New CDC ‘Community Levels’ Guidance Sets the Stage for Scaling Back Recommended COVID Mitigation Measures

Last Friday CDC released new recommendations for community masking to reduce the spread of COVID-19. The new recommendations now consider 3 key metrics: rate of new case detection, rate of new admissions to the hospital, and general ward occupancy. These recommendations are intended to apply to counties, not states. Currently, Maricopa, Coconino, Yavapai, and Santa Cruz Counties are rates as medium risk whereas all other counties are high risk.

You can visit the new CDC recommendations to see how the guidance applies to community spread in AZ right now. Among other things, it basically means that, in the opinion of CDC, indoor masking can responsibly scaled back in most indoor environments in the ‘moderate’ counties of Maricopa, Yavapai, Coconino & Santa Cruz. Universal masking is still recommended in congregate and healthcare settings.  

Here’s an excerpt of Dr. Gerald’s explainer of the new CDC guidelines from the Appendix of this week’s epidemiology & hospital occupancy report:

“… the CDC recommendations prioritize hospital utilization as the key metric to trigger masking. The advantage is that hospital utilization is easily measured and highly salient as a community metric. When hospitals are overwhelmed, we are all at risk whether we have COVID-19 or not.”

“The triggers would have fired at least 4 weeks prior to the observed peak. So, there would have been at least some opportunity for the incremental benefit of government mandated masking to moderate peak transmission and flatten the curve perhaps by 25 – 30%. While this would have blunted peak hospital utilization modestly, it would still “allow” large numbers of infections with the attendant risk of long-COVID and other post-infectious sequela.”

Editorial note: In other states, the new guidance may be used to inform the scaling back of statewide public health interventions. Because the governor and state health director are not now, nor have they been, using their public health emergency authority to require mitigation, the new CDC guidance will really only be useful for entities like K-12 schools, universities and private businesses to make decisions about masking requirements.

COVID-19 Cases & New Hospitalizations Drop: Omicron Has Nearly Completed Its Task of Infecting All Vaccine Holdouts

View Dr. Joe Gerald’s February 25 Epidemiology & Hospital Occupancy Report

From Dr. Gerald this week:

While Arizona continues to experience high levels of community transmission, we are experiencing rapid improvements that will meaningfully reduce risk of infection in March. Test positivity remains high but is also declining.

As of February 20th, new cases were being diagnosed at a rate of 170 cases per 100K residents per week. The risk of infection now falls below the CDC threshold for high transmission in Maricopa, Coconino, Yavapai, and Santa Cruz Counties. Residents in other counties should fall below high transmission this week.

During March more institutions and individuals will be drawing down their COVID-19 mitigations. For those who are healthy, vaccinated or recovered normalization will pose little risk. Those who have personal health conditions, family members with personal health conditions, or workers who interact with those who are vulnerable should continue to mitigate until transmission levels fall further. We are going to continue an awkward condition, where motivating the healthy to maintain their precautions to protect the vulnerable will become even more difficult.

COVID-19 hospital occupancy in the wards and ICUs is falling quickly. Even so, access to care continues to be constrained by COVID-19 occupancy, influenza cases, and the backlog of postponed care.

At least 27,931 Arizonans have lost their lives to COVID-19. Weekly totals in the low-400s are likely end soon as the Omicron surge resolved quickly.

Is BA.2 here in Arizona? Yes, it is present and now showing up in greater numbers (~10%). It should become the dominant variant over the coming month. The implication is that it will be a bit more difficult to push down transmission rates. https://pathogen.tgen.org/covidseq-tracker/

Other odds and ends…

Floor Votes Likely to Dominate Legislative “Crossover Week” 

This week is known as “Crossover Week” at the State Legislature. It’s one of the more chaotic weeks of the entire legislative session because all bills need to pass their chamber of origin and get transmitted to the other chamber in order to stay alive…  and that means there will be a ton of floor votes this week.

This upcoming week will be a busy one on the House and Senate floors. Several bills that we’re tracking and for which we’ve taken positions will have floor votes this week.  Many bills that we’ve taken a position on are now dead, so our tracking list is beginning to whittle down. But there are still lots of important bills in the hopper. Here’s a synopsis of last week’s action.

Let’s start with the good stuff from last week:

  • HB2125, the ‘good’ tobacco control bill unanimously passed through the House Health Committee. It still has a long way to go but the unanimity is encouraging.
  • SB1272, which will let AHCCCS cover postpartum care for members for 1 year post-delivery passed the Senate 26-2 and is headed for the House.
  • HB2157which will leverage $1.5B in mostly American Rescue Plan Act funds over the next 2 years to improve Home and Community Based Services for folks in their Long-Term Care Program passed the House 45-14 and is headed for the Senate
  • HB2033, which removes court-ordered fees and fines for juveniles (with some exceptions) passed through its committees 10-3 and will likely have a House Floor vote this week.
  • HB2111, which appropriates $10M for the DCS Healthy Families Program passed its House committees and will head to the floor this week.
  • HB2382, which appropriates $1M to ADHS for grants to statewide organizations dedicated to “promoting evidence based, inclusive health programs for people with intellectual and developmental disabilities” unanimously passed its committees and will head to the floor this week.

Now for the bad things:

  • HB2086, which will prevent future ADHS directors from doing a rulemaking to add the COVID-19 vaccine to the school required list passed the House Health and Education committees 5-4 and will go the floor this week.
  • HB2616, which prohibits this state or schools from requiring a person under 18 years of age to wear a mask without the parent’s written consent passed the House 31-28 and now goes to the Senate.
  • SB1164, which makes it a felony for a provider to perform an abortion after 15 weeks gestation passed the Senate 16-13 and was transmitted to the House.
  • HB2811, which will make it a Class 3 felony to manufacture, distribute, sell Mifepristone, Mifegyne, Mifeprex, RU-486, or other generic/non-generic drugs intended to cause/induce an abortion passed the Judiciary committee last week and will probably go to the floor this week.
  • HB2787, which will carve Maricopa County into 4 different counties passed the House Government and Elections committee 7-6 and will likely go to the House floor this week.
Senate Appropriations Committee Tuesday 9:00 am

There’s just one bill that we’re interested in that’ll be heard in committee this week. Senate Appropriations will hear SB1716 which would move governance of the Arizona State Hospital from the ADHS to a 5-member governing board appointed by the Governor.

This is a good solution to a longstanding problem, that the ADHS both runs and regulates ASH- never a good governance model. This move would transition accountability to a qualified governing board while the ADHS maintains its regulatory oversight.

SB1716 Arizona State Hospital; governing board – SUPPORT

Moves governance of the Arizona State Hospital from the Arizona Department of Health Services to a newly created Governing Board of 5 appointed members. ASH Superintendent would report to the Governing Board. Needs an amendment to appropriately compensate the Board.

Good Bills w Likely Floor Vote this Week

HB2125 electronic smoking devices; retail licensing SUPPORT

HB2144 health insurance coverage; biomarker testing SUPPORT

HB2060 supplemental nutrition assistance program; eligibility SUPPORT

HB2484 forcible entry; detainer; filing fee SUPPORT

HB2485 eviction dismissal; sealed records SUPPORT

HB2111 appropriation; healthy families program SUPPORT

HB2113 developmental disabilities; Down syndrome SUPPORT

HB2033 juvenile offenders; monetary sanctions; repeal SUPPORT

SB1151 charging station; pilot program; appropriation SUPPORT

SB1210 mentally ill; transportation; evaluation; treatment SUPPORT

Bad Bills w Likely Floor Vote this Week

HB2043 employer liability; COVID-19 vaccine requirement OPPOSED

HB2086 ADHS; school immunizations; exclusions OPPOSED

SB1567 vaccinations; prohibitions; evidence of immunity OPPOSED

HB2021 drug Offenses, homicide, sentencing OPPOSE

SB1298 government mask mandate; prohibition OPPOSED

HB2811 unlawful abortion medication; offense OPPOSED

SB1123 disruption; educational institution; concealed weapon OPPOSED

HB2787 Maricopa County; division; new counties OPPOSED

Dead Bills Removed from This Week’s List:

SB1153 state zero emission vehicle fleet SUPPORT

SB1391 state hospital transfer; AHCCCS NEUTRAL

HB2191 school immunizations; DHS; exclusions OPPOSE

HB2452 antidiscrimination; employment; vaccination status OPPOSED

HB2022 health emergencies; treatment; vaccinations; repeal OPPOSED

HB2029 vaccinations; evidence of immunity; prohibitions OPPOSED

HB2064 DHS; school immunizations; exclusions. OPPOSED

HB2534 feminine hygiene; exemption SUPPORT

HB2065 school immunizations; nonattendance; outbreak OPPOSED

HB2606 school districts; housing facilities; teachers SUPPORT

HB2674 municipal zoning; by right housing OPPOSE

SB1132 municipal bonds; environmental sustainability; prohibition OPPOSED

HB2403 appropriation; ADE; electric school buses SUPPORT

SB1413 pharmacists; prescriptions; refusal; prohibition OPPOSED

HB2311 school health program; appropriation SUPPORT

HB2155 health information organizations; research; disclosures SUPPORT

The complete list and explanation of all the bills for which AzPHA has taken a position were included in Sunday’s AZPHA Member Public Health Policy Update.

New COVID Cases Continue to Fall in All Age Categories as Hospital Conditions Continue to Improve

See Dr. Joe Gerald’s Weekly Epidemiology & Hospital Occupancy Report

Arizona continues to experience improving COVID-19 conditions. Even so, risk of infection remains high. Arizona should fall below the 100 cases per 100K residents per week threshold in early March.  A few counties may lag behind, so there will be some geographic differences.

The BA.2 Omicron variant is present in low numbers in Arizona (<5%). We can expect it to become the dominant variant over the coming months (not weeks like BA.1). The implication is that it will be a bit more difficult to push down transmission rates. https://pathogen.tgen.org/covidseq-tracker/ 

With fewer COVID hospital admissions over the last couple of weeks, COVID-19 hospital occupancy has been falling quickly. The census drop will continue as persons with previous COVID infections recover and are discharged or perish. Access to care continues to be constrained by COVID-19 occupancy and the backlog of postponed care.

At least 27,563 Arizonans have lost their lives to COVID-19. Weekly totals in the low-400s are likely for another couple of weeks. A large portion of those deaths could have been prevented if Governor Ducey, former Director Christ and Interim Director Herrington had used their authority to help, rather than impede the response over the last 2 years. Sadly, the opportunity to save those lives has come and gone.

UArizona Offering Master’s Degree in Research for Social Change in Program Design & Evaluation

COVID has turned our working environments upside down, and many of us may be looking for a way to transition to another role in our organizations or to gain new skills to improve our potential in the job market.

UArizona is offering a Master’s Degree in research for social change called Program Design & Evaluation.  This fully on-line graduate degree offers 7.5 week courses that are tailored for people who cannot meet for class at a specific time and need schedule flexibility.  The faculty bring a rich depth and breadth of expertise in community-based participatory and action research to each course.

This degree can be completed in 2 years and is price competitive with other online graduate degrees.  Many students approach their organizations to use tuition support or reimbursement programs to help with cost.

Enroll now to start classes this September! Enrollments will be every fall and spring. Please consider this opportunity for you, your staff or colleagues and share this email widely.   For more information, visit the program site. You can also contact the Director of Graduate Studies, Dr. Beth Meyerson at DGSSIROW@arizona.edu“>DGSSIROW@arizona.edu.

Legislative Committee Agendas Are Packed This Week: Here Are This Week’s Priorities

This Friday is the deadline for bills to be heard in their body of origin, so we’re beginning to get a clearer picture of what is likely to move forward in this year’s legislative session. It also means that the committee agendas this week are absolutely packed.

The Senate Health and Human Services Committee has a couple dozen of complex bills, five of which we’ve taken positions on. One of those bills would move the Arizona State Hospital to AHCCCS. We took a neutral position on that. While that bill rightly tries to solve the conflict that has existed for decades in which the ADHS both runs and regulates ASH, we don’t think giving it to AHCCCS is the best solution. A better solution would be to spin ASH off as its own agency.

Over in House Health there is a good tobacco control bill being heard on Monday afternoon. 

The most bizarre bill of the session – one that would break Maricopa County into 4 pieces is being heard Wednesday in the House Government and Elections Committee.

Perhaps the most exciting development is the progress of SB1272 which would expand AHCCCS coverage to post-partum women for one year post pregnancy.

In additional good news, most of the bad bills that would have jeopardized immunization rates seem to be dying off. On the other hand, a barrage of bills that further marginalize LGBTQ+ communities continue to advance their way through the legislative process.

Committee Hearings this Week

House Health & Human Services 2pm Monday

HB2144 health insurance coverage; biomarker testing SUPPORT

HB2125 electronic smoking devices; retail licensing SUPPORT

HB2394 monitoring program for developmental disability homes SUPPORT

 

Senate Health & Human Services 8:30am Wednesday

SB1044 contracts; grants; exclusions; sex education OPPOSED

SB1641 health care institutions; civil penalties SUPPORT

SB1391 state hospital; transfer; AHCCCS NEUTRAL

SB1210 mentally ill; transportation; evaluation; treatment SUPPORT

SB1203 health care institutions; architectural plans SUPPORT

 

House Appropriations Committee 1:30pm Wednesday 

HB2111 appropriation; healthy families program SUPPORT

 

House Education Committee 2pm Tuesday

HB2086 ADHS; school immunizations; exclusions OPPOSED

 

House Commerce Committee 2pm Tuesday

HB2484 forcible entry; detainer; filing fee SUPPORT

 

House Government and Elections Committee 8am Wednesday 

HB2787 Maricopa county; division; new counties OPPOSED

Bill Summary & AzPHA Positions

Public Health Emergency

SB1009– state of emergency; executive powerOPPOSED

Passed Senate 16-13. Transmitted to House. Beginning on Ducey’s last day, caps the length of a Governor’s public health emergency declaration at 30 days but allows the Governor to extend the state of emergency for up to 120 days in 30-day increments. Terminates a state of emergency after 120 days, unless extended by the Legislature. Allows the Legislature to extend the state of emergency as many times as necessary in up to 30-day increments.

HB2022 health emergencies; treatment; vaccinations; repeal OPPOSED

No action yetStill not assigned- probably dead. This bill eliminates public health emergency authority that currently allows the ADHS Director to mandate vaccinations in exposed persons in some circumstances

Vaccines

HB2029 vaccinations; evidence of immunity; prohibitions OPPOSED

No action yetStill not assigned- probably dead.   Prohibits government entities from requiring a COVID vaccine as a condition of employment. Also prohibits them from contracting with any private business that requires vaccination. Has a conditional exemption for healthcare institutions.

HB2043 employer liability; COVID-19 vaccine requirement OPPOSED

Passed Senate Judiciary 6-4Passed Rules. Heading to Senate Floor this Week. Makes employers liable for damages if the employer denies a religious exemption and requires a person to receive a COVID-19 vaccination and significant injury results from receiving the vaccine.

HB2064 ADHS; school immunizations; exclusions. OPPOSED

Double assigned to HHS and ED Committees. Hasn’t been heard. Probably dead. Prevents ADHS Director from ever adding COVID19 or HPV vaccines to the list required for school attendance

HB2065 school immunizations; nonattendance; outbreak OPPOSED

Double assigned to HHS and ED Committees. Hasn’t been heard. Probably dead. Removes the ability to exclude unvaccinated students from school during a school outbreak

HB2086 ADHS; school immunizations; exclusions OPPOSED

Passed House Health 5-4. Being heard in House Education 2/15. Prevents ADHS Director from ever adding COVID19 or HPV vaccines to the list required for school attendance

HB2191– school immunizations; DHS; exclusions OPPOSED

Double assigned to HHS and ED Committees. Hasn’t been heard. Probably dead. Prohibits ADHS from adding HPV, COVID-19 or any vaccine that is just emergency use authorized to list of vaccines required for school attendance.

HB2452  – antidiscrimination; employment; vaccination status OPPOSED

Still not assigned to committee. Probably dead. Prevents ‘discrimination’ against anybody because of the vaccination status.

SB1567– vaccinations; prohibitions; evidence of immunity OPPOSED

Passed Senate Health 5-4. Rules Committee then floor next. Prohibits businesses from requiring vaccinations of any kind and includes enforcement provisions including preventing the state from contracting with any entity that does so. Includes exemptions for certain healthcare facilities.

SB1052– medical procedures; prohibitions OPPOSED

Held by Senate Health last week.  Government entities and even schools would be unable to require vaccination if there is any threat of an adverse reaction that can result in death, even if the odds of that are for example 10,000,000 to one.

Family Planning

SB1044 contracts; grants; exclusions; sex education OPPOSED

Being heard in Senate Health 2/16. Prohibits ADHS from contracting with any entity that ‘provides or promotes abortion’ on their Personal Responsibility Education Program or the Sexual Risk Avoidance Education Grant Program grants. Adds Title X (if ADHS ever applies for that again).

Criminal Justice

HB2033 juvenile offenders; monetary sanctions; repeal SUPPORT

Passed Judiciary and Appropriations 10-3Rules then Floor vote.  Removes statute relating to court-ordered fees and fines for juveniles, except for victim restitution and specific driving under the influence offenses. Appropriates $2,531,000 from the state General Fund for costs relating to juvenile treatment services and court services.

HB2021  Drug Offenses, homicide, sentencing OPPOSE

Passed House Judiciary 10-0. Floor next. Increases penalties for homicides that happen when there is also a drug offense.

Food Insecurity

HB2060– supplemental nutrition assistance program; eligibility SUPPORT

Passed House Judiciary and Rules 8-0Floor next week.  Expands Supplemental Nutrition Assistance Program eligibility to individuals with felony drug convictions but still requires certain people to comply with probation conditions.

Housing

HB2606 – school districts; housing facilities; teachers SUPPORT

Assigned to House Ways and Means, no action yet. Permits all school districts to leverage district-owned property and facilities toward the development of housing for staff.  Current statute limits these “teacherages” to rural and tribal communities.  This bill would expand these abilities to urban and suburban districts.  It’s a technical change to existing statute, but should have promising health, educational and economic impacts.

HB2674 municipal zoning; by right housing OPPOSED

Being heard in House Commerce 2/15. Would prevent cities from implementing unreasonable zoning barriers that limit the production of affordable housing. Makes cities commit to policies that encourage affordable housing.

HB2484 forcible entry; detainer; filing fee SUPPORT

Being heard in House Commerce 2/15. Removes the answer fee or the requirement to file a fee deferral/waiver, which removes barriers for tenants and reduces work for the court.

HB2485 eviction dismissal; sealed records SUPPORT

Assigned to Commerce Committee. No action yet.  Would seal the eviction records for tenants whose cases are dismissed before an entry of judgment, or if a judgment is entered in favor of the tenant.  Essentially, in any case where there was no longer any legal merit to the landlord’s case, the eviction record would be sealed.

Maternal and Child Health

HB2111 appropriation; healthy families program SUPPORT

Passed House Health 7-2, being heard in House Approps 2/15. Appropriates $10 million from the state General Fund in FY 2023 to the Department of Child Safety for the Healthy Families Program.

HB2113 developmental disabilities; Down syndrome SUPPORT

Passed House Health 9-0. Needs Rules, then Floor.  Automatically qualifies persons with Down Syndrome for AHCCCS’ Long Term Care program (they currently need to go through a qualification process).

HB2311– school health program; appropriation SUPPORT

Assigned to House Education, no action yet. Requires school districts (and charters) to have evidence-based school health programs. Provides funding for such programs.

HB2616 mask mandates; minors; parental consent OPPOSED

Passed House Government Committee 7-6Rules then Floor next. Prohibits this state from requiring a person under 18 years of age to wear a face covering or mask without the express consent of the person’s parent or guardian.

SB1298 government mask mandate; prohibition OPPOSED

Passed Government committee 4-3. Rules then Floor next. Prohibits the state or any political subdivision, including the judiciary, that receives or uses tax revenue from imposing any requirement to wear a mask or face covering on any Arizona resident, except where long-standing workplace safety and infection control measures that are unrelated to COVID-19 may be required.

Tobacco

HB2125 electronic smoking devices; retail licensing SUPPORT

Assigned to House HHS, no action yet. This is the ‘good’ tobacco control bill. Has a host of evidence based interventions including retail licensing with proper enforcement.

SB1245  tobacco; vapor; alternative nicotine; regulation OPPOSED

Passed Senate Approps, held in Commerce Committee. Regulates tobacco products but in a bad way that isn’t evidence based. It preempts local jurisdictions from doing more than state law. Includes a tobacco license though, with weak enforcement. Would be managed by the LLC.

HB2125 electronic smoking devices; retail licensing SUPPORT

Being heard in House Health 2/14. Conforms the minimum legal age for the sale of tobacco products or electronic smoking devices to the federal minimum age of sale for tobacco products. Makes, to a petty offence and a maximum fine of $100 an underage person who uses an ID to misrepresent the person’s age with the intent to induce the other person to sell, give or furnish a tobacco product or electronic smoking device. 

Access to Care

HB2144– health insurance coverage; biomarker testing SUPPORT

Being heard in House Health 2/14. Requires health insurance plans to begin covering biomarker testing. Important bill as emerging therapies rely on biomarker testing to target therapies. Medicaid is included!

HB2155 – health information organizations; research; disclosures SUPPORT

Assigned to House HHS. No action yet. Makes deidentified health information more available for research.

HB2100 health information organizations; confidentiality; data. SUPPORT

Assigned to House HHS, Held. This emergency measure would allow Health Current to receive, use and redisclose confidential information received for any purpose allowed by HIPPA. Ducey’s Executive Orders and Enhanced Surveillance Advisories currently address this privacy protection, but it needs to be codified in statute to ensure there are no gaps in the protection of this data or in healthcare information.

HB2161 parental rights; schools; educational records OPPOSED

Passed House Education 6-4. Passed Rules. Floor next. Expands statutory parental rights regarding the upbringing, education, health care and mental health of a parent’s minor child.

Special Needs & Disabilities

HB2382– appropriation; health programs; disabilities SUPPORT

Passed House HHS 9-0. Passed Approps 13-0.  Floor next. Appropriates $1 million to ADHS for grants to statewide organizations dedicated to “promoting evidence based, inclusive health programs for people with intellectual and developmental disabilities”.

HB2394 monitoring program for developmental disability homes SUPPORT

Being heard in House Health 2/14. Creates review committee for developmental disability group homes.

HB2157 supplemental appropriations; community-based services SUPPORT

Passed House Appropriations 11-1. Rules then Floor. Appropriates $1.4B of expenditure authority and $30M from Kids Care in FY 2022 for home and community-based services and funding formula requirements.  This will leverage $1.5B in mostly American Rescue Plan Act funds over the next 2 years to improve Home and Community Based Services for folks in their Long-Term Care Program.  $1B will go for badly needed investments to promote and stabilize access to supportive services, and workforce retention/ consistency to improve member outcomes ($1B)

Clean Energy & Climate/Environmental Health

SB1132– municipal bonds; environmental sustainability; prohibition OPPOSED

Assigned to Senate Nat. Resources, no action yetProbably dead. Prohibits the use of municipal bonds for any project that is “green”. Defines anything green as basically anything to do with climate change, carbon emissions, or clean energy. Excludes other pollutants regulated by ADEQ.

HB2403– appropriation; ADE; electric school buses SUPPORT

Assigned to House Education, no action yet. Appropriates $1.5M for a pilot program for electric school buses

SB1150 electric vehicles; pilot program; appropriation SUPPORT

Passed Senate Transportation 6-3Still needs Approps vote. Appropriates $500K from the General Fund to the Arizona Department of Administration (ADOA) for the Electric Vehicle-Ready Homes Pilot Program.

SB1151– charging station; pilot program; appropriation SUPPORT

Passed Senate Transportation 7-2. Appropriates $500K from the General Fund to ADOA to establish the Electric Vehicle Charging Station Pilot Program.

SB1152– zero emission vehicles; plans SUPPORT

Passed Senate Transportation 7-2Still needs Appropriations. Requires ADOT to work in coordination with ADOA and ADEQ to develop a Zero Emission Vehicle Plan.

SB1153  state zero emission vehicle fleet SUPPORT

Assigned to Senate Transportation, still needs Approps, probably dead. Requires state agencies to buy zero emission vehicles when they buy new cars (when feasible).

SB1154 transportation electrification study committee SUPPORT

Passed Senate Transportation 7-2. Establishes the Transportation Electrification Study Committee

HB2226 fireworks use, limitations, prohibition SUPPORT

Passed Public Safety 13-1Passed Rules. Floor next. Limits fireworks use to before 11pm except for a few holidays when the deadline is 1am.

HB2601 kratom products; definitions NEUTRAL

Passed House Government 9-1. Rules then Floor. Includes Kratom products in the definition of food and regulated under the pure food control statutes. Also specifies that a kratom product is contaminated with a dangerous non-kratom substance if the product contains any controlled substance prescribed by rules adopted pursuant to the Controlled Substances Act.

Women’s Health

HB2534 feminine hygiene; exemption SUPPORT

Assigned to Ways and Means, no action yet. Exempts feminine hygiene products from sales taxes.

SB1164– abortion; gestational age; limit OPPOSE

Passed Senate Judiciary 5-3. Floor next. Except in a medical emergency, prohibits physicians from performing an abortion after 15 weeks gestation as measured starting on the 1st day of the last menstrual period. Punishes the doctor with a felony and unprofessional conduct on her or his license. No exemptions for rape etc.

SB1272 AHCCCS; postpartum care; eligibility; appropriations  SUPPORT

Passed Senate 26-2. Transmitted to House. Allows AHCCCS to pursue eligibility for postpartum care for members for 1 year post-delivery up to 161% of federal poverty limit. Expanded eligibility currently ends at delivery.

Violence and Firearms

SB1123 disruption; educational institution; concealed weapon OPPOSED

Passed Senate Judiciary 4-3Floor next. Prohibits the governing board of any university, college, or community college from prohibiting the possession of a concealed weapon by a concealed weapon permit holder, or the transportation or storage of a firearm.

State Agency Administration

SB1175– noncustodial federal monies; appropriation OPPOSE

Passed Senate 16-13. Transmitted to House. The legislature would need to appropriate federal funds that come through grants- including for example the maternal and child health block grant, WIC, SNAP, and many others.

SB1641 – health care institutions; civil penalties SUPPORT

Being heard in Senate Health 2/16. Raises the limit on ADHS healthcare institutions civil money penalties to $1K from $500.

SB1391 state hospital; transfer; AHCCCS NEUTRAL

Being heard in Senate Health 2/16. NO POSITION YET

This would move responsibility for operating the Arizona State Hospital from ADHS to AHCCCS.

SB1413 pharmacists; prescriptions; refusal; prohibition OPPOSED

Assigned to Senate Health Committee. Requires pharmacists to fill every prescription they receive. It would become unprofessional conduct to not fill a prescription, even if the pharmacist sees in the PMDP that the patient is doctor shopping or identifies a dangerous drug interaction.

HB2787 Maricopa county; division; new counties OPPOSED

Being heard in House Government & Elections Committee on 2/16. Would break Maricopa County into 4 separate counties.

Behavioral Health

SB1210 mentally ill; transportation; evaluation; treatment SUPPORT

Assigned to Senate HHS, no action yet. Stops the current practice of requiring that a police officer attend behavioral health ambulance transports.

SB1162 opioid prescriptions; intractable pain; exceptions SUPPORT

Passed Senate 27-0. Transmitted to House. Exempts patients with perioperative surgical pain, intractable pain or chronic intractable pain from statutory opioid prescription dosage restrictions. Contains good definitions of those words.

Arizona Blows Through the 27,000 COVID Death Threshold; AZ Ranks 2nd in the Nation in Per-capita Deaths Behind Only Mississippi

See Dr. Joe Gerald’s Weekly Epidemiology & Hospital Occupancy Report

Arizona blew through the 27,000 COVID-19 death threshold last week, only a couple of weeks after Arizona raced through the 26,000 cumulative death mark. Arizona still ranks 2nd in the U.S. in cumulative per-capita COVID-19 deaths (behind only Mississippi). Arizona had been on track to pass Mississippi and become the deadliest state, but an unexpected increase in new deaths in Mississippi in the last couple weeks has kept Arizona in 2nd place.

Arizona’s COVID death epi-curve for December continued to fill in last week as weeks old death certificates were processed. The week ending December 12th recorded 552 deaths to date (the deadliest week of 2021). A mortality report from the AzPHA indicates that official statistics undercount actual deaths.

Twenty-eight percent (28%) of Arizona’s 8,743 general ward beds were occupied by COVID-19 patients last week, a 20% decrease from the previous week. Four-hundred ninety-nine (499, 31%) of Arizona’s 1642 ICU beds were occupied by COVID-19 patients, a 21% decrease from last week’s 632 occupied beds.

Nevertheless, hospitals remain very busy. They have now experienced 181 consecutive days with a combined occupancy >2000 patients whereas the summer 2020 and winter 2021 saw 57 and 98 days, respectively. We experienced 75 days with >3000 combined occupancy with the Delta/Omicron waves whereas the summer 2020 and winter 2021 waves saw 35 and 78 days, respectively.

At least the rate at which new cases are reported has been moderating. For the week ending February 6th, more than 40,000 Arizonans were diagnosed with COVID-19, a 45% decrease from the 73,828 cases reported the prior week. This week’s tally is smaller than the January 2021 peak (65,094 cases) but it is higher than the June 2020 peak (28,009 cases). The risk of contracting Omicron remains extremely high.

Currently, rates are highest among those 25 – 64 years and lowest among those <15 years, 610 and 466 cases per 100K residents, respectively. Arizona’s new case ranking fell to 11th place with the nation’s leaders being Alaska (1231), Kentucky (990), West Virginia (920), Montana (905), and Mississippi (831).

See Dr. Joe Gerald’s Weekly Epidemiology & Hospital Occupancy Report

Looking to Make a Career Move in 2022?  Looking for New Members for Your Team?

The Arizona Public Health Association’s Career Center might be the ticket you’re looking for to find the right opportunity or candidate.

Looking for a Job?

One of your AzPHA member benefits is access to our career center, where you can find a multitude of jobs in the public health, healthcare, laboratory sciences and many other fields. Simply visit the site from time to time and check out what’s out there. You can also set up an account as a ‘Job Seeker” under that navigation tab at the top of the site.

There’s also a job center resource room to help you make your resume stand out, interview tips, and pointers to use social to help your search. You can also upload your resume to get more visibility by setting up the free job seeker account.

I’m in the process of priming the pump with more jobs at our organizational members’ workplaces, so be sure to check back from time to time to check what’s out there.

Interested in Posting a Job?

If you’re interested in posting a job on our site, simply create an employer account. We have several product categories depending on what your needs are, including Basic Posting, Passive Job Seeker Package, and Enhanced Posting- ranging from $99 to $199.

The $199 package includes getting your job emailed to to over 27,000 people, a 30 day posting period. Your job will be highlighted and will stay near top of list on job board too. There are additional package deals for posting multiple jobs.

If your employer is an organizational member of AzPHA, I can create some time-limited free coupons that you can use to post some jobs. To get one of those coupons contact me at willhumble@azpha.org“>willhumble@azpha.org.

Legislative Session Summary

As AzPHA’s Executive Director, I’m the registered lobbyist for our organization. I’m responsible for going into the state legislature’s website and documenting our positions on bills. When bills are up in Committee, I go into the Request to Speak system and provide more detail about our position and why. In some circumstances (like this week in the House and Senate Health & Human Services Committees), I attend and speak for a couple minutes.

Our positions on bills are based on Resolutions that members have passed over the years: Resolutions – AZ Public Health Association. If no Resolution is in place to support our advocacy position, our public health policy committee discusses the issue and makes a recommendation to the Board to validate our position.

You can also do your own advocacy and make your own voice heard. In order to do that, you’ll need to get a User ID and Password for the Legislature’s Request to Speak system. You can sign up at one of the kiosks in the House or Senate buildings or contact the folks at Civic Engagement Beyond Voting who can help you set up an RTS account.

Committee Hearings this Week

House Health & Human Services 2pm Monday 

HB2086– ADHS; school immunizations; exclusions OPPOSED

HB2450– outpatient treatment centers; licensure; exemption NEUTRAL

Senate Health & Human Services 8:30am Wednesday

SB1044 – contracts; grants; exclusions; sex education OPPOSED

SB1567– vaccinations; prohibitions; evidence of immunity OPPOSED

SB1641– health care institutions; civil penalties SUPPORT

SB1052– medical procedures; prohibitions OPPOSED

Senate Appropriations Committee Tuesday 2pm

SB1245  tobacco; vapor; alternative nicotine; regulation OPPOSED

Bill Summaries & AzPHA Positions

Public Health Emergency

SB1009– state of emergency; executive powerOPPOSED

Passed Senate 16-13. Beginning on Ducey’s last day, caps the length of a Governor’s public health emergency declaration at 30 days but allows the Governor to extend the state of emergency for up to 120 days in 30-day increments. Terminates a state of emergency after 120 days, unless extended by the Legislature. Allows the Legislature to extend the state of emergency as many times as necessary in up to 30-day increments.

HB2022  health emergencies; treatment; vaccinations; repeal OPPOSED

No action yet. This bill eliminates public health emergency authority that currently allows the ADHS Director to mandate vaccinations in exposed persons in some circumstances.

Vaccines

HB2029 vaccinations; evidence of immunity; prohibitions OPPOSED

No action yet. Prohibits government entities from requiring a COVID vaccine as a condition of employment. Also prohibits them from contracting with any private business that requires vaccination. Has a conditional exemption for healthcare institutions.

HB2043 employer liability; COVID-19 vaccine requirement OPPOSED

Passed Senate Judiciary 6-4. Makes employers liable for damages if the employer denies a religious exemption and requires a person to receive a COVID-19 vaccination and significant injury results from receiving the vaccine.

HB2064 ADHS; school immunizations; exclusions. OPPOSED

Being Heard in House HHS Monday, AZPHA Signed in Against. Prevents ADHS Director from ever adding COVID19 or HPV vaccines to the list required for school attendance

HB2065 school immunizations; nonattendance; outbreak OPPOSED

Assigned to Senate HHS, no action yet. Removes that ability to exclude unvaccinated students from school during a school outbreak

HB2086 ADHS; school immunizations; exclusions OPPOSED

Being heard in House HHS 2/7.  Prevents ADHS Director from ever adding COVID19 or HPV vaccines to the list required for school attendance

HB2191 school immunizations; DHS; exclusions OPPOSED

Being heard in House HHS 2/7 AzPHA Signed in Opposed. Prohibits ADHS from adding HPV, COVID-19 and/or any vaccine that is just emergency use authorized to list of vaccines required for school attendance.

HB2452 antidiscrimination; employment; vaccination status OPPOSED

No action yet. Prevents ‘discrimination’ against anybody because of the vaccination status

SB1567 vaccinations; prohibitions; evidence of immunity OPPOSED

Being Heard in Senate HHS Wednesday, 2/9. Prohibits businesses from requiring vaccinations of any kind and includes enforcement provisions including preventing the state from contracting with any entity that does so. Includes exemptions for certain healthcare facilities.

SB1052 medical procedures; prohibitions OPPOSED

Being heard in Senate HHS 2/9. Government entities and even schools would be unable to require vaccination if there is any threat of an adverse reaction that can result in death, even if the odds of that are for example 10,000,000 to one.

Family Planning

SB1044 contracts; grants; exclusions; sex education OPPOSED

Being Heard in Senate HHS 2/9.  Prohibits ADHS from contracting with any entity that ‘provides or promotes abortion’ on their Personal Responsibility Education Program or the Sexual Risk Avoidance Education Grant Program grants.

Criminal Justice

HB2033 juvenile offenders; monetary sanctions; repeal SUPPORT

Passed House Judiciary and Appropriations 10-0. Removes statute relating to court-ordered fees and fines for juveniles, except for victim restitution and specific driving under the influence offenses. Appropriates $2,531,000 from the state General Fund for costs relating to juvenile treatment services and court services.

HB2021 Drug Offenses, homicide, sentencing OPPOSED

Assigned to House Judiciary, no action yet. Increases penalties for homicides that happen when there is also a drug offense.

Food Insecurity

HB2060 supplemental nutrition assistance program; eligibility SUPPORT

Passed House Judiciary and Rules. Expands Supplemental Nutrition Assistance Program eligibility to individuals with felony drug convictions but still requires certain people to comply with probation conditions.

Housing

HB2606 school districts; housing facilities; teachers SUPPORT

Assigned to House Ways and Means, no action yet. permits all school districts to leverage district-owned property and facilities toward the development of housing for staff.  Current statute limits these “teacherages” to rural and tribal communities.  This bill would expand these abilities to urban and suburban districts.  It’s a technical change to existing statute, but should have promising health, educational and economic impacts.

HB2674 municipal zoning; by right housing SUPPORT

Assigned to House Commerce Committee. Would prevent cities from implementing unreasonable zoning barriers that limit the production of affordable housing. Makes cities commit to policies that encourage affordable housing.

Maternal and Child Health

HB2111 appropriation; healthy families program SUPPORT

Passed House Health 7-2, still needs House Appropriations. Appropriates $10 million from the state General Fund in FY 2023 to the Department of Child Safety for the Healthy Families Program.

HB2113 developmental disabilities; Down syndrome SUPPORT

Passed House Health 9-0. Automatically qualifies persons with Down Syndrome for AHCCCS’ Long Term Care program (they currently need to go through a qualification process).

HB2311 school health program; appropriation SUPPORT

Assigned to House Education, no action yet. Requires school districts (and charters) to have evidence-based school health programs. Provides funding for such programs.

Tobacco

HB2125 electronic smoking devices; retail licensing SUPPORT

Assigned to House HHS, no action yet. This is the ‘good’ tobacco control bill. Has a host of evidence based interventions including retail licensing with proper enforcement.

SB1245  tobacco; vapor; alternative nicotine; regulation OPPOSED

Being heard in Senate Appropriations Tuesday at 2pm. Regulates tobacco products but in a bad way that isn’t evidence based. It preempts local jurisdictions from doing more than state law. Includes a tobacco license though, with weak enforcement. Would be managed by the Department of Liquor License and Control.

Access to Care

HB2144 health insurance coverage; biomarker testing SUPPORT

Assigned to House Health, no action yet. Requires health insurance plans to begin covering biomarker testing. Important bill as emerging therapies rely on biomarker testing to target therapies. Medicaid is included!

HB2155  health information organizations; research; disclosures SUPPORT

Assigned to House HHS. No action yet. Makes deidentified health information more available for research.

HB2100 health information organizations; confidentiality; data. SUPPORT

Assigned to House HHS, Held. This emergency measure would allow Health Current to receive, use and redisclose confidential information received for any purpose allowed by HIPPA. Ducey’s Executive Orders and Enhanced Surveillance Advisories currently address this privacy protection, but it needs to be codified in statute to ensure there are no gaps in the protection of this data or in healthcare information.

HB2161 parental rights; schools; educational records OPPOSED

Passed House Education 6-4. Expands statutory parental rights regarding the upbringing, education, health care and mental health of a parent’s minor child.

Special Needs & Disabilities

HB2382 appropriation; health programs; disabilities SUPPORT

Passed House HHS 9-0. Appropriates $1 million to ADHS for grants to statewide organizations dedicated to “promoting evidence based, inclusive health programs for people with intellectual and developmental disabilities”.

HB2157 supplemental appropriations; community-based services SUPPORT

Passed House Appropriations 11-1. Appropriates $1,440,732,800 of expenditure authority and $30,121,100 from Kids Care in FY 2022 for home and community-based services and funding formula requirements.  This will leverage $1.5B in mostly American Rescue Plan Act funds over the next 2 years to improve Home and Community Based Services for folks in their Long-Term Care Program.  $1B will go for badly needed investments to promote and stabilize access to supportive services, and workforce retention/ consistency to improve member outcomes ($1B).

Clean Energy/Climate/Environmental Health

SB1132 municipal bonds; environmental sustainability; prohibition OPPOSED

Assigned to Senate Nat. Resources, no action yet. Prohibits the use of municipal bonds for any project that is “green”. Defines anything green as basically anything to do with climate change, carbon emissions, or clean energy. Excludes other pollutants regulated by ADEQ.

HB2403 appropriation; ADE; electric school buses SUPPORT

Assigned to House Education, no action yet. Appropriates $1.5M for a pilot program for electric school buses

SB1150 electric vehicles; pilot program; appropriation SUPPORT

Passed Senate Transportation 6-3. Appropriates $500K from the General Fund to the Arizona Department of Administration (ADOA) for the Electric Vehicle-Ready Homes Pilot Program.

SB1151 charging station; pilot program; appropriation SUPPORT

Passed Senate Transportation 7-2. Appropriates $500K from the General Fund to ADOA to establish the Electric Vehicle Charging Station Pilot Program.

SB1152 zero emission vehicles; plans SUPPORT

Passed Senate Transportation 7-2. Requires ADOT to work in coordination with ADOA and ADEQ to develop a Zero Emission Vehicle Plan.

SB1153  state zero emission vehicle fleet SUPPORT

Assigned to Senate Transportation, no action. Requires state agencies to buy zero emission vehicles when they buy new cars (when feasible).

SB1154 transportation electrification study committee SUPPORT

Passed Senate Transportation 7-2. Establishes the Transportation Electrification Study Committee

HB2226 fireworks use, limitations, prohibition SUPPORT

Passed Public Safety 13-1. Limits fireworks use to before 11pm except for a few holidays when the deadline is 1am.

Women’s Health

HB2534 feminine hygiene; exemption SUPPORT

Assigned to Ways and Means, no action yet. Exempts feminine hygiene products from sales taxes.

SB1164 abortion; gestational age; limit OPPOSED

Passed Senate Judiciary 5-3. Except in a medical emergency, prohibits physicians from performing an abortion after 15 weeks gestation as measured starting on the 1st day of the last menstrual period. Punishes the doctor with a felony and unprofessional conduct on her or his license. No exemptions for rape etc.

SB1272 AHCCCS; postpartum care; eligibilityappropriations  SUPPORT

Passed Senate Appropriations 10-0. Allows AHCCCS to pursue eligibility for postpartum care for members for 1 year post-delivery up to 161% of federal poverty limit. Expanded eligibility currently ends at delivery. Still requires CMS approval.

Violence and Firearms

SB1123 disruption; educational institution; concealed weapon OPPOSED

Passed Senate Judiciary 4-3. Prohibits the governing board of any university, college, or community college from prohibiting the possession of a concealed weapon by a concealed weapon permit holder, or the transportation or storage of a firearm.

State Agency Administration

SB1175 noncustodial federal monies; appropriation OPPOSE

Passed Senate Appropriations 5-4. The legislature would need to appropriate federal funds that come through grants- examples include the maternal and child health block grant, WIC, SNAP, and many others.

SB1641 health care institutions; civil penalties SUPPORT

Being heard in Senate HHS on 2/9. Raises the limit on ADHS healthcare institutions civil money penalties to $1K from $500.

SB1391 state hospital; transfer; AHCCCS NO POSITION YET 

Assigned to Senate Health and Human Services Committee, no action yetThis would move responsibility for operating the Arizona State Hospital from ADHS to AHCCCS.

Behavioral Health

SB1210 mentally ill; transportation; evaluation; treatment SUPPORT

Assigned to Senate HHS, no action yet. Stops the current practice of requiring that a police officer attend behavioral health ambulance transports.

SB1162 opioid prescriptions; intractable pain; exceptions SUPPORT

Passed Senate HHS 8-0. Exempts patients with perioperative surgical pain, intractable pain or chronic intractable pain from statutory opioid prescription dosage restrictions. Contains good definitions of those words.

Arizona on Track to Be the #1 State In Per Capita COVID-19 Deaths by Mid February

View Dr. Joe Gerald’s Weekly Epidemiology & Hospital Occupancy Report

Arizona continues to be on track to be #1 in per capita COVID-19 deaths in the U.S. within a couple of weeks. Weekly COVID-19 deaths will likely continue to be in the mid-400s for several more weeks. At that pace, we should pass Mississippi mid-month. So far, at least 26,530 Arizonans have lost their lives to COVID-19.

Hospitals will be burdened by >30% COVID-19 occupancy in general wards & ICU for the next several weeks. Access to care continues to be restricted by both COVID-19 occupancy and staff shortages owing to infections among healthcare workers. COVID-19 hospital occupancy in the wards is moderating and hopefully the ICUs will begin to decompress soon.

While new cases per week are certainly on the way down, Arizona’s remains in 7th place with 1,014 new cases per 100K residents per week. Our new case rate is just behind Alaska, North Dakota, Washington, West Virginia, and Wyoming.

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