Will Humble Professional Development, State Legislature, Wills Blog

Arizona’s 2026 Legislative Session: A PublicHealth Perspective Friday, August 28, 2026

View the Webinar

AI Webinar Summary

Will led a comprehensive review of the 2026 legislative session from a public health perspective, covering both passed bills and vetoed measures that would have harmed public health.

The session included several significant public health wins, including improved licensing and oversight of skilled nursing and assisted living facilities through bills 2176, 1162, and 2195, as well as new requirements for county jails to screen for mental health needs at intake through bill 2673.

The governor successfully vetoed numerous bills that would have negatively impacted public health, including measures that would have prohibited vaccine incentives for providers, restricted business vaccine requirements, and required hospitals to ask about immigration status.

The budget included important funding wins of $21 million for eligibility staffing at Access and DES to prepare for HR1 implementation, along with $13 million to modernize the Healthy Arizona Plus computer system.

Will also reviewed upcoming ballot propositions, noting that only nine measures would appear on the ballot after several were removed by courts, and discussed AZPHA’s positions against Propositions 144 (securing elections) and 319 (banning photo enforcement cameras).

2026 Legislative Session Public Health

Will presented a summary of the 2026 legislative session from a public health perspective, highlighting both positive developments and areas of concern. Key public health wins included new licensing structures for skilled nursing and assisted living facilities, improved notice requirements and informal dispute resolution processes, better collaboration between AHCCCS and ADHS, and enhanced access to personnel records. Will also discussed a compromise bill allowing cameras in assisted living facilities with resident and family consent, noting that while watered down from previous versions, it represented progress in addressing family concerns about facility oversight.

Long-Term Care Monitoring Requirements

Will explained that a new bill requiring long-term care facilities to disclose whether they allow video monitoring in residents’ rooms will take effect in a few weeks, though he noted this is only a partial step forward and AARP has been pushing for more comprehensive monitoring requirements for years.

The discussion then shifted to a new bill (2673) requiring county jails to screen for mental health needs at intake, though Will expressed concern about the weak enforcement provisions in the bill. The conversation ended with Will mentioning that Maricopa County jail has experienced deaths from drug overdoses and suicide, though the specific numbers were not provided.

Mental Health Court Bills Discussion

Will discussed two bills related to mental health court-ordered treatment and judicial review, explaining that House Bill 2923 aims to streamline the process for families seeking court-ordered treatment while balancing treatment needs with civil liberties. Will noted that current processes are cumbersome and may require additional legal action to address compliance issues in Maricopa County.

Sharon Barnes from Arizona Mad Bombs clarified that Senate Bill 1113 allows for process serving of individuals in hospitals and facilities without involving police, which helps avoid trauma from law enforcement interactions and reduces costs.

Police Presence and Housing Reforms

Sharon and Will discussed the challenges of police presence in facilities serving populations with trauma from past law enforcement interactions. Will agreed to update a slide with more depth on this topic based on Sharon’s input.

Will also explained a small victory in public health housing, highlighting changes to Arizona’s Residential Landlord and Tenant Act that make it easier for tenants to document payment of eviction judgments and potentially seal records, though he noted this is just a step toward needed reforms to balance landlord-tenant rights.

Legislative Updates and Veto Status

Will presented updates on recently passed and vetoed bills, including a new requirement for state agency chief medical officers to maintain active MD or DO licenses, and a victory for breast cancer screening cost-sharing prohibition in commercial health plans.

He emphasized the importance of stakeholders providing feedback to the governor’s office regarding why certain bills should be vetoed, as this helps justify the vetoes of problematic legislation. Will also highlighted that the governor successfully vetoed a bill that would have prohibited health plans from offering financial incentives to providers for high vaccine participation rates.

Budget and Vetoed Bills Update

Will discussed several vetoed bills, including one that would have stopped businesses from requiring masks or vaccinations, which the governor vetoed. He highlighted key budget wins, including $21 million allocated for eligibility staffing at Access and DES to handle new Medicaid requirements from HR1, and $13 million for modernizing the Healthy Arizona Plus computer system.

Will also reviewed upcoming ballot propositions, noting that only nine measures would appear on the ballot after some were removed by courts, and explained that AZPHA opposed Prop 144 (which would restrict mail-in voting) and Prop 319 (which would ban photo enforcement cameras).

Will Humble Professional Development, Public Health Law, Vaccination, Wills Blog

What Does It Take to Run the FDA: Is Overton Up to the Task?

The president has nominated Dr. Heidi Overton to be the next Commissioner of the FDA. She’ll be up for Senate confirmation at some point in the next few months presumably. Is she up to the task?

A good place to start is: What is the job, and how prepared to do a good job is she?

FDA is basically a regulatory agency. It oversees most foods moving in interstate commerce (including imports); prescription and over-the-counter drugs; vaccines; medical devices; tobacco products; cosmetics; and animal drugs and feed.

And it’s huge. FDA’s budget is $7B ($3.4B in appropriations and $3.6B in industry user fees. They have (or I should say had before DOGE) 18,200 FTEs, but after Kennedy implemented DOGE cuts, they only have 16,000 employees now.

So, the commissioner oversees roughly 16,000 employees, laboratories, inspectors and regulatory operations around food, drugs and animal products around the country and overseas.

FDA can’t wing the way it regulates foods and drugs. Their authority comes from statutes enacted by Congress (mostly the Federal Food, Drug, and Cosmetic Act and its amendments). Over decades FDA has adopted detailed regulations to guide their regulatory actions in Title 21 of the Code of Federal Regulations.

When FDA makes regulatory decisions or changes regulations, they’re supposed to follow federal administrative procedures (including notice-and-comment rulemaking) and they have to stay within their statutory and administrative boundaries. They have discretion, but they also have strict boundaries.

When people are adversely impacted by FDA decisions think FDA got it wrong, they’re not shy about suing FDA. Judges examine whether the agency stayed within its statutory authority, followed required procedures, applied their regulations properly and adequately explained its decision.

FDA decisions therefore have to survive not only scientific scrutiny but often judicial review because they’re a regulatory agency.

So… the FDA commissioner needs more than scientific credentials. The job requires leadership, administrative experience, discipline, and regulatory competence.

Oddly enough, Congress says nothing about the qualifications the FDA commissioner is supposed to have. 21 U.S.C. §393 says the commissioner is nominated by the president and confirmed by the Senate. There’s no required degree, scientific background, regulatory experience or management experience. That’s inadequate.

Arizona actually does somewhat better. ARS §36-102 requires the ADHS director to have administrative experience with progressively increasing responsibilities; an educational background preparing the director for the position’s administrative responsibilities; and health-related experience ensuring familiarity with health problems.

Those qualifications aren’t perfect, but at least they recognize the need for subject-matter knowledge and administrative experience.

Congress does spell out the FDA commissioner’s duties. The law says the commissioner provides “overall direction,” establishes and implements policies for FDA management and operations, and coordinates and oversees its administrative entities.

So how does Overton stack up?

Her medical and scientific background is good. She earned an M.D. from the University of New Mexico, trained in surgery at Johns Hopkins, earned a Ph.D. in Clinical Investigation from the Johns Hopkins Bloomberg School of Public Health and is board-certified in Public Health and General Preventive Medicine. Her peer-reviewed research includes work on opioid prescribing and improving physician practice using data.

She also has some policy experience. She served as a White House Fellow, became Chief Policy Officer at the America First Policy Institute and now serves as Deputy Director of the White House Domestic Policy Council.

She also served as a voting member of the University of New Mexico Board of Regents. The American College of Preventive Medicine notes that her specialty includes training in epidemiology, biostatistics and health-systems management.

The weak part of her résumé is large-scale operational management and a lack of regulatory experience. I can’t find any evidence that she has run a major agency, managed large numbers of employees or ran a complex regulatory organization.

There’s also a separate question about scientific independence. In a 2023 interview, Overton called for “conservative-based” scientific journals and alternative research infrastructure. She has also advocated restrictions on mifepristone from an explicitly anti-abortion policy perspective.

Overton appears to be scientifically qualified and has some policy experience. But (and this is really important for a huge regulatory agency) she really doesn’t have any executive and no regulatory experience.

There’s also a risk that her political viewpoints could override whatever past professional commitments she’s had to evidence-based decision making.

And for a regulatory agency as big and as important as the FDA… that’s a big question-mark. If she is rogue in the end, at least we still have checks and balances in the constitution and a fairly independent federal judiciary as a backstop.

Editorial Note: One reason I’m comforted a bit by the prospect of the public health damage an administrator Overton could do is the Supreme Court’s 2024 decision in Loper Bright Enterprises v. Raimondo, which overturned the 40-year-old Chevron deference doctrine.

Under Chevron, when a statute passed by Congress was in question, courts generally deferred to a federal agency’s reasonable interpretation of the law.

The Loper Bright case changed that. The Supreme Court held that under the Administrative Procedure Act, judges are supposed to independently assess what federal statutes mean rather than deferring to an agency’s interpretation.

I wasn’t enthusiastic about that ruling when it came out because it shifted authority away from subject-matter experts in federal agencies and toward judges.

But… there’s another side to it. If an ideologically driven FDA commissioner pursues an ideological agenda and makes inappropriate regulatory decisions federal courts now have way more authority to overturn federal agency decisions

Will Humble Climate Change, Public Health, Social Determinants, State Legislature, Wills Blog

Yet Another Giant APS Electricity Rate Hike & Return on Equity Boost? Really? 

Arizona Public Service (APS), the state’s largest (monopoly) electric utility, is asking the Arizona Corporation Commission (the five-member body that oversees monopoly utility rates) for a whopping 14% rate increase this year.

If you’re one of APS’s more than 1.4 million customers, you deserve to know a few things about their request that aren’t getting enough attention.

APS is a monopoly utility. If you live in its service territory, you don’t have any choice of which utility to get your power from—it’s the only one allowed to operate there.

The company knows this about its customers, which makes it especially important for the elected members of the Commission to scrutinize APS’ rate increase requests to make sure they’re really necessary. In recent years, they haven’t been doing that.

Let’s dig into some details. The Commission already rubber stamped an 8% rate increase that took effect in 2024. Now APS already wants another 14% rate increase?

And it’s not just rate increases that the Corporation Commission has been generous to APS with.

APS is already allowed a generous 9.55% return on equity — the return regulators allow the company to earn for its shareholders on the equity in its utility system.

Now APS wants the Commission to bump that up to 10.7%, on top of the 14% rate increase!

There’s compelling evidence that nothing close to a 14% increase is necessary to provide reliable service. Pinnacle West, APS’ parent company, had more than $616 million in net income in 2025.

CEO Ted Geisler received about $8.1 million in compensation that year. Former CEO Jeff Guldner received about $2.8 million. All that ultimately comes out of customers’ pockets.

Thankfully, Attorney General Kris Mayes has our back. She filed expert testimony showing that APS could maintain reliable service and a strong credit rating with an increase of about 3%—a far cry from the 14% we’re now told is needed.

The timing matters too. The Corporation Commission expects to decide this case by the end of December—after the November election but before newly elected Commissioners take office. In other words, the current Commission will decide whether APS gets its latest increase.

APS wants more than just higher rates and a higher return for shareholders. They’ve also been walking back their earlier clean-energy commitments.

In 2020, APS committed to providing 100% clean, carbon-free electricity by 2050.

It also set interim goals for 2030 and said it would end coal-fired generation by 2031. That would have set APS on a path to providing cleaner, more affordable energy for decades to come.

APS has since walked back those commitments and joined other Arizona utilities in backing a major new methane gas pipeline project to bring gas from West Texas to Arizona. When utilities make long-term investments in fossil fuel pipelines, supply contracts and power plants, they lock customers into those costs—and the resulting air pollution—for years to come.

The Corporation Commission is expected to vote on the request after the November 3 general election. Take time before then to tell the commissioners you’re not a piggy bank for companies that are already comfortably profitable.

You can find their contact information at www.azcc.gov.

And remember to research your vote for the Corporation Commission carefully this fall.

Your family budget is on the ballot!

See also in the Yuma Sun at: Guest Column: Yet another giant APS electricity rate hike? Really? | Humble Opinion | yumasun.com

Will Humble Healthcare, Medicaid, Public Health, Social Determinants, Wills Blog

Arizona’s First H.R. 1 Medicaid Cuts Arrive October 1 Refugees, Asylees & other legally present people are 1st in line for cuts

Beginning October 1, the first of the healthcare (Medicaid) cuts from H.R. 1 kick in – throwing thousands of legally present refugees and asylees off of Medicaid coverage.

Refugees, people granted asylum and several other humanitarian groups who’ve long been eligible will no longer qualify because federal Medicaid funding is being taken from these legally present immigrants.

The federal rules also knock off people in several other humanitarian immigration categories that previously counted as qualified noncitizens.

Folks that will still qualify are certain Cuban and Haitian entrants, people from Compact of Free Association countries (e.g. Marshall Islands) and lawful permanent residents (called LPRs or green-card holders).

The people who will get kicked off AHCCCS aren’t undocumented immigrants sneaking into Medicaid. They’re people the federal government (under federal law) legally admitted and allowed to remain in the US because they fled persecution, violence, trafficking or other dangerous things.

Here’s What That Means in Real Life

Imagine a woman named Samira.

She’s 42. In South Sudan she was a nurse. She fled after she and her family were threatened, leaving behind her profession, her home and almost everything familiar to her. She eventually made her way to the US, where the federal government reviewed her case and granted her asylum because she had a legitimate fear of persecution if she returned home.

Today, she lives in Arizona.

Her nursing credentials didn’t transfer easily, so she works as a nursing assistant, caring for seniors who need help bathing, dressing, eating and getting through their day. She works. She pays taxes. She’s building a life here. And she is here legally, with the permission and protection of the US government and under federal law.

Refugee Services | Valleywise Health

Samira also has Type 1 diabetes. AHCCCS pays for the insulin, testing supplies and regular medical care that allow her to manage her disease and keep showing up for work. With treatment, diabetes is something she lives with. Without treatment, it can become life-threatening very quickly.

On September 30, Samira is eligible for AHCCCS coverage.

On October 1, she’s not. She’s still the same person with the same income. She still has the same job. She is still caring for Arizona patients. She still has diabetes. She’s still legally living in the US under asylum granted by our own government.

But she’ll no longer qualify for full Medicaid coverage solely because she is an asylee, because of H.R. 1 (it’s not AHCCCS’ fault).

Unless Samira has since become a green-card holder or falls into one of the narrow immigration categories Congress preserved, she’s left with only Federal Emergency Services.

Federal Emergency Services can help pay when Samira is sick enough to have a true medical emergency. It doesn’t replace the insulin, routine doctor visits, laboratory testing and ongoing care designed to prevent that emergency from happening in the first place.

The AHCCCS Letters Are Going Out

AHCCCS has already sent advance notices to about 22,263 people who are likely affected by the H.R. 1 cuts. Another 12,000 people receiving SSI cash benefits will need to go through a separate review.

Members are beginning to receive Requests for Information asking them to provide documents so AHCCCS can figure out whether they still qualify.

See the initial AHCCCS letter

There are going to be two ways people lose AHCCCS coverage because of H.R. 1. The first is a real loss of eligibility.

Samira could turn in every document AHCCCS asks for and still lose her full coverage because she simply doesn’t fit the new rules Congress wrote.

The second is paperwork.

Suppose Samira had already gotten her green card. In that case she might still qualify. But AHCCCS needs to know that.

What happens if the letter goes to an old address? What if she doesn’t understand what AHCCCS is asking for? What if she can’t find the immigration document quickly enough? What if she sends something in but it isn’t exactly what the AHCCCS eligibility worker needs?

She could lose coverage even though she’s actually still eligible. Many will.

Get Used to Those Two Problems

These same two ways of losing Medicaid are going to become a much bigger issue next year.

Beginning in 2027, H.R. 1 puts new work and community-engagement requirements on many Arizona adults covered through Medicaid expansion. It also requires many of them to prove their eligibility twice a year instead of once.

AHCCCS now estimates about 380,000 Arizonans will be subject to the new work requirements after exemptions are considered.

Again, people will lose coverage in two different ways. Some won’t meet the new rules and will lose eligibility.

Others actually will meet the rules but could lose their AHCCCS because they didn’t or couldn’t successfully complete the paperwork needed to prove it.

UPDATED: Where Does Arizona’s Medicaid Work Requirement Planning Stand? A Summary – AZ Public Health Association

That second group matters.

Hospitals, community health centers and other providers will end up absorbing more uncompensated care, but not for routine kinds of care that people need and deserve. Just emergency care.

Remember who we’re talking about.

Refugees are people who fled persecution. People granted asylum went through a legal process and convinced a judge using US law rules that they needed our protection.

Trafficking victims have survived exploitation. Humanitarian parole is granted because the federal government found an urgent humanitarian reason to let somebody enter the country.

These are some of the most vulnerable people living among us.

They’re legally presnet. They qualified for Medicaid legally. They enrolled in AHCCCS legally. Many have doctors, medications and ongoing treatment just like everybody else.

Now Congress has decided to take that health coverage away from them. Arizona didn’t make that choice. AHCCCS didn’t make that choice.

Congress did.

Samira came to this country because we told her she could be safe here. She built a life, found a job caring for others and did everything we asked of her.

Beginning October 1, we’ll still benefit from the care she gives to others while taking away the health coverage that helps keep her well enough to provide it.

Who have we become?

Will Humble Professional Development, Wills Blog

AZ Grant Opportunities – Compiled by the Vitalyst Health Foundation

NEW Due August 20th: Rural AZ Navigator Program

Due August 21st: Technical Assistance: Operational & Fiscal Performance

Due August 21st: Rural Health Innovative Care Pilot Program

Due August 21st: Arizona Department of Health Services Lung Health Screening

Due August 26th: Continuum of Care Competition and Youth Homeless Demonstration Program grants NOFO

Due August 28th: Behavioral Health & SUD Expansion

Due August 28th: Adopt Shared Services Consortiums

Due August 29th: National Science Foundation Grants for Undergraduates

NEW Due August 31st: Food Systems Grant

Due September 1st: Grants to Indian Tribal Governments Program

Due September 1st: The Bolger Foundation Grants (Favors Capital Grants)

Due September 1st: Nationwide Foundation Grants (Metro Valley)

Due September 15th: Journey for Good Foundation Grants

NEW Due September 24th: Connecting Champions for Diversity, Equity, Inclusion, and Belonging in the Health Professions

NEW Due September 29th: ADEQ Recycling Grant

Due October 11th: Whole Foods Market Store Giving

Due October 31st: Dudley T. Dougherty Foundation Grants

Due October 31st: TJX Grant

NEW Due December (Opens October): Route 66 Historic Revitalization Grant

Ongoing: Nathan Cummings Foundation (Racial, Economic, and Environmental Justice)

Ongoing: Just Futures Initiative

Ongoing: Susan & Michael Dell Foundation Grants

Ongoing: SC Johnson Grants and Product Donations

Ongoing: Affirm Cares Grants
Ongoing: The Impact Fund Legal Case Grants

Ongoing Until September: GM Corporate Giving Grants

Ongoing: Arizona Housing Fund 

Leadership Development Opportunities

August 20th (Virtual): Attract, Engage, Retain: Building a Stronger Board

NEW Application Due August 21st: BLK RVR Artist Collective

August 25th (Peoria): Housing for All: Tackling Housing as Workforce & Economic Infrastructure

NEW August 27th (Virtual): Digital Security Workshop 2.0

September 8th (Virtual): AI Essentials for Non-Profits

September 9th (Virtual): AI In-Depth for Non-Profits

NEW September 10th (Virtual): Foundation or Federal? Choosing the Right Funding Strategy in an Uncertain Funding Environment

NEW September 10th (Virtual): All About Brand conference

September 10th (Phoenix): Beyond the Org Chart: Power + Practice in Management

NEW September 17th (Mesa): Grant Professionals Association Conference

September 29th (Virtual): Public Charities Can Lobby

November 17th (Phoenix): AZ Maternal and Child Health Workforce and Policy Summit

Ongoing: Your Part-Time Controller Resources

Various Opportunities: Bank of America Workshops

Will Humble Healthcare, Wills Blog

Just What the Doctor Ordered: UA Training Physicians Where We Need Them

The UA College of Medicine along with Phoenix and Gila River Health Care are creating the nation’s first MD medical-school branch located within a sovereign Tribal Nation.  The first DO-degree-granting medical school on tribal land is the “Oklahoma State University College of Osteopathic Medicine on the Cherokee Nation” in Tahlequah, OK. Its first class graduated in 2024.

Next summer (July 2027) 10 students will be admitted to the UA- Phoenix medical school into an accelerated three-year primary-care program. They’ll spend their first 18 months doing foundational medical education (in Phoenix) and then move to Sacaton for the final 18 months of clinical education.

Educate doctors where Arizona needs them most | Opinion

The clinical rotation part is the best. During the 18-month clinical rotation segment students will be part of the Gila River Health Care system, working under faculty supervision with patients across different clinical settings.

There’s also a workforce strategy behind the model.

Physicians are more likely to eventually practice in communities where they train. So instead of trying to recruit doctors to underserved areas after residency, this model builds the pipeline there in the first place.

UA launches medical school branch (and clinical rotations) on tribal land

Gila River Health Care is putting serious resources behind the idea ($25M through 2034), including full tuition scholarships, faculty and educational infrastructure. The partners are also exploring development of primary-care residency programs at Gila River Health Care.

Read the full announcement here

Arizona has struggled for decades to recruit physicians to rural, Tribal and underserved communities.

Embedding clinical medical education directly into those communities strikes me as just what the doctor ordered.

Will Humble Social Determinants, Wills Blog

Preventing an Eviction Is Public Health

This week Maricopa County launched a new Eviction Prevention Pilot Program to mitigate evictions. Evictions are super easy in Arizona due to our Residential Landlord and Tenant Act which is highly tilted toward landlords and against tenants. It was passed in 1972 and hasn’t been changed much since.

Updating Arizona’s Landlord-Tenant Act: A Crucial Step to Prevent Evictions and Save Lives – AZ Public Health Association

Kudos to the Maricopa County Board of Supervisors, the county staff who put this together, and their partners at the City of Phoenix.

This is a public health intervention. Why? Because eviction isn’t just a housing issue. It’s a public health issue.

Housing instability is associated with worse physical and mental health, interruptions in health care, financial stress and, in the worst cases, homelessness and of course heat deaths. An eviction can leave a lasting record that makes finding the next apartment even harder, or perhaps impossible.

And we have plenty of opportunities for prevention here. Maricopa County Justice Courts processed more than 80,000 eviction filings in 2025… the third year in a row above 80,000.

How Will the Pilot Work?

Sometimes a household that normally pays its rent hits a temporary financial IED like a car repair, reduced work hours, a medical bill, funeral expenses or some other unexpected expense. They fall behind on the rent, late fees start piling up, an eviction gets filed, legal costs get added and pretty soon a relatively manageable problem has become a much bigger one.

Eviction Prevention Pilot Program | Maricopa County, AZ

In Arizona they’re often on the street in just 28 days just because they were 5 days late paying rent.

The new Maricopa County program tries to interrupt that chain of events before the eviction gets into the court system.

The $800K pilot will initially focus on four Phoenix ZIP codes with high eviction rates: 85008, 85040, 85041 and 85042. Eligible households with a temporary financial hardship can receive help covering up to two months of rental arrears.

The goal isn’t to simply hand somebody money. It’s to resolve the problem before lawyers, court costs and an eviction judgment enter the picture.

It’s also a prevention program. Instead of waiting until a family has lost its apartment and then spending public resources dealing with homelessness, disrupted schooling, health problems and emergency services, this intervenes when the problem may still be solvable with a relatively modest investment.

The City of Phoenix will add utility aid and case management, HOM, Inc. will administer the program, and the Arizona Multihousing Association helped develop the structure and recruit participating property owners.

Importantly, the County will collect, analyze and publish the data to see whether the pilot actually works.

It’s an approach that’s perfectly aligned with effective public health practice. Try a promising intervention. Target it where the need is greatest. Measure what happens. Figure out what works and what doesn’t. Decide whether to expand it. Publish your results so other jurisdictions can learn from your pilot.

Research so far on emergency rental aid shows that it can improve short-term rent payment and reduce anxiety about eviction, although rental help by itself hasn’t consistently produced long-term housing stability.

That makes this initiative — early intervention, landlord participation, utility assistance, case management and follow-up especially important.

More of this please

County supervisors around Arizona should keep an eye on Maricopa County’s results. If the numbers show this pilot prevents eviction filings and keeps families successfully housed, there’s no reason this kind of upstream approach should stop at four Phoenix ZIP codes.

That’s evidence-informed public policy. Identify the risk, intervene early, measure the results and scale what works and publish your work.

Will Humble Injury Prevention, Public Health, Wills Blog

Prop. 319 Slams the Door on an Evidence-Based Core Injury Prevention Tool

Prop 319 Debate on Arizona PBS KAET Thursday at 5 and 10pm

Arizona voters will have several ballot propositions this fall. One that hasn’t gotten much attention yet is Proposition 319, the Legislature’s referral micromanaging photo enforcement of traffic laws including red light running cameras. It even slams the door on cities that might want to use red light running cameras and school zone speed cameras in the future.

We urge you to vote No.

While most people probably think of photo speed radar as those irritating cameras that catch people speeding (I get it), that’s not the part of this proposition that’s bad.

I’m much more interested in red-light cameras because those are proven to prevent violent and deadly T-bone crashes that kill and badly injure people.

Think about what happens when somebody blows through a red light at a busy intersection (you probably saw it happen this week).

The driver who has a green light presses ahead only to have the driver coming from the right or left blow through the intersection. The result is a catastrophic T-bone collision. Same thing for someone patiently waiting to turn left only to have the oncoming driver plow into the passenger side. Same deadly result.

Unlike a lot of traffic crashes, the person who gets badly hurt or killed isn’t necessarily the person breaking the law.

In fact, in 2024 1,119 people were killed nationally in crashes involving red-light running and more than 141,000 were injured. Half of the people killed were pedestrians, bicyclists or occupants of other vehicles hit by the red-light runner.

That’s where red-light cameras come in.

Do They Work?

Yes.

A large Federal Highway Administration study examined 132 intersections in seven jurisdictions and found that red-light cameras reduced T-bone crashes by 25%.

There’s even evidence from cities that have turned the cameras off.

Researchers found that cities with red-light camera programs had a 21% lower fatal red-light-running crash rate than would otherwise have been expected. In 14 cities that discontinued their programs, the fatal red-light-running crash rate afterward was 30% higher than researchers estimated it would have been if the cameras had stayed on.

Are intersection cameras perfect? Of course not.

They can increase rear-end crashes as some drivers stop abruptly. The same federal study found about a 15% increase in those crashes.

But… those rear enders are mostly injury free and much less violent when compared to violent right-angle crashes. When researchers put both effects together, the reduction in those violent side-impact crashes outweighed the additional costs associated with rear-end crashes.

That’s exactly how public health should work. Look at all the evidence and choose the intervention that produces the better overall outcome.

Here’s the Catch in Prop. 319

If Prop. 319 merely preempted future non-school zone speed radar (and not the intersection red light cameras) I’d be OK with that. I’m also OK with making jurisdictions asking the city and town residents to periodically validate Council decisions to implement photo enforcement on the ballot.

But that’s not what it does.

Under Prop. 319, an Arizona city or state agency can use photo enforcement only if it has a signed contract in place by December 31, 2026. Communities with existing programs would then have to get voter approval to continue them, with another vote every ten years.

Imagine a fast-growing Arizona community that doesn’t need red-light cameras today.

10 years from now, the population has doubled. Traffic patterns have changed. A particular intersection has become super dangerous. People are getting seriously hurt in T-bone crashes.

The police chief and Council think a red-light camera would help. Traffic engineers agree. The mayor and city council agree. Even the residents agree.

No Dice.

If that community didn’t have a contract by the end of 2026, Prop. 319 says they can never do it in the future. Ever.

We shouldn’t make a permanent traffic-safety decision today for communities that haven’t even encountered tomorrow’s problems yet.

That’s why I’m voting No on Prop. 319.

Sources

Will Humble Early Childhood, Public Health, Vaccination

New CDC Report: Arizona Again Among the Worst States for Childhood Vaccination Rates

Reasons range from our unenforced loophole-ridden school vaccine law to gross over-regulation of Vaccines for Children providers during the Ducey/Christ/Herrington administration

Each year the CDC compiles vaccination data reported by schools across the country, giving us a pretty good picture of how well protected kindergartners are against diseases like measles compared to other states.

The new numbers came out this week, and you won’t be surprised to learn that the news isn’t good for Arizona.

Just 87.4% of Arizona kindergartners are up to date on their MMR vaccine, down from 88.6% last year. Arizona ranks 44th among the 48 states (who submit data). Only Utah, Minnesota, Wisconsin and Idaho had worse MMR coverage.

Vaccination Coverage and Exemptions among Kindergartners | Data | Centers for Disease Control and Prevention

Nationally, MMR coverage slipped to 92.4%. That’s a long way from the roughly 95% coverage needed to provide community immunity against measles, one of the most contagious diseases around.

So, Why Is Arizona Doing So Poorly?

There isn’t just one reason.

One biggest one is our very permissive personal-belief exemption from school vaccination requirements. Arizona parents can simply opt their kids out of required vaccines based on personal beliefs by signing a simple form.

Another huge reason for our bad vaccination rates is that the Ducey/Christ/Herrington administration grossly over-regulated doctor’s offices that took part in the Vaccines for Children program, which made it unnecessarily difficult for parents who did want to vaccinate their kids to actually be able to do so.

AZ Childhood Vaccination Rates Declined During the Ducey Administration: Is it Bad Luck or Bad Policy & Management?

Arizona schoolkids’ immunization coverage declines, new numbers show

NEW: Arizona’s kindergarten vaccination rates among lowest in US

Arizona Ran Off Half Its Vaccines for Children Providers

The federal Vaccines for Children (VFC) Program supplies vaccines for kids who otherwise might not be able to afford them, including children enrolled in Medicaid, uninsured and underinsured kids. ADHS manages the federal (CDC) program.

Because of the over-regulation during the Ducey administration, Arizona lost 50% of its VFC providers… falling from about 1,200 providers in 2015 to just 600! That has ticked up a tiny bit in the last year… but the network remains at just over half of what it was before they decimated the network.

By the time Ducey, Christ, and Herrington left state government Arizona had only 6 VFC providers for every 10,000 Medicaid-eligible kids. The national average was 24.

In other words, Arizona now has just one-quarter of the national average VFC provider capacity for Medicaid eligible kids.

Source: Omni Report – Arizona Partnership for Immunization

The collapse of the network means that it has gotten a lot harder for parents who want to vaccinate their kids to be able to do so.

The ‘Vaccines for Children’ Program Is Critical to Maintaining Childhood Vaccination Rates… but Provider Participation Has Plummeted During the Ducey Administration

Why did so many providers quit VFC?

During former ADHS Director Cara Christ’s tenure, ADHS imposed a bunch of burdensome administrative requirements on VFC practices. One of the biggest problems was a punitive policy requiring providers to financially replace vaccine when their wastage exceeded certain levels.

Providers also reported cumbersome ordering and return procedures, difficulties working with the state’s immunization registry and an adversarial enforcement culture.

The assessment of Arizona providers confirmed that those administrative burdens and punitive practices were important barriers to participation: Omni Report – Arizona Partnership for Immunization .

The result? Doctors dropped out of VFC participation. And when doctors drop out of VFC, parents with kids on AHCCCS have fewer places to get their children vaccinated including parents who very much want their kids vaccinated.

Today’s Kindergarten Numbers Carry Yesterday’s Baggage

The kids entering kindergarten now were babies and toddlers during the latter part of the Ducey administration, during the years when they’re supposed to be getting many of their routine childhood vaccinations.

So today’s worse kindergarten vaccination numbers are partly because of decisions and actions at the ADHS Vaccines for Children program when Director Christ was in charge.

The Hobbs Administration Changed Course

The good news is that ADHS under the Hobbs administration eventually admitted the problem and made major changes to the VFC program in 2024, and the bleeding of participating providers stopped.

Among other things, ADHS ended the controversial dose-for-dose restitution penalties, relaxed unnecessarily rigid operating-hour requirements, simplified temperature-monitoring requirements, clarified rules for mobile clinics and began taking a more provider-friendly approach.

Those were important changes and long overdue but we’re still digging out of the hole. Once a pediatric or family practice quits VFC, dropping the rule that drove them away doesn’t automatically bring them back.

ADHS needs to continue aggressively rebuilding the VFC provider network, especially in communities where lots of kids are enrolled in AHCCCS.

At the same time, policymakers need to recognize that Arizona’s super-easy personal-belief exemption law continues to drive vaccination rates down.

Both need to be fixed.

Conclusion

Arizona now has the fifth-lowest childhood MMR vaccination rate among states reporting numeric estimates to the CDC. That means we’re more susceptible to measles and other vaccine-preventable disease outbreaks than just about anywhere else in the country.

Our permissive personal-belief exemption makes it super easy for parents to send an unvaccinated child to school. If Arizona wants vaccination rates comparable to better-performing states, the legislature will need to change that.

The second is access. For years ADHS made it harder than it needed to be for pediatricians and family practices to participate in Vaccines for Children. ADHS over-regulation ran off half the providers…  and most of them haven’t been willing to come back.

The Hobbs administration has made a good start fixing the VFC mess it inherited. But rebuilding that network will take years – and it needs to be a top agency priority.

Here’s why Arizona is at high risk for a measles outbreak

Arizona health experts say Trump vaccine order won’t bring immediate changes

Here’s why Arizona is at high risk for a measles outbreak
Will Humble Nutrition, Public Health, Wills Blog

Credit When Credit is Due

I spend plenty of time criticizing Kennedy’s public health decisions (including the piece above about last week’s vaccine executive order). But when his agencies do something good, I should recognize that.

I found one. This week the FDA proposed closing a food labeling loophole. For the last few decades federal food labeling regulations let some food ingredients skip the normal food-additive approval process if they’re generally recognized by experts as safe.

Read the FDA’s proposed rule in the Federal Register.

Right now, a food company can decide on their own that they believe a new ingredient they’re using is “Generally Recognized as Safe” and say that on the label without even telling the FDA.

Companies can send FDA their safety information for review, but right now they don’t have to.

Under the proposed rule, companies would have to tell FDA what ingredient they’re using and explain why they think it’s safe. That means FDA would finally have a better idea of what companies are putting into the food supply and what evidence they’re using to call those ingredients safe.

This wouldn’t mean FDA has to approve every ingredient a manufacturer declares as generally recognized as safe before it can be sold. A company could still put an ingredient on the market before FDA finishes reviewing its safety notice.

But requiring companies to tell FDA what they’re doing and show the evidence behind their safety claims is a meaningful improvement.

One thing the proposal wouldn’t change is food labeling. It wouldn’t require a company to tell consumers on the package that an ingredient went through the generally accepted as safe process nor would it tell you whether FDA has actually reviewed the company’s safety evidence.

So this proposal would make the food supply more transparent to the remaining FDA staff,  but it won’t make things any clearer for somebody standing in the grocery aisle reading a label.

Credit where limited credit is due. This is a sensible public health move from the Kennedy FDA.

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