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Legal
A partner at Coppersmith Brockelman in Phoenix, Marki Stewart assists hospitals, physician groups, telemedicine providers, laboratories and other healthcare organizations in a variety of business and regulatory issues. She has a special focus and interest in telemedicine, including licensing, reimbursement, credentialing and security issues. cblawyers.com
Legislation Changes ‘Telehealth’ Application
New legislation makes telehealth more accessible and profitable for healthcare businesses
by Marki Stewart
Governor Ducey recently signed House Bill 2454, a sweeping telehealth bill intended to expand access to telehealth in Arizona. The bill makes significant strides toward making telehealth more available, convenient and affordable for Arizona patients, but also benefits businesses, including the requirement that insurers pay for telehealth services at the same rate as in-person services.
Patients and providers alike benefit from the bill’s change in terminology, replacing “telemedicine” with “telehealth.” Telemedicine was previously defined to include only interactive audio, video or data communications, but telehealth includes asynchronous store-and-forward technologies, remote patient monitoring and the use of an audio-only telephone if an audio-visual telehealth encounter is not reasonably available. However, telehealth does not include the use of a fax machine, instant message, voicemail or email.
Providers and related businesses also benefit in four other ways:
Broader scope includes more types of health care
providers. The bill also amends the definition of “health care providers” to include additional types of professionals who can practice telehealth, including chiropractors, dispensing opticians, optometrists, physical therapists, occupational therapists, respiratory care givers, acupuncturists, athletic trainers, massage therapists, nursing care institution administrators and assisted living facility managers, midwives, hearing aid dispensers, audiologists, and speech language pathologists, as well as healthcare institutions licensed by Arizona Department of Health Services.
Removal of out-of-state licensing requirements
provides flexibility in hiring. All Arizona healthcare provider regulatory boards are now required to adopt a new registration for out-of-state providers who wish to provide telehealth services to Arizona patients. This means that a telehealth provider licensed in another state need not obtain full licensure in Arizona prior to treating Arizona patients via telehealth; rather, they need only complete a simple registration with the appropriate regulatory board. Arizonabased practices can therefore hire a physician from out of state to provide telehealth services to Arizona patients without the need to meet burdensome licensure requirements.
Reviewing and complying with guidelines avoids
severe consequences. Significantly, the bill establishes a telehealth advisory committee on telehealth best practices, consisting of representatives from a variety of healthcare professions and agencies appointed by the Governor. The committee is charged with reviewing national standards and peer review literature for telehealth best practices and conducting public meetings regarding the efficacy of various telehealth services. The committee is required to adopt telehealth best practice guidelines by June 30, 2022. Healthcare providers must then abide by those guidelines and recommendations when providing care to Arizona patients. Consequences for failure to comply could range from not receiving reimbursement for those services to becoming the subject of a licensing board disciplinary action, not to mention the risk of a malpractice claim.
Reimbursement matches in-person services.
Finally, the bill includes comprehensive terms regarding reimbursement for telehealth services provided in Arizona. Insurers may apply only the same limits or exclusions on a healthcare service provided through telehealth that are applicable to an in-person encounter for the same healthcare service, except for procedures or services that are not appropriate to be provided through telehealth. Insurers must reimburse providers at the same level of payment for equivalent in-person services provided through telehealth using an audio-visual format and must reimburse providers at the same level of payment for equivalent in-person behavioral health and substance use disorder services if provided through an audio-only format. Insurers must also cover services provided through an audio-only telephone encounter if that service is covered by Medicare or AHCCCS when provided through audio-only telephone; however, beginning in 2022, insurers must cover audio-only services if the telehealth advisory committee recommends that the service may appropriately be provided through an audio-only encounter. Telehealth providers should become familiar with these payment rules to maximize reimbursement for telehealth encounters.
In addition to making telehealth more accessible in Arizona — particularly important considering the significant increase in telehealth encounters during the COVID-19 pandemic — the new bill creates a variety of opportunities for healthcare providers. Those familiar with the bill will be positioned to flourish as telehealth continues to grow.
An early outreach game plan can mitigate zoning protests
by Adam Baugh
In my line of work with real estate and land-use entitlements, it’s not uncommon to engage with upset neighbors opposed to development. Whether it’s called NIMBYism (Not In My Backyard) or CAVErs (Citizens Against Virtually Everything), changing the status quo can certainly elicit strong emotions and intense anti-development sentiment.
In days past, those opposing a zoning case might circulate a petition, wear matching shirts or buttons or bring signs to protest at city hall. Today’s opposition is much different and includes social media postings, digital meetups, activist websites, online trolling and harassment, e-petitions, video production and more. In a recent instance, I saw one individual create personal websites attacking local city councilmembers to shame them for a vote they had yet to take, for a case that had yet to even be filed. Essentially, it was a proverbial shot across the bow, warning that if they took such action, they would risk public ridicule, shame and scorn.
Nobody is immune to what an online vigilante might post about them or their project. There is simply no accountability for them and if their aim is to stir up opposition, it’s frankly very easy to do. Thus, in a digital world, how might one manage and respond to digital opposition to new development? Here are some tips that have worked well in other situations.
First, community outreach and proper messaging are
key. Rather than letting the opposition overtake the story, it’s important the applicant frames the issue and highlights true facts. This is best handled by thorough community outreach that involves engagement with nearby owners and affected neighbors. Working one-on-one with nearby homeowner associations, adjacent neighbors and local organizations can help the applicant address concerns, correct misinformation and identify advocates for the project.
I saw this firsthand with a case in South Phoenix that found some initial opposition in an online neighbor app called Nextdoor. However, once we were able to implement an outreach plan that included the adjacent HOA, next door neighbors, and local community leaders, we were able to identify support that outweighed any opposition. Through the course of the zoning case, we were able to call on that support to balance against the opposition and tell our story.
The second step is to create an equally active online support campaign through a project website, social
media posting and targeted outreach. This means focusing on the advantages of the proposal and how the community will benefit from its construction, and not giving oxygen to wild accusations that will surface. People will love to debate the issue, not because they want to be informed but rather to show their online “friends” how courageous they are fighting from behind a keyboard.
A good rule of thumb is to not waste energy engaging
in online debates. There will always be detractors who, in most instances, are driven more by emotion than facts. An online agitator is rarely willing to consider a developer’s reasoning and justification. As the Bernard Shaw phrase goes, “Never wrestle with a pig. You get dirty and, besides, the pig likes it.”
It’s important to focus on the strengths of the
case. Does staff support it? Does the councilmember like it? Does it bring new jobs, housing, improve blight, address a longstanding vacancy, etc.? The most effective approach is to frame the project by the benefits it provides and highlight its strengths above all else.
Citizen involvement is a staple of our community, is mandated by state statute, and encouraged by local ordinances. Adapting to the digital world offers developers a new opportunity to tell their story.
An experienced problemsolver with a talent for removing obstacles that impede development, Adam Baugh is a land use and zoning attorney and partner at Withey Morris, PLC. While his skillsets include obtaining zoning and land use entitlements for the full scope of development clients and substantive work in liquor licensing, Baugh has developed unique experience working with infill development projects across the Valley. His success has helped clients obtain rezone approvals, stipulation changes, variances, use permits, site plan approvals, plats, and more. witheymorris.com
MIGHTY CHANGE
Homie’s contributions in July have gone toward Valley of the Sun United Way’s Mighty Change 2026 Impact Area of Housing and Homeless, one of the four pillars in the nonprofit’s five-year plan. The plan aims to help Arizonans get through the continual impact of COVID-19, as well as the mighty goal of decreasing homelessness in Maricopa County by 50%. “We’re beyond grateful for Homie’s contributions to our COVID-19 Response Fund and continued support,” says Carla Vargas Jasa, president and CEO of VSUW. “Homie’s compassion and commitment to keeping local families in their homes is unmatched, and the contributions will once again make a significant impact.” vsuw.org/what-we-do/ mighty-change-for-families
Tyler Butler is the head of Corporate Responsibility for Aventiv Technologies, where she leads programs that positively impact society. She is also founder and principal of 11Eleven Consulting and is often cited as a subjectmatter expert by Forbes, SHRM, Entrepreneur, U.S. News and World Report and more. 11elevenconsulting.com
Homie to the Rescue, Helping Arizona’s Homeless
The company lives its mantra, ‘We got your back’
by Tyler Butler
Newly released U.S. Census statistics have shown that Phoenix is indeed the fastest-growing city in the country. The housing market here is more chaotic than ever before and companies that are providing a less traditional approach are finding a niche. Homie is one such group, as its focus on the technology side of real estate is changing the way these assets are bought and sold by eliminating high fees and commissions.
Founder Mike Peregrina recognized the need for an alternative in the real estate industry six years ago when he lost all his properties. Following the recession, Peregrina learned firsthand what can happen to property value when the market takes a turn for the worse. It was this experience that led him to start Homie — he wanted to provide a resource and a solution.
Homie’s “We got your back” mantra is more than a slogan; it is the way the company does business. This organization is focused on having the backs of its agents, its clients and the communities it services. The Homie solution simplified an outdated and overcomplicated process through a combination of technology and experienced full-service real estate agent support. Originally launched in Utah, it is not only the No. 1 listing brokerage office in that state, but now also has offices in Arizona, Nevada, Colorado and Idaho, with plans to grow across the nation. With real estate and home loans, the Homie tech family is making every aspect of buying and selling a home simple and enjoyable.
Homie was founded on the principles of giving back. Through its corporate charity arm, the Homie Helps Program, it aims to give back to the community with outreach, volunteer and donation efforts as an extension of the company’s goals. Homie’s community efforts are localized for every community it serves. Across its markets, it works with local partners that include nonprofit organizations and government agencies to support housing initiatives. This includes promoting downpayment assistance programs, supporting rental and mortgage emergency assistance funds, and providing marketing and technology support to its partners.
Homie also recognizes the value of volunteerism. Homies, as its employees are called, are encouraged to band together and volunteer with nonprofit and community partners, including food banking, community cleanups, home rehabilitation and more. Homie provides team members a list of community events and communication tools to help empower its 400-plus people to volunteer and serve their community throughout the year.
The organization recognizes it is fighting a lot of forces that are out of its control, but its leadership believes that serving as a resource for education about the issue they are facilitating is an important first step. Homie has provided support to many organizations, but one campaign has significant importance as it is addressing both a real-time issue we are seeing because of the pandemic while also supporting an important Valley cause and its long-standing support of Phoenix.
When Homie Helps launched in 2020 in response to the effects of the COVID-19 pandemic, the first partnership Homie forged was with the Valley of the Sun United Way and VSUW’s beneficiary organizations. Homie Helps created a relief fund and donated $100,000 to VSUW to help people stay in their homes by helping them pay for their rent, mortgage and utility bills.
“When the COVID-19 pandemic began affecting our community, we wanted to do something impactful to give back to those who needed urgent support,” says Joshua Miller, general manager at Homie Arizona. “It was a challenging time for many people facing the possibility of losing their security net, and we wanted to alleviate some of that uncertainty for our fellow Phoenicians. We are so grateful to our Homie clients, who are really the ones to thank for making this possible.” In honor of Valley of the Sun United Way’s 95th anniversary, Homie Helps stepped up and pledged to donate $95 for every home bought or sold in July 2021.
This is but one campaign led by Homie’s philanthropic spirit. The company has also supported The Love Up Foundation in helping it keep homeless pets off the streets. It has aided the Girl Scouts with the pivot they’ve had to make for their traditional door-to-door cookie sales. And it convened a coalition of city officials, community and business leaders, and even a professional athlete to find solutions to the Black homeownership gap in Las Vegas. With so many philanthropic plans on the horizon, Homie is establishing itself as not only a good corporate citizen but as a leader doing business in an innovative way during difficult times.
Homie homie.com
SIDE-EFFECTS OF SLEEP DEPRIVATION
Lack of sleep increases the signs we associate with stress, some of which are: • Irritability • Anger • Feeling overwhelmed • Lack of patience • Decrease in interest • Reduced empathy • Inability to concentrate • Tendency to exercise less and eat more
Jen Butler, CEO of JB Partners, is the creator of Get SMaRT – Stress Management and Resilience Training for the workplace. Their SMaRT Club learning platform is the leading self-guided, tool for all companies looking to reduce stress and increase profits. Jen also travels throughout the United States to provide business leaders with one-on-one, onsite guidance in managing stress, turning around their business, and achieving real, longlasting results. jbpartners.com
Sleep Your Way to a Thriving, Less Stressful Life
Side effects of sleep deprivation drastically reduce C-suite execs’ effectiveness in their position
by Jen Butler
An upset stomach, an uncomfortable position, a startling noise, a too-active or too-inactive day, too much heat or too much cold— these minor stressors interfere with our sleep from infancy onward.
Unfortunately, as adults we encounter more reasons for poor sleep and at the same time we become more adept at ignoring the problem. Our world becomes more complicated and stressful, and so does our relationship with sleep.
We can reduce that stress and improve our sleep, resulting in a maximized work day with energy left over for family and friends.
THE TRUTH ABOUT SLEEP
Our body needs sleep to bolster our immune system, heart health and ability to absorb or retain information, all of which require a period of downtime. Studies have shown that sleeping less than seven hours also reduces sex hormone levels (up to 15%), increases weight and the likelihood of adult onset diabetes, and leads to car accidents.
The Harvard Medical School and National Sleep Foundation have discovered a direct correlation between sleep and stress. An unstressed adult who sleeps less than eight hours a night wakes up feeling stressed, and lack of sleep escalates stress for the 78% of adults who are already highly stressed. Lack of sleep increases the signs we associate with stress, some of which are listed at the side.
Depression, worry and anxiety make falling asleep and staying asleep difficult, no matter how warranted by circumstances. Too little sleep over a long period leads to depression in 27% of adults.
EXECUTIVES AND SLEEP
Side effects — a condensed list of which is shown on this page — drastically reduce C-suite execs’ effectiveness in their position. It’s immaterial which came first, the lack of sleep or stress; both are so intertwined that when one happens the other is sure to follow.
11 EASY WAYS TO INCREASE SLEEP DURATION
1. Wear socks. The National Sleep Foundation recommends warming the feet before bedtime to signal sleep readiness to the brain. 2. Breathe a little lavender. Aromatherapy with lavender can help induce a deeper and longer sleep. 3. Roll over. Sleeping on the side or stomach will help to breathe easier and reduce the effects of sleep apnea; sleeping on the left side will reduce heartburn and reflux; and sleeping on the back may help lower back pain. 4. Establish a routine. We can get our body used to going to bed at a definite time. Those who are natural night owls can acclimate their body by moving their bedtime 15 minutes earlier every three days, until they fall asleep at a time that allows them at least seven hours of sleep. 5. Replace the mattress and pillows. A mattress should be replaced every five to eight years, whenever it starts to sag, and if the person using it finds it is less comfortable to sleep on it than on other beds. Pillows should be replaced every one to two years. A good test is to fold a pillow in half and put a walking shoe on it — it should be able to fling off the shoe; if it doesn’t, it needs replacement. 6. Banish electronic devices. Electronic screens emit blue light, which interferes with production of the sleep hormone melatonin. Plus a dose of TV news, an argument over social media, or a difficult search for information will all operate against our ability to relax. 7. Opt for white noise and total blackout. Investing in earplugs, a white noise machine and black-out window coverings will pay off in better sleep. 8. Get up and relax. Soothing music, a bath, focused breathing or progressive muscle relaxation — these or anything similarly calming are options to break the cycle if sleep has still not come in 15 minutes. 9. Snack right. Nutritionists recommend chamomile or passion flower tea before bed, as they contain apigenin to promote sleepiness. A handful of almonds may help, as they contain magnesium. A couple tablespoons of unsweetened tart cherry juice contains high levels of melatonin and tryptophan, which is also the sleep-inducing ingredient in warm milk. 10.Adopt healthy habits. Late-night caffeine, alcohol and nicotine prevent our body from falling into a restful, restorative sleep; caffeine taken in the afternoon will affect our body for the next six to eight hours. It’s best to avoid eating or drinking anything substantial for at least two hours before bedtime. 11. Chill out. Our bodies rest most comfortably with a nighttime temperature of 60–67 degrees Fahrenheit (15.6–19.4 degrees Centigrade).
In Company Protocols, What about the 2.7 Billion Deskless Workers?
The pandemic was a wake-up call to businesses to modernize their employeefacing technology
by Joe Ross
So much has changed in the last year, and the way businesses operate is no exception. The pandemic accelerated the pace of change for many companies as they were forced to abandon old ways of communicating with their workforces, especially the 2.7 billion deskless workers. Corporations had no choice but to say goodbye to notices on bulletin boards hanging by the time clock and fliers in the breakroom to share important need-to-know information. Many deskless employees, who were left with no access to company intranet systems and no company-issued laptops while they were on lockdown, connected with their personal smartphones to nonsanctioned social platforms like WhatsApp to get the latest news on factory and shop closings, reopenings and health protocols. While this was not ideal for many large corporations, it was their wake-up call. Ready or not, the race to modernize their employee-facing technology was underway.
Now, finally, the deskless workers — who make up nearly 80% of today’s global workforce — would get their share of the technology investment, which up to this point was only a meager 1% of the total enterprise software spend. While many companies had long been investing in their supply chains, warehouses and new point-of-purchase systems, the technology that deskless workers desperately needed was not a priority. Their scheduling and time capture was being done on paper and with punch cards, last-minute callouts left teams understaffed and frustrated, overtime pay was often manually overwritten, employees suffered from burnout and fatigue, and the necessary trainings were intermittently delivered. How did this happen? How did some of the most important HR-based systems that hold the data on which an employee’s pay is based – their time and attendance – become obsolete and get left behind in the era of digital transformation?
Some of the disparity was the result of IT and management teams’ resistance to “bring your own device,” or BYOD. Worries about adoption for access to personal devices for business purposes are becoming non-issues for the generation of digitally native employees that now comprise about 73% of this working group. Not embracing this change neglects the robust and transformational opportunities that a realtime mobile application would have to enrich the daily work experience of hourly workers. This investment disparity stemmed from a lack of understanding of the deskless worker experience and underestimating the incredible impact they have on the business. But the pandemic changed this; many businesses are now working to determine how they can capitalize on the immediate positive and transformative impact that mobile-based applications in the hands of employees can have on the bottom line.
When modern technology finds its way into the hands of deskless workers, moments at work are simpler, fairer, even more transparent, with the added benefit of giving hourly employees the flexibility they need to balance their job with their lives outside of work. For example, the ability to quickly change schedules when there is a callout and connecting to replacement workers based on compliance rules keeps scheduling fair and in line with the regional, union and collective bargaining agreements that may exist. The technology also quickly improves employee satisfaction by reducing burnout and mitigating fatigue by delivering instant app-based check-ins between managers and employees who may be working excessive overtime, asking them how they are feeling about the added shifts. These answers can vary wildly, from someone not wanting more overtime and needing more time at home with family, to someone else who really could use the extra shifts to cover costs at home. It’s the moments at work that add up for employees to determine their overall satisfaction with an employer, and today’s technology allows employees to easily be heard in-the-moment while it also enables managers to engage in consistent and meaningful ways with their employees.
The pandemic has certainly been hard on all of us, and we owe it to our essential deskless workers to invest in their daily work experience and provide them mobile technology to make their work easier. With modern technology, deskless workers are supported in the moments that matter to them while at work. This continued engagement between employers and employees leads to less turnover, greater productivity and an improved bottom line. In fact, many corporations that invest in modern time and attendance platforms have seen a total ROI of greater than 300%. But most importantly, this modern technology truly connects employees and allows them to be heard and seen as important and valued contributors to the success of the business.
Joe Ross is chief product officer at WorkForce Software, a leading global provider of cloud-based workforce management solutions. The company’s WorkForce Suite adapts to each organization’s needs, delivering a breakthrough employee experience — no matter how unique the organization’s pay rules, labor regulations, schedules and employee self-service needs are. Enterprise grade and future-ready, WorkForce Software removes the noise from a managers’ busy day, protects the organization from compliance risks, provides leadership with strategic business insights, and delivers real employee engagement at the time and place work happens. workforcesoftware.com
Zac Dunn is a freelance writer based in Phoenix. As the founder of New Summit Communications, he uses his eye for narrative and character to tell the unique stories of organizations that are committed to improving their community, with work ranging from local nonprofits to Fortune 500 companies.
Collaboration between Education and Industry Forges a Stronger Workforce
And creates a welcome new talent pipeline
by Zac Dunn
While Arizona’s fourth-place ranking for GDP growth per year in the U.S. has attracted an influx of industries looking for a home in the Valley, it also highlights the lack of a “talentready pipeline for Arizona’s growing economy,” according to the Education Leadership Group, a collective of more than 50 education leaders from across the state.
That gap can only be filled by the collaboration of education and industry.
Financial services, for example, offers stability, competitive starting pay and plenty of chances for advancement. As industry giants continue to invest in Phoenix, opportunities abound for fruitful careers in the sector.
Yet filling those positions has proved challenging.
“Two years ago, I was approached by one of our employer partners who was having a really hard time getting people within their organization to successfully complete the SIE exam,” says Melanie Burm, director of external affairs, workforce development and community partnerships at Scottsdale Community College.
The Securities Industries Essentials (SIE) exam is, in most cases, a non-negotiable requirement for entering the financial sector. It is administered by the Financial Industry Regulatory Authority, and passing the exam establishes that an applicant has a firm understanding of the fundamental principles required to work in financial services. Failure to pass equates to a firm headshake from the bouncer and a stern finger point to the door.
“They had a very strict policy in place where they would hire someone as a consultant; they would give that consultant six months to pass the exam; if the consultant didn’t pass the exam at the end of the six months, then they had to let them go,” says Burm. “Employment was contingent entirely on passing that SIE exam.”
Burm connected that employer with Maricopa Corporate College to develop a non-credit exam prep course, and soon those employees were passing the exam with ease and were eligible for hiring.
The success of that pilot course led the Greater Phoenix Chamber Foundation to facilitate a wider collaboration between its Financial Services Workforce Collaborative and Maricopa Corporate College, which turned to SCC to create a for-credit course to prepare other candidates for the rigorous exam.
SCC’s unique positioning allowed it to create and implement the curriculum in the span of a few months. Compare this to the typical 18-month course development time for a major university, and it becomes clear why the institutional agility of a school like Scottsdale Community College was attractive when the financial industry was searching for educational partners.
Industry partners in the Collaborative convened by the Greater Phoenix Chamber Foundation include Charles Schwab, Merrill Edge, Nationwide, U.S. Bank, Vanguard and Wells Fargo, all of which benefit from this new talent pipeline that allows them to quickly recruit these qualified course completers, trading the six-month consultant window for an intensive four-week SIE crash-course that currently boasts a 100% exam pass rate.
The industrial boom isn’t something on the horizon — it’s here, and employers need these jobs filled now. The Collaborative designed the program to rapidly advance students into open positions. In less than two months, students can complete the course, pass the SIE exam, interview and be hired.
By passing the SIE exam, entry-level candidates can earn between $41,000 and $44,000 annually, with salaries increasing as additional industry-related credentials are achieved. Due to the for-credit nature of the course, students can build on the fundamentals as they pursue further licensing and accreditation, opening up new opportunities for advancement.
“Once someone gets into the job using this foundational skill set, the possibilities are endless. After six months to a year, they may be eligible for significant promotions because of their work,” says Burm.
The implications of this kind of collaboration between industry and education cannot be overstated. Partnership between the two to create a more streamlined and effective training and employment pipeline produces candidates who are better prepared for the specific skills they will need to succeed. When employers have a voice in academia, they can influence curriculum to better align with the unique needs of their industry, thereby producing candidates who are better prepared and require less on-the-job training.
The Education Leadership Group found as much in their “Dear Arizona: A Call from Educators” report, concluding that “ultimately, the education system, regardless of its quality, cannot sufficiently train students for careers without an active partnership with industry.”
“This is now the prototype for other industries,” says Burm of the SIE prep course. “It will serve as the model as we emerge from COVID with a renewed focus on the value of education in the workplace.”
