HJAR May/Jun 2021

DIALOGUE 10 MAY / JUN 2021 I  HEALTHCARE JOURNAL OF ARKANSAS   arguing over the benefit of providing health coverage to nearly 300,000Arkansans who would otherwise go without. It has helped keep our rural healthcare system viable, and there are numerous personal stories of lives saved by the program. That bill finally passed the week of April 19 after four unsuc- cessful votes in the House. In the early 1990s, then Governor Jim Guy Tucker, facing a large funding short- fall for Medicaid, pushed through a small tax on soft drinks, commonly referred to as the “soda pop” tax. The bottling industry filed a ballot referendum to try and over- turn the tax at the ballot box. To their sur- prise, the public strongly supported the continuation of the tax. The tax is placed into what is called the Medicaid Trust Fund and annually raises around $40 million. When needed to meet short-term spend- ing needs, these funds are matched 3-1 with federal dollars. It’s a win-win for Arkansas. The tax amounts to about 2 cents per can of soda. Nearly every session, some effort is made to repeal this tax, and this year was no exception. AMS, as well as most every healthcare organization, strongly opposed repeal of the tax and ultimately it appears we were successful. Beyond those two issues, AMS routinely deals with “scope of practice”bills. These are efforts by a variety of non-physician pro- fessionals to expand what they are legally allowed to do. Examples of this would be nurse practitioners wanting to prescribe controlled substances or pharmacists want- ing to diagnose and treat certain medical conditions or give immunizations to chil- dren, etc. These are always extremely diffi- cult and controversial. Each session, there can be as many as ten of these bills. They are the ones that tend to dominate our time at the Capitol. Sometimes we can compromise and work these out, but sometimes we sim- ply must oppose these efforts. This was a session where compromises were a practical and appropriate response. There were two primary bills — one dealing with APRNs and one with pharmacists. APRNs who wish to prescribe currently are required to have a “collaborative” agree- ment with a physician. They have sought for years to repeal this requirement, and AMS has, for years, opposed this move. Thanks to a lot of hard work by key legislators, some common ground was found on this issue. APRNs with approximately 6,000 hours of training under a collaborative practice agreement with a physician will be able to apply to an independent committee of physicians and nurses. If they meet other qualifications that will be determined by this committee, they will be allowed to pre- scribe without a collaborative agreement. However, it does not expand the types of medications they can prescribe. With the provisions of this bill, developed over the course of several weeks, AMS was able to be neutral on the bill. That bill, HB 1258, is nowAct 412 of 2021. HB 1246 was originally a bill that expanded the scope of practice of “Over the course of several months, the AMS supplied over 3 million pieces of PPE to over 500 medical practices across the state.”