Governor Hobbs Taps AzPHA Member Zaida Dedolph Piecoro to be her Health Policy Advisor

Good news! Governor Hobbs has tapped AzPHA Director of Public Health Policy Zaida Dedolph Piecoro to serve as her health policy advisor. Zaida is a long-time member of AzPHA and has been serving as the Director of Public Health Policy on our Board of Directors for the last few years. She begins her new post on Tuesday,

Zaida stepped down from her role at the Children’s Action Alliance and also stepped off our Board of Directors last Friday to avoid any kind of perceived conflict of interest.

It’ll certainly be delightful & refreshing to have a friend of evidence-based public health policy on the 8th Floor advising the governor and her team on administrative and policy matters!

According to our By-laws, it’s Kelli Donley Williams’ responsibility to name a new Director of Public Health Policy to the Board. In the meantime, I’ll run the weekly public health policy committee meetings.

Call to Action: Comment on ADHS’ Planned Revisions to the AZ Student Loan Program for Health Professionals: Comments Due by January 22

A law was passed last legislative session adding a Behavioral Health Loan Repayment Program to the existing ADHS State Student Loan Program for health professionals. The new law adds several disciplines to the list of folks who can qualify to participate in the program including behavioral health providers, behavioral health technicians, behavioral health nurse practitioners, psychiatric nurse practitioners, registered nurses, practical nurses, physicians, psychiatrists, or psychologists. Folks that qualify can have a generous portion of their student loans paid off if they serve in a behavioral health facility or the Arizona State Hospital.

Another change to the state student loan program makes folks eligible to participate if they work at an Indian Health Service facility, tribal or urban Indian health facilities that isn’t required to provide a sliding fee scale to be eligible.

ADHS has developed Administrative Code (Rule) changes to implement the new laws.  Whatever changes they adopt will be hard-wired into state code for many years so it’s essential that we examine the rules and make suggested changes while we can. This is an ‘emergency rulemaking’, meaning we have this one opportunity to examine the draft rules and make comments.

Comments are due in only 11 days: by January 22, 2023.

I especially urge those of you who have experienced the ‘back end’ of the student loan repayment program as a qualifying site or as a student to go through the rules and provide comments!

Here are the Proposed Draft Rules & a link to their Online Survey (Closes January 22, 2023).

I made the following suggested changes to the rules this morning adding an additional incentive for qualifying sites to donate to the State Loan Repayment Program (item number 6):

R9-15-104. Donations to a Loan Repayment Program

A person donating monies to a loan repayment program shall designate whether the donation may be used by the Department for either loan repayment allocations or for administrative costs associated with a loan repayment program or is to be used for loan repayment allocations for one or more of the following:

  1. The Primary Care Provider Loan Repayment Program, established according to A.R.S. § 36-2172;
  2. The Rural Private Primary Care Provider Loan Repayment Program, established according to A.R.S. § 36-2174;
  3. The Behavioral Health Care Provider Loan Repayment Program, established according to A.R.S. § 36-2175;
  4. A specific type or types of primary care provider, behavioral health care provider, or other eligible individuals; or
  5. A specific county in Arizona; or
  6. A specific qualifying service site or sites.

Express Your Support or Opposition to Bills this Session on AZLEG.gov

The Arizona State Legislature uses the ‘Request to Speak’ (RTS) system facilitate tracking of bills proposed and allowing the public to register an opinion on bills and to request to speak on a bill in a committee. It replaces the old slips of paper used back in the day and lets committee chairperson know you want to speak to the committee. Under the old paper system, you could only sign in to speak or register an opinion if you were physically at the capitol.

After the initial setup at a kiosk located in the House or Senate, the RTS program allows you to participate from your home or office. When the committee is in session, the committee members and the public will see a list of names of people who have registered an opinion.

It also shows whether you want to speak or not, who you represent. You can also leave more detailed comments or links to resources in comment boxes. This information is also available if a person searches past committee agendas. Legislators, journalists and the public will see your bill position throughout the process.

A catch is that you’re required to come to the capitol the first time you use the RTS system. When you come to the Capitol, you create an account and sign in on one of the Kiosks in either the House or Senate.

If you create an account at home, you’ll only be able to use the Bill Status Inquiry application to track activity on a bill, not register an opinion or create a request to speak until you come to the capitol and sign in on one of the Kiosks here.

Here’s a quick tutorial summarizing how to get set up and use Arizona’s RTS system: Using the Request to Speak Program

Using RTS has a bit of a learning curve, but if I can become proficient at using it- anybody can!

Compelling & Disturbing Testimony at the Joint Legislative Psychiatric Hospital Review Council Cries Out for Arizona State Hospital Governance Reform

A couple of years ago the state legislature passed a bill authorizing an Interim legislative committee called the Joint Legislative Psychiatric Review Council. Its mission runs through 2026 and includes making recommendations regarding psychiatric hospital capacity in AZ including the bed capacity at the Arizona State Hospital and other public facilities and the feasibility of transferring oversight of the Arizona State Hospital.

The Council published a report of their findings in December 2021 with a host of recommendations to improve psychiatric care in AZ. The findings of the report helped establish the need for two important bills from last legislative session including SB1444 – prohibiting ADHS leadership from retaliating against patients due to family participation in Arizona State Hospital Independent Oversight Committee meetings & forcing the ASH Superintendent and Chief Medical Officer attend and participate in meetings (they’d been blowing them off during the Ducey administration).

Joint Legislative Psychiatric Hospital Review Council

The legislature also passed, and the former governor signed SB1651 requiring AHCCCS to annually report to the Joint Legislative Budget Committee a host of additional fiscal records on expenses in the behavioral health system. It also earmarked $25M in the state budget to develop secure BH residential facilities for persons with a serious mental illness diagnoses who are chronically resistant to treatment.

The final action of the outgoing legislature occurred last week at the Joint Legislative Psychiatric Hospital Review Council. Testimony at the Council meeting last week was compelling, with Sommer Mutter describing in excruciating detail the trials and tribulations she experienced while her brother was civilly committed to the Arizona State Hospital (which is both run and regulated by ADHS).

I encourage you to listen to her testimony which you can do at this link on the AZLEG website: Video Player (azleg.gov). Shocking testimony.

New Psychiatric Hospital Review Council Recommendations

2023 Joint Legislative Psychiatric Hospital Review Council PowerPoint

Later discussions at the Council focused on the importance of fixing the conflict of interest posed by the fact that ADHS both runs and regulates the Arizona State Hospital.

More on the details about why having an entity regulate itself are here: Assaults at the Arizona State Hospital Highlight the Need for Governance Reform: A Primer

We sincerely hope the incoming legislature takes advantage of the work of the Council and holds ADHS accountable for fixing the problems left by the Ducey administration and investigates new legislation to improve institutional accountability at the Arizona State Hospital.

Editorial Note: I have confidence that the Arizona State Hospital will be honestly regulated under the Hobbs administration. However, a major institutional conflict of interest remains – with ADHS both operating & regulating ASH. While I expect conditions to improve at ASH under this administration, the institutional governance conflict needs to be fixed.

Unless institutional checks and balances are implemented it’s inevitable that a future administration will again have intentionally slipshod oversight of ASH operations as had occurred under former Governor Ducey & Director Christ.

Our Legislative Session Advocacy Approach

This week marks the beginning of the 2023 legislative session. The kickoff will be the Governor Hobbs’ State of the State address to the legislature at 2pm today when she’ll outline what he sees as priorities. It’ll be held in the House of Representatives and is generally open to the public (in the top gallery) buy you’d need to get there early. Visit the governor’s official website for details: Office of the Arizona Governor Katie Hobbs

Our Advocacy Approach

AzPHA will follow the session closely and express our support or opposition to bills based on a simple core principle…  we support bills that will have a positive impact on public health especially when they are evidence-based or evidence-informed.  We will oppose bills that are likely to have a negative impact on public health.  Our support or opposition to bills is located on the https://www.azleg.gov/ site under RTS Current Bill Positions.

We have a host of Resolutions that also guide our advocacy which are posted on the members only website and on our main website as well. The fact that we have Resolutions on so many core public health priorities make it easy for us to be swift with our support or opposition. Our Resolutions go all the way back to the 1930s. They are initiated by either the Board or our members and all resolutions have been voted on and approved by our members.

Our Public Health Policy Committee has a discussion board on Basecamp and that’s also where we post information, research and documents related to public health policy.  Let me know if you’d like to sign up for that Basecamp site at [email protected].

Our policy committee also has conference calls every Friday afternoon from 2 to 2:30 on Zoom (for members). Links to the meetings are in our Public Health Policy Committee Basecamp. Members can email [email protected] to get access to our Basecamp.

It’s Opening Day for the State Legislature Manana

Tomorrow is opening day for the 56th Arizona Legislature. As often is the case after redistricting, there’s a ton of turnover among legislators. In fact, more than half of the legislators are new this session! There are 30 new members in the House and 16 new members in the Senate.

Governor Katie Hobbs will also deliver her first State of the State address to a joint session of the Arizona House and Senate tomorrow morning.

The Senate Health committee is meeting on Tuesday at 2pm. They’ll be hearing a bill that would require AHCCCS to pay for medically necessary cochlear implants for their members (SB 1716). We have signed up in support of that bill (we’re the 1st organization to sign up in support!). In the committee comments we suggested they amend the bill to include a restoration of the bone anchored hearing aid benefit (which was eliminated by AHCCCS in 2010).

The House Health Committee isn’t meeting next week. They’ll be meeting on Monday mornings once they start work.

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COMMITTEE ON HEALTH AND HUMAN SERVICES

DATE: Tuesday, January 10, 2023, TIME: 2:00 P.M. ROOM: SHR 1

SENATORS: Borrelli, Hatathlie, Shamp (Vice-Chairman), Burch, Wadsack, Shope (Chair), Gonzales

HOUSE COMMITTEE ON HEALTH & HUMAN SERVICES

Monday, January 9, 2023, ROOM HHR 4 NOT MEETING THIS WEEK (future times TBD)

Members: Bliss, Hernandez, Shah, Contreras, Mathis, Parker B (Vice-Chair), Gress Pingerelli, Montenegro (Chair)

Governor Hobbs Issues Three Executive Orders During Her First Week in Office

Governor Hobbs issued 3 Executive orders last week addressing equal employment opportunities in state government and their contractors, housing and homelessness and elections. It certainly is refreshing to have a governor that sees these issues as priorities!

The executive orders identify the roles and responsibilities associated with each order and the objectives, deliverables, objectives and participants. 

Register Today for AzPHA’s Annual Members Meeting: January 11, 2023

AzPHA Annual Members Meeting:
January 11, 2023
11:00am – 1:00pm (Zoom)

Agenda

  • Welcome & Introductions
  • Approval of 2021 Business Meeting Minutes
  • Treasurer’s Report
  • Public Health Policy Committee Report
  • Professional Development Committee Report
  • Membership Committee Report
  • Community Health Justice Committee Report
  • Executive Director’s Report
  • Recognize Outgoing Board Members
  • Recognize New Incoming Board Members
  • Passing the Gavel & Remarks by Incoming President
Register Here

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AZ Appeals Court: Abortions Legal in Arizona Up to 15 Weeks Gestation

(via Stephanie Innes at the Arizona Republic)

Arizona appeals court judges on Friday ruled that abortions performed in the state by licensed physicians are legal up to 15 weeks of gestation despite a 19th-century, near-total abortion ban.

The ruling from the three-member panel from the southern division of the Arizona Court of Appeals clears up months of uncertainty over the legality of abortion in Arizona by stating that physicians who perform abortions under a new law that permits them up to 15 weeks of gestation are not subject to prosecution under the territorial-era near-total abortion ban.

Abortion law in the state had been in flux following the U.S. Supreme Court’s June 24 decision to eliminate the constitutional right to an abortion and leave the issue up to states, though both medication and surgical abortions have been legally occurring in Arizona up until 15 weeks of gestation since October, pending the appeals court decision, which was sought by Planned Parenthood Arizona.”

More available at: Appeals Court: Abortions legal in Arizona up to 15 weeks (azcentral.com)

View the Appelate Court Ruling Here

Note: Kris Mayes was sworn in as the AZ Attorney General yesterday. The courts were closed on Monday, January 2 so outgoing Attorney General Brnovich didn’t have an opportunity to appeal the case to the Arizona Supreme Court. I’m not a legal expert, but I think a 3rd party might have the ability to appeal the case to the AZ Supreme Court.

In the meantime, abortion services will be legal in Arizona up to 15 weeks gestation subject to a mandatory counseling session, compulsory ultrasound and a 24-hour waiting period. The ADHS will now presumably regulate licensed abortion clinics in accordance with the 15-week limitation even though their rules don’t include such a restriction.

Governor Hobbs Names Health & Human Services Agency Leadership Team

Governor-elect Hobbs named her health and human services executive leadership team last week, including naming AzPHA member Theresa Cullen, MD as her choice to lead the Arizona Department of Health Services finally bringing talented leadership back to ADHS once she starts in February (after she finishes transition activities in Pima County).

Dr. Cullen most recently served as Director of the Pima County Public Health Department. Prior to that, Dr. Cullen served 25 years in the U.S. Public Health Service, rising to the rank of Assistant Surgeon General.  Dr. Cullen received her M.D. from the University of Arizona, College of Medicine and M.S. in Administrative Medicine/Population Health from the University of Wisconsin, Madison.

Carmen Heredia was named to lead AHCCCS. Ms. Heredia currently serves as CEO of Valle del Sol, a community health center and behavioral health provider. She has extensive experience working with healthcare and community boards advocating for vulnerable and underprivileged groups in Arizona, including serving on the boards of the Arizona Council of Human Service Providers, the Arizona Alliance for Community Health Centers and Contexture. Carmen has a master’s degree in social work from Arizona State University.

Angie Rodgers will lead the Arizona Department of Economic Security – Angie Rodgers is President and CEO of the Arizona Food Bank Network. She has more than 25 years of experience in public policy and advocacy work. She has previously worked with DES on policy initiatives, welfare services and community coordination. Ms. Rodgers has a master’s degree in social work from Arizona State University.

Matthew Stewart will lead the Arizona Department of Child Safety – Mr. Stewart began his career in public service as a child safety specialist. He worked his way up in DCS, where he was entrusted with statewide management responsibilities for years. He has consulted extensively both locally and nationally to guide important changes in child welfare.

Joan Serviss will head the Arizona Department of Housing –Ms.  Serviss is the Director of the Arizona Housing Coalition, an association working to end homelessness in the state. She has over 20 years of experience working with state and local policy and organization. Ms. Serviss has a master’s degree in public administration from Arizona State University.