Will Humble Opioids, Wills Blog

Overdose Deaths Are Falling Nationwide Why Is Arizona Moving in the Wrong Direction?

There’s encouraging news about the overdose crisis in the United States. Drug overdose deaths fell for the third year in a row in 2025.

But Arizona is heading in the opposite direction.

In a new AzPHA special report by Allan Williams, PhD, MPH, we took a closer look at the numbers. Nationwide, estimated overdose deaths dropped by nearly 14% last year, falling from about 81,300 deaths in 2024 to just under 70,000 in 2025. That’s the lowest national total since 2018.

Arizona’s numbers are much more troubling. Estimated overdose deaths increased by 18%, rising from 2,531 in 2024 to 2,988 in 2025.

The increases weren’t limited to one type of drug. Deaths involving synthetic opioids — mostly fentanyl — increased by nearly 33%. Deaths involving methamphetamine and other stimulants rose by more than 15%. Cocaine-related deaths jumped by almost 70%.

The national decline shows that progress is possible. Wider access to naloxone, fentanyl test strips, treatment programs and other harm-reduction tools appears to be saving lives. Opioid-settlement funding may also be helping communities expand prevention and treatment services.

Arizona needs to make naloxone and fentanyl test strips easier to get. We need faster access to proven treatment for substance-use disorders. We also need to make sure opioid-settlement dollars are spent on programs that can show measurable results.

Nearly 3,000 Arizonans died from drug overdoses last year. Behind every number is a family, a workplace and a community.

Read the full AzPHA special report for the detailed numbers, charts and policy recommendations.

Will Humble Social Determinants, Wills Blog

Getting Past NIMBY’s Chokehold on Housing

One of the biggest obstacles to affordable housing is the NIMBY effect: “Not in My Backyard.”

Many people agree that we need more affordable housing, especially progressives. They support apartments, duplexes and townhomes in theory.

But when a proposed project is near their neighborhood, they’re suddenly totally against affordable housing. Their opposition is often loud and organized. They’ll say: “I’m all for affordable housing, but this isn’t the right place for it!”

The result is a chokehold on housing development as animated neighborhood groups mobilize the freeze zoning with onerous zoning restrictions that prevent apartments and the like.

People who need affordable housing usually don’t attend zoning hearings. But the people who oppose zoning changes almost always show up. That’s why state action to preempt unreasonable zoning is needed (in my opinion).

Arizona took a step in that direction in 2024. The Legislature passed the “casita bill,” which prevents larger cities from banning accessory dwelling units in many single-family neighborhoods.

These small homes can provide a place for an aging parent, an adult child or a renter. The Legislature also passed a “middle housing” law that makes it easier to build duplexes, triplexes, fourplexes and townhomes in some areas. They also passed a law to make it easier to build duplexes and triplexes near city centers (called the middle housing law).

The NIMBY pushback accelerated after those laws were passed. NIMBYs who lost the preemption battle at the legislature focused on weakening the new rules or carving out exemptions.

Their bill was called SB2118. It would have watered down the 2024 laws with language that housing in historic needed to match the “historic character, scale, and setting” of the neighborhood. Subjective words that they knew they could use to stop (through the back door) duplexes, triplexes, fourplexes and townhomes.

Fortunately that bill failed last week… but the sponsor says he’ll try to bring it back for reconsideration during the budget chaos. Let’s hope that doesn’t happen.

Arizona lawmakers reject bill to restrict demolition of historic homes to build middle housing

Case from the field:

Vitalyst Health Foundation helps communities find practical solutions. In Pinetop-Lakeside, Vitalyst supported a Blue Ridge Unified School District housing project for teachers and staff. Some employees had been driving for more than an hour to find an affordable place to live. The new teacher housing project makes it easier for the district to recruit and keep its workforce.

FY 2025 – Housing – Vitalyst Health

Vitalyst has also been working with school districts, churches and nonprofits to explore housing on underused property. These projects will not replace the need for zoning reform. But they show what can happen when communities look at the land they already have and ask a simple question: Could this property help solve a local housing problem?

Affordable housing is a public health issue. Stable housing supports better health, stronger schools and a more reliable workforce. Arizona needs more housing of all kinds. That’ll require local creativity, state-level action (preemption) and a willingness to stand up to the NIMBY pressure that blocks reasonable solutions.

Vitalyst is doing some great work to help at the margins…  but the real solution is to create conditions whereby cities and towns stop putting chokeholds on infill development.

I don’t think the NIMBY effect at the local level will ever go away…  but someday we may have the political will to start micromanaging cities and towns to force them to be more reasonable about multifamily development.

Will Humble Medicaid, Wills Blog

CMS Finally Defines What Counts Toward Their New Work Requirements

Dr. Oz finally released the details of the new Medicaid work and community engagement requirements for Medicaid members in the ‘expansion population’.

Medicaid Community Engagement Requirement for Certain Individuals Interim Final Rule with Comment Period (CMS-2454-IFC) | CMS

The new rules apply to people 19-64 with incomes between 100 and 138% of poverty. Starting January (or more accurately at their 1st redetermination date after January 1).

Members in the expansion population who aren’t exempt will need to prove they have at least 80 hours of approved activities. People subject to the requirement can meet the requirement by working, taking part in a job-training program, volunteering in their community or combining these activities.

The rules are scheduled to begin on January 1, 2027. For people who are already enrolled in AHCCCS, the new requirement will generally begin with the first regularly scheduled renewal process started on or after that date.

New applicants will need to show that they met the requirement for at least one month before applying.

One of the main things the new rules do is define who’s exempt. Included in the list last week are pregnant women, people receiving postpartum coverage, former foster youth, American Indians, certain caregivers, totally disabled veterans, people taking part in drug or alcohol treatment programs and people who are medically frail.

The biggest risk in terms of who will get kicked off Medicaid next year isn’t that people will no longer qualify because they don’t meet the new criteria.  The big problem is likely to be that people won’t be able to navigate the system to prove they meet the requirements (and Congress new that).

AHCCCS is supposed to use information already available to the government before asking members to submit more paperwork. When AHCCCS can’t confirm that a person meets the requirement or qualifies for an exemption, they need to send the member a notice. The member will then have 30 days to respond before losing coverage.

The Health-e-Arizona Plus website a big part of the story. The portal should be easy to use, easy to understand and easy to navigate on a phone. Notices must be clear. Customer-service staff must be available to help.

The thing is that Health-e-Arizona (AHCCCS’ portal to report compliance) isn’t easy to use right now. If AHCCCS doesn’t fix it in the next few months lots of people who actually meet the work requirements won’t be able to prove it and will lose coverage.

Arizona’s SNAP Eligibility Collapses, Signaling Big Administrative Problems at ADES

Thousands of people lost SNAP food assistance because of administrative errors at the agency level (ADES) and the clunky Health-e-Arizona plus computer portal.

That’s our call to action for them.

Up to 7 million people could lose insurance as states face tight timeline for Medicaid work requirement rules | Arizona Mirror

Will Humble State Legislature, Wills Blog

Legislative Budget Update (and Proposition Stuff)

Many of us thought there would be a budget agreement hashed out last week. Alas, it was not. Perhaps this week will break the ice?

In the meantime, the potential ballot referral measures stay in limbo – creating problems for people and organizations (like us) who want to weigh in on the measures.

The problem is that we still don’t know what will be on the ballot, and the portal for submitting arguments to the voter publicity pamphlet closes on June 24.

The portal for turning in arguments is already open Arizona Publicity Pamphlet Site, meaning people can turn in arguments in the event they end up on the ballot… but if they don’t make it you can’t get your money back.

Our Public Health Policy Committee met Friday to consider the various propositions that might end up on the ballot, and we’ll be making a recommendation to the Board about which to support and oppose next week (we’re recommending that the Board oppose 3 ballot referrals and support 2 voter initiatives.

Next week we’ll get with our Board to make final decisions and to finish argument language to submit. I’ll have that update next Sunday.

I presented the active possibilities last week at the 52nd Annual Rural Health Conference in Flagstaff. You can see the content of that presentation here: RHC Presentation 2026 Ballot Measures.

Will Humble Uncategorized

Grant Opportunities Compiled by the Vitalyst Health Foundation

Due May 27th: .org Impact Awards

Due May 29th: Tribal Projects (State; Tribal; Housing)

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

Due June 1st: Love Your Block

Due June 1st: Smith-Lever Special Needs Competitive Grants Program

NEW Due June 8th: HHS Addiction and Recovery Act Grants

Due June 9th: Expanding Nutrition Services Funding (Federal Funding)

Due June 9th: Arbor Rising

Due June 11th: Funding for Strategic Collaboration in the Impact Investing Sector

Due June 12th: Nonprofit Security Grant Program (State Funding)

Due June 12th: Wayne F. Placek Grants (LGBTQIA+)

NEW Due June 12th: Hanger Foundation Grants

NEW Due June 12th: Shipt Community Impact Grants

Due June 15th: Trauma-Informed Substance Use Prevention Program

NEW Due June 15th: USDA Rural Business Development Grants

Due June 16th: AI-Ready America

NEW Due June 23rd: USDA Rural Health and Safety Education Competitive Grants

NEW Due June 26th: Freeport-McMoRan Foundation Investments

NEW Due June 29th: USDA Rural Development Community Connect Grants

NEW Due June 29th: Bank of America Charitable Foundation Grants

NEW Due June 30th: USDA Rural Business Development Grants

NEW Due July 1st: Looking Out Foundation Grants

NEW Due July 10th: FY26 Transit-Oriented Development (TDO) Planning Pilot Due July 14th: The Indigenous Tomorrows Fund

Due July 15th: Spark Good Local Grants

NEW Due July 29th: W.T. Grant Foundation Research on Reducing Inequality Grants

NEW Due September 15: Journey for Good Foundation Grants

NEW Due October 11th: Whole Foods Market Store Giving

Due October 31st: TJX GrantNEW Ongoing: The Impact Fund Legal Case Grants

NEW Ongoing Until September: GM Corporate Giving Grants

NEW Ongoing: Novartis Educational Grants

NEW Ongoing: QuikTrip Community Grants

Ongoing: U-Haul Community Donations

Ongoing: Cogir Foundation (Youth, Seniors)

Ongoing: BNSF Railway Foundation

Ongoing: PNC Foundation (Education, Economic Development)

Ongoing: Brutten Family Foundation Grant (Environment, Education, Mental Health)

Ongoing: Community Possible grant program (Work, Home, Play)

Ongoing: Native Youth Media Project

Ongoing: Arizona Housing Fund 

Ongoing: Arizona Together for Impact Fund

Will Humble Community Health Workers, Social Determinants, Wills Blog

Public Comment Period Open for AHCCCS Community Health Worker Reimbursement Policy

The public comment period is now open for the AHCCCS Community Health Worker Reimbursement Policy. You can send your comments at this link.

To help prepare your comments, please review the Talking Points for the AHCCCS Public Comment Period on CHW Reimbursement. The document is attached, and the Google Doc is available here.

AHCCCS deserves credit for recognizing that more needs to be done administratively to support and expand the role of Community Health Workers in Arizona’s health care system. This public comment period is an important opportunity to help shape how that work moves forward.

Please consider sending a comment personally, giving one on behalf of your organization, and encouraging leaders from your community or organization to send comments as well.

AHCCCS also values hearing directly from members, so please share this opportunity with clients and community members who may want to provide input.

The public comment period closes August 4.

If you have questions you can kmtucker@arizona.edu at the UofA.

Will Humble Professional Development, Wills Blog

Management by Walking Around: An Evidence-based Best Management Practice

For much of my public health career, I’ve noticed something odd: I often solved work problems when I wasn’t officially “working.” Well actually, it is still happening to me now.

Sometimes it happens while mowing the grass. Sometimes it happens during a walk by myself. Sometimes it happened while fixing yet another irrigation problem at my house.

I also got into the habit of taking stakeholder meetings on the sidewalk. Instead of meeting in my office, I’d have a stakeholder meeting while walking around the Capitol complex. That loop took about a half hour. I found that we’d often solve problems faster on those walks than we did sitting across a table.

At the time, I just thought it worked for me. I didn’t know there was evidence behind it.

This week I ran across a 2014 study by Marily Oppezzo and Daniel Schwartz called “Give Your Ideas Some Legs: The Positive Effect of Walking on Creative Thinking.” It was in the Journal of Experimental Psychology: Learning, Memory, and Cognition.

The paper found that walking helped people come up with more creative ideas than sitting. In one part of the study, 81% of people were more creative while walking than while sitting. Across the experiments, walking increased creative output by about 60%.

You can read the article here: Give Your Ideas Some Legs: The Positive Effect of Walking on Creative Thinking.

The researchers even had people walking on a treadmill facing a blank wall. The benefit still showed up. They also assessed people outside, comparing walkers with people who moved through the same area in a wheelchair. Walking itself made the difference.

The study also found something useful for public health professionals… walking helps most when you’re trying to come up with ideas, not when you’re trying to pick the one right answer. Creativity.

Our work is full of problems that don’t have easy answers. How do we improve access to care? How do we build trust? How do we explain a complex policy in plain English? How do we collaborate with partners who don’t always see the issue the same way?

This doesn’t mean every meeting should become a hike. Arizona gets a vote in this matter, especially from June through September. But when the weather allows, walking meetings are an easy tool. No app. No consultant. No strategic retreat. Just shoes, a little time, and problem(s) to solve.

This week I learned that management by walking around isn’t just a leadership style that worked for me. It’s the best evidence-based best-management practice.

Will Humble Disease Control, Wills Blog

TB Control Depends on Public Health Tools

Maricopa County Public Health recently sent an advisory to clinicians about a cluster of genetically related infectious tuberculosis cases among county residents experiencing homelessness.

MCDPH is working to find and notify people who may have been exposed. Clinicians are being asked to keep TB in mind when seeing patients with compatible symptoms, especially people with unstable housing. Early testing and treatment are key, both for people with active TB disease and for those with latent TB infection who could develop active disease later.

Their advisory also gives clear infection control instructions for healthcare settings.

Now for the public health policy connection. TB control depends on public health authority. Authority that is on the precipice of being eliminated.

If HCR2056 makes it to the ballot and voters approve it, many of the tools needed to control outbreaks like this will be weakened or gone. It’s framed as a “right to refuse” medical mandates, but it goes way beyond school vaccines. It would place broad limits on the ability of counties to require medical treatment or interventions as a condition of access to public spaces or services. That would mean that a person with active TB who won’t take their medicine can just roam around town infecting people.

Resources:

Maricopa County Department of Public Health Tuberculosis
Will Humble Public Health, Wills Blog

Register to Vote!

In recognition of the vital connection between civic participation and community health, AZPHA encourages you to check your voter registration ahead of Arizona’s voter registration deadline for the upcoming primary election on July 21st. 

Primary elections are where huge decisions get made. Turnout is often much lower than in November, which means your vote can carry even more weight in shaping the policies that affect you, our patients, and our communities.

Take 30 seconds right now to verify that you are registered to vote at your current address: vote.health/azpha.

Check your Voter Registration Status

There is a lot at stake right now. Policies that affect public health priorities, and patients’ affordability and access to healthcare, get decided early in these primaries, and we cannot afford healthcare voices to be missing from that process. VoteER has prepared some materials for us to use:

Will Humble Uncategorized

AZPHA Coffee & Conversations Trends in Cancer Screening among Arizona Medicaid Members: 2018-2024

AZPHA Coffee & Conversations

Trends in Cancer Screening among Arizona Medicaid Members: 2018-2024

Biography – Gloria D. Coronado, PhD

Dr. Gloria Coronado is an epidemiologist and cancer prevention researcher who serves as Associate Director for Population Sciences at the University of Arizona Cancer Center and Professor in the Department of Epidemiology and Biostatistics.

With over 25 years of experience in cancer research, Dr. Coronado specializes in developing community- and practice-based health innovations and leading disparities research across diverse healthcare settings. Her research focuses primarily on using electronic health records and risk-stratification tools to deliver targeted preventive care services—particularly colorectal cancer screening and follow-up—to high-need patient populations.

This work has fostered successful partnerships with integrated delivery systems, federally qualified health centers, Medicaid health plans, and rural practices. She has developed and tested digital tools and visual communication strategies to increase colorectal cancer awareness and screening uptake. Dr. Coronado serves as Vice-Chair of the National Colorectal Cancer Roundtable and is a workgroup member of NCI’s National Cancer Advisory Board.

She has published more than 250 peer-reviewed publications or book chapters and served as PI or co-I on more than 50 federally funded grants. In 2021, Dr. Coronado was named ‘Mentor of the Year’ by the Healthcare Systems Research Network.

Dr. Coronado earned her bachelor’s degree from Stanford University and her doctoral degree from the University of Washington. Before coming to the University of Arizona, Dr. Coronado held positions as Assistant and Associate Member at the Fred Hutchinson Cancer Center from 2004 to 2010, followed by roles as Senior and Distinguished Investigator at the Kaiser Permanente Center for Health Research from 2010 to 2023.
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