Board of Supervisors - Regular Meeting

Things. So we might as well get the opening meeting formalities over with. And I would like to welcome everyone to the Maricopa County Board of Supervisors informal meeting of Monday, 03/23/2026. Madam Clerk, would you be so kind as to take role?

Yes. Thank you, madam chair. Supervisor Gallardo is joining us shortly. Vice chair Lasko?

Here.

Supervisor Galvin will be joining us remotely here in just a bit. And supervisor Stewart

Here. Chair Brophy McGee. Here. So we do have a quorum, which is which will be growing to a full board compliment. Madam clerk, if you could please note for the record when our fellow supervisors arrive.

I will. Thank you.

Today's sole agenda item is the 2026 heat season plan and 2025 heat season results update. And I'd like to call forward Janine Fowler, Doctor. Nick Staub, and good to see you again, Doctor. Staub, to make the presentation. And please be sure to turn your microphone on and let everybody in the audience or online know who you are.

Morning. Thank you for having us today. My name is Janine Fowler. I the am Executive Director for Public Health. My colleague, Doctor. Nick Staub. Today we're going to go through some results from our 2025 heat season and give you an update of our plans for 2026. Unfortunately, it's already very hot. But let's get started.

Oops. I'd

like to start our presentations with just grounding in our vision and mission. Our vision is to create a healthy, thriving Maricopa County for all. And our mission is to increase the quality of life for our residents by collaborating with the community to develop and implement strategies, programs, and services addressing the emerging and changing needs of public health. And I think you'll see that reflected today.

Oh, and please note, excuse my interrupting, for the record that Supervisor Galvin has joined us. Welcome, sir.

All right. Good morning. There we go. Good morning. Very good to be here this morning, Madam Chair.

Please introduce yourself for the record.

Supervisors, I am Doctor. Nick Staub. I'm the Chief Medical Officer for Maricopa County Public Health. So I'm going to start with a review of our surveillance data from the 2025. So this first slide here is a snapshot from our dashboard that is online.

You can see here, over the 2025, high temperatures are in the red on top, and the low temperatures are in yellow, with the stacked bars below being heat related deaths that were investigated and confirmed over the 2025. Notably, on this slide, you will see that there are a total of four twenty seven confirmed with one investigation pending. This is preliminary data, so we will be finalizing this data in the coming weeks and presenting a final report. I will go over a little bit more about what those temperatures during the summer, kind of how they measured up to summers previous, but really notable here are those low temperatures. So what we see in our data specifically for heat related deaths are that those overnight lows, the high lows overnight, are what are the biggest risk factor for our community.

Here are some demographics that go with those heat related deaths. You can see across the top there the age ranges. We see that individuals 35 to 64 are particularly at risk in this population. There's a male predominance, about three quarters are men. We see that the majority are white, non Hispanic individuals, but that there's an over representation amongst black and American Indian Alaskan natives.

And over there in the two blocks in the lower right hand corner, see that sixty four percent of cases were in individuals who were also using substances, and about fifty percent are in individuals experiencing homelessness. That number, the sixty four percent involving substances is a significant increase over 2025 when they're

Excuse me. Welcome, supervisor.

Thank you. I apologize.

Oh, no worries.

We're just

Good morning. In page three of our heat presentation. Thank you, supervisor.

And when we look at where these heat related deaths are occurring, you can see that they're occurring all over Maricopa County, with a there are more deaths along the I-ten and I-seventeen corridors, relatively speaking, but again, every community across the county is affected.

May I ask you, sir? Yes. It seems like some of the dots are bigger and some are smaller. What does that represent? I'm trying to

Yeah. So these are heat related deaths by zip code. So each of those dots represents different zip code, and the relative size of the dots are how many deaths occur. So the larger dots would represent zip codes that have a higher number of heat related deaths within them. Okay.

And this dashboard looks at heat related illness. So we spend a lot of time focusing on our heat related deaths, because those are the most significant outcomes, but heat related illness does also play a significant role in the community. We see different sets of demographics with heat related illness, so you see a greater number of individuals who are young and older being affected by heat related illness. The male female split that we see in heat related deaths is about three quarters male, is less so here with heat related illness. And then in the boxes there on the lower right, you see that the number of unhoused and individuals using substances is significantly less in heat related illness.

So this is an area where we will be spending some more time going into 2026, really looking at how heat related illness is affecting our community. So now I'm gonna put those numbers in a little bit more context for you. When you look at the total number of heat related deaths, again, that number is four twenty seven for 2025. That represents a thirty percent decrease from the 2024. And again, there's been a lot of thoughts around this as to why we saw that.

Doctor. Staub, if it's alright with the presenters, I will invite the board to stop for questions. Supervisor Lusko?

Thank you, Madam Chair. On the this slide, that was the heat related illnesses, hospital visits. I was wondering if they ask at the hospital, like, what these folks do for a living. Like, they do they work out? Are they contractors that work out on the roads or the roofs, or do they ask at all?

Sure. Thank you for that question, Supervisor Lesko. Those so the way we look at heat related illness is different than heat related deaths. The heat related deaths are extensive investigations. They get a lot of information about the individual and the circumstances of the death.

This heat related illness that we show on our dashboard is from syndromic surveillance, so essentially we're looking at large data sets coming out of healthcare, and how those visits are being coded in order to define heat related illness. So in this data, we don't have that specificity, but when I mentioned wanting to do additional work in this area, it is kind of looking more at each of those cases and trying to better understand population risk factors, including occupation.

Thank you.

Okay. And then, very quickly, as long as we're on that slide, it says one point eight percent involving drugs. Would that also include alcohol?

Yes, that would include substances in general, but again, pulling that data out of what we call our syndromic surveillance is more difficult, and so Got it. You know, whether or not that's coded in their visit information is of question.

Thank you, sir. Okay,

so back to trends. Again, we see that thirty percent decrease, and a number of people have asked whether that could be related to a perception that the 2025 was relatively cooler than summers previous, and so we have looked at some of the defining features of the weather. One of those is days over 110 degrees, and consecutive days. So you can see here in green, we have twenty twenty five numbers compared to 2024 and 2023 before it, and you can see here that the number of consecutive days over 110 is significantly lower in the 2025. However, overall, the 2025 was ranked the fourth hottest on record.

So even though we did see relative cooler temperatures, the records still were set. And again, this doesn't take into account those overnight lows that I had mentioned that really are a great risk for our populations that are unhoused. We also look at days that were defined as an excessive heat warning day. Here you can see that in 2025, forty two percent of heat related deaths occurred on one of those excessive heat warning days. We like to use this as an opportunity to encourage community members to have a plan throughout the heat season, not only on those days that that are defined as an excessive heat warning day.

Madam Chair? Please. This is something I've always wanted to ask and never had. So how do you determine, or who determines? I would imagine the state department of health maybe determines if it's a heat excessive day. Who makes that decision at this day? Because I spend a lot of time outside, and all of a sudden, least over the last couple of weeks, I've been getting all these notices coming up, and it's hot, but it's gonna get hotter. Who who makes that determination? What are the criterias? How is that determined that today is gonna be a heat excessive warning day?

Thank you, supervisor Gallardo. It's a great question. I do know part of the answer, so it's the National Weather Service that declares a day as an extreme heat warning day. There are a number of factors that go into that, but again, it's not my area of expertise, so I won't try to explain them all, but they do part of it depends on the weather pattern, so days before and after, so that's why we're seeing excessive heat warning days, like the last couple days. You have an excessive heat warning day temperature than other days, and again, it's it's looking at the the pattern, not just the absolute high temperature, if that makes sense.

But again, National Weather Service declares those days, and so it's not a public health declaration.

National Weather Service?

National Weather Service.

I'm sorry, my bad. But that's nothing, I mean, we see these warnings right now, in the nineties, mid nineties, upper nineties, and we all know it's gonna go into the triple digits.

And I know, too, that some of it is based on kind of the idea that as you get into the season, you become relatively acclimated to the warmer temperatures. And so it's the day to day change that plays into it being excessive heat warning day as much as the absolute temperature.

Madam chair, I have lived here all my life. Yes. I am what? I'm 57. I'm still not acclimated to this type of heat. It's just but we we deal with it. Yeah. Thank you.

Well, no. Actually, I think it's worse, but if you were to believe the weathermen we watch, weather people, every day. It's alert, alert, alert. It's kinda silly, but

And I have a couple of slides here too to get to that point. So we do look amongst the heat related deaths at where people are from. Okay? So we have in 2025, eighty four percent of heat related deaths were Maricopa County residents. I think sometimes when we talk about acclimating to our summer heat, there's a thought that it's a bigger risk for people who are coming from outside of Maricopa County, and our data does not support that.

We do see that most are county residents. And furthermore, not only are they county residents, but this data indicates that many of them are longtime county residents. So people who've lived here for twenty years or more make up sixty percent of our heat related deaths. And now I will go briefly into some of the data around our operations for heat response. The backbone of our operations are the heat relief network.

This is a group of heat relief sites throughout Maricopa County that are supported by our local cities, community based organizations, faith based organizations who stand up these sites. This past summer in 2025, there were more than a 100, so there are a 122 hydration stations where people can get water, 97 cooling centers, 26 respite centers, which allow people to lay down and have uninterrupted time while they're cooling off, which distinguishes those respite centers from the cooling centers. This past summer, we added outreach organizations as part of the heat relief network, so defined those organizations and are tracking the activities that they're doing in the community. There were donation centers where people organizations could donate water and other needed items. And overall, there were 108 separate organizations who contributed to the network.

So may I ask, doctor, if you could give me an example of an outreach organization?

Yeah. So good example would be something like U of A Street Medicine. So the University of Arizona has a street medicine organization that goes out, tries to find individuals who need help, get them resources, and connect them to resources in the community.

And further follow-up, just thinking about it's kind of a center in Sunny Slope, but it's only open from like eleven to two. Mhmm. Do you have you counted all these unique organizations, or have you identified them all? Because we deal with a significant amount of homeless individuals in Sunny Slope.

Yeah. So thank you, Madam Chair. The heat relief network has strict definitions of what is a cooling center, so what is a cooling center versus a respite center, donation center, hydration center. And so in order to be part of the heat relief network and be placed on the map that is kind of a critical tool for the network, you have to meet those definitions. So there may be other organizations, other operations out there that are specifically working in their community to support individuals who may be at risk. They may not necessarily be part of the heat relief network if they don't sign up to be and then meet those definitions.

And what's the incentive? Money? More dollars?

I think that's a great question. I think for a lot of these organizations, it's being involved in giving back and contributing to the community. We know that a lot of these organizations are gonna do the work they're doing, whether or not they're part of the Heat Relief Network or not. Being part of the Heat Relief Network gives you access to the map and other resources that come with just coordinated effort.

Sort of like a food bank network.

Correct.

Thank you.

Madam Chair, if I can just chime in here, and I think you touched on something that is so important and one of the most difficult things to do, and that's how do you engage the public? And that's always been It's been kinda my big thing for the last ten years being on this board, is how do we engage the public? And when you're talking about engaging, it's not you and I, it ain't the folks up here, it's what we would probably refer to as the hard to reach. These are the unhoused people. These are the folks that They don't have access to the Internet, they don't.

They don't have access to any type of public notification, whether it be radio or television or anything like that. They don't have access to it, so how do you engage them? We saw it through COVID. COVID was a perfect example. How do you get these folks that are very hard to connect with? They don't have a telephone. They don't have Internet. How do you get them tested? How do you get them the vaccine? How do you get them?

And you saw many organizations during COVID walk around with an iPad, and they were signing up people. They were going door to door and and going in these communities, and and when you talk Sunny Soa is a perfect example of a fairly large area with so many people that are they live in a different world than you and I. They really do, and I can't imagine being in that situation, but they are. So how do you reach them? And more than likely, these are the folks that are gonna pass away because of heat.

They're than likely are gonna be the ones that do have substance abuse issues. It's hard. So that's always been, madam chair, is one of my pet not pet pee, I think missions, I guess, on the board is how do you engage the community. Let it be a public health quality issue, let it be just a heat relief type message, how do you get it out there? I know there's ways, just don't know.

I've been on a school board. If there's a lockdown and a push of a button, every parent in that school is notified. It is, in the push of a button. It's notification. Unfortunately you have an elderly who may have dementia or something that gets lost, you have the the gray alert, or a child, you have the amber alerts, you see them on the freeways, and so how do you how did we engage the community in around the issue of heat relief?

How do you get those hard we all we all have access to air conditioning for the most part. I would imagine the vast majority of the folks, but you do have a segment that may not have access, and then you have a whole another segment of folks that just live in a different world. It's always been the biggest struggle, like how do you engage them? We're the fourth largest county we should be looking at. How do we engage this population? I wish I had a crystal ball. I wish I knew. I just don't know. How does LA do it? How does Cook County do it?

These large metropolitan areas, how do they do it? I wish I knew. But this is communicating this message on where the sites are. It's good to have the sites, but if no one knows where to go, it's unfortunate.

So yeah, thank you, supervisor Gallardo. You, I think, set me up well to describe, I think, why we are having success with the Heat Relief Network, and it really is in that outreach. I would like to emphasize that a lot of these sites are run by community based organizations and faith based organizations that are operating year round. They know their communities best, they know how to reach people. Again, they are not just doing heat relief, they are doing community based efforts throughout the year, and so when they open up these sites as cooling centers, people know how to access them and know where they are.

We very intentionally, when we started this work two summers ago, knew that street signage was the primary way that people were finding out where these cooling centers were, and so we standardized the heat relief network symbol in that signage, made sure that heat relief sites were putting those signs out on the sidewalk so that people knew how to find a cooling station. Our work with two eleven has been really important because we know that the map is really kind of the backbone of this heat relief work. But to your point, not everyone has a smartphone in their pocket. And so working with two eleven so that people could call and find out where the nearest heat relief site is has been a real asset. We've spent a lot of time putting two one one cards out into the community, so not just paper cards, but plastic ones that are more durable, to make sure that people know that they can just call 211 to find the site nearest them.

And not only that, but they can get transportation there if they need it. So through two eleven and Lyft, we were able last summer to give almost 8,000 rides to cooling centers. Again, the two eleven cards are a big part of this, because we know that having that information in your pocket is really important, so more than 30,000 of those cards have been distributed. And again, we know that our sites are being used based on data we're collecting from those sites, so more than 4,000 surveys were collected from sites to better understand the number of people who were using them, and any difficulties those sites were having in operating, so that we could gather that information and support them. So with our dedicated staff at Public Health, we were able to reach out to sites that are having any sort of reported strain, whether that's based on numbers or some other operational issue that they're having, and making sure that we're helping them address that.

So again, I think that's another reason why these different organizations are choosing to be involved with the Heat Relief Network is for that support.

Please.

And Madam Chair, I don't want to get on a soapbox, but I will real quickly. Trust me. But the two one one, you nailed something there. And I know this is a little off topic in terms of heat relief, but it's it's it's part of how how do you engage. And I really do believe in and I see Zach there. Zach, we gotta get our communication folks say, two one one should be plastered everywhere. It really should. And it's not just heat relief. It's domestic violence. It's it's suicides. It's all these social issues that people face every day. The problem is they don't know what two one one is. You ask someone down the street and you ask them, hey, what's 911? Everyone knows what 911 is. You ask them what 211 is, they have no idea.

I mean, it's something and that's something, I guess, maybe a mission on the board or something. We plaster that 211 everywhere, that if someone is needed help, this is a simple number you can call, and they can get service or help in any way. But, no, I totally agree, two eleven, awesome program, awesome operation. I've been there, I've toured it so many times, I've met with those folks. They do wonderful work, I'm glad we're using them.

Well, to that point, supervisor, is 211 funded? It's it's always it it is just it drives me nuts. 911, everybody agrees, should be funded. I agree it should be funded, but two one one is a much more nuanced operation. You could be threatening suicide. You could have a domestic violence issue. You could have an unpaid utility bill. What do I do? All these different and these operators are trained, but it was a constant struggle every year to ensure that it got continued funding. So my question is, is it funded Chair Rufus McGee. Five days a week.

I although I can't speak directly to two one one's funding, I have been in contact with them, and they have been trying to work with the governor's office to get it into the budget, but they are right now not funded.

It drives me nuts because you have that level of trained operator who knows all these places that and and they leave because they don't know if their job's gonna be there tomorrow. So

Yeah. Madam, this is a project we probably take on. Two on one should be a lottery bucket, one of the lottery buckets. There should be a permanent revenue stream going to it, and I've always felt like this I brought this up many years ago, it should be a lottery bucket. It should be part of that lottery stream where those funds go there.

But anyways a great idea, but the other point is a lot of times you need emergency help, a different kind of emergency. It's gonna be 09:00 on a Saturday night, and they're not open on the weekends. Are they still limited hours? I think July 21. Don't know. If you just let me know or get back.

Chair Brophy McGee, their hours change frequently, so we can definitely get back to you. They were 20 for a while, but I'm not sure right now.

So just any kind of continuity. Anyway, I'm I'm going to talk to my chief about making it a funding priority. Because for not that much money, you can get people networked into those places.

And Chair Brophy Migi, Supervisor Gallardo, another point I would make about the heat relief network is that it's a great opportunity. It's really the only opportunity we have where people come to us and we don't have to go to people. So City of Phoenix has seen great success with setting up navigators at heat relief sites. And it's not the first or the second or maybe the third time where someone will agree to get services. But after seeing them for two, three weeks, we're seeing a lot of success with getting people into services simply because they want to get out of the heat, and we're able to engage.

And super quick, sorry, could you explain the difference again between cooling and respite centers?

So a cooling center only provides a cool space for individuals to spend some time. They are not allowed to lay down, fall asleep.

Okay.

So it's temporary. Yeah, so it's a cool space, but it doesn't allow for the rest in that space that a respite center would.

Thank you.

So part of our effort has been to expand access those respite sites, so I will get to that in a little more data here. So I just wanted to show you how we are using the data that we're collecting to help inform our operations. So in this slide, you can see visits throughout the season. You see that they, this is average, and this is very much a sample. We require reporting from all sites, unless they're being funded by us.

But I think what you see here in this slide is that in May and June, you start to see visits, but really you see those visits sustained all the way through September, with the highest number of visits being towards the end of the season. So I think demonstrating the need in the community for this effort throughout the heat season.

Thank you. Vice Chair.

Thank you, Madam Chair, and maybe you said that I missed it. What was the reason that it increased in September even though the temperatures went down?

So I I don't know exactly why. We just know that we see this pattern. I think as the I can imagine as the summer goes on, people continue to, need a cool space to go. Even though the the temperatures may be coming down, they're still hot. And so I think back to the messaging around the risk not only not only on days that have excessive heat warnings, but on other days, the risk of heat doesn't go away just as the temperatures start to fall.

And Madam Chair, in my, I may have an old handout, but on one of these pages that came before the last slide, it said you had about 8,000 Lyft rides. And so I was curious, what's the criteria for that? Like, where can they go? Who gets these Lyft rides, and where can they go?

Yeah, thank you, Supervisor Lesko. So one thing I would like to point out is working with Solari and two eleven has really been kind of a highlight of my work the last couple summers. They have worked to ensure that individuals who are calling to get those rides are being taken to the nearest cooling center to them unless they have a need such as if they have a pet and the nearest cooling center doesn't allow pets, then they will find them the nearest site that does. And in that effort, they have been able to significantly decrease the cost per ride over in the summer twenty five compared to 2024. And so I I think that's a a good example of the service that two one one is providing, not only to their customers, but to the county as well as a partner.

And Madam Chair, can you explain how you reduced the cost per ride? How did that happen? You got more people in a car or what?

So we changed the criteria so that they could only be taken to the nearest cooling center, and it wasn't their choice. In the summer prior, they had greater choice to go where they wanted to go.

I see. So this isn't like you get a ride to a doctor's office or anything like that. It's just to a cooling center.

That is correct.

Okay. Thank you.

Madam madam chair, does Valley Metro play a role in our process? I thought they did at one point, where if someone I may be wrong, I don't know, maybe it was a pipe dream I had, that if someone was at a bus stop and a bus came by, they were able to get on the bus if they just let them know that they just needed some relief, and they were able to get on the bus without an actual paying the fare to get on the bus. I thought maybe it's a pipe dream, I don't I thought they had a we had a partnership or a program at one point.

Madam Chair, supervisor Gallauder. I don't I'm not really familiar with that particular partnership, but it's a great idea. I'll reach out to Valley Metro and see maybe you know something we don't know.

Yeah. I remember during elections, if you told the bus driver you're headed to go vote, they'll allow you to get on the bus to go vote. But I think it might be something where I mean, if they declare and and and, you know, you're hoping that those that declare really do need the relief, but they declare that they needed some relief that they'd be able to get on the bus for a short period of time and they'll have to go wherever the bus is going, they're going, but it'd be something that yeah.

Alright. I think your comments, supervisor Lesko, about more visits. That's in September than August. It's called sick of the heat syndrome. Just get so tired of it. To that point, the serious point is that prolonged exposure over a prolonged period of time makes you even more susceptible. Am I understanding that properly?

Yeah, I think we start to get into very individual cases when we talk about that susceptibility, and so it gets a little hard to put numbers to it.

Okay.

But certainly, I think, you know, we see in our data the need for these operations through the heat season, including September and sometimes into October. Just to give you a sense of, we talked about respite centers, the difference between respite centers and cooling centers, and really the need in the community to have respite centers. So part of our work in the past couple summers has been to expand the number of respite centers and ensure that there are respite centers in every part of the county so that people can access that need if they need more than just a cooling center. So here you can see over time we've expanded to 27, including two overnight cooling centers, one in Phoenix and one in Chandler this past summer.

Vice Chair Lasko. Yeah, thank

you, Madam Chair. You had mentioned times, doctor, that the number of deaths seem to go up when the temperature at night is higher. And so I thought that was interesting because I would have thought that it would be the daytime temperatures. And so what is that all about? Is that just because they can't get out of the heat at all for an extended period of time? Tell me more about this, why this happens.

Thank you, Supervisor Lesko. So it's a relatively easy concept. When you think about the number of individuals who are unhoused, are reflected in our heat related death data, for those individuals who are often spending their nights outside, their bodies don't have the opportunity to cool off overnight, same way those of us who live in air conditioned spaces can when we sleep. And without that ability to kind of reset overnight, it's just the cumulative effects of days after days, and we see that reflected in our data. So if you went back to our dashboard page, you can see that when we have spikes in heat related deaths, that the overnight low temperature is elevated.

Oftentimes you'll see that sustained for a period of time, and that doesn't give individuals that opportunity, their bodies that opportunity to recover from the heat of the day.

Madam Chair. Please. Has there any ever been any thought of, you know, having one of those, like, type thing? I I know you'd have to clean it up and everything, but, like water to cool people off? You know, like, you know how how kids play in those well, and adults too play in those splash things? Have have we ever utilized that or is it just too much to clean up? Tell me about that.

So, Supervisor Lesko, I am not aware of the use of those facilities specifically individuals who are unhoused overnight. So I think that's really what we're talking about is that opportunity overnight to cool off. I am aware, I think I heard on the radio, that the city of Phoenix did open a lot of their splash pads this past week early in order for people to have that place to go, but I've not heard of those places being used as heat relief.

What I do know is when the firefighters pick somebody up off the street, they pack them in ice.

That that is correct.

And typically, they have to go to the burn center because they've made contact with the hot sidewalk.

Yeah. So supervisor Brophy McGee, practice that the city of Phoenix has started, and a couple of other local jurisdictions have followed suit. Those cases have to meet pretty strict criteria, so those are individuals who are suffering heat stroke, and so kind of the most severe heat related illness, and they are using ice immersion therapies to try and bring the core body temperature down. They have been seeing a lot of success in that. Interestingly enough, this past summer in 2025, they had fewer, the city of Phoenix had fewer ice immersion cases than they had the previous summer, even though their total number of calls, EMS calls, for heat related illness went up.

So we are working with the City of Phoenix to try and get access to their EMS data, expecting that that will give us greater insight into kind of the pre hospital nature of what's going on with regards to heat related illness.

Thank you.

One more data slide here to show you that So this is looking throughout the day. So these are hours throughout operations on a typical heat day. What I would like to call your attention to here is that the highest number of visits occur between six and seven p. M. So we see that sustained need throughout the day.

Our operations have really focused on ensuring that heat relief sites are open with extended hours into the evenings, oftentimes hoping to keep sites open till nine or ten p. M. You see the drop off here really is reflecting the fact that a lot of our heat related sites do close in the evenings, but we do see that need for ongoing cooling into the evenings.

So to that point, and I was waiting for questions at the end, but when someone comes to a heat center or a respite center, do you have data on root causes? Like if it's an older person, my air conditioner is broken. Younger person, my landlord is a slumlord, and my temperature in my apartment is 102. Do you work to identify the root cause of why the cause is, of why the person is there and what sorts of help you can get them, or is part of the equation? So they don't have to keep coming back.

Thank you, Supervisor Brophy McGee. We do not regularly collect that information from each individual who is using cooling sites. Three years ago, we did conduct a cooling center evaluation that was a survey for individuals using cooling centers as well as for the general public to get a better sense of why people needed certain services and what the need was in the community. That data has informed our operations, so led us to initiate our partnership with two eleven, the signs that I mentioned, getting signs out on the street that are consistent, as well as knowing that people needed that respite level of service in cooling centers, as well as these extended hours. We have not conducted that survey again since we initially did it, but we also Jeanine mentioned the different services that the city of Phoenix has in terms of navigators who are working at these sites to engage individuals and connect them to services other than cooling services.

So that is something that we are interested in expanding as well as I know a lot of our partners have relationships with different human services navigators to make sure that they're getting what they need, ideally getting someone into a better situation where they don't need daily cooling sites, but continuing to offer those in the meantime.

If I might add, Chair Ruffey McGee. And so in the I think one of the reasons we don't want to necessarily collect the data on-site is we want it to be low barrier, and we don't want people to feel any sort of embarrassment or why we just want them to use the facility. So we think by putting navigators and other people there so that if they do want services, training our volunteers that are on-site who are able to just talk and communicate with people, make it really low barrier to try when they're ready to connect them to whatever services that they might need.

So that is in place now? Mhmm. Okay. Because again, I go back to Sunny Slope, which is an amazing demographic, and I have a lot of older folks who live there whose air conditioners don't work that well or don't work at all. But there's a lot of pride there too. So yeah, that's helpful.

So I'm going to pass it over to Janine to talk about our 2026 heat response plans. Okay.

So

before we jump into 2026, we thought it would be important just to talk about our environment and where we are today. So some drivers that we believe could impact heat season and our heat outcomes this year. None of these will be a surprise to anyone. The first sustained temperatures, we're having our earliest heat wave ever on record. So how long and how hot it will be is anyone's guess.

Rising costs, we know that this is an area that we're all experiencing right now. This is we're very concerned about those living on fixed incomes, how they're going to pay their air conditioning bills, and how that's going to play out during heat season. Heat relief centers versus neighborhood concerns. We love our heat relief centers. They do great work.

But in a lot of communities, they're also right in the middle of neighborhoods. A lot of our heat relief centers are churches. And there is some conflict that we're working with our partners to try to resolve, but it's challenging. Housing affordability we know is an issue in our community. Mobile home and RV living, those living in mobile homes have higher likelihood of experiencing poor outcomes related to heat, whether it be illness or death.

So we're doing more work in that space. Supervisor Lesko mentioned outdoor workers earlier. We know that our outdoor workers start earlier, but still it's getting hotter. The overnight temperatures are not cooling off, so it puts our outdoor workers at higher risk. And then people who are using drugs, using substances in our community are at higher risk for poor outcomes due to heat.

So this is our guiding strategies for how we have developed our heat plan the last few years. Transportation and heat relief call center support, which we've already talked about, increasing visibility with signage for HR heat relief network locations, expanding cooling center hours, increasing opportunities for data collection to inform future response, partnering with local municipalities to expand and support efforts and partnering with substance use initiatives to leverage resources and partnerships. These are themes you've heard throughout today and we'll continue to hear more about. So in 2026, we'll continue funding the 24 sites that the board has provided ARPA funding for us to continue. This year will be especially challenging because we have to ensure everybody is billed and all of their contracts are complete to close out ARPA.

So we'll be spending a lot of time on that. We're working with jurisdictions and MAG to support heat relief network. We've got the map of site locations that we've talked about. The map is especially important for 02/11. So people don't need to know necessarily where they need to go.

They just need to know to call 211, and 211 does all the rest, and we'll get them to a center that's closest to them. We will continue to have some overnight sites available. And we have taken it upon ourselves to do site visits for all of the heat relief network locations, because what we noticed is sometimes people forget to update their hours on the map, or they maybe forget to put their signage out. So, we have public health staff visiting every site to ensure that they're keeping up and that their information is accurate with two eleven. We also, through one of our ARPA contracts, are managing water distribution with St.

Mary's. And we rolled out volunteer training modules to staff that are working the heat relief sites to ensure that they understand how to evaluate heat related illness, when to call EMS. So we've put some training together. And we've also developed a heat relief network partner resource center at our building, and so resources that are made available either that we have or through partner agencies. It was becoming problematic to try to us to deliver all of these to sites around the county, so we have them in one location where people can come to us and get the resources that we might have.

We also have our medical reserve corps that we mentioned earlier, and that medical reserve corps can provide site support to heat relief sites that might need additional volunteers. We find that the heat relief sites don't work well if they're 100% volunteer, but if you have paid staff with a mix of volunteers, that seems to be sort of the secret sauce that makes those work. And they will also be helping us with that heat relief partner resource center. And we're really trying to do our best to standardize the system across. So if you're volunteer, when you go to any heat related site heat related network site, you'll know what to expect from our volunteers.

They're trained in a certain way, and they know what they're prepared to offer. What we're really excited about in 2026 is that we've identified family specific respite centers. So what we saw last year, sadly, we had a lot of families at our heat relief sites. And we didn't think it was most appropriate for our families to be mixed in with general population, and that they really needed a space for themselves. And families have different needs, different resources that we could offer.

So working with our partner, the Arizona Faith Network, we're in the process of developing a site. I don't have the location today, but we're very close. It will be at a faith based location. And city of Phoenix is also working on a place where they can send families. We're also working on a pilot with MCSO and CHS at the ITR. That's a lot of acronyms. And what we're hoping to do when people are leaving the ITR, obviously very hot and a lot of people don't have transportation. They don't know sort of what's next for them. So we're trying to just see what it would look like if we're able to provide transportation to potentially the campus. The to Change, thanks.

The Keys to Change campus. Or we're still working details of exactly where they will be transported to, but I'll provide more information. The RFP just is on the street now.

Can you tell me what these acronyms are? I mean, I know MCSO, but ITR, that's the Intake? Intake Transfer Release

Center, yes.

Okay, and these are people that are being released?

They are released from jail,

yes.

And then CHS? Correctional health, sorry. Okay, correctional health, thank you.

We are also working on refining the map. So really trying to lean into technology and what technology can do for us. We've been working in the off season with Arizona State and MEG to try to make the heat relief map a little more user friendly. So where we want to get to is that if you want to sign up to be a heat relief center, you would enter in your own portal. You would enter your information.

If you close down your site, you'd be able to go in and remove it from the map. Right now it's not set up for all these things. So that's sort of our long term goal that I'm pretty optimistic we'll get to. I talked a little bit about people living in mobile homes, and although it wasn't our work, I thought it was important for you to know that there is a lot of work going on with the Red Cross to go into mobile home parks and educate people on the dangers of heat to let them know that cooling centers are available. They've got trained volunteers.

They also have two eleven cards. And it's a bit of a challenging location because a lot of people who are living in the parks don't really want people walking around handing out information, but Red Cross has a lot of great relationships. So we're trying to expand our access there. Also, we talked a lot about heat relief and substance use, so we're really trying to do more in this space. Last year, we piloted naloxone at some of our sites.

This year, we're going to try to have naloxone at all of our and respite centers. We're also, through opioid settlement funds, going to ensure electrolytes are also at our heat relief centers, because water isn't enough. They really need electrolytes. So having that addition is going to be really important.

Vice Chair Lasko.

Thank Vice you, Madam Chair. And who pays for the naloxone? Is that coming from Maricopa County opioid settlement money, or where is that? Is it a combination of places?

That is coming from opioid settlement dollars.

Okay. Thank you.

Yes.

And we're also trying to really lean into the existing contracts we have on both the opioid settlement funds and overdose data to action, which is our big CDC grant. We have contracts with probably 30 community based agencies. So how can they help us with heat relief with the audiences that they're working with? So really trying to develop innovative real time solutions as we're seeing things happen to ensure that we're all working on heat relief during the summer. We talked a little bit about two eleven already, but they will continue to fund heat rides for the most vulnerable out of one of our CDC grants.

And through a CDC grant that will be ending on June 30, we're funding call center staff. I've talked with two eleven and they'll be able to continue responding to callers throughout the summer for us up through October. And as Nick mentioned earlier, we were able to reduce the average cost of rides from $20.24 to $20.25 by 40%. Also trying to always refine how we're doing surveillance and getting better. We're exploring, as Nick mentioned earlier, ways to increase understanding of heat related illness, looking at things like pre hospital data, EMS data.

We're also really trying to

Which HMIS? Oh, sorry.

Homeless Management Information System. Thank you. And also, we're going to start trying to do a better job of studying out of season events like the one we're having now and what are the real impacts of our out of season. So both on the front end and on the back end because sometimes we're hot in October, Usually it's over late in October. But if it carries on, really trying to understand how that's impacting our community.

Working with the Office of the Medical Examiner to automate data transfer and analysis, just trying to get data quicker so we can analyze and get it to the community so that we can make it actionable. And continuing to share data with partner agencies, county departments to develop innovative strategies. We provide a lot of data to the city, city of Phoenix, just so we can try to be as responsive to what the data is telling us as quickly as possible. Supervisor Guyardo left during communications. Oh, well.

We're going to continue we have a toolkit that we've developed a year or two ago that we'll continue maximizing. Thanks to our County Office of Communications, we hope to continue to have our Clear Channel billboards. Hope you've all seen those. They're very creative and here's a sample of it in the presentation. Press releases, ongoing media.

Heat is especially challenging because you can only tell someone so many times it's hot. And like how many different ways can we communicate and try to make sure that people are actually doing something to be responsive to the heat. We do a lot of social media, and we continue to coordinate with all our heat relief partners on what sort of grassroots communications we can do. And my final slide is we recognize that ARPA is not going to be around forever, and we're really trying to lean in and look for other opportunities. So we've been spending some time talking with both foundations, and we've just started meeting with a few businesses to see if they are willing to contribute to the heat relief effort.

And it doesn't necessarily have to be to Maricopa County, but we've got 108 partner agencies that could use funding. We've met with the Arizona Community Foundation who has agreed to work with one of our local nonprofits to give some additional funding for the family respite center. We've talked to BHSHS Legacy. They've agreed. They're a foundation in town.

Madam Chair, is that banner? No, it's What's BHHS?

I don't know. That's usually what they go by. I think Chair Brophy McGee, Supervisor Lesko, I can get you that name. I name off the top of my head. They're also working with one of our nonprofits due to a meeting we had. And we also met with Mayo, who is talking with Solari to try to help with that. So just working with

yes? Baptist hospitals and health systems. Thank you. I'm used to, for my hospital board, I was always having to look stuff up. But I was gonna ask the same question. Please continue.

So I will just say that we also have started meeting with a few private companies in town to try to explain to them how important heat relief is, why this is an issue that we all need to be involved with, and we're feeling good that even if not this year, we're building some relationships to lean into in the future.

Ms. So Madam Chair?

Ms. Please.

Ms. So the ones that have agreed to help so far out of these three are the Arizona Community Foundation, and you're working on the other two?

Female No, all three are working I with can't say it's a done deal, but they're working with Solari and two nonprofits to provide some additional funding support.

Okay. Thank you.

Supervisor Galvin, I know you've been listening online. I wanted to check and see if you had any questions or comments, sir.

Madam Chair, thank you. Yes, I have been listening and appreciate the presentation. I have one comment and then one question. My comment, the name Solari has come up a few times during this hearing, and I had the privilege of taking a tour and meeting with folks from Solari. And I just wanna extend my thanks to them. I know what a valuable partner they are for the county and for staff. So I just wanna point out and highlight Solari and thank you them for all the work that they do. And then just in the last couple of minutes, there was a question about getting information out. My question for staff, madam chair, have TV stations and or radio stations provided free airtime for PSAs, public service announcements, so we can help amplify our message? Thank you, madam Chair.

Chair Brophy McGee, Supervisor Galvin, I have to get back to you on exactly I don't know that PSAs work in the same way as they used to work for us. A lot more is done on social and online. So I'd need to check-in to see exactly if they're offering any airtime.

Madam Chair, have a quick follow-up.

Please.

Yeah. I just think it's worth pursuing and exploring because there are just a lot of folks, especially senior citizens who are not on the Internet or on email. I can point to specific numbers of my family who are over the age of 80. They don't live in the state, but they're not involved with the Internet or email. But they still have TVs and radios, and I just hope that there's different ways of communication we can reach vulnerable populations. Thank you, madam chair. Thank

you, mister Galvin. Doctor Staub, did you have a follow-up?

Yes. Supervisor Galvin, thanks for the question. I I think it is important to note that our dashboard updates weekly, and we are almost certain to get regular media requests almost on weekly basis. So it does seem to me like the local channels are committed to covering the issue of heat throughout the heat season and we do take the opportunity as often as we can to get on media and make sure that people are hearing the message.

Okay. I wanted to speak to, and the last half of the presentation really outlined how Maricopa County behaves as a coordinator for all these different entities, whether it's government, nonprofit, private, faith based. Do you have or madam county manager, do you have an idea the total funding package? A lot of it sounds like it's going away. What is the total funding package for this year's initiative, direct and indirect, just ballpark?

Chair Rofie Magee, I don't want to give you the wrong number. The reason it's a little challenging is because we braid so much funding. So we're using current county ARPA funding, we're using CDC funding, opioid settlement dollars. So I'd be happy to I could get you the number. I'd like to add all those up and not leave out funding sources to give you a good number.

And that'd be helpful. And also then a slide which indicates what can be continued and what's going away. Because a lot of it is going away. And I remember it's been many years that people were talking about the deadly heat here in Arizona. Oh, I wanted to go back and one more question related to emergency management and the public health work with emergency management, because right when I got on the board, it was when the fires happened over in California and all these communities burned down.

And so people were asking, and I presented with three different city council districts on Maricopa County's role as coordinator, whether it's floods, don't you wish, regional fires, you know, urban wildland fire interface. And I asked the presenter from emergency management what his most deadly scenario was. And his most deadly scenario was a power grid failure on a hot summer's day, because they do these tabletop and planning exercises for that. So getting people to generation what do they call it? Generator powered community centers where people can survive.

And so they were actually working on that particular scenario. I would assume that involves a lot of public health. Do you work with them extensively?

Chair Prophie McGee, yes, we work extensively with McDemm and our state partners. Also, very big fear of ours, especially during our heat season, would be any sort of issue to our grid.

And I absolutely refuse to tie this to climate change, period, because then you get into the politics and the solutions. That's not my interest. My interest is the deadly heat and how we can keep it at bay and inform people. I'm married to a man from Iowa, and I always used to complain to him about the heat. And he said, but, Catherine, you don't have to shovel heat.

But it's a far, far different peril that doesn't come with floods and snows out of the skies, and it is extremely deadly. And I think recognizing that and recognizing that we have a lot of work to do so that people figure that out, I can't thank you all enough. Let's see if we can keep people alive this summer and appreciate your efforts. Okay. I think that's it.

So if you'll get a slide or something that shows the funding, what stays, and we can count on what is going away, and then what our other partners contribute, as long as I'm asking. Would appreciate it.

And Madam Chair, too want to thank you, but also your staffs and also the volunteers. I think it takes, you know, a special kind of people to do this, and I really appreciate them. Thank you. Thank you. Excellent.

The board will now consider item number two. Madam Vice Chair, is there a motion to go into executive session?

Madam Chair, I move we go into executive session.

Is there a second?

Second.

It's been moved and seconded. All in favor will say aye. Aye.

Aye. Aye.

The motion carried unanimously. We will now convene executive session in the Sullivan Conference Room. Thank you to everyone who attended and who attended online. This meeting is adjourned.