AHCCCS’ “Get Ready to Renew” Messaging Toolkit Available to Help Medicaid Members Prepare for Upcoming Renewals

An updated messaging toolkit about the end of the public health emergency (expected in July) is now available on the AHCCCS Return to Normal Renewals web page.

The toolkit includes suggested social media posts, text messages, on-hold messages, and fliers you can use to help AHCCCS members get ready for their renewals. Community partners, health plans, advocacy organizations, and providers are welcome to use this messaging guidance in their communication to AHCCCS members.

The federal public health emergency (PHE), which suspended most Medicaid disenrollments, is expected to end on July 16, 2022. When the PHE ends, many temporary programmatic changes that were implemented during the pandemic will also end and normal business processes will be reinstated.

You can help AHCCCS members take steps to get ready for their renewal. To make sure that eligible members do not experience any gap in health care coverage, AHCCCS asks them to: Ensure that their mailing address, phone number, and email address on file is correct in www.healthearizonaplus.gov, or by calling Health-e-Arizona Plus at 1-855-HEA-PLUS (1-855-432-7587), Monday through Friday 7:00 a.m. – 6:00 p.m.  Find more information, please refer to the AHCCCS Return to Normal Renewals web page

Journal Article of the Week: In-person Schooling & COVID-19 Risk Spring 2021

In-person schooling and associated COVID-19 risk in the U.S. spring semester 2021

Because of the importance of schools to childhood development, the relationship between in-person schooling and COVID-19 risk has been one of the most important questions of this pandemic. Previous work in the United States during winter 2020–2021 showed that in-person schooling carried some risk for household members and that mitigation measures reduced this risk.

Here, we use data from a massive online survey to characterize changes in in-person schooling behavior and associated risks over that period. We find increases in in-person schooling and reductions in mitigations over time. In-person schooling is associated with increased reporting of COVID-19 outcomes even among vaccinated individuals. 

Teacher masking was associated with the greatest risk reduction across all COVID-19–related outcomes, followed by daily symptom screens, universal student masking, and restricted entry (Fig. 4B).

Looking to Make a Career Move?

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.

Abortion & Public Health on A Crash Course if Roe is Overturned & ARS 13-3603 Becomes the Law of the Land

Teen pregnancy is an important public health indicator.  Having a baby as a teenager impacts the mom, the dad, the baby and the whole community. Teen parents often don’t finish high school which, in turn, reduces their ability to financially take care of their newborn and results in increased health care, foster care, incarceration, and lost tax revenue nationwide. It’s also a key driver of inter-generational poverty, which comes with a cascade of poor public health outcomes.

Here’s a link to the CDC’s latest Birth Data for 2020 (National Vital Statistics Reports Volume 70, Number 17, February 7, 2022) which includes the teen birth rate.  Arizona’s teen birth rate decreased 10% in the last year.  In fact, since 2010 the Arizona teen birth rate has dropped more than 64%…  from 41.9/1000 in 2010 to only 16.6/1000 in 2020.

Table B: National Vital Statistics Reports, Vol. 61, No. 1 (8/2012) vs. Table 8 National Vital Statistics Reports Volume 70, Number 17, February 7, 2022

There are lots of theories as to why the teen birth rate is dropping.  The share of teens using some form of highly effective contraceptive methods is increasing. The share of sexually active female teens who have used emergency contraception (e.g., the morning-after pill) rose from 8% in 2002 to 23% in 2011-15. And a Centers for Disease Control and Prevention analysis found that the use of long-acting reversible contraceptives such as IUDs and implants rose from 0.4% in 2005 to 7.1% by 2013. It is most certainly higher than that today.

See Previous Posts:

If Roe is overturned and ARS 13-3603 becomes the law of the land, abortion will no longer be an option for women that become pregnant and are unprepared for the financial and other responsibilities of becoming a parent. Additionally, a plain reading of 13-3603 suggests that even “Plan B” and Intrauterine Devices may become illegal if they are determined to be a “… medicine, drug, substance or instrument” that causes a miscarriage, all of which will result in increased poverty and the downstream poor health outcomes that result. 

A key question then becomes… will state government step up and provide additional safety net services to support these new families? You have to say Arizona doesn’t have a strong track record in that regard.

AzPHA Action Alert: Comment on EPA’s Heavy & Medium Duty Truck Emission Standards Rule by Friday

Urge EPA to Select ‘Option 1’ for Heavy Duty Trucks & Add A Particulate Pollution Standard

The EPA has proposed new vehicle emission standards for medium and heavy-duty trucks! That’s a good thing because the last medium and heavy-duty emission standards were established in 2002, light years ago technology wise.

This important rulemaking will help to clean up and help transition the transportation sector toward lower emissions of harmful air pollutants and greenhouse gas emissions. 

Because vehicles purchased will be on the road for many years, potentially two decades, it’s critically important to start setting standards now. 

Heavy-Duty 2027 and Beyond: Clean Trucks Proposed Rulemaking – (EPA-420-F-22-007, March 2022)

Comment on the Proposed Rule Here

Heavy-duty trucks and buses drive American commerce and connect people across the country. Creating cleaner trucks is an economic opportunity to support jobs and make more efficient vehicles while reducing harmful pollution. Heavy-duty trucks and buses continue to contribute significantly to air pollution at the local, regional, and national level, often disproportionally affecting communities of color and low-income populations.

A EPA’s “Clean Trucks Plan” will result in significant emissions reductions from new medium- and heavy-duty vehicles, improve air quality, and addressing the climate crisis. The regulatory actions that make up the Clean Trucks Plan are as follows:

  • Setting stronger nitrogen oxide (NOx) standards for heavy duty trucks beginning in 2027; and
  • Tightening the “Phase 2” greenhouse gas emissions in 2027 and beyond.

The proposed standards would significantly reduce emissions of NOx from heavy-duty gasoline and diesel engines and set stronger greenhouse gas standards for heavy-duty vehicles.

EPA is proposing two regulatory options. We’re asking AZPHA members to comment on the EPA rules and urge them to select Option 1, which will implement stronger NOx standards in two steps. The first improvement would be required in 2027 with a second more stringent standard 2031 (under Option 1 the 2031 NOx standard would be 90% lower than today’s standards).

We’re also urging our members to ask EPA to include emission limits on particulate pollution in addition to the NOx standards. As it stands, the current rule only sets new goals for NOx – not particulate matter. While cutting NOx emissions can cut particulate matter emissions including more stringent particulate standards will motivate engineers to ensure that both goals are achieved

EPA’s public comment period ends Friday, May 16, 2022. It’s important that public health weigh in on the Rule because industry is pushing back.

Comment on the Proposed Rule Here

Rule: Control of Air Pollution from New Motor Vehicles: Heavy-Duty Engine and Vehicle Standards; Extension of Comment Period

Arizona Abortion Statistics

Back in 2010 the state legislature passed a bill (SB1304) that required clinicians that provide abortion services to report certain data points to the ADHS and talked the agency with writing an annual report. Ever since, the agency has been developing annual reports. Here is the 2020 Arizona Abortion Report, the last report for which data are available.

The report contains more than 15 tables with various statistical and demographic characteristics of abortions performed in Arizona. For example, about 95% of abortions are performed at less than 15 weeks gestation, and important statistic considering that, beginning later fall abortions will likely be limited to those less than 15 weeks because of the signing of SB1164 (although it’s also possible that all abortions except those necessary to save the lifo of the woman would become illegal to provide).

Other meaningful charts in the report document the marital status of the women seeking the abortion as well as the self-disclosed reasons for seeking the abortion. About 4% of abortions were to protect the health of the mother, and Table 7 documents the various maternal characteristics for that category.

Arizona’s 2020 abortion report found that 1,218 of the 13,186 abortions provided in 2020 were among teens (9.3% of the total).  By contrast, 1,512 of the 11,438 abortions provided in 2010 were among teens (13.2%).

Arizona Abortion Rights In a Post Roe U.S.

All of you know by now about the draft opinion that leaked out of the U.S. Supreme Court suggesting that the court is seriously considering overturning the Roe v Wade case in its entirety. If that stands, it will remove constitutional protections for abortion rights and send the regulation of abortion to the states.

Naturally, that brings up speculation about what the impact might be in Arizona. If Roe is overturned, the impact will hinge on whether the newly signed SB1164 (restricting abortions to the first 15 weeks gestation) is the law of the land, or whether a territorial-era law from 1901 [ARS 13-3603] takes precedence.

13-3603. Definition; punishment

A person who provides, supplies or administers to a pregnant woman, or procures such woman to take any medicine, drugs or substance, or uses or employs any instrument or other means whatever, with intent thereby to procure the miscarriage of such woman, unless it is necessary to save her life, shall be punished by imprisonment in the state prison for not less than two years nor more than five years.

If courts determine that the new statute that Ducey just signed (limiting abortions after 15 weeks but not outlawing them before 15 weeks) (SB1164) has precedence [Chaptered Version], then abortion services will still be available in Arizona (at less than 15 weeks gestation). Because about 95% of abortions in Arizona occur at less than 15 weeks gestation, there will be little change for the majority of women seeking an abortion.

The thing is that SB1164 also says:

This act does not: Repeal, by implication or otherwise, section 13-3603, Arizona 20 Revised Statutes, or any other applicable state law regulating or restricting abortion. 

While I’m not a lawyer, it looks to me like SB1164 makes it clear that the territorial era law would take immediate effect… making all abortions illegal to provide unless it is necessary to save the woman’s life (punishable by 2 to 5 years in ADOC).

Note: A plain reading of 13-3603 suggests that even “Plan B” and Intrauterine Devices may become illegal if they are determined to be a “… medicine, drug, substance or instrument” that causes a miscarriage. We’ll cover how that could impact public health and poverty on Wednesday. Tomorrow I’ll Arizona’s abortion statistics.

May 8 Legislative Roundup

There wasn’t much action in the state legislature this week- at least out in the open. It’s possible there were behind-the-scenes budget negotiations – but none of it has been transparent if it happened.

The only thing I weighed in on this week was a bill that would require group homes that provide services to folks with developmental and cognitive disabilities to be licensed by the ADHS (SB1308). Right now, those homes are generally just overseen by ADES (who is also the agency funding the services). We’re signed up in favor of the bill and I explained to a few legislators why last week.

There was no action on the other bills we’re advocating for or against, so I’ll just refer to last week’s update on that: May 2 Legislative Roundup – AZ Public Health Association.

As expected, Ducey signed SB1009 this week, restricting future governors & ADHS directors to 120 days of public health emergency authority (amending ARS 26-303). 

Editorial Note: Perhaps next time we have a public health emergency we’ll be lucky enough to have a governor and ADHS director that will actually try to save lives and use evidence to drive decisions using their (now diminished) public health emergency authority. Sadly, that didn’t happen this time around, at a great cost of life.

Legislative Roundup

There wasn’t much action in the state legislature this week- at least out in the open. It’s possible there are behind-the-scenes budget negotiations happening- but none of it has been out in the open.

The only thing I weighed in on this week was a bill that would require group homes that provide services to folks with developmental and cognitive disabilities to be licensed by the ADHS (SB1308). Right now, those homes are generally just overseen by ADES (who is also the agency providing the services). We’re signed up in favor of the bill and I explained to a few legislators why last week.

There was no action on the other bills we’re advocating for or against, so I’ll just refer to last week’s update on that: May 2 Legislative Roundup – AZ Public Health Association.

As expected, Ducey signed SB1009 this week, restricting future governors & ADHS directors to 120 days of public health emergency authority (amending ARS 26-303). 

Perhaps next time we have a public health emergency we’ll be lucky enough to have a governor and ADHS director that will actually try to save lives and use evidence to drive decisions using their (now diminished) public health emergency authority. Sadly, that didn’t happen this time around, at a great cost of life.

New Book: Healthy Aging Through The Social Determinants of Health

Healthy Aging Through The Social Determinants of Health

AzPHA Member  M. Aaron Guest, PhD, MPH, MSW; Elaine T. Jurkowski, PhD, MSW

People are growing older and experiencing a much longer life span than that of prior generations. Many people over the age of 60 are healthier today and living in place within their home-based communities with noninstitutionalized care. In addition, only about 5% of the older adult population is living in institutional care.

Despite this reality, the focus on older adults in much of the previous research has focused on institutional care. It is only within the last decade that we have begun to see publications related to healthy aging and community-based opportunities through the lens of public health. To date, there has been precious little attention to how we discuss and frame aging through a public health lens.

To this end, the Aging and Public Health Section of the American Public Health Association has worked to provide a seminal piece of work, this book on healthy aging, to help practitioners and public health professionals better prepare for their work with the older adult populations.

Section I of this book provides an overview of how the social determinant of health care and access to health care play a role in the course of healthy aging.

Section II on neighborhood and the built environment addresses the impact that neighborhood and different types of built environments have on the health and social outcomes of older adults.

Section III addresses the critical role that social support plays within the process of healthy aging. Social support, caregiving, and the role of these supports are important factors within the healthy aging process.

Section IV addresses education, access to education, and the impact of education on health outcomes and health literacy.

Lastly, Section V deals with economic and policy issues that play a role in the healthy aging process. Factors such as pensions, economic resources, and policies that shape these outcomes are discussed in this section.

You can order this important book through APHA
Print: Healthy Aging Through the Social Determinants of Health
E-book: Healthy Aging Through The Social Determinants of Health ($62)

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