Governor Napolitano is defending her executive orders that allocated $430,000 from the Health Crisis Fund in June to market state and federal insurance programs — spending that some members of the Joint Legislative Budget Committee say is abuse of the funds.

Under A.R.S § 36-797, the fund receives up to $1 million from the Medically Needy Account of the Tobacco Tax and Health Care Fund for health crises, and the governor says the money will deal with the “crisis” caused by a what the state reports are 1 million Arizonans without health insurance and senior citizens who can’t afford prescription drugs.

“It may not be a crisis in the view of some of our legislators, but in the view of actual people in Arizona, it is a crisis,” Ms. Napolitano said Aug. 18.

She said marketing plans have not yet been implemented that will inform residents about Health Care Group, an AHCCCS program to insure employees of small businesses, and the state’s CoppeRx Card, or “Copper Card,” prescription drug discount program and new Medicare drug benefits.

The governor also authorized almost $146,000 from the fund to combat West Nile virus and more than $219,000 for machines that keep track of drugs dispensed at the Arizona State Hospital. Neither was challenged by the JLBC at an Aug. 17 meeting.

Sen. Burns: Napolitano Should Have Consulted Lawmakers

Sen. Bob Burns, R-9, chairman of the committee, called the Governor’s Office on the carpet, telling one of her aides that Ms. Napolitano had created a “gubernatorial slush fund.”

“These are not things that need immediate attention,” he told Tim Nelson, Ms. Napolitano’s chief counsel and manager of the Copper Card program.

Mr. Burns said there might need to be a discussion about whether to sue the governor, and that she should have come to the Legislature to fund the marketing programs.

Mr. Nelson told the committee, “Uninsurance is a crisis,” and Ms. Napolitano has not violated the purpose of the fund. He also said the expenditures fit the legal definition of a crisis.

Ms. Napolitano said the next day, “If they want to sue me for trying to get health care information and health care insurance for Arizonans, I don’t think that’s a very productive use of the court’s time.”

A.R.S. § 36-797 defines a health crisis as a “situation in which the health status of an area in this state is, was or could be adversely affected” and, as examples, it specifies chemical contaminations, disruptions in delivery of basic health care services, disruptions in medically underserved areas and outbreaks of disease.

Governor Defends Actions

In the lengthy statement, Ms. Napolitano defended her actions.

“If you’re a small business and would like to insure your employees and don’t know where to go for affordable insurance, or you’re a senior citizen struggling with how Medicare cards work and what’s the best deal, and how I can afford my prescriptions, or if you’re a hospital administrator and you’re running an emergency room into which uninsured people are coming for medical care for which they are uninsured, you have a crisis.”

Mr. Burns said at the meeting the state is exaggerating the number of people without health insurance — that some choose not to buy health insurance or decide to buy a new car instead.

JLBC Co-Chairman Rep. Russell Pearce, R-18 questioned why the governor should spend money to promote the federal prescription discount program.

“That really falls short of anybody’s definition of crisis,” he said.

Mr. Nelson answered that Medicare has only $123 million to get the word out about the program, and the state has the obligation to inform low-income residents about both discount programs.

“That’s a stretch,” Mr. Burns said, adding that the Copper Card program, which Ms. Napolitano established through executive order on her first day in office, should have been a legislative function.

AHCCCS Director Questioned About Funding

The Legislature this year approved $3.2 million for Health Care Group administrative costs, including marketing. Mr. Burns questioned AHCCCS Director Tony Rodgers about the additional funding from the Health Crisis Fund.

“The money was for infrastructure,” he said. “A portion was for outreach.” Mr. Rodgers said there was not much money left for actual marketing of the program to small businesses.

Mr. Burns replied, “That’s an issue for AHCCCS. You ought to be following the rules.”

Mr. Rodgers said, “Very few small businesses are aware of Health Care Group. We requested the money, and the governor agreed.”

Sen. Tim Bee, R-30, said, “This doesn’t appear to me to be a crisis.”

Health Care Group hopes to enroll 20,000 small business employees over the next few years, and Mr. Rodgers said it recently signed up 500.

Sen. Robert Cannell, D-24, asked the governor’s aide Mr. Nelson if any requests for money from the fund were denied.

Mr. Nelson said no. “We waited to make sure there were no other pressing emergencies,” he said.

Sen. Mark Anderson, R-18, suggested the Legislature might consider tightening the definition of health “emergency” and, when there is money left in the fund at the end of the year, permit spending for other purposes or be rolled into the next year’s fund.

Sen. Jack Harper, R-4, said the Governor’s Office violated state procurement laws by not re-bidding the Copper Card program when it decided to eliminate a $20 enrollment fee. Mr. Nelson said the fee would not have affected the bids from a host of companies that provide pharmacy discounts.

The discounts, the state says, have saved senior and disabled citizens more than $4 million.

John Rivers, president and CEO of the Arizona Hospital and Healthcare Association, said the Health Crisis Fund was set up to give the governor some “discretionary authority.”

“It was designed to be a fund for the chief executive to meet certain needs,” he said. “We do have a crisis in our EDs (emergency departments) and have had for some time.”

The state Republican Party on Aug. 19 sent out of news release saying Ms. Napolitano placed the state prescription drug card and Health Care Group programs ahead of fighting the West Nile virus.

“Breaking her pledge not to use taxpayer money [for the state drug discount card]… Napolitano is using $230,000 of a state health crisis fund to advertise her CoppeRx Card and $200,000 to promote health insurance for the self-employed.

“Governor Napolitano needs a refresher course in the meaning of ‘crisis,’” the release says. —