Biden Issues an Executive Order to  Reduce Gun Violence & Make Communities Safer

What Will it Do?

Last Tuesday the President issued an executive order called Reducing Gun Violence and Making Our Communities Safer. At a high level, the Order basically instructs federal agencies to use their existing authority to implement measures to reduce gun violence. Much of the executive order focuses on coordinating implementation of the Bipartisan Safer Communities Act.

The Act:

  • Supports state ‘crisis intervention orders’ AKA Red Flag Laws (which Arizona doesn’t have);
  • Creates $750M for states to administer laws that help ensure deadly weapons are kept out of the hands of individuals a court has determined to be a significant danger to themselves or others;
  • Adds convicted domestic violence abusers in dating relationships to the National Instant Criminal Background Check System;
  • Cracks down on criminals who illegally evade licensing requirements and clarifies which sellers need to register, conduct background checks, and keep appropriate records;
  • Requires an investigative period to review juvenile and mental health records, including checks with state databases and local law enforcement, for buyers under 21 years of age;
  • Creates federal straw purchasing and trafficking criminal offenses, allowing prosecutors to target dangerous illegal gunrunners; and
  • Provides $250 million in funding for community-based violence prevention initiatives.

Executive Order: Reducing Gun Violence & Making Communities Safer

Last week’s Executive Order basically coordinates implementation of that Act. For example, The Attorney General, HHS, and the Departments of Education, and Homeland Security are supposed to turn in their plan of action to maximize the use of the Bipartisan Safer Communities Act.

The U.S. Attorney General is supposed to implement a plan to clarify the definition of who is a firearm dealer required to become Federal firearms licensee, prevent former licensees whose licenses have been revoked or surrendered from continuing to engage in the business of dealing in firearms; and publicly release inspection reports.

The Defense Department, Attorney General, Homeland Security and HHS are supposed encourage effective use of extreme risk protection orders (“red flag” laws), partnering with law enforcement, health care providers, educators, and other community leaders. Sadly, Arizona doesn’t have a Red Flag law.

See AzPHA’s Special Report: Firearm Violence in Arizona: Data to Support Prevention Policies

Legislative Update

This week’s meeting of the Senate Health Committee is a busy and important one. There are 5 good bills up for consideration including: HB2053 – nurse home visitations; HB2168 – good samaritan medical assistance; HB2194 – drug overdose teams; HB2338 – AHCCCS preventive dental; and HB2753 – graduate medical education at communtity health centers.

The House Health Committee has a pretty meager agenda & other committees aren’t acting on our priority bills this week.

Here’s our updated Bill Tracker Spreadsheet and Evergreen Session PowerPoint.

AZ Childhood Vaccination Rates Declined During the Ducey Administration: Is it Bad Luck or Bad Policy & Management?

Childhood vaccination rates in Arizona consistently eroded during the Ducey Administration. The conventional wisdom has been that it was because of a general decline in parental enthusiasm for vaccines. However, more and more it’s looking like it’s because of eroding access to vaccines resulting from the actions of ADHS’ Vaccines for Children program. A primer:

State law requires the ADHS to collect data about the vaccination rates for Child Care/Preschool; Kindergarten; and 6th grade. Schools submit the data to the ADHS each fall (deadline is November 15) and in the spring ADHS is required to publish the data by school. ADHS then published that data. See: Childhood Vaccination Rates Continue to Drop In the 2021-2022 School Year

The news isn’t good. Childhood vaccination rates continuously declined during the Ducey administration with the statewide immunization rate for Kindergarteners now at 91%, well below the community immunity threshold for measles of 95%.

The conventional wisdom and talking points from ADHS leadership during the Ducey era were that parental choice was driving lower childhood vaccination rates. But is that true?

No. It’s increasingly looking like the erosion of access to vaccine for lower income kids is a bigger driver of Arizona’s eroding childhood vaccination rates – making it harder for parents to get their kids vaccinated.

Evidence is emerging that vaccination rates among kids who are Medicaid members has been declining while the rates for non-Medicaid member kids has remained stable. Why would vaccination rates be declining among AHCCCS member kids but not the rest?

The decisions and operational behavior of ADHS’ Immunization Office during the Ducey Administration appears to be a big part of why rates are dropping. ADHS’ over-regulation of the Vaccines for Children program has been running doctors’ offices out of the VFC program…  meaning parents of kids who are Medicaid members are having a harder and harder time finding a time and place to get their kids vaccinated, lowering overall vaccination rates.

Here’s a deeper dive into why:

Vaccines for children enrolled in Medicaid come via the U.S. Vaccines for Children Program. States distribute them to physicians’ offices & clinics that take part in the VFC program. The ADHS manages the VFC program in our state.

Doctor’s offices and clinics are required to be enrolled as a VFC provider by ADHS to take part in the Medicaid (AHCCCS) program…  so, the number of providers enrolled in VFC has a direct impact on the adequacy of a state’s care network for kids enrolled in AHCCCS.

Arizona lost 50% of its Vaccines for Children providers during the Ducey administration, going from 1,200 providers to 600…  reducing access to childhood vaccines & harming AHCCCS network capacity

Why the decline? Anecdotally, providers who left VFC over the last few years say they quit because of the administrative hassles imposed on them by the state during the Ducey administration (ADHS not AHCCCS).

At the top of the list of grievances is ADHS’ punitive practice (during Director Christ’s tenure) of financially punishing providers with wastage rates over 5% making participation financially difficult (see this letter to AZAAP members regarding the former ADHS policy).

Arizona now only has 6 VFC providers per 10,000 Medicaid eligible kids, while the national average is 24 providers per 10,000 Medicaid kids… only 25% of the national average.

The Ducey-era ADHS never conducted an analysis to determine why so many providers have stopped participating in VFC during the Ducey administration. Thankfully, the Arizona Partnership for Immunization has been working with the OMNI Institute to figure out why so many have quit so we can right the VFC ship.

We expect the results of this landmark report to be out this summer… ideal timing for the new ADHS to conduct interventions to right the ship like:

1) Reversing Ducey administration VFC policies;

2) Changing ADHS operational procedures;

3) Making leadership changes at ADHS’ Immunization Office; and/or

4) Exploring moving VFC to AHCCCS.



Share Your Talent with Arizona: Consider Serving on a Board or Commission

Perhaps now that we have new leadership in the Governor’s Office you also have a renewed interest in serving on one of the many Boards and Commissions in Arizona? Serving on a board or commission gives you a chance to make a significant contribution to the governance of Arizona by lending your experience, judgment, and ability. Here’s some background about ways you can serve.

Board & Commissions are independent bodies consisting of members who are appointed by Governor Hobbs (there are a few exceptions however). Appointments are created statute enacted in the State Legislature or by an Executive Order.

There Are 220 Active Boards & Commissions in Arizona:
Boards and Commissions List

There are two types of boards and commissions: regulatory and advisory. Regulatory boards oversee the licensing, handle complaints, and enforce disciplinary actions of individuals or industries that fall within the jurisdiction of the board’s authority. For example, a complaint filed by a patient against a physician would be reviewed, investigated, and appropriately acted upon by the Arizona Medical Board.

Advisory boards, develop policy and makes recommendations to public officials on how to address specific issues. For example, the Civil Rights Advisory Board investigates and holds hearings on infringements of Arizona civil rights laws and then advises the civil rights division of the Attorney General’s Office.

Time commitment varies depending on the board. Most boards meet once a month for four to six hours, with some added preparatory work needed. However, there are many boards that meet quarterly or even as little as twice a year. Most Board members serve terms that range from two to seven years for most boards and commissions, while other members serve ‘At the pleasure’ of the Governor.

How to Apply

You can apply online from the Governor Hobbs’ Boards & Commissions WebsiteIn the application you can describe the kinds of boards you’re interested in. A vacancy list is also available on the Governor’s Boards and Commissions Website which is updated monthly with current board positions.

Submit an Application

AzPHA Career Center: An Opportunity to Advance Your Career?

Finding the right talent and candidates seems to be getting harder in today’s competitive job market. Having those open positions in your organization is costing time, energy, and productivity. Posting your open jobs with the AZPHA Career Center is the best solution to get your positions in front of a niche audience, allowing you to create a pipeline of talented and serious candidates.

Posting on the AZPHA Career Center provides exposure to reach over 27,000 members and job seekers. There’s also a national clearing house for public health jobs at  

Deepen Your Public Health Commitment: Become a Civic Health Fellow!

Vot-ER is a nonpartisan, nonprofit organization working to integrate civic engagement into healthcare. 

Vot-ER is accepting applications for its next cohort of Civic Health Fellows. During the seven-month program, fellows train with experts in civic engagement, health equity, and community organizing (including a Nobel-nominated activist!) and work in teams on a voter access project in their community.

The priority application deadline is March 15th and the final deadline is April 1. Financial aid is available. Apply at

AZPHA Breakfast & Learn – Gun Violence in Arizona: Data to Inform Prevention Policies

Friday, March 24, 2023 from 9-10am

Gun Violence in Arizona:
  Data to Inform Prevention Policies
Our Speaker:

Allan N. Williams, MPH, PhD Adjunct Assistant Professor, University of Minnesota School of Public Health Retired, Chronic Disease & Environmental Epidemiology, MN Dept. of Health


At a 2022 strategic planning retreat the AZPHA Board of Directors committed to putting resources toward improving community health by advocating for evidence-based policies to stem the tide of increasing firearm injuries in Arizona.

The first step in that process was to develop comprehensive firearm injury epidemiology and an evidence-review of effective interventions.

During this hour-long webinar, our speaker and a primary author of our landmark report Gun Violence in Arizona: Data to Inform Prevention Policies will present the major findings from our report which will:

  • Identify and review the relevant literature on gun violence;
  • Identify and utilize available key data sources for gun violence;
  • Define the human and financial toll of gun violence in Arizona;
  • Characterize the different forms of gun violence including suicide, homicide, police shootings, and unintentional shootings;
  • Characterize the demographics of gun violence by age, gender, race/ethnicity, and urbanicity;
  • Compare gun violence rates in Arizona to rates in other states and the U.S.;
  • Identify gun laws and policies that have been shown to reduce gun violence; and
  • Show where Arizona stands with respect to key gun laws.

Register Here

View the Webinar PPT Slides

Where: Zoom (registrants will receive the link) 

When: Friday, March 24, 2023   9-10 am AZ Time

Cost: Free for AzPHA Members!

Legislative Update: March 12, 2023

The action in the legislature last week was dominated by floor votes (3rd Read) in the House and Senate. A handful of the bills that we’re in favor of advanced to the other chamber. You can view this updated PowerPoint with the 30 or so bills on our short list and our Excel file bill tracker managed by our interns.

The public health highlight last week was House approval of HB2338 which would provide preventive dental services to adult Medicaid members. Prior to the 2009 recession, Medicaid members (including adults 21 and over) had a dental benefit. All dental services for folks 21 and over were eliminated that year.

Over the last few years we’ve made incremental gains, first by restoring an emergency dental benefit for persons with disabilities and later an emergency benefit capped at $1K/year for all adult members. 

HB2338 still needs to be successful in the Senate and then get baked into the budget for this important public health gain to be realized. JLBC estimates the benefit would increase AHCCCS General Fund formula costs by $3.5M and that the Hospital Assessment match fund would need to go up $3.8M.

Sadly, a floor amendment by Rep. Gress (Ducey’s former budget director) specifies that the Hospital Assessment Fund can’t be used for preventive dental care services, reducing the chances this will end up in the final budget.

Committee Work this Week

Committees are meeting this week including House & Senate Health, but their agendas are pretty thin. See the Senate Health & House Health agendas.

The only bill I’m signed up to speak on this week is HB1710 in House Health (the bill that would extract the Arizona State Hospital from ADHS): Good Bill Moving the AZ State Hospital Out of ADHS to an Independent Governing Board Up in House Health Committee Monday

Legislative Update: Early March

State Legislature Committees didn’t meet again last week as both chambers focused on floor action. Floor action in the House ground to a halt last Tuesday afternoon when the House Republican caucus decided that no bills sponsored by Democrats will be brought to the floor unless a majority of Republicans express support for the bill, essentially requiring a super-majority for any bill sponsored by a Democrat.

In response, the House Democratic caucus began voting NO on every bill brought to the floor, which would stop any bill not supported by every single Republican (and with no absences). The House continued with Committees of the Whole, but it is still unclear how many bills may move to a full floor vote if the Democratic caucus continues to withhold their support for all bills until the process changes.

The Senate cleared quite a few bills this week and sent them over to the House to begin the process all over again before the next deadline of March 24 when bills must be heard in committee in their opposite chamber.

Here our 2023 Legislative Session Working Powerpoint. I’ll update this ppt each week to keep it accurate – a particularly challenging task when the Strike All Amendment gets in full swing. You can also follow public health related bills on this  Excel File tracker.

Valleywise Health Begins Countdown to Opening of New Medical Center

After officially breaking ground on the brand new 673,000 square-foot, 10-story Valleywise Health Medical Center three years ago the public teaching health system is proud to announce the countdown to the grand opening in October. Valleywise Health is a top-level Organizational Member of AZPHA.

The new medical center will replace the more than 50-year-old facility Valleywise Health is currently running in at 24th Street and Roosevelt.  The new building is 75% complete and on budget. The exteriors and infrastructure (power, water, HVAC, medical gasses, etc.) are nearly complete and final trim for the mechanical, plumbing and electrical work is ongoing.  

Over the course of the last three years, Valleywise Health has also constructed and opened five new community health centers in South Phoenix/Laveen, North Phoenix, Peoria, West Maryvale and Mesa. Each center provides access to primary and pediatric care, integrated behavioral health services and on-site pharmacy to for patients in need.