Will Humble Firearm Safety, Injury Prevention, Wills Blog

A Firearm Safety Call to Policy Action: Guest Blog by AZPHA Member Mike Humphrey

Pima County continues to suffer from firearm-related violence.  Data provided by the Pima County Health Department showed that in 2023 there were 213 firearm related deaths. Latest figures (2021) from the Pima County Health Department showed that the local firearm death rate was 22.7 per 100,000, which is significantly higher than the national average of 14.6 deaths per 100,000 (Pew Research Center).

During 2022 (the latest full year reported), there were 533 hospital and emergency visits costing $33M. Seventy percent of these costs were covered by public funds. During the first half of 2023, over $23 million dollars was spent on treating firearm related injuries in our community. 

Nationally, the U.S. Sentencing Commission estimates that 88.8% of firearm offenders sentenced were prohibited from having a firearm in the first place. 

Information provided by the Pima County Attorney’s Office shows that between 1/5 to 1/3 of firearm crimes are committed by prohibited possessors. Given the current situation, what can be done to curtail the easy accessibility of firearms for prohibited possessors – persons who cannot legally own firearms as defined by ARS 13-3101.

There are several possible ways within current state statutes to limit the ability of prohibited possessors to obtain and retain firearms. Local judges, prosecutors and law enforcement agencies working in collaboration with state and federal authorities can: 

One, limit the ability of persons to sell or transfer firearms to a prohibited possessor. Local law enforcement agencies should enforce the provisions of ARS 13-3102 (Misconduct Involving Weapons) which makes it illegal for a persons to sell or transfer a firearm to a prohibited possessor. Enforcement of the statute should be in coordination with ATF&E (Bureau of Alcohol, Tobacco, Firearms and Explosives).

Using the existing firearm retailer ATF&E notification system, whereby retailers alert ATF of potential straw purchasers, ATF&E could share this notification with local law enforcement agencies to encourage enforcement of the state statute, in coordination with federal straw purchase enforcement efforts.

Enhanced enforcement should be combined with public education.  This education should take two forms: one, informing the public that selling or transferring firearms to a prohibited possessor is a crime and they will face arrest and prosecution; and two, working with FFL dealers on how to better find and deter persons trying to buy firearms for prohibited possessors. 

Two, ensure that adjudicated prohibited possessors as defined by ARS 13-3101(Prohibited Possessors)k, surrender their firearms to local law enforcement in compliance with ARS 13-3105 (Seizure of Weapons). Develop,  implement and monitor uniform procedures to ensure that court-ordered firearm surrender requirements are met. Rand Research pointed out the need for more enforcement of firearm surrender, stating in part:

“Although firearm surrender laws exist in several states, there is evidence that they may not be implemented well…Even when firearms are ordered to be surrendered, there is often no clear procedure for enforcing such orders”.

Three, ensure that prohibited possessors surrender their concealed carry permits (CCW) in compliance with ARS 13-3112 (Concealed weapons). Develop, implement, and check uniform procedures to ensure the  surrender of CCW’s, including notifying the Department of Public Safety to remove the person’s name from the State’s CCW registry. This step is needed to prevent prohibited possessors from walking into a gun shop and buying a firearm without a background check.

Four, ensure that minors convicted of  firearm-related crimes be identified as prohibited possessors per the provisions of ARS 13-3111 (Minors Prohibited from Possessing Firearms) and required them to surrender their firearms in accordance with ARS -13-3105. This is crucial, as we have seen the heart-breaking carnage inflicted by even very young persons with firearms. 

While these actions in and of themselves will not end illegal access to firearms by prohibited possessors, they are worth the effort in making the acquisition and retention of firearms more difficult and by so doing, reduce firearm-related deaths and injuries in our community. 

Let’s all work together to make this happen. Thank you. 

Will Humble Professional Development, Wills Blog

Arizona’s Public Health Training Center: An Introduction

In 2022 the Western Region Public Health Training Center was awarded $4.1 million by the Health Resources and Services Administration to help support a skilled and knowledgeable public health workforce through 2026.

Over those years, they’ll continue to provide interactive training programs that impart critical skills for providing quality services that meet community needs and address emerging threats at the local, state and national levels.

The Western Region Public Health Training Center is one of 10 Regional Public Health Training Centers funded by the Health Resources & Services Administration to support the public health workforce.

They’re a consortium of public health professionals that develop and provide innovative, skill-based training to address gaps identified by training needs assessments for the public health workforce. They:

  • Develop and implement of skill-based public health trainings (online, in-person, webinars)
  • Offer free continuing professional education courses.
  • Are an accredited provider of CPEUs that is available to all Registered Dietitians/Nutrition and Registered Dietetic Technicians.
  • Are an accredited provider of continuing education contact hours (CECH) that are available to all Certified Health Education Specialists (CHES).
  • Provide stipends to support undergraduate juniors, seniors, and graduate students conducting community-based health projects.
  • Customize & implement online public health core competency and training needs assessments for public health organizations.

Home | Western Region Public Health Training Center

Will Humble Professional Development, Wills Blog

Maricopa County Department of Public Health Fellowship Recruitment Beginning Soon

Maricopa County Department of Public Health Fellowship program will begin recruiting their second cohort soon! This two-year program will connect recent graduates of advanced degrees with practical, hands-on learning experience. Fellows will:

  • Get full pay and benefits
  • Work with internal projects to execute initiatives aimed at current public health issues in our communities
  • Get continuous support and mentorship from Fellowship Coordinator and Project Point of Contact
  • Be a part of a Fellowship cohort
  • Transition to Senior status when a new cohort of Fellows join the program

Positions are expected to post in mid-April at Internships and Volunteer Opportunities | Maricopa County, AZ.

Will Humble Behavioral Health, Wills Blog

Common-Sense Governance Reform for Our Arizona State Hospital Will Have to Wait Yet Another Year

A key government accountability bill (SB1688) that would have fixed the governance flaw at our Arizona State Hospital failed again this year.

You’re probably tired of reading pieces by me about why this bill was so important so I’ll spare you the details of why ADHS shouldn’t be both running and ‘regulating’ our state hospital.

In the end, opposition from the governor’s office led Senate Democrats to vote against the bill – ending its chances again. It was approved for reconsideration after its failure on the floor the first time but was never put back on the board.

We won’t (or at least I won’t) give up. I’ll be back year after year after year until we fix this.

Senate Fails Key Arizona State Hospital Governance Reform Bill: State Hospital will Continue to be Run & ‘Regulated’ by ADHS

Will Humble Assurance & Licensure, State Legislature, Wills Blog

Key Assisted Living & Skilled Nursing Accountability Bill Advances (HB2764): Companion Bill Abandoned

Regulating facilities where Arizonans receive services is a key, one might say cornerstone, function of a state health department. When a state health department is doing a good job regulating facilities like nursing homes, assisted living centers, behavioral health facilities, outpatient treatment clinics and the like, journalists’ stories are generally about how a facility did poorly on an inspection and highlight agency enforcement actions.

It’s an altogether different story when an agency deprioritizes their assurance and licensure mission. When that happens, journalists end up writing about poor regulation and unchecked substandard care.

That’s precisely what happened toward the end of the prior administration when ADHS licensing programs continued to atrophy until the Arizona Auditor General exposed gross nonfeasance on the part of the agency.

See ‘The Bitter End’ Series by Caitlin McGlade & Sahana Jayaraman: How The Arizona Republic reported on resident harm in senior living facilities & Licensing & Regulating Care Facilities: A Root Cause Analysis of Arizona’s Failure to Protect Vulnerable Persons & Pathway to Redemption

Legislators are rightfully frustrated by what they’re hearing from constituents and reading in the newspaper and are proposing several bills that would help the ADHS do a better job regulating institutions over the long run.

One focused on regulatory reform continued its advance this week (HB2764) while a sister bill that focused on internal accountability (e.g. incident reporting and allowing for limited elective electronic monitoring) died (HB2653).

HB2764 long-term care; enforcement; passed out of Senate Health this week with a unanimous pass recommendation. If it passes the Senate floor and is signed by the Governor, it would:

  • Require in person agency inspections of health care institutions that aren’t in substantial compliance with licensure requirements.
  • Stop ADHS from accepting an accreditation report in lieu of a compliance inspection for assisted living and skilled nursing care facilities (unless the institution is owned by a hospital). Deficiency free facilities would enjoy a two-year reprieve from ADHS compliance surveys.
  • Increase the cap on civil penalties for violation of health care institution statutes or rules from $500 to $1,000 per resident/patient.
  • Void a health care institution license if they don’t pay civil penalties or provider agreement fees before the due date.
  • Let ADHS to pursue enforcement action against a licensee, even if they’re in the process of being sold or has closed.
  • Let ADHS deny a new license application current licensee while enforcement action is pending if patient safety may be in jeopardy due to the licensee’s actions or if the change in ownership would jeopardize patient safety (i.e. prevents ‘license flipping’ to avoid accountability).

ADHS and AHCCCS signed up in favor of the bill – signaling that if it’s unchanged and passes the full Senate the Governor may sign the package.

Major Arizona assisted living reform proposal blocked despite widespread stakeholder support

Meanwhile, the long-term care industry killed HB2653 long-term care; reporting; monitoring; injury this week by denying it a hearing in the Senate Health committee before last week’s deadline.

That bill would have allowed for limited and optional electronic monitoring of some areas of a facility (with resident and roommate consent) and required more reporting of abuse, neglect, or exploitation of vulnerable adults in facilities.

Will Humble Climate Change, Injury Prevention, Wills Blog

New Maricopa County Public Health Reports: 2023 Heat Death Surveillance & Evaluating Cooling Center Effectiveness

Maricopa County Department of Public Health published 2 reports last week regarding last summer’s tragic heat deaths.

Their preliminary report of heat-related deaths in 2023 found a record- breaking 645 heat-associated deaths last summer. That total breaks the previous year’s total by over 50%. The persons most affected are folks experiencing homelessness.

Their evaluation of the effectiveness of a cooling centers investigated what brought people to cooling centers and the barriers that kept people from using them. Among those findings:

  • Most visitors to cooling centers had been to one previously and spent at least an hour during each visit for heat relief
  • Word of mouth and street signs were suggested as the top two ways to inform people of where cooling centers are located
  • The biggest barriers to using cooling centers are:
    • Not knowing they exist
    • Lack of transportation to cooling centers
    • Not knowing where cooling centers are located

Based on this information, MCDPH is working to address these needs with cities and community partners like:

  • Supporting a bilingual heat relief call center to answer calls and connect people to resources and transportation to and from cooling centers
  • Partnering with City of Phoenix to create signs for all Maricopa County heat relief locations to make them visible from the street
  • Working with cities and community organizations that have experience running cooling centers to expand hours and days of operation, ensuring water and snacks will be available
  • Ordering heat relief items like reusable water bottles, cooling towels, and hats to distribute at smaller community cooling centers, which may not be able to afford those supplies on their own

For a timeline of the Heat Relief Network’s 2024 activities and more details on donations, visit https://azmag.gov/Programs/Heat-Relief-Network.

Will Humble Health Equity, Wills Blog

Vot-ER: A Civic Engagement Tools for Every Corner of Healthcare

Vote-ER develops nonpartisan civic engagement tools and programs for every corner of the healthcare system—from private practitioners to medical schools to hospitals. Their work is driven by a community of health care professionals, organizers, clinical students, and technologists united by a common vision: healthy communities powered by inclusive democracy.

Vot-ER’s Community Civic Engagement Program funds between $5,000 and $10,000 to Community Health Centers, Federally Qualified Health Centers, and look-alikes to implement non-partisan voting initiatives and turnout activities.

Vot-ER programs are in over 500 locations and have helped tens of thousands of Americans register and prepare to vote.

Vot-ER’s Community Civic Engagement Program application deadline is Friday: March 22, 2024

The application, FAQs, and informational webinar recording are available on our CCEP webpage at vot-er.org/ccep/. If you have any questions, contact [email protected] or  [email protected].

Will Humble Behavioral Health, Injury Prevention, Wills Blog

Can Synthetic Delta 8 THC from Hemp be Sold in Head Shops that Aren’t Licensed Dispensaries?

In short, no – as of last week.

Head shops around Arizona have been selling something called Delta 8 THC that’s a psychoactive chemical derived from the hemp rather than the classic marijuana plant. The shops have been exploiting the confusion about whether Delta 8 TCH from hemp can be sold in their stores even though they’re not a licensed dispensary.

The confusion ended last week with a clear Attorney General opinion that says such products can only be sold in dispensaries licensed by ADHS.

Sale of products containing delta-8 and other hemp-synthesized intoxicants | Arizona Attorney General

Here’s the question posed to Mayes:

Does Arizona law permit an entity that is not appropriately licensed by the Arizona Department of Health Services to sell products containing hemp-synthesized intoxicants like delta-8 tetrahydrocannabinol (“THC”), delta-10 THC, or any other product that has been synthetically converted from naturally occurring cannabidiol or other cannabinoids into intoxicating substances?


Answer:

“No, Arizona law does not permit the sale of delta-8 and other hemp-synthesized intoxicants by entities that have not been licensed by Health Services.”

“Irrespective of delta-8’s arguable federal legality under the 2018 Agriculture Improvement Act (“Farm Bill”), Arizona continues to define and regulate “industrial hemp” in a manner that precludes the sale of hemp-synthesized intoxicants in convenience stores, smoke shops, and other unlicensed locales.”


Kris Mayes: AZ law bars smoke shops from selling delta-8 THC products • Arizona Mirror

Arizona AG rules delta-8 can’t be sold without cannabis license – Axios Phoenix

Will Humble Community Health Workers, Wills Blog

Are You a Primary Care Provider Looking for a Way to Help Your Patients Better Manage Chronic Diseases?

Referring them to a Community Health Worker Might Just be the Ticket

Community Health Workers are frontline public health workers who have a trusted relationship with the community and help access to a variety of services and resources for community members.

CHWs facilitate access to services and improve the quality and cultural competence of service delivery, including the coordination of services to improve medical and behavioral health outcomes.

Building CHWs into the continuum of care has been proven to both improve health outcomes and reduce healthcare costs… especially when it comes to preventing and self-managing chronic diseases.

Arizona has been working hard over the last several years to build the infrastructure to use the skills of Community Health Workers at scale within Arizona’s healthcare network.

We finally made it!

This week AHCCCS announced that they will begin registering CHWs as AHCCCS providers setting the stage for Medicaid reimbursement starting April 1, 2024.

Claims for covered services provided by the certified Community Health Worker need to be sent by a registered AHCCCS provider. CHWs can be employed by multiple AHCCCS registered providers.

The Community Health Worker needs to be certified by ADHS and can only deliver covered services within their scope of practice under specified AHCCCS registered provider types (provider types are listed in Question 8 of the CHW/CHR Frequently Asked Questions).

Additional billing guidance is available in this AHCCCS Provider Billing Manual. You might also check with your contracted Medicaid health plans for a list of in network CHWs available for clinician referral.

Kudos to the network of industrious and tenacious folks who have been working toward this goal over the last several years!

Let’s start referring patients!

Note: For a picture of how CHWs can fit into a continuum of care, take a look at this report from the NAU Center for Health Equity Research in collaboration with the UA Prevention Research Center which provides insight into innovative strategies for integrating, sustaining and scaling of the CHW workforce within Medicaid.

1 … 28 29 30 31 32 … 170