Cochise County officials urge ADHS to adjust grant formulas to help rural counties

Cochise County health officials told visiting representatives from the Arizona Department of Health Services on Dec. 6 that state grant formulas based strictly on population leave rural counties underfunded and hamper local public-health work.

The comment came during a site visit by ADHS leadership, who met with Cochise County Health and Social Services staff and Board of Health members. Mike Hilleth, deputy health director for Cochise County, summarized the meeting and said the county pressed ADHS on funding distribution and workforce challenges.

"The primary things that we talked about were obviously internal things to the health department about grants and how they were set up and how they get invoiced," Hilleth said. He told the visiting officials that many grants allocate funding by population, which he said leaves sparsely populated counties with less capacity to deliver services over long distances.

The county urged ADHS to reassess how federal and state public-health grant dollars are apportioned, arguing that rural counties face higher per-capita delivery costs because of travel distances and limited local tax bases. Hilleth said Cochise County advocated that funding models should account for those differences rather than relying solely on population.

Board members and staff also raised workforce development as a priority during the meeting. Evelyn Whitmer, with the University of Arizona Cooperative Extension, and other board members noted that health-care capacity in neighboring Mexican communities could be an asset if certification and cross-border practice barriers were addressed. One board member suggested pursuing pathways so clinicians trained in Sonora could obtain certification to work legally in Cochise County.

The Board of Health discussion recorded no formal motion or vote. County staff said ADHS officials took materials back to Phoenix for review; Hilleth said the county will wait to see whether the state implements changes.

Why it matters: Cochise County officials say current grant formulas and workforce limits hinder rural public-health delivery and that state-level adjustments could shift resources toward counties with higher per-capita service costs. County leaders also signaled interest in exploring cross-border workforce options that would require state-level certification changes.

What was not decided: ADHS did not announce any immediate changes during the visit, and no formal commitments were recorded in the meeting notes.