Will Humble Public Health, State Legislature, Wills Blog

Senate Confirmation Circus Forces Out Heredia & Cunico: Will the Senate Majority Ever Choose Governance Over Grandstanding?

Governor Katie Hobbs has once again been inappropriately hamstrung by the hyper-partisan Senator Jake Hoffman – the Chair of the Senate’s Director Nominations Committee.

This week, his ongoing political theater forced the resignation of two important health directors: AHCCCS Director Carmen Heredia & ADHS Director Jennifer Cunico.

The Arizona Republic and AZ Capitol Times both reported that the directors resigned ahead of expected rejections by the Senate committee, which has repeatedly used its power (mostly Mr. Hoffman) not to vet nominees in good faith – but to publicly humiliate and undermine the governor’s choices.

AHCCCS & ADHS Directors Resign | Arizona Capitol Times
AHCCCS, Health services directors resign before Senate confirmation

It would be one thing if Hoffman were looking at the statutory requirements of the jobs and vetting the nominees based on whether their experience meets the statutory requirements – but that’s not what he’s doing.

Rather than perform his legitimate constitutional duty to evaluate and confirm nominees, Hoffman is focused on sabotaging the executive branch when it’s not held by his party. Ducey nominees wouldn’t be getting this treatment regardless of how unqualified were.

See: View ARS 36-102 Statutory Qualifications for the ADHS Director

This behavior isn’t new — my op-ed published two years ago highlighted how Hoffman’s treatment of nominees hasn’t been about qualifications but about political ideology and partisan sabotage.

Senate committee doesn’t ‘vet’ nominees. It sabotages them

Heredia and Cunico weren’t ‘fringe figures with radical ideologues’ as suggested by Hoffman. Both were respected inside and outside their agencies. All the information I have suggests they were driven to resign not because of a scandal or mismanagement, but because Mr. Hoffman disagrees with their opinions.

Hoffman’s behavior—grilling nominees on partisan talking points, delaying hearings, or simply refusing to confirm them is basically sabotage – not legitimate legislative oversight of the executive branch.

Who will want to serve in Arizona government and leave jobs they like knowing their reputation will be dragged through the mud for political theater?  

Per ARS §38-211(B), Hobbs must now “promptly” nominate new directors for both ADHS and AHCCCS. While the statute doesn’t define “promptly,” the need to name at least interim directors is immediate because state agencies can’t execute administrative or regulatory decisions without directors at the helms.

38-211 – Nominations by governor; consent of senate; appointment

Will the Senate majority ever choose governance and accountability over grandstanding?

Not until President Petersen changes who is chair of the DINO Committee or scraps it all together and goes back to the old way of vetting through normal standing committees.

 

Will Humble Public Health, Wills Blog

Kennedy’s Sweeping HHS Cuts Continue to Assault Public Health & Research Infrastructure

A leaked Office of Management and Budget document reveals drastic plans by Kennedy to slash $40 billion from the department’s budget, a reduction of nearly one-third.

The cuts, outlined in a 64-page internal document, fundamentally restructure HHS and dismantle major agencies and programs vital to public health and scientific research.

Leaked HHS budget projects $40B in cuts, ACA subsidies expire

Key casualties include the HRSA, SAMHSA, AHRQ, NIH, CMS, CDC and FDA. The National Institutes of Health faces an added 40% budget cut, shrinking from $47 billion to $27 billion, severely undermining biomedical research. 

Scoop: Leaked PDF outlines major HHS restructuring proposal (authenticity now confirmed). “The safety nets are being blown up right and left.”

HHS has already eliminated 10,000 positions and announced that was just the beginning of a planned reduction, saying in a press release, “The current 82,000 full-time employees will be reduced to 62,000.”

  • The FDA will decrease its workforce by approximately 3,500 full-time employees.
  • The CDC will decrease its workforce by approximately 2,400 employees.
  • The NIH will decrease its workforce by approximately 1,200 employees.
  • CMS will decrease its workforce by approximately 300 employees.
  • Ten regional offices will become five, a tool to get people to quit rather than move.

Kennedy also proposes to no longer subsidize Affordable Care Act Marketplace premiums – effectively ending insurance coverage for an estimated 4 million people and significant revenue losses for hospitals, especially in rural communities.

The implications are stark: the U.S. risks reversing decades of progress in disease prevention, health equity, and medical innovation.

Vulnerable The only real hope for the US’ public health system rests with the Judicial branch of government.

Will Humble Environmental Health, Wills Blog

Rabies on the Rise in Southern AZ – Just In Time for Spring Camping Season

Arizona is in the middle of a rabies surge among wildlife, particularly in the southern regions of the state.​

There has been a significant uptick in rabies cases among wildlife, mostly among skunks, foxes, and bats (the usual cast of characters).

Pima County has reported 36 confirmed rabies wildlife cases so far this year, accounting for nearly half of Arizona’s total cases. The majority of these cases involve bats, but also a mountain lion. ​

Pinal has had multiple rabies advisories following positive tests in gray foxes, skunks, and a bobcat. Santa Cruz County has 10 confirmed cases, while Cochise County has had 8. The presence of healthy populations of common rabies carriers, such as foxes and skunks, in these areas may contribute to the higher number of cases.

Rabies cases among wildlife are usually found because someone – either a member of the general public or fish and game or state or federal parks staff meet an animal that’s acting outside the normal behavior for the species.

Bats are consistently the most common source of rabies exposure to humans in Arizona… and each year about 30 people are exposed to rabid animals (usually bats).

They euthanize the animal, and the brain is tested by staff at the ADHS state laboratory (all the lab staff that do this work are vaccinated against rabies virus).

Wildlife cases are seldom found because they bite a human – but it does happen. If wildlife does bite and behavior is weird it’s important to be able to find the animal so it can be tested. If the animal can’t be found then the general approach is to do a risk assessment to figure out whether it’s a higher risk exposure to decide whether post exposure prophylaxis is called for.

Manual for Rabies Control and Animal Bite Management

Keep in mind that rabies is 100% fatal if post exposure prophylaxis isn’t started on time. Once symptoms appear – it’s too late.

The main things to remember are not to mess with bats – dead or alive – and make sure your kids know that too. Never approach or handle wild animals, especially those with weird behavior, such as aggression or lack of fear of humans. If you meet a sick or dying wild animal, contact the Arizona Game and Fish Department at 623-236-7201.

The cost of the treatment (immunoglobulin and vaccine) is around $10K – so health insurance plans usually like to see the risk assessment before they agree to pay for the prophy.

If I could give one piece of advice it’s to make sure your kids and grandkids know not to mess with bats.

When I was a kid, I found a bat at Mt. Lemmon and brought it to school in a shoe box for show and tell. Nothing happened to me, but it could have. My parents don’t remember whether they brought the bat in for testing or not.

Will Humble Reproductive Health, Wills Blog

Title X Under Siege?

Guest Piece from AZPHA member and Affirm CEO Bre Thomas:

In light of the recently leaked Office of Management and Budget (OMB) 2026 Discretionary Budget Passback, which includes the proposed elimination of the Office of Population Affairs (OPA) and zeroing out the Title X Family Planning Program, I am writing to provide you with an update from Affirm.

We understand the document is pre-decisional and does not represent a finalized proposal. However, we want to share current Arizona’s Title X program data to support any internal discussions and monitoring. As you know, Title X is the backbone of the nation’s reproductive health safety net. It supports essential services for individuals and families who would otherwise go without care.

In Arizona, the impact of Title X is broad and deep. In 2024:

  • 35,629 clients received care through Title X-supported services.
  • These individuals accounted for 50,106 visits across dozens of clinic sites statewide.
  • Services were delivered by 505 staff members supported by Title X funding at 53 clinics statewide.
  • Most critically, 19,790 of the clients served lived at or below the federal poverty level.

Title X is the only federal program dedicated solely to providing individuals with comprehensive family planning and preventive health services. These include access to contraception, STI testing and treatment, cancer screenings, and basic preventive care for those with limited or no insurance coverage.

We are closely tracking updates and taking part in national briefings to understand the implications of the FY 2026 budget process. Please let us know if we can provide any additional information. We deeply appreciate your leadership.

Will Humble Behavioral Health, Wills Blog

Arizona’s Missing Link in Mental Health Care

Arizona is facing, and has faced for a long time, a major gap in our mental health care system: the lack of Secure Behavioral Health Residential Facilities (SBHRFs) for individuals with serious mental illness resistant to treatment.

These are often folks with conditions like schizophrenia or bipolar disorder who, due to the nature of their illness, are unwilling to engage in voluntary treatment. Their families are left watching loved one’s cycle through emergency rooms, jails, and homelessness—without access to the long-term, structured care they need.

In 2019, families and advocates achieved a significant milestone when legislation was passed to authorize SBHRFs in Arizona. These facilities would offer a secure, therapeutic environment where individuals with SMI could receive intensive treatment while also being protected—and protecting others—from the consequences of untreated illness.

But despite the legal green light, not a single SBHRF has opened.

Efforts to implement these facilities have been met with stiff resistance, especially from the ACLU of Arizona (who appears to have a hotline to the Governor’s Office) and the Arizona Center for Disability Law.

The absence of secure residential treatment is a policy failure with real human consequences. It leaves Arizona’s most vulnerable residents (and their families) without hope for recovery and puts their families in a position of helplessness.

AzPHA will continue to push for the creation of SBHRFs, insisting that compassion and safety must guide mental health policy—not fear or ideology.

Please take a few minutes to read this article from Natalie Robbins at the Tucson Sentinel ‘Major gap in our system’: Arizona lacks secure facilities for people with serious mental illness

Whether we’re able to get these critical residential settings finally off the ground will depend on whether the upcoming state budget funds these important treatment spaces – and whether SB1604 is passed and signed.

While the ACLU does some good things and has been pushing back on some of the more harmful decisions by the Trump administration (and filing lawsuits) they’re 100% off the mark on this SBHRF issue.

We’re crossing our fingers that Governor Hobbs will listen to the Mad Moms and the Association, the Chronically Mentally Ill and AzPHA instead of just the ACLU when SB1604 hits her desk and when start-up one-time funding for SBRFs are discussed in the budget.

Helping Loved Ones Get the Care they Need – Secure Residential Treatment: A Crucial (and Scarce) Resource for Supporting Mental Health Treatment (Part III of III) – AZ Public Health Association

Will Humble Disease Control, Public Health, Wills Blog

The Real H5N1 Threat: Kennedy’s Assault on Our Public Health System

Last week’s 60 Minutes segment on H5N1 focused on some shortcomings in the US agricultural sector as they grapple with H5N1 influenza infections among poultry, cattle, and some dairy workers.

The segment focused on legit gaps like poor USDA oversight, limited worker protection, and the spread of the virus through dairy herds. The veterinary experts featured in the piece rightly presented arguments about the need for better biosecurity and surveillance in the ag sector.

Bird flu poses growing risk to people as pathogen spreads, scientists warn | 60 Minutes – CBS News

But let’s be honest… H5N1 isn’t something we’re going to “contain.” It’s global. It’s in migratory birds, domestic poultry, and now cattle — not just in the U.S., but around the world. Mitigation is the only practical path forward at the farm and ranch level.

The real threat to humans is Kennedy’s rapid disassembly of our public health system. He’s intentionally unraveling our capacity to respond if (or when) H5N1 adapts for sustained human-to-human transmission and becomes more virulent.

Local and state health departments — the frontline of any pandemic response (think surveillance, antiviral distribution and vaccine delivery and administration) is being cut dramatically by Kennedy.

The U.S. has walked away from the WHO. Trust in public health institutions is at historic lows largely because of Kennedy and Trump’s behavior and decision-making.

Those who should be reinforcing evidence-based public health practice (Secretary Kennedy) are instead waging a war on science, vaccine development, and the very concept of public health.

NIH researchers who once focused on rapid vaccine development (and zoonotic spillover) are being defunded, fired and driven out. Entire teams are gone, and his plan is to cut even further into NIH’s mission next year.

If H5N1 reassorts and sparks a human pandemic, we’ll be ‘responding’ with an eviscerated system. And it won’t just be about late vaccine timelines or scarce antivirals (or public health’s ability to distribute and administer them) — it’ll be about the absence of the workforce and infrastructure to mount a response at all.

After just 4 months of this administration, we’re already in worse shape now than we were for H1N1 in 2009. What we’ve already lost and continue to lose isn’t just funding or programs, its institutional knowledge, technical capacity, and our public health and research workforce and institutions.

If things don’t change, three and a half years from now we’ll be responding to pandemics with stone knives & bearskins.

Will Humble Professional Development, Wills Blog

Public Health Journalism this Week

Sen. Ruben Gallego says proposed Medicaid cuts will leave families uninsured

KFF Tracking Poll on Health Information and Trust: The Public’s Views on Measles Outbreaks and Misinformation | KFF

Poll: Belief in false measles claims correlated with lower vaccination rates | Arizona Mirror

‘Major gap in our system’: Arizona lacks secure facilities for people with serious mental illness

What to know about 3 big AHCCCS fraud cases in Arizona

New law increases oversight of Arizona sober living homes

A Note from the Chairmen of Best Buddies and Special Olympics: The Gifts of People with Autism – Best Buddies International

Will Humble Public Health, Wills Blog

Vitalyst’s Suzanne Pfister to Retire this Summer

After more than 11 years leading Vitalyst Health Foundation, Suzanne Pfister, President and CEO, has announced her retirement this upcoming summer.

Suzanne has led Vitalyst through many successes, including the creation of its Systems Change Grants, the rebranding of the Foundation from St. Luke’s Health Initiatives to Vitalyst Health Foundation in 2017, and the adoption of the Elements of a Healthy Community.

The Vitalyst Board of Trustees has retained DSG | Koya to lead the search for our next Chief Executive Officer. DSG | Koya is a nationally recognized executive search firm with deep expertise in placing transformative leaders in mission-driven organizations. The search is being conducted by Managing Director Michelle Bonoan and her team. 

Candidates can inquire here  Vitalyst_CEO@koyapartners.com.

Vitalyst’s Suzanne Pfister Announces Retirement This Summer – Vitalyst Health

Will Humble Professional Development, Public Health, Wills Blog

ASU Opening New School of Technology for Public Health

The School of Technology for Public Health, at ASU is launching this Fall with two new graduate degree programs – a two-year master of public health degree with a concentration in public health technology and a one-year master of science in public health technology (a brand-new gap year degree for the emerging field of public health technology).

These programs are the first-of-their-kind in the nation to weave together public health with elements of engineering, data science, design, and entrepreneurship. The program is hosting ongoing information sessions that we encourage you to attend in addition to reviewing the attached flier. You can also reach the department via email at stph@asu.edu or by phone at 602-496-0100.

The Master of Science in Public Health Technology weaves together introductory public health knowledge with basic elements of engineering, data science, design, and entrepreneurship, with a focus on designing and deploying accessible, ethical, and equitable digital health tools and technologies.

The Master of Public Health, Public Health Technology concentration program is for students who are seeking an education that knits together biostatistics, epidemiology, environmental health and policy with elements of engineering, data science, design and entrepreneurship.

Will Humble Uncategorized

CDC Vaccine Recommendations in Limbo Amid Leadership Uncertainty

Last week the CDC’s Advisory Committee on Immunization Practices recommended expanding RSV vaccinations to adults aged 50–59 with underlying health conditions and endorsed a new combination meningococcal vaccine for teens.

Normally, this ACIP recommendation would be translated into policy when (if) the CDC adopts the recommendation. Not this time. Acting CDC Director Susan Monarez has recused herself because of “legal limitations” pending her Senate confirmation… meaning the CDC Chief of Staff  – Matthew Buzzelli (a former federal prosecutor with zero medical or public health training) will decide whether to adopt the ACIP recommendations.

Health insurance coverage for vaccines typically follows CDC recommendations. Under the Affordable Care Act private insurance plans must cover new vaccine recommendations in the next plan year.

Until the CDC officially adopts ACIP’s recommendations, coverage for both these vaccines will remain as is. Buzzelli may very well not decide at all or veto the ACIP’s recommendation.

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