Will Humble Public Health, Wills Blog

Welcome Our New Board Member:  Rebecca Sunenshine, MD, FIDSA

When an AZPHA Board Member leaves before their term is up our AZPHA by-laws say the President appoints the replacement. That happened recently, and we’re pleased to announce that our President, Sena Clendaniel, has appointed Dr. Rebecca Sunenshine as a Public Representative on our Board.

Dr. Rebecca Sunenshine has served in federal, state and local public health for the last 21 years, most recently as the Chief Medical Officer for the Maricopa County Department of Public Health.

She’s a retired Captain in the US Public Health Service and previously served for 18 years as a CDC Career Epidemiology Field Officer assigned to the ADHS for 4 years and Maricopa County Public Health 15. 

She’s trained as an infectious disease epidemiologist with specialties in internal medicine and infectious diseases from the Oregon Health & Science University and completed the CDC Epidemic Intelligence Service Fellowship in the Division of Healthcare Quality Promotion in 2006.

Her more than 60 publications include a broad range of public health topics including coccidioidomycosis, healthcare associated infections, vectorborne disease epidemiology and the health effects of heat.

Please welcome Dr. Sunenshine to our Board of Directors!

Note: AzPHA currently has an open Board Officer position of Treasurer. If you’re interested in serving please contact our President, Sean Clendaniel at [email protected]. You can see the Treasurer responsibilities in our AZPHA By Laws

Will Humble Professional Development, Wills Blog

Applications Opening Soon for Maricopa County Department of Public Health Fellowship Program

Maricopa County Public Health will begin recruitment for their third cohort of the Maricopa County Department of Public Health Fellowship Program in mid-March!

This two-year paid fellowship provides recent graduates with practical, hands-on experience, professional development, and mentorship in the public health field.

  • Real-World Impact – Work on key public health initiatives affecting our communities.
    Full Pay & Benefits – Enjoy a competitive salary and benefits package.
  • Ongoing Support – Receive mentorship from the Fellowship Coordinator and a dedicated project Point of Contact.

MCDPH will soon be inviting candidates who have recently graduated with the following degrees to apply: 

  • Public Health
  • Social Work
  • User Experience (UX)
  • Communications
  • Psychology
  • Public Administration

Positions are expected to post in mid-April. Visit MCDPH Fellowship for updates.

Will Humble Public Health, Vaccination, Wills Blog

mRNA Research: NIH Putting the Kibosh on Promising Cancer & Vaccine Innovation

In a puzzling move this week, NIH officials told senior vaccine scientists that references to mRNA vaccines should be removed from future funding applications.

This new directive is downright bizarre considering how crucial mRNA technology has become in recent years. Despite its growing promise in treating diseases like cancer and speeding up vaccine development, the NIH, under the leadership of Mr. Kennedy, is bailing on its support of this innovative approach despite its promise.

One of the major benefits of mRNA vaccines and therapies is their speed. Having the ability to develop a vaccine on a much faster time schedule has the potential to save millions of lives.

Traditional methods for producing vaccines—like the flu vaccine, which relies on growing viruses in chicken eggs—can be slow and cumbersome. mRNA technology, on the other hand, can be adapted much more quickly to respond to emerging threats, ensuring we’re always prepared for the next wave.

mRNA technology is also being used to develop new cancer treatments, potentially revolutionizing how we fight diseases like pancreatic cancer (just one example) by teaching the immune system to target and destroy tumor cells more effectively.

So, why the sudden shift at the NIH?

According to sources at KFF the move is part of a larger political and ideological struggle as the MAHA/MAGA movement is against mRNA technology because most of the COVID vaccines were developed using mRNA technology.

The NIH’s latest stance will hinder critical breakthroughs for the next 4 years, slowing down our ability to make vaccines more safe, effective and faster to manufacture – and squelching cancer treatment.

I don’t really have a call to action here. This NIH decision is discretionary and it’s unlikely judges can or will overturn this depressing decision by HHS.

Will Humble Health Insurance, Healthcare, Wills Blog

Medicare Telehealth Largely Ends Next Week (April 1)

Telehealth has been an efficient way to provide certain kinds of health care services for many people on Medicare (and their providers) – providing easier access to healthcare for patients and better use of time for providers ever since the pandemic.

That’s about to largely end as restrictions on telehealth reimbursement and geographic restrictions are set to take effect after April 1, 2025. impacting how and where (and sometimes whether) Medicaid members get their care.

Medicare telehealth set to expire

The expansion of telehealth during the pandemic showed remarkable improvements in access to care. As documented in a Kaiser Family Foundation report, before the pandemic, Medicare’s telehealth coverage was limited. Only patients in rural areas or specific settings had access, and visits had to be conducted via real-time audiovisual technology.

The public health emergency lifted these barriers, enabling all Medicare beneficiaries to use telehealth for a broad range of services, including behavioral health, chronic disease management, and primary care visits. 

A study published in Health Affairs highlighted how these changes improved care access for members who had struggled to see their doctors regularly. Older adults, those living in rural & underserved areas, and patients managing multiple chronic conditions benefitted the most.

Geographic Restrictions & Behavioral Health Services

Medicare beneficiaries can still access telehealth services from virtually anywhere, but they won’t be able to in a couple weeks.  Starting April 1, 2025, geographic restrictions will return.

This means that telehealth services will be limited to rural areas unless members receive specific services, like monthly visits for home dialysis or certain mental health treatments.

If you’re in an urban area and require telehealth for general care or mental health services, you’ll likely need to visit a healthcare facility in person after 4/1.

Behavioral health services have seen significant benefits from telehealth, allowing patients to access care from home. After April 1, most of those services will require in-person visits, especially if they’re part of an ongoing treatment plan.

Medicare Advantage Plans May Offer More Flexibility

Medicare Advantage plans sometimes offer more flexibility when it comes to telehealth. These private plans often have broader coverage options and may not be as restricted by geographic limitations. If you’re enrolled in a Medicare Advantage plan, check with your plan provider to understand the specific telehealth benefits and flexibility available after April 1, 2025.

What Could Have Been

It didn’t have to be this way. The bipartisan CONNECT for Health Act offered a comprehensive and efficient solution. This bill proposed permanent expansions of telehealth in Medicare (including the removal of geographic site requirements that restrict telehealth to rural areas) and drops in-person visit rules for behavioral health.

Importantly, it also included measures to reduce potential fraud and abuse, something sorely needed to prevent fraud and make telehealth services sustainable over time. Those measures include setting stricter guidelines for billing and ensuring better auditing of services.

The CONNECT Act also addresses concerns about overuse of telehealth by focusing on finding high-value services that are proper for virtual care.

Sadly, it appears that Congress will wait until they hear from mad constituents before they take up the CONNECT Act.

Will Humble State Legislature, Wills Blog

Legislative Update: Week of March 24, 2025

This week was a busy one – with several floor vote sessions and cramped committee agendas. This upcoming Friday the deadline to hear bills in committees other than Rules and Appropriations – so many more bills will fall by the wayside by this time next week. After this week things will settle down as most committees will have ended. 

Here’s a list of the public health related bills that are still alive these days:

Senate

SB1019 photo enforcement; traffic (AzPHA opposes)
SB1071 SNAP TANF verification (AzPHA Opposed)
SB1108 international medical licenses; provisional licensing (no Position)
SB1612 RFP document retention; AHCCCS (No Position)
SB1347 comprehensive dental; ahcccs (AzPHA Supports)
SB1604 licensed secure health facility; defendants (AzPHA Supports)

SB1623 GME appropriations (AzPHA Supports)

House

HB2001 behavioral health temporary licenses (AzPHA Supports)

HB2012 emergency use products; employers (AzPHA Opposed)

HB2130 claims; prior authorization (AzPHA Supports)

HB2058 immunization proof; higher education (AzPHA Opposed)

HB2063 parental notification; school immunizations (AzPHA Opposes)

HB2125 insurance coverage; hearing aids (AzPHA Supports)

HB2126 medical records; parental choice (AzPHA Opposes)

HB2145 registered sanitarians; qualifications (AzPHA Supports)

HB2164 school lunches; ultra processed food (AzPHA Supports)

HB2165 SNAP; prohibited purchases (AzPHA No Position)

HB2175 claims; prior auth; company conduct (AzPHA Supports)

HB2176 training; investigations; complaints (AzPHA Neutral)

HB2257 DCS, vaccination; child placement (AzPHA No Position)

HB2291 opioids, red cap packaging (AzPHA Supports)

HB2449 AHCCCS presumptive eligibility (AzPHA Opposed)

HB2894 Silver alert criteria (AzPHA Supports)

We’re set to testify in committees next week in favor of:

SB1604 licensed secure health facility

SB1347 comprehensive dental; ahcccs

SB1623 GME appropriations

See this week’s House and Senate Health Committee lineup

Will Humble Professional Development, Wills Blog

Arizona Grant Opportunities – Compiled by the Vitalyst Health Foundation

Due March 7th: Broadband Equity, Access & Deployment Program

Due March 12th: Community-Based Archives

Due March 13th: Sexual Violence Prevention and Education

Due March 14th: Conserving Black Modernism Grant

NEW Due March 15th: Greater Arizona Development Authority Technical Assistance

Due March 15th: Sundt Foundation

Due March 17th: AZ Reads – K-12 Literacy Initiative

Due March 17th: Tribal Maternal, Infant, and Early Childhood Home Visiting Program Grants

Due March 18th: Local Data for Equitable Communities Program

NEW Due March 20th: SaludArte (Public Heart + Arts)

Due March 20th: Rural Emergency Medical Services Training

Due March 21st: Tribal Projects (State Funding)

Due March 21st: The Peter and Pat Hirschman University-Community Research Partnership Fund

NEW Due March 27th: Momentum Maker Grant )Maternal Mental Health)

Due March 28th: Responsive Grants (Southeast Arizona)

NEW Due March 31st: Community Reinvestment Program

Due March 31st: Hometown Grants (Community Spaces)

Due March 31st: Building Capacity for Health Advocacy

Due March 31st: Sunset Grant

NEW Due April 4th: Capacity Building Grants

Due April 4th: Rural and Tribal Community Technical Assistance Grants

Due April 4th: Smart and Connected Communities

Due April 7th: Emergency Drought Relief for Tribes

Due April 6th: Rural Business Development Grants

NEW Due April 9th: AmeriCorps State and National Native Nation Planning Grants

NEW Due April 14th: White Mountain Apache Tribe Regional Partnership Council- Inclusion of Children with Special Needs

NEW Due April 15th: Spark Good Local Grants

Due April 25th: The Gadfly Project (Software Implementation/In-Kind)

Due May 10th: The Max and Victoria Dreyfus Foundation

Due May 11th: Broadband Equity, Access & Deployment Program

Due May 16th: Trans Justice Funding Project

NEW Due May 31st: Fast Pitch Competition (Women Founders Network)

Due June 4th: Systems for Action: Community-Led Systems Research to Address Systemic Racism

  • Applicant Webinar February 24th: Register

Due June 30th: Stable Housing and Empowering Communities

Due August 4th: Innovative Grant (Southeast Arizona)

NEW Ongoing: Colorado Plateau Rapid Response Grants

NEW Ongoing: The National Grassroots Organizing Program (Social and Environmental Injustice)

Ongoing: Arizona Housing Fund 
Will Humble Professional Development, Wills Blog

AZPHA Conference in 2 Weeks – Modernizing Public Health Practice: Building an Innovative Infrastructure for the Public Health of the Future

The Arizona Public Health Association’s 2025 Annual Conference is just around the corner (April 3), and this is your chance to register for an event that promises to explore groundbreaking innovations in public health.

This year’s theme, “Using AI to Enhance Public Health Practice, Data, Informatics, and the Public Health Workforce” focuses on how artificial intelligence is transforming the field of public health.

From data-driven decision-making to workforce development, this conference offers valuable opportunities for professionals, students, and organizations to learn from leading experts and take part in forward-thinking discussions.

Whether you’re looking to enhance your skills, explore new AI-driven technologies, or network with fellow professionals, the AZPHA 2025 Conference is an essential event for public health practitioners. Don’t miss out—register now to secure your spot and take advantage of early bird rates!

View Our Conference Brochure & Agenda

Keynote
  • Opening Keynote: Improving Perinatal Public Health: An Opportunity for Healthcare and Public Health to Collaborate
Breakout Sessions

Using AI to Enhance Public Health Practice

  • Leveraging AI to Standardize Housing Interventions
  • Merging Minds and Machines | Re-envisioning Public Health Innovation
  • Leveraging AI for Smarter Public Health Decision-Making: Balancing Innovation with Cultural Responsiveness
  • The AI Co-Worker You Never Knew You Needed

Data Infrastructure and Informatics

  • Enhancing Depression Care for Pregnant and Postpartum Women Through Data Visualization
  • Integrating Data to Action: Enhancing Overdose Surveillance and Response in Pima County
  • Substance Use Data to Action: Development of the City of Phoenix Opioid Overdose Alert System Methodology and Program Framework
  • Data as a Driver of Action: Leveraging Wastewater Monitoring for H5 Detection and Response
  • The ADHS 2024 State Health Assessment

Public Health Workforce

  • Public Health Inclusion & Belonging and Employee-Driven Approach
  • Bridging the Gap: Cultivating Public Health Leaders Through Workforce Innovation and Experiential Learning
  • Fostering Connection and Quality: Improving Behavioral Health Care Through Collaboration
  • Tribal Healthcare Workforce Development: A Collaborative Approach
  • Building a Sustainable Mental Healthcare Workforce in Arizona
  • Strengthening the Public Health Workforce by Reimaging Graduate Education
Panel Discussion
  • ADHS Data Modernization Initiative: Building an Innovative Infrastructure for Public Health Practice

Don’t miss this opportunity to be part of an exciting and forward-thinking conference. Register today and join us in exploring how AI is reshaping the future of public health!

Special Discounts:

  • Student Discounts: Affordable rates for AZPHA student members
  • Group Discounts: Organizations registering 10 or more people can access special pricing.
  • Member Discounts: AZPHA members receive exclusive discounts
  • Free Membership: General registration includes a complimentary one-year membership with AZPHA, giving you access to additional resources and networking opportunities.
For full registration details, fees, and sponsorship opportunities, visit our registration page

Register

View Our Conference Brochure & Agenda

Will Humble Opioids, Wills Blog

A Turning Point in the Opioid Crisis?

New national data from the CDC and National Center for Health Statistics has revealed a 24% decline in opioid drug overdose deaths in the last 12 months compared with the previous 12. The biggest decline was among those 18-44 years old.

NCHS: Vital Statistics Rapid Release – Provisional Drug Overdose Data

Fatal fentanyl overdoses are down in every state : NPR

CDC Reports Nearly 24% Decline in U.S. Drug Overdose Deaths | CDC

So, what’s behind this encouraging trend? Several key factors appear to be driving the decrease in fatalities, and it’s worth taking a closer look at these interventions that are making a tangible difference in people’s lives.

Widespread Naloxone Distribution

One of the most impactful public health interventions has been making naloxone (the fast-acting reversal drug) much easier to get and afford – allowing bystanders access to the reversal drug. Thanks to widespread, data-driven distribution efforts and investments by state, county and local jurisdictions in naloxone their opioid settlement and other COVID relief funds.

First responders, community organizations, and people in high-risk environments and social groups are equipped with this vital quick reversal medication – and are increasingly using the reversal drug. Wider availability of fentanyl test strips may also be playing a role in the decline.

Naloxone is available for purchase in Arizona at local pharmacies without a prescription thanks to a bill from the state legislature a couple years ago. Benchmark price is between $75 and $80 per dose.

I’m not aware of surveillance data that collects the prevalence of naloxone use in the field, however. Anecdotally I’ve heard that some Arizona high school staff have used the drug to quickly reverse overdoses in schools – but like I said I don’t think there’s good data on how often it’s being used.

Better Access to Treatment

Another major factor contributing to the decline in overdose deaths is increased access to evidence-based treatment for substance use disorders. The opioid settlement funds have played an important role in funding local and national initiatives that improve treatment availability, ensuring that individuals struggling with opioid addiction have the support they need. Medications like methadone and buprenorphine, combined with counseling and other treatment modalities, continue to provide a comprehensive approach to recovery.

Shifts in the Drug Supply

While fentanyl continues to be a dominant threat in the illegal drug market, shifts in the drug supply itself may be contributing to the decline in overdose deaths. Anecdotally, there has been a shift towards a more varied and, in some cases, less potent illegal drug supply. However, the prevalence of fentanyl is still a major challenge, requiring constant vigilance.

Other Factors?

Some experts suggest that another factor may be that the people most susceptible to opioid addiction and the use of illicit fentanyl already died in the now more than 15-year epidemic, leading to a natural reduction in overdose deaths.

Opioid Overdose Deaths Decline: A Turning Point Fueled by Harm Reduction & Settlements?

Summary

Despite the progress, overdose is still the leading cause of death for young adults in the U.S., and some states, including Alaska and Nevada, are still having increases in overdose deaths.

While the opioid crisis is far from over, the recent drop in overdose deaths is a testament to the power of effective, multi-faceted public health strategies. By ensuring that naloxone is available, expanding treatment options, and continuing to adapt to the changing drug landscape, we are slowly turning the tide against the opioid epidemic. But there’s still much more to do to keep the momentum going and save even more lives.

CDC: Drug Overdose Mortality by State

Will Humble Environmental Health, Public Health, Wills Blog

Trump Administration Rolling Back Environmental Protections

The president promised to roll back environmental protections in the leadup to the election and he is following through. This week his administration (EPA) announced they’ll be embarking on a several months rulemaking to undermine a host of existing environmental protections – mostly focusing on rolling back carbon reduction provisions.

While these changes won’t be immediate (they need to go through the federal rulemaking process) their intent is clear: to reverse climate policies and weaken or end carbon reduction policies while weakening environmental safeguards like soot and particulate matter control measures and goals.

EPA signals it will slash climate and pollution rules, including for cars and power plants

Under the new rules, they promise that car manufacturers would be given a free hand to produce vehicles that emit higher levels of carbon and other pollutants. Coal fired power plants, which are major contributors to greenhouse gases, will face fewer restrictions.

They also said they’ll be scaling back or ending soot (particulate matter) emission standards for industry and transportation which will have bad public health consequences (respiratory illnesses, cardiovascular problems, and other health issues) that disproportionately affect vulnerable populations.

Long-Term Impact

Environmental advocates, scientists, and public health experts like APHA are voicing their concerns, warning that the EPA’s proposed changes are not just about reducing government intervention—they’re about dismantling critical protections that have helped mitigate the effects of climate change.

What’s Next?

Over the coming months expect the EPA to propose their rule rolling back the regulations. They’ll need to propose and publish a draft rule (CFR’s) and respond to comments before publishing a final rule. At that point I expect nonprofits and perhaps Democratic state Attorney Generals to file lawsuits challenging the rules – arguing they aren’t in accord with the direction given to the EPA by congress.

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