AHCCCS is accepting public comments through March 31 about their dental policies. You can submit a comment to AHCCCS to encourage the expansion of preventive dental benefits to adults over 21 years of age on the site.
Note: HB2338 which would add a preventive adult dental benefit to AHCCCS is being heard in the Senate Health Committee this Tuesday. Make sure you’ve signed up in support of that bill if you haven’t done so yet.
A few years ago, the Arizona Department of Agriculture brokered a compromise among stakeholders interested in protecting the safety of Arizona’s supply of eggs, those interested in more humane treatment of egg-laying hens, and egg producers when they adopted rules phasing out caged environments for egg-laying hens. Arizona joined California, Oregon, Washington, Michigan, Colorado, Nevada, Utah, Massachusetts, and Rhode Island in outlawing the use of cages for egg laying chickens.
Starting on January 1, 2023, all eggs and egg products sold in Arizona are supposed to be from hens that are housed in accordance with the UEP Animal Husbandry Guidelines. The chickens are supposed to have at least one square foot of usable floor space per egg-laying hen. Beginning January 1, 2025, all eggs and egg products sold in Arizona are supposed to be from hens housed in a cage-free manner.
Last month, along came the “Pacific Legal Foundation”, petitioning the Governor’s Regulatory Review Council to throw out the cage free rule. Surprisingly, GRRC is considering the Pacific Legal Foundation’s proposal to throw out the Rule at their upcoming March 28 meeting.
Minimizing foodborne illness is a key component of protecting public health and welfare. When enacting the cage-free regulations, ADA reviewed science-based evidence and concluded that ensuring eggs produced and sold in our state come from cage-free facilities minimizes food safety risks and advance public health goals.
Eggs contaminated with Salmonella and Campylobacter are much less common when produced in cage-free environments
The science related to hen housing has not changed since last year, and the existing policy still better protects public health outcomes.
For these reasons, AZPHA Chicken Egg Cage Rule Comment GRRC AZPHA to the Governor’s Regulatory Review Council urging them to leave in place Arizona’s cage free law (Arizona Administrative Code R3-2-901 – R3-2-907) and reject the Pacific Legal Foundation’s petition at GRRC’s upcoming March 28, 2023 meeting.
The federal Title V Maternal and Child Health Block Grant Program is a partnership between the federal government and states which supports the health and well-being of all mothers, children, and families.
One of the beauties of the MCH block grant is states have wide guardrails on how they can spend the funds. In Arizona we’ve traditionally developed a plan every 5 years – using stakeholder input – about how to best leverage the money in the block grant.
The block grant is refreshing because so often federal grants come with strict criteria and leave little room for discretion. The Title V block grant isn’t that way. HRSA administers the grants to states.
Funds from the Title V MCH Block Grant help:
ADHS is seeking input on how to spend the block grant funds via this online survey. For example, this is a great opportunity to elevate oral health as we know inequitable access to oral health remains a key issue facing Arizona’s children and families.
The survey will close on March 31, 2023. For more information about the grant program, visit ADHS‘ website.
Last Tuesday the President issued an executive order called Reducing Gun Violence and Making Our Communities Safer. At a high level, the Order basically instructs federal agencies to use their existing authority to implement measures to reduce gun violence. Much of the executive order focuses on coordinating implementation of the Bipartisan Safer Communities Act.
The Act:
Executive Order: Reducing Gun Violence & Making Communities Safer
Last week’s Executive Order basically coordinates implementation of that Act. For example, The Attorney General, HHS, and the Departments of Education, and Homeland Security are supposed to turn in their plan of action to maximize the use of the Bipartisan Safer Communities Act.
The U.S. Attorney General is supposed to implement a plan to clarify the definition of who is a firearm dealer required to become Federal firearms licensee, prevent former licensees whose licenses have been revoked or surrendered from continuing to engage in the business of dealing in firearms; and publicly release inspection reports.
The Defense Department, Attorney General, Homeland Security and HHS are supposed encourage effective use of extreme risk protection orders (“red flag” laws), partnering with law enforcement, health care providers, educators, and other community leaders. Sadly, Arizona doesn’t have a Red Flag law.
See AzPHA’s Special Report: Firearm Violence in Arizona: Data to Support Prevention Policies
This week’s meeting of the Senate Health Committee is a busy and important one. There are 5 good bills up for consideration including: HB2053 – nurse home visitations; HB2168 – good samaritan medical assistance; HB2194 – drug overdose teams; HB2338 – AHCCCS preventive dental; and HB2753 – graduate medical education at communtity health centers.
The House Health Committee has a pretty meager agenda & other committees aren’t acting on our priority bills this week.
Here’s our updated Bill Tracker Spreadsheet and Evergreen Session PowerPoint.
Childhood vaccination rates in Arizona consistently eroded during the Ducey Administration. The conventional wisdom has been that it was because of a general decline in parental enthusiasm for vaccines. However, more and more it’s looking like it’s because of eroding access to vaccines resulting from the actions of ADHS’ Vaccines for Children program. A primer:
State law requires the ADHS to collect data about the vaccination rates for Child Care/Preschool; Kindergarten; and 6th grade. Schools submit the data to the ADHS each fall (deadline is November 15) and in the spring ADHS is required to publish the data by school. ADHS then published that data. See: Childhood Vaccination Rates Continue to Drop In the 2021-2022 School Year
The news isn’t good. Childhood vaccination rates continuously declined during the Ducey administration with the statewide immunization rate for Kindergarteners now at 91%, well below the community immunity threshold for measles of 95%.
The conventional wisdom and talking points from ADHS leadership during the Ducey era were that parental choice was driving lower childhood vaccination rates. But is that true?
No. It’s increasingly looking like the erosion of access to vaccine for lower income kids is a bigger driver of Arizona’s eroding childhood vaccination rates – making it harder for parents to get their kids vaccinated.
Evidence is emerging that vaccination rates among kids who are Medicaid members has been declining while the rates for non-Medicaid member kids has remained stable. Why would vaccination rates be declining among AHCCCS member kids but not the rest?
The decisions and operational behavior of ADHS’ Immunization Office during the Ducey Administration appears to be a big part of why rates are dropping. ADHS’ over-regulation of the Vaccines for Children program has been running doctors’ offices out of the VFC program… meaning parents of kids who are Medicaid members are having a harder and harder time finding a time and place to get their kids vaccinated, lowering overall vaccination rates.
Here’s a deeper dive into why:
Vaccines for children enrolled in Medicaid come via the U.S. Vaccines for Children Program. States distribute them to physicians’ offices & clinics that take part in the VFC program. The ADHS manages the VFC program in our state.
Doctor’s offices and clinics are required to be enrolled as a VFC provider by ADHS to take part in the Medicaid (AHCCCS) program… so, the number of providers enrolled in VFC has a direct impact on the adequacy of a state’s care network for kids enrolled in AHCCCS.
Why the decline? Anecdotally, providers who left VFC over the last few years say they quit because of the administrative hassles imposed on them by the state during the Ducey administration (ADHS not AHCCCS).
At the top of the list of grievances is ADHS’ punitive practice (during Director Christ’s tenure) of financially punishing providers with wastage rates over 5% making participation financially difficult (see this letter to AZAAP members regarding the former ADHS policy).
Arizona now only has 6 VFC providers per 10,000 Medicaid eligible kids, while the national average is 24 providers per 10,000 Medicaid kids… only 25% of the national average.
The Ducey-era ADHS never conducted an analysis to determine why so many providers have stopped participating in VFC during the Ducey administration. Thankfully, the Arizona Partnership for Immunization has been working with the OMNI Institute to figure out why so many have quit so we can right the VFC ship.
We expect the results of this landmark report to be out this summer… ideal timing for the new ADHS to conduct interventions to right the ship like:
1) Reversing Ducey administration VFC policies;
2) Changing ADHS operational procedures;
3) Making leadership changes at ADHS’ Immunization Office; and/or
4) Exploring moving VFC to AHCCCS.
Related:
Perhaps now that we have new leadership in the Governor’s Office you also have a renewed interest in serving on one of the many Boards and Commissions in Arizona? Serving on a board or commission gives you a chance to make a significant contribution to the governance of Arizona by lending your experience, judgment, and ability. Here’s some background about ways you can serve.
Board & Commissions are independent bodies consisting of members who are appointed by Governor Hobbs (there are a few exceptions however). Appointments are created statute enacted in the State Legislature or by an Executive Order.
There are two types of boards and commissions: regulatory and advisory. Regulatory boards oversee the licensing, handle complaints, and enforce disciplinary actions of individuals or industries that fall within the jurisdiction of the board’s authority. For example, a complaint filed by a patient against a physician would be reviewed, investigated, and appropriately acted upon by the Arizona Medical Board.
Advisory boards, develop policy and makes recommendations to public officials on how to address specific issues. For example, the Civil Rights Advisory Board investigates and holds hearings on infringements of Arizona civil rights laws and then advises the civil rights division of the Attorney General’s Office.
Time commitment varies depending on the board. Most boards meet once a month for four to six hours, with some added preparatory work needed. However, there are many boards that meet quarterly or even as little as twice a year. Most Board members serve terms that range from two to seven years for most boards and commissions, while other members serve ‘At the pleasure’ of the Governor.
You can apply online from the Governor Hobbs’ Boards & Commissions Website. In the application you can describe the kinds of boards you’re interested in. A vacancy list is also available on the Governor’s Boards and Commissions Website which is updated monthly with current board positions.
Finding the right talent and candidates seems to be getting harder in today’s competitive job market. Having those open positions in your organization is costing time, energy, and productivity. Posting your open jobs with the AZPHA Career Center is the best solution to get your positions in front of a niche audience, allowing you to create a pipeline of talented and serious candidates.
Posting on the AZPHA Career Center provides exposure to reach over 27,000 members and job seekers. There’s also a national clearing house for public health jobs at www.publichealthcareers.org
Vot-ER is a nonpartisan, nonprofit organization working to integrate civic engagement into healthcare.
Vot-ER is accepting applications for its next cohort of Civic Health Fellows. During the seven-month program, fellows train with experts in civic engagement, health equity, and community organizing (including a Nobel-nominated activist!) and work in teams on a voter access project in their community.
The priority application deadline is March 15th and the final deadline is April 1. Financial aid is available. Apply at vot-er.org/fellowship
Friday, March 24, 2023 from 9-10am
Allan N. Williams, MPH, PhD Adjunct Assistant Professor, University of Minnesota School of Public Health Retired, Chronic Disease & Environmental Epidemiology, MN Dept. of Health
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At a 2022 strategic planning retreat the AZPHA Board of Directors committed to putting resources toward improving community health by advocating for evidence-based policies to stem the tide of increasing firearm injuries in Arizona.
The first step in that process was to develop comprehensive firearm injury epidemiology and an evidence-review of effective interventions.
During this hour-long webinar, our speaker and a primary author of our landmark report Gun Violence in Arizona: Data to Inform Prevention Policies will present the major findings from our report which will:
