Strange “Polio Like Syndrome” Cases in CA

March 3rd, 2014 by Will Humble No comments »

Maybe you heard news reports this week about kids in California with a “polio-like syndrome.”  Here’s a synopsis:  Over the last 18 months, 5 kids have been identified by California’s Department of Public Health with a paralysis in one or more limbs. Multiple tests have been run on them.  Poliovirus wasn’t found, but enterovirus-68 was isolated in 2 of the cases. There are hundreds of enteroviruses (poliovirus is one of them). Enterovirus-68 was first isolated back in the 1960s, but it usually causes cold-like symptoms instead of a paralysis. CA continues to run studies to determine if enterovirus-68 is the true cause of this exceedingly rare paralysis syndrome. 

There aren’t any documented cases of enterovirus-68 causing paralysis in Arizona, but we’re continuing to monitor the situation closely. Other enteroviruses are commonly seen here, causing “summer colds” and mild respiratory illnesses. To prevent catching an enterovirus, you should wash your hands and keep sick children away from others. There’s no vaccine for enterovirus-68, although there is for polio. All kids should receive the polio vaccine to prevent its recurrence in this country.

Driving Down Cesarean Delivery Rates

March 1st, 2014 by Will Humble 1 comment »

There’s widespread agreement within the public health community that the percentage of women who deliver by Cesarean Section these days is too high.  In fact, 1/3 of women in the US have cesarean deliveries these days (up from 9.5% in 1990 and 23% in 2008).

Last week the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine collaborated to produce an Obstetric Care Consensus document entitled  Safe Prevention of the Primary Cesarean Delivery, which provides new research analyses and interpretation to help “…health care providers to understand the short-term and long-term tradeoffs between cesarean and vaginal delivery, as well as the safe and appropriate opportunities to prevent overuse of cesarean delivery, particularly primary cesarean delivery.”  The consensus seems to be that it’s safe to let someone labor longer than had been previously recommended.

When we amended our regulations that govern the practice of licensed professional midwives in AZ, we allowed for the new guidelines that we hoped were coming out.  This long awaited document will provide clinicians and our licensed midwives with evidence-based information they can use to help more of their patients have a successful vaginal delivery.


Car Seat Safety and Collection Events This Weekend

February 28th, 2014 by Will Humble No comments »

Tomorrow Rural/Metro will hold two events in the East Valley to help parents make sure they have the right seat for their kids and the seats are properly installed. They will also collect gently used and new car seats so the state can donate them to families in need in Mexico. Rural/Metro is a partner in our child safety seat program that was established as cooperative partnership at the Arizona-Mexico Commission last summer. All child safety seats donated by Arizonans for transfer to Sonora will be inspected using the Used Car Seat Check List


The safety seat checks are from 9 a.m. to 2 p.m. Saturday at the Fountain Hills Fire Station 1, 16426 E. Palisades, and Wal-Mart, 1725 W. Hunt Highway, San Tan Valley.


If you can’t attend this weekend’s events, you can always drop off car seats you no longer need at several Rural/Metro locations around the state, at the Department of Health Services building in Phoenix, 150 N. 18th Avenue, and at Courtesy Chevrolet, located at1233 East Camelback Road, through March 17. For more information, visit A Safe Ride Home .  


USDA Announces New School Nutrition Guidelines

February 28th, 2014 by Will Humble No comments »

The USDA announced proposed new guidelines for school wellness policies as part of the Healthy Hunger-Free Kids Act of 2010 this week.  The new policies set goals in nutrition, physical activity, and other school-based activities promoting student wellness. Additionally, the school wellness policies include a guideline on food marketing in schools, setting a standard that if an item cannot be sold or served in schools, it cannot be marketed to kids in schools.

The U.S. Department of Agriculture also launched a new School Nutrition Environment and Wellness Resources website, which includes sample wellness policy language for school districts and a dedicated page of resources for food marketing practices on the school campus.

Today’s Arnold v. Sarn “Fairness Hearing” a Success

February 27th, 2014 by Will Humble 3 comments »

A few weeks ago the Governor announced a final agreement had been reached in the 32 year old Arnold vs. Sarn case regarding care and services for individuals with serious mental illness. The Settlement is the foundation to end the lawsuit while establishing a blueprint for a successful community-based behavioral health system in Arizona. 

This morning we had a fairness hearing in Maricopa County Superior Court on the case. The Governor and I were among the speakers.  The hearing went well, and at the end, Judge Bassett entered an Order from the bench that accepts the Settlement Agreement. Under the terms of the stipulation approved by the Court today as fair and reasonable, Arizonans with serious mental illnesses will be assured of enhanced community-based services that allow them to participate in society in a meaningful way, including: crisis services; supported employment and housing services; assertive community treatment; family and peer support; life skills training; and respite care services. Additionally, the stipulation includes metrics, national standards and evidence-based best practices to ensure quality, transparency and accountability in Arizona’s mental health system. 

We expect to have a dismissal hearing later this year- which will officially end the Arnold vs. Sarn lawsuit that was filed in 1981. Of course, we’ll still be expected to live up to the terms of the Settlement- which is among our Agency’s top priorities.

Dispensary Agent Collaborative

February 27th, 2014 by Will Humble 17 comments »

Last Wednesday we held a Medical Marijuana Dispensary Collaborative.  It was modeled after last year’s successful ADVICE Collaborative, which brought dialysis facilities together to share best practices and engage in a dialog to reduce infection control violations and improve patient care.  The goal of the meeting was to avoid future deficiencies by ensuring that dispensaries understand our expectations and to help us better understand their challenges. 

The Dispensary Collaborative had a great turnout, with almost 150 dispensary agents, board members, and medical directors. The all-day meeting covered dispensary inspection results, patient and dispensary agent educational resources offered by the Arizona Poison Control, the administrative rules process, financial audit requirements (including the difference between profit and non-profit entities), and our computerized Point of Sale system that’s used by dispensaries to verify the status of cards and record marijuana transactions. 

Overall, the input and suggestions that we received from the dispensaries was constructive and will be helpful as we continue to move forward with building a solid relationship with our dispensary stakeholders.

Maricopa County Transition Moves a Step Closer

February 26th, 2014 by Will Humble 1 comment »


Last week a Superior Court Judge denied a motion to Stay the transition of the Maricopa County behavioral health services contract from Magellan to Mercy Maricopa on April 1.  With this ruling it looks like everything is happening according to schedule. Magellan still has the opportunity to appeal the decision and exercise due process in the matter… but we’ll continue pressing ahead with the transition.

Stay in touch with what’s happening in the behavioral health world by reading our ADHS Behavioral Health Services Blog.

Detecting Scary Diseases

February 25th, 2014 by Will Humble 2 comments »

Disease outbreaks can come from anywhere. In Arizona we’ve had illness from contaminated pomegranate seeds from the Middle East, measles from Switzerlandsalmonellosis from African dwarf frogs and cholera from Peru. More recently a Canadian traveler died of H5N1 after she returned home from a long trip to China. An exotic disease from another country is only hours away. West Nile virus likely came from Israel on a plane ride to New York in 1999 and now we see it every year here in Arizona. 

Right now, world health officials are keeping an eye on dozens of potentially dangerous new pathogens, from H7N9 bird flu in China, to the MERS virus in the Middle East, drug resistant bacteriaH5N1 bird flu in Southeast Asia, to Bas-Congo virus in the Congo. The Bas-Congo virus is a two-headed monster that causes bleeding like Ebola and invading the nerves like rabies. 

Effective disease surveillance in other countries helps to protect both their population and the US, since infectious diseases are only a plane ride away. Working with local governments and health officials, CDC recently set up two demonstration projects in Uganda and Vietnam to see if it would be possible to quickly scale up an effective surveillance and response. 

The project focuses on: 1) strengthening the public health laboratory system; 2) enhancing the existing communications and an online information system, and 3) developing a public health emergency operations center. In just six months, the CDC pilot program in Uganda found cases of West Nile virus, Zika virus, Crimean-Congo Hemorrhagic Fever virus, hepatitis E virus, and a bacteria that causes dangerous meningitis. 

We don’t know which disease will come next, but I’m confident the public health surveillance and laboratory system will detect it. for Rural Primary Care Posts

February 24th, 2014 by Will Humble No comments »

Access to primary care providers in rural AZ is a problem.  Our National Health Service Corps Loan Repayment Program and the State Loan Repayment Program are part of the solution- recruiting primary care workforce resources in those areas.  Still, there’s not enough providers in rural Arizona- and 150 rural communities in Arizona need access to primary care providers. 

To help alleviate this problem and support recruitment of providers in rural areas, our Bureau of Health Systems Development recently developed a partnership with the Center for Rural Health and the Arizona Alliance of Community Health Centers to support the National Rural Recruitment and Retention Network (3RNet) Program.  It’s kinda like a for linking health care professionals and jobs in rural and underserved areas.

The 3RNet Program is made up of members from state agencies and non-profit organizations that work together to help many health care professionals find jobs in rural and underserved areas.  They also work collaboratively to provide technical assistance to clinics about this free recruitment tool.  This provides clinics with no cost marketing including tools allowing them to post online photos, detailed descriptions, maps, and other materials to attract health care professionals.

For questions about the 3RNet Program, please email the representatives from each individual agency: Ana Roscetti at, Joyce Hospodar at, or Lourdes Paez at  If you’re an employer or clinic, register to become a 3Rnet user here.

Influenza Still Widespread in AZ

February 21st, 2014 by Will Humble 1 comment »

A report out by the CDC this week found that people between 18 and 64 years old make up 61% of all flu-related hospitalizations so far this season in the US.   In normal years only about 35% of flu hospitalizations are from this age group. H1N1 (the flu strain we saw circulating in the 2009 flu pandemic) is still the main culprit.  H1N1 is included in this year’s vaccine, so people who got vaccinated will be protected from the flu in most cases.  People who’ve been vaccinated with the flu shot this year are 61% less likely to have to go to the doctor according to today’s report. 

Influenza is still widespread In Arizona.  If you haven’t been vaccinated yet, you may need to call around to find whether a healthcare provider or pharmacy near you still has vaccine in stock. Remember to get your shot early next season so you’re protected for the entire flu season. Visit to find a shot.