Rationale and Purpose
Suicide is a major public health problem; in 2016, suicide became the cause of 1310 deaths in Arizona (Arizona Health Care Cost Containment System [AHCCS], 2018, p. 1). However, the legislation related to the reduction of suicide rates in Arizona is limited. Suicide prevention policies at schools have received attention (House of Representatives, 2018a; State of Arizona Senate, 2018a). Furthermore, the End to Suicide in Arizona state plan has been developed (AHCCS, 2018), and some funds are appropriated by it as well (House of Representatives, 2018b). The House of Representatives Bill 2593 makes some stipulations about the plan (House of Representatives, 2018b), but they are rather general.
Suicide is a complex issue, which requires a comprehensive approach to its solution (AHCCS, 2018). However, the bills of Arizona only specify the activities related to school staff training in suicide prevention, leaving the rest of the measures for the AHCCS (2018) to determine. The policy needs to be changed for at least three reasons: because suicide is major issue in Arizona, because it requires a comprehensive approach that is not limited to its prevention policies (AHCCS, 2018), and because the presently existing legislation does not enable the comprehensive approach (State of Arizona Senate, 2018b). The present paper suggests developing a bill that would focus on a comprehensive set of evidence-based suicide prevention measures.
Bill Wording
The Arizona Legislative Council [ALC] (2016) drafts bills to ensure that the legislation is appropriately worded. Based on the ALC (2016) Bill Drafting Manual, as well as the national and Arizona plans for suicide prevention (AHCCS, 2018; Office of the Surgeon General & National Action Alliance for Suicide Prevention, 2012), the following wording is proposed.
Be it enacted by the Legislature of the State of Arizona:
Section 1. Arizona health care cost containment system administration; suicide rate reduction
The Arizona health care cost containment system administration shall coordinate a comprehensive set of state-level suicide reduction efforts. The efforts shall include:
- Training programs and guidelines for school, community, and clinical staff.
- Surveillance systems for suicide prevention.
- Efforts to limit access to the means of suicide.
- Mandatory therapy (6 weeks) for people after suicide attempts.
- Programs to reduce the stigma around suicide and promote its accurate representation in media.
- Promotion programs for suicide prevention research.
The efforts shall:
- Be community-based.
- Be evidence-based.
- Have specific, measurable, attainable, realistic, and timely goals.
- Have the means of measuring progress.
Legislative Process
To initiate bill drafting, the legislator who is interested in it provides the drafter with the information about their legislative proposal (ALC, 2016). After drafting, the legislator submits the bill, which will then be read in either the House of Representatives or the Senate (depending on its origination). It is assigned to one or more committees, and during this period the bill is open for amendments. Also, the bill must pass the Rules Committee, which ensures that it is constitutional (Arizona State University [ASU], n.d., para. 6). After two readings, the amendments are accepted or rejected by the Committee of the Whole, and the legislature is sent to the Legislative Council again for engrossment, after which it cannot be amended again. Then, it has its third reading, after passing which it is sent to the other chamber for the process to be repeated.
The support of the two-thirds of a chamber is needed for passing (Arizona State Constitution, 2018). Any amendments made in the second chamber must be reviewed and accepted by the first one. After the chambers reach an agreement, the legislation is sent to the Governor. The Governor can sign the bill, making it a law, or veto it; the veto can be overridden by the two-thirds of the House of Representatives and Senate (ASU, n.d., para. 11). In summary, the legislative process is aimed at improving the bill and ensuring its constitutional nature, appropriate wording, quality, and legislators’ support.
Implementation Plan and Champions
Recent bills demonstrate that some of the legislators who would be interested in suicide prevention include Senators Bowie and Peshlakai and Representatives Epstein, Chávez, and Salman. Representative Epstein introduced several suicide-related bills, which makes contacting her reasonable. Based on the legislation that they have sponsored or co-sponsored, Kyrsten Sinema (n.d.) and Raul M. Grijalva (n.d.) are the federal representatives of Arizona who can be interested in a public health initiative. I voted for Kyrsten Sinema (n.d.) and generally support her activities. Furthermore, the Arizona Suicide Prevention Coalition [ASPC] (2016) should be engaged, including its President Nikki Kontz. The AHCCS (2018) and the Arizona Nurses Association [ANA] (n.d.) should be involved in the process with the representatives that they would choose. All these organizations and individuals are influential and have the helpful experience of advocacy and lobbying.
Based on the information presented above, the following implementation plan can be offered. Having engaged the stakeholders, especially AHCCS (2018), ASPC (2016), and ANA (n.d.), the initiator of the change will contact Representative Epstein. Simultaneously, the above-mentioned organizations will engage the public through the events and statements about the issue. The Representative will be presented with the evidence of the importance of the subject and the interest of the people in it.
After the Representative is engaged, the objectives of the change will be discussed until a final version of them is drawn. Representative Epstein will communicate the information to the drafter, and after the draft is completed, Representative Epstein will introduce the legislation as a bill. It may be amended as required, and after it goes through the legislative process, the stakeholders initiate bill implementation. The first steps will include the development of plans and program recommendations, and the organizations in question will work to enable the community to conform with the new legislation. If the legislation idea is rejected at any point of time (for example, the Representative will refuse to sponsor it), the concept will be reworked and promoted with the public to increase its chances of success.
References
Arizona Health Care Cost Containment System. (2018). An End to Suicide in Arizona 2018 state plan. Web.
Arizona Legislative Council. (2016). The Arizona legislative bill drafting manual 2015 – 2016.
Arizona Nurses Association. (n.d.). Professional advocacy. Web.
Arizona State Constitution. (2018).
Arizona State University. (n.d.). Arizona legislative process. Web.
Arizona Suicide Prevention Coalition. (2016). Board of directors.
House of Representatives. (2018a). HB 2592.
House of Representatives. (2018b). HB 2593.
Kyrsten Sinema. (n.d.). Co-sponsored legislation. Web.
Office of the Surgeon General, & National Action Alliance for Suicide Prevention. (2012). 2012 National strategy for suicide prevention: Goals and objectives for action: A report of the US Surgeon General and of the National Action Alliance for Suicide Prevention. Washington, DC: US Department of Health & Human Services.
Raul M. Grijalva. (n.d.). Legislation sponsored or cosponsored by Raul M. Grijalva. Web.
State of Arizona Senate. (2018a). SB 1519.
State of Arizona Senate. (2018b). SB 1520.