The American Rescue Plan Act is landmark legislation that will provide significant resources with which to address the social determinants of health and to reinforce the public health workforce.
Of course, the mere fact that there are additional resources being provided doesn’t mean that we will see improvements in the field. That will only happen if our elected and appointed officials that will control these funds use them in evidence-based ways that have a high return on investment. Whether that will happen in Arizona remains to be seen.
There still aren’t clear dollar figures for Arizona, but the Joint Legislative Budget Committee made some estimates this week based on the finding formula. They estimate that state government will receive about $12B (more than the entire state general fund for a single year), with an additional $2.6B to local governments, and $1.2B in business aid. $8.5B of the $12B consists of the stimulus payments some people will be getting.
State government will receive $4.8B between now and December 31, 2024, so much of the funding will be available to the next governor (the Ducey Administration will be gone in January 2023). The $4.8B (spread out over 4 years) can be used “… to respond to COVID-19 or its negative economic impacts, premium pay to essential workers (up to a maximum of $25,000 per worker), lost revenues, and broadband infrastructure.” That sounds pretty open-ended and it will be very important for stakeholders from all sectors to keep a close eye on how the Governor and his agency heads use these funds.
Importantly, the funds can’t be used to directly or indirectly cut taxes.
Local governments will get about $2.6B over the 4-year period. I can’t find much on what that can be used for. Local government in AZ also qualifies for an additional $187M for capital projects to carry out “…critical capital projects directly enabling work, education and health monitoring, including remote options, in response to the public health emergency.”
There’s also $40M “Tribal Consistency Fund” available to AZ tribes (until September 30, 2023)
Public Health & Healthcare:
There are a ton of additional resources that will be coming to public health and healthcare in addition to the state and local fund distributions.
The ADHS will be getting about $1.7B (which is several times higher than their annual state budget). Most of that must go toward COVID-19 testing, contact tracing, and mitigation ($960M) and buying vaccine including administration fees ($150M).
However, a very sizeable chunk of money ($153M) will be for “… state/local public health departments for recruiting, hiring, and training of public health workers”. Thankfully, those funds never expire which means that they could be spread out over a several year period (for example over a 10-year period) which could really help our long-term public health workforce infrastructure.
Because it will be spread out over many years, not all the decisions will be made by the Ducey Administration, and we will also have an opportunity to influence a future administration on evidence-based uses for these funds (the Ducey Administration will be leaving in 21 months – January 2023).
For example, we could modify the state loan repayment program to include public health professions including community health workers and significantly boost overall funding to that program. There are many other opportunities for using these funds that we will be exploring at our August 26 Conference.
There are significant investments that will help AHCCCS to provide additional evidence-based services as well. Here are some of those line items:
Grants for Teaching Health Centers that operate Graduate Medical Education: $7M (thru 9/2023)
Community Mental Health Services Block Grant: ($30M) (thru 9/2325).
Substance Abuse Prevention Treatment Block Grant: ($30M).
AHCCCS will also be able to extend eligibility to women for 12 months postpartum for the next 5 years, will have enhanced federal match at 85% for mobile crisis intervention services; and will have no cap placed on drug rebates.
Coronavirus Capital Projects Fund:
Arizona will get $187M for capital projects to carry out “critical capital projects directly enabling work, education and health monitoring, including remote options, in response to the public health emergency.” States need to apply to the US Department of Treasury to use these earmarked funds.
Education ($3.2B) – ADE; ADES; Universities, Community Colleges, & the Arizona Commerce Authority. Details here
Other safety net resources that will come through the Act over the next few years include:
Federal Pandemic Unemployment Compensation (additional $300/week): 100% federal funding through September 6, 2021.
Many tax provisions designed to assist working low-income persons.
Human Services ($979M) – for ADES, ADE, Department of Child Safety, Department of Veterans’ Services programs.
Arizona Department of Housing ($787M) for various programs
Editorial Note: There will be more information coming out in the coming months about how these resources may be lawfully used. It’s our job as the independent voice for public health (along with many other nonprofit organizations in Arizona in the health and human services sector) to influence how these funds are used and to ensure that the decisions that the Ducey administration makes are evidence-based and fair.