2024 AzPHA Public Health Awards Event – Register Today!

Each year AzPHA recognizes public health professionals,  health professionals and community members across Arizona who are performing extraordinary services to our community at our annual awards event. Many of our awards go back decadesWe’re proud to announce that our 2024 award program will be held:

Thursday, October 24, 2024

5:30 – 8:00pm

Equality Health: 7720 N. Dobson Rd., Suite 200 Scottsdale, AZ 85256

Register Today: Only $40!

Includes complimentary drinks, Taco Bar from Senior Taco, & networking opportunities!

This Year’s Award Winners:

Policymakers of the Year

Senators Catherine Miranda & Consuelo Hernandez

Arizona State Senators

 

Senator Andy Nichols Honor Award

Barbara Burkholder

Arizona Asthma Coalition

 

Pete Wertheim Public Health Leadership Award

Rebecca Sunenshine, MD

Chief Medical Officer,

Maricopa County Department of Public Health

 

Cele Cohen Nursing Award

Deanna Grabill

Manager of Population Health,

Valleywise Health

 

Elsie Eyer Commitment to Underserved People Award

Arizona Special Olympics

 

Harold B. Woodward Award

Gordon Jensen

 

Corporate Public Health Service Award

The Arizona Republic

Investigative Journalism: Mental Health, Senior Care & Criminal Justice

 

Health Education Award

Pima County Health Department

The Health Loteria Program

AZPHA Breakfast & Learn – Arizona’s 2024 Ballot Measures: A Public Health Perspective

AZPHA Breakfast & Learn
Arizona’s 2024 Ballot Measures: A Public Health Perspective
Wednesday, October 16, 2024 –  9-10am

There will be 13 ballot measures on your November ballot. The vast majority of them (11) were placed directly on the ballot by the legislature – largely because the Governor had earlier vetoed the measure or certainly would have. Others are designed to permanently change the state constitution.

AZPHA has taken positions against 5 of the ballor measures and is supporting two of them (both citizen initiatives). 

This session will cover each of the ballot measures with color commentary from Will Humble about the pluses and minuses of each.

Join us for this important voter education webinar: Arizona’s 2024 Ballot Measures: A Public Health Perspective, Wednesday, October 16th from 9-10am.

Our Speaker:

Will Humble, MPH

Executive Director

Arizona Public Health Association

Register Here

View Our PowerPoint

 

COVID-19 Virus Continues to Evolve

The XEC and MV.1 variants are newly identified strains of the COVID-19 virus. While research is ongoing, they are believed to be sublineages of Omicron with increased transmissibility, and possibly some immune evasion. However, there is limited evidence at this point suggesting they lead to more severe disease.

These variants exhibit mutations that may enhance transmissibility and immune evasion, though there’s no current evidence suggesting they cause more severe disease than earlier variants. Both variants are closely monitored for potential increases in infection rates and their ability to bypass immunity from previous infections or vaccinations.

  • XEC: This variant appears to be circulating predominantly in parts of Europe and North America. It has been identified through genomic sequencing, and scientists are tracking its spread to assess any notable shifts in transmission dynamics or vaccine effectiveness.
  • MV.1: The MV.1 variant has been detected in multiple countries but is currently less widespread than XEC. Early reports indicate circulation in Asia and parts of Europe, but global health agencies are keeping a close watch on its spread and potential impacts.

Both variants are being closely monitored to determine if they will become more widespread. The new COVID-19 booster vaccines, targeting Omicron subvariants (particularly XBB.1.5), are expected to offer protection against severe outcomes from XEC and MV.1, though real-world data on their specific effectiveness against these strains is still being collected.

Yiu can track which strains of the virus are circulating in Arizona by visiting TGen”s Pathogen Center at: Arizona COVIDseq Tracker

Legislation to Build EV Infrastructure Leading to a Sustainable Future

Electric vehicle sales are surging across the country, and the Grand Canyon state is leading the charge, ranking among the top 10 states for EV registrations per capita.

As a proud new member of Arizona’s nearly 70,000-strong EV community, I can personally attest to the benefits of making the switch to an electric vehicle. 

My experience with an EV has been nothing short of transformative, especially when it comes to cost savings. During a recent trip to Tucson, when gas prices were a bit higher than they are now, I traveled  217 miles with the air conditioning on full blast, and my EV averaged 3.4 miles per kilowatt-hour (kWh).

Charging at home using Salt River Project’s off-peak rate of $0.09 per kWh, the entire trip cost me a mere $5.70. To put that in perspective, with gas prices hovering around $4 per gallon, my EV effectively delivered the equivalent of 155 miles per gallon – a level of efficiency that’s impossible with traditional gasoline-powered vehicles.

However, while I’m fortunate to have a home charging set up, I know that the lack of widespread, reliable charging infrastructure remains a significant barrier for many Arizonans considering an EV. This is where the Bipartisan Infrastructure Law (BIL) comes into play.

This landmark legislation, coupled with the Inflation Reduction Act, is set to revolutionize our state’s transportation landscape by making EVs more accessible and convenient for everyone. 

One of the key provisions of the Inflation Reduction Act is expanding EV charging infrastructure, particularly in areas that have been underserved. Here in Maricopa County, the Air Quality Department has recently been awarded $15 million to advance the installation of public EV charging stations across the county.

This funding will not only make it easier for current and future EV owners to charge their vehicles but will also contribute to the broader goal of reducing transportation emissions and improving air quality in our communities. 

Importantly, this initiative aligns with the Harris-Biden administration’s  “Justice40 initiative,” which ensures that 40% of the overall benefits of clean energy and climate investments are directed to disadvantaged communities.

By prioritizing the placement of charging stations in Justice40-designated areas, Maricopa County is taking significant strides toward environmental equity, ensuring that the benefits of the green economy are shared by all. 

Additionally, the recent update by the Arizona Department of Transportation to build fast-charging stations along nine new highways across the state further underscores the state’s commitment to a sustainable future.

These investments represent a critical step forward in reducing our dependence on fossil fuels, improving air quality, and making clean energy accessible to all Arizonans. 

The Bipartisan Infrastructure Law and the Inflation Reduction Act are more than just a policy – it’s a vision for a cleaner, healthier, and more equitable future.

By investing in EV infrastructure, we are not only making it easier for Arizonans to make the switch to electric but also paving the way for a future where clean energy is available to everyone, regardless of where they live. 

Kudos to the Maricopa County Air Quality Department and the Arizona Department of Transportation for their leadership, and a shout out to all members of Congress who supported the BIL and the IRA. Together, we are driving Arizona toward a brighter, more sustainable future. 

Legislation to Build EV Infrastructure Leading to a Sustainable Future

Pay Attention Arizona: Your Arizona Corporation Commission Vote Will Impact Public Health & Your Wallet

When you think about public health, you probably don’t immediately think about the Arizona Corporation Commission (ACC). But the reality is that the decisions made by the Commission have a profound impact on public health and your family’s finances.

The Connection Between Utility Rates & Health

Utility costs aren’t just a financial issue—they’re a public health issue. Skyrocketing electricity bills have a direct impact not just on family’s ability to keep their house cool but on their ability to pay all the other household bills important for family health and development.

In recent years, the ACC has been quick to approve almost every rate increase requested by utilities, despite concerns that this puts undue financial stress on families.

These rate hikes make it harder for many Arizonans to afford their energy bills, forcing tough decisions about where to cut costs. For some, it means skipping out on medications or buying cheaper, less healthy food.

It’s essential that ACC candidates prioritize consumer health over industry profits. The Commissioners—and the staff they hire to conduct analysis—should be focused on keeping energy affordable so families can live in healthy, safe environments, not just industry profits.

Air Quality & Health

Decisions made by the ACC also directly affect Arizona’s air quality, which has a big impact on public health. Air pollution, particularly from energy production, is linked to respiratory issues like asthma and other chronic lung diseases.

Recent decisions, like creating loopholes in utility environmental review requirements have allowed utilities to bypass critical environmental checks. This means more pollutants in the air affecting communities near energy production sites.

Clean Energy & Public Health

Another major area where the ACC’s decisions influence public health is via clean energy development. Transitioning to renewable energy sources like solar doesn’t just help fight climate change—it directly affects public health by reducing air pollution.

Sadly, decisions made by the Commission in recent years suggest they’ve been more interested in protecting the interests of traditional utility companies than pushing for clean energy innovation. Instead, recent ACC decisions have been far too willing to approve fossil fuel-based projects that contribute to pollution.

Industry Influence Over the ACC

One of my biggest concerns in recent years is that the Commission appears to have been “captured” by the industries they’re supposed to regulate. From approving rate hikes to loosening environmental review standards, the Commission prioritizes utility company profits over the health & financial well-being of Arizonans.

When utility companies can count on the Commission to approve nearly every request, they ask for it creates a dangerous cycle where public health takes a backseat to industry interests and investors.

Your Vote Matters

When you cast your vote for Arizona Corporation Commissioners, you’re voting for people who will make decisions that directly affect your family’s health and well-being.

The Arizona Public Health Association urges you to pay close attention to candidates’ histories and their commitment to protecting public health—because the decisions made by the ACC will have far-reaching impacts on Arizona’s communities and families.

The Arizona Corporation Commission’s decisions may not always make front-page news, but they profoundly shape our daily lives. From the air we breathe to the electricity bills we pay; we need the Commission to protect the public interest—not just industry profits.

Do your homework and research on candidates for the Corporation Commission Arizona. Your family’s and your community’s well-being are on the line.

From Sunshine to Savings: How the Inflation Reduction Act Made Clean Energy Accessible for Arizona Families

A year ago, my wife and I decided the time was right to take a leap and join the growing number of Arizona homeowners who are harnessing the power of the sun by installing rooftop solar panels. With Arizona boasting more sunny days than almost any other state, it seemed like a no-brainer. But what truly tipped the scales for us were the solar tax credits by the Inflation Reduction Act. These credits cover up to 30% of installation costs, significantly reducing the financial burden and making the decision to go solar not just environmentally responsible but also economically sensible. 

Last September, we had solar panels installed on our garage. We were eager to see the impact on our electricity bills, but we never anticipated just how transformative the results would be. 

Over the past year, our monthly electricity bills have consistently been slashed by 30% to 60%, demonstrating the real and immediate benefits of solar energy.

For instance, in February, our electricity bill dropped from $140 to $71 –, a 50% reduction. This was a pleasant surprise during the cooler months when our electricity usage is typically lower. But, the true test of our solar investment came during the sweltering Arizona summer. As any Arizonan knows, summer is when energy bills typically soar due to the relentless need for air conditioning. In July, our electricity bill fell from $441 in 2023 to $286 in 2024—a savings of $155, or 33%.

We’re going to save more than $1,000 in electricity costs, just in the first year alone. These savings underscore the importance of the Inflation Reduction Act’s solar tax credits, which made this initial investment feasible. While the upfront cost of installing solar panels was significant, the tax credits provided substantial relief, and we are well on our way to recouping those costs through our reduced energy bills. 

The savings aren’t just about the dollars in our pocket. By generating our own clean energy, we are directly contributing to a broader public health effort to reduce our reliance on fossil fuels. This is particularly crucial in a state like Arizona, where fossil fuel-generated electricity contributes to air pollution, which is linked to respiratory problems, cardiovascular disease, and other health issues. By switching to solar, we are helping to improve air quality and reduce the overall carbon footprint, which benefits everyone in our community.

In addition to the environmental and financial benefits, there is a profound sense of empowerment that comes with generating your own energy. Instead of being at the mercy of utility companies and fluctuating energy prices, we have taken control of our energy future.

This is a critical step not just for individual households but for society as a whole. As more people adopt solar energy, we collectively reduce the demand for fossil fuels, driving down emissions and mitigating the impacts of climate change.

Going solar was a major, money-saving step for our household, and one we likely wouldn’t have been able to do without the tax credits from the Inflation Reduction Act.

These incentives are crucial in making solar energy more accessible and affordable for more Arizona families. By easing the financial burden of installation, the IRA has opened the door for countless households, to enjoy the same financial and environmental benefits that we experienced. 

Solar energy is not just an investment in your home; it’s an investment in our collective future. The Inflation Reduction Act’s tax credits are a powerful tool in helping more Arizonans make this important transition, ensuring the benefits of solar energy are within reach for all.

As a public health professional, I see firsthand the value of reducing pollution and promoting sustainable practices, and I am proud that our decision to go solar is part of a larger movement toward a cleaner, healthier, and more resilient future. 

In conclusion, our experience with solar energy has been overwhelmingly positive. Thanks to the financial support provided by the Inflation Reduction Act, we’ve been able to save money, reduce our environmental impact, and contribute to the health and well-being of our community. I encourage other Arizona homeowners to consider making the switch to solar—not just for the immediate savings, but for the long-term benefits to public health and the planet.

Why Arizona’s Proposition 315 is Unnecessary & Harmful to Our Healthcare System

Arizona’s healthcare system is under threat from Proposition 315, set to appear on the 2024 ballot. This proposition, if passed, would introduce new bureaucratic hurdles into an already well-functioning regulatory system, potentially leading to delays, logjams, and increased costs for healthcare delivery.

What proponents of Proposition 315 overlook is that Arizona already has a robust system of checks and balances in place to ensure that agency rulemaking is both transparent and economically sound.

The Importance of Regulatory Stability

A stable and predictable regulatory environment is crucial for businesses, particularly in healthcare, where the consequences of regulatory uncertainty can be severe. Arizona’s current regulatory framework has allowed our healthcare system to thrive, helping patients and contributing to a strong state economy.

Proposition 315 disrupts this balance by imposing excessive legislative oversight on agency rulemaking. The uncertainty that Proposition 315 would introduce could lead to higher costs for healthcare providers, who may need to navigate a more complex and politically charged regulatory landscape, passing these costs on to consumers.

Existing Oversight: A Strong Foundation

Proponents of Proposition 315 argue that it will enhance oversight and accountability in agency rulemaking. However, this ignores the fact that Arizona already has a comprehensive oversight system in place.

Both the Governor’s Regulatory Review Council and the Administrative Rules Oversight Committee (an arm of the state legislature) are already tasked with ensuring that agency rules are carefully scrutinized before they take effect.

The Governor’s Regulatory Review Council, for example, already reviews all proposed rules to ensure they follow statutory authority and are necessary to achieve the desired public policy goals.

The Governor’s Regulatory Review Council already evaluates the economic impact of these rules, considers how they will affect businesses, and individuals. This process provides an existing check on agency power, ensuring that regulations are not only effective but also economically feasible.

Similarly, the state legislature’s Administrative Rules Oversight Committee already provides legislative oversight by giving legislators the ability to scrutinize and challenge any rule that raises concerns.

The existing system already holds state agencies accountable and strikes a balance between allowing agencies the flexibility to implement necessary regulations while ensuring legislative oversight.

Proposition 315: Redundant & Risky

Given the existing oversight mechanisms, Proposition 315 is not only redundant but could also have serious negative consequences for Arizona’s healthcare system by requiring legislative approval for a broader range of agency rules, slowing down the rulemaking process and creating potential bottlenecks.

This additional layer of oversight could lead to significant delays in implementing important regulations, which could jeopardize public health and safety.

By inserting more legislative oversight into the process, Proposition 315 politicizes rulemaking, potentially leading to decisions based more on political considerations than on the expertise and evidence that currently guides agency rulemaking.

The Bottom Line

Arizona’s healthcare system depends on a stable, predictable regulatory environment—one that is already well-protected by existing oversight mechanisms. 

By adding unnecessary layers of legislative oversight to state agency work, Prop 315 introduces uncertainty and delays into this system that will harm patients, healthcare providers, and the state’s economy.

The current regulatory framework for state agency regulation development, with its robust checks and balances, is more than sufficient to ensure that agency rulemaking is transparent, accountable, and economically sound.

For the sake of Arizona’s healthcare system and quality healthcare, we urge you to reject Proposition 315.

 

Arizona’s Proposition 315: An Unnecessary Overreach Jeopardizing Public Health, Safety, & the Environment

Proposition 315, set for the 2024 ballot in Arizona, seeks to mandate that all state agency rulemakings be ratified by the legislature before taking effect. Proponents argue that this measure would ensure greater legislative oversight and accountability, preventing state agencies from enacting rules without sufficient scrutiny.

However, this proposition is a solution in search of a problem. Arizona already has robust mechanisms in place to oversee agency rulemaking, making this new requirement both redundant and potentially harmful to effective governance.

Existing Legislative Oversight of Agency Rules

Arizona’s current legislative framework already provides ample oversight of state agency rulemaking through the legislature’s existing Administrative Rules Oversight Committee [ARS 41-1046 to 41-1048]. This committee is tasked with reviewing and recommending actions on any proposed rules or existing rules that it thinks problematic.

AROC ensures that the legislature has a direct hand in monitoring agency rulemakings, giving legislators the ability to scrutinize and challenge any rule that raises concerns.

This existing system strikes a balance between allowing agencies the flexibility to implement necessary regulations while ensuring legislative oversight. The introduction of Proposition 315 would upend this balance, unnecessarily clogging the legislative process and delaying important regulations.

By requiring legislative ratification for every rule, the proposition risks creating bottlenecks that could stymie the implementation of critical public health and safety regulations, among others.

Governor’s Regulatory Review Council (GRRC)

In addition to legislative oversight, Arizona also has the Governor’s Regulatory Review Council [ARS 41-1051 to 41-1057] which plays a crucial role in reviewing and approving agency rules before they can take effect. The GRRC is charged with ensuring all proposed agency rules meet specific statutory criteria, including necessity, statutory authority, and cost-effectiveness.

One of the key requirements under ARS 41-1055 is that agencies must provide a thorough economic, small business, and consumer impact statement.

This statement is intended to assess the potential costs and benefits of the proposed rule, ensuring that it does not impose unnecessary burdens on businesses or consumers. GRRC then reviews these impact statements alongside the proposed rule, evaluating whether the rule is justified and in line with state law.

Before approving any agency rulemaking ARS 41-1052(D) requires that GRRC ensure that each rule:

  • Is necessary and does not impose excessive costs on the public
  • Is within the agency’s statutory authority
  • Doesn’t conflict with other state laws
  • Is clear, concise, and understandable
  • Has undergone proper public consultation

These criteria serve as a robust safeguard against the enactment of unnecessary or overreaching regulations. By the time a rule reaches the GRRC, it has already been subjected to rigorous internal review within the agency, public comment, and economic analysis.

The Risks of Proposition 315

The added layer of legislative bureaucracy proposed in Proposition 315 is not only totally unnecessary but could be detrimental to the health and safety of Arizonans and the environment.

Under this proposition, a single committee chair could effectively kill a proposed rule by refusing to give it a hearing. Moreover, the president of the senate or the speaker of the house could block the rule’s ratification simply by not bringing it to the floor for a vote.

This level of gatekeeping sets the stage for partisan sabotage and poses significant risks to the prompt implementation of regulations that protect public health, safety, and the environment.

Proposition 315 would concentrate too much power in the hands of a few legislators, allowing them to override the thorough review processes already in place.

This could result in important regulations being delayed or blocked entirely for political reasons, rather than being evaluated on their merits.

If you care about keeping up to date with evidence based public policy you should definitely vote no on Prop 315.

 

Arizona’s Move Toward a Sustainable Transportation Landscape

Electric vehicle (EV) sales are surging across the country, and the Grand Canyon state is leading the charge, ranking among the top 10 states for EV registrations per capita. As a proud new member of Arizona’s nearly 70,000-strong EV community, I can personally attest to the benefits of making the switch to an electric vehicle. 

My experience with an EV has been nothing short of transformative, especially when it comes to cost savings. During a recent trip to Tucson, when gas prices were a bit higher than they are now, I traveled 217 miles with the air conditioning on full blast, and my EV averaged 3.4 miles per kilowatt-hour (kWh).

Charging at home using Salt River Project’s off-peak rate of $0.09 per kWh, the entire trip cost me a mere $5.70. To put that in perspective, with gas prices hovering around $4 per gallon, my EV effectively delivered the equivalent of 155 miles per gallon – a level of efficiency that’s impossible with traditional gasoline-powered vehicles.

However, while I’m fortunate to have a home charging set up, I know that the lack of widespread, reliable charging infrastructure remains a significant barrier for many Arizonans considering an EV. 

This is where the Bipartisan Infrastructure Law (BIL) comes into play. This landmark legislation, coupled with the Inflation Reduction Act, is set to revolutionize our state’s transportation landscape by making EVs more accessible and convenient for everyone. 

 One of the key provisions of the IRA is expanding EV charging infrastructure, particularly in areas that have been underserved. Here in Maricopa County, the Air Quality Department has recently been awarded $15 million to advance the installation of public EV charging stations across the county.

This funding will not only make it easier for current and future EV owners to charge their vehicles but will also contribute to the   broader goal of reducing transportation emissions and improving air quality in our communities. 

Importantly, this initiative aligns with the Harris-Biden administration’s “Justice40 initiative,” which ensures that 40% of the overall benefits of clean energy and climate investments are directed to disadvantaged communities.

By prioritizing the placement of charging stations in Justice40-designated areas, Maricopa County is taking significant strides toward environmental equity, ensuring that the benefits of the green economy are shared by all. 

Additionally, the recent update by the Arizona Department of Transportation to build fast-charging stations along nine new highways across the state further underscores the state’s commitment to a sustainable future.

These investments represent a critical step forward in reducing our dependence on fossil fuels, improving air quality, and making clean energy accessible to all Arizonans. 

The Inflation Reduction Act is more than just a policy – it’s a vision for a cleaner, healthier, and more equitable future. By investing in EV infrastructure, we are not only making it easier for Arizonans to make the switch to electric but also paving the way for a future where clean energy is available to everyone, regardless of where they live. 

Kudos to the Maricopa County Air Quality Department and the Arizona Department of Transportation for their leadership, and a shout out to all members of Congress who supported the Bipartisan Infrastructure Law and the Inflation Reduction Act. Together, we are driving Arizona toward a brighter, more sustainable future. 

 

Arizona’s Worsening Public Health Heat Crisis: A Plea for Housing Reform

Recent reports from the ADHS underscore the worsening trend of increasing deaths and hospitalizations from heat related illnesses in Arizona – especially among the unhoused.

The “Heat-Related Illness Emergency Department and Inpatient Admissions in Arizona by Year, 2019-2023” and “Heat-Related Mortality Year 2012-2023” reports highlight a troubling increase in heat-related health outcomes and mortality, with unhoused individuals bearing the brunt of this escalating crisis.

Heat Related Mortality in Arizona: 2012-2023
Heat Related ED and Inpatient Hospitalizations in AZ: 2019-2023

Heat-Related Illnesses Continue to Rise

Between 2019 and 2023, Arizona experienced a marked increase in heat-related emergency department visits and hospital admissions. The report shows that the number of such cases has steadily risen, with 2023 recording some of the highest figures. 

The reports indicate that certain populations are disproportionately affected. Older adults, individuals with pre-existing health conditions, outdoor workers, and especially those who are unhoused are at significantly higher risk.

The unhoused population in particular is over 500 times more likely to die from heat-related causes compared to housed individuals. This alarming statistic underscores the urgent need for targeted interventions to protect the most vulnerable.

Heat-Related Mortality: A Growing Crisis

The “Heat-Related Mortality” report highlights a disturbing trend: a sharp increase in deaths attributed to extreme heat over the past decade.

The data reveals that heat-related mortality has been rising steadily, with a significant jump in deaths in recent years. In 2023 alone, the number of heat-related deaths in Arizona reached unprecedented levels.

Maricopa County and Pima Counties are the epicenters of this crisis. The high concentration of unhoused people there (especially in the urban areas) drive the elevated mortality rates.

Despite the implementation of several interventions by county health departments and the cities of Phoenix and Tucson—including cooling centers, water distribution, and public awareness campaigns—these efforts have not been sufficient to curb the rising death toll.

The Role of Housing and Policy Reform

While local interventions have provided some relief, the root causes of the crisis remain largely unaddressed. Arizona’s ongoing housing affordability crisis and our antiquated and landlord-favoring Landlord and Tenant Act, exacerbates the vulnerability of at-risk populations, particularly the unhoused.

The Arizona Public Health Association (AzPHA) has highlighted the urgent need for housing reform as a critical component in addressing heat-related mortality.

Evictions, Homelessness & Heat Related Deaths: Is Arizona’s Antiquated Landlord & Tenant Act Part of Our Problem?
Updating Arizona’s Landlord-Tenant Act: A Crucial Step to Prevent Evictions and Save Lives

The state’s failure to provide adequate affordable housing options has left thousands of individuals exposed to life-threatening heat conditions. Moreover, the current landlord-tenant laws and restrictive zoning driven by Nimbyism make it difficult for renters to secure and maintain stable housing and for developers to build affordable multi-family housing.

Unless profound changes are made to create more affordable housing and reform Arizona’s landlord-tenant laws to offer better protections for renters and preempting cities’ overly restrictive zoning limits driven by Nimbyism the homelessness crisis will continue to exacerbate the state’s already staggering heat-related mortality rates.

Local interventions, while valuable, will never be enough to stem the tide of deaths among the unhoused population,