Will Humble Medicaid, Wills Blog

AHCCCS Seeks Public Input on Proposed Medicaid Work Requirements & 5-Year Lifetime Limit on Benefits

Back in 2015, the Arizona Legislature passed & Governor Ducey signed SB1092, mandating that AHCCCS ask for federal approval to limit lifetime eligibility to 5 years for all ‘able-bodied’ adults (regardless of income).

The law also requires them to ask permission to implement work requirements for all “able-bodied adults” receiving Medicaid.  

AHCCCS is supposed send their request to CMS each April. AHCCCS first submitted the plan and got the green light back in 2019 – but they didn’t implement it because of an ongoing court case challenging the legality of the plan.

The COVID-19 Public Health Emergency put things on hold throughout the rest of 2020.  In February 2021, the Biden Administration’s CMS rescinded approval for the AHCCCS Works program.

As April approaches, AHCCCS is getting ready to submit the request again – and launched their draft proposal, which they plan to submit to CMS in a couple of months.

What they put in their final plan is super important as Dr Oz (the CMS Administrator) is certain to approve the plan (unless he thinks it’s not harsh enough).

According to the draft plan released this week, able bodied adults can be exempt from the work requirements by doing the following things for at least 20 hours per week:

  • Be employed;
  • Attend school; or
  • Attend an Employment Support programs like:
    • English as a 2nd language courses;
    • Parenting classes;
    • Disease management education;
    • Courses on health insurance competency; and/or
    • Healthy living classes.

Not everyone will be subject to these proposed rules (including the 5-year lifetime limits on eligibility) as AHCCCS’ draft proposal exempts the following populations from the definition of ‘able bodied’:

  • People over 55
  • American Indians
  • Pregnant women up to 90 – 120 days post-delivery
  • Former foster youths up to age 26
  • People with a serious mental illness
  • Those receiving temporary or permanent long-term disability benefits
  • Individuals deemed medically frail
  • Full-time students in high school, college, or graduate school
  • Victims of domestic violence
  • Individuals experiencing homelessness
  • Those recently affected by certain events (e.g. death of a household family member)
  • Parents, caretaker relatives, foster parents, and caregivers of family members enrolled in the Arizona Long Term Care System

AHCCCS wants to hear from you about their draft proposal. They’re encouraging the public to review the proposal and share their thoughts.

You can send your comments via email to [email protected]. There are also some public forums about their proposal at AHCCCS Works 1115 Waiver Amendment Request.

Please take some time to look at their proposal and let them know if you have ideas to make it more palatable. All comments are due by March 20, 2025. 

Remember – it’s still important to comment if you think AHCCCS has done a good job identifying the exempt populations and providing a broad interpretation of how members can meet the work (community engagement) requirements!

Editorial Note: How AHCCCS implements the program will be critical to minimizing the number of people who are thrown off of AHCCCS coverage once this is approved and implemented.

In other states that have implemented a similar work requirement lots of people met the community engagement/work requirements but weren’t able to successfully document their service or work – or didn’t know how to – and were thrown off Medicaid even though they were doing what was required of them.

Will Humble Public Health, Wills Blog

What is DEI & Why is it Important in Public Health Practice?

You’ve no doubt heard that the White House recently issued an Executive Order directing federal agencies to stop any and all “Diversity Equity and Inclusion’ policies, personnel positions and activities.

You can read that Executive Order here: Ending Radical And Wasteful Government DEI Programs And Preferencing – The White House

Interestingly, but not surprisingly, the EO doesn’t define exactly what DEI is. There’s no definition in the Executive Order. It refers to the term over and over but doesn’t define it.

So, what is DEI? Diversity, Equity, and Inclusion are foundational principles in public health management that ensure public health policies serve all individuals fairly and effectively.

By integrating DEI into public health strategies, leaders can create more fair health outcomes, reduce health disparities, and improve the overall health & well-being of diverse communities.

  • Diversity encompasses the broad range of differences in race, ethnicity, gender identity, age, disability status, sexual orientation, socioeconomic background, and cultural identity within a population or workforce. A diverse public health workforce reflects the communities it serves, improving cultural competency and responsiveness, and is more likely to develop and effectively implement interventions that improve health outcomes among diverse populations.
  • Equity focuses on cutting systemic barriers to healthcare access and ensuring that resources are distributed based on need rather than equality alone. Unlike equality, which assumes everyone benefits from the same resources, equity acknowledges historical and social disadvantages and looks to address them to level the playing field.
  • Inclusion ensures that diverse voices are actively engaged in decision-making, creating policies and programs that are both representative and effective. An inclusive public health system values different perspectives and fosters a sense of belonging for all individuals.
The Importance of DEI in Public Health Management

Reducing Health Disparities Structural inequalities have long contributed to disparities in healthcare access and health outcomes.

For example, racial and ethnic minorities, low-income individuals, and rural populations often have higher rates of chronic diseases, maternal mortality, and infectious disease exposure. By embedding DEI principles into public health strategies, leaders can tailor interventions that address these specific challenges and reduce disparities.

Enhancing Cultural Competency A diverse and inclusive public health workforce is better equipped to understand and address the unique needs of various communities. Culturally competent care and policies need to consider language barriers, traditional health beliefs, social contexts, and improve healthcare engagement among marginalized populations by fostering trust and credibility.

Improving Public Health Communication Effective health communication requires an understanding of diverse populations. Messaging about vaccination, disease prevention, and health promotion need to be culturally sensitive and linguistically accessible. Without DEI considerations (and diverse staff), public health campaigns are less likely to succeed.

Building Community Trust Marginalized groups have faced discrimination and mistreatment in healthcare, leading to distrust in medical institutions. By prioritizing DEI, public health leaders are better able to rebuild trust through transparent policies, fair resource allocation, and community involvement in decision-making.

Strengthening Public Health Policies Inclusive policymaking that involves diverse stakeholders leads to more effective and sustainable health interventions. Policies that consider the needs of all communities create healthier, more resilient populations and reduce long-term healthcare costs.

By prioritizing DEI, public health management can create fairer, more effective systems that improve health outcomes for all individuals, ensuring that no community is left behind.
Despite the President’s executive order (which applies to the federal government) I expect that many local and state health departments will continue to implement policies and make staffing and hiring decisions using DEI principles.

Why? Because using DEI principles to inform public health policies and staffing decisions is a best management practice.

Besides – many people in the public health profession recognize that structural racism is real – that it has real-life public health consequences and is fundamentally unfair.

Those things alone should be sufficient to sustain grass-roots DEI principles through the next 3.9 years.

DEI Literature

Understanding the Dynamics of Diversity in the Public Health Workforce – PMC

Addressing Health and Health-Care Disparities: The Role of a Diverse Workforce and the Social Determinants of Health – PMC

Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care – PMC & 04/PHR118-4/Betancourt/et al

Structural Interventions to Reduce and Eliminate Health Disparities – PMC

Will Humble Professional Development, Wills Blog

AZPHA’s 2025 Conference – Modernizing Public Health Practice: Building an Innovative & Inclusive Infrastructure for the Public Health of the Future

Thursday, April 3, 2025
Desert Willow Conference Center – Phoenix AZ

This exciting event will take place on April 3, 2025. We’ll have innovative thinkers, practitioners, and researchers to share insights and strategies that drive transformative change in public health in the areas of:

  • Using AI to enhance public health practice and patient population outcomes
  • Data infrastructure and informatics
  • Public health workforce
  • Engaging public health professionals

One of the conference’s key tracks will explore the role of artificial intelligence in public health. As highlighted in Health Affairs, AI is revolutionizing public health by enabling advanced disease surveillance, predictive modeling, and efficient resource allocation. For instance, AI tools are being used to detect outbreaks earlier, allowing for faster interventions.

View Our Agenda!

We’ll have innovative thinkers, practitioners, and researchers to share insights and strategies that drive transformative changes in public health:

  • Engaging Keynote Presentation from Jyoti) Pathak, PhD – Inaugural Dean – ASU School of Technology for Public Health
  • Sixteen (16) breakout sessions with 30 participants in the areas of: Data Infrastructure and Informatics, Public Health Workforce, and Using AI to enhance PH practice
  • Closing Panel Discussion: Innovative Methods and Techniques in Public Health Implementation Science

Register Here Today

Agenda
7:45 45min Registration, breakfast, and posters
8:30 40 min Welcome, opening remarks & Legislative Updates- Cottonwood
9:10 50 min
Plenary Keynote: Improving Perinatal Mental Health: An Opportunity for Healthcare and Public Health to Collaborate

Jyotishman (Jyoti) Pathak, PhD; Inaugural Dean – ASU School of Technology for Public Health
10:00 30 min Break & posters
10:30 50 min Breakout #1
Ocotillo Identifying and explaining suicide, homicide, and overdose hot spots in Arizona, plus an Arizona Violent Death Reporting System dashboard presentation

  • Charles  Katz, School of Criminology & Criminal Justice, Arizona State University, Professor
  • Jordan Batchelor, Center for Violence Prevention and Community Safety, Arizona State University, Research Analyst
  • Laura Lightfoot, School of Criminology & Criminal Justice, Arizona State University, Doctoral student
Cottonwood Leveraging AI to Standardize Housing Interventions: Advancing Public Health Infrastructure in Arizona’s Continuum of Care Programs

  • Kristin Ferguson, Arizona State University School of Social Work Professor
  • Natasha Mendoza, Arizona State University School of Social Work, Associate Professor & Research Director
  • Cinthia Martinez, ASU SIRC, Senior Program Manager, Community Engagement
Brittlebush Public Health Inclusion and Belonging and Employee-Driven Approach

  • Sue Damiata, Pinal County Public Health, Workforce Development Program Manager
Desert Star Enhancing Depression Care for Pregnant and Postpartum Women Through Data Visualization: Insights from the Arizona EQUIDEM Pilot Project

  • Matt Martin, Arizona State University, Clinical and Research Associate Professor
11:20 10 min Transition
11:30 50 min Breakout 2
Ocotillo The 2024 State Health Assessment

  • Celia Nabor, MPA, Arizona Department of Health Services, Assistant Director, Prevention Services
  • Nicole DeWitt, Arizona Department of Health Services, Assistant Deputy Director, Public Health Preparedness
Desert Star Merging Minds and Machines (M & M’s) | Re-envisioning Public Health Innovation

  • Deanna Lewis, DrPH, MBA, PA-C, Forward Moving Concepts, llc, Consultant
Cottonwood Bridging the Gap: Cultivating Public Health Leaders Through Workforce Innovation and Experiential Learning

Diana Kinsfather MS, RDN, Maricopa County Department of Public Health Applied Professional Experiences Supervisor (APEX)

  • Lisa Polovin, Maricopa County Department of Public Health Fellowship Coordinator
  • Lisa Clarke, MS, RD, CNSC, Maricopa County Department of Public Health Dietetic Internship Coordinator
  • Tatiana Gleason, MPA, Maricopa County Department of Public Health Public Health Internship Coordinator
Brittlebush Integrating Data to Action: Enhancing Overdose Surveillance and Response in Pima County

  • Mark Person, Senior Program Manager, Pima County Health Department.
  • Rachael Hinkel, Epidemiologist, Pima County Health Department.
12:20p 70 min Lunch & posters
1:30 50 min Breakout 3
Cottonwood Substance Use Data to Action: Development of the City of Phoenix Opioid Overdose Alert System Methodology and Program Framework

  • Kelli Kostizak, MPH, City of Phoenix, Special Projects Administrator
  • Matt Miller, PhD, ASU’s REACH Institute & SATRN Postdoctoral Fellow
  • Nick Shively, City of Phoenix Business Analyst
  • Yanitza Soto, MPH, City of Phoenix, Public Health Advisor
Ocotillo Leveraging AI for Smarter Public Health Decision-Making: Balancing Innovation with Cultural Responsiveness

  • Prabhneet Girn, MPH, Arize Care Consulting, Founder & CEO
Desert Star Fostering Connection and Quality: Improving Behavioral Health Care Through Collaboration

  • Victoria Tewa MS, LPC, The Alliance ACO/ NARBHA Institute, Director of Clinical Advancement
Brittlebush Tribal Healthcare Workforce Development: A Collaborative Approach

  • Ernestine Nasingoetewa, American Indian Health – Area Health Education, Center Grants Program Coordinator
2:20 15 min Break and transition
2:35 50 min Breakout 4
Cottonwood Data as a Driver of Action: Leveraging Wastewater Monitoring for H5 Detection and Response

  • Chelsi  White, MS, CIC Maricopa County Department of Public Health Senior Surveillance Epidemiologist
  • Crystal M.Hepp Ph.D, Translational Genomics Research Institute and NAU Associate Professor
  • Sarah Avalle, MS, Arizona Department of Health Services   Wastewater Surveillance Epidemiologist
Desert Star The AI Co-Worker You Never Knew You Needed

  • Carmen Batista, Maricopa County Department of Public Health, Division Administrator
  • Nina Lindsey, Maricopa County Department of Public Health, Grant Unit Manager
Brittlebush Building a Sustainable Mental Healthcare Workforce in Arizona: Provider Perspectives and Solutions

  • Nathanial Meitl, Arizona State University College of Health Solutions, Undergraduate Researcher
Ocotillo Building the Future: Strengthening the Public Health Workforce by Reimaging Graduate Education

  • Abigail York, Arizona State University, Professor
  • Kristen Pogreba-Brown, University of Arizona, Associate Professor
  • Megan Jehn, ASU, Professor
3:25 15 min Break & Transition
3:40

 

50 min
Closing Plenary Panel
Innovative Methods and Techniques in Public Health Implementation Science – Panel Presentation
  • Cameron Adams, AHCCCS Program Administrator
  • Taylor Vaughan, MPH, ASU Data Science Specialist
  • Samantha Basch, MS, Research Project Coordinator, ASU Targeted Investments Program
  • Nga Vu, Student Researcher, ASU Targeted Investments Program
4:30 5 min  Closing Remarks and Evaluation

 

See Our Sponsorship Opportunities

Register Here Today

See Our Agenda

Will Humble Reproductive Health, Wills Blog

Navigating Arizona’s Post-Prop 139 Abortion Landscape

In November 2024, Arizona voters decisively approved Proposition 139, enshrining a constitutional right to abortion care prior to fetal viability—typically around 24 weeks.

This landmark decision reflects a significant shift in public sentiment toward reproductive rights in Arizona. However, the journey to fully align state laws with this new constitutional amendment is proving complex.

Despite the passage of Prop 139, several pre-existing abortion restrictions are still active in Arizona. These include mandatory waiting periods, requirements for patients to view ultrasounds, and extensive data collection mandates for providers.

Such regulations are seen by many as obstacles that contradict the spirit of Prop 139, which aims to ensure accessible abortion care up to the point of viability.

In response, Senator Ortiz has introduced SB 1553 which aims to repeal more than 40 abortion-related statutes that impact Arizonans’ access to care. 

The primary goal of SB 1553 is to harmonize Arizona’s statutory framework with the constitutional protections established by Prop 139. By dropping outdated restrictions, the bill aims to ensure that state laws do not impede the reproductive rights affirmed by voters.

Despite its intentions, SB 1553 hasn’t even been assigned to a committee, suggesting it won’t be successful.

After Prop 139, Arizona Democrats try to remove abortion restrictions

Meanwhile, legal challenges are another avenue to address the conflicts. Healthcare providers are challenging the existing law restricting access to abortion in Arizona beyond 15-weeks of pregnancy in court, arguing that the law is incompatible with the constitutional rights established by Prop 139.

The interplay between legislative initiatives and judicial proceedings (mostly judicial it appears at least for the next 2 years) will determine whether and how quickly Arizona will harmonize the will of the people as expressed by Prop 139 & the conflicting barriers to care that were in statute prior to the passage of the voter approved law guaranteeing abortion care rights in our state constitution.

Will Humble Public Health, Wills Blog

Public Health Journalism this Week

Health Secretary Robert F. Kennedy Jr shares views on vaccines – Arizona PBS

Fentanyl is easy to find. Addiction medications? Not so much | Opinion

State finds safety violations at Mesa birth center after baby dies | 12news.com

Arizona cares more about bathrooms than teen gun deaths | Opinion

House GOP budget cuts $4.5B in taxes, likely paid for by slashing Medicaid & social programs • Arizona Mirror

RFK Jr. confirmed as nation’s health chief despite vaccine denial, conspiracy theories • Arizona Mirror

Kris Mayes sues Trump over cuts to medical, public health research

Research universities reel from ‘catastrophic’ Trump administration cut to NIH funding • Arizona Mirror

Will Humble Medicaid, Wills Blog

Arizona’s Medicaid on the Brink: 550,000 May Lose AHCCCS Health Insurance Amid Federal Cuts

Leadership in Congress has tasked their committees with coming up with details to slash trillions of dollars in federal funding for various programs – including Medicaid. While leadership didn’t define exactly which programs to cut – they gave the various committees the task of ‘finding the money’ to cut among the executive branch agencies that they oversee.

Among the likely early proposals will be one to cut way back on the federal contributions for Medicaid coverage for what’s known as the ‘expansion population’ (in our state that’s ‘childless adults & people between 100 and 138% of poverty).

The current plan to ‘come up’ with the cuts is to reduce the federal contribution for Arizona’s expansion population from 90% to 65%, triggering automatic coverage losses under state law. The result? Approximately 550,000 Arizonans, including low-income adults and individuals earning between 100% & 138% of the federal poverty level would be left uninsured. 

Interestingly, the parts of the state that voted for Mr. Trump by the widest margins are in the very areas that stand to lose the most if these cuts happen. Thirty-six percent of working-age Arizona adults who live in rural Arizona are covered by Medicaid versus 17% who live in urban areas, data from Georgetown University’s Center for Children and Families shows.

Medicaid funding cuts could put thousands of Arizonans in peril

Arizona’s existing “trigger law” means any reduction in federal funding automatically cuts coverage for these populations unless the state steps in to fill the financial gap.

And that’s where the problem lies. Arizona’s Hospital Assessment—designed to fund the state’s share of Medicaid expansion—is already at its legal limit of 6% of net patient revenue. To keep coverage, the state would need to find nearly $1 billion annually to replace the lost federal funds.

Given the Republican majority in the Arizona Legislature, which has historically opposed increasing state Medicaid funding, there’s little chance that lawmakers will allocate the necessary resources.

Without a new funding mechanism, Arizona’s Medicaid expansion will collapse, disproportionately affecting rural residents who rely on it for primary and emergency care.

Beyond the direct human cost, these cuts will place strain on Arizona’s healthcare system. Hospitals in rural areas would have a sharp rise in uncompensated care costs as uninsured patients crowd emergency rooms—often their only choice for medical treatment (care that the hospitals won’t get paid for).

This financial pressure could force some hospitals to scale back services or even shut down, further worsening the healthcare crisis in underserved communities.

Politically, the cuts are part of a broader effort to dismantle key ACA provisions, rolling back Medicaid expansion in multiple states. While some states might be able to cushion the blow by reallocating funds, Arizona’s trigger law ensures an immediate impact.

The High Stakes of Medicaid Cuts: What Arizona Stands to Lose (and a simple solution) – AZ Public Health Association

For now, advocacy groups are focusing on convincing Representative Ciscomani to be wary of going along with a change in the federal contribution to support enrollment of the expansion population. Other representatives in a few other ‘trigger’ states like ours are also being targeted for ‘education’.

We’ll see later this year if it makes any difference.

Rep. Juan Ciscomani signals doubt about Republican Medicaid cuts

Will Humble Professional Development, Public Health, Wills Blog

Arizona Grant Opportunities (Compiled by the Vitalyst Health Foundation)

Due February 10th: FORGE Grant (Racial & Gender Equity)

Due February 15th: EmpowHer Grants (Female Business Founders)

Due February 15th: Emerging Leader Grant (Christian Orgs)

NEW February 15th: Trans Justice Funding Project

NEW Due February 18th: South32 Hermosa Community Fund (Santa Cruz)

NEW Due February 21st: Communities Transforming Policing Fund

Due February 21st: Comunidad Grants (Southern Arizona)

Due February 21st: CORE Grants (Southern Arizona)

Due February 21st: Strategic Prevention Framework – Partnerships for Success for Communities

Due February 27th: Technical Assistance to Tribes

NEW Due February 28th: Marshall Foundation Grants (Pima County)

Due February 28th: From the Heart (Glendale)

Due February 28th: Rural Business Development Grant Program

Due February 28th: Partners for Places

Due Late February: The Scottsdale Charros (Scottsdale)

NEW March 1st: Mini Grants (Bisbee)

Due March 1st: Endowment for the Arts Grant

Due March 1st: Dr Scholl Foundation

NEW Due March 4th: National Academy of Medicine Catalyst Award Competition

Due March 6th: Distance Learning & Telemedicine Grants

NEW Due March 13th: Sexual Violence Prevention and Education

Due March 14th: Pathway Home 6 (Reentry Workforce)

Due March 15th: Sundt Foundation

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

Due March 20th: Rural Emergency Medical Services Training

NEW Due March 21st: Tribal Projects (State Funding)

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

NEW Due March 31st: Building Capacity for Health Advocacy

  • Application Webinar February 13th: Register

Due March 31st: Sunset Grant

NEW Due April 4th: Smart and Connected Communities

Due April 7th: Emergency Drought Relief for Tribes

Due April 6th: Rural Business Development Grants

NEW Due May 16th: Trans Justice Funding Project

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

  • Applicant Webinar February 24th: Register

NEW Ongoing: Legal Reform (Indian Land)

Ongoing: Arizona Housing Fund 

Ongoing: Arizona Together for Impact Fund
Will Humble Public Health, Wills Blog

Navigating Uncertainty: Arizona’s Public Health System at Risk from Federal Funding Slash Threat

Arizona’s public health system has been trying to navigate a storm of uncertainty due to the federal public health grant funding cuts planned by the Trump administration.

Their initiative to halt a broad spectrum of state and local public health grants and cooperative agreements has been temporarily paused by a federal judge, but the looming threat of these essential programs being eliminated remains.

Arizona’s public health system is heavily dependent on federal funding, primarily through grants and cooperative agreements with federal agencies.

Critical areas such as sexually transmitted disease prevention, high-risk perinatal programs, maternal and child health services, overdose and substance use disorder prevention, public health preparedness, SNAP education, Ryan White HIV medications, immigrant and refugee health programs, and adult vaccinations are all at risk.

The situation is further complicated by the funding structure between county health departments and ADHS (the primary grant recipient who passes the money to the counties). 

Typically, county health departments run on cost reimbursement contracts, meaning they initially cover the expenses for vital public health initiatives with the expectation of being reimbursed through federal funds. With the potential freeze or reduction in federal funding, these departments face significant financial strain, jeopardizing their ability to maintain essential services.

The Trump Administration’s primary grievance with public health practice appears to be public health’s focus on health disparities and health equity – which are foundational principle of public health practice.

As reported in Governing, the Trump administration has issued orders to freeze disbursement of federal loans and grants, with language suggesting a reevaluation of programs related to diversity, equity, and inclusion.

State Health Departments Prepare for a Period of Uncertainty

The uncertainty surrounding federal funding is causing major disruptions and anxiety at the local health department level. Public health officials, their county managers and supervisors are grappling with the challenge of planning and executing programs without assured financial support.

For Arizona, the stakes are especially high. Our reliance on federal funds means that any disruption can have cascading effects on the health outcomes of Arizonans. 

Sadly, despite that advocacy, it may in the end be up to judges to decide whether the administration’s goal of eliminating public health practice is a violation of law and or the constitution.

Challenging times.

Will Humble Firearm Safety, Injury Prevention, Public Health, Wills Blog

Firearms: A Leading Cause of Death Among Children and Adolescents

Guest blog by AZPHA Member Allan Williams, PhD

In 2018, a paper by Cunningham et al in the New England Journal of Medicine reported that between 1999 and 2016, firearm injuries were the second leading cause of death among children and adolescents (ages 1-19) in the US, trailing only motor vehicle crashes.

A subsequent analysis by Goldstick et al in the same journal using data thru 2020 found that by 2020, firearm deaths became the leading cause of death in that age group, exceeding for the first time motor vehicle deaths. An additional finding was that drug overdose and poisoning deaths surpassed cancer deaths as the third leading cause.

Using the same definitions and methods as those previous reports, the situation in Arizona differed from the US in that three different causes have competed for the leading cause of death since 2020.

As shown in the figure below, drug overdoses and poisoning were the leading cause in 2020, while motor vehicle crashes were again the leading cause in 2021 and 2022.

Then, in 2023 firearm deaths became the leading cause of death.

Firearm injuries have remained the leading cause of death among children and adolescents in the US during 2022-2023. As shown below, among the states with adequate data during that period, firearm injuries were the leading cause of death in 23 states and tied with motor vehicle crash deaths as the leading cause in two states (AZ & KY). 

In Arizona, 31% of the firearm deaths among youth were classified as unintentional or suicides while 63% were classified as homicides, all outcomes that could be reduced with secure gun storage legislation and public awareness by households with guns. A 500-page critical systematic review of research by the RAND Corporation (Smart et al, 2024) concluded that:

“We find supportive evidence, our highest evidence rating, that CAP laws, or safe-storage laws, reduce self-inflicted fatal or nonfatal firearm injuries, unintentional firearm injuries and deaths, and firearm homicides among youth.

There is also moderate evidence that CAP laws reduce firearm suicides among young people, and limited evidence that such laws reduce unintentional firearm injuries among adults. The evidence is stronger for negligent-storage laws than for reckless endangerment laws; reckless endangerment laws are sometimes considered a weaker form of CAP law.”

“States without negligent-storage CAP laws should consider adopting them or other safe-storage laws as a strategy to reduce total and firearm suicides, unintentional firearm injuries and deaths, and firearm homicides among youth.”

Several cities and 26 states have such laws. However, as noted in the 2023 AZPHA comprehensive report Gun Violence in Arizona: Data to Inform Prevention Policies, Arizona lacks these and most other gun violence prevention laws and ranks 43rd in the country in 2025 for the overall strength of its gun laws by Everytown Research.

Will Humble State Legislature, Wills Blog

Legislative Update: February 9, 2025

Last week the legislature advanced bills to:

  1. require health insurance companies to tell their enrollees why their claim or prior auth was denied and who to contact for an appeal (HB2130);
  2. require ADHS to be more transparent with complaint investigations at licensed healthcare institutions (HB2176);
  3. remove the requirement that opioid bottles have a ‘red cap’ because it facilitates diversion (HB2291); and
  4. prohibit DES from considering the vaccination status of foster families as a condition of placement. 

They failed to advance a bill that would have tasked DES with asking USDA to allow them to exclude candy and soda pop from the list of foods SNAP recipients can choose (HB2165).

This week they’ll be considering bills to:

  1. allow parents to see all of their child’s medical records (we oppose HB2126 because of STI issues);
  2. include serious mental illnesses on the list of conditions that can be considered for ALTCS enrollment (they are currently excluded – we support HB2491);
  3. allow hospitals to transfer patients between their hospitals via ambulance by getting an expedited interfacility certificate of necessity (we support HB2124);
  4. allow the Sanitarian Council to expand the kinds of prerequisite college credits that qualify an applicant to take the sanitarian exam (we support HB2125);
  5. include preventive dental care in the current $1K AHCCCS dental benefit (we support SB1347); and 
  6. appropriate funds to establish secure residential behavioral health facilities (we support SB1442)
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