Will Humble Climate Change, Wills Blog

AzPHA Letter to ADOT Regarding their New EV Infrastructure Deployment Plan

September 8, 2025

Dear Jesse,

On behalf of the Arizona Public Health Association, I write in support of ADOT’s 2025 update to the Electric Vehicle (EV) Infrastructure Deployment Plan. Our Association has long supported ADOT’s efforts to expand charging infrastructure across Arizona, and we appreciate the inclusive, data-driven process that shaped this update.

We commend ADOT’s consistent stakeholder and public engagement. By seeking broad geographic and sector input and responding to feedback, ADOT has developed a plan that reflects both community needs and statewide priorities.

The proposed addition of EV charging stations along nine state highways will:

  • Close critical gaps that drivers identify as barriers to EV travel.
  • Expand access beyond major urban centers, giving families confidence that EVs can meet everyday needs.
  • Support local economies by drawing travelers to businesses and creating jobs in construction and maintenance.
  • Improve air quality and public health by reducing tailpipe pollution, lowering risks of asthma, heart disease, and other pollution-related illnesses.

AzPHA had earlier put in comments urging ADOT to locate charging stations at state Rest Areas. While we still believe that would have been a better decision for some of the locations – we nevertheless support your final plan.

The 2025 update is a clear step forward for Arizona’s economy, environment, and health. We strongly encourage ADOT to adopt and implement the plan, and we look forward to working with you on next steps.

Sincerely,

Will Humble,

Executive Director,
Arizona Public Health Association

Will Humble Healthcare, Public Health, Wills Blog

mRNA Cancer Vaccines: A New Hope for Targeted Treatment (if Kennedy Doesn’t Stop the Research)

Cancer treatment has traditionally relied on chemotherapy, a blunt instrument that attacks all rapidly dividing cells, often causing many side effects.

However, new NIH funded research using mRNA technology is showing a smarter way to fight cancer. Messenger RNA (mRNA) vaccines, first used for infectious diseases, are now being assessed as treatments that can train the immune system to attack tumors.

mRNA vaccines work by teaching the body’s cells to make proteins that look like parts of cancer cells. This “training” helps the immune system recognize and attack cancer more effectively. Unlike regular vaccines that prevent diseases, mRNA cancer vaccines are designed to help the body fight existing cancers.

Over 120 clinical trials are studying mRNA vaccines for cancers like melanoma, pancreatic cancer, and glioblastoma. For example, Moderna’s mRNA vaccine combined with Merck’s immunotherapy drug showed promising results in melanoma patients, lowering the risk of the cancer coming back.

This research is very exciting, but it could be slowed or stopped if Kennedy decides to end mRNA research because of his opposition to the technology. Right now, cancer mRNA research is still moving forward, but he has already ended mRNA research for infectious disease prevention.

Chemotherapy is a blunt tool that attacks all fast-growing cells, causing side effects like hair loss, nausea, and fatigue. mRNA vaccines are different because they specifically target cancer cells, helping the immune system fight the disease while leaving healthy cells mostly unharmed.

mRNA vaccines may one day replace or work alongside, or even replace chemotherapy, offering more precise, less harmful cancer treatments. If current trials continue to show positive results (and if research isn’t stopped by Kennedy) these vaccines could become a key part of cancer care, making treatments safer and more effective.

mRNA technology could change the way we treat cancer, offering hope for more targeted and personalized care. The science is promising, but its success depends on continued research.

Let’s hope that Kennedy’s anti-mRNA bias doesn’t lead him to end this promising work before it has a chance to save lives.

I think he will.

Will Humble Assurance & Licensure, Wills Blog

AZPHA Supports ADHS Licensing Fee Rulemaking

We are urging our members and partners to actively support the Arizona Department of Health Services’ proposed rulemaking to update licensing fees for health-care institutions.

The proposal (published last Friday in the Arizona Administrative Register) is the first proposed fee adjustment since 2010. For 15 years, ADHS has been asked to regulate and oversee a growing and increasingly complex health system without a fee structure that keeps pace.

See the Licensing Fee Rulemaking Text Starting on Page 2705

9 A.A.C. 10 HCI Fees Economic Impact Evaluation

  • Patient Safety and Oversight Are at Stake
    Licensing fees fund the critical work of ensuring healthcare facilities meet standards for safety, quality, and accountability. Without an update, ADHS lacks the resources it needs to protect patients and communities.
  • Some Institutions May Oppose
    While many providers understand the need, we expect opposition from some healthcare institutions reluctant to pay higher fees. That’s why it’s especially important for public health voices like ours to speak out in support.
  • Equity and Community Health Depend on It
    Strong licensing programs ensure that care in Arizona is delivered fairly, safely, and consistently—especially for vulnerable populations.

Timeline and Participation

  • Oral Proceeding: Monday, September 22, 2025
  • Public Comment Deadline: September 22, 2025

The rules can be reviewed in the Arizona Administrative Register (page 2705).

We support ADHS’s fee adjustment because it:

  • Provides sustainable funding for inspections and oversight.
  • Strengthens protections for patients and residents.
  • Ensures ADHS can keep pace with emerging public health challenges.

This is a commonsense update that reflects 15 years of inflation, rising operational costs, and expanded responsibilities.

AzPHA’s Letter of Support for ADHS’ Licensing Fees for Healthcare Institutions Rulemaking

Call to Action: Make Your Voice Heard

  • Submit written comments before September 22.
  • Speak at the oral proceeding in support of the rulemaking.
  • Share AZPHA’s position with colleagues and networks.

With healthcare institutions expected to push back, ADHS needs the backing of stakeholders who put community health first. By adding our voice to the choir, we can help ensure that ADHS has the tools it needs to safeguard patient safety, support healthcare quality, and protect all Arizonans.

Sample Comment

I am writing in strong support of the Arizona Department of Health Services’ proposed rulemaking to update licensing fees for healthcare institutions. These fees have not changed since 2010, while the Department’s responsibilities and costs have grown significantly.

Updating fees are essential to ensure ADHS has the resources to conduct thorough inspections, uphold safety standards, and protect patients and communities across Arizona.

Without this adjustment, oversight ability will continue to erode, putting vulnerable populations at risk.

I urge ADHS to adopt the proposed rule and thank the Department for its careful, evidence-based approach.

Submit comments to:

Stacie Gravito Office Chief, Administrative Counsel and Rules

150 N. 18th Ave., Suite 200

Phoenix, AZ 85007

stacie.gravito@azdhs.gov

Will Humble Public Health Law, Wills Blog

How Arizona’s Lawsuit Saved Millions in Public Health Infrastructure: States that Didn’t Sue Got Walloped

Earlier this year, Kennedy canceled nearly 700 CDC grants across the country. Those grants, worth about $11B for local public health, have deliverables focusing on things like vaccination programs, reducing health gaps between groups, updating old systems to track diseases, and hiring community health workers.

At first, the cuts hit both red and blue states about the same. But then, attorneys general and governors in about two dozen states with Democratic Attorney’s General (including Arizona) took the federal government to court.

Judges blocked many of the cuts via injunctions (so far), and the results between states that sued and those that didn’t are huge. States that joined the lawsuits (like AZ) got back almost all of their CDC money (80%).  States that didn’t sue got back less than 5%.

The federal government wanted to cut 17 CDC grants in Arizona, worth more than $239 million. Because Attorney General Kris Mayes joined the lawsuit, Arizona county health departments kept nearly all of that funding (so far) – losing just one grant.

That’s especially important because CDC money makes up more than half of what local health departments rely on to do their work.

These lawsuits are still working their way through the courts and a final decision on the legality of Kennedy’s cuts is yet to be determined. But, for the time being Arizona is receiving help from having a talented Attorney General interested in doing what she can to protect Arizona’s public health infrastructure.

Read more: Blue States That Sued Kept Most CDC Grants, While Red States Feel Brunt of Trump Clawbacks – KFF Health News

Will Humble Professional Development, Wills Blog

Public Health Journalism this Week

CDC chaos prompts Senate calls for investigation into Trump health agency purge | Arizona Mirror

Five Arizona hospitals earned top scores in annual federal rating

‘Best’ hospital ratings need more focus on patient safety, experts say

Colorado City measles cases: What to know about 9 new cases

U.S. Supreme Court gives go-ahead for Trump to cancel $783M in NIH research grants | Arizona Mirror

Measles cases are on the rise in this small Arizona-Utah border community

Measles case counts in Mohave County went from 9 to 12 in two days

Native rehab programs try to recover after sober living scams

Will Humble Public Health, Wills Blog

Kennedy’s Assault on Evidence-based Public Health Policy Intensifies: Fires CDC Director

Kennedy fired Susan Monarez as the Director of CDC last week barely a month after she was narrowly confirmed by the Senate. She was reportedly given the chance to quit. When she refused, she was fired.

According to multiple reports both in the media and among my contacts at the CDC – Monarez had an acrimonious meeting with Kennedy early in the week.

In that DC meeting, Monarez disagreed with Kennedy’s decision to dismiss all the members of the Advisory Committee for Immunization Practices and replacing them with several anti-vaccine activists.

My sources tell me she also clashed with Kennedy about her response to the murder of a CDC employee when the Atlanta campus was sprayed with gunfire a couple of weeks ago. Monarez let some staff temporarily work from home and spoke openly about trauma and recovery in an all-staff meeting. Kennedy admonished her for her response to the shooting. Her response was well-received by rank-and-file CDC staff.

Four senior leaders at CDC quit in response to the firing: Debra Houry, Demetre Daskalakis, Daniel Jernigan, and Jen Layden. They all warned that political interference and misinformation now threaten the evidence-based foundation of public health in the U.S.

Behind the scenes, Kennedy is preparing to release a September “report” trying to tie vaccines to autism, despite decades of evidence disproving that claim. In a cabinet meeting last week, he said he’ll follow the report with “aggressive interventions”.

While he didn’t say what that means, it likely will drive big changes to the recommended childhood vaccine schedule (dropping vaccines) and perhaps even delicensing some vaccines. Perhaps Monarez pushed back on that in the meeting this week. I don’t know that, but it makes sense.

The next CDC director will almost certainly be chosen for political loyalty, not expertise or commitment to evidence-based public health policy. If Kennedy actually selects a credentialed professional, that person will likely be the type of person more interested in keeping the job than actually doing the job.

Update: Kennedy has appointed a guy named Jim O’Neill as acting Director. O’Neill holds only degrees in the humanities and lacks any professional training in medicine, public health, epidemiology, or the life sciences.

His career path includes stints as a biotech investor, a speechwriter during the Bush administration, and an aide within HHS; none of which prepare him to manage disease surveillance, guide scientific research, or oversee complex health emergencies.

He advocates a “post-market” approach to drug approvals, suggesting drugs be licensed after brief safety trials, with efficacy determined only later. He has even suggested people should be able to buy and sell organs as a means to increase supply.

Under U.S. law (42 U.S.C. § 242c), the CDC Director must be appointed by the President with Senate confirmation, and is tasked with directing all disease prevention efforts, setting policy, supervising operations, and coordinating with internal divisions to protect public health both domestically and globally. O’Neill’s experience doesn’t match these requirements and responsibilities.

Will Humble Behavioral Health, Prevention, Wills Blog

Building Hope in Santa Cruz County: The Story Behind the SOSA Consortium

In 2019, the Santa Cruz County Overcoming Substance Addiction (SOSA) Consortium was created to address the growing impact of substance use disorder (SUD) and opioid use disorder (OUD) in this rural border community. Led by Mariposa Community Health Center and supported by the Health Resources and Services Administration (HRSA) Rural Communities Opioid Response Program, the initiative began as a planning effort to create a coordinated network of care.

Today, SOSA has become a cornerstone of community collaboration—bringing together healthcare providers, behavioral health professionals, first responders, educators, law enforcement, and local organizations to prevent overdose, expand access to treatment, and reduce the stigma of addiction.

SOSA’s work has transformed systems and lives across Santa Cruz County. Through a series of targeted initiatives, the Consortium created new pathways and access to care and empowered the community to respond more compassionately and effectively to substance use.

Key successes include:

  • The launch of sosaheal.org, a community information hub with access to local services, treatment referrals, and prevention resources.
  • A Treat & Refer program with EMS, allowing individuals who experience an overdose to be connected immediately to a peer support specialist and treatment options.
  • Naloxone (Narcan) training is now widely available, including at local smoke shops and bars as well as embedded in First Aid and CPR training through the Fire Department and EMS.
  • The Nogales Police Department CARES program, where officers can connect individuals with SUD directly to peer navigators and real-time treatment support.
  • Expanded community access to recovery groups such as AA and NA, including regular meetings at a local faith-based shelter.
  • Ongoing youth prevention programs, offering education around substance use, mental health, and building healthy coping skills across generations.
  • Stronger coordination between medical and behavioral health providers, increasing warm handoffs to Medication Assisted Treatment (MAT) and re-entry services for justice-involved individuals.

SOSA includes individuals with lived experience—as well as their family members, caregivers, and friends—in planning, decision-making, and outreach. Their insights and advocacy help shape programs that are relevant, respectful, and responsive.

By putting people with lived experience at the center, SOSA is helping change the narrative—from blame to understanding, from isolation to community.

To meet the increasing demand for services, the Consortium has helped grow the rural public health workforce by adding peer support specialists, case managers, psychiatric providers, and behavioral health professionals.

To conduct these significant public health wins, the Consortium includes more than 30 individuals and 12 lead partners:

  • Mariposa Community Health Center
  • HOPE Inc.
  • SEAHEC
  • Nogales Police Department
  • Rio Rico Fire & Medical Department
  • Pinal Hispanic Council
  • Circles of Peace
  • Santa Cruz County Justice Court
  • Santa Cruz County Sheriff’s Office
  • Santa Cruz County Superintendent’s Office
  • Crossroads Nogales Mission
  • University of Arizona Prevention Research Center

Together, they continue to share resources, coordinate care, and drive innovation to ensure every community member can access the help they need—when they need it.

For those studying public health or considering a career in the field, rural communities offer both challenge and reward. In Santa Cruz County, public health work is personal.

The impact is visible, and relationships are deep. You are not just improving systems—you are walking alongside your neighbors, creating real change in real time. Rural public health also teaches flexibility, creativity, and collaboration across sectors. Every effort counts, and every person matters.

With persistence, partnership, and purpose, the SOSA Consortium is helping transform how rural communities respond to addiction—not just in Santa Cruz County, but as a model for others nationwide.

These public health heroes are reducing stigma, increasing access, and rebuilding lives—one connection at a time.

For more information, visit sosaheal.org.

Will Humble Prevention, Wills Blog

Southern Arizona Partnership Shows the Power of Collaboration in Tackling Hypertension

Hypertension remains a leading preventable cause of years of life lost in the US. Preventable, because high blood pressure goes unrecognized or undertreated leaving people at risk for heart disease, stroke, and other preventable complications.

A new study published in the American Journal of Public Health highlights how safety-net providers like community health centers and local health departments in Southern Arizona are teaming up to better recognize and treat hypertension.

The article highlights an innovative partnership led by El Rio Community Health Center in Tucson, alongside other federally qualified health centers and three county health departments including Pima County (who coauthored the publication).

Formed in 2023, the collaboration is showing what’s possible when primary care and public health collaborate using evidence-based practices.

By combining the clinical expertise of FQHCs with the surveillance, communication, and policy functions of local health departments, the partnership has amplified efforts to reduce the burden of hypertension.

They’re sharing best practices among clinicians, expanding community education and awareness, strengthening referrals to primary care, and aligning public health strategies to address the root causes of disease.

Reference:

American Journal of Public Health. (2025). “Building Regional Partnerships Between Community Health Centers and Local Health Departments to Address Hypertension in Southern Arizona.” https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2025.308196

Will Humble Disease Control, Public Health, Wills Blog

Mohave County Working Hard to Contain Measles Outbreak in Colorado City

The measles virus found some fertile ground to flourish up in Colorado City, AZ.

Why is it fertile ground?

Because the childhood immunization rates in that community are astonishingly low (well below herd immunity levels) so it’ll be super easy for the virus to infect new susceptible kids.

Note: Only 7.7% of kindergarten students at Colorado City’s Cottonwood Elementary have had the MMR vaccine. Only 40% of kindergarten students at Masada Charter School are vaccinated.

What started with one case a couple of weeks ago has now grown to at least 9 cases. Measles spreads super easy via coughing, sneezing, or even just being in the same room as someone who is infected.

An Arizona town is at the center of a budding measles outbreak | Phoenix New Times

The Mohave County Department of Public Health, led by Health Director Melissa Palmer, and her team have been “all hands on deck” to slow this outbreak.

Their team is working long hours to find people who may have been exposed, help infected people voluntarily isolate so they don’t spread it further, supporting families who need to stay home in voluntary quarantine, and encouraging families to choose to vaccinate their kids before they too become infected(vaccines are readily available at the Creek Valley Health Clinic).

Mohave County also held a vaccine event in the community Friday that vaccinated over 80 children and adults. Director Palmer reports good communication with the residents, and their nursing manager and Palmer will be meeting with the school board on Monday.

This outbreak is especially hard to manage because of two big challenges.

First, vaccination rates in Colorado City are very low. Many (probably most) kids there have not received the MMR vaccine, which is the best protection we have against the disease.

Second, most kids in the community are homeschooled through the state’s ESA voucher program. In most outbreaks, health departments can use school records to quickly find which children are vaccinated and which are not. In Colorado City, that tool isn’t available.

Instead, public health staff have to do “retail contact tracing” like finding and talking with families one at a time. That takes a lot of time and effort.

One factor working in the community’s favor is that so many kids are homeschooled via ESA vouchers – and there are likely to be fewer large scale school exposures than in other towns.

Note: There are 476 ESA recipients among 783 houses in Colorado City’s ZIP code

But… other types of community gatherings can spread the virus fast like church services and activities, 4H activities, playdates, birthday parties and family visits.

The good news is that if health officials find exposed people fast enough, they can sometimes stop measles. But that requires cooperation from the community.

For example, if someone who isn’t vaccinated gets the MMR shot within 72 hours after being exposed it can protect them or at least make the illness less severe.

This outbreak is a reminder that measles isn’t a problem from the past. It’s now in the present and will remain so until immunization rates improve to levels they were 15 years ago.

Mohave County’s public health team deserves a lot of credit for stepping up at showtime… but this will be a challenging outbreak to deal with especially if there’s little community cooperation.

Will Humble Assurance & Licensure, Public Health, Wills Blog

AzPHA’s Letter of Support for ADHS’ Rulemaking to Increase Licensing Fees for Healthcare Institutions

August 22, 2025

Via Electronic Submission

Thomas Salow, Assistant Director
Public Health Licensing
Arizona Department of Health Services
150 N. 18th Ave., Suite 500
Phoenix, AZ 85007

Stacie Gravito, Office Chief
Administrative Counsel and Rules, Director’s Office
Arizona Department of Health Services
50 N. 18th Ave., Suite 200
Phoenix, AZ 85007

Re: Notice of Proposed Rulemaking for Title 9, Chapter 10, Health Care Institutions: Licensing

Dear Mr. Salow and Ms. Gravito,

On behalf of the Arizona Public Health Association (AzPHA), I am writing in support of the Department’s Notice of Proposed Rulemaking to increase licensing fees for health care institutions.

AzPHA agrees with ADHS that by leaving fees unchanged since January 2010 (when I began my tenure as Director), the Department has not had the necessary financial resources to fulfill its licensing and oversight duties.

For more than 15 years, the revenue generated from health care institution licensing fees has been inadequate to support the staffing, oversight, and enforcement functions that protect the health and safety of patients and residents.

Indeed, when I was Director and we set the licensing fees in 2009–2010, we neglected to include agency indirect in the fee calculation. That omission meant the fees were insufficient even then, and the gap has only widened over the past 15 years.

The revenue shortfall has been unsustainable for nearly a decade, and AzPHA has consistently urged the Department to increase its licensing fees since 2017. Sadly, Directors Cara Christ and Don Herrington ignored our pleas.

These proposed fee increases will allow the licensing division to maintain adequate staffing levels, accommodate inflation and rising technological costs, and prepare for future legal & legislative demands.

Without these changes, the Department’s ability to meet compliance and enforcement responsibilities will continue to erode, impairing financial stability and lead to unaddressed neglect of some of Arizona’s most vulnerable residents.

The consequences of underfunding licensing have been severe. Multiple reports by the Arizona Auditor General from 2019 through 2022 documented gross underperformance by the Department in responding to complaints and inspecting skilled nursing and other care facilities.

Faced with insufficient resources (or because former Director Christ & Assistant Director Colby Bower were unwilling to concede that the Auditor General found gross shortcomings in the Department’s performance), Christ & Bower chose to reclassify more than 95% of high-risk complaints as “low risk,” allowing the agency to delay investigations by up to a year, an indefensible decision that contributed to tragic and lethal outcomes for vulnerable Arizonans.

While those choices were largely the result of unethical leadership decisions during the Ducey Administration, it’s also clear that inadequate funding contributed to the Department’s failures.

AzPHA also commends the Department for preparing an objective and thorough economic impact evaluation as part of this rulemaking. By assessing the financial implications for providers and the Department, ADHS has provided stakeholders with clear, evidence-based justification for these fee adjustments.

This is precisely the kind of data-driven approach AzPHA has long urged the Department to adopt. Since 2017, we consistently advocated both higher fees and transparent economic analyses to prove their necessity.

The fact that ADHS has now conducted such an evaluation reflects a welcome shift toward evidence-based decision-making and accountability… actions that will strengthen both the agency and the public’s trust over time.

This rulemaking will finally provide the financial resources necessary for ADHS to meet its licensing responsibilities. While adequate funding cannot by itself ensure that future administrations will always prioritize health and safety, it does provide the Department with the means to do so.

Importantly, AzPHA now has confidence in the Department’s current leadership. With Mr. Salow as Assistant Director for Licensing and Interim Director Sheila Sjolander on board, we are now assured that the agency has ethical and talented leaders who are committed to restoring public trust and improving agency performance.

We applaud ADHS leadership for advancing this rulemaking and for your commitment to correcting the licensing division’s deficient performance during the Ducey administration.

These fee increases are not only long overdue, but also absolutely essential, and AzPHA strongly supports their adoption.

Sincerely,

 

Will Humble, MPH
Executive Director, Arizona Public Health Association
Director, Arizona Department of Health Services (2009–2015)

See ADHS’ Proposed Rulemaking – HCI Licensing Fees
1 … 17 18 19 20 21 … 197