Will Humble Medicaid, Wills Blog

Rural Arizona at Risk: The Dramatic Impact of Project 2025 Medicaid Cuts

A proposed federal budget (and the Trump Administration’s policy template – Project 2025) is proposing to reduce the federal government’s contribution for covering childless adults and other notch populations covered by AHCCCS in Arizona, which would leave over 550,000 Arizonans without coverage—primarily childless adults.

Rural Arizonans to feel outsized burden of proposed Medicaid cuts

The proposed cuts would slash over $1 billion from Arizona’s Medicaid budget by changing the federal contribution for childless adults and the expansion population (people from 100 to 138% of federal poverty) from 90% to 64%.

Such a move would cancel the state statute that authorizes AHCCCS to collect a hospital assessment to pay for the state portion for these 550,000 people.

Rural Arizona, which overwhelmingly voted for Trump, stands to lose the most. For rural communities, this would mean shuttered clinics, overwhelmed emergency rooms, and longer drives to access care.

Medicaid is a critical source of funding for rural hospitals, accounting for up to 60% of their revenue in some cases. Without it, these facilities may close their doors, forcing residents to travel for hours for even basic medical needs.

The High Stakes of Medicaid Cuts: What Arizona Stands to Lose

Childless adults, who make up the majority of those at risk of losing coverage, are important to rural economies. They include farmers, ranchers, service workers, and small business employees. Without access to healthcare, their health—and their ability to work—will suffer, creating ripple effects across entire communities.

Medicaid’s Role in Small Towns and Rural Areas – Georgetown Center For Children and Families

Medicaid doesn’t just help people – it supports jobs and keeps healthcare facilities afloat. When Medicaid funding is cut, everyone feels the impact, from healthcare workers to local businesses that rely on healthy customers.

Rural Arizona deserves better. Cutting Medicaid would disproportionately harm the very communities that rely on it the most.

It’s time for rural policymakers (e.g. Rep Ciscomani) to recognize the real-life consequences of these decisions and prevent congress from reducing the federal contribution for covering childless adults.

Will Humble Public Health, Wills Blog

Action Alert: Urge Senators Kelly & Gallego to Vote NO on RFK Jr’s Nomination as HHS Secretary

RFK Jr Confirmation Hearing this Wednesday in the Senate Finance Committee

The nomination of Robert F. Kennedy, Jr. as Secretary of the U.S. Department of Health and Human Services is extremely concerning given his history of basing his opinions and policy priorities on hunches rather than evidence. As the department that oversees CMS (Medicare & Medicaid), CDC, HRSA, NIH, FDA HHS requires leadership with relevant experience and the proven ability to trust and follow evidence & science. Mr. Kennedy does not.

Mr. Kennedy will be in front of the Senate Finance Committee this Wednesday and on the floor of the Senate later in the week. I’ve already contacted Senator Kelly and Gallego’s offices urging them to vote No on Kennedy’s confirmation this week – and you can do so too by using the APHA’s Action Center to let the Senators know how you feel.

Will Humble State Legislature, Wills Blog

Late January Legislative Session Update

The 2025 legislative session has gotten off to a slow start this year. In previous years the committees have been pretty active. No bills of public health consequence were heard last week.

This week there are a few, but not many. Here are the bills up this coming week:

House Regulatory Oversight (Tuesday 2pm)

HB2055 immunizations; requirements; exemption (AZPHA position is NO)

Declares that school/employer immunization requirements must include exemptions unless strict criteria are met that go way beyond current vaccine licensing requirements for every school required vaccine like co administration testing with combinations of vaccines, long term evaluation for cancer/infertility, 2 year post clinical trials against placebo/similar vaccine, ADHS post injuries/disease caused by vaccine, etc. It also would remove all conditions when claiming a personal exemption.

House Health (Monday 2pm)

HB2001behavioral health; temporary licensure; graduates (AZPHA Position YES)

Requires the Arizona Board of Behavioral Health Examiners to issue temporary licenses to behavioral health graduates who are applying for an associate level license. Temporary licensees would still need to work under the direction of a fully licensed professional. Includes counseling, marriage and family therapy, social work and addiction counseling.

Public Health Related Bills So Far:

House

HB2001 behavioral health; temporary licensure; graduates YES

HB2012 emergency use products; employers; prohibition

HB2022 school safety; employee certification; policies NO

HB2055 immunizations; requirements; exemption NO

HB2057 parental rights; medical records

HB2058 school immunizations; exemption; adult students

HB2062 sex-based terms; laws; rules; regulations

HB2063 parental notification; school immunization exemptions

HB2125 insurance coverage; hearing aids; children YES

HB2130 claims; prior authorization; denials; contact YES

HB2145 registered sanitarians; qualifications YES

HB2159 prohibited weapon; bump-fire device; accessory YES

HB2165 SNAP; prohibited purchases; waiver YES

HB2175 claims; prior authorization; conduct YES

HB2211 severe threat order of protection YES

HB2214 failure to secure weapon; minor YES

HB2250 AHCCCS; preventative dental care YES

HB2276 legislative ratification; rulemaking; regulatory costs NO

HB2293 tobacco products; vaping; minimum age YES

HB2309 vacation rentals; short-term rentals; restrictions

HB2518 employment; prohibitions; corporation commission YES

HB2619 assault weapons; magazines; prohibition; registration YES

HB2620 firearm sales; permit verification; requirements YES

HB2621 firearm sales; transfers; background checks YES

HB2683 working conditions; heat illness; prevention YES

Senate

SB1019 photo enforcement systems; prohibition NO

SB1020 disruption; educational institution; concealed weapon NO

SB1043 homeless shelter services fund; appropriation YES

SB1044 secure behavioral health facilities YES

SB1045 secure behavioral health facilities; appropriations YES

SB1046 mental illness; prisoners; diagnosis; treatment YES

SB1125 psychologists; prescribing authority YES

Will Humble Professional Development, Wills Blog

Tick Tock… Time is Running Out to Submit Your Presentation at Our Upcoming Conference

Are you ready to help redefine public health for the future? The Arizona Public Health Association invites you to submit your ideas for presentations at our upcoming annual conference:

Modernizing Public Health Practice:
Building an Innovative & Inclusive Infrastructure for the Public Health of the Future

This exciting event will take place on April 3, 2025, with a call for presentations through February 2, 2025. We’re seeking innovative thinkers, practitioners, and researchers to share insights and strategies that can drive transformative change in public health in the areas of: 1) data, informatics and artificial intelligence; 2) public health workforce; and 3) engaging young professionals.
What We’re Looking for:

The 2025 conference focuses on modernizing public health infrastructure to meet emerging challenges and opportunities. We encourage submissions that explore topics in the following tracks:

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

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

But the promise of AI comes with challenges. Presentations on this topic could examine issues like algorithmic bias, ethical considerations, data privacy, and the need for equitable implementation. How can public health professionals harness AI’s potential while maintaining public trust? We want to hear your ideas!

Why Submit?

Presenting at AzPHA’s annual conference is a unique opportunity to:

  • Showcase your expertise and innovations to a diverse audience of public health enthusiasts
  • Spark meaningful conversations that shape the future of public health practice
  • Connect with peers, leaders and organizations working toward shared goals

Whether you’re conducting groundbreaking research, implementing impactful programs, or developing innovative tools, your work could inspire and guide others.

How & When to Submit

Our submission deadline is February 2, 2025. If you have any questions, please contact Will Humble ([email protected]) or Lauriane Bellot Hanson ([email protected]). View additional conference details and submit your abstract by February 2, 2025, here: AzPHA Annual Conference April 3, 2025- Call for Abstracts

Let’s collaborate to build a public health infrastructure that’s innovative, inclusive, and ready for the future.

Your voice matters—join us in shaping the conversation!

Submit Your Proposal: 
AzPHA Annual Conference April 3, 2025- Call for Abstracts –
Will Humble Public Health, Wills Blog

U.S. Withdrawal from the World Health Organization: A Setback for Global Health or a Blessing in Disguise?

This week President Trump signed an executive order withdrawing the United States from the World Health Organization.  This decision may be a setback for global public health, particularly considering that the U.S. funds about 20% of the WHO’s budget. But could it actually be a good thing too?

Withdrawing The United States From The World Health Organization – The White House

The WHO’s work is indispensable in developing countries, where it provides essential services such as disease surveillance, emergency response, and health education. The loss of U.S. funding threatens these programs, potentially leading to setbacks in controlling diseases like malaria, tuberculosis, and HIV/AIDS. Communities that rely on WHO support may experience increased health disparities and diminished ability to respond to health emergencies.

The U.S. is the largest financial supporter of the WHO, contributing over $400 million annually. This funding is important for the WHO’s operations, especially in developing nations where the organization plays a vital role in combating infectious diseases, supporting vaccination programs, and strengthening health systems.  Without U.S. contributions, these initiatives face financial shortfalls, potentially leading to reduced services and increased vulnerability to health crises.

By withdrawing from the WHO, the U.S. also gives up its seat and voting rights at the World Health Assembly and Executive Board, the organization’s decision-making bodies responsible for electing the Director-General, approving budgets, and setting global health policies. This absence diminishes the U.S.’s ability to influence international health priorities and opens the door for other nations (e.g. China) to assume a dominant role in shaping the global health agenda. But considering this administration’s hostility toward evidence based public health policy – could the US’ removal from the body actually do more good than harm over the next 4 years?

Trump leaves the  WHO:  Here are seven possible impacts on the U.S. and the world | Science | AAAS

Given the Trump administration’s opposition to evidence-based global public health initiatives, perhaps the U.S. withdrawal from the WHO will be a good thing overall as Trump administration functionaries will no longer have a voice at the WHO Executive Board and World Health Assembly and will be unable to negatively influence WHO policies, priorities, and operations for the next 4 years.

WHO Governance

In other words, while the WHO will need to make some budget cuts and increase revenues somehow – at least they’ll be free from unhealthy meddling by the US for the next few years.

Will Humble Professional Development, Wills Blog

WRPHTC Future Leaders Program February – May 2025: session dates & info

The WRPHTC’s Future Leaders is a program designed to support students conducting applied public health experiences by providing training, funding (a $3,500 stipend), and community during the course of their projects. Program components include:

  • An applied public health experience (i.e., field placement or faculty-student collaborative project)
  • 3 virtual exchange sessions with a small cohort of health professions students
  • Poster presentation to summarize your public health project
  • Supplementary self-paced online training on communication skills

Applications for the spring semester are due January 31

For Students | Western Region Public Health Training Center

The Future Leaders program is an initiative by the Western Region Public Health Training Center to support students conducting applied public health experiences by providing training and funding during the course of their projects. Students must conduct either a field placement or faculty-student collaborative project to take part in the Future Leaders program.

  • Field Placement Project: A structured experience that provides students with opportunities to apply their knowledge and skills in a public health setting (such as with a nonprofit or public health agency or organization) under the guidance of an experienced professional.
  • Faculty-Student Collaborative Project: A research project and/or community intervention led by a faculty advisor where students collaborate with a public health agency to enhance public health services to rural and/or medically underserved communities.

The goal of these projects is to provide students with applied public health experience under the guidance of faculty and field placement preceptors. Both types of projects should have specific target populations that include underserved communities and project goals that center achieving health equity in these communities.

The WRPHTC will provide stipends to support students accepted into the Future Leaders program through support from the HRSA.

Will Humble Professional Development, Wills Blog

Empowering County Health Departments to Properly Use AI: The NACo AI Leadership Academy

Artificial intelligence has the potential to revolutionize public health practice. For county health departments, using AI can lead to more efficient operations, better decision-making, and improved health outcomes.

However, to harness AI’s full potential, public health practitioners need to understand how to effectively implement these tools. That’s where the National Association of Counties (NACo) Artificial Intelligence (AI) Leadership Academy comes into play.

NACo Artificial Intelligence (AI) Leadership Academy | National Association of Counties

The NACo AI Leadership Academy is a fully online, six-week program designed to equip county government leaders with the knowledge and tools to understand and use AI effectively.

The curriculum includes insights from experienced government leaders, industry experts, and academics, focusing on:

  • Understanding the power and potential of AI.
  • Mitigating risks associated with AI implementation.
  • Navigating the complexities of change brought about by AI advancements.

The first cohort of 2025 begins on January 27. This presents a timely opportunity for county health managers to encourage key staff members to enroll and gain essential AI competencies. By enrolling in the NACo AI Leadership Academy, your team will:

  • Enhance Leadership Skills: Learn practical cases, frameworks, and tools to lead with AI for good governance.
  • Improve Operational Efficiency: Discover how to use AI to streamline processes and reduce workload.
  • Stay Ahead of the Curve: Equip your department with the latest knowledge to navigate the evolving landscape of public health.

Given the rapid advancements in AI and its growing role in public health, it’s important for county health departments to build internal expertise. Encouraging your staff to take part in the NACo AI Leadership Academy is a proactive step toward enhancing your department’s capabilities.

Don’t miss the opportunity to be part of the inaugural cohort starting January 27. For more information and to enroll, visit the NACo AI Leadership Academy page: NACo Artificial Intelligence (AI) Leadership Academy | National Association of Counties

Embrace the future of public health by empowering your team with the skills and knowledge to use AI effectively

Will Humble Public Health, Wills Blog

New Threat to Public Health: Preventive Care on the Chopping Block

The Affordable Care Act is often thought of as a tool to just make health insurance more accessible and affordable. But it’s a lot more than that.

There are lots of things in the Act about health insurance coverage (and hospital reimbursements) to keep people healthier (and less expensive).

One cornerstone of the ACA is its requirement that health insurance plans cover a range of preventive services without any patient co-pays… services like screenings, immunizations, behavioral counseling, and medications designed to catch or prevent diseases early—before they become costly and life-threatening.

The preventive services that private plans and Medicaid expansion programs must cover are based on those that have an A or B level recommendation by the U.S. Preventive Services Task Force and vaccines recommended by the Advisory Committee on Immunization Practices.

Those task forces use rigorous criteria to make sure all of their recommendations are evidence based. The US Supreme Court has now accepted a case that threatens to overturn this important coverage requirement.

A and B Recommendations | United States Preventive Services Taskforce

Those recommendations are grounded in rigorous, evidence-based research.

But now, this foundation of public health and cost control is under threat. Last week the U.S. Supreme Court has agreed to hear Braidwood Management Inc. v. Becerra, a case that could strike down the ACA’s preventive care coverage requirements.

If the Court overturns these provisions, the consequences for public health could be expensive in more ways than one.

Without guaranteed coverage without a co-pay many people will skip screenings, vaccines, or preventive medications because of the co-pay… leading more undiagnosed cancers (or later, deadlier diagnoses), untreated chronic diseases, and preventable infections—all of which would result in higher rates of hospitalizations and emergency treatments.

Explaining Litigation Challenging the ACA’s Preventive Services Requirements: Braidwood Management Inc. v. Becerra | KFF

The ripple effects would be felt across the health care system, driving up costs for insurers, employers, and taxpayers alike.

Preventive services aren’t just a public health priority—they’re a financial one. By catching diseases early or preventing them entirely, these services save money in the long run.

For example, a colonoscopy that detects and removes precancerous polyps is far cheaper than chemotherapy for advanced colorectal cancer.

Overturning these provisions would disproportionately harm low-income individuals and communities of color, worsening health inequities.

This isn’t just about insurance coverage—it’s about maintaining a healthier, more equitable, and cost-effective health care system.

The Supreme Court’s decision will shape the future of public health. Let’s hope they choose to uphold the ACA’s preventive care protections—for the health of individuals, families, and the entire nation.

Sadly, I’m not optimistic.

The new administration’s Solicitor General may not even defend the lawsuit, or if she or he does, they might do a bad job on purpose

Will Humble State Legislature, Wills Blog

Legislative Session Update: January 18, 2025

The Legislative Session officially began last week. The main activities have been legislators putting the final touches on their proposed bills and accumulating cosponsors. The major committees didn’t meet last week – including the House and Senate Health Committees.

House and Senate Health Committees aren’t really meeting next week (well the Senate is but just two minor bills on the agenda). In the coming weeks the House Health meetings Mondays at 2pm with Senate Health meeting on Wednesdays at 9am.

Below are the bills related to public health so far. There are undoubtedly some I’ve missed (they are being posted at a fast and furious rate) – but we will catch up. Where you see a YES or NO that means we signed up in RTS for or against the bill.

Here’s a link to our short committee meeting at 2pm this afternoon: https://us06web.zoom.us/j/84425365182 

 

Bills So Far:

House

HB2001 behavioral health; temporary licensure; graduates YES

HB2012 emergency use products; employers; prohibition

HB2022 school safety; employee certification; policies NO

HB2055 immunizations; requirements; exemption NO

HB2057 parental rights; medical records

HB2058 school immunizations; exemption; adult students

HB2062 sex-based terms; laws; rules; regulations

HB2063 parental notification; school immunization exemptions

HB2125 insurance coverage; hearing aids; children YES

HB2130 claims; prior authorization; denials; contact YES

HB2145 registered sanitarians; qualifications YES

HB2159 prohibited weapon; bump-fire device; accessory YES

HB2165 SNAP; prohibited purchases; waiver YES

HB2175 claims; prior authorization; conduct YES

HB2211 severe threat order of protection YES

HB2214 failure to secure weapon; minor YES

HB2250 AHCCCS; preventative dental care YES

HB2276 legislative ratification; rulemaking; regulatory costs NO

HB2293 tobacco products; vaping; minimum age YES

HB2309 vacation rentals; short-term rentals; restrictions

HB2619 assault weapons; magazines; prohibition; registration YES

HB2620 firearm sales; permit verification; requirements YES

HB2621 firearm sales; transfers; background checks YES

 

Senate

SB1019 photo enforcement systems; prohibition NO

SB1020 disruption; educational institution; concealed weapon NO

SB1043 homeless shelter services fund; appropriation YES

SB1044 secure behavioral health facilities YES

SB1045 secure behavioral health facilities; appropriations YES

SB1046 mental illness; prisoners; diagnosis; treatment YES

SB1125 psychologists; prescribing authority YES

Will Humble Opioids, Social Determinants, Wills Blog

Pioneering Reentry Care: Arizona’s Evidence-Based Step to Improve Health for Incarcerated People Just Prior to Release

Arizona is taking a groundbreaking step to address the health care needs of incarcerated individuals reentering their communities. Thanks to the efforts of Governor Katie Hobbs, AHCCCS Director Carmen Heredia, and their dedicated teams, Arizona’s Medicaid program (AHCCCS) has received federal approval to implement an innovative, evidence-based system designed to improve health care access during this critical transition.

Reentry Interventions that Address Substance Use: A Systematic Review – PMC

This new initiative addresses a long-overlooked gap in health care, ensuring that individuals leaving correctional facilities receive the medical support they need to rebuild their lives. The program includes several key components that could transform reentry health care in Arizona:

Medication-Assisted Treatment (MAT) for Substance Use Disorders

Substance use disorders (SUDs) are common among incarcerated individuals, and untreated SUDs significantly increase the risk of overdose and recidivism after release. AHCCCS’ plan ensures that individuals can access MAT for all types of SUDs, combining medications with counseling and behavioral therapies. Research consistently shows that MAT is one of the most effective treatments for SUDs, significantly reducing relapse rates and improving long-term outcomes.

A study published in Health Affairs underscores the importance of this approach, noting that expanding access to MAT for justice-involved populations reduces overdose deaths and improves public health outcomes. By making MAT accessible immediately upon release, Arizona is leading the charge in implementing evidence-based solutions to one of the most pressing public health challenges of our time.

30-Day Prescription Supply Upon Release

Another critical feature of the AHCCCS program is ensuring that individuals leave correctional facilities with a 30-day supply of all prescribed medications. This provision addresses a common and dangerous gap in care: the abrupt discontinuation of necessary medications.

Whether it’s managing chronic conditions like diabetes or hypertension, treating mental health disorders, or continuing MAT for SUDs, this policy ensures continuity of care during a vulnerable period. It’s a straightforward yet transformative measure that demonstrates Arizona’s commitment to improving health outcomes for all residents.

Access to Practitioner Office Visits

The program also includes comprehensive coverage for practitioner visits upon release. These visits could include physical exams, wellness checks, mental health counseling, or substance use disorder treatment. This approach ensures that individuals can quickly connect with medical professionals to address urgent health needs, manage ongoing conditions, and establish long-term care plans.

A Model for the Nation?

Arizona’s proposal is more than just a policy; it’s a blueprint for how states can address the health care needs of justice-involved populations. Studies show that providing access to health care during reentry improves health outcomes, reduces recidivism, and ultimately lowers costs for taxpayers.

This initiative is a testament to the leadership of Governor Hobbs and Director Heredia. Their commitment to evidence-based policymaking and their recognition of the human dignity of all Arizonans are commendable. They’ve set a high bar for what compassionate, innovative governance can achieve.

A Healthier Future for Arizona

By addressing the health care needs of incarcerated individuals reentering society, Arizona is paving the way for healthier communities and safer neighborhoods. This program recognizes that health care is a right, not a privilege, and that everyone deserves a chance to succeed.

Kudos to AHCCCS and its partners for this bold, forward-thinking initiative. Let’s hope other states follow Arizona’s lead in transforming reentry health care.

Next Steps

Next steps: AHCCCS is working on their implementation plan (due in late April) and will eventually need legislative approval of their plan.

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