Will Humble Professional Development, Wills Blog

Do You Have a Renewed Interest in Serving in State Government Now that We Have New Executive Leadership?

Consider Serving On a Board or Commission

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 220 Active Boards & Commissions in Arizona:
Boards and Commissions List

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.

How to Apply

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.

Submit an Application
Will Humble State Legislature, Wills Blog

Action In the House & Senate Accelerating: Director Confirmation Hearings Start Thursday

After a slow few weeks in the House and Senate Health & Human Services Committees action is picking up. There are several bills we’re signed up for and against next week.

Committee Hearings

In Senate Health Agenda we’ve expressed our support for SB1221 which will allow the state health information exchange to capture childhood immunization data – which will help coordinate care. We signed up against SB1293 which would basically outsource inspections of nursing homes and assisted living centers to a 3rd party who the ADHS would contract with. I understand the frustration w/ ADHS after the 2019 and 2022 Auditor General’s reports, but the problem isn’t the statute or system but nonfeasant leadership during the Ducey/Christ administration.

I suggest holding ADHS accountable rather than outsourcing inspections and complaint investigations. See: Auditor General’s Office Produces Scathing Review of ADHS’ Nursing Home Complaint Investigations During the Director Christ Era. We’re neutral on a bill that would allow international medical graduates from a list of 9 countries to get a provisional medical license upon submitting certain documentation about their residency etc. (SB1241).

Over in House Health Agenda we’re signed up against a controversial bill being sold as a solution to homelessness – but the AZ Housing Coalition and others we trust believe the bills would do more harm than good, so we’re signed up against that one (HB2284). We’re signed up neutral on the House mirror bill for international medical graduates (HB2467).

Executive Nominees

In a party line vote the Senate also approved new rules creating a new committee new committee tasked with gathering info and evaluating qualifications on Governor Hobbs’ executive nominees. According to the mission of this new committee they are supposed to ‘recommend a course of action for the Senate to take on each individual.” Historically nominees have been evaluated by the standing committee most closely associated with the job. For example, ADHS and AHCCCS director nominees would be heard by the Senate Health & Human Services committee.

The Committee chair is Hoffman with Kerr as the vice chair. Other members are Shope, Marsh and Burch. Placing Hoffman as the chair could be considered a shot across the bow by Senate President Peterson.

As of this writing, Dr. Cullen (ADHS), Karen Peters (ADEQ) and Angie Rodgers (ADES) are scheduled before the committee on Thursday, February 9 at 2pm. We’ll see if that schedule holds, I doubt it.

Budget Drama

Meanwhile, both chambers have introduced a continuation budget, meaning keeping funding levels largely flat from FY2023 with only required formula changes. The budget has been advancing through the Senate on party-line votes, with Republican leadership asserting that it’s responsible to ensure the state can continue to operate beyond June 30 when the state fiscal year closes.

The Democratic minority is not supportive of the “kick the can down the road” approach and has chastised the majority for their unwillingness to negotiate. The House began their budget hearings Wednesday afternoon, but Governor Hobbs has publicly stated she intends to veto a continuation budget, so even if the budget makes it through both chambers and up to the 9th floor, it won’t become the FY2024 state budget.

Monday marked the final day Senators could introduce new bills without special permission. House members may still introduce bills for a few more weeks, but they are limited to no more than seven bills each. The next important deadline is Friday, Feb. 17, when bills must have advanced through committee in their chamber of origin to continue through the process.

Will Humble Medicaid, Public Health Law, Wills Blog

AHCCCS Doing Full Court Press to Prepare for Member Redeterminations

The COVID-19 federal public health emergency gave generous incentives to state Medicaid agencies (AHCCCS) in exchange for not disenrolling people from Medicaid during the federal public health emergency.

The disenrollment suspension had been set to end when the PH emergency expires (now set for May 11, 2023) but the federal budget bill from last December directed states to begin their Medicaid redetermination on April 1, 2023, regardless of when the PH emergency ends, so redetermination will start in about 60 days.

AHCCCS thinks about 600,000 of the 2.5 million currently enrolled AHCCCS members may lose eligibility over the coming year once their year-long redetermination process is finished… and half of those that lose coverage could be for failing to respond to requests from AHCCCS for information to determine eligibility.

AHCCCS has a multi-pronged plan in place to make the redetermination process as smooth and accurate as possible… and to make sure as few people are disenrolled due to a lack of response as possible. Here are the basics of the plan:

AHCCCS will determine eligibility automatically for as many people as possible by coordinating with other federal and state data sources like social security and the Supplemental Nutrition Assistance Program. AHCCCS thinks they can do about 75% of eligibility determination work automatically, meaning members won’t need to do anything.

When members are successfully auto renewed, they’ll will get a summary letter saying: “If the information on the summary is correct, you do not need to do anything. You do not need to call or contact AHCCCS.”

If a member’s eligibility can’t be confirmed automatically, they’ll get a written request from AHCCCS that more information is needed. By rule, the person will need to reply within 30 days, which means having up-to-date contact information like addresses will be super-critical. AHCCCS plans to disenroll folks found to be ineligible before people that didn’t respond to their letter in time.

See AHCCCS’ “End of Continuous Enrollment Toolkit” with fliers, social, & a lot more for stakeholders to use to reach Medicaid audiences.

Note: by federal rule, AHCCCS can’t disenroll a member whose mail is returned undeliverable until making other good-faith attempts to contact the member.

Note 2: AHCCCS members who get kicked off because they’re not eligible anymore qualify for a special open enrollment with the federal marketplace. Marketplace and other sources for coverage options (see www.healthcare.gov).

What’s the Call to Action for AHCCCS Members Right Now?

Make sure AHCCCS has the correct mailing address, phone number, and email address for you! If you moved since March of 2020 – be proactive and make sure to update your contact information in www.healthearizonaplus.gov, or call Health-e-Arizona Plus at 1-855-HEA-PLUS (1-855-432-7587).

If AHCCCS determines that you no longer qualify for Medicaid, they’re supposed to tell you: 1) When your enrollment will end; 2) Information on how to appeal that decision if you believe the disenrollment was in error, and 3) Information about other health care coverage options available from Healthcare.gov.

More Information is Available in AHCCCS’ End of Continuous Enrollment Toolkit, at Preparing for the End of COVID-19: Return to Regular Renewals webpage, and this End of Continuous Enrollment Fact Sheet

Will Humble Medicaid, Public Health Law, Wills Blog

What Will Change When the Federal Public Health Emergency Ends May 11?

President Biden announced that HHS will be ending the federal public health emergency on May 11, 2023. What will ending the PH emergency do and how will things change? Here’s my best crack at summarizing what will change once it expires.

The emergency gives the federal government flexibility to change requirements in Medicare, Medicaid, KidsCare, and private health insurance. It also set up a streamlined and separate system for authorizing medical countermeasures and gives some tort liability protection to providers who administer services.

Besides the PH emergency, congress passed the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security (CARES) Act , the American Rescue Plan Act, the Inflation Reduction Act, and the Consolidated Appropriations Act, 2023 – which each had tentacles tied to the declaration…  and some of the provisions in those acts will also expire with the PH emergency.

I found a good table that the Kaiser Family Foundation put together that summarizes the things that will end or change on May 11 including Medicaid match rates, requirements of private health insurance, and a host of other countermeasures like the numerous Emergency Use Authorizations for COVID-19 tests, and treatments like antiviral agents and monoclonal antibodies, and vaccines. Access to those things under EUA may end but I’m not sure whether that means they’ll no longer be available for private purchase.

Anyway- here’s a good chart that summarizes the changes that will happen on May 11 from KFF:

Tomorrow: AHCCCS Doing Full Court Press to Prepare for Member Redeterminations
Will Humble State Legislature, Wills Blog

Legislative Update: Week Three

Things are still moving slowly at the legislature by historical standards. The House Health Committee held its first meeting of the year last week with an abbreviated agenda and the Senate Health Committee didn’t even meet. 

The rumors circulating are that the Legislature will send a continuation budget to Governor Hobbs this next week even though they know she’ll veto such a proposal. Experts in the process say that would be risky because Governor Hobbs could line-item veto the budget, which would force the Legislature to live with last year’s bipartisan budget for any agency the Governor approves.

If the Legislature attempts to pass a continuation budget next week, it is also speculated that committee milestone deadlines will need to be extended because of the slow start over the last three weeks and many, many bills haven’t been heard in committee yet.

Tuesday’s Senate Health Committee Agenda doesn’t really have any blockbuster bills on it. We are signed in for SB1088 – Good Samaritan; drug overdose; extension – which would remove the sunset provision currently in place protecting folks from tort liability exposure when helping someone having an opioid overdose episode.

House Health on Monday has a more robust Agenda. We’re signed up in support of 3 bills, against one, and neutral on one. None rise to the level of asking to speak on the bills at the podium. You can look at our tracking spreadsheet to see the status of the various bills.

Will Humble Healthcare, Social Determinants, Wills Blog

Hobbs Establishes Independent Prison Oversight Commission

Executive Order 6 | Office of the Arizona Governor

Governor Katie Hobbs announced an additional executive order as part of her First 100 Days Initiative… establishing an Independent Prison Oversight Commission to improve accountability (and transparency) in Arizona’s corrections system. The yet to be appointed team is tasked with issuing a preliminary report by November 15, 2023 with initial findings and objective recommendations.

The Commission will inspect prison facilities and records, talk with staff and inmates to independently and objectively assess mental health and medical care, drug treatment programs, and accessibility to basic necessities such as nutrition, medicine, sanitary products and sufficient number of qualified staff.

This is a management best-practice and welcome intervention for a very troubled correctional system in Arizona. 

Will Humble Professional Development, Wills Blog

Musings from the President: The Year Ahead by Kelli Donley Williams, AzPHA President

Have you paused recently before answering the standard dinner party question, “What do you do for a living?” Prior to the pandemic, I had no hesitation in proudly saying without concern, “I work in public health.” But on a recent vacation, when asked this question multiple times a day, I tried variations that wouldn’t lead to dark conversations about vaccine deniers, the horrors of American politics, or predictions on the next disease coming our way.

(For the record, vaccines are the best life-saving public health tool ever, with seat belts perhaps coming in second. I rarely want to talk about politics, much less with strangers. And finally: I have no idea! Alas, my public health degree didn’t come with a crystal ball.)

By the end of the trip, I had reevaluated, dodging any invasive follow up questions. Instead, I told anyone who looked my way, “I work in public health!” And, I’d like to encourage you to do the same, with pride and joy for our field.

Yes, we are slowly emerging from a global pandemic where communication about public health strategies and advancements was unclear at best. And yes, unfortunately millions have died from COVID since 2019. However, imagine what our community and state would look like today if our public health work force hadn’t shown up and done their very best?

I had the chance to volunteer with the public health corps at Maricopa County Health during the first round of vaccines. I watched public health workers and retirees volunteer in droves to drive around the county, working long, thankless hours to get vaccines in the arms of the willing. They did so at risk to their own health and wellbeing. They did so when the call came, regardless of the time of day or weather. They did so because they remembered that working in this field is not about the individual, but about the greater community need.

We before me is the ultimate public health tenant. I watched these heroes in action, and it refilled my professional sails. What an honor to be part of this field, to work and walk alongside each of you.

In 2023, our association will be focused on three primary areas: increasing public health infrastructure, including workforce; health equity; and firearm safety. I hope to see you at our February conference and to share more details about each of these. And further, I hope you’ll find new ways to get involved with AzPHA this year. Join the book club, be a mentor, attend a Friday “conversations and coffee” to hear what colleagues in another corner of Arizona are working on.

Join us. Together, we can improve the public health in Arizona!

Will Humble Professional Development, Wills Blog

AzPHA Annual Conference: Don’t Miss Out – Registrations Filling Fast

Addressing Health Disparities:
Building Infrastructure & Engaging the Next Generation of Public Health Leaders
View Our Agenda & Conference Brochure
Desert Willow Conference Center
4340 E Cotton Center Blvd, Phoenix, AZ 85040
Thursday, February 23, 2023
8:30am – 4:30pm

Register Closed

Maricopa County Department of Public Health is Offering Free Scholarships to AZPHA Members:Use Scholarship Code AZHD2023 When Registering

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See Our Sponsorship Opportunities and View Sponsorship Benefits in Our Sponsorship Packet
Will Humble Vaccination, Wills Blog

Righting Arizona’s ‘Vaccines for Children’ Ship

The U.S. Vaccines for Children Program makes sure kids whose parents can’t afford vaccines can still get their kids vaccinated. Funding for VFC comes via the CDC, who buys vaccines at a discount and distributes them to states. States distribute them to physicians’ offices & clinics that take part in the VFC program. The Arizona Department of Health Services 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.

Arizona lost 50% of its Vaccines for Children providers during the Ducey administration, going from 1,200 providers to 600…  reducing access to childhood vaccines & harming AHCCCS network capacity

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 has 6 VFC providers per 10,000 Medicaid eligible kids, while the national average is 24 providers per 10,000 Medicaid kids…  meaning Arizona only has a quarter of the number of VFC providers per Medicaid kid compared with the national average. Many people believe the declining immunization rates among AZ kids are in part due to a thinning network of VFC providers in Arizona.

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 is now partnering with the OMNI Institute to figure out why so many have quit so we can right the VFC ship.

They’ve developed this Childhood Vaccine Provider Survey for medical provider offices that administer vaccines to children to collect data that can be then used to develop interventions to reverse this troubling trend. The survey takes 10-15 minutes to complete depending on your answers. Responses will be combined with other providers’ responses and no identifying information will be included in any report. Here’s the link to the Childhood Vaccine Provider Survey

The results of this landmark report can then be used to conduct interventions that either reverse Ducey administration VFC policies, change ADHS operational procedures, inform staffing changes, or explore moving VFC to AHCCCS. But…  good results depend on good participation – so please get the word out!

Participate in the Survey

Related: Childhood Vaccination Rates Continue to Drop In the 2021-2022 School Year

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