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Will Humble: Agency head turned policy wonk

Will Humble spent decades at the Department of Health Services, including six years as director, before transitioning to advocacy. A self-described policy wonk, Humble reflected on his career in an interview with Arizona Capitol Times and said he isn’t done just yet.

What originally drew you to public health?

I was kind of a lost soul in my early 20s. I didn’t know what I wanted to do for a living. I got a bachelor’s degree at NAU in business. I worked at a hardware store … and I hated it. It wasn’t something I cared about and I need something to care about if I’m gonna work, or at least I want to care about it … So I went back to ASU and got another bachelor’s degree in microbiology. One of the guest lecturers was a guy from the Maricopa County Environmental Services Department – guy’s name was Mike Sparks. He was giving a guest lecture in an epidemiology class. A light bulb went on, because he started talking about public health and vector control and mosquito abatement and food safety … I left class that day like, “This actually sounds interesting.” So, I took the test to be a restaurant inspector, and that was my first public health job. So that’s what got me started in public health, a guest lecture on a random day. 

What got you into the policy side of public health?

After my 10,000th inspection, I went back and got a master’s in public health at Berkeley, and then I came back, and that’s when I got my job at the state health department, just as a regular worker doing risk assessments for Superfund sites in Arizona. It wasn’t really until I was about 40, in about the year 2000 when I started getting into the kind of jobs where you actually make policy decisions. So my first bureau chief job was all the infectious disease programs. Policy became part of my job, because I got to start making decisions. That’s when I started following legislation. I think I can remember one of the first bills that I really paid a lot of attention to was a bill that passed through this House and Senate that would have said, “You can’t let people ride in the back of pickup trucks.” It passed, but Governor [Jane)]Hull vetoed it, and I remember thinking, “Why?” Her veto signing statement said, “It’s too hard on Navajo, Hopi people who buy their truck for their family.” I put myself in the shoes of a governor. Here’s this obviously a good bill because everyone needs to wear a seat belt … and yet, she vetoed it. But then I thought about, well, OK, people are making huge investment decisions on the family scale, and this would make it a lot harder. That’s the first bill I remember taking a real interest in.

You were at DHS for decades. What made you stick around for so long and what ultimately made you leave?

I’ve always liked my work. When I was a restaurant inspector, it became a point pretty early on, that I’m making a living at this, but I’m not really learning anything … But that never happened at [DHS]. In some ways, I got lucky, because after about three years, the next position would tend to open up. So I had a really nice career pace, where first I had three direct reports, and then I had 10, and then I had an office where I had 30, and then I had 150 as a bureau chief … accepting more and more responsibility, but at a pace that was manageable … And then-Governor [Janet] Napolitano suddenly quit to become Homeland Security secretary … So there was a guy who was going to become [Gov. Jan] Brewer’s deputy chief of staff, Brian McNeil. Brian’s like, “meet me in this parking lot at 8:30 in the morning,” … So we three deputies met, and [McNeil] said, “We need a director for this agency, call me at 8:30 tomorrow morning and tell me which one of you three is willing to do it, but realize that this gig is probably for 30 to 90 days, and then we expect to have somebody different in the job after that.” No sooner did he drive away, then [they] looked at me, and they’re like, “It has to be you.” … It was really hard at the beginning, but it wasn’t operationally hard because I knew the place inside and out. I have to say, I’ve thanked her for this many times, Susan Gerard left a really good team in place, and it makes such a huge difference in an agency that size to have talented people around you. Often many of them were good at things that I’m not that good at, and I’m good at things that they’re not good at. We had a diversity of personality and interests and that is partly what made the job so fun, is that I had people I could rely on that I already knew … It was a great run, and I loved working for Brewer and we still stay in touch. What I appreciated the most is that … there wasn’t a whole lot of micromanagement that was going on. Then [Gov. Doug] Ducey came in and they asked me to stay and I said yes. But it wasn’t very long before I realized this was going to be very different. Not ideologically, because they’re both pretty conservative, but the expectations about how you can make decisions … was gonna be completely different. And I’m like, it’s been a great six-year run, but the next six aren’t gonna be the same.

Why did you decide to stick around at the Capitol in an advocacy role?

Partly it’s just fun, like policy is my hobby. I know that’s a weird, wonky thing to say, but it is. Not just Arizona public policy … I like to read about things that are happening around the world, and not just public health policy, but just policy in general. Because I was in the executive branch for so long, I think I add a sort of street cred-perspective on policy matters, and combine that with the fact that I don’t have any clients. I mean, I’m a registered lobbyist, but only as the representative for the Public Health Association. So my only client is good policy. I don’t want to retire, I don’t know what would happen, it kind of freaks me out to even think about. I feel like I’m providing some value added. Some people listen to me and some people, whatever I say they do the opposite. Although I have to say there’s a big difference between running a state agency and being in my position. Honestly, it’s more fun to make decisions than it is to try to influence decisions. Although I’m not complaining. There’s a lot of freedom that comes with this job too. 

What do you wish people — lawmakers or the public — knew about state agencies and their role in government?

At least during my tenure, we really did try to stay within the guardrails of our statutory authority. I think there’s some people down here skeptical that agencies are run amok and expanding their authority beyond what it should be expanded to. That, in my experience, was never the case. I will say that when we did administrative rulemakings, I did try to use all the authority I had, all the way up to the edge. If you give me the authority and you give me a governor that lets me make the policy decisions, then I’m going to write my regulations in a way that uses that full breadth of authority. And by and large, state employees want to do the right thing. There’s not much activism, honestly. They might have personal feelings about how they’re going to vote on this person and that person, but … they’re people just doing their jobs. Another thing is, I think many state employees would like to have more ability to meet with lawmakers on their own, but through all of the different governors that I worked under, who was allowed to go talk to legislators was usually pretty limited. I made it a point to bring people in, both to add color to the conversation, but also for professional development. So I wish lawmakers knew that there are state employees below the director level that would be interested in talking to them, but they’re often not given that opportunity. 

What legacy do you hope you leave on the state of Arizona?

In those six years I was the director of DHS, I think we did a lot of really good things, probably the two biggest were the two things that were least noticed. One was the Arnold v. Sarn lawsuit. We worked through with the plaintiffs and did a settlement agreement on the Arnold suit, and committed to a lot of things … We wanted to hold future administrations accountable for the things that we agreed to in the settlement agreement on behavioral health, mental health. I think we were an important part of improving the system for people with a serious mental illness and other kinds of psychiatric disorders during that period. The other thing I think we left that’s also long lasting is back in 2013 we rewrote all of the regulations for assisted living, skilled nursing, adult therapeutic foster homes, childcare facilities, behavioral health group homes, all the licensed category of health care. Prior to our changes in the regulations, the regulations were very one dimensional. It was a checklist, and we rewrote the regs so that they were three dimensional. What we wrote in 2013 is still there. They haven’t done anything with the rules. So here we are, more than 10 years later, and that overhaul of all those regulations, I think, put us in a much better position now. 

 

Hobbs wants end to abortion questionnaire, needs new law

Calling them “government surveillance,” Gov. Katie Hobbs wants lawmakers to repeal a host of laws that require abortion providers to report details on pregnant women to the state.

The governor’s call comes as the Department of Health Services on Dec. 18 released its annual report spelling out not just the number of abortions performed but various details, ranging from the procedure used and the gestational age of the fetus to the race of the woman and the reason she wanted to terminate a pregnancy.

While the doctors and clinics making the reports know the identity of their patients, none of that is furnished to the health department. And none is included in the public report.

But the governor said the requirement to even gather the information – something that is not required of any other medical procedure – is unacceptable.

Hobbs, Prop 400, legislation, sales tax, transportation tax
Gov. Katie Hobbs

“This report is an attack on our freedom, is unacceptable, and must be brought to an end,” Hobbs said in a prepared statement. “The government has no place in surveilling Arizonans’ medical decision-making or tracking their health history.”

Hobbs, however, can’t do this on her own: The reporting requirements are set out in state law, meaning she needs approval of the Republican-controlled Legislature. There, she will get a fight from Cathi Herrod, president of the anti-abortion Center for Arizona Policy, who said collecting the information is squarely within the duties of the health department.

“They say abortion is health care,” Herrod said of those who support abortion rights. “Well, if abortion is health care, then is there not a valid reason to know what’s going on with the provision of that health care?”

Herrod also pointed out that women are free to refuse to answer the questions. And in all cases, the medical providers do not share the names of the women with the state.

Still, she said, just having doctors ask the questions can be helpful.

Consider, Herrod said, a situation where a woman discloses that she’s seeking to terminate her pregnancy because she’s being coerced or is the victim of sexual assault. In that case, Herrod said, the abortion provider can give her information on her to report a crime.

“The appropriate question is, why does Governor Hobbs not want Arizona lawmakers and the public to know what’s going on with abortion and how to help women,” Herrod said.  

And it remains questionable at best whether the Republican-controlled Legislature will go along.

Hobbs, however, remains adamant that doctors and clinics shouldn’t be asking the questions in the first place.

“Starting a family is a sensitive and personal experience for a woman and her loved ones,” the governor said. “There should be no room for government surveillance and publication of that decision.”

Some of the information collected is strictly statistical.

For example, the report shows there were 12,705 abortions performed in 2023  on Arizona residents. By contrast, there were 77,881 live births among Arizonans.

That number of abortions is the lowest since the state began using the current reporting standards in 2011 – with one exception.

In 2022, there were just 11,407 abortions performed. That was the year the U.S. Supreme Court overturned Roe v. Wade and its pretty much unrestricted right to an abortion, at least through fetal viability, generally considered between 22 and 24 weeks. And for a few months, most abortions in Arizona came to a halt after a judge ruled to allow prosecutors to enforce that territorial-era law outlawing abortion except to save the life of the mother.

That ruling eventually was stayed. But what has been left since is a law limiting abortions to just the first 15 weeks of pregnancy.

That should soon go away with voter approval of Proposition 139, which enshrined the right to abortion in the Arizona Constitution.

But for 2023, it meant that of the 12,705 abortions performed, just 21 were beyond 15 weeks.

By contrast, in 2021 – the last full year before Roe was overturned – there were 824 abortions after 15 weeks out of 13,896 performed.

But the fetal age is just one of the many statistics that the health department gathers and reports and that the governor finds unnecessarily intrusive. For example, there’s the question asked about why a woman is terminating her pregnancy.

The vast majority are listed simply as elective. But other reasons cited include a desire not to have children and financial considerations to the woman being a victim of domestic violence as well as either fetal or maternal health considerations.

And one-third of women simply refused to answer.

There’s also data about the race and ethnicity of those who get an abortion, whether the woman is married, how much education she has and even the number of times she has been pregnant before and how many prior abortions she has had.

“The existence of a government registry of pregnancies grossly infringes on our right to privacy,” Hobbs said in her statement.

Gubernatorial press aide Christian Slater acknowledged that nothing in the report identifies any particular individual.

But he said that someone might be able to analyze the data to figure out who has had an abortion, particularly as the report contains information about the residency of a pregnant woman.

For example, there were just eight abortions performed on women from Apache County, with 11 each from Mohave and La Paz counties.

Other data in the report show that there were six women who had abortion-related complications in 2023, with five of those resulting from abortions performed between 14 and 20 weeks.

And 31 minors sought abortions without getting parental consent; judges granted 28 of those.

Legislation to repeal the reporting will be sponsored by Rep. Stephanie Stahl Hamilton. The Tucson Democrat was the author of legislation earlier this year that led to the repeal of the territorial-era ban on abortions.

What Hobbs is trying to do has the backing of Dr. Jill Gibson, medical director of Planned Parenthood Arizona.

“Our government should not have the right to surveil and maintain records of Arizona women’s personal medical decisions, or those of the doctor providing them care,” she said in a prepared statement. But Gibson said it goes beyond privacy.

“As a doctor, I know firsthand how this reporting, mandated by the state Legislature, requires providers to take time away from providing actual care to our patients and to instead spend countless hours reporting their private health history and personal characteristics to the state,” she said “This type of reporting is medically unnecessary, and unfairly applied to abortion care.”

 

 

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