Arizona Rural Health Association, Inc. News

AzRHA is hosting a Rural Digital Storytelling Contest

Thu, 02 Apr 2026 21:02:46 GMT

Would you like to bring attention to health issues in your rural Arizona community? Producing digital stories is easier than ever. A good digital story can be created in 10-15 hours. We want to hear your voices and elevate your stories. Please review the attached context description. We are offering two cash prizes to the winners!

Contest Description

Photo Release Form

Arizona: Contribute to a National Effort on Mobile Health Innovation

Wed, 01 Apr 2026 19:22:55 GMT

The National Rural Health Association is leading a national initiative, in partnership with the Leon Lowenstein Foundation, to better understand the role of mobile health clinics in rural and frontier regions. Through a comprehensive environmental scan, this effort will identify successful models, promising practices, and the policies needed to support mobile care delivery across diverse geographies, including Arizona.

Mobile clinics are especially critical in Arizona, where geographic distance and provider shortages present unique challenges. Insights from local providers, tribal health organizations, and community leaders will help inform a national report focused on strengthening rural health infrastructure through targeted policy and funding strategies. Arizona’s participation is key to ensuring these solutions reflect real-world needs.

Stakeholders across Arizona are encouraged to engage in this effort. If you have information on mobile health activities or can recommend individuals for informational interviews, your input is essential. Please contact Mory Bell at Mbell@ruralhealth.us or Marguerite Peterseim at Mpeterseim@ruralhealth.us to share your expertise and contribute to this national initiative.

Congressional Recess Announcement

Wed, 25 Mar 2026 15:48:52 GMT

Congress is going into a 2-week recess next week. While they're heading back to their home states, the advocacy does not stop! NRHA is excited to share our newest advocacy resource, our rural health in-district advocacy toolkit, to help guide your advocacy and engage your Members of Congress when they return from D.C. to their home states and districts.

Spring Recess Dates:

Senate Recess: March 28, 2026 to April 12, 2026
House Recess: March 28, 2026 to April 13, 2026

Inside the toolkit you'll find guidance on finding your members of Congress and understanding the importance of leveraging their committee assignments, identifying district-level congressional events you can attend, and engaging with your Member of Congress via a meeting, email, or social media. The toolkit also provides template emails that you can utilize for your outreach as well as our 2026 rural health advocacy talking points and other NRHA advocacy materials that can assist you in your in-district advocacy as well.

In-District Advocacy Toolkit

Obstetric Simulation Training Across Rural Arizona 2025-2026

Mon, 16 Mar 2026 21:20:27 GMT

Over the past year, AzRHA has worked with the Arizona State Office of Rural Health (SORH) to bring obstetric simulation training to rural health professionals in Arizona. In the rural communities visited, patients commonly travel 45-60 minutes to reach a facility with birthing services. These trainings were offered to health professionals working at critical access hospitals without birthing services, but where women seek care in the case of a precipitous birth. Nearly half of the participants were nurses, and a third were paramedics or emergency medical technicians. The number of attendees by location and profession is detailed in the following table and chart.

OB Simulation Training Dates, Facilities, and Number of Participants

Dates	Facilities	Participants
4/24/25-4/25/25	Copper Queen Community Hospital & Douglas Emergency Department	35
6/10/25-6/11/25	Hopi Health Care Center	28
7/8/25-7/9/25	La Paz Regional Hospital & Parker Indian Healthcare Center	31
9/16/25-9/17/25	Sage Memorial (Ganado)	15
10/21/25-10/22/25	Northern Cochise Community Hospital	23
12/4/25	San Carlos Apache Healthcare Center	11
1/12/26-1/13-26	Benson Community Hospital	26
Total Participants (completed the pre-test survey)	169

Professional Discipline of OB Simulation Training Attendees

In speaking with rural health professionals, several mentioned that, because the volume of obstetric cases is very low, they have limited experience and skill gaps due to infrequent exposure or limited professional training. Participants consistently described hands-on simulation training as realistic, memorable, and confidence-building.

“As far as I can remember, [my prior experience with obstetric training has] only been in class, so when I did my basic course coming into EMS, and then when I … attended my advanced EMT classes last year. And they weren't as in-depth as this was, it was just very, like, you know, briefly touched on, just, like, going over mother's history, a quick APGAR kind of thing. There was simulations in class, but again, not, like, a full in-depth [training].”

“I really like how the instructors are very positive, very straightforward. And a lot of them were very aware of the situations on the reservation, and what, both, like, ethical and, cultural. They're very knowledgeable about that. But the main thing that was… that stood out was the actual mannequin [inadible]. It's just, helping assist the baby dummy and mom, like, and then having us assist with that, With that delivery part. So just kind of having, like, that visual hands-on was the most helpful. Only because they made it realistic. I mean, they really lubed up that mannequin, and it was difficult to handle. Just, again, just being super realistic and not, [inaudible]-coating it in a way. But they were, they were very, very helpful.”

“[the most helpful part of the training was] Just, like, to remain calm. Like, just, like, the process. I like the simulation. It was, like, I mean, like, something to see. Especially, we never, like, seen childbirth before, like, it's… it's, like, a real model of, like, how fast everything goes.”

In one facility, a precipitous birth occurred shortly after the training, and health professionals felt prepared to assist.

“Yeah, and perfect timing, because [a precipitous birth] was so soon after the training, it was still fresh in everyone's minds.”

A clear takeaway is that simulation training, delivered on-site at rural critical access hospitals, is an effective way to improve confidence and experience in low-volume skills. Beyond skill acquisition, simulation was described as reinforcing teamwork, clarifying role delineation, and strengthening communication. Several participants expressed a desire for expanded outreach and recurring sessions, suggesting perceived value in ongoing skill reinforcement within low-volume rural settings. This partnership between AzRHA and the SORH demonstrates an effective model for future rural health training programs.

Click here to view a pdf copy of this article

A New Year Message: Looking Ahead to 2026

Fri, 09 Jan 2026 12:48:38 GMT

As we reflect with gratitude on 2025 and look ahead to 2026, I want to extend my sincere appreciation to our members, partners, and supporters of the Arizona Rural Health Association.

This past year reminded us of both the challenges and the resilience present across rural Arizona. From access to care and workforce shortages to infrastructure and sustainability, rural health issues continue to demand collaboration, innovation, and commitment. I am deeply thankful for the dedication of our members and rural health champions who continue to show up for their communities every day.

As we move into 2026, we are excited about opportunities for growth and impact. We look forward to welcoming new members into our association, expanding our collective voice, and strengthening our advocacy for rural Arizona. We are also optimistic about incoming grant opportunities and the important work they will support, helping us advance programs and initiatives that truly make a difference.

Collaboration remains at the heart of our mission. We look forward to working closely with our rural community partners, clinics, and hospitals throughout the year as we continue addressing the unique health needs of rural and frontier communities across the state.

It is an honor to serve as President of the Arizona Rural Health Association. I am committed to doing my very best to support our mission, uplift our members, and work alongside you to improve health outcomes for rural Arizona.

Thank you for your continued trust, partnership, and dedication. Wishing you a healthy, hopeful, and successful New Year.

Warm regards,
Guadalupe Campos
President
Arizona Rural Health Association

Update to Arizona's RHTF Application

Tue, 06 Jan 2026 16:29:05 GMT

The State of Arizona submitted an application to the Centers for Medicare & Medicaid Services (CMS) under the Rural Health Transformation (RHT) program requesting $200 million to support rural healthcare system stability and access. Arizona was awarded $167 million through the program. The state has indicated it will submit a revised budget to CMS reflecting the final award amount.

Arizona’s original application focused on two primary objectives: strengthening the rural health workforce and improving access to care in rural and frontier communities. A central component of the proposal was a Rural Health Workforce Development and Training Program, which requested approximately $57 million annually over five years. This program was designed to support recruitment and retention of clinicians and allied health professionals through high school and career and technical education pathways, expanded rural clinical rotations and residency programs, financial incentives such as stipends and relocation assistance, and training programs tied to rural service commitments. The application also identified workforce retention challenges related to long travel distances, housing availability, professional isolation, and burnout.

In addition to workforce initiatives, Arizona’s proposal included a Priority Health Initiative addressing behavioral health and substance use disorder services, chronic disease prevention and management, and maternal, fetal, and infant health. The application also proposed expanding telehealth capacity, supporting mobile and satellite care delivery models, and reducing administrative burdens for small rural providers through shared services such as electronic health record licensing and back-office support.

The application outlined a funding structure that would distribute resources through subawards and cooperative agreements to eligible rural hospitals, clinics, local governments, educational institutions, and community-based organizations. It also included planned investments in data systems, performance dashboards, and fiscal tracking tools to meet federal reporting and accountability requirements.

Oversight and implementation of Arizona’s RHT funds are assigned to the Arizona Office of Economic Opportunity, with coordination planned across state agencies that administer workforce and Medicaid-related programs. The proposal references collaboration with entities that have existing responsibilities for healthcare delivery, workforce development, and program compliance.

Arizona’s award of $167 million represents a partial allocation relative to the amount requested. At the time of reporting, the specific components reduced or modified as a result of the final award level have not been publicly identified. The state’s revised budget submission to CMS will reflect programmatic adjustments consistent with the awarded funding level.

Governor Katie Hobbs Submits State Application for Federal Rural Health Transformation Program Grant

Fri, 07 Nov 2025 16:34:37 GMT

Governor Katie Hobbs recently announced that Arizona has submitted the state’s application for the federal government’s Rural Health Transformation Program alongside a bipartisan letter of support for the Governor’s plan. The program was designed to support health care access in rural communities through investments in health care workforce and technology.

“Arizonans are struggling with health care that is unaffordable and inaccessible,” said Governor Katie Hobbs. “And rural Arizonans face challenges like potential service reductions and hospital closures, a lack of health care professionals, long wait times, insufficient access to specialty care, and outdated technology that is holding our communities back. As health care in rural Arizona continues to be under threat, I’m going to fight to deliver this critical funding for our state and protect Arizonans at risk of losing accessible and affordable health care.”

The Governor’s plan, which was developed in consultation with rural Arizona nurses, doctors, hospitals, health care plans, and community leaders, focuses on the following key initiatives:

Rural Health Care Workforce – $57 million/year for five years

Investments will increase residencies, and will subsidize health education for future clinicians and allied health professionals who commit to working in rural Arizona, including at universities, colleges, career and technical education schools, and high schools. Will also include retention, relocation, and commuting incentives for existing health professionals who work in rural Arizona, upskilling and training grants to improve our existing rural workforce, and the creation of the Arizona Healthcare Workforce Project at the Arizona Office of Economic Opportunity to lead healthcare workforce strategy and to create statewide training networks to supercharge our existing workforce.

Rural Health Care Access – $45 million/year for five years

Investments will focus on improving access to healthcare in rural communities, including via telehealth, co-location of services, mobile clinics, and improved care coordination and health transportation.

Key Health Initiatives – $27 million/year for five years

$10 million for behavioral health and substance use disorder, to include access to naloxone, tele-behavioral health services, and crisis services for rural Arizonans;

$5 million for maternal-fetal health initiatives to improve obstetrician care and access to maternal mental health resources for rural Arizonans; and

$12 million for chronic illness prevention and treatment, including increases to screenings and public health resources; and

Rural Health Care Resiliency – $51 million/year for five years

Investments to focus on subsidizing rural providers’ fixed costs, including for electronic health records, healthcare technology and equipment, scaling back-office resources, and reducing administrative burdens faced by rural providers, including related to credentialing, licensing, and interoperability challenges.

“With significant input from rural health care clinics, hospitals, clinicians, Medicaid health plans, Tribal partners, universities, and elected officials from across the political spectrum, I’m confident that this plan will be able to deliver truly lasting change for rural Arizona communities and protect Arizonans from threats to their health care,” continued Governor Katie Hobbs.

Arizona expects to receive an announcement regarding its funding award before December 31, 2025, and will begin awarding contracts and subgrants, and distributing funds to rural Arizona in early 2026.

In a letter supporting the submission, bipartisan members of Arizona’s congressional delegation highlighted rural Arizona’s geographic diversity and the unique challenges faced when delivering health care to communities. Read the full letter here.

In another letter submitted with the application, 17 Arizona associations and organizations praised Arizona’s efforts to engage with the health care community to submit an application that will meet Arizona’s needs. Signers include health associations representing Arizona’s hospitals, community health centers, behavioral health providers, nursing homes, doctors, nurses, ambulances, fire chiefs, fire districts, and Medicaid health plans. The letter is also supported by members of the business community, including the Arizona Chamber of Commerce. Read the full letter here.

Read Governor Hobbs’ submitted plan here.

Expanding OB Simulation Training Across Rural Arizona: Program Update

Mon, 29 Sep 2025 19:56:40 GMT

Dr. Anaeme delivering “Sophie” assisted by Julia Chan DNP, CNM

By Elizabeth Kizer, DrPH

Earlier this year, the Arizona Rural Health Association (AzRHA), in collaboration with the Arizona State Office of Rural Health (AzSORH) and partners, announced the launch of a grant-funded initiative to strengthen obstetric (OB) care in communities with non-birthing Critical Access Hospitals (CAHs). Since then, the program has made significant progress.

To date, five of the seven targeted CAHs have hosted OB simulation training under this project: Douglas ER & Copper Queen Community Hospital, Hopi Health Care Center, La Paz Regional Hospital, Parker Indian Health Service, and Sage Memorial Hospital. In October, the team will train at Northern Cochise Community Hospital, with San Carlos Apache Healthcare Center scheduled before year’s end. Also, White Mountain Regional Medical Center served as the pilot site.

So far, 147 health professionals have attended these trainings. Over half were nurses, EMTs, and paramedics. Additionally, many nurse practitioners, pharmacists, physicians, and other allied health professionals attended. Notably, about half of the attendees reported they had never worked in a facility with birthing services—yet more than two-thirds had previously assisted with a precipitous vaginal birth. This highlights the importance of preparing rural providers for the precipitous births they are likely to encounter, even though their facilities are “non-birthing” hospitals.

I was able to attend the training at Sage Memorial Hospital on September 16-17th. Participants shared their experiences with a precipitous birth in an ambulance in a remote community, and I reflected on my own experience living over an hour from my OB/GYN and birthing hospital when I was pregnant with my first child in Apache County. Listening to medical professionals discuss their experiences, ask questions, and engage in the simulated birth gave me a renewed appreciation for the skill and care they provide to rural residents.

Early evaluation results are promising. Pre- and post-surveys show participants overwhelmingly gained confidence in their skills and knowledge. The program’s success was also highlighted nationally on September 24, 2025 when the AzRHA team presented outcomes at the Critical Access Hospital Conference in Kansas City, Missouri.

This work is a clear reflection of AzRHA’s mission: to lead in partnerships, education, and policy to improve the health status of rural communities in Arizona. By equipping rural healthcare teams with the skills to respond to precipitous births, AzRHA and its partners are advancing safer birthing experiences and better health outcomes for rural families across the state.

Arizona’s BEAD Final Proposal

Thu, 28 Aug 2025 20:56:27 GMT

The Arizona Commerce Authority’s State Broadband Office has released Arizona’s BEAD Final Proposal for a 7-day public comment window. The window will allow Arizonan’s to provide feedback related to broadband expansion across the state. The public comment window will close at 5:59 pm AZ-MST on Wednesday, September 3, 2025.

To submit feedback, click the Get Started button below. You will have the opportunity to download the BEAD Final Proposal Draft and submit your feedback through an online form.

GET STARTED

On behalf of the State Broadband Office, thank you to all stakeholders for your continued dedication for providing reliable, high-speed internet to every Arizonan.

Arizona Rural Health Transformation Program Toolkit

Tue, 19 Aug 2025 21:20:33 GMT

The Arizona Rural Health Association is working with state healthcare partners to maximize funds that the state will receive from the Rural Health Transformation Program (RHTP) as part of the One Big Beautiful Bill, passed earlier this summer.

We encourage you to explore this toolkit, published by the Arizona Center for Rural Health, to learn more about these funds and how to get involved with utilization of the program by the state.

Click on the link below to access this toolkit.

AzRHA Members and Board Represented at the Arizona Rural Health Conference

Thu, 19 Jun 2025 21:39:58 GMT

More photos of AzRHA members and board leadership at the 2025 Arizona Rural Health Conference. Click here to view all photos from the conference.

Amanda Aguirre (rt) talks with Leila Barraza

L to R: Lisa O’Neill, DBH, MPH, Dan Derksen, MD, Maria Losoya

Erin McMahon with Jill Bullock

Lupe Campos with Jill Bullock

Jill Bullock, Jennifer Barton, and Dan Derksen

L to R: Joseph Finkelstein MD, PhD, Erin McMahon, Elizabeth Kizer

OB simulation team: Elizabeth Kizer, Jill Bullock, Ashley Brock, Erin McMahon Mc
Mahon

Carrie Foote, BS, BA, Associate Director, Administration, ATP & Program Administrator, SWTRC, Arizona Telemedicine Program and Southwest Telehealth Resource Center

AzRHA Reps Present Poster at AZ Rural Health Conference

Thu, 05 Jun 2025 21:23:32 GMT

Several representatives from the Arizona Rural Health Association participated in the recent Arizona Rural Health Conference and presented a poster titled Obstetric Simulation Training in Rural Arizona Communities without Birthing Centers.

Participants in the research and featured in the photos are Ashley Brock, MS Student; Jill Bullock; Elizabeth Kizer, DrPH; and Eric McMahon, CNM, EdD. Also featured is AzRHA president-elect Lupe Campos and board member Jeffrey Axtell.

Federal Reconciliation Package - Advocate Today

Fri, 30 May 2025 20:59:26 GMT

On May 22nd, the House passed its reconciliation package. The legislation now heads to the Senate and will likely see changes. The National Rural Health Association (NRHA) is extremely concerned by the House’s efforts to limit enrollees’ access to health care coverage through constraining states’ use of provider taxes and state directed payments, apply work requirements, more frequent eligibility redeterminations, and limiting retroactive coverage.

This legislation will result in significant coverage losses and will further limit access to care for all rural patients by closing rural facilities and ending health care coverage for rural residents nationwide.

Now that the bill heads to the Senate for consideration, your advocacy is critical! Use our updated advocacy campaign to contact your Senators about the importance of protecting Medicaid.

AzRHA Call for Board of Directors Nomination

Tue, 20 May 2025 15:18:59 GMT

Dear AzRHA Members,

It’s that time of year again when we call upon our valued members to participate in shaping the future of the Arizona Rural Health Association through the election of our Board of Directors.

This year, the terms of two current board members are expiring. As such, we are opening a call for nominations to fill vacant seats on the Board of Directors.

If you know someone who has been an active member of AzRHA for at least one year, we encourage you to nominate them for board service. Self-nominations are also welcome.

Important Details:

Nomination Deadline: June 10, 2025 at 5:00pm (MST)
Once nominations are received, the elections committee will review all applications.
A voting link will be distributed to the full membership following the nomination period.

Please remember active AzRHA members make up the voting body for electing our Board of Directors.

If you have any questions or need assistance with the nomination process, feel free to contact us at azrhassociation@gmail.com.

Thank you for your continued commitment to improving rural health across Arizona. We appreciate your time, engagement, and dedication to the mission of AzRHA.

Respectfully,

Holly Figueroa
President
Arizona Rural Health Association

Federal Funding Cuts - Advocacy to Save Funding

Fri, 02 May 2025 13:50:38 GMT

By: Program and Policy Committee

AzRHA recognizes the threats to Medicaid coverage across Arizona

Cuts to Medicaid would mean fewer Arizonans with health care coverage, resulting in more individuals delaying care until they are sicker and requiring more costly interventions. It would also increase uncompensated care burdents for hospitals and clinics, many of which already operate with limited resources. Nationwide, adults under 65 and children in small towns and rural areas are more likely to be enrolled in Medicaid than their urban counterparts.

Medicaid in Arizona: Essential Coverage, Powerful Federal Support

Arizona’s Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS), plays a vital role in covering low-income residents—supported heavily by federal funding through the Federal Medical Assistance Percentage (FMAP). FMAP is calculated using a state’s per capita income over three years; the lower a state's income compared to the national average, the higher the FMAP. By law, the federal government pays at least 50% of Medicaid costs.

For Fiscal Year 2025, Arizona’s FMAP is 64.34%, meaning for every $1 the state spends, the federal government contributes $1.80. Some Medicaid enrollees, specifically those eligible through Arizona’s 2014 Medicaid expansion to 138% of the federal poverty level (FPL), are covered at an even higher federal match rate of 90%.

Arizona’s Medicaid Expansion Supports 500,000—but Faces a Funding Trigger Risk

Arizona’s Medicaid expansion, launched by voters through Proposition 204 in 2000 and extended by the legislature in 2014, currently covers over 500,000 low-income adults and children. Funded through provider taxes returned to health care facilities, the program expanded eligibility up to 138% of the federal poverty level—$35,632 for a family of three in 2024. However, this coverage is at risk: a state law trigger would end the expansion if the federal funding match (FMAP) falls below 80%, also eliminating the hospital assessment that funds the program.

AzRHA’s Commitment to Rural Health Access

AzRHA remains committed to advocating for policies that protect and strengthen Medicaid coverage across Arizona. In partnership with other healthcare stakeholders, we continue to support efforts that preserve this critical funding stream and ensure equitable access to care for rural residents.

Medicaid Cuts Could Leave Half a Million Arizonans Without Coverage

If proposed Medicaid cuts move forward this fall, more than 500,000 Arizonans could lose their AHCCCS coverage—jeopardizing access to care for some of the state’s most vulnerable residents. The effects would be far-reaching: health insurers could lose hundreds of thousands of enrollees, while hospitals and physicians would face a steep rise in uncompensated care. Rural and critical access hospitals could be forced to shut their doors, and emergency rooms would likely become overwhelmed as uninsured patients turn to them for care they can no longer afford elsewhere. These cuts don’t just threaten coverage—they risk destabilizing Arizona’s entire rural health care infrastructure.

Lawmakers are currently considering proposals which would reduce the amount contributed by the Federal government. Arizona residents covered under Prop 204 and the ACA Expansion are at the greatest risk.

HHS Announces Transformation to Make America Healthy Again

Thu, 27 Mar 2025 18:33:08 GMT

Today, the U.S. Department of Health and Human Services (HHS) announced a dramatic restructuring in accordance with President Trump's Executive Order, "Implementing the President's 'Department of Government Efficiency' Workforce Optimization Initiative."

The restructuring will address this and serve multiple goals without impacting critical services. First, it will save taxpayers $1.8 billion per year through a reduction in workforce of about 10,000 full-time employees who are part of this most recent transformation. When combined with HHS' other efforts, including early retirement and Fork in the Road, the restructuring results in a total downsizing from 82,000 to 62,000 full-time employees.

Secondly, it will streamline the functions of the Department. Currently, the 28 divisions of the HHS contain many redundant units. The restructuring plan will consolidate them into 15 new divisions, including a new Administration for a Healthy America, or AHA, and will centralize core functions such as Human Resources, Information Technology, Procurement, External Affairs, and Policy. Regional offices will be reduced from 10 to 5.

Third, the overhaul will implement the new HHS priority of ending America's epidemic of chronic illness by focusing on safe, wholesome food, clean water, and the elimination of environmental toxins. These priorities will be reflected in the reorganization of HHS.

Finally, the restructuring will improve Americans' experience with HHS by making the agency more responsive and efficient, while ensuring that Medicare, Medicaid, and other essential health services remain intact.

"We aren't just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic," HHS Secretary Robert F. Kennedy, Jr. said. "This Department will do more – a lot more – at a lower cost to the taxpayer."

The specific contents of the restructuring plan that have been announced so far are as follows:

Creation of the Administration for a Healthy America (AHA), which will combine multiple agencies - the Office of the Assistant Secretary for Health (OASH), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Toxic Substances and Disease Registry (ATSDR), and National Institute for Occupational Safety and Health (NIOSH) - into a new, unified entity. This centralization will improve coordination of health resources for low-income Americans and will focus on areas including, Primary Care, Maternal and Child Health, Mental Health, Environmental Health, HIV/AIDS, and Workforce development. Transferring SAMHSA to AHA will increase operational efficiency and assure programs are carried out because it will break down artificial divisions between similar programs.
Strengthening the Centers for Disease Control and Prevention (CDC): the Administration for Strategic Preparedness and Response (ASPR), responsible for national disaster and public health emergency response, will transfer to the CDC, reinforcing its core mission to protect Americans from health threats.
New Assistant Secretary for Enforcement: HHS will create a new Assistant Secretary for Enforcement to oversee the Departmental Appeals Board (DAB), Office of Medicare Hearings and Appeals (OMHA), and Office for Civil Rights (OCR) to combat waste, fraud, and abuse in federal health programs.
Research and Evaluation for Health Policy: HHS will merge the Assistant Secretary for Planning and Evaluation (ASPE) with the Agency for Healthcare Research and Quality (AHRQ) to create the Office of Strategy to enhance research that informs the Secretary's policies and improves the effectiveness of federal health programs.
Reorganization of the Administration for Community Living (ACL): Critical programs that support older adults and people with disabilities will be integrated into other HHS agencies, including the Administration for Children and Families (ACF), ASPE, and the Centers for Medicare and Medicaid Services (CMS). This reorganization will not impact Medicare and Medicaid services.

"Over time, bureaucracies like HHS become wasteful and inefficient even when most of their staff are dedicated and competent civil servants," Secretary Kennedy said. "This overhaul will be a win-win for taxpayers and for those that HHS serves. That's the entire American public, because our goal is to Make America Healthy Again."

Arizona Rural Health Association Receives Grant to provide Obstetric (OB) Simulation Training

Fri, 14 Mar 2025 22:12:08 GMT

By Elizabeth Kizer, DrPH

In an exciting development for rural healthcare, the Arizona Rural Health Association (AzRHA), in collaboration with the Arizona State Office of Rural Health (AzSORH), has been awarded a grant to enhance obstetric (OB) care in communities with non birthing Critical Access Hospitals (CAHs). This initiative, which began under the Arizona Rural Hospital Flexibility program (AzFlex), will bring OB simulation training to seven CAHs and communities lacking birthing centers over the coming year, enhancing maternal care and emergency preparedness.

Rural community hospitals are vital in maternity care, delivering 15% of babies in the U.S. However, by 2020, less than half of these hospitals could offer obstetric services, leaving many rural women in Arizona traveling over 100 miles to reach the closest birthing hospital. The Arizona reproductive healthcare Maternal Vulnerability Index is 94/100, indicating an extremely high level of vulnerability for Arizona women. Of all U.S. states, Arizona ranks one of highest in maternal mortality with a rate of 31.4 per 100,000 live births as compared to 23.5 in the US

AzFLEX and the Nurse Midwife program at the University of Arizona developed a novel OB simulation training to address these gaps. The initial training was successfully offered in January 2025 at the White Mountain Regional Medical Center, located 50 miles from the closest birthing center at Summit Healthcare in Show Low. However, expanding the program to other regions across the state was not feasible due to limited resources.

When funding became available through the National Rural Health Association, the Arizona Rural Health Association (AzRHA) took the lead in expanding OB Simulation training. Partnering with the AzSORH, AzFLEX, the University of Arizona’s Nurse Midwife program, and Arizona State University’s (ASU) College of Health Solutions, AzRHA developed a proposal that would expand training to equip non-birthing CAHs and first responders with the skills needed to support emergency OB care in rural communities.The training will be provided to seven CAHs without OB services, including two located in OB deserts, and three serving tribal communities. The priority hospitals for this initiative include:

Copper Queen Community Hospital & Douglas Emergency Department
San Carlos Apache Healthcare Center
Hopi Health Care Center
Huhukam Memorial Hospital / Gila River Healthcare
La Paz Regional Hospital (OB desert) & Parker Indian Healthcare Center (OB desert)
Northern Cochise Community Hospital
Benson Community Hospital

A graduate student from ASU’s College of Health Solutions, specializing in healthcare systems and quality improvement within the Master of Science in Healthcare Administration and Policy program, will lead the program evaluation and share the findings. The evaluation will focus on measuring changes in participant knowledge, assessing program impact, and conducting interviews with medical personnel to gain insights and establish best practices.

This collaborative effort underscores AzRHA’s and the SORH's commitment to elevating the standard of care in rural healthcare settings and ensuring all communities have access to quality obstetric services. As the program unfolds, it promises to foster safer birthing experiences and enhance health outcomes in Arizona's rural populations.

If you want to learn more or have questions about this program, please contact AzRHA Board member Elizabeth Kizer (azrhassociation@gmail.com).

Arizona Rural Health Association Mourns the Passing of Congressman Raul Grijalva

Fri, 14 Mar 2025 12:41:06 GMT

The Arizona Rural Health Association is deeply saddened to learn of the passing of Congressman Raul Grijalva, who represented Arizona’s 7^th District with dedication and passion. We extend our heartfelt condolences to his family and loved ones during this difficult time.

Congressman Grijalva was a steadfast advocate for rural and tribal communities across Arizona. His leadership in tackling critical issues, from safeguarding the Grand Canyon to expanding healthcare access through the Affordable Care Act, has left a profound and lasting impact. Most memorably, we had the privilege of meeting with him during the National Rural Health Association Policy Institute Capitol Hill visits to discuss rural health concerns in Arizona.

His commitment to equity, access, and the well-being of our communities will not be forgotten. We honor his legacy and the work he championed, knowing that his impact will continue to inspire future efforts in rural health and beyond.

Holly Figueroa,
President
Arizona Rural Health Association

AzRHA Addresses Proposed Cuts to Medicaid and Medicare

Fri, 28 Feb 2025 04:23:39 GMT

On behalf of the Arizona Rural Health Association (AzRHA) and the National Rural Health Association (NRHA), we are writing to emphasize the critical importance of federal funding-including grants, Medicare, and Medicaid-to rural hospitals, federally qualified health centers (FQHCS) and Rural Health Clinics (RHC)s., where much of the population faces economic hardship and resides in medically underserved areas. Federal funding plays a vital role in ensuring access to quality healthcare for these communities.

What’s At Stake for Medicaid?

In short, the House resolution passed last night proposes $880 billion in funding cuts from programs under the Energy & Commerce Committee’s jurisdiction. While Medicaid isn’t the only program in this category, it is by far the largest. If the Senate agrees with the House’s plan, we can assume the bulk of the $880 billion in cuts would come from Medicaid. What this looks like exactly has yet to be determined. There have been several Medicaid changes floated by House Republicans, though not yet put into draft legislation. Proposals include mandatory work requirements, scaling back the financial incentive for the Medicaid expansion in 40 states and imposing per capita caps on individual Medicaid enrollees.

What’s Next?

Senate and House leadership must now reconcile their different budget resolutions before crafting legislation that specifically proposes Medicaid cuts. After that, the Senate Finance Committee and the House Energy & Commerce Committee must draft the actual policy changes to Medicaid necessary to generate truly huge savings.

This could take weeks, or months. Every day along the way is an opportunity to reach out to your elected officials to demand they oppose significant cuts to Medicaid.

How Can I Take Action?

If you have five minutes free:

Customize and send a letter to your elected officials and share this link to colleagues, family, and friends: https://thenationalcouncil.quorum.us/campaign/107658/

If you have 15 minutes free: Pick up the phone and dial your elected officials or send an email. Use the below resources:

	Phone number	Share your Thoughts
Senator Mark Kelly DC office	(202) 224-2235	Share Your Thoughts
Senator Ruben Gallego DC office	(202) 224-4521	Contact
Rep David Schweikert District 1 DC office	(202) 225-2190	Contact
Rep Eli Crane District 2 DC office	(202) 225-3361	Contact
Rep Yassamin Ansari District 3 DC office	(202) 225-4065	Contact
Rep Gregory Stanton District 4 DC office	(202) 225-9888	Contact
Rep Andy Biggs District 5 DC office	(202) 225-2635	Contact
Rep Juan Ciscomani District 6 DC office	(202) 225-2542	Contact
Rep Raύl Grijalva District 7 DC office	(202) 225-2435	Contact
Rep Abraham Hamadeh District 8 DC office	(202) 225-4576	Contact
Rep Paul Gosar District 9 DC office	(202) 225-2315	Contact

Share messaging on your social media:

If you have 1 hour free: In-person or virtual meetings with staff from your elected officials’ offices are invaluable. Contact the National Council to help coordinate next steps.

https://thenationalcouncil.quorum.us/campaign/107658/

The Medicaid program is a lifeline for the rural hospitals, providers, and patients. Medicaid cuts will close rural hospitals. Since 2010, nearly 190 rural hospitals have shuttered their doors or stopped inpatient care.¹ Public payers, including Medicare and Medicaid, comprise a larger share of hospital services in rural areas, making rural hospitals more vulnerable to cuts in these programs. Medicaid funding is critical for sustaining rural healthcare systems, including hospitals, clinics, community health centers, and long-term care facilities. Right now, almost half of all rural hospitals across the country are operating with negative margins, meaning that any reductions to Medicaid funding would force many facilities to reduce or eliminate essential services, delay much-needed equipment upgrades, or close their doors entirely. Data shows that Medicaid expansion is strongly associated with improved rural hospital financial viability and substantially lower likelihoods of closure in rural markets.² When a rural hospital closes, not only does the community lose access to vital health care, but a major employer and community lynchpin ends, affecting the economic health of the larger community.

Any cuts to the Medicaid program will disproportionately affect rural communities. Rural Americans rely on Medicaid coverage with about 20% of non-elderly adults and 40% of children living in rural areas enrolled in Medicaid and CHIP.³ In almost all states rural areas have higher rates of Medicaid enrollment than metropolitan areas.⁴ Cuts to Medicaid would shift health care costs onto rural families, many of whom already struggle with financial instability. Medicaid cuts would force families to face higher out-of-pocket expenses, leading many to delay or forgo necessary treatments. This burden would worsen health outcomes, especially for those managing chronic conditions like diabetes, heart disease, and cancer. When a hospital or clinic closes in a rural area residents must travel further to receive basic or emergency care. Right now, rural residents already travel on average two times further to access healthcare compared to their urban counterparts.⁵ Cutting the Medicaid program will cause greater access challenges for rural Americas.

Further, any cuts to one part of the healthcare system will shift costs elsewhere, which makes sweeping Medicaid cuts a serious concern for rural providers. Rural populations are older, tend to rely more on public coverage, and are more likely to be low-income, unemployed, and under- or uninsured.⁶ This means that on average, over 70% of rural hospital revenue comes from public payers – Medicare, Medicaid, and the Marketplace.⁷ Loss of coverage under any of these payers means an increase in uncompensated care that rural providers cannot sustain. NRHA further urges Congress against any cuts to the Medicare program, which aids in keeping rural providers afloat. Maintaining public payers, like Medicaid, supports strong rural health infrastructure that is critical to the future of rural areas. Thank you for your work on behalf of rural Americans.

¹ Rural Hospital Closures, N.C. Rural Health Research Center, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill https://www.shepscenter.unc.edu/programs-projects/rural-health/ruralhospital-closures/. ² Zachary Levinson, Jamie Godwin, Scott Hulver, Rura Hospitals Face Renewed Financial Challenges, Especially in States That Have Not Expanded Medicaid, KFF, Feb. 23, 2023, https://www.kff.org/health-costs/issue-brief/rural-hospitals-facerenewed-financial-challenges-especially-in-states-that-have-not-expanded-medicaid/. ³ Joan Alker, Aubrianna Osorio, & Edwin Park, Medicaid’s Role in Small Towns and Rural Areas, GEORGETOWN CENTER FOR CHILDREN AND FAMILIES, Jan. 15, 2025, https://ccf.georgetown.edu/2025/01/15/medicaids-role-in-small-towns-and-ruralareas/. ⁴ Id. ⁵ Marvellous Akinlotan, et al., Rural-Urban Variations in Travel Burdens for Care: Findings from the 2017 National Household Travel Survey, SOUTHWEST RURAL HEALTH RESEARCH CENTER, July 2021, at ⁵, https://srhrc.tamu.edu/publications/travel-burdens-07.2021.pdf. ⁶ Vann Newkirk & Anthony Damico, The Affordable Care Act and Insurance Coverage in Rural Areas, KFF, May 29, 2014, https://www.kff.org/uninsured/issue-brief/the-affordable-care-act-and-insurance-coverage-in-rural-. ⁷ Zachary Levinson, et al., Key Facts About Hospitals: Rural Hospitals, KFF, Feb. 19, 2025, https://www.kff.org/key-factsabout-hospitals/?entry=rural-hospitals-rural-discharges-by-payer.

Holiday Message from the AzRHA President

Fri, 13 Dec 2024 17:19:23 GMT

As we come to the close of another year, I would like to take a moment to wish everyone a joyous and peaceful holiday season. This is a time to reflect on all that we have faced and overcome together, and to celebrate the many accomplishments that have strengthened rural health in Arizona.

Your dedication and resilience in addressing the unique challenges of rural communities continue to inspire. It is through this collective effort that we ensure better health outcomes and create lasting impacts for those we serve.

I hope you take the holiday season to reflect, recharge, and find gratitude in the progress we’ve made together. May this time bring you renewed inspiration and a strengthened spirit of community as we look ahead to 2025 with hope and determination.

Thank you for all that you do. Wishing you health, happiness, and success in the year to come.

Respectfully,

Holly Figueroa
President
Arizona Rural Health Association

2024 Federal Election Dates and Information

Mon, 23 Sep 2024 19:50:51 GMT

The Arizona Rural Health Association encourages all members and attendees to exercise your rights at citizens and vote for your preferred candidates for office. Below includes important information as we approach election day in November.

Important Election Dates

General Election Day: November 5^th (6 a.m. to 7 p.m.)

Voter Registration Deadline: October 7^th

Early Voting Begins: October 9^th

Last Day to Request Ballot by Mail: October 25^th

Mail Back Early Ballot: October 29^th

Last Day to Vote Early in Person: November 1^st at 7 p.m.

Registering to Vote:

If you are eligible and want to vote in the November election, you must register to vote before the applicable registration deadlines, which vary by state and territory. Learn more about registering to vote in your home state at vote.gov, where you will find a guide to voting and information for college students.

In the state of Arizona, Oct. 7^th, is the last day to register to vote. You can complete your Arizona voter registration online, by mail (postmarked Oct. 7), or in person. Eligible voters who will turn 18 on or before Nov. 5 can register to vote by the Oct. 7 deadline. Review the requirements for registering and voting in Arizona

Early Voting Options

https://azsos.gov/elections/about-elections/elections-procedures/early-voting-procedures

County Election Officials Contact Information

https://azsos.gov/elections/about-elections/county-election-officials-contact-information

What ID should I bring to the poles? https://azsos.gov/elections/voters/voting-elections (click on Election Day Voting)

SENS. SINEMA, KELLY SAY THEY’VE SECURED OVER $25M IN FEDERAL FUNDS FOR ARIZONA

Sat, 30 Mar 2024 16:47:58 GMT

BY SERENA O'SULLIVAN

KTAR.com

Sens. Kyrsten Sinema and Mark Kelly have recently secured over $25 million in federal funds for Arizona.

The money is supporting small businesses, community health centers, workforce training programs, fire prevention and more, according to an announcement from last week.

“I’m proud to deliver strong investments for Arizona — supporting projects and priorities that will grow our economy, protect the health and prosperity of our families and loved ones, secure our border and keep families safe,” Sinema said in a statement.

Both senators secured a variety of investments to support leaders at county, city and local levels. The money will enhance the safety, health, security and economic strength of Arizona’s communities, the senators said.

CMS Releases Medicare Prescription Payment Plan

Fri, 16 Feb 2024 23:03:52 GMT

Recently, CMS released the Medicare Prescription Payment Plan (M3P) Part Two Draft Guidance. The Medicare Prescription Payment Plan is a new program required under the Inflation Reduction Act under which Part D sponsors must provide enrollees the option to pay out-of-pocket prescription drug costs in the form of monthly payments over the course of the plan year, instead of all at once at the pharmacy, beginning in 2025. A 30-day comment period for the draft part two guidance opened today and concludes on March 16, 2024.

Press Release: https://www.cms.gov/newsroom/press-releases/cms-issues-additional-guidance-program-allow-people-medicare-pay-out-pocket-prescription-drug-costs

Fact Sheet: https://www.cms.gov/files/document/fact-sheet-medicare-prescription-payment-plan-draft-two-guidance.pdf

M3P Draft Part 2 Guidance: https://www.cms.gov/files/document/medicare-prescription-payment-plan-draft-part-two-guidance.pdf

The Healthcare Workforce Shortage: how it affects Mohave County and what legislators are doing about it

Fri, 26 Jan 2024 16:40:33 GMT

By MADELINE ARMSTRONG | January 17, 2024
Today's News-Herald

House Representative Selina Bliss has proposed a bill that establishes a Health Care Workforce Advisory Council as well as an Arizona Health Care Workforce Investment Fund that would address the healthcare workforce shortage in Arizona.

“As of January 2022, Arizona ranked among the top 5 states with the most severe healthcare staffing shortages,” reads a press release from the Arizona State Board of Nursing.

Among those most affected by the healthcare workforce shortage are Arizona’s rural communities including Mohave County.

According to a report released from the Arizona Department of Health Services on medically underserved areas in Arizona, Mohave County is home to a number of underserved areas including Lake Havasu City, Bullhead City, Kingman, Golden Valley, Colorado City and the Hualapai Tribe.

Phil Fitzgerald, CEO for Havasu RegionalMedical Center in Lake Havasu City and Valley View Regional Medical Center in Bullhead City, said that staffing shortages are a challenge that his hospitals have faced for years.

“Every range of departments is experiencing some type of shortage,” Fitzgerald said. “We’re not able to open as many beds as we have before. We can’t bring in as many patients as we would like to - people who are trying to access our facility for care, so we do have to send some of those patients outside of their own support area.”

Fitzgerald said that there are a number of reasons why Mohave County is facing a healthcare workforce shortage including the cost of living in the area.

“The area that we’re in; it’s hard. The cost of living has something

Click here to view the full article

NRHA is accepting health equity presentations through Dec. 7

Thu, 30 Nov 2023 16:05:50 GMT

Consider submitting a presentation proposal or research poster to contribute to NRHA's Health Equity Conference, one of the only meetings in the nation to focus on health equity issues in rural America, May 6-7, 2024, in New Orleans, La.

Presentations are due by next Thursday, Dec. 7 for this one-of-a-kind event, while posters are due by Feb. 8.

Coordinated by NRHA's Health Equity Council, this conference is designed for those who are dedicated to bringing quality health care and health care services to underserved and often under-represented populations. These include LGBTQIA+, veteran, and homeless rural residents as well as multiracial and multicultural members of rural communities.

Click here to submit an abstract

Holly Figueroa Recognized as Arizona’s “Community Star” on National Rural Health Day

Mon, 30 Oct 2023 17:39:36 GMT

Holly Figueroa Recognized as Arizona’s
“Community Star” on National Rural Health Day

Arizona Center for Rural Health – Holly Figueroa, BCBSAZ Health Choice & Arizona Rural Health Association, has been named Arizona’s 2023 “Community Star” by the National Organization of State Offices of Rural Health (NOSORH).

On the third Thursday of November, NOSORH leads National Rural Health Day (NRHD), an annual celebration that shines a light on those who serve the vital health needs of the nearly 61 million people living in rural America. Holly Figueroa will be featured prominently on the official NRHD website, PowerOfRural.org, on November 16, 2023, alongside other Community Stars from across the nation. This platform will showcase each Star’s remarkable dedication and contributions to rural healthcare.

Arizona Center for Rural Health is proud to join NOSORH in honoring Holly Figueroa as Arizona's Community Star. Ms. Figueroa has shown steadfast commitment to improving health systems in her community and throughout Arizona. We are honored to work with her and congratulate her on this well-earned recognition.

In 2015, the Community Star Recognition Program was established in conjunction with NRHD to tell the stories of the people and organizations who make a difference in rural communities. Since then, over 300 inspiring rural stars have been honored nationwide on NRHD.

Additional information about National Rural Health Day can be found at PowerOfRural.org. To learn more about Arizona Center for Rural Health visit crh.arizona.edu.

Ann Garn
Arizona Center for Rural Health
agarn@arizona.edu

Release Date: November 1, 2023

Elizabeth Hall-Lipsey Completed NRHA Fellowship

Wed, 27 Sep 2023 16:00:35 GMT

Elizabeth Hall-Lipsey, JD, MPH, past president of AzRHA and faculty of the College of Pharmacy at the University of Arizona, recently completed her fellowship with the National Rural Health Association (NRHA). NRHA's Rural Health Fellows program is a yearlong, intensive training program that develops leaders who can articulate a clear and compelling vision for rural America.

AzRHA Board of Directors - Call for Nominations

Fri, 22 Sep 2023 03:06:00 GMT

The Arizona Rural Health Association (AzRHA) has announced a call for nominations for its 2024 board of directors. If you are interested in nominating a colleague or self-nominating, you may click here to complete the board application form.

General Information About At-Home COVID-19 Diagnosis

Thu, 07 Sep 2023 19:14:57 GMT

Diagnostic tests can show if you have an active COVID-19 infection.

These at-home OTC COVID-19 diagnostic tests are FDA authorized for self-testing at home (or in other locations). This means you collect your own sample, perform the test, and read the result yourself without the need to send a sample to a laboratory.

Learn more

Governor Hobbs Declares September to be Suicide Prevention Month

Fri, 01 Sep 2023 15:41:59 GMT

Arizona Governor Katie Hobbs signed a proclamation dedicating the month of September as Suicide Prevention Month. The Arizona Rural Health Association joins fellow associations in thanking the Governor for the recognition of suicide prevention.

Click here to view the proclamation

Spotlight: Holly Figueroa on serving tribal nations and rural Arizona

Thu, 22 Jun 2023 18:35:06 GMT

When Holly Figueroa accepted the role of president of the Arizona Rural Health Association board of directors in July 2022, she knew the term was only a year, but hoped she could dig deep to make changes that would help the organization’s role in rural health advocacy grow in meaning and in action.

“There was a time of transition, and I didn’t always feel that I'd have the opportunity to really dig deep into what AzRHA would like to accomplish,” Figueroa said.

Medicaid Unwinding Update

Thu, 04 May 2023 15:40:52 GMT

Provided by Congressman Raúl M. Grijalva | Arizona District 7

Have you heard about upcoming changes to Medicaid or the “Medicaid Unwinding” and wonder how this impacts you? Use the guidance below to learn more about the Arizona Health Care Cost Containment System (AHCCCS) Medicaid unwinding plan.

Background
At the start of the pandemic, Congress enacted a law which required Medicaid and KidsCare programs to keep people continuously enrolled through the end of the COVID-19 public health emergency (PHE). Congress has now ended this requirement, meaning states can disenroll individuals that no longer meet Medicaid eligibility requirements. Arizona has begun this “unwinding” process of determining who is still eligible for Medicaid and KidsCare.

What’s Happening Now?
Starting April 1, 2023, AHCCCS will begin disenrolling members who no longer meet Medicaid or KidsCare eligibility requirements. This process will take 12 months. Here’s what will happen:

During renewal, AHCCCS will attempt to determine eligibility automatically. They believe approximately 75% of eligibility determinations can be completed automatically and members will not need to take any action.
- If their eligibility is continued, they will receive a summary letter that says, “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 eligibility cannot be automatically continued, they will receive a written request from AHCCCS for more information. They must respond within 30 days.
AHCCCS cannot disenroll a member whose mail is returned undeliverable until making other good-faith attempts to contact the member.

Immigrants who are “qualified non-citizens” are generally eligible for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), if they meet their state’s income and residency rules. Applying for or receiving Medicaid or CHIP benefits, doesn't make someone a "public charge". This means it won’t affect their chances of becoming a Lawful Permanent Resident or U.S. citizen. Find more information here.

Members who are no longer eligible for Medicaid will be referred to the Healthcare Marketplace and other sources for coverage options (see www.healthcare.gov).

What Can Members Do to Prepare?

Make sure your mailing address, phone number, and email address is correct. Login to www.healthearizonaplus.gov, or call Health-e-Arizona Plus at 1-855-HEA-PLUS (1-855-432-7587), Monday through Friday 7:00 am - 6:00 pm.
Check your mailbox for a letter from AHCCCS about renewal of coverage. The envelope will look like this:
Respond to any requests from AHCCCS for more information so the agency can accurately determine your eligibility.
Sign up for texts or emails from AHCCCS about your renewal. Login to (or create) your Health-e-Arizona Plus account.
Watch Out for Fraud! AHCCCS will never ask you to pay money to renew your AHCCCS or KidsCare coverage.

Where Can I Go for More Information?
More information on AHCCCS’s Medicaid unwinding plan, along with frequently asked questions can be found at HERE.

General Medicaid Eligibility Information can be found HERE.

Senator Kelly Seeking Congressionally Directed Spending Proposals

Tue, 07 Mar 2023 16:00:17 GMT

Senator Kelly’s office invites Arizonans and organizations based in Arizona to submit requests for policies or funding to be included in the fiscal year 2024 appropriations bills, including both programmatic requests and requests for Congressionally Directed Spending. As a reminder, programmatic requests can include requests to increase or decrease federal funding for federal agencies or programs, or requests that the government funding bills, or their adjoining committee reports, include language to direct federal agencies or programs to take certain actions. Congressionally Directed Spending requests are requests for funding for specific projects or programs within the state or Arizona.

To find Senator Kelly’s forms to submit programmatic and Congressionally Directed Spending requests, click here. The deadline all appropriations requests is 11:59pm MST on Wednesday, March 15th.

President's Message - January 2023

Thu, 26 Jan 2023 17:47:01 GMT

A happy new year to you all! I hope you celebrated the start of 2023 safely and in good spirits with family and friends.

2022 was a transformative year for the Arizona Rural Health Association. It was a year in which we strengthened the association further, growing by welcoming new members and strategizing on important initiatives that will help us to be a leader in partnerships, education and policy for improving the health status of rural communities in Arizona.

Working together we made good progress toward our strategic goals despite challenges – not the least of which were ongoing disruptions from the pandemic that continues to have an impact on our own work and home lives, as well as on the lives of our communities.

I was proud to see how quickly we were able to pivot with each new challenge and how the association came together to make the most of the opportunity. A great example of this includes the successful rebranding of the Arizona Rural Health Association’s logo.

The work we are doing is more relevant than ever today. Our communities and partners rely on us to keep them connected and informed.

2023 is set to be an exciting year for us. We can look forward to working further on the many initiatives to continue to be a leader in partnerships, education and policy for improving the health status of rural communities in Arizona.

I want to thank you for your continued commitment and effort. Every one of us has an important role in the work ahead and I’m confident that we are stronger together and we will achieve great things.

I wish you and your loved ones a happy and successful 2023!

Respectfully,

Holly Figueroa,
President
Arizona Rural Health Association

AzPHA Member Public Health Policy Update

Sat, 10 Dec 2022 00:13:03 GMT

December 4, 2022

Governors & Executive Branch Agency Culture

The Governor is just one person. There are 32,000 people working in various capacities in state government. So how is it that just one person, the governor, can impact the work culture and morale of 32,000 employees? It’s all about leverage.

The governor is the most powerful person in the state. She or he has enormous statutory authority and can hire or fire just about any state employee (virtually all state employees are ‘at will’ these days - meaning they can be fired for no reason at all).

Governors seldom reach deep down into agencies and fire and replace people… but it's common for governors to replace agency heads, deputies, legislative affiars people and communication directors (especially at the beginning of an administration). It’s also customary for the governor to make wholesale changes in governors office personnel.

So how does all that statutory authority including the authority to change agency directors and their deputies change the work culture of state government?

Perhaps the biggest thing is that agency directors set the tone for workplace behavior, agency priorities, flexible work schedules, whether to allow programs to hire folks, selects the deputy and assistant directors to carry out her or his wishes, gives the programs green, yellow, or red lights to apply for grants, and makes decisions about administrative rulemakings.

The decisions that the directors and her or his assistants make have a profound impact on workplace culture and morale. Add to that the kinds of executive orders the governor gives, like capping agencies at a certain FTE level or freezing changes to administrative code and you can start to see how a single person can have such a profound impact on work culture.

Agency director management style can influence culture in more subtle & insidious ways. For example, appointed directors can stifle innovation and harm morale by instructing staff to clear all decisions with them before proceeding. Even worse, appointees may tell staff to halt action until he or she "hears back from the governor's office"... resulting in long delays or even a complete lack of progress.

When there’s a change in the governor, as there will be in about 30 days, it’s a real opportunity for cultural change.

Many persons that work in various sectors of public health in private, nonprofit, or among other levels of government will be looking forward to potential changes in the coming work environment and may be attracted to serve in the new administration if they believe the incoming governor better appreciates the importance of evidence-based public health practice and improves morale by creating a healthier agency culture.

Many people are likely looking forward to a cultural renaissance in Arizona state agencies and will be looking forward to working with the new administration.

Some folks who might not have considered working for the ADHS over the last few years might be willing to give the agency a 2nd look in the coming months. I expect interest in (and competition for) positions at ADHS to pick up once the governor is sworn in and new leadership is selected. Why not get in on the ground floor?

On one hand, it’s a shame that there are nearly 100 open positions at ADHS these days, but on the other hand – those vacant positions represent opportunities for folks to join the new team early in the administration.

A quick review of open positions on the AZ State Jobs website reveals openings for epidemiologists, emergency medical servicers staff, newborn screening positions, maternal health (PRAMS) jobs, laboratory and behavioral health tech’s, a tribal liaison, several positions in licensing and compliance, vaccine coordinators, opioid prevention, biomedical research, even the agency director.

You get the idea… there are many open positions that many of you may be interested in exploring in anticipation of the cultural changes that’ll be coming to state government in the coming months. Now is a good tome to explore the possibilities.

You can start your search at this link – the AZ State Jobs Website.

Submit Your Resume to the Hobbs Administration Resume Bank to be Considered for a Leadership Post in the Administration

_________________________________

Arizona Child Fatality Review Program: 29th Annual Report

Back in the mid 1990’s the AZ State Legislature established the Arizona Child Fatality Review Program to evaluate every child death and provide evidence-based policy recommendations to prevent child deaths.

Over the years many policy and operational interventions came out of these reports, from safe sleep to new seat belt laws for kids. The goal of each year’s report by conducting a comprehensive review of all child deaths and make policy recommendations to prevent as many as possible.

Last year's report found that firearm deaths increased 41% over the previous year, while child death rates were 250% higher than the national average (likely due to the lack of mitigation measures implemented by soon to be former governor Ducey and former director Christ.

View the the Arizona Child Fatality Review Program 29th Annual Report

The Arizona Child Fatality Review Program’s goal is to reduce child deaths in Arizona by conducting a comprehensive review of all child deaths to determine what steps could have been taken, if any, to prevent each child’s death.

In 2021, 863 children died in Arizona, an increase from 838 deaths in 2020. Fourth-eight percent (48%) of the 863 deaths were preventable. The three most common causes of preventable death were motor vehicle crashes, firearm injuries, and suffocation. Fifty-six (56) children died from a firearm injury (100% of these deaths were determined to be preventable).

In 43% of the preventable deaths, substance use was a contributing factor, and in 33% of these deaths, poverty was a risk factor. There were 44 suicide deaths in 2021. In 68% of these deaths, recent warning signs for suicide were the most common risk factor, and 17 suicide deaths were due to firearm injury.

Prematurity was the most common cause of death for neonates (infants less than 28 days old) while suffocation was the common cause of death among infants 28 days to less than 1 year of age. Drowning was the most common cause of death in children 1-4 years of age as 68% of the 44 drowning deaths occurred in this age group.

There were 65 SUIDs in 2021. An unsafe sleep environment was a factor in 95% of these deaths and bedsharing in 58% of the deaths.

Arizona’s abuse/neglect mortality rate increased 36% from 5.8 in 2020 to 7.9 in 2021. Of the 128 children who died in 2021 from abuse/neglect, substance use was a contributing factor in 59% of the deaths, and the child’s families had prior involvement with a CPS agency in 46% of the deaths.

Importantly, the report proposes several evidence-based interventions that should be implemented that would reduce preventable childhood deaths. Those recommendations are laid out on pages 90-99 of the Arizona Child Fatality Review Program | Twenty-Ninth Annual Report.

Intervention recommendations are proposed for preventing abuse & neglect, COVID-19, drowning, firearm injuries, car crashes, prematurity, substance use, SIDS, and suicide.

We expect this year's Child Fatality Review Program report to be more infuential in informing public policy as the incoming governor is more receptive to prioritizing evidence-based public health policy & practice than the outgoing administration.

______________________

AzPHA Firearm Injust & Death Surveillance Report Coming in January

Report to Include a Policy Intervention Evidence Review

The AZPHA Board of Directors met in early 2022 for a strategic planning session. One of the outcomes from the session was to set longer term public health policy priorities for AZPHA to work on.

Among those priorities was a focus on prevention of deaths from firearm injuries and deaths. Our workplan for that priority started with pulling together a public health surveillance report of firearm injuries and deaths in Arizona and a literature review of evidence-based interventions (no such surveillance report has been produced by ADHS during the Ducey administration - leaving an 8-year gap in surveillance evidence).

We expect our report to be published in mid-January. In the mean-time we will be presenting snippets from the report in these weekly policy updates.

A huge shout out to our authors for the report, Julia Jackman & Allan Williams, who have put in countless hours preparing our report!

President's Message - December 2022

Tue, 06 Dec 2022 21:10:47 GMT

It is hard to believe we are rapidly coming to a close this year and have been through so much change and growth together. It’s been a long year, and we’re all looking forward to a well-deserved break!

As this holiday season starts, one of the most spiritual times of the year also begins, the Winter Solstice. It is our transcendent time to reconnect to the natural world and access our most powerful selves. In its time of twilight, the Winter Solstice is also a time to reflect spiritually and inwardly - to care for self, for our loved ones, and to prepare for the longer days ahead.

It is also the season to pause, acknowledge goodness, kindness, possibilities, and hope. Most importantly, to embrace thankfulness, positivity, and humanity towards one another.

On behalf of AzRHA, I share my sincere appreciation for generously giving of your time, expertise, and wisdom to drive the work of the association. The association promises to continue to grow, learn, and work hard to be leaders and advocate for rural health in Arizona. The Association exists because of the passion, support, and contributions of our members, staff, partners, and stakeholders. We take time to acknowledge and say Thank You.

I express my pride and gratitude to those I work with, the people who make the mission and values of Arizona Rural Health Association a reality. I want to to express the same gratitude and sincerity to the communities we serve and our loyal members, partners and stakeholders that support us in many ways.

I wish you a Blessed Season and a prosperous New Year. May these days be filled with joy, peace, and hope for the New Year!

Governor Ducey Declares November 17th as Arizona Rural Health Day

Thu, 03 Nov 2022 19:48:23 GMT

The Arizona Rural Health Association (AzRHA) is pleased to announce that Arizona Governor Doug Ducey has signed a proclamation declaring Thursday, November 17, 2022 to be Rural Health Day in Arizona.

The Governor’s proclamation, made at the request of AzRHA, celebrates the important contributions of health care professionals who serve Arizona’s rural communities.

Recognized by the Governor’s proclamation are members of the Arizona workforce who work in rural hospitals, health clinics, behavioral and community health centers, county health departments, private clinical and dental practices, pharmacies, paramedics, and emergency medical services (EMS) and community health workers.

Many Arizona residents who live in rural communities experience significant challenges accessing health services due to geographic isolation, income inequities, lack of health insurance, language barriers, or other service barriers. They experience health workforce shortages in every professional category; in response, federal agencies have designated most of rural Arizona as Health Professional Shortage Areas (HPSAs). These conditions create barriers for people seeking services and contribute to stress among the health professionals who serve rural communities.

Rural health organizations often have difficulty competing with urban care providers in recruiting and retaining health professionals because of salary inequities. Rural health professionals are under pressure to maintain practice environments and often find it harder to sustain operations.

Honoring Rural Health Day, AzRHA is planning a no-cost public webinar titled “The Rural Health Landscape.” This webinar is scheduled for November 16, 2022 at 11 a.m. and will feature Mr. Alan Morgan, CEO, National Rural Health Association. Webinar co-sponsors include the University of Arizona’s Center for Rural Health, Arizona Telemedicine Program, Southwest Arizona Telehealth Resource Center, and the All-of-Us Research Program.

To learn more and register for this webinar or about Arizona Rural Health Day, visit www.azrhassociation.org.

President's Message

Thu, 03 Nov 2022 19:47:05 GMT

As President of the Arizona Rural Health Association, I am honored to have accepted the responsibility to serve as the president of AzRHA for the 2022-2023 year. I want to express my sincere gratitude for this opportunity.

It has been a challenging couple of years with the public health emergency. I am heartened by the strong and focused commitment of the membership that continue to serve on the AzRHA Board of Directors. AzRHA provides an excellent platform for members to develop and contribute to communities they serve. I look forward to working toward excellence with the AzRHA Board of Directors as I have known this team to care as I do. We serve because we care.

My goal is to grow, strengthen and energize the AzRHA membership, provide meaningful educational opportunities for the AzRHA membership, increase membership communication continue to advocate for rural health policy during my service as Board President. We will work on putting extra effort into outreach.

I am sincerely grateful for past president, Elizabeth Hall-Lipsy, for her outstanding leadership during her tenure as the Board President. Her commitment and leadership inspire me.

Lastly, I am genuinely grateful for the trust to serve, and I will work to fulfill the goals and mission of AzRHA. I thank you for your support, guidance, and encouragement.

Respectfully,

Holly Figueroa
President
Arizona Rural Health Association