2004
Annual
Report

Leadership for a Healthy Arizona

Director’s Message
I have been deeply honored to serve the residents of Arizona as Director of the Arizona Department of Health Services. Under the
leadership of Gov. Janet Napolitano, I believe we have made major strides to improve the Department and the health status of
Arizona's residents.
The accomplishments that you’ll read about in this Annual Report provide a strong testament to how far we have come as a
Department - and as a state.
The Arizona Department of Health Services offers a vast array of programs that benefit every state resident and visitor. I like to remind people that we are
with you from birth to death. In fact, we provide certificates for both events through our Office of Vital Records.
If you drink the water, eat the food, require hospital or nursing home care or use a child care facility, the Arizona Department of Health Services has
touched your life in some important way.
Assuring the quality of our food and water, setting standards for hospitals and nursing home and child care, maintaining the State’s vital records,
screening newborns for genetic diseases, protecting the public from disease and overseeing the state’s mental health system and Arizona State Hospital are
just some of the duties of the Arizona Department of Health Services.
Governor Napolitano is committed to improving the health status of Arizona residents, and I will continue to work tirelessly to improve the Arizona
Department of Health Services and to meet the Governor’s goals for public and behavioral health.
I am also very fortunate to be working with an extremely professional and dedicated staff whose reputation for quality and excellence is known across the
country.
If you would like to learn more about the Department, please visit our Web site at www.azdhs.gov
Sincerely,
Catherine Eden

Mission Statement
The mission of the Department of Health Services is:

Setting the standard for personal and community health through
direct care delivery, science, public policy, and leadership.

1

Who We Are
The Arizona Department of Health Services is involved in a wide array
of activities designed to promote and protect the health of Arizona
citizens. These activities include:
• Identifying public health threats by collecting health data, monitoring
trends, and performing tests at the Arizona State Health Laboratory.
• Educating and alerting the public and health care providers about
public health threats, including bioterrorism.
• Performing screenings of every Arizona newborn to detect eight
metabolic disorders so that effective, early treatment is possible.
• Gathering and retaining vaccination information to help ensure
Arizona’s children are completing recommended vaccination
schedules.

Director Catherine Eden chats with Department of Environmental Quality Director
Steve Owens.

• Collecting and disseminating public records information, including
birth and death certificates.

• Educating the public about the dangers of smoking, and providing
smoking cessation services to thousands of Arizonans through the
Arizona Smokers’ Help Line.
• Tracking outbreaks of communicable diseases such as HIV/AIDS and
Hepatitis C, and providing medications and/or community
service referrals.
• Coordinating the State’s Women, Infants, and Children program, a
federal program aimed at providing nutritional foods for women and
their children during pregnancy and postpartum.
• Supporting the primary care of nearly 50,000 uninsured individuals,
and supporting the dental care of another 10,000 individuals.
• Licensing and educating over 5,400 health care and over 3,100 child
care facilities and group homes to ensure safety and high quality care
for Arizonans.
• Delivering publicly funded care to over 130,000 people annually with
behavioral health care problems, directly through the Arizona State
Hospital, and indirectly through our contracted Regional Behavioral
Health Authorities.

The Department's new state of the art State Public Health Laboratory.

2

SUCCESS IN THE DEPARTMENT OF
HEALTH SERVICES PUBLIC HEALTH
Under Governor Napolitano’s leadership, the Arizona Department of
Health Services has rebuilt, piece by piece, the Department’s public
health infrastructure, making the state better prepared to deal with any
public health emergency, including bioterrorism.
In June 2004, Governor Napolitano dedicated a new state of the art
Arizona State Health Laboratory that puts Arizona at the forefront of
biodefense preparedness. The 73,000-square-foot facility replaces a
crumbling old facility, which houses Bio-Safety Level 3 facilities, the
highest in the state. The next highest is Bio-Safety Level 4, which is
only found at the federal Centers for Disease Control and Prevention.
Public Health Veterinarian Elisabeth Lawaczeck conducts a test during the state's 2004
West Nile Virus outbreak.

Arizona was the first health agency to win federally funded bioterrorism
preparedness grant from the federal Centers for Disease Control and
Prevention. The Department has developed a statewide response system
in case of a bioterrorism attack or other public health emergency. This
system includes:

Accomplishments
• January 2005, Collaboration with University of Arizona Sarver Heart
Center and the creation of the SHARE Program developed by the
Arizona Department of Health Services, Bureau of Emergency
Medical Services (BEMS). The SHARE initiative promotes public
awareness, public education, data collection, and research of cardiac
arrest. Most of all, SHARE is designed to advance research in
cardiac arrest and seek new strategies to save lives.

• The creation and testing of emergency response plans,
• The coordination of state, tribal, county, and local resources,
• The development of the capabilities to rapidly provide emergency
medicines and vaccines to all Arizonans
• The development of emergency communications capabilities between
public health, public safety and health care professionals, and;

• October 2004: When the flu vaccine crisis hit the state and nation,
Governor Napolitano provided the funds to acquire 22,500
additional doses of flu vaccine to ensure those Arizonans at highest
risk for complications for the flu were protected. The additional flu
vaccine was provided through a $250,000 allocation from the health
crisis fund.

• The ability to conduct electronic surveillance for diseases and outbreaks
by connecting hospitals and laboratories across the state, and;
• The capacity to test for the top bioterrorism agents of concern using
state-of-the-art laboratory technologies,
• And an overall improvement of the training and emergency
infrastructure at all the hospitals in the state.

• The pregnancy rate for Arizona teenagers is at a record low. The
pregnancy rate for girls 15-19 years old in 2003 was 68.9
pregnancies for 1,000 females, 2.4 percent lower than in 2002 and
32.5 percent lower than in 1994 when it reached the decade’s peak
of 102.0 per 1,000 girls. The pregnancy rate for younger teenagers

Under the leadership of Governor Napolitano, the Department has led
the state in promoting optimal health in wellness among Arizona
residents.
3

15-17 years old also reached a record low in 2003, dropping to
41.6/1,000, a 36.4 percent lower rate than in 1994.

Arizona delegation
in teams to develop
action plans for
preventing and
managing chronic
diseases.

• Childhood immunizations rates are at a high point. Seventy-seven
percent of Arizona children had received recommended vaccinations
as of July 2004, up from 67 percent in July 2000.
• Infant mortality is at an all-time low. The rate in 2003 was 6.5 per
1,000 births, down from 7.6 per 1,000 in 1998, and 7.7 per 1,000
in 1993. The 2003 rate was the second lowest recorded in Arizona
since at least 1950.

• The Department,
utilizing funds
awarded from
CDC, developed a
Comprehensive
Cancer Control
Plan, which will be
released in 2005.

• Arizona was awarded a “Steps to a Healthier US” $1.4 million
federal grant to fight diabetes, asthma and obesity in school-age
children and adults in border communities. “This grant gives us a
new weapon against debilitating chronic disease in Arizona,”
Governor Napolitano said.

Craig Levy, manager of the Department's Vector-Borne

• By utilizing funds
and Zoonotic Disease Section, mans a public information
booth during the 2004 West Nile Virus outbreak.
from the U.S.
Department of
Health and Human Services, ADHS provided funds to conduct the
Arizona Continuing Care Clinic for the Uninsured Persons with
Diabetes Demonstration Project.

• A total of $245,000 in new funds for suicide prevention programs
has been awarded to community agencies throughout Arizona.
• Through a new national program called State Action for Oral Health
Access, The Robert Wood Johnson Foundation (RWJF) awarded
nearly $1 million to Arizona to address the problem of inadequate
access to oral health care services. Tooth decay is the leading chronic
childhood condition in the nation-even five times more common
than asthma-and states can play a major role in addressing this
problem.

• The Department is expanding our network of community health
centers – which play a key role in helping to reduce racial disparities
in health.
• In conjunction with the National Office on Women’s Health Arizona
presents Women’s Health Week. Activities include a launch event
attended by the Governor and a high-profile speaker followed by
educational sessions and free screenings for women.

• Governor Napolitano launched the Governor’s Call to Action:
Maintaining Healthy Weight in Children and Families forum in
early 2004. The event launched a statewide nutrition and physical
activity campaign focused on developing new programs to get
residents active and eating healthier. One innovative program
developed out of this initiative was “Eat and Play the Native Way” a
program that promotes traditional Native American games as a way
for Native American children to stay active and to eat healthier in
Coconino County.

• Community based efforts to improve women’s health have been
funded through local grants from the Maternal and Child Health
Block Grant. Five local projects supporting women to stop smoking,
maintain healthy weight, engage in regular physical activity, eat five
fruits and vegetables a day and effectively manage their stress.
• The Department’s Well Woman Health Check program provides
more than 10,000 mammograms and 9,000 Pap tests for uninsured
or underinsured women each year.

• A delegation from Arizona was selected to attend the National
Governor’s Association Policy Academy on Chronic Disease
Prevention and Management in late 2003. Experts worked with the
4

• Based on America’s Health: State Health Rankings Report, Arizona
has moved from a rank of 32nd in 2003 to a rank of 23rd for
2004. Major contributions to this change in ranking for 2004 is
attributed to the following health measure:
• Prevalence of smoking from 29 to 15
• Prevalence of obesity from 15 to 10
• Lack of health insurance from 39 to 35
• Limited activity days due to illness from 38 to 31
• Cardiovascular deaths from 9 to 8
• Cancer deaths from 7 to 5
• Total mortality from 15 to 14
• Infant mortality from 23 to 21
• Increased immunization rate from 74.2% to 77.5%

Nutrition champion “Bobby B. Well”.

• ADHS has established a Wellness Council, which provides health
education and physical activity opportunities to the Department’s
employees. This may lead to inclusion of a wellness component to
the state’s new health insurance program.
• Arizona’s diverse population commands that ADHS strive provide
information in multiple languages. English and Spanish materials
are developed by most offices/programs. Plus, ADHS develops
materials specific to the needs of target markets (i.e.: including
providing hepatitis B information at several Asian Pacific Islander
events in Korean, Japanese, Vietnamese).
• DHS’s offices and programs have attended and distributed
information at numerous health fairs and public events.
• DHS’s Tobacco Program has visited 37 schools in 8 Arizona
counties reaching more than 14,000 elementary school students
through assemblies with the Phoenix Suns Gorilla mascot spreading
its anti-tobacco message. 33 of the schools visited have mediumhigh risk youth populations.

Epidemiologist William Frank conducts RAMP testing during the 2004 West Nile Virus
outbreak.

5

LICENSING SERVICES
Documentation Training for Surveyors: The Division identified the
need to improve the process for writing Statements of Deficiencies.
These are the core products that are produced after a survey or
complaint investigation, and services to notify the licensed providers
of violations. By improving the process and strengthening the
evidence that is included in each Statement of Deficiencies, the
Division will be able to reduce the number of disputed deficiencies
and support its position when a hearing is requested.
In September 2004, the Program Managers from the different
licensing areas began to work with a team of three training specialists
from among our surveyors and managers to develop training for all
surveyors and team leaders. By December 2004 all staff had been
trained, and the Division had begun to see improvements in the way
deficiencies were written and supported.

Dedication of the new Arizona Department of Health Services Building.

Fingerprinting: The Division worked with representatives from the
assisted living and nursing home professions to improve the way in
which the Division interprets and enforces fingerprinting
requirements. A Substantive Policy is currently being finalized to
clarify these requirements, and a list of Frequently Asked Questions
has been developed to be posted on the Department website and used
for training and education. All staff will be trained by March 1, 2005.

Website Improvements: The Division continued to make significant
improvements to the Website this year. In addition to the searchable
facility database that was developed in FY 2003, the Division began
planning for survey and complaint investigation information to be
available to the public through the Website. It is anticipated that Child
Care information will be on the Web by June 2005, followed by Nursing
home information by September 2005. The Department continues to
post enforcement actions on the web, and beginning January 2005 is
increasing the enforcement information to include specific reasons for
action against the facilities. There is now more information for the
public on how to choose a facility, and more information for providers
on which deficiencies are most commonly cited.

Regulation of Assisted Living Training Programs: Legislation was
passed early this year to give the Division the authority to take
enforcement actions against assisted living training programs that do
not meet minimum standards. This additional authority will help the
Division to protect the health and safety of those Arizonans living in
assisted living facilities, because so many of the problems in this
setting are associated with inadequate training.

Electronic Licensing: The Department has begun preliminary work to
make it possible for providers to submit renewal licenses and license
fees electronically. In the Office of Assisted Living Licensing, the
Department has initiated a pilot program, which enables providers to
submit Plans of Corrections electronically, rather than through
traditional mail. This voluntary method will increase the speed at
which Plans of Corrections can be reviewed and revised by the facility
if not acceptable.

MDS profiling project: This is a collaborative effort with the
University of Arizona College of Nursing and Arizona Center on
Aging Health Services Advisory Group and St. Luke’s Health
Initiatives. In this study, Minimum Data Set (MDS) data submitted
to the Arizona Department of Health Services Division of Licensing
Services for nursing home residents were analyzed for the years 1999,
2000, and 2001. MDS data are a comprehensive set of data completed
6

on all nursing home residents in Medicare certified facilities. Between
these years, over 83,000 individuals were admitted to Arizona’s nursing
homes. On a single day of each of these years, almost 40,000
individuals were living in Arizona’s nursing homes. This data will be
used to clearly understand these residents and their needs and to
conduct quality improvement projects to improve care in Arizona’s
nursing homes.

Technical Assistance in Behavioral Health licensing: The OBHL has
implemented technical assistance training program to assist licensed
facility staff to better achieve and maintain substantial compliance
with rule requirements. The program focuses on increasing
understanding of the licensing process and rule requirements for both
individuals seeking initial licensing and facilities seeking renewal
licensing.

Joint Program Contractor Project. This is a project that coordinates
program contract monitoring with the survey process conducted by
DHS in an effort to reduce duplication. The results from ADHS
surveys, complaint investigations and enforcement actions will be
placed on the Health Services Advisory Group’s web portal. This will
allow easy access by both contract providers and the Health Services
Advisory Group. The program contractors have obtained approval
from AHCCCS to use this information to help them monitor their
contract with the nursing homes, instead of duplicating surveys and
complaint investigations.

Monthly training sessions are provided to persons interested in
operating behavioral health treatment facilities. The session details the
information necessary to complete the initial application. This
appears to have decreased the time previously required for OBHL staff
to review and initial application.
Technical assistance is also extended to providers who, upon receipt of
the respective statement of deficiencies, request assistance in
completing the plan of correction. The assigned surveyor initially
gives this assistance. When a provider requires a more in-depth
assistance, a referral is made to the two OBHL surveyors whose
primary responsibilities are the TATP. The affords the provider the
opportunity for corrections to be made more accurately and timely
while the other surveyors continue to complete survey assignments.

Nursing Home Incentive Grant: The Department supported
legislation that awarded a financial incentive grant to each nursing
home that received a quality rating of “excellent” for two consecutive
years. 36 facilities are the recipients of this one-time award.
$600,000 of civil money penalty funds is being distributed to these
facilities according to their total census days for projects specifically
designed to enhance the quality of life for their residents.

Technical assistance training program has also been utilized internally.
The goal of this program aspect is two fold. The primary purpose is
to improve staff understanding of rule requirements. A second goal,
and of equal importance, is for the surveyors to develop a statement of
deficiencies in a format that is detailed yet easy to comprehend by the
provider. The subsequent internal training outcome is to maintain or
improve the consistency of rule interpretation by the survey staff
through verbal and written processes.

Nursing Home: The Office of Long Term Care and AZ Attorney
General’s Office interceded on behalf of a nursing home scheduled for
closure two weeks before Christmas due to financial difficulties.
Working in collaboration with AHCCCS measures were taken in
order to allow the facility to quickly stabilize and transfer to a new
viable owner.

The Department is working on new and innovative efficiency review
measures, the most exciting of which is the exploration of on-line
licensure options for child and adult caregivers. This is a joint effort
with the Government Information Technology Agency (GITA).

Transfer of the Inspection of Child Foster Homes from the
Department to DES: In the last legislative session the Department
transferred the inspection of Child Foster Homes from the
Department to DES. This prevented duplication of services, increased
timeliness of inspections and provides better customer services to the
providers.
7

Division of Licensing FY 2004
Licensing Program

Surveys Conducted

Complaints Investigated

Enforcement Actions Taken

Civil Money

(Including Stipulations)

Penalties Collected

Childcare Facilities

3,290

1,156

93

$72,070

Assisted Living

2,337

522

69

$139,023

Behavioral Health

822

89

111

$53,170

Long Term Care

447

747

17*

$40,250

Medical Facilities

710

406

18

$167,525

Special Licensing

5,346

0

0

$0.00

12,952

2,920

308

$472,038

Total

* Represents State enforcement only. Other enforcement action was taken and penalties assessed at the Federal level.

8

MENTAL HEALTH

•

More than 170 individuals with serious mental illness from the
Arizona State Hospital and 76 residents from supervisory care
homes have moved into community living homes or
apartments.

•

The 10-year-old Jason K lawsuit over children's behavioral
health has been settled, and now thousands of children and
families are being given renewed promise for better lives.

December 2004:
More than 17,000
people with serious
mental illness in
Maricopa County will
benefit from a historic
agreement in a 25-yearold class action lawsuit,
Arnold vs. Sarn.

In 2000, the Legislature provided approximately $42 million for
services to people with mental illness. The State Auditor General
recently found that more than 2,000 consumers had received help
from Assertive Community Treatment teams, which provide intensive
treatment for those most in need.

This groundbreaking
agreement sets forth a
workable plan to finally
Front of Civil Hospital
end a costly and longstanding legal battle, but more importantly, it ensures people with
mental illness in Maricopa County will receive the services they
deserve.

The Department of Health Services conducted a consumer satisfaction
survey of nearly 2,000 mentally ill adults across Arizona, including
829 in Maricopa County.
The result: 88 percent of adult consumers across the state and in
Maricopa County were satisfied with their services.

Governor Janet Napolitano said, "This agreement demonstrates our
firm commitment to reform, and to protecting the most vulnerable
members of our community. It has been a long road, it has been
difficult, but this is the right answer to an incredibly challenging
problem."

OTHER ACCOMPLISHMENTS
1. Efficiency Review Highlights:
In FY 2005 the Department of Health Services is continuing to
strive for efficiency savings and should realize savings of $6.4
million. This savings represents a tremendous effort on the part of
the Department and its many statewide partners.

A Superior Court judge accepted the pact in December 2004. The
agreement sets forth the first timetable for exiting the 25-year-old
lawsuit.

ACCOMPLISHMENTS
•

Housing for the seriously mentally ill in Maricopa County has
increased by 40 percent. Today, there are 5,387 units available.

•

Forty-four percent of the seriously mentally ill who were
homeless or living in supervisory care homes are now in
apartments or homes.

•

More than 1,000 individuals with serious mental illness were
prevented from becoming homeless.

• $5.6 million in cost avoidance will come from avoiding cost
increases to Medicaid-reimbursable behavioral health services by
reducing contractors’ allowable administrative costs and profit.
• $570,000 in savings will come from reducing allowable
administrative costs for non-Medicaid funded behavioral health
services. This is the result of streamlining intake and assessment
processes, reducing paperwork, and reducing contractors’
administrative costs.
9

• $232,200 will come from Perational savings will account for the
rest; including adding information technology staff rather than
hiring consultants; consolidating personnel advertising;
converting the State Hospital cafeteria to a vending operation,
decreasing postage, reducing travel, reducing printing costs,
eliminating some vehicles, eliminating some long distance
services, and charging State
Hospital patients/residents for
damage.
Throughout this process, the
Department is continuing its
collaborative efforts with other
State Agencies, including:
• Consolidating program
applications for children with
severe birth defects (Health
Services, AHCCCS, DES)
• Reducing tobacco use in the
AHCCCS populations (Health
Services, AHCCCS)
• Improving the referral process and
reducing medical care costs at the
State Hospital (Health Services,
AHCCCS, Juvenile Corrections)

Entrance to Desert Sage Patient Unit at Civil Hospital.

2004 Leader of the Year. Debra Traskos RN in photo with Dr.
Jerry Dennis.

2. Website for Arizona Birth/Death Records: Governor Janet
Napolitano unveiled a new state web site that puts more than
400,000 historical Arizona birth and death records at the fingertips
of genealogy buffs.
“This powerful new tool provides professional genealogists and casual family tree
researchers alike a new connection to Arizona’s past,” Governor Napolitano said.
“This site enables them to save time when searching for their family roots.”

2004 Team of the year: Left to Right: Larry Nance MHPS III, James
Stratton MHPS III, Sid Jelani MHPS III, Tabari Johnson MHPS III,
Dawn Hopkins RN (front), Debra Traskos RN, Melinda Jaurigue
MHPS IV (front), Jayne Bazeck MHPS III, Dr. Jerry Dennis. Other
team members unavailable for picture include Linda Peterman RN,
Trish Willemsen RN, Couzue Karbbar MHPS II.

10

Our Plan for A Healthier Future
STRATEGIC PLAN FISCAL YEAR 2005-2009
LEADERSHIP FOR A HEALTHY ARIZONA • EXECUTIVE SUMMARY
Department is targeting prevention and health
promotion as the path to optimal health and wellness
for all Arizonans and is striving to reduce health
disparities in Arizona by working collaboratively with
communities to improve access to public health
information and resources.
Strategy 2: Build and support public health
infrastructures that detect, control and protect
Arizonans from infectious and environmental threats
and enhance the State’s ability to respond to public
health emergencies: In response to increasingly diverse
public health threats and emergencies, including
bioterrorism, the Department is partnering with
community providers and public health entities to
better coordinate response efforts and to decrease the
incidence of injury and disease.

The Arizona Department of Health Services is one of
the largest departments in Arizona State Government,
with a budget of more than $1 billion and more than
1,800 employees. The Department oversees a wide
array of programs and services designed to protect and
ensure the health of the state’s diverse population.
These include public health, emergency medical
services, the state laboratory, public health data and
statistics, vital records, disease control, the state’s
behavioral health system, with more than 130,000
clients, the Arizona State Hospital, and the licensing
and certification of health and child care facilities.
In looking at the major health opportunities and
challenges facing Arizona in the twenty-first century,
the Department has identified four Departmental
Goals that define the Department’s continuing
commitment to a healthy Arizona. These goals are
supported by key strategies that align with the
Department’s vision and set the Department’s longterm strategic direction.

Strategy 3: Enhance collection, analysis, and
dissemination of data and public health surveillance
efforts to support Departmental goals and
programmatic and public policy decisions: The Department is working
to ensure that Arizona has a viable public health system to monitor and
identify diseases, health risks, and populations at risk and to rapidly
disseminate information to ensure appropriate public health response.

Framed by an agency description, mission statement, vision statement,
and core values, the Arizona Department of Health Services 2006-2010
Strategic Plan integrates these goals and strategies and further defines
them through targeted objectives and performance measures.

Strategy 4: Identify, connect, and provide support for programs and
practices that encourage and enable older adults to remain healthy,
engaged community members: The Department is actively promoting
health and good quality of life for Arizona's older adults through its
Healthy Aging 2010 and Healthy Aging 2010 projects. These projects
foster collaboration with local, county, tribal, and state agencies on
health promotion and injury prevention for older adults.

Goal #1: To promote and protect the health of Arizona’s children
and adults.
This goal reflects the Department's public health responsibilities and is
supported by five key strategies:
Strategy 1: Improve Arizonans’ Health Outcomes By Preventing
Disease, Reducing Disability, And Increasing Access To Care: The
11

Our Plan for A Healthier Future
Strategy 5: Recognize, involve, and communicate with public health
constituencies: To ensure the success of Arizona's public health efforts,
the Department is building strong relationships with other state
agencies, universities, county and local health departments, federal and
bi-national health entities, public health associations, advocacy
organizations, and Arizona tribes.
Goal #2: To ensure a comprehensive, unified behavioral health
system for Arizonans.
This goal reflects the Department's responsibilities for Arizona's
behavioral health system and the Arizona State Hospital and is
supported by seven key strategies:
Strategy 1: Promote understanding of the importance of behavioral
health in overall wellness: Through collaborative efforts with other
organizations and the primary care system, the Department is
improving suicide prevention and treatment services, improving services
to persons with serious co-occurring physical and behavioral health
disorders, and working to reduce the stigma associated with being a
behavioral health recipient.

Early Childhood Assessment, the Department is promoting service
delivery excellence through implementation of best and promising
practices.

Strategy 2: Ensure provision of consumer and family-focused
behavioral health care: The Department is actively involving consumers
and families in the design, implementation and monitoring of the
behavioral health system, implementing federal grievance system
requirements, and expanding the oversight responsibilities of Regional
Human Rights Committees to include the non-Medicaid, non-Seriously
Mentally Ill population.

Strategy 6: Provide a safe, secure environment for patients and staff at
the Arizona State Hospital and the community at-large: The
Department is monitoring and addressing current and potential factors
affecting hospital safety, enhancing its hospital staff, and improving
technological support at the hospital to better access and maintain
patient information.

Strategy 3: Enhance access to services where barriers exist: The
Department is improving access to culturally competent behavioral
health care, improving access to care in rural and geographically remote
areas, and expanding and enhancing the statewide network of providers.

Strategy 7: Ensure that data collected is reported accurately and made
accessible: Actively working to improve the information and reports
available to meet community needs, the Department is improving
submission of claims and encounters received from providers and
Regional Behavioral Health Authorities and improving the timeliness,
completeness, accuracy and consistency of enrollment and
disenrollment transactions and demographic data sets.

Strategy 4: Establish a common practice of early behavioral health
screening, referral, and assessment: In addition to implementing the
12

Our Plan for A Healthier Future
Goal #3: To ensure the health and safety of all Arizonans through a
comprehensive system for licensing, monitoring, and technical
assistance.
This goal reflects the Department's responsibilities for the regulation of
health and child care services and is supported by two key strategies:

Strategy 3: Support the implementation of Department goals through
improved business services: Also aligned with the Governor's Efficiency
Review Initiative, the Department is improving internal performance
and efficiency. Current projects include securing more timely and costeffective travel services, improving procurement processes, finding
statewide/agency-contracting opportunities, and developing a selfsufficient, customer-oriented copy center.

Strategy 1: Increase the timeliness and effectiveness of the
Department's processes for licensing and investigating regulated
facilities: The Department uses a proactive regulation model that better
protects the health and safety of Arizonans by increasing provider
compliance with health and childcare regulations, improving efficiency
of the licensing survey process, and improving staffing levels in each
licensing program.

Strategy 4: Develop and implement information technology system
solutions to improve the delivery of public health programs: Committed
to increasing customer service to internal and external customers, the
Department is pursuing an E-Business strategy, which allows both
internal and external customers to access, manipulate, and use agency
information. The Department is defining internal and external
customer requirements for agency-owned data, creating an agency
Intranet solution, and providing critical business partners access to
specific internal information resources.

Strategy 2: Improve communications to consumers and providers: The
Department is committed to working effectively with consumers and
licensed providers and is enhancing communications and improving
website information available to consumers.
Goal #4: To deliver courteous, efficient, responsive, and
cost-effective service to the agency’s external and internal customers,
stakeholders, and key policymakers.
This goal reflects the Department's emphasis on operational and service
excellence and is supported by four key strategies:
Strategy 1: Address the needs of the Department’s current and future
workforce: Faced with the an aging workforce, the Department is
working aggressively to determine how an aging workforce will affect
the Department now and in the future and to develop and implement
methods of addressing opportunities and challenges posed by an aging
workforce.
Strategy 2: Effectively and efficiently track and manage the agency’s
resources: Aligned with the Governor's Efficiency Review Initiative, the
Department is improving systems for managing and tracking the
agency’s human resources and tracking of Department equipment.
13

ARIZONA DEPARTMENT OF HEALTH SERVICES
Expenditures by Program
Fiscal Year 2003 - 2004

PROGRAM
ADMINISTRATION (ADMIN)
Administrative Services
Information & Technology Services (ITS)**
Business & Financial Services
TOTAL
22,247,026

ASSURANCE & LICENSURE (ALS)
Licensure Administration
Enforcement Training
Child Care Licensure
Health Care Licensure Certification
TOTAL
11,224,391

COMMUNITY AND FAMILY HEALTH (FHS)
Bureau Chief
Children W/Special Health Care Needs**
Women & Children Health
Nutrition
Oral Health
Prevention & Health Promotion
TOTAL
210,249,651

EPIDEMIOLOGY AND DISEASE CONTROL (EDC)
Bureau Chief
Bioterrorism
Environmental Health
HIV/AIDS/STD Services
Infectious Disease Control
Immunization (Vaccine)
TOTAL
35,177,827

ASSISTANCE
TO OTHERS
STATE

OTHER
FUNDS

0

1,034
2,295,317
60,451
2,356,803

1,158,509
279,600
1,801,015
3,114,349
6,353,472

2,500
2,500

20,301
(2,520)
(2,291)
1,121,603
1,137,093

598,264
46,423
1,296,481
476,405
450,122

4,207,308
4,404,248
519,773
198,069

2,867,694

9,329,398

578,551

300,500

STATE
FUNDS

2,706,403
5,371,986
11,124,386
19,202,775

511,251
1,862,850
95,265
3,243,350
6,291,267

13,103
1,866,915
365,704
2,035,047
45,531
3,670
4,329,971

ASSISTANCE
TO OTHERS
OTHER

FEDERAL
FUNDS

ASSISTANCE
TO OTHERS
FEDERAL

TOTAL

0

153,405
345,789
188,254
687,448

0

2,860,842
8,013,092
11,373,092
22,247,026

123,126
4,168
324,545
3,279,487
3,731,326

0

1,301,936
281,248
2,123,269
7,517,938
11,224,391

0

29,187
48,231,068

689,762
961,956
2,490,804
7,895,687
248,426
91,782
12,378,416

866,385
1,432,697
6,341,954
123,603,323
287,752
580,993
133,113,104

2,167,513
52,106,569
16,269,043
137,770,993
1,229,900
705,632
210,249,651

0

129,197
2,012,369
456,845
9,087,649
460,400
2,231,642
14,378,101

43,591,270
1,369,851
3,240,759

963,060
263,687
386,794
386,794

1,527,247

2,593,793
7,007,478
349,534
2,643,612
12,594,417

1,008,248
4,606,161
968,096
18,921,037
1,168,886
8,505,398
35,177,827

Page 1 of 2

14

Arizona Department of Health Services Expenditures by Program Fiscal Year 2003-2004 – Continued
EMERGENCY MEDICAL SERVICES (EMS)
EMS Operations
EMS Programs
TOTAL
5,120,123

1,857,558
242,601
2,100,160

STATE LABORATORY SERVICES (LAB)
Bureau Chief
Environmental & Analytical Chemistry
LAB License, Certification & Training
Environmental & Clinical Microbiology
Newborn Screening
Lab Support & Technical Services
TOTAL
9,693,737

1,647,351
464,158
857,752
1,137,811
2,468,586
274,512
6,850,170

MEDICAL AND PUBLIC HEALTH SERVICES (MPHS)
Assistant Director
Vital Records
Health System Development
Health Registry
Public Health Statistic
TOTAL
50,286,635

14,888,696
391,624
609,954
698,841
546,071
17,135,185

BEHAVIOR HEALTH SERVICES (BHS)
Assistant Director**
Community Behavioral Health**
Arizona State Hospital
TOTAL
845,796,324

475,312
3,568,027
52,201,466
56,244,805

117,045,528

DEPARTMENT TOTALS
1,189,795,714

2,453,295
2,453,295

0

0

(4,431)
429,565
(69,218)
6,274
(69,980)
292,211

0

11,718,064

361,150
121,514,417

1,857,558
3,262,565
5,120,123

1,642,920
974,409
960,120
3,443,169
2,468,586
204,532
9,693,737

0

2,551,356

0

4,089,445

0

3,890,823
251,091
185,018
610,081
296,204
5,233,216

4,343,105

10,632,019
1,000,000
23,350,083

361,082
361,082

80,686
171,586
2,299,084

89,401
49,555
57,826
28,264
225,046

205,586
205,586

253,661

34,676,429
692,270
11,680,651
1,366,747
1,870,538
50,286,635

126,890
601,427,492

64,165
1,117,737

10
37,094,622

121,875,567

2,785,805
24,080,992
978,238
27,845,035

601,554,382

1,181,903

37,094,632

3,813,332
788,803,287
53,179,705
845,796,324

158,538,090

36,572,952

649,785,450

40,347,352

187,506,341

1,189,795,714

** BHS & FHS State Matching Transfer to AHCCCS
Internal Service Funds Amount

138,177,990
19,468
1,327,993,172

NOTE: EXPENDITURES ARE REPORTED AS OF JUNE 30, 2003 THIRTEENTH MONTH PRIMARILY ON A CASH BASIS.
Page 2 of 2

15

Arizona Department of Health Services
Assistance to Others
Programs Administered by Counties
Fiscal Year 2003-2004

* S = STATE FUNDS
* F = FEDERAL GRANT FUNDS
* O = OTHER FUNDS

APACHE

COCHISE COCONINO

COMMUNITY AND FAMILY HEALTH SERVICES (FHS)
Bureau Chief
F
44,172
75,559
Children w/Spec
Health Care Needs
F
Children w/Spec
Health Care Needs
O
Nutrition
F
150,110
752,694
Nutrition
O
20,497
9,192
Nutrition
S
20,604
22,511
Oral Health
F
Oral Health
S
Prevention &
Health Promotion
F
Prevention &
Health Promotion
O
Office of Women
& Children Health
F
62,386
35,260
Office of Women
& Children Health
O
49,785
51,335
Office of Women
& Children Health
S
26,141
72,801
EPIDEMIOLOGY AND DISEASE CONTROL (EDC)
Bioterrorism
F
99,877
150,854
HIV/AIDS/STD Services
F
4,586
206,910
HIV/AIDS/STD Services
S
16,000
28,219
Offc of Infectious Diseases F
Ofc of Infectious Diseases S
4,000
8,000
Vaccine
F
35,070
124,825
MEDICAL & PUBLIC HEALTH (MPHS)
Office of Assistant Dir
F
171,349
Office of Assistant Dir
O
Office of Assistant Dir
S
213,495
Health Sys Development F
Health Sys Development S
130,724

137,921
403,378

GILA

GRAHAM

GREENLEE

LA PAZ MARICOPA

MOHAVE

NAVAJO

PIMA

PINAL

48,446 66,456

750

7,750

131,115

64,356

33,819

76,060

36,141
34,326
540,759 143,461
387,323 11,891
28,074 18,930
6,255

250,801
52,025

259,344
22,993
32,850

39,395

60,000
7,738,211
839,465
84,074
227,765
36,993

73,980
23,243
1,938

9,860

7,420

6,535

577,219
8,279
69,992
3,750

759,273

160,317

9,387

44,290

277,570
87,182
13,996

36,200

SANTA
CRUZ

YAVAPAI

YUMA

TOTAL

77,702

83,138

71,526

780,848

780,848

780,848

48,500

19,990

104,631

104,631

104,631

2,480,680 1,095,342
284,432
180,654
65,159
8,920
11,274
39,666

1

31,575
754,059 1,031,514
61,302
287,474
32,030
69,720

44,516

44,516

29,187

29,187

329,468

378,870

416,678

135,905

2,621,833

81,900

56,021

100,000

94,228

545,506

117,600 27,590

21,965

18,827

18,827

492,974

66,859

46,726

127,033

88,941

19,068

191,325

174,498

1,511,175

180,386 104,406
451,275 11,650
39,305 16,510

70,651
17,309
17,565

60,412
2,929
17,129

67,091

228,664
43,865
19,174

95,744
23,716
16,894

115,957
41,376
26,125

115,278
149,787
23,367

4,000
47,645

4,000
29,690

9,094
50,510

4,000
153,170

4,000
57,785

309,689
533,266
147,309
41,415
40,000
417,325

185,242
53,053
47,942

8,000
55,795 67,815

672,821
1,528,131
321,752
101,935
72,500
1,166,278

8,000
30,550

42,093

4,000
89,304

136,721
228,456
80,214
38,456
40,000
126,905

2,593,793
3,296,311
838,130
181,806
251,687
2,452,667

142,910 115,676

116,553

104,399
419,196

163,330

400,803

206,941

97,782

195,800

199,767

2,329,415
419,196
7,823,574
2,683
950,823

480,055 224,537

202,158

20,625

114,996 161,186
113,780 154,727

3,046,279

279,991

1,262,606

1,500

326,146
2,683
180,049

190,666

382,053

543,701

638,550

BEHAVIORAL HEALTH SERVICES (BHS)
Assistant Director
Community Behavioral Hlth
TOTAL
45,797,054

1,048,796

2,079,459

125,901
15,874,943
2,223,930
459,876
257,964
76,659

2,859,476 816,956

853,178

478,533

489,479

17,288,952

1,967,531

1,136,954

6,654,276

3,043,071

533,068

3,288,238

3,259,087

State

Federal

Other

125,901
15,874,943
2,223,930
459,876
257,964
76,659
44,516

125,901
15,874,943
2,223,930
459,876
257,964
76,659
44,516

29,187
2,621,833

29,187
2,621,833

545,506
1,511,175

545,506
1,511,175

2,593,793
3,296,311

2,593,793
3,296,311
838,130
181,806
251,687
2,452,667

838,130
181,806
251,687
2,452,667

2,329,415
419,196
7,823,574
2,683
950,823

Total

2,329,415
419,196
7,823,574
2,683
950,823

0
0

0
0

45,797,054

11,911,924.01 30,541,409.82 3,343,720.03 45,797,053.86

NOTE: SOME PROGRAMS ADMINISTERED BY ONE COUNTY MAY BENEFIT ONE OR MORE ADJOINING COUNTIES.
Exhibit “A”

16

Arizona Department of Health Services
Assistance to Others
Programs Administered by Other Organizations
Fiscal Year 2003-2004

* S = STATE FUNDS
* F = FEDERAL GRANT FUNDS
* O = OTHER FUNDS

NARBHA

PGBHA

EXCEL

OPTIONS
HEALTHCARE

COLO RIVER
INDIAN
TRIBE

NAVAJO
NATION

PASCUA
YAQUI
TRIBE

OTHER
ARIZONA
TRIBES

STATE
WIDE

TOTALS

State

ASSURANCE & LICENSURE (ALS)
Health Care Licensure Certification

S

2,500

2,500

2,500.00

MEDICAL & PUBLIC HEALTH (MPHS)
Assistant Director
Assistant Director
Health System Development
Health System Development
Public Health Statistic

S
F
S
F
O

3,475,295
1,760,030
9,681,196
250,978
1,000,000

3,475,295
1,760,030
9,681,196
250,978
1,000,000

3,475,294.51

EMERGENCY MEDICAL SERVICES (EMS)
Programs
Programs

F
S

361,082
2,453,295

361,082
2,453,295

300,500
3,682,290
67,497
145,532
190,945

300,500
3,711,167
124,930
12,000
167,728
190,945

78,492
4,207,308
1,328,066
43,465,369
107,684,503
971,655
59,897
536,477
2,893,074
3,720,121
824,345
29,788
121,410

85,537
4,207,308
1,328,066
43,465,369
107,728,380
1,016,829
59,897
536,477
2,893,074
3,720,121
824,345
29,788
121,410

10
44,690
361,150
8,474,746
137,021,393
32,644,429

10
126,890
361,150
37,094,622
601,427,492
121,514,417

121,514,416.86

367,838,062

950,032,828

145,206,970

EPIDEMIOLOGY AND DISEASE CONTROL (EDC)
Bureau Chief
S
HIV/AIDS/STD Services
F
HIV/AIDS/STD Services
S
Infectious Disease Control
S
Infectious Disease Control
F
Vaccine
F

FAMILY HEALTH SERVICES (FHS)
Bureau Chief
Children's W/Special H/C Needs
Children's W/Special H/C Needs
Children's W/Special H/C Needs
Nutrition
Nutrition
Nutrition
Prevention & Health Promotion
Office of Women & Children Health
Office of Women & Children Health
Office of Women & Children Health
Oral Health
Oral Health

F
S
F
O
F
O
S
F
S
F
O
F
S

BEHAVIORAL HEALTH SERVICES (BHS)
Assistant Director
Assistant Director
Assistant Director
Community Behavioral Health
Community Behavioral Health
Community Behavioral Health

F
O
S
F
O
S

TOTALS

25,595
40,077
8,000
22,196

2,045

3,282
17,356
4,000

2,500

30,170

4,200

1,500

4,112,105
58,247,473
13,728,514

1,669,215
33,921,349
5,194,817

1,432,417
25,610,164
3,563,533

21,406,139
345,567,602
65,365,289

76,092,292

40,788,926

30,606,115

432,415,530

9,684

2,500

43,877
5,320

76,500

38,549

520,436
740,701

539,075
238,585

68,719

1,357,005

793,126

73,053

Federal

Other

Total

2,500

1,760,030.02
9,681,196.14
250,977.62
1,000,000.00

361,082.46

361,082
2,453,295

2,453,295.19

300,500.00

300,500
3,711,167
124,930
12,000
167,728
190,945

3,711,167.12
124,930.00
12,000.00
167,728.25
190,945.00

85,536.56
4,207,307.50
1,328,065.56
43,465,369.03
107,728,379.80
1,016,829.44
59,896.50
536,477.39
2,893,073.68
3,720,121.23
824,345.43
29,788.18
121,410.00

10.00
126,890.00
361,150.00
37,094,622.17
601,427,492.08

156,964,931

0
3,475,295
1,760,030
9,681,196
250,978
1,000,000

647,860,926

85,537
4,207,308
1,328,066
43,465,369
107,728,380
1,016,829
59,897
536,477
2,893,074
3,720,121
824,345
29,788
121,410

10
126,890
361,150
37,094,622
601,427,492
121,514,417

950,032,828

NOTE: PROGRAMS ADMINISTERED PRIMARILY BY NON-PROFIT ORGANIZATIONS AND INDIANS TRIBES FOR RECIPIENTS QUALIFYING UNDER THE PROGRAMS. OPTIONS HEALTHCARE IS A FOR-PROFIT ORGANIZATION
Exhibit “B”

17

Arizona Department of Health Services
Arizona State Hospital Financial Summary
Fiscal Year 2003-2004

Collections:
Patient Care Collections to General Fund
$779,588
Patient Care Collections to Az State Hosp Fund - RTC
8,506,935
Patient Care Collections to Az State Hosp Fund - Title XIX 2,563,777
Non-Patient Care Collection to General Fund
2,987
Total Collections
$11,853,287

Funding Sources (General Operations Based on Budget Allocations): *
Personal Services and Related Benefits - General Fund
$29,433,601
All Other Operating - General Fund/Az State Hosp Fund 12,496,195
Rental Income
726,185
Endowment Earnings
650,000
Patient Benefit Fund
30,500
Donations
18,000
Psychotropic Medications
63,500
Community Placement - General Fund
5,574,100
Community Placement - Az State Hosp Fund
1,130,700
Total Funding
$50,122,781

Expenditures: *
Personal Services and Related Benefits
Professional and Outside Services**
Travel (In-State)
Travel (Out-of-State)
Food
Other Operating
Capital Equipment***
Assistance to Others
Total Cost of Operations

* Excludes SVP Program.
** Contract Physicians, Outside Hospitalization Costs, Outside Medical Services, and privitization of support
services.
***The negative amount in the Capital Equipment line reflects a transfer from DOA construction for the
purchase of Pyxis machines resulting in a credit to expenses until the machines are paid for through the
Administrative
Adjustment process during FY05.

Daily Costs by Treatment Program:****
Medical Psychiatric
Adolescent Treatment
Special Psychiatric Rehabilitation
Psychiatric Rehabilitation
Forensic - Restoration to Competency
Forensic Rehabilitation
Average

$29,576,695
8,297,569
58,218
577
0
4,913,377
(43,608)
6,704,800
$49,507,628

****Rates became effective 11/01/01.

18

$437
$656
$465
$401
$409
$340
$401

Communicable Disease Summary
Number Of Reported Cases Of Selected Notifiable Diseases By Category For Each County, Arizona, 2003
DISEASES

Vaccine Preventable
Measles
Mumps
Pertussis
Rubella
Congenital Rubella Syndrome
Haemophilus influenzae b
(invasive disease in children < 5 years old)

Central Nervous System
Aseptic Meningitis
Meningococcal Disease
Viral Encephalitis - Total
Enteritides
Amebiasis
Campylobacteriosis
Cholera
Cryptosporidiosis
E. coli O157:H7
Giardiasis
Salmonellosis (except S. Typhi and S. Paratyphi)
Salmonella Paratyphi A
Salmonella Paratyphi B
Salmonella Paratyphi C
Shigellosis
Typhoid Fever
Mycosis
Coccidioidomycosis (Valley Fever)
Hepatitides
Hepatitis A
Hepatitis B (acute)
Hepatitis B, Perinatal
Hepatitis C (acute)
Hepatitis D
Hepatitis E
Hepatitis Non-A Non-B
Tuberculosis
Pulmonary TB
Total TB

Arizona

Apache

Cochise

Coconino

Gila

Graham

Greenlee

La Paz

Maricopa

Mohave

Navajo

Pima

Pinal

Santa Cruz

Yavapai

Yuma

1
1
128
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

0
0
3
0
0

0
0
0
0
0

0
0
0
0
0

0
0
0
0
0

1
1
75
0
0

0
0
4
0
0

0
0
2
0
0

0
0
29
0
0

0
0
0
0
0

0
0
0
0
0

0
0
15
0
0

0
0
0
0
0

8

0

0

0

1

0

0

0

2

3

0

1

0

0

0

1

1516
34
28

0
0
0

32
0
0

7
1
0

1
0
0

0
0
0

0
0
0

0
1
0

1140
26
21

31
1
0

10
0
0

196
4
0

42
1
0

11
0
0

15
0
0

31
0
4

43
850
1
6
41
256
782
3
4
0
566
2

1
57
0
0
0
2
30
0
0
0
8
0

0
10
0
0
0
1
10
0
0
0
4
0

0
66
0
0
1
7
31
1
0
0
12
0

0
5
0
0
0
2
9
0
0
0
1
0

1
8
0
0
0
3
11
0
0
0
2
0

0
0
0
0
0
0
1
0
0
0
0
0

0
2
0
0
0
1
1
0
0
0
1
0

28
464
1
5
28
168
380
2
4
0
338
1

0
5
0
0
1
16
19
0
0
0
5
0

0
14
0
1
0
3
19
0
0
0
7
0

11
147
0
0
7
36
151
0
0
0
101
1

1
12
0
0
1
5
36
0
0
0
54
0

1
13
0
0
0
2
14
0
0
0
24
0

0
16
0
0
3
3
33
0
0
0
6
0

0
2
0
0
0
5
24
0
0
0
3
0

2695

1

5

11

7

6

0

6

2019

39

4

449

99

4

23

11

280
283
3
7
0
0
0

0
1
0
1
0
0
0

8
7
0
0
0
0
0

3
5
0
0
0
0
0

2
3
0
0
0
0
0

1
2
0
2
0
0
0

0
1
0
0
0
0
0

7
1
0
0
0
0
0

151
180
3
2
0
0
0

8
14
0
0
0
0
0

3
2
0
1
0
0
0

50
39
0
0
0
0
0

14
14
0
0
0
0
0

2
3
0
0
0
0
0

2
7
0
1
0
0
0

28
4
0
0
0
0
0

251
295

3
5

0
0

0
0

3
4

0
0

0
0

3
3

165
195

1
2

2
3

21
24

29
30

1
2

2
2

21
25

19

Number Of Reported Cases Of Selected Notifiable Diseases By Category For Each County, Arizona, 2003 - Continued
DISEASES

Sexually Transmitted
Genital Herpes
Gonorrhea
Gonococcal PID
Resistant Gonorrhea
Syphilis (primary and secondary)
Syphilis-Total
Chlamydia
Zoonoses/Vectorborne
Brucellosis
Colorado Tick Fever
Dengue
Ehrlichiosis
Hantavirus Pulmonary Syndrome
Human Rabies
Lyme Disease
Malaria
Plague
Relapsing Fever, Tickborne
Rocky Mtn. Spotted Fever
St. Louis Encephalitis
Tularemia
West Nile Virus
Other
Legionellosis
Listeriosis
Streptococcal Group A (Invasive)
Streptococcal Group B
(Invasive disease in infants<30 days old)

Streptococcus pneumoniae (Invasive)
Reyes Syndrome
Toxic Shock Syndrome
Botulism
Vibrio spp. (except toxogenic V. cholerae)
Vancomycin resistant
Enterococcus spp. (VRE)
Yersiniosis (except Y. pestis)

Arizona

Apache

Cochise

Coconino

Gila

Graham

Greenlee

La Paz

Maricopa

Mohave

Navajo

Pima

Pinal

Santa Cruz

Yavapai

Yuma

910
3576
0
2
186
1094
12785

20
41
0
0
3
15
372

4
26
0
0
0
5
149

12
26
0
0
2
5
417

3
9
0
0
0
4
97

5
9
0
0
0
11
78

0
2
0
0
0
0
10

4
1
0
0
0
2
31

583
2683
0
2
132
824
7764

8
26
0
0
2
4
151

13
98
0
0
0
7
425

194
468
0
0
40
125
2392

32
109
0
0
2
77
319

4
5
0
0
4
6
62

10
19
0
0
1
4
185

18
54
0
0
0
5
333

1
0
0
0
0
0
4
17
0
0
1
5
1
12

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
1
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
1
0

0
0
0
0
0
0
0
0
0
0
0
0
0
2

0
0
0
0
0
0
1
0
0
0
0
0
0
2

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

1
0
0
0
0
0
1
11
0
0
0
5
0
6

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
1
0
0
0

0
0
0
0
0
0
1
3
0
0
0
0
0
2

0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
1
0
0
0
0
0
0

0
0
0
0
0
0
1
1
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0

21
12
260

0
0
6

0
0
4

0
1
12

0
0
1

0
0
0

0
0
1

0
0
0

12
8
149

2
0
14

0
0
7

2
2
48

0
0
12

0
0
0

2
1
5

1
0
0

42
718
0
9
0
19

0
27
0
0
0
0

2
17
0
1
0
1

1
39
0
0
0
2

0
3
0
0
0
0

0
5
0
0
0
2

0
1
0
0
0
1

0
3
0
0
0
1

29
423
0
5
0
8

1
30
0
0
0
0

0
16
0
0
0
0

8
96
0
3
0
4

1
38
0
0
0
0

0
1
0
0
0
0

0
5
0
0
0
0

0
4
0
0
0
0

1013
7

6
0

23
0

19
0

15
0

2
0

0
0

3
0

622
7

30
0

10
0

196
0

42
0

1
0

15
0

15
0

Notes: Non-resident cases have been excluded. Cases with unknown county of residence are included in the Arizona total. Streptococcus pneumoniae is lab reportable only. Haemophilus influenzae b includes all invasive H. influenzae b, not just meningitis. Meningococcal Disease includes all invasive disease caused by Neisseria meningitidis,
not just meningitis. Animal rabies is not included. PID is Pelvic Inflammatory Disease. Resistant Gonorrhea includes PPNG, penicillinase producing Neisseria gonorrhoeae, a form of gonorrhea which destroys penicillin, and CHRNG, chromosomally mediated resistant Neisseria gonorrhoeae, a form of gonorrhea which is resistant to penicillin.
Source:Arizona Department of Health Services, Bureau of Epidemiology and Disease Control Services, Office of Infectious Disease Services, Infectious Disease Epidemiology Section, Tuberculosis Elimination Section, Vector-Borne/Zoonotic Disease Section and Office of HIV/STD Services.

20

For more information about Arizona Department of Health Services programs, goals, and services,
please contact the Public Information Office at 602-542-1001, or visit us on the web at www.azdhs.gov

Janet Napolitano, Governor
Catherine R. Eden, Director
150 North 18th Avenue
Phoenix, Arizona 85007