The Arizona House last week passed HB 2691, a bill to increase the amount of healthcare workers in the state through education and workforce program grants.

The bill appropriates $42.5 million a year starting in fiscal year 2023 through fiscal year 2025 to the Department of Health Services and is divided between nurse education, nurse clinical rotations, licensed nurse training, and a preceptor grant program. 

Arizona is experiencing one of the in the U.S. The shortage existed prior to COVID-19, but has been exacerbated by the pandemic, with increased employee burnout and nurse retirements and not enough properly trained new nurses to replace them. 

According to the American Association of College of Nursing, more than in 2019 were turned away from educational institutions because of nursing faculty shortages, lack of clinical training sites and supervisors, and budget constraints. 

The bill additionally allocates $5 million a year to the state’s Medicaid program from fiscal years 2023 to 2025 for behavioral health workforce training in Maricopa and Navajo County Community Colleges

“At the core of healthcare is its workforce,” bill sponsor Rep. Joanne Osborne, R-Goodyear, said. “We are struggling in Arizona and need to take major steps to filling our nursing pipeline.” 

Kathy Busby, a representative from the Arizona Nurses Association, said there is high demand in the state for nursing education. 

“We have waiting lists for nursing school. Over 2,200 on the list in Maricopa County and over 600 in rural counties who could qualify but can’t get in,” she said. 

Robin Shephard, division vice president and chief nurse executive for Dignity Health, said the nursing need in her company is acute.

“I have never seen the harsh toll of the nursing shortage that is being exacted in our profession until this year,” she said. “At Dignity Health, we approximate that we will need to hire 1,300 nurses per year for the next five years to keep pace with Arizona’s population growth and to replace nurses that are either retiring or leaving the profession.” 

The bill is supported by a broad coalition of the health care, higher education and business communities, including the Health System Alliance of Arizona, the Arizona Board of Regents, and the Arizona �鶹��ýӳ�� of Commerce & Industry. 

The bill passed the House 44-15 and now heads to the Senate.

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Last week, and , managers and operators of the new $280 million multi-purpose sports and entertainment complex in southeast Mesa, announced is a Founding Partner and the Official Healthcare Provider of Bell Bank Park. 

As part of the multi-year agreement, the health system will open a new 3,915 square-foot clinic offering and at the park. Phoenix Children’s – Bell Bank Park will serve young athletes injured on the field or court as well as children and adolescents throughout the community. 

“Phoenix Children’s is proud to be a founding partner and official medical provider to Bell Bank Park,” said Robert L. Meyer, president and CEO, Phoenix Children’s. “As our community grows, so does Phoenix Children’s, and providing sports medicine and urgent care at Bell Bank Park is an extension of our mission to serve all children throughout the region.” 

Phoenix Children’s – Bell Bank Park is expected to open in mid-2022. From 8 a.m. to 5 p.m. Monday through Friday, the clinic will offer sports medicine diagnostic services to address the full gamut of , from concussions and fractures to meniscal tears and anterior cruciate ligament (ACL) tears.  

On evenings and weekends, Phoenix Children’s – Bell Bank Park will provide comprehensive urgent care services for minor medical conditions. Infants, children and teens – including athletes at Bell Bank Park who need medical attention – can access urgent care from 5 to 11 p.m. on weekdays and from 10 a.m. to 9 p.m. on weekends. 

And during sporting events at Bell Bank Park, Phoenix Children’s physicians will provide on-call support for athletic trainers on the field or court who need guidance on appropriate care of injured athletes. 

“Kids and teens have different needs, medically and developmentally, than adults, and they deserve care that’s right-sized for them,” said at Phoenix Children’s. “This clinic will be staffed by doctors, nurses, physical therapists and other health care professionals who have special training in caring for children and adolescents.”

“We are thrilled to welcome Phoenix Children’s as a Founding Partner at Bell Bank Park,” said Brett Miller, President, Bell Bank Park. “Our missions are aligned in creating unbelievable experiences for the community and family. With the number of athletes training here daily, we’re fortunate that Phoenix Children’s will be opening a treatment center here to help our athletes return to competition and provide best practices for staying in shape and nourishment.” 

“Phoenix Children’s is consistently recognized as best-in-class and will be instrumental in providing exceptional medical care for our guests, as well as community members of the southeast valley.” said Peter Luukko, co-chair, Oak View Group Facilities. “Our ability to partner together to provide high quality medical care with Phoenix Children’s furthers our mission in establishing Bell Bank Park as a full-service, world-class facility.” 

The community partnership between Phoenix Children’s and Legacy Sports USA at Bell Bank Park will evolve over time. Phoenix Children’s staff are already developing a variety of community outreach and education initiatives to support healthy, active living along with fundraising opportunities in conjunction with , including teaming up to build a Miracle Field later this year. 

The partnership was brokered by Legacy Sports USA and OVG Global Partnerships. To learn more about Phoenix Children’s – Bell Bank Park, click .

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Valleywise Health, Maricopa County’s healthcare system for low-income, underserved and ethnically diverse populations, is undergoing a major transformation, including a major upgrade and a new 10-story tower for its public teaching hospital in central Phoenix. 

In addition, it has been adding new healthcare centers across the region and expanding its array of services to better serve those in need. 

County voters made it all possible when they overwhelmingly approved Proposition 480 in 2014. The measure approved the $935 million program. 

Among the goals voters approved was to expand the health system’s reach into underserved areas, incorporate behavioral health services into its model of care, and replace the outdated Maricopa Medical Center with a new, modern acute care facility, the . 

This public teaching hospital contains a Level One trauma center and houses the state’s only nationally-verified burn center. 

Expanding healthcare in underserved areas 

, a national construction and program management firm, was hired to put together a comprehensive, integrative plan for the project, including demographic studies to determine where patient services are lacking. 

“If you look at the drivers that keep people from seeking preventive medical care, the main one is a lack of access,” said Jennifer Frost, Vanir’s Arizona area manager. “Convenient, timely access to integrated, effective and efficient healthcare can reduce the overall cost of care and allow for greater access for all.”

As part of its goal to reach underserved patients, Valleywise Health is testing innovative programs like , a web‐enabled, smartphone-based platform, which provides visual guides to help patients describe their symptoms even if they don’t know the words in English. 

“Care Reimagined” construction projects completed and in the works

The expansion of the healthcare system, whose mission is to bring high quality, convenient and affordable care to every corner of the Valley, has been underway for the past three years. 

Here’s a look at projects that are completed or underway:

Valleywise Medical Health Center Construction is underway to build a new tower and update and expand the current hospital at 24th Street and Roosevelt in Phoenix, which was built in 1967. 

The project, which is scheduled for completion in 2023, will include a new 10-story, 673,000-square-foot tower with 233 private patient rooms, a dedicated floor for the , 10 operating rooms, two interventional radiology areas, two catheterization labs, a dedicated procedural floor, rooftop and ground-level helipads and more.

Valleywise is also constructing a new 100,000 square foot support services building and an underground utility system on the campus. The project is replacing outdated structures from the 1980s. 

Valleywise Comprehensive Health Center  – Peoria This new, state-of-the-art comprehensive health center at the corner of Grand Avenue and Cotton Crossing is currently offering services including primary care, cardiology, dialysis, ultrasound, phlebotomy and a pharmacy for current and new Valleywise Health patients. The final phase, scheduled to open this summer, will include an urgent care center, dental clinic, outpatient operating rooms, dialysis, a retail pharmacy, a cafe and a Family Learning Center.

Valleywise Community Health Center – South Phoenix/Laveen Located at 35th and Southern avenues in South Phoenix, this state-of-the-art facility opened last year and offers primary and pediatric care, women’s health, radiology, a pharmacy, diabetes care, behavioral health services with in-person and telehealth appointments, and more. 

Valleywise Community Health Center – North Phoenix Completed in 2020, this center is located at 19th and Northern avenues, offering primary and pediatric care, women’s health, radiology, a pharmacy, diabetes care, behavioral health services with in-person and telehealth appointments, and more. 

Valleywise Behavioral Health Center – Maryvale This 250,000 square-foot, 192-bed psychiatric center opened in 2019 at 51st and Campbell avenues. It is housed in the remodeled former Maryvale Hospital, which shut down in 2017.  

Two other community health centers are also planned for West Maryvale and Mesa, to open later this year and in early 2022, respectively. 

Rebranding a system that dates back to 1877 “pest house”

In addition to the construction projects, part of the proposition funding was used to rebrand the healthcare system, whose history dates back to 1877, when doctors and patients banded together to build a “pest house” for contagious diseases.

Included in the rebranding was changing the system’s name from the Maricopa Integrated Health System to Valleywise Health. 

“Becoming Valleywise Health (has allowed) us to more effectively articulate under one distinct and memorable name our bold vision to improve community health, while providing a modern network of services and facilities in which to train the next generation of physicians, nurses and allied health professionals,” said Steve Purves, Valleywise Health president and CEO.

Massive project employs local and out-of-state companies

The massive project involves the work of more than a dozen local and out-of-state companies including:

Affiliated Engineers, Inc.

Blue Cottage Consulting

Cuningham Group/EYP Health

DFDG Architecture

DLR Group

Gilbane Building Company

DWL Architects + Planners, Inc.

Hobbs+Black Architects

Kitchell Contractors

Land Advisors Organization

NNR Multicultural Business Development

Okland Construction

Siegel + Gale 

Sundt Construction

The Innova Group

Vanir 

To read more about the healthcare system’s 144-year history in the Valley, visit: .

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America is dealing with an unprecedented shortage of skilled labor. The Department of Labor reports that while there are 7.6 million unfilled jobs, only 6.5 million people were looking for work. This is the same situation in Arizona. 

The industries seeing the largest talent gap are construction, health care and personal care, followed by computer and mathematical occupation. Better than average employment and a shortage of employable workers may leave the Arizona economy in a tough spot.

Career and technical education (CTE) programs may be the answer. CTE program education gives students the academic, technical and employability skills needed for workplace success.

A local Arizona CTE public school district is preparing more than 37,000 students from 48 high schools in the North and West Phoenix Metropolitan area with the skills and certifications needed to obtain a career in the industries that desperately need young talent to help replace an aging group of tradespeople who are getting ready to retire.

Construction

The skills gap in construction is well known. Baby boomers are reaching retirement age, leaving a large space for younger workers to step in. In fact, according to the, the utmost cost concern of contractors was access to qualified workers. 

CTE programs, like the one at Western Maricopa Education Center (West-MEC), help to prepare students to enter both the commercial and residential construction industry. Students learn about safe work practices, construction diagrams, concrete and masonry equipment, concrete formwork, concrete placement methods and finishing techniques, structural concrete and masonry applications, inspection protocols, product testing, and quality control.

Specialized programs are a good way for students to develop into a specific niche, which will be important as the industry continues to move forward in the age of automation and technology. 

At West-MEC, the Electrical Trade Specialty program introduces students to the elements of electrical systems. Students perform maintenance on electrical circuits, work with control systems and install lighting, and motors.

CTE programs often even provide opportunities to learn and work in a real-life scenario. The Energy and Industrial Technology Program at West-MEC is run in close partnership with APS, Palo Verde Nuclear Generating Facility and Estrella Mountain Community College. 

This model of hands-on-learning strengthens both general knowledge and specific skill sets, ensuring students are prepared and qualified for future opportunities.

Healthcare

The healthcare industry is expected to add 3.8 million new jobs by 2024, according to the Labor Department’s projections. While nurses and physicians are the most visible positions in the industry, this growth will impact everyone. Phlebotomists, pharmacists, clinical hospital staff, physical therapy and medical technicians are among the positions that will see the most growth. 

Fortunately, CTE programs are available for such opportunities. 

The West-MEC Pharmacy Technician program teaches students pharmaceutical services alongside licensed pharmacists in a pharmacy setting. Students learn medical terminology, pharmacy law, quality customer service, pharmacology, preparing prescription medications, and administrative duties such as inventory of drugs and pharmacy operations.

Students who go through programs for Medical Assisting receive clinical and administrative knowledge, including how to properly administer injections, take vital signs, record EKGs implement basic accounting procedures. Once the program and certification test are completed, graduates are entry-level medical assistants. 

Computer Science 

Research suggests that nearly one million technology jobs will be unfulfilled by 2024. Employers in the industry say the problem is that college computer science programs were designed to teach theory, not engineering education and practice. 

The CTE education model is staunchly dissimilar. For example, students pursuing education in coding software development, they actually learn how to design and develop software and applications on the desktop, websites and back-end programming, and write and test computer code.

In IT Security, students learn to secure computer networks and manage risk. Students even learn ethical hacking defense, troubleshooting Linux OS and mitigating security risks.

CTE graduates entering the computer science and technology field find they are ready to jump into their next opportunity. 

As the workforce ages out of their skilled labor positions, it is necessary to replace them with professionally qualified and certified talent.  Without CTE options, these industries would suffer greatly. 

Greg Donovan is the superintendent at Western Maricopa Education Center

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Dear Friends,

Today was Maricopa County’s single highest reported positive COVID-19 case count at 1,377 positive cases.  We have a total of 20,670 positive cases with 52.5% of those cases occurring June 1- June 15 since we began tracking cases on January 22.  We are also seeing record numbers of emergency room visits and hospitalizations since the pandemic started.  Through yesterday, 49% of positive cases were within the 20-44 age range with a 12% hospitalization rate.  On June 1, that age group only made up 42% of positive cases with a 7% hospitalization rate.

This data is available at 

Maricopa County has added over 100 contact tracing positions and has partnerships with AZ 2-1-1, a Crisis Response Network program, as well as partnerships with ASU and UofA to support contact tracing efforts.  Ultimately, we will have roughly 500 people working on contact tracing.  However, currently test results are taking 7-10 days due to the sheer number of people presenting symptoms and needing tests.  The labs are at capacity.

We know the risk of serious illness is greater for adults over 65 and those with chronic medical conditions, but anyone can spread the disease and a positive case typically spreads the virus to two to three others.

Please do your part to stop the spread of COVID-19.  Wear a mask if you cannot social distance 6 feet or more.  Wear a mask if you are in a public place such as a grocery store or retail store. Limit gatherings to 10 people or less. And as always, wash your hands or use an alcohol based hand sanitizer.

Stay Safe,

Bill Gates

Gates serves as a County Supervisor for the Maricopa County Board of Supervisors.

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Cigna, one of the largest health insurance providers in the world, has expanded its virtual mental health provider network to make it easier for patients to access care during the COVID-19 pandemic and beyond. Patients can talk, text or video with a therapist on demand. 

The expansion includes partnering with major mobile therapy company, Talkspace, to provide patients access to licensed therapists on demand from their cell phone or computer. In Arizona and other select states, patients can also access virtual mental health services through Meru Health’s 12-week app program.  

Coronavirus taking toll on emotional health

COVID-19 has accelerated the need for digital options for patients, said Dr. Rodgers M. Wilson, market medical executive for Cigna in Arizona where the company has over 465,000 customers.

Isolation, unemployment, being cooped up at home. These are raising anxiety levels and substance abuse in American households.

“We do know clinically, there’s an increase in alcohol consumption, there’s an increase in anxiety and there’s a recent report that indicated that 46 percent of Americans are concerned about getting the COVID-19 virus,” Wilson said.

Americans under stress, drinking more 

National surveys depict a rise in anxiety levels among many Americans.   

A new 2020 survey published by the American Psychological Association (APA) finds that many Americans are experiencing considerable stress related to the coronavirus. Parents are among those feeling the most overwhelmed, the study shows. Adults with children report stress levels 20 percent higher than adults without children.  

The Substance Abuse and Mental Health Services Administration (SAMHSA) reported an extreme spike in calls to its “Disaster Distress Helpline.” In March, calls increased 891 percent from last year. 

Substance abuse is of particular concern because peer-support is linked with successful treatment, Wilson said. 

“We’re telling everybody to socially distance; that increases the risk for those in recovery who require peer support in order to recover from their substance abuse addiction,” Wilson said. 

Now, there are options for virtual anonymous peer support. 

More patients seeking virtual therapy 

Since the pandemic started, patients have increased their use of virtual therapy, Wilson said.

Behavioral health visits have increased by 75 percent during the pandemic. Of those 25 percent have been video-enabled.

“That’s really exciting. Prior to the lockdown quarantine, virtual utilization was 2 percent. Presently, at post lockdown, it was at 57 percent,” Wilson said. 

Now, Wilson hopes that people who have been reluctant to seek treatment or counseling will be more comfortable doing it by phone or text.    

“This allows us to get services for people who would not seek services due to pandemic. But also it’s an opportunity to increase access for people who don’t seek behavioral health because of stigma. So it’s a great opportunity to engage those individuals also.”

Advice for those feeling more anxious

Wilson’s advice for those feeling more anxious but not in need of therapy? Nutrition, sufficient sleep, meditation or prayer. And turn off social media.

“Really limit your exposure to the constant banter of the pandemic; I think we need to reduce the amount of exposure to the news that goes on and on.” 

Virtual care services expanded in Arizona and nationwide

Cigna has launched the following virtual care providers in select states to deliver more support for mental health needs for customers:

·        Anxiety, Depression and Burnout: Through a 12-week app-based program, Cigna customers receive daily support from licensed clinicians and anonymous peers to treat anxiety, depression and burnout. The program is conducted through Meru Health and is available to customers in Arizona, California, and Colorado.

·        Substance Use Recovery: Cigna customers can access substance use recovery support by connecting with certified peer support specialists virtually through a partnership with MAP Health Management. The program is available to customers in Connecticut, Florida, Illinois, Maryland, New Jersey, New York, Pennsylvania, Texas, Virginia, and Washington, D.C.

·        Obsessive Compulsive Disorder (OCD): Customers who are diagnosed with obsessive compulsive disorder (OCD)  have access to NOCD, a treatment program led by a licensed, OCD-trained therapist with live video appointments and support in-between sessions by messaging the therapist and leveraging the platform’s digital tools. It is available to customers in California, Michigan, and North Carolina.

All of these virtual services will be available through Cigna’s outpatient behavioral health coverage, subject to benefit plan cost share.

COVID-19 resources for all communities

Cigna also is providing supportive resources for all customers, clients and communities for managing anxiety, fear, stress and improving resiliency during COVID-19. For more information, visit Cigna’s .

About Cigna

Cigna Corporation is a global health service company with subsidiaries, including Cigna Health and Life Insurance Company, Cigna Life Insurance Company of New York, Connecticut General Life Insurance Company, Express Scripts companies or their affiliates, and Life Insurance Company of North America. To learn more about Cigna, visit .

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When the coronavirus two months ago limited medical practices’ ability to perform elective procedures, major health insurers across Arizona had to move quickly to find innovative ways to help providers stay in business and keep patients receiving care.

There is an overwhelming need right now. The American Medical Association that 97 percent of physician practices have experienced a negative financial impact directly or indirectly related to COVID-19. Less than half of primary care clinicians have enough patient volume and cash to stay open another month. 

Meanwhile, of primary care doctors indicate that many providers have had problems securing forgivable loans through the new federal Paycheck Protection Program (PPP). 

With insurance claims down, major health insurers in Arizona including Arizona Complete Health, Blue Cross Blue Shield, Cigna, and UnitedHealthcare are pouring resources and funding into helping providers and patients. 

Most are incorporating more flexibility for providers, helping them start or expand telemedicine, and providing resources and assistance to help them access PPP loans and financial assistance. They have eliminated and reduced many copayments, given credits on premiums, eliminated many COVID-19 related charges, and made substantial donations to help medically vulnerable populations. 

“This has been a surreal pandemic from so many factors so we need to make sure we are investing in our health care sector and ensuring that we have viable providers coming out of this process,” explained Monica Coury, vice president of legislative and government affairs for Arizona Complete Health (ACH), a subsidiary of the Centene Corporation that serves Arizonans through Medicare Advantage, Marketplace, AHCCCS and other programs. 

Innovation required 

Coury said health plan administrators have had to “think outside of the box” to help providers — and patients — survive. 

For example, when Centene learned that some members with complex care needs did not have enough data or minutes on their cell phones to receive telehealth visits, it issued funds to providers to purchase phones or upgrade patients’ phones to avoid healthcare crises. 

Here’s a look at a few of the measures Complete Health and other Arizona insurers are taking to shore up providers and patients during the coronavirus. 

UnitedHealth Group accelerates $2 billion for provider liquidity

UnitedHealth Group announced it is accelerating nearly $2 billion to health care providers to support liquidity needs, initially investing more than $70 million to help communities in need and protect the health care workforce.

This month it also announced it is providing premium credits and discounts worth $1.5 billion to health plan members and employers impacted by the pandemic. For commercial fully insured individual and employer customers, credits ranging from 5 to 20 percent will be applied to premium billings in June.

For a complete list of resources, go to: . 

Cigna emphasizes flexibility 

Cigna Healthcare of Arizona is helping providers a number of ways, including making it easier for hospitals to transfer patients to long-term acute care hospitals, skilled nursing facilities, and acute rehabilitation facilities to help manage COVID-19 patients.

Like all insurers, helping providers move to telehealth has been a big emphasis. Telehealth now accounts for approximately 85 percent of Cigna Medical Group visits. Of these, 25 percent are virtual video visits, company officials said.

They are offering billing and reimbursement guidance for providers and free home delivery of up to 90-day supplies for prescription maintenance medications and 24/7 access to pharmacists.

The Cigna Foundation, in partnership with the New York Life Foundation, has launched The Brave of Heart Fund and is contributing an initial $50 million to the fund that provides grants and support to the survivors of frontline healthcare workers who lose their lives fighting COVID-19.

“Our customers, our employees, and our communities need us now more than ever,” said Courtney Nogas, Cigna spokesperson. “Our top priority is the safety and service of our customers, patients, clients, employees and partners. And, Cigna will continue to do our part to support those on the frontlines.”

For a complete list of resources, go to: .

Blue Cross Blue Shield launches prepayment assistance

One of the ways Blue Cross Blue Shield of Arizona (BCBSAZ) is supporting primary care providers during the pandemic is through a new prepayment financial assistance program for providers in the BCBSAZ Patient Centered Medical Home (PCMH).

These advances will help BCBSAZ PCMH providers cover monetary shortfalls due to the global health emergency and provide critical funding, so they can continue serving Arizonans in need of medical attention, the company stated. Providers can receive partial prepayment of their estimated annual quality incentive payment. 

For more information about how BCBSAZ is supporting healthcare providers, members and the community during the COVID-19 pandemic, visit:  .

Arizona Complete Health offers PPP loan and telehealth assistance

As health providers move to more virtual patient visits, Arizona Complete Health is providing $5 million to help its federally qualified health centers “stand up”  telehealth programs and support in incorporating them into their business models, Coury said.

The company also is providing webinars and other resources to help providers access PPP loans, grants and other financial assistance.

“Our physician practices and healthcare providers are mostly small businesses just like everybody else and, so, there are multiple funding streams right now to help shore up the healthcare sector,” she said. 

As the economy reopens, they will be faced with a new healthcare model, she said. 

“This will be something that sticks with us,” Coury said. “What does it look like after we transition out of this situation?  We cannot load up waiting rooms anymore. That’s going to be in the past. We’re going to have to manage through that and we’re going to have to do that together; payers, providers and policy makers.” For a complete list of Arizona Complete Health resources for providers, visit: .

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