Will Humble Vaccination, Wills Blog

FDA Recommends Dropping B Strain from 2024/2025 Influenza Vaccine – Moving to a Trivalent Shot

FDA’s Vaccines and Related Biological Products Advisory Committee met this month to make their recommendation for a formula for this year’s influenza vaccine.

The FDA is recommending influenza vaccine manufacturers drop the B/Yamagata lineage and just go with a trivalent vaccine this year (down from a quadrivalent vaccine that has been in place for many years).

The decision was rooted mostly in surveillance data and antigenic characteristics of recent influenza isolates. The committee recommended that the trivalent formulation of egg-based influenza vaccines for the U.S. 2024-2025 influenza season have the following:

  • an A/Victoria/4897/2022 (H1N1)pdm09-like virus;
  • an A/Thailand/8/2022 (H3N2)-like virus; and
  • a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.

Manufacturers will now begin making the vaccines for the 2024/25 season. The egg-based vaccines will get started first because of the long lead time needed for that process.

Selecting Viruses for the Seasonal Influenza Vaccine | CDC

The final step will be the CDC recommendations. The Advisory Committee for Immunization Practices will be meeting on June 26-28 to make their final recommendations, which will almost vaccine recommendations based on demographics like age, pregnancy etc.

Will Humble Early Childhood, Vaccination, Wills Blog

ADHS Making Major Policy Changes to the Vaccines for Children Program

Goal Is to Stop & Reverse Vaccination Network Atrophy

ADHS will be making changes to many of their Vaccines for Children policies! The policy changes are in response to provider, stakeholder, parent & AZPHA advocacy urging the department to change their Vaccines for Children policies, decisions, and leadership.

Arizona lost 50% of our VFC providers during the Ducey era – going from 1,200 to 600 participating providers, reducing access to vaccine, lowering childhood vaccination rates, & harming overall AHCCCS network capacity.

Arizona now only has 6 VFC providers per 10,000 Medicaid eligible kids. The national average is 24 providers per 10,000 Medicaid kids… meaning Arizona has just 25% of the number of VFC providers per Medicaid enrolled kid compared with the national average.

Are We Finally Turning the Corner on Arizona’s Decaying Childhood Vaccination Network?

A workgroup organized by ADHS has met a few times this year to identify critical control points that have been running providers off and to recommended strategies to improve participation in VFC.

New CDC Report: Arizona Has Among the Lowest Childhood Immunization Rates in the U.S.

By all accounts, the new leadership in the vaccine program and preparedness service line have been receptive to the committee’s recommendations. ADHS has scheduled a webinar on Tuesday, April 9th at 9:00 a.m. to announce & discuss the upcoming changes and “… share insights, outcomes, and additional collaborative efforts for the future”.

Zoom Meeting on Tuesday, 4/9/24 at 9 am

Meeting ID: 834 5545 582 Passcode: 576904

Note: ADHS will soon be accepting applications for a new leader for the Immunizations Bureau and a new Assistant Director for the Public Health Preparedness service line (immunizations reports through public health preparedness).

Those positions are not yet posted, but y’all should put on your thinking caps and encourage strong candidates to apply when the posts open.

Will Humble Public Health, Wills Blog

Public Health Journalism this Week

From veto to law: Hobbs signs the ‘tamale bill’ to loosen rules for food vendors • Arizona Mirror

Two GOP bills putting restrictions on SNAP are headed to Hobbs’ desk  Arizona Mirror

Indigenous advocates host townhall for victims, families of sober living crisis (azmirror.com)

Why is it so difficult to teach sex-ed in Arizona? (azmirror.com)

Hobbs signs bills to ‘free the tamales,’ make Pluto the state planet (azcentral.com)

Sen. Theresa Hatathlie’s sober living bill blocked by fellow Democrats (azcentral.com)

Arizona Attorney General seeks immediate takeover of assisted living facility – Arizona PBS (azpbs.org)

A new cause of Valley Fever – Arizona PBS (azpbs.org)

2023 breaks record for heat-related deaths in Maricopa County – Arizona PBS (azpbs.org)

Will Humble Firearm Safety, Injury Prevention, Wills Blog

A Firearm Safety Call to Policy Action: Guest Blog by AZPHA Member Mike Humphrey

Pima County continues to suffer from firearm-related violence.  Data provided by the Pima County Health Department showed that in 2023 there were 213 firearm related deaths. Latest figures (2021) from the Pima County Health Department showed that the local firearm death rate was 22.7 per 100,000, which is significantly higher than the national average of 14.6 deaths per 100,000 (Pew Research Center).

During 2022 (the latest full year reported), there were 533 hospital and emergency visits costing $33M. Seventy percent of these costs were covered by public funds. During the first half of 2023, over $23 million dollars was spent on treating firearm related injuries in our community. 

Nationally, the U.S. Sentencing Commission estimates that 88.8% of firearm offenders sentenced were prohibited from having a firearm in the first place. 

Information provided by the Pima County Attorney’s Office shows that between 1/5 to 1/3 of firearm crimes are committed by prohibited possessors. Given the current situation, what can be done to curtail the easy accessibility of firearms for prohibited possessors – persons who cannot legally own firearms as defined by ARS 13-3101.

There are several possible ways within current state statutes to limit the ability of prohibited possessors to obtain and retain firearms. Local judges, prosecutors and law enforcement agencies working in collaboration with state and federal authorities can: 

One, limit the ability of persons to sell or transfer firearms to a prohibited possessor. Local law enforcement agencies should enforce the provisions of ARS 13-3102 (Misconduct Involving Weapons) which makes it illegal for a persons to sell or transfer a firearm to a prohibited possessor. Enforcement of the statute should be in coordination with ATF&E (Bureau of Alcohol, Tobacco, Firearms and Explosives).

Using the existing firearm retailer ATF&E notification system, whereby retailers alert ATF of potential straw purchasers, ATF&E could share this notification with local law enforcement agencies to encourage enforcement of the state statute, in coordination with federal straw purchase enforcement efforts.

Enhanced enforcement should be combined with public education.  This education should take two forms: one, informing the public that selling or transferring firearms to a prohibited possessor is a crime and they will face arrest and prosecution; and two, working with FFL dealers on how to better find and deter persons trying to buy firearms for prohibited possessors. 

Two, ensure that adjudicated prohibited possessors as defined by ARS 13-3101(Prohibited Possessors)k, surrender their firearms to local law enforcement in compliance with ARS 13-3105 (Seizure of Weapons). Develop,  implement and monitor uniform procedures to ensure that court-ordered firearm surrender requirements are met. Rand Research pointed out the need for more enforcement of firearm surrender, stating in part:

“Although firearm surrender laws exist in several states, there is evidence that they may not be implemented well…Even when firearms are ordered to be surrendered, there is often no clear procedure for enforcing such orders”.

Three, ensure that prohibited possessors surrender their concealed carry permits (CCW) in compliance with ARS 13-3112 (Concealed weapons). Develop, implement, and check uniform procedures to ensure the  surrender of CCW’s, including notifying the Department of Public Safety to remove the person’s name from the State’s CCW registry. This step is needed to prevent prohibited possessors from walking into a gun shop and buying a firearm without a background check.

Four, ensure that minors convicted of  firearm-related crimes be identified as prohibited possessors per the provisions of ARS 13-3111 (Minors Prohibited from Possessing Firearms) and required them to surrender their firearms in accordance with ARS -13-3105. This is crucial, as we have seen the heart-breaking carnage inflicted by even very young persons with firearms. 

While these actions in and of themselves will not end illegal access to firearms by prohibited possessors, they are worth the effort in making the acquisition and retention of firearms more difficult and by so doing, reduce firearm-related deaths and injuries in our community. 

Let’s all work together to make this happen. Thank you. 

Will Humble Professional Development, Wills Blog

Arizona’s Public Health Training Center: An Introduction

In 2022 the Western Region Public Health Training Center was awarded $4.1 million by the Health Resources and Services Administration to help support a skilled and knowledgeable public health workforce through 2026.

Over those years, they’ll continue to provide interactive training programs that impart critical skills for providing quality services that meet community needs and address emerging threats at the local, state and national levels.

The Western Region Public Health Training Center is one of 10 Regional Public Health Training Centers funded by the Health Resources & Services Administration to support the public health workforce.

They’re a consortium of public health professionals that develop and provide innovative, skill-based training to address gaps identified by training needs assessments for the public health workforce. They:

  • Develop and implement of skill-based public health trainings (online, in-person, webinars)
  • Offer free continuing professional education courses.
  • Are an accredited provider of CPEUs that is available to all Registered Dietitians/Nutrition and Registered Dietetic Technicians.
  • Are an accredited provider of continuing education contact hours (CECH) that are available to all Certified Health Education Specialists (CHES).
  • Provide stipends to support undergraduate juniors, seniors, and graduate students conducting community-based health projects.
  • Customize & implement online public health core competency and training needs assessments for public health organizations.

Home | Western Region Public Health Training Center

Will Humble Professional Development, Wills Blog

Maricopa County Department of Public Health Fellowship Recruitment Beginning Soon

Maricopa County Department of Public Health Fellowship program will begin recruiting their second cohort soon! This two-year program will connect recent graduates of advanced degrees with practical, hands-on learning experience. Fellows will:

  • Get full pay and benefits
  • Work with internal projects to execute initiatives aimed at current public health issues in our communities
  • Get continuous support and mentorship from Fellowship Coordinator and Project Point of Contact
  • Be a part of a Fellowship cohort
  • Transition to Senior status when a new cohort of Fellows join the program

Positions are expected to post in mid-April at Internships and Volunteer Opportunities | Maricopa County, AZ.

Will Humble Behavioral Health, Wills Blog

Common-Sense Governance Reform for Our Arizona State Hospital Will Have to Wait Yet Another Year

A key government accountability bill (SB1688) that would have fixed the governance flaw at our Arizona State Hospital failed again this year.

You’re probably tired of reading pieces by me about why this bill was so important so I’ll spare you the details of why ADHS shouldn’t be both running and ‘regulating’ our state hospital.

In the end, opposition from the governor’s office led Senate Democrats to vote against the bill – ending its chances again. It was approved for reconsideration after its failure on the floor the first time but was never put back on the board.

We won’t (or at least I won’t) give up. I’ll be back year after year after year until we fix this.

Senate Fails Key Arizona State Hospital Governance Reform Bill: State Hospital will Continue to be Run & ‘Regulated’ by ADHS

Will Humble Assurance & Licensure, State Legislature, Wills Blog

Key Assisted Living & Skilled Nursing Accountability Bill Advances (HB2764): Companion Bill Abandoned

Regulating facilities where Arizonans receive services is a key, one might say cornerstone, function of a state health department. When a state health department is doing a good job regulating facilities like nursing homes, assisted living centers, behavioral health facilities, outpatient treatment clinics and the like, journalists’ stories are generally about how a facility did poorly on an inspection and highlight agency enforcement actions.

It’s an altogether different story when an agency deprioritizes their assurance and licensure mission. When that happens, journalists end up writing about poor regulation and unchecked substandard care.

That’s precisely what happened toward the end of the prior administration when ADHS licensing programs continued to atrophy until the Arizona Auditor General exposed gross nonfeasance on the part of the agency.

See ‘The Bitter End’ Series by Caitlin McGlade & Sahana Jayaraman: How The Arizona Republic reported on resident harm in senior living facilities & Licensing & Regulating Care Facilities: A Root Cause Analysis of Arizona’s Failure to Protect Vulnerable Persons & Pathway to Redemption

Legislators are rightfully frustrated by what they’re hearing from constituents and reading in the newspaper and are proposing several bills that would help the ADHS do a better job regulating institutions over the long run.

One focused on regulatory reform continued its advance this week (HB2764) while a sister bill that focused on internal accountability (e.g. incident reporting and allowing for limited elective electronic monitoring) died (HB2653).

HB2764 long-term care; enforcement; passed out of Senate Health this week with a unanimous pass recommendation. If it passes the Senate floor and is signed by the Governor, it would:

  • Require in person agency inspections of health care institutions that aren’t in substantial compliance with licensure requirements.
  • Stop ADHS from accepting an accreditation report in lieu of a compliance inspection for assisted living and skilled nursing care facilities (unless the institution is owned by a hospital). Deficiency free facilities would enjoy a two-year reprieve from ADHS compliance surveys.
  • Increase the cap on civil penalties for violation of health care institution statutes or rules from $500 to $1,000 per resident/patient.
  • Void a health care institution license if they don’t pay civil penalties or provider agreement fees before the due date.
  • Let ADHS to pursue enforcement action against a licensee, even if they’re in the process of being sold or has closed.
  • Let ADHS deny a new license application current licensee while enforcement action is pending if patient safety may be in jeopardy due to the licensee’s actions or if the change in ownership would jeopardize patient safety (i.e. prevents ‘license flipping’ to avoid accountability).

ADHS and AHCCCS signed up in favor of the bill – signaling that if it’s unchanged and passes the full Senate the Governor may sign the package.

Major Arizona assisted living reform proposal blocked despite widespread stakeholder support

Meanwhile, the long-term care industry killed HB2653 long-term care; reporting; monitoring; injury this week by denying it a hearing in the Senate Health committee before last week’s deadline.

That bill would have allowed for limited and optional electronic monitoring of some areas of a facility (with resident and roommate consent) and required more reporting of abuse, neglect, or exploitation of vulnerable adults in facilities.

Will Humble Climate Change, Injury Prevention, Wills Blog

New Maricopa County Public Health Reports: 2023 Heat Death Surveillance & Evaluating Cooling Center Effectiveness

Maricopa County Department of Public Health published 2 reports last week regarding last summer’s tragic heat deaths.

Their preliminary report of heat-related deaths in 2023 found a record- breaking 645 heat-associated deaths last summer. That total breaks the previous year’s total by over 50%. The persons most affected are folks experiencing homelessness.

Their evaluation of the effectiveness of a cooling centers investigated what brought people to cooling centers and the barriers that kept people from using them. Among those findings:

  • Most visitors to cooling centers had been to one previously and spent at least an hour during each visit for heat relief
  • Word of mouth and street signs were suggested as the top two ways to inform people of where cooling centers are located
  • The biggest barriers to using cooling centers are:
    • Not knowing they exist
    • Lack of transportation to cooling centers
    • Not knowing where cooling centers are located

Based on this information, MCDPH is working to address these needs with cities and community partners like:

  • Supporting a bilingual heat relief call center to answer calls and connect people to resources and transportation to and from cooling centers
  • Partnering with City of Phoenix to create signs for all Maricopa County heat relief locations to make them visible from the street
  • Working with cities and community organizations that have experience running cooling centers to expand hours and days of operation, ensuring water and snacks will be available
  • Ordering heat relief items like reusable water bottles, cooling towels, and hats to distribute at smaller community cooling centers, which may not be able to afford those supplies on their own

For a timeline of the Heat Relief Network’s 2024 activities and more details on donations, visit https://azmag.gov/Programs/Heat-Relief-Network.

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