, representing self; Jennifer Turrell, representing self; Jacolyn B Marshall,
representing self; Cynthia Wagner, representing self; Robin LaVoie, representing self; Phillip Riffle, representing
self; Barbara Lynn Carpenter, representing self; Penny Boone, representing self; Dan Schwartzstein, representing
self; David Myers, representing self; Roy Verdery, representing self; Susan Morris, representing self; Jennifer
Dawson, representing self; Kathy Pyner, representing self; Katherine Doman Sheydayi, representing self; Alexei
Sheydayl, representing self; Donna Corbin, representing self; Nancy Hancock, representing self; Sarah Harris,
representing self; Linda Block, representing self; Kathy Boelte, representing self; Linda Edwards, representing self;
Ariana Flores, representing self; Michael Pyska, representing self; Jill Anderson, representing self; Gary Rulapaugh,
representing self; Charlie Silver, representing self; Paula Feely, representing self; Margaret Owen, representing
self; Nancy Lecrone Nonini, representing self; Carolyn Blackmore, representing self; Dwight Moore, representing
self; Karen Harris, representing self; Shelley Stephenson, representing self; Steve Gorman-Hackstadt, representing
self; Melinda lyer, representing self; Robert Stansfield, representing self; Marilyn Childs, representing self; Eileen
Hollowell, representing self; Bruce Flocken, representing self; Karina Sampson, representing self; Carol Garnett,
representing self; Howard Neiberg, representing self; Micheal Slattery, representing self; Barbara Hollway,
representing self; Mary Lisa, representing self; Claire Bickel, representing self; Claudia Oreck-Teplitsky,
representing self; Norman Fuchs, representing self; Barbara Oliver, representing self; Nora Welsh, representing
self; Anne Leota Hart, representing self; Linda Reichert, representing self; Joseph Alexander, representing self; RITA
DEPUYDT, representing self; Loretta O'Connor, representing self; Margaret Tinsley, representing self; Kathieen
Coilins, representing self; Virginia Dotson, representing self; Mary-Jeanne Fincher, representing self; Peggy
Yeargain-Williams, representing self; Erin Edwards, representing self; Gary Townsend, representing self; Ralph
Meredith, representing self; Hope Busto-Keyes, representing self; Dorothy Reed-Inman, representing self; Gayle
Meredith, representing self; John Neville, representing self; Carmen Terrell, representing self; Suzette Taillac-Streit,
representing self; Charlotte Lis, representing self; Alice Patricia Price, representing self; Teresa Neiberg,
representing self; Tom Savage, LEAGUE OF ARIZONA CITIES & TOWNS; Margaret Cordovano, representing self;
Margaret Baca, representing self; Janet Senf, representing self; Jennifer Carusetta, PHOENIX CHILDREN'S
HOSPITAL; Roger Blain, representing self; Margaret Winchell, representing self; Lawrence Peters, representing self;
Kathryn Anderson, representing self; Elizabeth Lyons, representing self; Karen VanAllen, representing self; Robert
England, representing self; William S. James, representing self; SUSAN ARNOLD, representing self; Joseph Myers,
representing self; Karen Robbins, representing self; Nataly Reed, representing self; Donna Sullivan, representing
self; Nicole Fordey, representing self; Jessica Ebel, representing self; Laura Pearl, representing self; Dana Jolly,
representing self; Kristin Sellers, representing self; Jerry Wegenast, representing self; Dieter Knecht, representing
self; Laura Libman, representing self; Lisa Koenig, representing self; Carol Campbell, representing self; Eric Kadel,
representing self; Judy Wegenast, representing self; Rivko Knox, representing self; Leslie Hanson, representing self;
Janie Smieszek, representing self; Barbara Jones, representing self; Gabe Leadley, representing self; Leslie Hirsch,
representing self; Brianna Miller, ARIZONA ORAL HEALTH COALITION; Sally Caruso, representing self; Lois Hansen,
representing self; Sundrop Carter, representing self; Dawn Norton LD29, representing self; Melissa Westbrook,
representing self; Nora Plonsky, representing self; Susan Heck, representing self; Thomas Dunning, representing
self; JOHN FIENE, representing self; Devon Sloan, representing self; Jonn MacDonald, TOBACCO-FREE KIDS ACTION
FUND; Srinivas Manne, representing self; Beth Ballmann, representing self; Kathryn Dorn, representing self;
Cynthia Paster, representing self; Amanda Rusing, AZ MEDICAL ASSN; HELI NIELSON, representing self; Mark
Barnes, TOBACCO TO 21; Jacob Raiford, representing self; John Fetherston, American Heart Association
Ail Comments:
kathleen mayer, Self: meddling in local affairs again. do something important - like dealing with our water crisis!;
Pat VanMaanen, Self: This is bad for AZ. We need comprehensive TRL program that will help reduce youth access
to deadly tobacco products not this bill supported by Big Tobacco.; Karen McClelland, Self: Cities and towns must
have the right to impose stricter laws on tobacco etc. Yes should be statewide prohibition on younger than 21- but
local laws must be allowed.; Mary Pradelt, Self: These products have been proven to be carcinogenic and addictive.
What are you doing this?; Kevin Brown, Self: Now you are supporting smoking?; Beatriz Urrea, Self: The health of
the AZ population is at stake with this bili. Eliminate it!; Lisa Olson, Self: | oppose this bill.; Karen Syversen, Self:
Please tell me why schools, for example, need tobacco supplies close to them?; Christina Mollica, Self: This
obstructs local control. Cities should be able to regulate tobacco themselves.; Elizabeth Putnam-Hidalgo, Self: NO
on HB2630--do NOT deregulate the tobacco industry. Isn't it enough that their products killed off an entire
generation?; Edna Weigel, Self: don't micromanage; allow !ocal regulation of tobacco.; Lisa Maczura, Self: Anti-
tobacco is pro-life.; Cynthia Couture, Self: Has someone been given a tobacco industry payoff? This banning of
regulations makes no sense.; Kathleen Dubbs, Self: LOCAL CONTROL! How often do we have to cite this?; Marilyn
Coyle, Self: Outlaw tobacco products; Crystal Bazarnic, Self: Why are we suddenly pro-tobacco? Vote nol; Rebecca
Haynes, Self: This is legislation pushed by the tobacco industry that would block cities, towns and counties from
regulating the sale of their products. This would override virtually every local regulation now in existence.; Joan
Murphy, Self: reinventing the wheel are we??; Sandra Rizzo, Self: No. This negates so many things on the books,
and takes away this authority from cities and communities.; Jackie Rich, Self: Allow local governments to do their
job. This would be state government over-reach.; Jennifer Jones, Self: This would override virtually every local
regulation now in existence, ranging from how far tobacco shops have to be from schools to enhanced penalties
for retailers who sell to anyone who is underage.; Nelson Morgan, Self: This is state government overreach on
matters best handled locally. But even statewide, | don't see the public benefit to facilitating tobacco further, given
the public health risks.; Marilyn Murov, Self: This sounds like pork for the tobacco industry. Tobacco is addictive
and a known carcinogen. Regulation of this product is part of public health.; llene Riffle, Self: This would override
virtually every local regulation now in existence, ranging from how far tobacco shops have to be from schools to
enhanced penalties for retailers who sell to anyone who is underage; Jennifer Turrell, Self: This bill would override
virtually every local regulation now in existence, ranging from how far tobacco shops have to be from schools to
enhanced penalties for retailers who sell to anyone who is underage. Strongly oppose.; Cynthia Wagner, Self: This
would override virtually every local regulation now in existence, ranging from how far tobacco shops have to be
from schools to enhanced penalties for retailers who sell to anyone who is underage; Penny Boone, Self: Tobacco
sales MUST be heavily regulated. This bill is the opposite of what is supported by public health experts. | oppose!;
Roy Verdery, Self: As a physician | know that tobacco and other nicotine products are addictive and increase the
risk of many diseases and cause death. They should be vigorously regulated. Besides, kissing a smoker is like
licking an ashtray!; Susan Morris, Self: You don't get to decide what local governments do. They have powers, too,
whether you like it or not.; Jennifer Dawson, Self: This appears to be legislation pushed by the tobacco industry
that would block cities, towns and counties from regulating the sale of their products. This would override virtually
every local regulation now in existence. Unacceptable!; Kathy Pyner, Self: I'd rather see all tobacco products
banned from the entire state. Having had four family members that died from lung cancer gives me a very strong
opinion.; Donna Corbin, Self: 1 guess Republicans haven’t heard that smoking is bad for people. They should be
protecting citizens from the dangerous tobacco lobby.; Margaret Owen, Self: Cities, towns & counties already have
their own local regulations in place. This legislation would override local communities’ wishes. That's a problem. AZ
is all about LOCAL management of our communities as our members see fit.; Melinda tyer, Self: This would
override local regulations ranging from how far tobacco shops have ta be from schools to enhanced penalties for
retailers who sell to anyone who is underage. That weakens public health.; Carol Garnett, Self: This is the tobacco
industry wanting more addicts. The local regulations help to curb the use of this dangerous drug.; Barbara Oliver,
Self: Smoking kills!; Loretta O'Connor, Self: What a maverick! -cough, cough-; Margaret Tinsley, Self: Please vote no
on this one.; Virginia Dotson, Self: Let's not start promoting the tobacco industry again. Our regulations are in
place to protect young people.; Mary-Jeanne Fincher, Self: Local control puts decision-making in the hands of
those closest to the voters.; Gary Townsend, Self: This would override virtually every local regulation now in
existence, ranging from how far tobacco shops have to be from schools to enhanced penalties for retailers who sell
to anyone who Is underage.; John Neville, Self: Bad bil! intended to hurt kids and profit bad companies.; Margaret
Winchell, Self: Bad policy!; Lawrence Peters, Self: KP is doing the bidding of special interest tobacco industry.
Republican Big Brother government at its worst. Interferes with the right of municipalities to govern themselves.
Abuse of legislative power.; Robert England, Self: This bill is slight of hand, benefitting the tobacco industry. It
preempts local decisions. It poorly defines tobacco products. It does not create a license, and has no means to
enforce registering. Please don't aid Big Tobacco.; Joseph Myers, Self: Would likely create a black market for these
products; Jerry Wegenast, Seif: local regulation is best; Laura Lipman, Self: Is Payne getting $$$ from the tobacco
lobby?; Eric Kadel, Self: Tobacco companies are not able to regulate themselves. Their only though is how to make
more money.; Rivko Knox, Self: A classic example of ‘special interest' legislation -- in this instance for the tobacco
industry that would override local ordinances re selling to underage people etc.; Janie Smieszek, Self: Would
override current local regulations. Wasn’t it decided smoking tobacco is dangerous for health.; Lois Hansen, Self:
this must be sponsored by the tobacco industry. these city, municipal and county regulations should be allowed to
stand. stop attempting to contro/ everything with state statutes which are unnecessary or contrary to the public
good; Dawn Norton LD29, Self: This bill, backed by tobacco industry, would block local regulations on sale of
tobacco products, overruling current regulations such as distance from schools & penalties for underage sales,
Vote no.; Guy Bentley, Self: Unavailable to present in person testimony.; Melissa Westbrook, Self: These products
are bad for everyone and we should not be promoting this.; Susan Heck, Self: Oppose; Thomas Dunning, Self: Are
you for lung cancer? This bill is. You can feel the heavy hand of tobacco companies pushing this bill. Gut
protections against tobacco sales. Sell more tobacco to kids. Spread as much lung cancer as you can. The word for
this bill is: disgusting.; JOHN FIENE, Self: | thought this issue was dead in 2019. Why not tell kids that strawberry
flavored rat poison is the in-thing? Tobacco products are life threatening, and getting kids addicted is homicidal.;
Lora Lida Walradt, Self: Bill, section 21, is unclear in meaning of pre-empting additional regulation & whether if it
would result in cities being unable to regulate further. Should be re-written to clarify Sec. 21, however rest of the
bill, increasing fines, etc is good.; Srinivas Manne, Self: Let cities set their own guidelines about tobacco and vape
sales.; Beth Ballmann, Self: The state needs to stop micro-managing cities, towns and counties. Regulating the sale
of tobacco products is a good thing.; Kathryn Dorn, Self: Tobacco is deadly. Let cities protect their people from
premature tobacco-product-induced death!
ARIZONA STATE LEGISLATURE
Fifty-sixth Legislature - First Regular Session
COMMITTEE ATTENDANCE RECORD
COMMITTEE ON REGULATORY AFFAIRS
CHAIRMAN: Laurin Hendrix VICE-CHAIRMAN: Cory McGarr
DATE 01/25/23|4// 123| 22/# 123| 2/4123
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RECESSED 2:19 pon PSB pm
RECONVENED 52 sa) pn 400 pon
ADJOURNED 2.33 pl Biczprl ZH VIF pm
MEMBERS
Bravo 7 ” a “A
Gutierrez wa a i “a
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Payne ~~ a i “a
Pefia ~~ ea vw “A
McGarr, Vice-Chairman va LY “a ae
Hendrix, Chairman ~~ x“ Va Va
Present -- Absent exc Excused
Attachment 3
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature
First Regular Session
HB 2625: residential care institutions; inspections
Sponsor: Representative Carter, LD 15
Committee on Regulatory Affairs
Overview
Adds a residential care institution to the list of entities from which the Director of the Department
of Health Services (DHS) cannot accept an accreditation report instead of a compliance
inspection.
History
Current law defines Residential Care Institution as a health care institution that provides resident
beds and supervisory or personal care services, behavioral health, directed care or health-related
services for persons not needing continuous nursing services. Residential Care Institution does
“not include a hospital or a nursing care institution (A.R.S. § 36-424).
The Director of DHS must inspect the premises of each health care institution and investigate the
applicant's character and qualifications to ensure compliance with DHS statutes and
administrative rules. The Director may in certain circumstances accept an accreditation report in
lieu of a compliance inspection upon receiving a report for the licensure period and the health
care institution accreditation by an independent, nonprofit organization approved by the secretary
of the U.S, Department of Health and Human Services (A.R.S. § 36-424).
Statute prohibits the Director from accepting an accreditation report instead of a compliance
inspection from an intermediate care facility for people with intellectual disabilities; or a health
care institution that was under enforcement action in the preceding year (A.R.S. § 36-424).
Provisions
1. Stiputates that the Director of DHS cannot accept an accreditation report instead of a
compliance inspection for a residential care institution. (Sec. 1)
2. Clarifies institution as a health care institution. (Sec. 1)
Ci Prop 105 (45 votes) { Prop 108 (40 votes) Emergency (40 votes) CI Fiscal Note
HB 2625
Initials DC Page 1 Regulatory Affairs
Attachment A
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature - First Regular Session
ROLL CALL VOTE
COMMITTEE ON Regulatory Affairs BILL NO. __HB 2625
DATE February 15, 2023 | MOTION: _, 2
PASS | AYE NAY | PRESENT | ABSENT
Bravo. Va
Gutierrez VV
Hernandez A a
Payne \~
Pefia \~
McGarr, Vice-Chairman VA
Hendrix, Chairman va
Lo CO C2 /
APPROVED: EOMMITTEEBECRETARY
LG es IN FENDRE Shaimnan
Y MCGARR, Vice-Chairman
ed
ATTACHMENT. 2
HB 2625 — inspections for group homes not waivabie
What this bill does:
This bill specifies that group homes (i.e. private residences located in neighborhoods around the state,
typically privately owned and operated) that accept residents from the State of Arizona (people
adjudicated guilty but insane, under psychological treatment as wards of the state, etc.) are not able to
get out of the regular yearly inspections by producing an accreditation report from a non-profit.
Why is this bill necessary?
Two years ago a man was adjudicated guilty but insane for the murder of his grandparents. He was in
the state psychological hospital until they released him to a group home in Gilbert. He murdered his
roommate there. Because of this scandal, it became known that this particular group home was not
inspected by the state for years because they the state can waive the inspection if they receive an
accreditation report. After this scandal the state inspected the home and found over 17 violations and
evidence that the murder may have been avoided had these violations been discovered at the home.
They were not discovered because the home was never inspected thanks to this accreditation waiver.
What this bill does not
This bill does not create any new regulation or expand any regulatory scheme. This bill does not cost
more because the inspections are funded by the group homes. This bill has no effect on whether these
homes exist or how or why the State can assign people to them. [t only specifies that they can't get out
of inspections by providing an accreditation report.
Reasons this is a good bill:
1.) This bill is just one step in making sure that a murder in a group home doesn't happen again.
2.) This bill does not expand any program or create any new regulatory structure
3.) This bill has minimal cost impact since the inspections are funded by fees paid from the group
homes themselves anyway.
i
Attachment a oP
Gilbert group home murder
isn't first resident death at
Tilda Manor
Gilbert police tell us they’ve had 52 calls for service at the
Tilda Manor group home address since January 2019.
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Author: Erica Stapleton
Published: 5:37 PM MST April 15, 2021
Updated: 6:00 PM MST April 15, 2021
PHOENIX — A 12 News I-Team investigation reveals that the parent
company of the group home at the center of a murder earlier this week has a
long history with police.
On Monday, Gilbert police arrested Christopher Lambeth for allegedly
murdering Steven Howells, another resident at the group home.
Lambeth had previously been convicted of a double murder more than a
decade ago and was ruled "guilty except insane."
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He was sentenced to 25 years to life at Arizona State Hospital, which is
designed to treat people suffering from mental illnesses. But Lambeth was
released early and eventually placed at the group home run by Tilda Manor in
Gilbert.
12 News left several messages for Tilda Manor but haven't heard back. When
we tried to connect with the owners Thursday afternoon, they did not directly
answer questions.
Court and business records say that Samuel and Grace Ashu run Tilda
Manor, Inc., which, according to their website, oversees five group homes in
the East Valley.
The company hasn't publicly said anything about the murder at their facility.
Neighbors say they've seen police before at the group home on Wildhorse
Drive. Gilbert police say they've had 52 calls for service at that address since
January 2019.
And Howells’ death wasn’t the first for Tilda Manor as a nonprofit company. In
2009, court records showed that a resident at another location in Gilbert died
by suicide. His family sued Tilda Manor and the Ashus, claiming the facility
was understaffed and that the resident should have had more supervision at
the time he died.
The Ashus denied the claims and the lawsuit was eventually dismissed.
In Monday's murder investigation, records show Lambeth told police he was
the only other person in the house aside from the victim.
Documents from the state's Psychiatric Security Review Board show that
Lambeth’s should have been in a flex-care facility, which might mean some
unsupervised hours.
It’s not clear if staff members were inside the Tilda Manor group home at the
time he’s accused of killing Howells or if they were supposed to be.
In December 2020, the same Tilda Manor location was also cited by the state
for leaving a resident alone when they shouldn’t have been.
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature
First Regular Session
HB 2622: cost sharing; health coverage; report
Sponsor: Representative Hendrix, LD 14
Committee on Regulatory Affairs
Overview
Includes in the report to the Joint Legislative Audit Committee (JLAC), any restrictions on the form
or amount of cost sharing related to a health plan benefit issued by an insurer, hospital, medical,
dental, optometric or other heaith care services organization.
History
Statute currently requires the submission of a report to. JLAC when an individual or organization
advocates for any legislative proposal to mandate certain health coverage by an insurer, hospital,
medical, dental, optometric or health care service corporation, organization, or any component of
individual or group policies (Insurer), The person or legislator must submit the written report that
explains the statutory factors (A.R.S. 20-182), including the social and financial impact and the
effectiveness of the treatment or service. Currently, the person or legislator must submit. the
report by September 1 prior to the legislative session for which the legislation is proposed.
JLAC then assigns the written report to the pertinent legislative committee of reference (COR).
The COR will hold at feast one public hearing, take public testimony and make final
recommendations, which are included in the final report to JLAC, the governor, leadership of the
State Senate and House of Representatives, and the director of the Department of Insurance and
Financial Institutions by December 1 of the year of the report.
Provisions
1. Requires the written report to JLAC to also include any restrictions on the form or amount of |
the cost sharing applied to a health plan benefit issued by an Insurer. (Sec. 1)
2. Stipulates that the report must assess the social and financial impacts of the coverage or cost
sharing restrictions. (Sec. 1)
3. Modifies the report factors to include the cost sharing restrictions for both the social and
financial impacts. (Sec. 2)
4. Adds factors to the financial impact that must be included in the report as follows:
a) the impact on other policyholders that do not use the treatment or service subject to the
mandated coverage or cost sharing restriction; and
b) an analysis of whether the state will be required to defray the costs that a treatment or
service may add to the federal marketplace subsidies. (Sec. 2)
5. Makes technical and conforming changes. (Sec. 2)
LJ Prop 105 (45 votes) © Prop 108 (40 votes) (Emergency (40 votes) C Fiscal Note
HB 2622
Initials DC Page 1 Regulatory Affairs
Attachment v4
ARIZONA HOUSE OF REPRESENTATIVES.
Fifty-sixth Legislature - First Regular Session
COMMITTEE ON
Regulatory Affairs
ROLL CALL VOTE
BILL NO.
DATE February 15, 2023
MOTION:
HB 2622
OF
PASS |
AYE
“NAY | PRESENT
ABSENT
Bravo
Gutierrez
Hernandez A
VAL
Payne
Pena
McGarr, Vice-Chairman
Hendrix, Chairman
APPROVED:
i, Pe
oe AUBERT HENDRIX/Chairman
CORY MCGARR, Wice-Chairman
PSIAA AVA
2
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ONMITTEE -SBCRETARY
ATTACHMENT.
&
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature
First Regular Session
HB 2630: tobacco; alternative nicotine; vapor products
Sponsor: Representative Payne, LD 27
Committee on Regulatory Affairs
Overview
Increases, from 18 to 21 years, the age for purchasing, using or possessing tobacco, requires
tobacco retailers to register with the Arizona Department of Revenue (DOR) and establishes
related requirements.
History
It is a petty offense, with a maximum fine of $300, to knowingly sell, give or furnish a tobacco
product or vapor product or any related instrument or paraphernalia solely designed for smoking
or ingesting tobacco or shisha to a minor. Arizona law also prohibits selling tobacco-related
products to minors, such as beedies or bidis, which are products that contain tobacco and which
are wrapped in teburni or tendu leaves (A.R.S. § 36-798.01). A minor who buys, possesses or
knowingly accepts a tobacco product or vapor product, or who misrepresents the minor's age to
do so, is also guilty of a petty offense (A.R.S. §13-3622), Tobacco products include cigars,
‘cigarettes, cigarette papers and smoking and chewing tobacco. Statute also outlines other
requirements related to the sale of these products. Tobacco products cannot be sold through a
vending machine except in bars and employee lounge areas not open to the public in businesses
that do not employ minors (A.R.S. § 36-798.02), and are prohibited on school grounds except
for use in a school-sanctioned tobacco-prevention program (A.R.S. § 36-798.03).
‘On December 20, 2019, the federal government enacted legislation that.raised the minimum age
for the saleof any tobacco product, including cigarettes; smokeless tobacco, cigars,
hookah tobacco and e-cigarettes, from 18 to 21 years of age nationwide. The law applies to all
retail establishments in all states and on tribal lands.
Provisions
Products ;
1, Increases the age, from 18 to 21, for a person to purchase, use or possess tobacco products,
alternative products and vapor products (products). (Sec. 1)
2. Adds alternative nicotine products to the prohibitions on the following:
a) Selling, giving or furnishing the product to a person under 21 years of age;
b) A person under 21 buying, possessing or accepting the product;
c) Misrepresenting the person's age by means of a written instrument of identification with
the intent to induce a person to sell, give or furnish the product. (Sec. 1)
3. Removes knowingly as the state of mind for a person selling, giving or furnishing products or
related paraphernalia to a person under 21 years of age. (Sec. 1)
LJ Prop 105 (45 votes) C1 Prop 108 (40 votes) (i Emergency (40 votes) 1 Fiscal Note
HB 2630
initials DC Page 1 Regulatory Affairs
GF
Attachment 7
10.
11.
12.
13.
14.
15.
16.
“47,
18.
19.
Prohibits retail tobacco vendors from selling products by any means other than assisted sales
in which the customer has no direct access to a product except through the assistance of the
retail tobacco vendor. (Sec. 5)
Adds alternative nicotine products and vapor products, in addition to tobacco products, to the
prohibitions as follows:
a) the use and possession on school grounds;
b) selling through vending machines except in specified areas;
c) unsolicited delivery to any Arizona residence. (Sec. 1, 5)
Increases the fee from $300 to $1,000 for a first offense and a range of $1,000 to $2,500 for
a subsequent offense as follows:
a) selling, giving or furnishing products or related paraphernalia;
b) selling products through a vending machine except in specified areas. (Sec. 5)
Removes tobacco-prevention programs as an exception for having tobacco products on
school grounds. (Sec. 6) ,
Increases the maximum fee, from $300 to $500, for using or possessing products on school
grounds. (Sec. 7)
Increases the fine for a retail tobacco vendor to sell, furnish, give or provide beedies or bidis
to a person under 21 years of age, from a maximum $500 to $1,000 for the first offense and
a range of $1,000 to $2,500 for a subsequent offense. (Sec. 4)
Sales
Prohibits a retail tobacco vendor from selling, offering to sell, furnishing or giving products:
a) toa person who reasonably appears to be under 30 years of age without first examining
the person's government-issued phoio identification to establish that the person is at least
21 years of age; or
b) except in the manufacturer's original packaging. (Sec. 8)
Prohibits the retail tobacco vendor from opening packaging and selling a portion of products
contained in such packaging. (Sec. 8)
Classifies the above offenses as petty offenses and establishes fines of $500 for a first offense
and a range of $1,000 to $2,500 for a subsequent offense. (Sec. 8)
Retailers
Requires every retailer that sells or offers to sell tobacco products, alternative nicotine
products or vapor products to consumers in Arizona to register each retail location with the
Department of Revenue (DOR) on a form and in a manner prescribed by DOR. (Sec. 10)
Requires the Director of DOR to determine and charge an annual registration fee. (Sec. 10)
Requires DOR to adopt rules to carry out these requirements. (Sec, 10)
Prohibits retailers from selling products unless in compliance with these requirements and all
applicable rules adopted by DOR, beginning January 1, 2024. (Sec. 10)
Requires DOR to do both of the following:
a) publish on its website the name of every registered retailer; and
b) update the list as needed and at least once each month. (Sec. 10)
Classifies a violation of these requirements as a petty offense and establishes fines of $1,000
for a first offense and $1,000 to $2,500 for a subsequent offense. (Sec. 10)
Requires DOR to use the fees and penalties:
HB 2630
Initials DC Page 2 Regulatory Affairs
20.
21.
22.
23.
- 24,
25,
26.
2/.
28.
a) to administer and enforce registration and related requirements; and
b) to share any remaining monies with local law enforcement agencies to conduct retailer
compliance inspections, undercover investigations of retailers and activities to identify and
intercept contraband or illicit products. (Sec. 10)
Miscellaneous
Delineates a sign that retail tobacco vendors must display, which states:
a) itis illegal for someone under 21 to purchase cigarettes or products; and
b) on conviction, a $300 fine may be imposed. (Sec. 8)
Preempts the following:
a) further regulation of the sale and marketing of products by a county, city, town or other
political subdivision of this state; and
b) allinconsistent laws, rules, regulations, codes, ordinances or policies adopted by a county,
city, town or other political subdivision. (Sec. 8)
Specifies that the preemption does not limit a political subdivision’s authority pursuani to the
SmokeFree Arizona Act. (Sec. 8)
Defines alternative nicotine product as any non-combustible product that contains nicotine
from any source and that is intended for human consumption, whether chewed, absorbed,
dissolved, ingested or consumed by any other means. (Sec. 1)
Specifies that alternative nicotine products do not include:
a) any tobacco product, vapor product or shisha; or
b) any product regulated as a drug or device by the U.S. Food and Drug Administration under
Chapter V of the federal Food, Drug, and Cosmetic Act. (Sec. 1) |
Removes the requirement that a vapor product must be tobacco-derived to meet the definition.
(Sec. 1)
Makes technical and conforming changes. (Sec. 1, 3, 4, 5, 6, 7, 9)
Contains a severability clause. (Sec. 11)
Becomes effective on January 1, 2024. (Sec. 12)
HB 2630
Initials DC ’ Page 3 Regulatory Affairs
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature - First Regular Session
~ ROLL CALL VOTE
COMMITTEE ON Regulatory Affairs BILL NO. HB 2630
DATE February 15, 2023 MOTION: Fzéfeq/ -
PASS AYE NAY PRESENT | ABSENT
Bravo . va
Gutierrez Vail
Hernandez A WA
Payne Vv. ~~
Pefa ~~
McGarr, Vice-Chairman i
Hendrix, Chairman Vo
3 | } O
BEB LEO
APPROVED: ACONMITTER’SECRETARY
“A DEIX-Chairman
CORY MCGARR, Vice-Chairman
attacHMent__/Q
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature
First Regular Session
House: HHS DP
HB 2166: DHS; licensure; group homes
Sponsor: Representative Dunn, LD 25
Committee on Regulatory Affairs
Overview
Requires, beginning July 1, 2024, behavioral-supported group homes and group homes operated ©
in Arizona by a service provider and under contract with the Arizona Department of Economic
Security (DES) to be licensed and regulated through the Arizona Department of Health Services
(DHS).
History .
Under current faw, DHS is responsible for the licensure and regulation of Arizona health care
institutions. These institutions are defined as every place, institution, building or agency, whether
organized for profit or not, that provides facilities with medical, nursing, behavioral health, health
screening, supervisory care, personal care, directed care or any other health-related services,
including home health agencies, outdoor behavioral health care programs and hospice service
agencies (A.R.S. § 36-401).
Group homes are community residential settings for not more than six individuals with
developmental disabilities that are operated by service providers under contract with DES. These
homes provide room and board, daily habilitation and other assessed medically necessary
services and supports to meet the needs of each person. A group home does not include adult
- developmental homes, child developmental homes, -nursing-supported group homes or
intermediate care facilities for individuals with intellectual disabilities (A.R.S. § 36-551).
DHS is authorized to license and regulate the health and safety of group homes for persons with
developmental disabilities. DHS must issue a license to an accredited facility for a 3-year
accreditation period and conduct inspections to ensure that the facility meets health and safety
licensure standards. Additionally, DHS establishes requirements for group homes through the
Division of Developmental Disabilities (DDD) within DES (A.R.S. §§ 36-132 and 36-591).
Provisions
1. Specifies that group homes and behavioral-supported group homes are exempt from
complying with zoning standards for health care institutions as prescribed by DHS. (Sec. 2)
‘2. Forbids the DHS Director from accepting an accreditation report in lieu of a compliance
inspection of a behavioral-supported group home, group home or nursing-supported group
home. (Sec. 3)
3. Requires, by July 1, 2024, behavioral-supported group homes and group homes operated in
Arizona by a service provider and under contract with DES to be licensed through DHS.
(Sec. 4)
4. Prescribes the types of rules that the DHS Director must adopt regarding behavioral-
supported group homes, including:
0 Prop 105 (45 votes) XC Prop 108 (40 votes) O Emergency (40 votes) UL Fiscal Note
HB 2166
initials AG/BSR Page 1 Regulatory Affairs
Attachment fl
a) ensuring that client's behavioral treatment plans are developed, integrated, coordinated
and monitored by clinical professionals that meet specified training, experience and
education requirements;
b) requiring direct care staff in a behavioral-supported group home to meet specified
experience and training standards;
c) ensuring clients have an integrated treatment plan that is reviewed by the entire
multidisciplinary team every 90 days to determine the effectiveness of the plan
interventions; and
d) ensuring that clients have a functional behavioral assessment completed by a qualified
clinical professional in consultation with a multidisciplinary team. (Sec. 4)
Specifies that the multidisciplinary team be composed of, if appropriate:
. a) psychiatric, medical, nursing and nutrition providers;
40.
11,
12.
13.
14,
15.
b) physical, occupational and speech therapists;
c) educational personnel;
d) behavioral health providers;
e) group home direct care staff;
f) home health personnel;
g) day program staff;
h) client, their family or guardian; and
i) DDD Representatives. (Sec. 4)
Defines the following terms:
a) behavioral-supported group home;
b) development disability;
c) group home;
d) habifitation;
e) behavioral treatment plan;
f) client and
g) integrated treatment plan. (Sec. 1, 4, 5)
Includes behavioral-supported group homes in the definition of community residential setting.
(Sec. 5)
Modifies the definition of group home to specify that a behavioral-supported group home is
not a group home. (Sec. 5)
Exempts behavioral-supported group homes that are licensed by DHS from the licensure
requirement for a community residential setting regarding contracts for the purchase of
residential care services. (Sec. 6)
Exempts DHS and DES from rulemaking requirements for 18 months. (Sec. 7)
Requires, beginning July 1, 2024, DHS to transfer all group home licenses to the appropriate
subclass of health care institution licenses. (Sec. 8)
Clarifies that for the purposes of licensure, a group home for individuals with developmental
disabilities is considered a group home as defined in statute, as amended by this legislation.
(Sec. 8)
Specifies that a group home's initial licensure date or previous license expiration date that is
before July 1, 2024, is to be considered their anniversary date for health care institution
licensing purposes. (Sec. 8)
Repeals the group home licensing transfer requirements on July 1, 2026. (Sec. 8)
Makes technical and conforming changes. (Sec. 1-3, 5)
HB 2166
initials AG/BSR Page 2 Regulatory Affairs
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature - First Regular Session
ROLL CALL VOTE
COMMITTEE ON Regulatory Affairs BILLNO. HB 2166
DATE February 15, 2023 MOTION: DY
PASS NAY PRESENT | ABSENT
>
x
mi
Bravo
Gutierrez
Hernandez A
Payne
Pefia -
McGarr, Vice-Chairman
Hendrix, Chairman
VIARRINARSS
iff : i
APPROVED: Via i
pe Le |
ae CARRIN DRX; Chairman
CORY MCGARR, Vice-Chairman
ATTACHMENT. lad
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature
First Regular Session
HB 2094: technical correction; tax debt; enforcement
S/E: mobile food vendors; operation; rules
Sponsor: Representative Payne, LD 27
Committee on Regulatory Affairs
Summary of the Strike-Everything Amendment to HB2094
Overview
Enables mobile food vendors to operate on private property in a residential area with restrictions
and details regulatory and licensing requirements for cities, towns and counties addressing mobile
food units.
History
Currently, statute allows a city or town to be able to restrict mobile food vendors from operating
in areas at public airports, public transit facilities, within 250 feet of or on properties zoned for
residential use. In addition, cities and towns may continue to enforce regulations and zoning
codes on mobile food units unless prevented in the law.
In contrast, cities and towns are prohibited from:
1) requiring a mobile food vendor to apply for a special permit that is not required for other
temporary or mobile vending businesses in the same Zoning district;
2) requiring mobile food vendors to operate a specific distance from commercial
establishments or restaurants, unless where building, fire, street and sidewalk codes are
applicable;
3) prohibiting a mobile food vendor from using a legal parking space, including metered
parking, except to restrict the number of spaces, vehicle size, parking duration and
occupying sites with insufficient parking capacity as set by focal zoning ordinances or
federal law; and
4) requiring a mobile food unit to be inspected by the fire department before operation if the
unit passed another fire inspection in another city or town within the past 12 months.
(A.R.S. 9-485.01)
A mobile food unit's state license is designated into one of three classifications depending on the
food dispensed and the way it is handled. These classifications or categories are:
1) Type 1 mobile food units, which dispense commercially processed food, individually
packaged and frozen that requires time and temperature control for safety;
2) Type 2 mobile food units, which dispense food that requires limited handling and
preparation; and
3) Type 3 mobile food units, which prepare, cook, hold and serve food. (A.A.C. R9-8-110).
Adopted. ~~ . # of Verbals |
4
Attachment __//3 7
Not Offered Analysts Initials: | ‘|
- ~ HB 2094
Initials DC/TM Page 1 Regulatory Affairs
Failed Withdrawn
Provisions
1.
Allows mobile food vendors to operate on private property in a residential area if the mobile
food vendor:
a) receives written permission from the property owner;
b) does not serve the general public;
c) is not the property owner, spouse or trustee of the property owner. (Sec. 1)
Prevents a city or town from requiring a mobile food vendor:
a) to pay more than one fee per year; and
b) to be fingerprinted in order to operate. (Sec. 1)
Instructs the Director of the Department of Health Services (DHS) to include a fourth category
of mobile food units that do not require access to commissary or servicing area agreements
for licensing. (Sec. 2)
Enables DHS to designate licensing inspections for mobile food units without a commissary
or servicing area agreement to the county health department where the mobile food vendor
resides. (Sec. 2)
Clarifies that the bill does not preclude a city, town, or county from requiring licensure for
mobile food vendors. (Sec. 2)
[1 Prop 105 (45 votes) Oo Prop 108 (40 votes) (Emergency (40 votes) 1 Fiscal Note
HB 2094
Initials DC/TM Page 2 Regulatory Affairs
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Fifty-sixth Legislature
First Regular Session
COMMITTEE ON REGULATORY AFFAIRS
HOUSE OF REPRESENTATIVES AMENDMENTS TO H.B. 2094
(Reference to printed bill)
Strike everything. after the enacting clause and insert:
"Section 1. Section 9-485.01, Arizona Revised Statutes, is amended
to read:
9-485.01. Mobile food vendors; mobile food units: operation
A. In relation to a mobile food vendor or mobile food unit, a city
or town by ordinance or resolution may:
1. EXCEPT AS OTHERWISE PROVIDED IN THIS PARAGRAPH, prohibit or
restrict a mobile food vendor from operating at a public airport or public
transit facility, in an area zoned for residential use or within two
hundred fifty feet of an area zoned for residential use. A MOBILE FOOD
VENDOR MAY OPERATE ON PRIVATE PROPERTY IN A RESIDENTIAL AREA IF ALL OF THE
FOLLOWING APPLY: ;
(a) THE MOBILE FOOD VENDOR OBTAINS WRITTEN PERMISSION FROM THE
PROPERTY OWNER. .
(b) THE MOBILE FOOD VENDOR DOES NOT SERVE MEMBERS OF THE GENERAL
PUBLIC. | a |
(c) THE MOBILE FOOD VENDOR AND THE PROPERTY OWNER, THE SPOUSE OF THE
PROPERTY OWNER OR, IN THE CASE OF A LIVING TRUST, THE TRUSTEE ARE NOT THE
SAME PERSON. | | |
2. Continue to enact. and’ enforce regulations and zoning codes on
mobile food units or mobile food vendors that are not otherwise prohibited
by law. - . | .
B. In relatian to a mobile food vendor or mobile food unit, a city
or town may not:
| 1. Require a mobile food. vendor, property owner or lessee of a
property to apply for and receive: any special permit that is not required
Attachment 17 |
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House Amendments to H.B. 2094
for other temporary or mobile vending businesses in the same zoning
district. ;
2. Require a mobile food vendor or mobile food unit to operate a
specific distance from the perimeter of an existing commercial
establishment or restaurant, except as required by applicable. building,
fire, street and sidewalk codes.
3. Prohibit or restrict a mobile food vendor or mobile food unit
from using any legal parking space, including metered parking, except to
restrict the number of spaces, vehicle size and parking duration and the
ability to occupy sites with insufficient parking capacity as prescribed by.
a jocal zoning ordinance of the city or town or as otherwise prohibited by
federal law.
4, Require a mobile food unit to be inspected by a city or town fire
department before operation if the mobile food vendor provides evidence
that the mobile food unit passed a fire inspection by another city or town’
fire department in this state within the preceding twelve months.
5. REQUIRE A MOBILE FOOD VENDOR TO PAY MORE THAN ONE FEE PER YEAR TO
OPERATE WITHIN THAT CITY OR TOWN.
6. REQUIRE A MOBILE FOOD VENDOR TO BE FINGERPRINTED.
C.A city or town with a population of more than fifty thousand
persons shal} make available all applicable license applications in an
electronic format that is available online and may not require a mobile
food vendor to apply in person..
Sec. 2. Section 36-1761, Arizona Revised Statutes, is amended to
read: . | .
36-1761. Mobile food vendors; mobile food units: rules: health
and safety licensing standards
A. The director shall adopt rules that do all of the following:
1. Establish health and safety licensing standards for mobile food
vendors and mobile food units that apply on 4 statewide basis. The
licensing standards shall:
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House Amendments to H.B. 2094
(a) Include three categories of mobile food units that are based on -
the type of food dispensed and the amount of handling and preparation
required. -
(b) Include general physical and operation requirements of a mobile
food unit, including: ,
(1) Installation of compressors, generators and similar mechanical
units that are not an integral part of the food preparation or storage
equipment.
(ii) Necessary commissary or other servicing area agreements.
(iii) Vehicle and equipment cleaning requirements.
(iv) Waste disposal requirements during and after operation on
public or private property, which may not include the size or dimensions of
any required solid waste receptacle.
(c) INCLUDE A FOURTH CATEGORY OF MOBILE FOOD UNITS THAT DOES NOT
REQUIRE ACCESS TO A COMMISSARY OR OTHER SERVICING AREA AGREEMENT.
9. Establish statewide inspection standards that are based on
‘objective factors for use by the county health departments.
3. Establish a licensing process for mobile food units that does all
of the following:
(a) Requires a separate license for each mobile food unit.
(b) Requires a license to be renewed annually.
(c) Delegates to the county health department EITHER in the county
where the mobile food vendor's commissary -is located OR, IF A COMMISSARY IS
NOT REQUIRED, IN THE COUNTY IN WHICH THE MOBILE FOOD VENDOR RESIDES the -
licensing and health and safety inspection for state licensure using the
statewide inspection standards adopted pursuant to this section. The
licensing process shall require random inspections by county health
departments at no additional cost except as provided in section
11-269.24. A mobile food unit license issued bya county health department
pursuant to this section shall have reciprocity in each county of this
state. A county health department may enforce the statewide inspection
standards regardless of where the license was issued.
-3-
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House Amendments to H.B. 2094 ,
(d) Requires all employees of a mobile food vendor to have a valid
“food handler card or a: certificate from an accredited food handler training
‘class as specified:in rule by the department.
(e) Requires that the license be displayed in “the mobile food
vendor's operating location in a conspicuous Jocation for public view.
— Bb. The rules adopted pursuant to this section may not do either of
the following: |
1. Require a mobile food vendor or mobile food unit to operate a
specific distance from the perimeter of an existing commercial
establishment or restaurant.
2, Address the operating hours of a mobile food unit.
C. Except as otherwise specified in this chapter, the director may
adopt rules that are substantively the same as the reguiations that are in
place on August 3, 2018 in Maricopa county regarding mobile food
establishments. ,
D. This section does not preclude a city, town or county from
requiring a mobile food vendor to be licensed tf—thetirenstrgo—systen
srctodes a ackyroumd creck or ident fh tcattor and Porgerprinting ot—tte
owner—ofthecmobtte food venditg-operatton CONSISTENT WITH SECTION 9-485.01
OR 11-269.24, AS APPLICABLE."
Amend titTe to conform
- And, as so amended, it do pass
LAURIN HENDRIX
CHAIRMAN
2094REGULATORY AFFAIRS. docx
02/15/2023
04:44 PM
C: LAT
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature - First Regular Session
ROLL CALL VOTE
COMMITTEE ON Regulatory Affairs BILLNO. HB 2094
DATE } February 15, 2023 MOTION: DE. 4h L Sr
PASS AYE NAY PRESENT | ABSENT. -
Bravo
Gutierrez
KX
Hernandez A
Payne
Pena
McGarr, Vice-Chairman |
Hendrix, Chairman
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~ APPROVED: . . | GPNMITTEE pee
AE EAURIN SENDRIX, Chairman
CORY MCGARR, Vice-Chairman
ATTACHMENT. 22
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature
First Regular Session
HB 2558: dietitian nutritionists; licensure. _
Sponsor: Representative Hernandez A, LD 20
Committee on Regulatory Affairs
Overview
Allows the Director of the Department of Health Services (DHS Director) to create licensing for
Licensed Dietitian Nutritionists (LDN) and implement an advisory committee to aid in
administrative functions and duties related to licensing.
History
The Department of Health Services (DHS) is responsible for providing a majority of public health
programs in the state addressing such topics as: 1) disease. prevention and control; 2) health
promotion; 3) community public health; 4) environmental health; 5) maternal and child health; 6)
emergency preparedness; 7) and regulation of healthcare-related institutions.
The Academy of Nutrition and Dietetics (Academy) defines Registered Dietitian Nutritionists
(RDN) as practicing food and nutrition experts with education in an accredited dietetics program
who have completed supervised practice and the national exam. The Commission on Dietic
Registration is a credentialing agency for the Academy and is responsible for providing and
enforcing credentialing standards, requirements and the national exam for registered dieticians
and RDNs,
Current Statute allows hospitals to grant registered dieticians or nutritional professionals ordering
abilities for diets, enteral feeding, nutritional supplementation or parenteral nutrition if authorized
by a member of medical staff (A.R.S. 36-416).
Provisions
Prescription Orders
1. Allows a licensed dietician nutritionist (LDN) in either a hospital, if authorized or granted
standing ordering privileges by medical staff, or a nonhospital health care institution to make
a prescription order consisting of:
a) diets or a change in diet orders;
b) enteral feeding;
- ¢) durable medical equipment related to nutrition;
d) nutritional supplementation;
e) parenteral nutrition;
f} medical nutrition therapy; and
g) laboratory tests to check and track nutrition status. (Sec. 3, 4)
2. Directs that a hospital or nonhospital health care institution to prescribe necessary
qualifications for qualified nutrition professionals to issue orders. (Sec. 3, 4)
3. Requires nonhospital health care institutions to respond to adverse events that ensue from
orders issued by an LDN or unlicensed dietician nutritionist. (Sec. 3)
L Prop 105 (45 votes) C] Prop 108 (40 votes) [1 Emergency (40 votes) ( Fiscai Note
HB 2558
Initials DC/TM Page 1 Regulatory Affairs
Attachment w/e
10.
11.
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13.
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Licensing and the Advisory Committee
Authorizes the DHS Diréctor to license all applicants qualifying for the practice of dietetics and
nutrition, authorize all disbursements, adopt qualifications and standards and scope of
practice consistent with the Academy. (Sec. 5)
Grants the DHS Director the authority to appoint an advisory committee to offer
recommendations and aid in the completion of duties including:
a) addressing disciplinary actions;
b) issuing and renewing licenses;
c) denying, suspending, revoking or refusing to renew a license;
d) developing and publishing rules; and
e) requiring licensees to provide complaints to the department. (Sec. 5)
Includes the DHS Director, a licensed physician, three LDNs and one public member be
appointed to the committee and outlines committee members qualifications. (Sec. 5)
Lists the licensure requirements for an LDN as:
a) holding either a current registration as a registered dietitian or registered dietitian
nutritionist;
b) having a baccalaureate degree, master's degree or doctoral degree from a qualified
university with a major in a nutrition and dietetics-related field;
c) completing an accredited and approved planned clinical program consisting of at least
1;000 hours of supervised experience;
d) passing the examination for registered dieticians from the Commission on Dietic
Registration or another equally accredited exam approved by the DHS Director; and
e) having good moral character and not having a license suspended or revoked in the past
two years in any state. (Sec. 5)
Allows the DHS Director to waive educational requirements for applicants who have taken
equivalent coursework in another couniry. (Sec. 5)
Assessment of Fees and Management of Monies
Permits the DHS Director to prescribe and collect fees for the following:
a) an application for a license;
b) the issuance of a license or duplicate license;
c) the renewal of a license; and
d) late fees. (Sec. 5)
Stipulates that all monies collected regarding licensure and duties of the advisory committee
have 10% be put into the general fund including civil penalties and the remaining 90% into the
health services licensing fund. (Sec. 5)
Issuance and Maintenance of License
Makes licenses valid for two years and requires renewal upon the expiration of the license.
(Sec. 5)
Requires licenseés to meet the qualifications and continuing education requirements set by
the DHS Director. (Sec. 5) ,
Mandates a licensee to notify the DHS Director of their place of practice and whether they
change the address of that location, the DHS Director must maintain a record of these
locations to provide notice. (Sec. 5)
Ensures that individuals have appropriate licensing when practicing and use proper titles in
the field of dietetics and nutrition and asserts that any violation of this would be considered
consumer fraud. (Sec. 5)
HB 2558
Initials DC/TM Page 2 Regulatory Affairs
15.
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Active-Duty Military Licensure Extension
Specifies that licenses for military or national guard members do not expire while on active
duty and are extended 180 days after return or release from service. (Sec. 5)
Licensure Violations and Legal Actions
Specifies what constitutes a denial, revocation or suspension of a license as:
a) being convicted of a felony or misdemeanor involving moral turpitude;
b) securing a license through fraud or deceit;
¢c) engaging in unprofessional conduct or incompetence; and
d) using a false name in practice. (Sec. 5)
Allows DHS to deny a license without a hearing unless the denied applicant requests one.
(Sec. 5)
Grants the DHS Director the authority to revoke or suspend a license either permanently or
temporarily and requires a hearing before the official action. (Sec. 5)
Authorizes the DHS Director to file a letter of concern, issue a decree of censure, prescribe a
period of probation, restrict or limit the practice of a licensee in place of denying, revoking or
suspending a license. (Sec. 5)
Requires the DHS Director to notify a licensee's employer if disciplinary action has been
initiated against that licensee. (Sec. 5)
Permits the DHS Director to enforce these provisions through injunction and prevents a prior
or current proceeding from barring an enforcement proceeding. (Sec, 5)
Establishes that any violation of these provisions constitutes a class 3 misdemeanor. (Sec. 5)
Provides the DHS Director the ability to impose a civil penalty not. exceeding $500 for
violations of these provisions in addition to any other penalties. (Sec. 5)
Enabies the Attorney.General or the County Attorney to bring an action in the appropriate
Superior Court to enforce the imposed civil penalties. (Sec. 5)
Miscellaneous
Exempts the DHS from rulemaking requirements for one year following the effective date.
(Sec. 6)
Contains a legislative intent clause. (Sec. 7)
Defines terms. (Sec, 3, 4, 5)
Makes conforming changes. (Sec. 2, 3)
HB 2558
Initials DC/TM - Page3 Regulatory Affairs
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-sixth Legislature - First Regular Session
ROLL CALL VOTE
COMMITTEE ON Regulatory Affairs BILLNO. —_HB2558
DATE February 15, 2023 MOTION: D)
McGarr, Vice-Chairman
Hendrix, Chairman
PASS AYE NAY PRESENT | ABSENT
Bravo Vaal
Gutierrez Val
| Hernandez A a
Payne —
Pefa ~~
7
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G
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APPROVED: : MMITTEE SBORETARY
ATTACHMENT. | 7
Access to MNT by RDNs Is
Good Policy.
Better Patient Health, More Treatment Options and Lower Costs
4-6
IMPROVE | - DECREASE ACHIEVE INCREASE
Health of the Nation Costs _ Improved Social Consumer Choice
Determinants of Health
Registered Dietitian Nutritionists Improve Health Outcomes
Results of studies of Registered Dietitian Nutritionists (RDNs) who use medical nutrition therapy (MNT) show
-improved patient outcomes in diabetes, hypertension, lipid metabolism disorders, HIV infection, pregnancy,
chronic kidney disease, and unintended weight loss in older adults.' Additionally, RONs have demonstrated improved
outcomes related to weight management.
RDNs = Positive RO!
MNT results in improved clinical outcomes and reduced costs for physician time, medication use, and hospital admissions
for people with obesity, diabetes, and lipid metabolism disorders, as well as other chronic diseases.? By using their
expertise and extensive training, RDNs deliver care that is coordinated, cost-effective, and supports higher performance
in pay-for-value models of care. They help patients achieve significantly improved outcomes with lower total cost of care.
Find an RDN by visiting wwiw.eatright.org. Attachment _/S
‘Academy of Nutrition and Dietetics Evidence Analysis Library. Medical Nutrition Therapy Effectiveness Systematic Review 2009, 2013-2015. http://www.andeal.org/mnt.
?Academy of Nutrition and Dietetics. MNT: Weight Management. https://www.andeal.org/topic.cfm?menu=5284&cat=5230, 2015. Accessed December 3, 2019.
3Wolf, AM; Siadaty, MS; Crowther, JQ; et al. Impact of lifestyle intervention on lost productivity and disability: improving control with activity and nutrition,
J Occup Environ Med, 2009;51(2):139-145. doi:10.1097/jom.0b013e3181965db5.
Registered Dietitian Nutritionists
ear Academy of Nutrition
reget. and Dietetics
6
Optimizing Health through Food and Nutrition
Registered dietitian nutritionists, or RDNs, are the food and nutrition experts, translating the science
of nutrition into practical solutions for healthy living. Working in a number of practice settings,
~ RDNs advance the nutritional status of their patients and clients.
RDNs are recognized as the most qualified food and nutrition experts by the National. Academy of
Medicine (formerly IOM).'
EXPERTISE
RDNs receive extensive training that
combines academic preparation
with hands-on, practical client and
patient experience.
- Minimum of a Bachelor’s degree
- Participate in an accredited
practice program
‘» Pass a national registration
- Maintain their credential through
continuous education
- Over half of RDNs hold a
graduate degree
Physicians, clients, patients, industry
and government agencies value
and trust the contributions of RDNs.
Primary care physicians identified
dietitians as the most qualified
provider to care for patients
with obesity.?.
70%
indicated that RDNs are the most
trusted source for information
about what types of food to eat.
Registered dietitian nutritionists
are everywhere and touch the lives
of many.
1.5 BILLION
estimated number of clients/
patients counseled by RDNs yearly.
Numerous clinical guidelines and
the United States Preventive Services
Task Force (USPSTF) highlight that
RDNs provide nutrition care more
effectively at a lower cost than
physicians, nurse practitioners,
and physician assistants.
Sources: Academy RDN Reach and Influencer Survey 2018 and Compensation and Benefits Survey of the Dietetics Profession, 2019.
‘Committee on Nutrition Services for Medicare Beneficiaries. “The Role of Nutrition in Maintaining Health in the Nation’s Elderly: Evaluating Coverage of Nutrition
Services for the Medicare Population.” Washington, DC: Food and Nutrition Board, Institute of Medicine; January 1, 2000 (published).
2Bleich SN, Bennet WL, Gudzuna KA, et.al 8M/ Open 2012;2:e001871. doi: 10.1136/bmjopen-2012-001 871,
eee’ Academy of Nutrition
Felt. and Dietetics
www.eatright.org
120 South Riverside Plaza
Suite 2190
Chicago, Illinois 60606-6995
800.877.1600
1150 Connecticut Avenue NW
Suite 615
Washington, D.C. 20036
February 13, 2023 800.877.0877
RE: HB2558 dietitian nutritionists; licensure
Dear Chairman Laurin Hendrix and Members of the Regulatory Affairs Committee:
On behalf of the Academy of Nutrition and Dietetics (the Academy) and the over 108,000 registered
dietitian nutritionists (RDNs) we represent, including 982 living in Arizona, I urge you to support
HB2558, knowing this bill protects the public by identifying qualified providers and establishing a
scope of practice for such providers that will help ensure access to timely, qualified nutrition services,
and HB2558 does not limit opportunities for personal trainers, health coaches, and other unlicensed
practitioners.
Regulation of the nutrition and dietetics profession increases public safety by reducing the
prevalence of unethical and unsafe practices. At present, 47 states, Puerto Rico and the District of
Columbia have statutory provisions regulating the practice of nutrition and dietetics and/or
associated titles used by such practitioners, such as “dietitian” and “nutritionist.” The Academy’s
dedication to protecting consumers is reflected in our advocacy to enact, maintain, or strengthen
states’ dietetics licensure laws that hold these health care practitioners to high standards, and thus
we support HB2558.
In 2014, recognizing the competency of qualified dietitians and potential for cost savings and
improved timely care, Federal regulations provided authority for qualified dietitians to conduct
independent order writing in the hospital setting; similar authority was granted to long-term care
facilities in’ 2016.1 HB2558 identifies qualified dietitians and grants state authority for such
providers, through obtaining privileges or through policies, consistent with Federal Regulations,” to
write orders for: therapeutic diets, including enteral and parenteral nutrition; modifications to such
diets; durable medical equipment related to nutrition; and laboratory tests to check nutrition status.
HB2558 allows licensed dietitian nutritionists to practice at the height of their scope and in turn,
consistent with the aims of the referenced Federal changes, will expand access to timely, qualified
care.
. Per section 36-4207 of HB2558, this bill is a title protection only bill. Although we believe it is in
the best interest of the public to regulate the practice of medical nutrition therapy, which is
nutrition care services provided to treat or manage a disease or medical condition, HB2558 does
not create restrictions on the ability of CrossFit trainers or holistic health coaches to provide
nutrition services. Fitness professionals play an integral role in helping individuals achieve a
142 CFR § 482.28(b); 42 CFR § 483.60(e)(2). For discussion of reasoning behind this change, see: Medicare and Medicaid
Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction; Part IJ, Federal ‘
Register, available at: httns://www.federalregister.gov/dacuments/2014/05/12 /2014-10687 /medicare-and-medicaid-
progrems-regulatorv-provisions-to-promote-procram-efficiency-transperency-and (last accessed February 10, 2023).
2 See id.
healthier lifestyle by assisting their clients in increasing regular physical activity and
understanding nutrition information. However, as recognized by the American Council on
Exercise, fitness professionals who have not obtained additional requisites qualifying them to
lawfully practice medical nutrition therapy should only “share general nonmedical nutrition
information with their clients.? Thus, because HB2558 only addresses title protection and
because fitness professionals, without additional qualifications, should not provide medical
nutrition therapy, concerns raised by such persons and groups are misplaced.
We believe HB2558 serves the citizens of Arizona and urge you to support its passage.
Sincerely,
PBN
Charla M. Burill, JD, RDN
Senior Director
State Government & Legislative Affairs
Ce: Flavio Bravo
Nancy Gutierrez
Alma Hernandez
Cory McGarr
Kevin Payne
Michele Pefia
3 ACE Position Statement on Nutrition Scope of Practice for Fitness Professionals, available at:
https: //acewebcantent.ezureedgenet/certifiednews/images/article/pdfs/NutritionScopeOfPractice.ndf (last accessed
February 7, 2023}.
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