Posted: Oct 25 2016

By Francine Kiefer, Staff writer OCTOBER 25, 2016 | Christian Science Monitor

SEARCH FOR SOLUTIONS Daniel Derksen, who drafted part of Obamacare, has had a front seat to the implosion of Arizona's private insurance marketplace. But as a rural health expert, he also sees how it's helped.  

Daniel Derksen knows only too well how polarizing Obamacare can be.

In 2012, he was leading an effort to build a health insurance marketplace for New Mexico under the new law. The state’s Republican governor, Susana Martinez, and Dr. Derksen – also a Republican – were committed to standing up a robust, competitive marketplace that would be run by the state, not the federal government. 

Initially, things went pretty smoothly for this family physician and health-policy expert. Derksen, who had actually drafted part of the Affordable Care Act, had secured a first round of federal funding for the state’s marketplace exchange. He was readying his proposal for a second round of funding. 

» See full article here.

Posted: Oct 25 2016

KidsCare Health Coverage is backAfter more than six years' hiatus, KidsCare is now finally available as a health coverage choice for working families. This is exciting news for Arizonans who have been waiting for an affordable option for medical insurance for their children.

Now, families across Arizona who earn too much to qualify for the Arizona Health Care Cost Containment System (AHCCCS), yet find the cost of private health insurance unaffordable, will be able to apply for low-cost coverage through KidsCare. KidsCare is tailored specifically to the needs of Arizona children, some 30,000 of whom may be eligible, according to AHCCCS.

There are no enrollment deadlines, but the sooner families apply, the sooner coverage for qualified applicants will begin. Computer-savvy parents can either apply through AHCCCS at if they are comfortable doing so on their own, or get free, professional help close to home by scheduling an appointment. They can either call 1-800-377-3536 or visit book a convenient time and location online.  

Posted: Oct 14 2016

Yuma Sun | By Rachel Twoguns

Phoenix native Patrick Kishi ventured to Yuma last summer as part of the Rural Health Professions Program Certificate of Distinction, which was created by The University of Arizona College of Medicine-Phoenix to address the shortage of physicians in rural and underserved areas.

Three students from the class of 2017 will be the first cohort of students who will graduate with the Certificate of Distinction in Rural Health. Among them will be Kishi, who spent 15 weeks in Yuma during his third year.

As part of the certificate’s requirements, students must attend a seminar series, complete a scholarly project on a subject relevant to rural health, participate in a four-week summer rural pre-clinical experience and a 19-week rural clerkship that exposes them to internal medicine, family medicine, pediatrics and surgery.

Rural areas in which students may be sent to complete their clerkship include Yuma, Lake Havasu, Prescott, Sedona, Flagstaff, Page, Williams, Show Low, Lakeside, Snowflake, Florence, Morenci, Silver City, NM and Deming, NM.

Posted: Oct 14 2016

The U.S. Environmental Protection Agency has invited rural communities to apply for planning assistance to develop strategies that help grow the economy and revitalize downtown neighborhoods. EPA is offering this assistance as part of Rural Advantage, a suite of federal economic development planning assistance programs for rural communities.

“Rural Advantage is helping communities reinvent themselves in ways that are good for the economy and the environment,” said EPA Administrator Gina McCarthy. “We are excited to partner with communities that want to use their unique rural assets to create a brighter, healthier future.

Posted: Sep 29 2016


WASHINGTON – Arizona communities need to do more to combat and treat drug addictions or face potentially devastating long-term consequences, Coconino County’s chief health officer said during a national conference call this week.

Dr. Marie Peoples said cities and towns in Arizona are “behind the eight ball” in terms of providing treatment for opioid addicts. Among possible solutions, she said, are implementing a prescription monitoring system and tracking data from medical examiners and emergency rooms.

If local officials do not fix the problem, Peoples said during a call on what local communities can do to fight the drug epidemic, they could face long-term consequences, including rising child care and emergency room costs.

“These are real-world problems facing us today,” Peoples said during the International City/County Management Association call. “It’ll be even more difficult to deal with in the upcoming years.”

Peoples said Arizona “fortunately hasn’t faced an intense epidemic,” compared to states with high overdose death rates like New Mexico and Ohio, but is not exempt in terms of an opioid addiction crisis.

The latest figures from the Centers for Disease Control and Prevention reported that 1,211 people in Arizona died from opioid overdoses in 2014. Opioids include illegal drugs like heroin as well as prescription drugs, such as Oxycontin and Vicodin. 

An additional 1,052 people in the state required emergency room treatment for drug overdoses that year, the CDC found.

“The issue is on our radar,” Peoples said. “We look at arrest data, but we can’t arrest our way out of this problem.”

The Arizona Department of Health Services found an increase in the number of deaths in 2014 for both prescription and heroin overdoses. Heroin overdoses accounted for 605 deaths in 2014, up from 521 in 2013. Prescription drug overdoses claimed, on average, one person per day in 2014, the state data showed.

Dr. Daniel Derksen, director of the University of Arizona’s Center for Rural Health, said a viable option for combating opioid overdoses is enacting local prescription drug monitoring programs. They let doctors and pharmacies check for potential abuse by tracking how often a patient is being prescribed highly addictive medication.

“One of the areas we can work on is educating health providers and pharmacies on the appropriate use of controlled substances,” he said. “States with these programs have done well (in terms of combating opioid addiction).”

Marty Harding, director of training and consultation at the Hazelden Betty Ford Foundation, said although community intervention is essential to fighting the drug epidemic, regional officials need to work together to protect their cities from being exposed to an influx of opioids.

“This issue does not stop at your border,” she said. “State leaders need to have a regional conversation and have an effective strategy for prevention with treatment and law enforcement.”

Derksen acknowledged that Arizona has made progress in addressing the problem with opioid addiction in the state, but said local communities need to start addressing the issue independent of state and national governments. 

“It’s a fairly accurate description to call this an epidemic,” he said. “As communities understand better how devastating this problem really is, they can approach it from a public health perspective, where they are dealing with different tools to improve on health outcomes.”

Posted: Sep 23 2016

From Arizona Public Media | Story by Bryn Bailer

Law enforcement agencies and fire departments in Santa Cruz County and along the border frequently work together. But they can’t always communicate with each other, because more than 80 percent of their service area has “dead spots” unreachable by their shared radio channel.

“Santa Cruz County has a longstanding history of communication problems based on the terrain we have,” said Santa Cruz County Emergency Services Director Ray Sayre.
“We have rolling hills and it’s difficult to get coverage in the shadow areas,” he added. “Can’t hear you. Can’t see you.”

Sayre said the equipment upgrades will cost $330,000, which will be covered by two already approved grants. After federally mandated environmental and historic preservation reviews are completed, construction will begin in 2017.
For now, radio transmissions are frequently garbled in low-lying areas along Interstate 19, said Al Flores, a battalion chief in the Rio Rico Medical and Fire District. Other trouble spots are in Nogales, Rio Rico and Tubac.
“Without communication you’re basically playing hide and go seek,” he said. “Nobody knows where anybody’s at.”

The Arizona Interagency Radio System – commonly known as AIRS – is operated by the Arizona Department of Public Safety. In theory, it enables departments that work on different radio frequencies to all talk together.
Two Homeland Security grants will enable the county to add or upgrade three radio-signal repeater sites for a shared emergency services channel, and connect them via microwave linkages.
“We need more repeaters, higher towers that can actually be seen from over the hills,” Flores said. “Technology for this is always changing.”

Currently, firefighters, customs agents, highway patrol officers and others have to call their separate dispatch centers to relay information, or lend each other matching radios, or communicate face-to-face. None of those tactics is easy at a large wildfire or other chaotic emergency scene.

“The public in Santa Cruz County deserves the same quality of dispatch as the rest of the state – and anywhere in the country,” said Rio Rico Medical and Fire District Chief Les Caid.


Posted: Aug 29 2016 | By Stephanie Innes Arizona Daily Star  Updated Aug 28, 2016


Fewer health insurers and higher rates are expected on the federal marketplace, where more than 150,000 Arizonans bought plans last year.

Last year, five insurance companies sold 31,161 marketplace plans to Pima County residents. Open enrollment begins Nov. 1 for coverage in 2017.

So far this year, the number of insurers expected to sell to Pima County on the marketplace is two — Health Net of Arizona and Blue Cross Blue Shield of Arizona.

And there has not yet been a commitment from any company to sell marketplace plans in Pinal County, where 9,600 consumers bought Affordable Care Act marketplace plans last enrollment season.

Posted: Aug 19 2016

Thursday, August 18, 2016 7:23 PM EDT | KVOA News 4 Tucson
Written By Sam Salzwedel

Arizonans all over the state are losing health insurance coverage options. Pinal County is the only known place in the country where no options are available through the Affordable Care Act exchange. 

Dr. Daniel Derksen teaches at the University of Arizona College of Public Health and has extensively studied the Affordable Care Act. He said the ACA has cut the number of uninsured Arizonans in half. “I don't think there is a great reason why Pinal County would be different than our 14 other counties in Arizona,” Derksen said. 


Posted: Aug 11 2016

Friday, August 5, 2016 | UAHS Announcements

From New York to New Mexico, Couple Offers Advice
Being a physician in a small, rural town offers a unique perspective.

Victor Cruz, MD, and Francine Jacobs, MD, visited the University of Arizona College of Medicine – Phoenix recently to share their experience of moving from the fast pace of New York City to a small, rural area in New Mexico to practice medicine. The couple, whose family backgrounds originate in the Caribbean, offered advice and encouragement to medical students.

They spoke as part of a Rural Health Seminar, one of the requirements for students participating in the Certificate of Distinction in Rural Health. The seminar was open to the entire campus.

Posted: Aug 8 2016

Thinking of working in rural health, or recruiting others? This video (4:25) from the Washington State Department of Health describes the benefits, from the point of view of healthcare providers.

Posted: Aug 5 2016

Jill BullockJill Bullock, Associate Director of the Arizona Center for Rural Health was recognized with a "Spirit Award" for her collaboration and innovative contributions to the Medicare Beneficiary Quality Improvement Project, presented by the Federal Office of Rural Health Policy. This award is presented to the Flex Coordinator that exemplifies the collaborative and innovative spirit of the Flex Program.

Posted: Jul 20 2016

MBQIP Certificate of Excellence was presented to Jill Bullock on July 20, 2016 by the Federal Office of Rural Health Policy - Hospital-State Division.

The 2016 Spirit Award for collaborative and innovative collaborations to the Medicare Beneficiary Quality Improvement Project.

Posted: Jul 20 2016

An estimated 162,000 Arizona children are without health insurance, but that number is expected to drop significantly this fall.

On Tuesday, the state of Arizona will for the first time in six years begin taking applications for the government-sponsored health-insurance program KidsCare, for coverage beginning Sept. 1.

KidsCare is Arizona’s version of the federal Children’s Health Insurance Program, known as CHIP. CHIP was created in 1997 with bipartisan support during the Clinton administration. Between 1997 and 2012, the uninsured rate for children in the U.S. fell by more than half, from 14 percent to the current rate of 6 percent.

Arizona’s rate of uninsured children is 10 percent, according to research conducted by Georgetown University.

KidsCare is administered by the state’s Medicaid program, which is known as the Arizona Health Care Cost Containment System (AHCCCS).
Federal dollars will cover the entire cost of the program at least until 2017. Gov. Doug Ducey signed Arizona law SB 1457 reinstating the program on May 6. The Arizona House passed it 38-21, and the Senate vote was 16-2.

Critics worried that Arizona will eventually have to pick up the tab for the program. Supporters said reopening the program was the moral thing to do for Arizona children.

Until now, Arizona has held the distinction of being the only state without an active CHIP program. The state also has the third-highest rate of uninsured children in the U.S., according to a study by the Center for Children and Families at Georgetown. Only Alaska and Texas have higher rates.

The Georgetown study said that despite positive effects of the Affordable Care Act in Arizona, “It remains among the worst states in children’s coverage, likely reflecting the lack of KidsCare.”

Health-policy experts and supporters of KidsCare say families in the KidsCare income bracket are making too much to qualify for AHCCCS but often not enough to afford commercial insurance, including what’s offered on the federal marketplace, even with subsidies.

Before an enrollment freeze that began in 2010, KidsCare in Arizona provided health care to low-income children in families with incomes from 138 percent to 200 percent of the federal poverty level, or an income of $27,000 to $40,000 per year for a family of three, or up to $48,600 for a family of four.

At one time, the program enrolled nearly 50,000 children. Enrollment is now down to 549 children.

“KidsCare restoration helps cover our most vulnerable population — our children. Studies demonstrate that such coverage improves health outcomes, and yields significant benefits in terms of educational attainment for these children,” said health-policy expert Dr. Daniel Derksen, a professor at the University of Arizona’s Mel & Enid Zuckerman College of Public Health.

Posted: Jun 17 2016

Published in The Atlantic | DEBORAH FALLOWS  | June 13, 2016  

Finding Health Care in the Desert

With the closest hospital 100 miles away, Ajo, Arizona’s Desert Senita Health Center acts as the region’s clinic.

We returned to rural Arizona for our American Futures project this spring. During our travels, we have visited a number of towns that could easily be called rural: Eastport, Maine (pop. 1,300), far down-east and a mile across the strait from Campobello Island, and  Chester, Montana (pop. 850), 40 miles from Canada, vie for being the smallest.

Ajo, Arizona, one of our favorite towns, is slightly bigger. About 2,300 people live there throughout the year, and the numbers swell to almost twice that when the snowbirds arrive from the states that border Canada. Many winter residents arrive in their RVs or campers, and others settle into charming stand-alone small houses.  By snowbird standards, Ajo is very affordable.

Posted: Jun 15 2016

Arizona Public Media | Story by Gisela Telis

May 20, 2016 -- Sheri George, founder of the San Tan Valley Substance Abuse Coalition, fights to get her neighbors the help they need by bringing mental health care services to rural Arizona. (Video length: 8:52)