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.

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

Best for Who? Looking Beyond U.S. News ‘Best Hospitals’ Ranking

When U.S. News & World Report released its annual list of “Best Hospitals” last week Mayo Clinic Arizona once again topped the state rankings.

U.S. News Announces 2025-2026 Best Hospitals | Press Room | U.S. News

Before you draw conclusions that they’re really the best – let’s explore what these rankings actually measure and what they don’t.

U.S. News uses a scoring system that focuses on high-end specialty care. Hospitals are rated on their performance in 16 high-end medical & surgical specialties (e.g. cancer, heart surgery, neurology) and in 21 specific technical procedures. They also survey board-certified physicians to assess hospitals’ reputation in complex specialty care.

That might sound comprehensive, but it misses the mark when it comes to public health, especially low-income and Medicaid populations.

Here’s why:

  • Access to Care Isn’t Considered: U.S. News doesn’t measure whether low-income patients can actually get an appointment or whether they accept Medicaid members.
  • Medicaid & Safety-Net Care Aren’t Measured: The rankings don’t ask how many Medicaid patients a hospital serves, or how much charity care it provides (if any).
  • Specialty Procedure Weighting: By putting the most emphasis on advanced specialty services, the rankings favor referral centers like Mayo that primarily serve patients with Medicare or private insurance.
  • ·Patient Mix Matters: Safety-net hospitals (like Valleywise Health) care for poorer and sicker patients with fewer resources.

That’s why it’s so important not to confuse the U.S. News rankings with measures of actual public health & overall community benefit.

In other words. if your question is: “Which hospital provides the best high end specialty care for patients with comprehensive private health insurance” then the rankings give you an answer.

But if you want to know which hospitals do the most for public health and Arizona’s behavioral health and underserved communities, the US News and World Report is the wrong metric.

Note: Mayo Clinic in Arizona only accepts Medicaid coverage for transplant services and only if AHCCCS pre-authorizes the procedure.

To look at public health and community benefit you’d need to look toward hospitals that focus on underserved populations with the greatest health burdens like Valleywise Health does.

From the Diane & Bruce Halle Arizona Burn Center to its extensive behavioral health programs, Valleywise stands out as the backbone of our safety-net healthcare system, providing the kinds of services like inpatient and outpatient psychiatric care and first episode centers that other hospitals aren’t interested in providing.

And that’s exactly why Proposition 409 on the Maricopa County ballot this fall is so critical. It’ll provide much-needed investment in Valleywise Health facilities, ensuring continued care for those who need it most, including those struggling with serious mental illness, and providing the kind of care that really builds community benefit.

It’s fine to recognize excellence in high end specialty care for people with gold plated health insurance, I have no problem with that…  but let’s keep our focus on what matters most for public health – robust and accessible primary and acute care and services like inpatient and outpatient mental health care and other safety net services.

How ‘Crime-Free Lease Addendums’ Fuel Homelessness & Heat Deaths

More and more landlords in AZ have been requiring tenants to sign “crime-free lease addendums” in rental agreements as a condition of letting them rent.

These addendums let landlords evict tenants right away by simply claiming (even without evidence) that the tenant has done something illegal. No proof is needed. There doesn’t need to be an arrest or a conviction. Basically, no due process.

The Intersection of Public Health and Housing – AZPHA

Drug use is often the focus. A landlord can allege a tenant used illegal drugs, even something like “magic mushrooms” and use that as an excuse to evict. This can happen even if the tenant has paid rent on time and isn’t breaking any term of the lease agreement.

Arizona’s Residential Landlord and Tenant Act already makes eviction easy. For example, a tenant can be forced out in as little as 30 days for being just 5 days late on rent. Crime-free lease addendums make it even easier.

Arizona Republic’s Hannah Dreyfus’ Series:
Protecting Your Housing Rights: A Primer on AZ’s ‘Fair Housing’ Law 
Arizona renters sign away protections with crime-free lease addendum
Arizona renters can lose housing aid even when evictions are dropped
What renters in Arizona should know about crime-free lease addendums

Being evicted in Arizona often means losing access to shelter in extreme heat (unlike other states Arizona’s landlord tenant allows evections even during extreme weather). In 2024, more than 600 people died from heat-related causes in the state. People without housing are at far greater risk, over 500 times the risk of people who are housed.

Maricopa County Heat Deaths in 2023: A Crisis for the Homeless & a Call for Housing Reform

When a landlord can remove someone from their home based only on an unverified claim like alleged illegal drug use, it increases the chance that more people will end up living outside during the summer. This puts lives in danger.

Attorney General Mayes is looking into whether crime-free lease addendums are legal. But an investigation alone won’t fix the problem, we need a change in the law:

  • Ban lease clauses that allow eviction based only on an allegation.
  • Require real evidence before eviction, like a conviction or at least a serious felony indictment.
  • Prevent eviction during extreme heat except in cases where there’s a clear safety threat.

Landlords shouldn’t be able to evict people without proof. It’s time for the Legislature to forbid crime-free lease addendums. Without action, more people will lose their apartments based on simple claims and more lives will be at risk in the summer heat.

See the PowerPoint on this Topic I’m Presenting at this Week’s AZDHS Public Health & Housing Summit Registration

Crime Free Lease Addendum Advocacy Plan Fall 2025

EPA to Tribes: ‘No Solar for You!’

EPA Administrator Lee Zeldin ended the federal Solar for All program last week.

The $7B initiative (funded under the Inflation Reduction Act’s Greenhouse Gas Reduction Fund) had been designed to bring rooftop and community solar to low and middle-income households, with a Tribal focus. Zeldin’s action is a $156M loss for AZ tribes.

The funding that had already been awarded will now be revoked, including $25M for the Hopi Utilities Corporation to install solar panels across the Hopi Tribe, $62M to expand access for Tribal nations statewide, and seed projects like Arizona’s first green bank, rural solar-plus-storage systems, and even solar/down-payment assistance for new homebuyers.

The impact is especially painful for Arizona’s Tribal communities, which were on track to gain some energy sovereignty, reduce dependence on outside utilities, and keep more economic activity within their own communities.

Like so many other actions by this administration – Zeldin’s decision will likely be challenged in court. For now, clean, affordable energy for Arizona’s most underserved communities is on hold and contracts canceled.

This Week’s Vote Proves Arizonans Chose a Pro-Carbon Corporation Commission

This week, the Arizona Corporation Commission voted to start the process of repealing the state’s Renewable Energy Standard and Tariff Rules, known as the “REST rules.”

Those rules were put in place back in 2006. They required big utilities to get 15% of their electricity from renewable sources by 2025. Part of that had to come from small-scale sources like rooftop solar on homes and businesses.

The all-Republican ACC said the rules aren’t needed anymore because monopoly utility companies already have their own clean energy plans.

That claim is false. Last week APS announced it’s ditching all its clean energy goals including the pledge to get 45% of its power from renewables by 2030. At least APS’s CEO admitted their earlier ‘goals’ were never really goals at all – just ‘aspirations’.

APS Abandons Clean Energy Goals & While Demanding Yet Another Rate Hike

The rulemaking change will likely take months, but it’s clear the ACC staff will eventually get their REST repeal.

None of this should surprise anyone. Voters put commissioners in office who openly favor fossil fuels over clean energy. This week’s vote is just the latest sign of what happens when pro-carbon politicians run the agency in charge of regulating Arizona’s monopoly utilities.

Note: Because the ACC’s REST repeal rulemaking relates to their constitutional authority to regulate monopoly utilities they’re exempt from Governor’s Regulatory Review Council review, meaning the repeal is a done deal and GRRC won’t be able to stop the repeal.

When the ACC proposes rules related to statutory authority given to them by the Legislature, they are subject to GRRC – but the REST rulemaking will be under their constitutional authority.

AZPHA’s Letter to the Docket Urging the ACC to Keep Renewable Energy Standards

August 13, 2025

Kevin Thompson, Chair
Nick Myers, Vice Chair
René Lopez
Lea Marquez Peterson
Rachel Walden

Arizona Corporation Commission
1300 W. Washington Street
Phoenix, AZ 85007

Re: Leave the Renewable Energy Standard and Tariff Rules
Docket RE-00000A-24-0026

Dear Commissioners,

The Arizona Public Health Association urges you to reject the proposal to repeal the Renewable Energy Standard and Tariff Rules (“REST Rules”). Repeal would raise power bills, weaken grid reliability, and threaten one of Arizona’s most vibrant job-creating industries.

Since 2006, the REST Rules have ensured that utilities steadily increase clean energy use 15% by 2025, with 30% from distributed sources like rooftop solar.

APS has already abandoned its voluntary goal of 45% renewable power by 2030. Without enforceable rules, Arizona risks losing investment and jobs to other states. More dependence on fossil fuels means more exposure to price spikes and supply disruptions.

The Commission’s duty is to ensure rates are just, reasonable, and supported by evidence. The evidence here is clear: the REST Rules protect ratepayers, support economic growth, and safeguard public health.

Repealing the REST Rules would raise power bills for Arizona families and businesses, undermine the reliability of our electric grid, and jeopardize a vibrant renewable energy industry that supports tens of thousands of jobs and generates tens of millions of dollars in tax revenue annually.

Adopted in 2006, the REST Rules were groundbreaking: they required Arizona utilities to get 15% of their electricity from renewable resources by 2025, with 30% from distributed energy sources like customer-owned rooftop solar. The Commission recognized that enforceable rules—not voluntary pledges—were necessary to drive investment, innovation, and cost reductions.

That vision has been realized. Since the REST Rules took effect, the cost of utility-scale solar has dropped 84% and wind costs have declined 55%. Both are now cheaper to build than new natural gas, coal, or nuclear plants.

Renewables protect ratepayers from volatile natural gas prices. Arizona’s abundant sunshine has made us the fifth-largest solar-producing state, and distributed solar reduces the need for costly peak-hour energy imports.

The economic benefits are equally compelling. Renewable energy now accounts for nearly half of Arizona’s power sector jobs. In 2023 alone, the solar industry generated over $155 million in state, county, and local tax revenues. Rural and urban communities benefit from renewable energy investments, which ripple through the state’s economy in construction, manufacturing, operations, and maintenance.

The rationale for repeal, reducing compliance and administrative costs, is dwarfed by the economic, environmental, and public health benefits of maintaining the REST Rules. Moreover, APS’ decision this week demonstrates that utilities won’t keep voluntary renewable commitments.

The Commission’s ratemaking authority carries the responsibility to ensure rates are just, reasonable, and supported by substantial evidence. Stripping away the REST Rules would expose ratepayers to unnecessary price volatility and undercut the long-term stability of our energy system.

We urge you to update, but not repeal, the REST Rules, ensuring they’ll continue to deliver affordable, dependable, clean energy for millions of Arizonans while sustaining a thriving industry that benefits our economy and public health.

Sincerely,

Will Humble, MPH

Executive Director

Arizona Public Health Association

AZ Grant Opportunities Compiled by the Vitalyst Health Foundation