At the Arizona Senate Health and Human Services Committee meeting on Tuesday, members passed four bills, and heard a presentation on child and teen health issues as it relates to military recruitment.
Scott Turner, president and CEO of Healthy Future US—a country-wide initiative that seeks to increase physical activity, healthy nutrition, and mental wellbeing in children and youth—spoke about the impact of negative child health outcomes.
“One of the concerns that’s been heard a lot recently is the shortfall in military recruiting due to health issues,” Turner said. “Some of you might know that we’ve gotten to the point where we only have about 23 percent of 17-24 year olds in the country who are qualified to enter the service, and the main reason that they are not qualified is health reasons.”
Turner focused on Pentagon estimates: in 2013, 71 percent of individuals in this age group were unqualified, but now that percentage has jumped to 77. This year, the US military is expected to experience a 41,000 shortfall in new recruits. Turner said the Pentagon predicted the shortfalls for years. He noted how the allegedly strong economy has allowed younger folks to pursue different career paths due to the increase in opportunities, but that isn’t the only influential factor.
“There’s low trust in institutions, from the military to many other institutions, and a lot of kids don’t have people in their family who’ve been in the military,” Turner said, adding how familial military service has been a key indicator.
By surveying teenagers over the years, Turner found there are growing tendencies for sadness and attempted suicides—which have worsened in the last 10-15 years. He said more physical activity and stress management can reduce rates of depression and suicidal ideation. He also brought up the issues of child obesity and prediabetes, the latter of which he said is the biggest concern. Rates of prediabetes in children are much higher than the rates of child obesity, he said.
“That is something I think has certainly surprised me, and we’re now at the point where we probably have about a third of teens in the country, and in Arizona, with prediabetes,” Turner said.
What’s the cause of increased rates of prediabetes in children and youth? Turner believes it is largely due to the reduction of physical activity at schools and homes. All types of diabetes have accompanying stereotypes, with the most popular ones being that sugar causes diabetes or that all people with diabetes are overweight. According to Turner, 25 percent of children who are a normal weight get prediabetes.
“When we use weight or body shape as part of health interventions, it has a lot of negative psychological interruptions,” Turner said. “Thinking about the whole area of health-related education, sometimes there’s been a focus on certain controversial topics, but when you think about it from a parent’s point of view, you can tell from the data [that] parents are struggling on these mental and physical health issues.”
Turner emphasized the importance of increasing physical activities in the school setting, as well as providing health and nutritional education to youth to prevent these health outcomes.
Going further into the health and wellbeing of children and youth, the committee unanimously passed Senate Bill 1067. The bill includes physical injury and emotional damage to a child by an employee of the Department of Child Safety’s contracted child welfare agencies where the child is placed as part of the statutory definition of abuse.
SB 1037, which would expand the Arizona Health Care Cost Containment System (AHCCCS) dental services from solely emergency care and extractions, to include the coverage of comprehensive dental care for members 21 and up. Matt Jewett, director of health policy for the Arizona Children’s Action Alliance, was in support of the bill because it restores access to dental service cuts from years prior.
“This bill keeps the $1,000 annual cap for services for adult AHCCCS members, but it replaces the word ‘emergency’ with ‘comprehensive’ so people can get the care they need to stay healthy and out of expensive emergency rooms,” Jewett said.
Comprehensive oral health for children is already covered by AHCCCS, but Jewett said that poor dental health can lead to preterm births, and low birth weights.
“Especially at a time when our country is facing a maternal mortality crisis, we should take action to support maternal and child health,” Jewett said.
SB 1037 passed by a vote of 5-1, with Sen. Justine Wadsack (R—Pima County) voting no and Sen. Sonny Borrelli (R— La Paz County) being absent.
Under Arizona law, health professional groups seeking to become regulated or to expand their scope of practice are required to complete the statutory sunrise process. This process requires the submission of an annual report about outlined statutory factors to the Senate president and the Speaker of the House. The sunrise process also allows for informational hearings to present proposals to the House and Senate health committees before the beginning of a legislative session. SB 1021 would repeal that requirement.
Committee chair and bill sponsor Sen. TJ Shope (R—Pinal County) created an amendment to this bill that was introduced in last year’s legislative session, but didn’t pass.
“The process I took to get to the amendment is that, obviously this bill passed with overwhelming support in both the House and Senate last year. In fact, [it received] majority support from both caucuses, and a two-thirds majority was vetoed by the governor,” Shope said. “While largely the same bill—the sentiment is the same—it does take into account some of the concerns that the governor’s office had with the bill overall.”
In opposition to SB 1021 was Amanda Sheinson, director of government relations at the Arizona Medical Association. She said the association sees much value in the sunrise process and would like to see it kept in place.
“We believe the value is both for the community, the public, the legislature, and for staff down here. We think that this ensures that health professionals have the training and education and clinical experience to safely expand their scope and practice in our state,” Sheinson said. “Simply put, this bill removes data from the decision-making process, and we think it gives more weight to politics, and encourages things to move more quickly.”
Don Isaacson spoke in support of SB 1021 on behalf of the Arizona Optometric Association, stating that the optometric profession has undergone the sunrise process numerous times.
“Sunrise has been used as a roadblock by the medical professions against the expansion and natural evolution of growth of nursing, optometry, dental hygienists, and many others,” Isaacson said.
He brought up how under the sunrise process, proposals must be submitted ten weeks before the start of a session. He noted how election years might be impacted, like proposals being submitted before committee members and chairmen or chairwomen are selected. He also said legislation evolves quickly during that 10-week period.
The committee passed the bill by a vote of 5-1, with Sen. Theresa Hatathlie (D—Greenlee County) in opposition.
SB 1062 passed unanimously, and would broaden the scope of practice of substance use counseling to allow for the treatment of all types of addictions that are persistent and compulsive dependencies of behavior or substance, including eating disorders. It also replaces the language of the bill text from “substance abuse counseling” with “addiction counseling.”