Q&A: Sen. Kate Brophy McGee on the legislative work ahead

Senator Kate Brophy McGee represents Legislative District 28 in the Arizona State Senate. As Chair of the Senate Health and Human Services Committee, Brophy McGee will be a key player in the Legislature’s ongoing response to COVID-19. With talk of a special session being convened in Arizona this summer, State of Reform reached out to Brophy McGee to get a sense of where the Legislature left off in March and what needs to get done when session reconvenes. 

The Senator did not mince words about the daunting workload looming ahead for the Legislature. Over the course of this interview, we discussed her mental health omnibus bill, prescient advances the state made in the telemedicine space, and the reforms needed to improve Arizona’s health system in this time of crisis. 

 

 

Michael Goldberg: The 2020 session was suspended. On the health policy front, where did the Legislature leave off?

Sen. Kate Brophy McGee: We were fortunate to get quite a bit done last year but we stopped right in the middle of some very important initiatives that were being offered on a bipartisan basis across the board. It really has, in a sense, broken my heart. 

That being said, I am extremely grateful they were able to pass a 100% bipartisan mental health omnibus bill called ‘Jake’s Law’, which I sponsored along with a cosponsor in the House. It built on some enormous successes we’ve had delivering behavioral health in schools – which a lot of people said couldn’t be done. As a matter of fact, it is being done and it’s being done very successfully. With that bill came a raft of reforms. It established parity; requiring the insurance companies to provide behavioral health services just as they would provide physical health services.

Jake’s Law was named after a young man who was, unfortunately, in that merry-go-round of being admitted, getting discharged too soon, having to start all over again, and all of the problems with behavioral health services as provided by private insurance plans. We sat down with the biggest group of stakeholders I’ve ever worked with, there were hospitals, behavioral health providers, private insurance companies, the School Boards Association; pretty much everybody in the world, and we got a ton done in that bill. We added $8 million to bridge the gap between the insurance companies gearing up and enacting true parity and ensuring every kid who showed up exhibiting a behavioral health problem in the school setting got the help they needed regardless of their insurance. It also included things like ensuring that on an insurance card, it says whether it’s an ERISA plan or a Central Benefits plan, and so on. It’s going to be a huge implementation bill and I’m hoping we can build more off of it because it’s desperately needed in our communities.”

MG: What is the sense among you and your colleagues that there will be a special session to address the impacts of the pandemic?

KBM: There has been conversation around it. I’m trying to sort through whether that’s code for wanting to get back and do really “great bills” so you get reelected, or whether it’s about getting done what we really need to get done. I’m cynical because it’s an election year. From what most people are saying, I think there is a high likelihood we will get called back for a special session during the summer months so that we can take action on public health issues related to the crisis.”

MG: We spoke to you last year in February and when asked what topics you were focussed, telemedicine was the first topics you mentioned, specifically you referred to Senator Carter’s bill to work toward telemedicine coverage parity, that’s something we’ve seen providers calling for across most of the states we cover. Can you speak to that issue in Arizona?

KBM: We are so fortunate that that work happened when it did. It has really geared up and AHCCCS embraced it immediately. It’s been a little slower with the Medicare folks but I think that’s on the way as well. It’s really in the nick of time. Dr. Shah – who is a Democratic representative and emergency room doctor from the House – had a really important telemedicine bill which could easily be incorporated into our statute going forward. That might be something we could pick up and enact during the special session.”

MG: Last time you spoke to us you also mentioned the first public health initiative you’d be working as chair of the Health and Human Services Committee which was collecting data related to maternal mortality and morbidity and figuring out ways to lower those statewide rates. In terms of the process involved in conducting public health analysis and policy development, did you learn anything from carrying out that public health initiative that you’ve been able to apply to the public health crisis we’re in right now?

KMB: I learned a lot. They put that initiative together in record time, and it needed to happen. It paints the picture we all thought was true – that we have a major lack in public health services for high risk mothers in those demographically challenged areas. It set the stage for us to pursue additional initiatives, like dealing with maternal mental health.

One of those things we weren’t able to get to was newborn screening legislation, which was part of the maternal health packages that Senator Carter and I put together this year. We didn’t get to it and I’m very concerned that we’re not going to be able to get to it. The Department of Health has been consumed with COVID.”

MG: Thinking back to the Arizona health system in January, in what ways do you think the health system will look different once the dust settles from this pandemic?

KBM: We are learning so many lessons on the fly in so many arenas around social safety nets, public health, and a virus that nobody knew existed three months ago. We’re still in the response phase but as part of these lessons learned, we must plan for the future. The strategies that we’ve implemented to solve these problems on the fly to make it possible for people to be safe, in some sense or another, those lessons are going to apply going forward. You have to look at managing COVID-19 in a post-stay-at-home world.

When we started this stay-at-home order, it was with the intention of saving lives, and we’ve done that. We have the hospital capacity to handle the beds, ICUs, ventilators, and that was paramount. But at the same time we’ve created enormous financial stresses on our health system which is the one system we need to be most healthy. I think we’re building a public health response that no longer offers a choice between lives and livelihoods, but instead a choice between lives and lives. Suicides are spiking, behavioral health issues are increasing, and the experts tell me domestic violence is on the rise.

We have to build a response around testing and adequately funded public health. As businesses open, we also need to teach the appropriate practices to prevent spread while at the same time shoring up our health care system. We’ve got to continue the health care workforce initiatives we started. We’ve got to come up with an independent supply of PPE. 

I think once the tsunami has receded and you see the flotsam and jetsam, you need to ask yourself: ‘Where are we and where do we need to go from here.’ It’s not like, ‘Oh we’re going to be fine;’ we’re not. We’re going to see a resurgence in all likelihood, but we need to be prepared for that and we have our work cut out for us.”

This conversation has been edited and condensed for clarity.