Will Humble Opioids, Wills Blog

What’s Up with All that Opioid Settlement Money & How Come There’s No State Plan for It Yet?

I’m sure you’ve heard about the settlement agreement that was finally reached in a multi-state lawsuit (including Arizona) against Cardinal, McKesson, AmerisourceBergen, and Johnson & Johnson – punishing the firms for their unethical behavior as they marketed their opioid products.

Arizona is set to receive $542 million over the next 18 years to combat an ongoing epidemic after the defendants and state plaintiffs $26 billion settlement for their roles in the opioid crisis. Settlement funds will be disbursed to the state and its subdivisions.

90 cities and towns and all 15 counties are signed on to a framework called the One Arizona Memorandum of Understanding (One Arizona Plan) to expeditiously distribute funds. The One Arizona Plan provides funding for programs to address and ameliorate opioid abuse, and includes reporting requirements for greater transparency of how money is used:

  • 56% of the total settlement will go to local governments for opioid mitigation programs.
  • 44% of the total settlement goes to a State for yet to be determined interventions.
  • Funds must be spent in accordance with approved, nationally recognized strategies to pay for future costs incurred by the State and local governments to address the opioid epidemic.

The funds are in some ways restricted in that they are supposed to go directly to relief and resources related to opioids, including to diversion programs to prevent people from going to prison for an addiction or substance-use disorder.

Because these are long-term funds that recently became available, there’s still not a lot of granularity about how the state and local jurisdictions intend to invest the funds… but county staff is certainly undergoing planning to make sure that they wisely use the funds. A priority for Pima County is to make sure they get input from the community before making decisions- always a good idea.

There’s no information on the ADHS website about the opioid settlement funds. If you do a google search, you’ll see that other states have info about the settlement on their website, but not in Arizona. Perhaps the executive branch is yet to decide whether ADHS or AHCCCS will be the primary recipient of the funds. Who knows?

In any event- we will have a new governor in just 208 days, so perhaps the new governor and their leadership team will finally put together a comprehensive plan for the state funds that will work hand in hand with the counties and cities. Frankly, I think the best steward for the state funds would be AHCCCS rather than ADHS (given current leadership).

Will Humble Professional Development, Wills Blog

State and County Health Departments Launch ‘AZ Public Health Connect’ to Provide Support for Public Health Workers

AZ Public Health Connect

Thanks to a new initiative by the state and county health departments, the public health workforce can enroll now to receive twice-weekly supportive text messages by texting AZPHconnect to 60298. (http://slkt.io/7YfV)

A workgroup made up of Arizona county health partners & ADHS team members is developing messages and resources that public health professionals can use to implement well-being into their daily lives. These texts include encouraging messages and resources on self-care, gratitude, and social connection.

For a little background on the program, the Arizona Nurses Association created the RN Connect 2 Well-being initiative designed to support nurses facing significant burnout, fatigue, and increased stress.

Arizona nurses were invited to enroll in a free text messaging program that provided 2x weekly messages with tips on various topics such as stress management, mindfulness, and healthy living. The RN Connect program was successful in providing well-being support for Arizona nurses and has allowed for the opportunity to extend this service to Arizona public health professionals.

The Arizona Nurses Association has graciously allowed the state county health department team to use their platform for the new AZ Public Health Connect (AZPH Connect) for the public health workforce.

Following the model of the RN Connect 2 Well-being initiative, public health professionals are encouraged to enroll in the AZ Public Health Connect program as a way to get a little extra support and encouragement.  We anticipate the first text messages to begin the week of June 6, but people can continue to enroll after that date.

See this promotional flyer for more information and feel free to share this well-being resource with your Arizona public health partners. For questions, more information, suggestions, or to express interest in joining the workgroup of public health professionals developing the messaging, please contact Erika Garcia at erika.garcia@azdhs.gov

It’s been a pleasure working on this new initiative for the public health workforce, and I hope you will find it to be of value for yourself.

Sheila Sjolander, MSW

Assistant Director

Division of Public Health – Prevention Services

 

Will Humble Air Quality, Wills Blog

Time Running Out for Cleaner, Healthier Future

Time Running Out for Cleaner, Healthier Future

Our state’s continued dependence on fossil fuels jeopardizes Arizona’s health and climate today and will continue to do so into the future – unless we act now.

Once again, we see Arizona communities ranked among the most polluted in the United States. The American Lung Association’s “State of the Air” 2022 report puts a fine point on this – Pinal County is one of just a handful of communities in the United States to earn failing grades for ozone, short-term and annual particle pollution levels. In fact, Pinal County is considered the 18th most polluted county in the U.S. for annual particle pollution levels.

Phoenix, the largest and most populated metro area, faces even greater challenges with air quality. Although this year’s report found fewer days of unhealthy ozone, Phoenix saw increases in both short-term and annual particle pollution levels. It remains one of the most polluted cities in the U.S., ranking as the fifth smoggiest city, and eighth most polluted in terms of year-round soot, nestled between California cities on each list.

Exposure to air pollution causes respiratory issues such as lung inflammation, chest tightness, and severe asthma attacks. It also contributes to cardiovascular harm including heart attacks, strokes and, in extreme cases, premature death. While poor air quality is dangerous for all, it disproportionately impacts vulnerable populations such as children, the elderly, low-income individuals, and people of color. Nationally, people of color are 3.6 times more likely to live in a county with failing air quality for ozone, short-term and annual particle pollution than white people.

People living near major transportation hubs and electricity generating power plants are at even greater risk. This is especially true for residents of Randolph in Pinal County, which is home to some of the most polluted air in the United States. This is why the Arizona Corporation Commission’s decision to deny expansion of fossil fuel combustion at the Coolidge Generating Plant was a necessary step to avoid adding yet more emissions in Pinal County. This decision should send a clear message to utilities and state leaders: we must transition away from fossil fuels and invest in renewable, non-combustion energy today.

Last month, another report by the Lung Association, “Zeroing in on Healthy Air,” illustrated the potential health and climate benefits if we were to transition to a zero-emission transportation sector and shift to clean, renewable energy. Acting now could result in $15.1 billion in public health benefits in Arizona over the coming decades – this includes 1,360 avoided deaths, 38,500 avoided asthma attacks, and 32,300 avoided lost workdays.

Moreover, some of the most impacted communities can reap the greatest health benefits. The report looked at the 100 U.S. counties with the highest percentage populations of people of color, approximately $155 billion in health benefits are projected – and swift action will benefit all Americans.

The more we delay investments in transportation electrification and renewable energy, the more health savings we leave on the table. Delays are something Arizona cannot afford, and something Arizonans do not want.

Last year, a poll of Arizona voters revealed 75% of voters support shifting investments away from fossil fuels like coal, oil and gas and toward clean, non-combustion energy sources and technologies like wind, solar and zero-emission vehicles.

The research is clear, and voters have spoken – we must act on our climate crisis and make bold investments in zero-emission technologies to protect the health of all Arizonans.  Our health and well-being depend on a rapid transition to zero emission technologies, especially in communities like Pinal County which faces some of the worst air pollution in the United States.

 JoAnna Strother is senior director of advocacy for the American Lung Association in Arizona. 

Will Humble is executive director of the Arizona Public Health Association and former director for the Arizona Department of Health Services. 

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Will Humble Medicaid, Wills Blog

Federal Public Health Emergency Likely to Extend to October 15, 2022: Here’s What that Means

Back on April 15, HHS Secretary Becerra extended the federal public health emergency for COVID-19 to July 15 [See renewal declaration here]. Both he and the president have said that they will give states 60 days’ notice if they intend to let the public health emergency expire.

This week that 60-day notice period came and went, meaning we can count on the federal government to keep the emergency in place through October 15. Many policy changes are tied to the federal public health emergency like flexibilities to waive or modify certain requirements in a range of areas, including in the Medicare, Medicaid, and CHIP (KidsCare) programs, mandates for private health insurance, authorization of medical countermeasures, telehealth, providing liability immunity to providers who administer services, and authorizing the FDA to do emergency use authorizations, among other things:

The Kaiser Family Foundation out together this good summary of what changes are coming when the federal declaration ends: What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access

Here are the sub-categories:

The thing I’m most concerned about is that once the federal emergency ends on October 15, AHCCCS will begin its redetermination processes. AHCCCS estimates that as many as 500,000 members have moved in the last 2 years and didn’t update their address. Once the federal emergency ends, they’ll send out notices to members and those that don’t reply will eventually get kicked off.

Thankfully AHCCCS and their contracted managed care organizations are working hard up front to make sure folks that have moved in the last year update their addresses at www.healthearizonaplus.gov or 1-855-432-7587.

Listen to Director on KJZZ’s The Show Here

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