Maricopa Transportation Tax Makes it to the November 2024 Ballot After All

Good news. Cooler heads finally prevailed, and the legislature passed a measure last week that will allow Prop 400 on to the ballot in Maricopa County in the fall of 2024. Maricopa County is the only county that needs legislative approval to get their transport tax on to the ballot. It’d kind of a weird story. If you’re interested read this piece: Why Maricopa County’s Prop. 400 transit tax needs OK from Legislature

The measure is a compromise between various factions in the legislature – mainly the Dems and a few of the more centrist Republicans.

The measure will basically ask voters in Maricopa County to continue Proposition 400, a half-cent transportation tax that funds roads and public transportation. (See Senate Bill 1102). The tax funds street and highway projects, along with public transportation.

The money distribution ($24B over 20 years) is as follows: 40.5% allocated to freeways and highways, 37% to public transit and 22.5% to roads and intersections. It includes specific language saying that pot of money can’t be used to build new light rail lines.  It also makes sure there won’t be a new light rail station or line around the Capitol.

All Schools are Required to Administer School Attendance Vaccine Requirements & Report Results: Will the New Pop-up ESA Micro-schools Comply?

State law requires all schools to check the vaccination status of their students and ensure they meet statutory requirements for attendance (e.g. are immunized with the required vaccines or has a proper exemption). Schools are also required to submit that data to the ADHS each fall (deadline is November 15). Data submission is required for Child Care/Preschool; Kindergarten; and 6th grade. ADHS is required to publish the data by school. That report comes out each Spring.

ADHS posts some aggregate tables but also a big giant spreadsheet with the vaccination rate by school. A clever parent that knows how to sort in Excel could quickly find the vaccination rate for their kid’s school. Here’s the big file with all the school data. You can look up individual school immunization rates here: ADHS – Arizona Immunization Program – State & National Immunization Coverage Data – Immunization Coverage Data

The statute requiring immunization administration and reporting makes it clear that private schools must comply See: ARS 36-671: “School” means a public, private or parochial school that offers instruction at any level or grade through twelfth grade…”

The cornucopia of new voucher micro-schools popping got me wondering… will the Arizona Department of Education & ADHS be following up to make sure the new unregulated micro schools are actually asking parents for immunization records (or an exemption form) as a condition of attendance this fall? Will they be reporting the results?

Private schools springing up as Arizona’s school voucher program grows

Established private schools have had some years to get up to speed, but the new micro and religious schools popping up overnight (and enjoying little accountability) are brand new.

Inquiring minds want to know what kind of outreach is happening to ensure compliance. Perhaps an Arizona journalist will follow up with Superintendent Horne & ADHS Director Cunico to find out!

See the Statutes:

ARS 15-871 Definition

ARS 15-872 Proof of Immunization; Noncompliance; Notice to Parents; Civil Immunity

ARS 15-873 Exemptions; Nonattendance During Outbreak

ARS 15-874 Records, Reporting Requirements

ARS 36-671 Definitions

ARS 36-672 Immunizations; department rules

ARS 36-673 Duties of local health departments; immunization; reimbursement; training; informed consent

ARS 36-674 Providing proof of immunization

Arizona Administrative Code Requirements 9-R9-6-700 through 708

school-immunization-requirements fact sheet

Hobbs Nominates Jennifer Cunico as ADHS Director

In a Tweet yesterday afternoon Governor Hobbs mentioned she’s naming Jennifer (Jennie) Cunico to be the director of the Arizona Department of Health Services. In January Governor Hobbs had asked Cunico to be the acting director pending Dr. Theresa Cullen’s start date. Sadly, that nomination was sabotaged by the Chair of the Senate’s Committee on Director Nominations (Hoffman), and Cunico has continued to be in the acting director post until yesterday.

Jennie Cunico becomes Gov. Katie Hobbs’ pick at AZ Health Department

Professional Background

Ms. Cunico has worked at ADHS since 2014. For the first 5 years (2014–2019) she was an assistant bureau chief for emergency preparedness. For the second half of 2019 she was the deputy head of ADHS’ human resources department.

She was the chief professional development & community engagement officer for the next 3 years. That position didn’t exist when I was director & I don’t see it on the ADHS Org Chart, so I’m not sure what that job entails. In May 2022 former Interim Director Don Herrington promoted her to be the deputy director for operations – responsible for procurement, accounting, personnel and I.T.

Education

Ms. Cunico has a Bachelor of Science degree in Psychology from ASU (1990) and a Masters in Marriage & Family Therapy from the University of Phoenix (2004).

The Road Ahead

Ms. Cunico was in an acting position from January through yesterday. Her name wasn’t submitted to the Senate as the nominee during the 2023 legislative session. With this new decision, the Governor is supposed to turn in Ms. Cunico’s nomination to the Senate for confirmation in the first 2 weeks of the 2024 legislative session (ARS 38-211C).

At that point, the ARS 38-211E ‘one year clock’ will begin. If the Senate takes no action during the 2024 legislative session, Ms. Cunico could continue to be the official director until January 15, 2025 – two years after having taken up the director post (despite the 1-year limitation in ARS 38-211E).

Legislative Session Finally Ends: Senate Fails to Vet & Confirm Agency Nominees

Senate committee doesn’t ‘vet’ nominees. It sabotages them

Hobbs’ nominee for health director rejected in partisan Senate fight

 

Note: Here are the statutory qualifications for the ADHS director position:

ARS 36-102 Department of Health Services; Director; Qualifications

The director shall be appointed by the governor pursuant to section 38-211 and shall serve at the pleasure of the governor. The director shall be a person who has:

  1. Administrative experience in the private sector, with progressively increasing responsibilities.
  2. An educational background that prepares the director for the administrative responsibilities assigned to the position.
  3. Health related experience which insures familiarity with the peculiarities of health problems.

Legislative Session Finally Ends: Senate Fails to Vet & Confirm Agency Nominees

Hobbs Has Several Possible Work-Arounds

Arizona’s longest ever legislative session ended last week. Despite being in session for a record 7 months, the Senate completely failed in their responsibility to consider, vet, and confirm (or not) Governor Hobbs’ nominees to lead state agencies and other boards and commissions. That dereliction of duty creates very real governance and operational efficiency problems for agencies that have critical responsibilities.

It’s not just the nominees that are left in limbo…  It’s also the rank-and-file staff who suffer because they are unclear about who will be in charge of their agency, what priorities they have, and direction regarding key decision-making and regulatory actions. Recruitment and retention of staff is difficult as it is- and the failure of the Senate leadership to do their job makes matters worse.

Look no further than the scathing Auditor General reports about the nonperformance and misconduct regulating nursing homes during the Ducey Administration to see the very real impacts on everyday Arizonans poor agency leadership can have: Auditor General’s Office Produces Scathing Review of ADHS’ Nursing Home Complaint Investigations During the Director Christ Era

Governor Hobbs has nominated dozens of persons to lead agencies who require Senate confirmation, yet the Senate has only confirmed 6 (Confirmed are: Glover; Ben Henry, Department of Liquor Licenses and Control; Susan Nicolson, Department of Real Estate; Ryan Thornell, Department of Corrections; Thomas Torres, Department of Forestry and Fire Management; and Jennifer Toth, Department of Transportation).

Senate Committee Doesn’t ‘Vet’ Nominees. It Sabotages Them

A big part of the inaction in the Senate is tied to a new committee that was assembled this year called the Committee on Director Nominations (DINO) chaired by Sen. Jake Hoffman. Previously, committees organized by topic area considered nominees (for example, a Senate Health and Human Services Committee would vet the governor’s pick to lead AHCCCS, ADES, and ADHS).

According to reporting done by Stacy Barchenger at the Arizona Republic, Senate President Petersen has promised that: “We’re going to continue nominations, the committee will continue meeting soon. That’ll occur shortly.” He also said there was a possibility of a special session to confirm nominees and said some could be confirmed next year when the Legislature returns to work. AZ Senate confirms DPS director on final day, leaves other nominees in limbo

The DINO Committee chair (Hoffman) has publicly stated that “The Committee on Director Nominations has postponed all further nominations pending this meeting.” Referring to a demand that Hobbs meet with Hoffman et.al. about grievances he (they) have about executive orders Hobbs has made.

Let’s assume the Senate Republican leadership doesn’t change their mind and continue to fail to do their job (e.g. don’t have a special session). What can be done to help out state government and staff? Anything?

Fortunately, the statutes about senate confirmation requirements are sufficiently vague and provide loopholes that could give Team Hobbs some stability and governance options in the absence of Senate feasance. See: 38-211 – Nominations by governor; consent of senate; appointment

You’ve probably heard that agency directors can serve up to one year without being confirmed by the Senate. While that’s true – the reality is that the law ARS 38-211 is more permissive than that. While the Legislature is in session, the ‘one year clock’ doesn’t start until the Governor actually sends the nominee’s name to the Senate. If the Governor doesn’t send the nominee’s name in, then the clock never starts.

If the term of any state office that is appointive pursuant to this section expires, begins or becomes vacant during a regular legislative session, the governor shall during such session nominate a person who meets the requirements of law for such office and shall promptly transmit the nomination to the president of the senate. If the senate rejects the nomination the nominee shall not be appointed, and the governor shall promptly nominate another person who meets the requirements for such office. If the senate takes no formal action on the nomination during such legislative session… the governor shall after the close of such legislative session appoint the nominee to serve, and the nominee shall discharge the duties of office, subject to confirmation during the next legislative session.

For example, Governor Ducey named Don Herrington as the acting ADHS director in the Summer of 2021. Ducey never formally nominated Don nor sent his name to the Senate… meaning the ‘one year time clock’ never started for him & he ended up in the job for more than 18 months despite the time limit in 38-211E:In no event shall a nominee serve longer than one year after nomination without senate consent.’

Why? Because he was never really the nominee according to the statute.

Note: Jennifer Cunico has been the acting ADHS director since January 2, 2023, but hasn’t been formally nominated. As such, her ‘one year’ timeclock has not yet begun.

The Governor has several work-around options I can think of, and there may be more:

Option 1: Replicate the ‘Herrington/Cunico’ Model

Hobbs could also just keep replicating the Herrington/Cunico model. Simply keep naming ‘Acting’ agency directors. Appear to be recruiting a permanent nominee without really doing it. Never formally nominate the person but tell them and their staff and stakeholders that the acting status is permanent. Not an ideal arrangement, but it supplies more stability than the status quo.

Option 2: Recess Appointments

Now that the legislative session is officially over, a different part of the confirmation statute applies:

If the term of any state office that is appointive pursuant to this section… becomes vacant during a time in which the legislature is not in regular session, the governor shall nominate a person who meets the requirements of law for such office and shall transmit the nomination to the president of the senate during the first week of the next regular session. The nominee shall assume and discharge the duties of the office until rejection of the nomination or inaction of the senate.

Now that session is over, when Hobbs nominates folks for posts who require confirmation, the person’s one year time clock won’t start until at least early January – and even then, not until Hobbs actually formally sends the person’s name to the Senate. This could be paired with the Herrington/Cunico model. Simply keep the recess appointment directors “acting’ on paper indefinitely.

Option 3: The Wizard of Oz

Even persons who Hobbs has formally nominated for agency director posts but for whom the Senate took no action (e.g., Carmen Heredia at AHCCCS, Karen Peters at ADEQ etc.) have easy options for staying in their director position indefinitely even without confirmation (their one-year time clock started in February/March 2023)

For example, prior to the one-year time clock running out on an agency nominee (in March 2024) Hobbs could move the nominated director to a Deputy position that doesn’t require confirmation. Hobbs could then name a new ‘Acting Director’ (possibly even the former deputy). The Governor’s Office could make it clear to agency staff and stakeholders that the Deputy is the ‘real’ director, providing governance certainty for stakeholders and staff. The (fake) Acting Director could stay on indefinitely as long as Hobbs doesn’t formally nominate the person to the job. The Governor could even rotate the directors on paper – with the acting director and deputy trading positions after a year. Again, staff and stakeholders could be told exactly who the real decision-maker is Not ideal: but again… better than the status quo that Hoffman has delivered.

Editorial Note: As I noted above, a root cause of the confirmation problem is that Senator Jake Hoffman is thwarting the Senate’s confirmation responsibilities…. but DINO committee nonfeasance may take care of itself before the next legislative session.

Mr. Hoffman is one of 11 ‘fake electors’ who submitted (forged) false slates of electors to the national archives, avowing that he was among Arizona’s “duly elected and qualified electors” (part of the effort to illegally overturn the 2020 election). On Jan. 5, 2021, Hoffman even sent a letter to Vice President Mike Pence asking him not to accept the state’s official electoral votes. The letter was sent on official state letterhead and had a return address of the state Capitol. See: Arizona’s 11 Republican fake electors face state, federal scrutiny

Arizona Attorney General Kris Mayes has launched an investigation into Arizona’s fake electors (including Hoffman), similar to a probe in Michigan which has resulted in state criminal felony indictments. It is entirely possible that serious state criminal charges could be filed against Hoffman prior to the next legislative session, increasing the likelihood that Republican Senate leadership could remove his committee assignments (including as DINO Chair) pending trial, or possibly even expelling him, solving the DINO committee’s nonfeasance.

Arizona State Hospital Needs Independent Oversight, Isn’t Getting It

Arizona State Hospital needs independent oversight, isn’t getting it

Arizona State Hospital fails patients, and oversight efforts are going nowhere

Opinion: The Arizona State Hospital cares for some of the state’s most vulnerable people. Yet a lack of independent oversight is putting their lives at stake.

Senators Catherine Miranda and T.J. Shope

The two-year effort to improve care at the Arizona State Hospital went up in a puff of smoke again this year at the state Legislature.

That’s a bad thing for patients, their families and every Arizonan.

The Arizona State Hospital is located on a 93-acre, 260-bed campus in Phoenix providing inpatient psychiatric care to people with mental illnesses who are under court order for treatment. 

Treatment at the hospital is considered “the highest and most restrictive” level of care in the state.

Patients are admitted because of an inability to be treated in a community facility.

The needs of patients at the state hospital can be complex and the patients are vulnerable, so it’s critical to make sure the hospital uses best practice treatment and follows a rigorous set of regulations.

A prerequisite to ensuring quality care is having a governance structure that’s accountable and free from conflicts of interest.

Sadly, that’s not what we have.

The Arizona State Hospital is part of the Arizona Department of Health Services — the same agency that’s responsible for regulating the Arizona State Hospital.

That’s a classic example of the fox watching the henhouse.

After suicide, it found ‘no deficiencies’

There is evidence that the lack of independent regulation has resulted in unchecked substandard care.

For example, in 2019, the state health department investigated a homicide at facility under its jurisdiction and concluded it wasn’t doing anything wrong and didn’t need to fix anything — indicating that there were “no deficiencies.” 

And in 2021, a patient was provided scissors and let into a bathroom, where he died by suicide.

The department downplayed its role, as a spokesperson told ABC 15, “There appears to be an inaccurate assumption that every event should automatically result in a citation or a noted deficiency for a health care institution.”

These are not isolated incidents, and as former state health director Will Humble has pointed out, suicides and homicides are almost always the result of a deficient practice, such as a poor treatment plan or medical psych assessment.

State health department won’t regulate itself

We’ve learned a lesson the hard way that we can’t count on the state health department to regulate itself.

We need better institutional controls free from conflicts of interest.

For the last couple legislative sessions, Sen. David Gowan has proposed a commonsense solution to the governance problem that’s been plaguing care: Simply separate running and regulating the Arizona State Hospital.

‘Scary place’: Arizona State Hospital has safety concerns, critics say

Senator Gowan’s bill would have set up a five-member State Hospital Governing Board and transferred operational responsibilities to the board.

Members of the governing board would be appointed by the governor. The Arizona State Hospital superintendent would report to the governing board rather than the state health director.

The Arizona Department of Health would then regulate the facility, just like it does every other hospital, but without a conflict of interest.

It’s time to fix this systemic flaw

There was bipartisan support for this important change — with the bill passing 27-2 in the state Senate, only to be undermined in the House at the 11th hour because the governor’s office had concerns about the “civil rights implications” of the bill.

For the life of us we don’t understand why there would be resistance to this commonsense change.

It’s time to fix this systemic flaw.

We call on Gov. Katie Hobbs to call together lawmakers of both parties and come up with a plan she can support to fix this major conflict of interest that has been jeopardizing patient care.

Fixing the governance structure may not guarantee that the state hospital will be well regulated, but it improves the chances that it will be.

The most vulnerable people in the state are counting on our elected and appointed officials to have their back.

So are their families. So does the public.

Let’s stop disappointing them, shall we?

Sen. Catherine Miranda is a Democrat representing Arizona Legislative District 11 (downtown Phoenix, Laveen, South Mountain, Guadalupe). Sen. T.J. Shope is a Republican representing Arizona Legislative District 8 in Pinal County and is chair of the Senate Health and Human Services Committee. On Twitter: @CatherineSenate and @TJShope

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