The Reference Committee recommends amending this by striking "advocate for" and inserting "encourage" in the first resolve  and adopting this as new ArMA Policy.

Is it directly applicable to the healthcare community? Yes, it affects trainees in the healthcare community.

Does it reflect emerging healthcare trends? Yes, multiple recent studies show the prevalence of food insecurity among medical trainees.

Is it within ArMA's or the AMA's scope to accomplish? Yes, it relates to healthcare and the healthcare training

Whereas, food security is a fundamental social determinant of health, and lack of consistent access to nutritious food adversely affects physical health, mental health, academic performance, and overall well-being^1,2; and

Whereas, medical trainees face unique financial, time-related, and structural barriers (such as educational debt, limited income, and demanding schedules) that increase their vulnerability to food insecurity³; and

Whereas, in a multi-institutional survey of 1,834 U.S. medical students, 21.2% reported food insecurity, with higher odds of insecurity among students of racial/ethnic minority backgrounds, those with dependents, and those relying on loans rather than parental support⁴; and

Whereas, in a single institution survey administered at Yale New Haven Health system, 27% of residents reported being food insecure: with 26% reporting having skipped or cut down on meal size, 22% frequently ate less, and 15% reported feeling hungry because they lacked sufficient food⁵; and

Whereas, intersectional risk factors such as low income, disability, and under-representation in medicine (URiM) further amplify the likelihood of food insecurity among medical students⁶; and

Whereas, food insecurity is also a documented problem among Arizona university students more broadly: a work-group report by the Arizona Board of Regents indicated that 25–50% of students at ASU, NAU, and UA experience food insecurity⁷; and

Whereas, validated social determinants of health screening tools (i.e. PRAPARE) already include standardized questions to assess food insecurity, and existing support pathways such as SNAP and other government benefit programs provide established mechanisms for connecting food-insecure individuals with resources^8,9; therefore, be it

Resolved, that ArMA ENCOURAGE advocates for institution-level screening and support systems to identify and assist food-insecure medical trainees in Arizona (e.g., medical student and resident food pantries, “meal ticket” programs, access to SNAP or emergency grants); and be it further

Resolved, that ArMA supports statewide efforts to collect and stratify data on food insecurity among Arizona medical trainees to inform targeted policies and interventions that promote equity, well-being, and retention in the physician workforce.

Reference:

1. Julie Berrett-Abebe, Sarah C Reed, Exploring the Relationship between Food Insecurity, Chronic Health Conditions, and Serious Mental Illness in the United States: Implications for Social Work, Health & Social Work, Volume 49, Issue 3, August 2024, Pages 147–156, https://doi.org/10.1093/hsw/hlae012
2. Betancourt-Núñez A, Díaz R, Nava-Amante PA, et al. Beyond the Classroom: The Influence of Food Insecurity, Mental Health, and Sleep Quality on University Students' Academic Performance. Foods. 2024;13(16):2508. Published 2024 Aug 11. doi:10.3390/foods13162508
3. AAMC: Physician Education Debt and the Cost to Attend Medical School
4. Shanab BM, Khosla P, Hammad NM, et al. Food Insecurity Prevalence Among US Medical Students. JAMA Netw Open. 2025;8(8):e2529926. doi:10.1001/jamanetworkopen.2025.29926
5. Vázquez M, et al. Food insecurity in medical residents at Yale New Haven Health System. Poster presented at: Pediatric Academic Societies (PAS) Meeting; May 4, 2024; Toronto, Ontario, Canada. Poster 424.1565.
6. Nguyen M, Shanab BM, Khosla P, et al. The Intersection of Disability, Race, Ethnicity, and Financial Background on Food Insecurity Among Medical Students. Acad Med. 2025;100(10S Suppl 1):S113-S118. doi:10.1097/ACM.0000000000006156
7. Arizona Board of Regents: Student Food and Housing Insecurity
8. Weir, R. C., Proser, M., Jester, M., Li, V., Hood-Ronick, C. M., & Gurewich, D. (2020). Collecting Social Determinants of Health Data in the Clinical Setting: Findings from National PRAPARE Implementation. Journal of health care for the poor and underserved, 31(2), 1018–1035.
9. Arizona Department of Economic Security: Nutrition Assistance

The Reference Committee recommends this be adopted as new ArMA Policy.

Does the resolution address a current need? Arizona has implemented harm reduction policies through legalized syringe service programs, but conflicting paraphernalia laws create inconsistent legal protections that may limit their effectiveness and contribute to preventable infectious disease and overdose risk.

Is it directly applicable to the healthcare community? Healthcare providers in Arizona routinely manage complications of injection drug use, including human immunodeficiency virus, hepatitis C, overdose, and soft tissue infections, which contribute to increased emergency department utilization, hospitalizations, and long-term healthcare costs. Legal barriers affecting access to sterile syringes and harm reduction services influence patient behavior and may increase preventable morbidity, resource utilization, and cost burden on healthcare systems and providers.

Does it reflect emerging healthcare trends? Harm reduction is increasingly recognized as an evidence- based public health strategy at both the state and national levels, with expanding legislative and clinical efforts focused on reducing overdose mortality and infectious disease transmission. Arizona’s recent adoption of syringe service program legislation reflects this shift, and further alignment of legal frameworks represents a logical next step in advancing prevention-focused care.

Is it within ArMA's or the AMA's scope to accomplish? ArMA has previously supported harm reduction strategies, including policies related to syringe service programs and efforts to reduce opioid-related harm, and routinely engages in legislative advocacy to improve public health outcomes.

Addressing legal inconsistencies that affect the implementation of existing harm reduction policies represents a natural extension of ArMA’s current advocacy efforts and aligns with its role in shaping state-level healthcare policy.

Whereas, Arizona Revised Statutes §36-798.51–52 authorize overdose and disease prevention programs, including syringe service programs, to reduce the spread of human immunodeficiency virus, viral hepatitis, and other bloodborne diseases, while providing limited legal immunity only for syringes obtained through such programs with proper verification, and

 Whereas, Arizona law continues to classify syringes as drug paraphernalia outside of authorized program participation, creating a dual legal framework in which access to sterile syringes is permitted in limited contexts but otherwise subject to criminal penalties under A.R.S. §13-3415, and

 Whereas, substance use disorder and drug overdose continue to contribute to significant morbidity and mortality in Arizona, and syringe service programs are evidence-based interventions that reduce transmission of infectious diseases and facilitate entry into treatment without increasing drug use or crime, and

 Whereas, Arizona has entered a transitional stage in which harm reduction policies have been implemented but remain incompletely aligned with existing legal frameworks, potentially limiting their effectiveness and accessibility; therefore, be it

Resolved, that the Arizona Medical Association support efforts to align drug paraphernalia laws with existing harm reduction policies in order to reduce legal barriers that limit the effectiveness of authorized syringe service programs, and be it further

Resolved, that the Arizona Medical Association advocate for policies that ensure consistent legal protections for individuals participating in authorized harm reduction programs across Arizona, and be it further

Resolved, that the Arizona Medical Association encourage education of physicians and healthcare professionals regarding the public health benefits of harm reduction strategies and the legal framework affecting patient access to these services.

Budget impact to ArMA. The impact on the ArMA budget would be minimal. Implementation would primarily require staff time for policy review, coordination with existing advocacy efforts, and engagement with stakeholders involved in harm reduction, including syringe service programs and public health organizations. No significant direct financial cost is anticipated.

The Reference Committee recommends this be adopted as new ArMA Policy.

Does the resolution address a current need? Yes, maternal outcomes need improvement in Arizona.

Is it directly applicable to the healthcare community? Yes, it applies to peripartum care and expanding access to obstetric providers.

Does it reflect emerging healthcare trends? Yes, maternal health is an important focus in healthcare.

Is it within ArMA's or the AMA's scope to accomplish? Yes, ArMA can support policies that would improve maternal health.

Whereas, Arizona continues to experience significant disparities in maternal health outcomes, including higher rates of severe maternal morbidity, inadequate prenatal care, and adverse birth outcomes in rural and underserved populations compared with urban regions^1,2; and

Whereas, geographic inequities in obstetric access persist, with at least one Arizona county classified as a maternity care desert and multiple counties identified as having limited maternity care access, resulting in increased travel distances and delayed care for pregnant patients³; and

Whereas, physician-led interdisciplinary maternity care models, rural training tracks, and telehealth-supported obstetric consultation have been shown to improve the coordination of care in underserved areas^4,5; and

Whereas, expanded infrastructure allows appropriately trained family physicians to provide comprehensive obstetric care in under-resourced communities⁶ and the Society for Maternal Fetal Medicine supports expansion of the maternity care team to improve maternal health outcomes⁷; and

Whereas, a majority of high-risk pregnant rural patients deliver in facilities with inappropriately low-level care despite the fact that states with perinatal regionalization systems are better able to utilize limited maternal-fetal medicine resources and telehealth can facilitate appropriate transfers^8,9; and

Whereas, Arizona initiatives such as AHCCCS-funded maternity care supports and maternal mortality review efforts demonstrate progress but require broader implementation and sustained investment to meaningfully reduce preventable maternal morbidity and mortality¹; therefore, be it

Resolved, that ArMA advocates for expanded access to comprehensive prenatal, intrapartum, and postpartum care throughout Arizona, especially in rural areas, including the use of telehealth-supported consultations; and be it further

Resolved, that ArMA supports the evaluation and adoption of evidence-based programs that improve maternal health outcomes and reduce preventable maternal mortality; and be it further

Resolved, that ArMA supports the use of maternal mortality and morbidity review committees to facilitate ongoing data collection and reporting on maternal morbidity, mortality, and maternity care access disparities in Arizona to guide equitable policy interventions and resource allocation; and be it further

Resolved, that ArMA encourages the recruitment and retention of obstetric providers in rural and underserved areas through student and resident exposure to rural obstetric practice environments, loan repayment programs, enhanced Medicaid reimbursement for maternity services, medical liability support mechanisms, and rural practice incentives; and be it further

Resolved, that ArMA encourages expanded training programs in management of pregnant patients and availability of obstetric resources for family medicine and emergency medicine physicians working in rural areas; and be it further

Resolved, that ArMA supports the utilization of physician-led, integrated care models to enhance the delivery of obstetric services in maternity care deserts.

Reference:

1. Arizona Department of Health Services. Arizona Maternal Mortality Review Program Annual Report. Phoenix, AZ: ADHS; 2023.
2. Centers for Disease Control and Prevention. Pregnancy Mortality Surveillance System. Updated 2022.
3. March of Dimes. Nowhere to Go: Maternity Care Deserts Across the U.S. 2023 Report. Arlington, VA; 2023.
4. Centers for Medicare & Medicaid Services. Maternal Health Models and Medicaid Innovation Initiatives. 2023.
5. National Rural Health Association. Rural Maternal and Obstetric Care Toolkit. 2021.
6. Rodney WM, Rodney Arnold K, Rodney JRM, Behymer N, Fox C, Albitawi M. Sustainable Family Medicine Obstetrics as a Safety Net for Marginalized Low Resource Communities 2005-2022: The Impact of Expanded Training and Office Redesign. J Am Board Fam Med. 2025;38(2):199-208. Published 2025 Jun 27. doi:10.3122/jabfm.2024.240161R2
7. Society for Maternal-Fetal Medicine (SMFM), Gaur P, Goulding AN, Spong CY, Werner EF; SMFM Health Policy and Advocacy Committee. Society for Maternal-Fetal Special Statement: Transforming the maternity care team model. Pregnancy (Hoboken). 2025;1(3):e70018. doi:10.1002/pmf2.70018
8. Handley SC, Formanowski B, Passarella M, et al. Risk-Appropriate Childbirth Care Among Higher-Risk Pregnant Rural Residents. JAMA Health Forum. 2025;6(11):e254241. doi:10.1001/jamahealthforum.2025.4241
9. Miller HE, Yee LM, Heuser C, et al. SMFM Special Statement: Opportunities to improve access to maternal-fetal medicine care in rural and underserved communities. Pregnancy. 2026;2:e70211. doi:10.1002/pmf2.70211.

Introduced By: Deborah White, MD

The Reference Committee recommends this be adopted as new ArMA Policy.

Does the resolution address a current need? Yes. Growing trends in hospital administrative policies have led to the systematic purging of electronic and physical patient records once the minimum legal retention period is met. This creates a critical "data gap" for patients with long-term healthcare needs.

Is it directly applicable to the healthcare community? Yes. Longitudinal care for oncology, cardiology, and complex surgical patients depends on the availability of historical clinical data (e.g., chemotherapy regimens, pathology, and surgical notes) that may be required decades after the initial treatment.

Does it reflect emerging healthcare trends? Yes. As the industry moves toward precision medicine and survivorship care, the loss of historical data hinders personalized treatment. Furthermore, the lack of transparency regarding these "stealth" deletions prevents patients from taking ownership of their medical history.

Is it within ArMA’s or the AMA’s scope to accomplish? Yes. ArMA is the primary advocate for the physician-patient relationship and the ethical standards of medical practice in Arizona.

WHEREAS, Arizona law and federal HIPAA regulations establish minimum retention periods that frequently fail to align with the lifetime clinical needs of patients, particularly those managing cancer recurrence or chronic conditions; and

WHEREAS, Many healthcare systems have adopted aggressive record-deletion policies for both electronic and physical charts without proactive notification to the patients or the physicians involved in their care; and

WHEREAS, The loss of historical clinical data—including specific medication dosages, diagnostic staging, and surgical findings—compromises the ability of physicians to provide evidence-based care during subsequent medical crises; and

WHEREAS, The premature destruction of medical records creates significant "data gaps" in retrospective cohort studies and longitudinal research, particularly in identifying the late-term effects of pharmaceuticals, surgical implants, and radiation therapies; and

WHEREAS, The advancement of medical science and the improvement of patient safety protocols rely on the availability of historical clinical data to conduct "look-back" studies and to validate long-term outcomes of emerging treatments; and

WHEREAS, Modern technological advancements in "cold storage" data management have significantly reduced the cost of maintaining long-term digital archives, making the permanent deletion of clinical data an unnecessary administrative shortcut; therefore, be it

RESOLVED, That ArMA advocate for state-level policies requiring hospitals and health systems to provide clear, proactive disclosure of their record retention and destruction schedules to patients at the time of service; and be it further

RESOLVED, That ArMA support legislation or regulatory changes that require healthcare entities to make a good-faith effort to notify patients (or their designated representatives) prior to the permanent destruction of their medical records, offering the patient an opportunity to obtain a digital or physical copy; and be it further

RESOLVED, That ArMA advocate for the protection of clinical data archives, encouraging health systems to utilize long-term digital storage solutions as a standard of care to preserve vital information for future medical research and public health surveillance; and be it further

RESOLVED, That ArMA collaborate with the American Medical Association (AMA) to study the clinical and scientific impact of current record retention laws and develop "Best Practice" guidelines that prioritize patient care continuity and research integrity over administrative data management.

FISCAL IMPACT: Minimal. This falls within the scope of existing legislative and advocacy activities.

The Reference Committee recommends amending this by striking the first resolve  and adopting this as new ArMA Policy. ArMA has current policy addressing mandatory helmet laws and restrictions on hand-held devices while driving. 

Does the resolution address a current need? Yes, motor vehicle crashes remain a leading cause of preventable injury and death in Arizona, despite gains in traffic safety.

Is it directly applicable to the healthcare community?  Yes, physicians routinely care for crash victims and are well- positioned to advocate for prevention through education, public health initiatives, and policy development.

Does it reflect emerging healthcare trends?  Yes, public health and medical organizations increasingly emphasize upstream injury‑prevention policies, including occupant restraints, helmet use, and distracted-driving laws.

Is it within ArMA's or the AMA's scope to accomplish? Yes, ArMA can support evidence‑based traffic safety measures and expand existing policy on handheld devices while driving.

Whereas, motor vehicle crashes continue to cause substantial preventable injury and death in Arizona and remain a significant public health concern, even as recent years show modest declines in traffic fatalities, and

Whereas, evidence‑ based interventions, including occupant‑restraint laws, motorcycle helmet requirements, and distracted‑driving restrictions, are associated with reduced crash‑ related morbidity and mortality, and

Whereas, the Arizona Medical Association already encourages physicians to educate patients about the public health risks of text messaging and other uses of handheld devices while driving, and

Whereas, the Arizona Medical Association currently lacks broader policy addressing comprehensive motor vehicle injury prevention, and additional policy guidance would support physician advocacy and public health efforts while remaining consistent with existing policy, therefore, be it

Resolved, that the Arizona Medical Association support evidence‑based traffic safety measures in Arizona, including enforcement of occupant‑restraint laws, restrictions on handheld device use while driving, and motorcycle helmet requirements, and be it further

Resolved, that ArMA encourage physicians to educate patients and the public about motor vehicle injury prevention, including seat‑belt use, avoidance of distracted driving, and motorcycle safety, consistent with existing Arizona Medical Association policy, and be it further

Resolved, that ArMA collaborate with public health agencies, policymakers, and community organizations to educate the public and promote evidence-based motor vehicle injury-prevention strategies.

Budget impact to ArMA. Low

Resources:

1. City of Phoenix. (2022). Vision Zero Road Safety Action Plan (p. 94 of 210). https://www.phoenix.gov/...
2. Piontkowski SR, Peabody JS, Reede C, Velasco Soltero J, Tsatoke G Jr, Shelhamer T, Hicks KR. Reducing motor vehicle-related injuries at an Arizona Indian Reservation: Ten years of application of evidence-based strategies. Glob Health Sci Pract. 2015 Dec 17;3(4):619-29. doi:10.9745/GHSP-D-15-00249. PMID: 26681708; PMCID: PMC4682586.
3. Voinea GD, Boboc RG, Buzdugan ID, Antonya C, Yannis G. Texting while driving: A literature review on driving simulator studies. Int J Environ Res Public Health. 2023 Feb 28;20(5):4354. doi:10.3390/ijerph20054354. PMID: 36901364; PMCID: PMC10001711.
4. Ferdinand AO, Menachemi N, Sen B, Blackburn JL, Morrissey M, Nelson L. Impact of texting laws on motor vehicular fatalities in the United States. Am J Public Health. 2014 Aug;104(8):1370-7. doi:10.2105/AJPH.2014.301894. Epub 2014 Jun 12. PMID: 24922151; PMCID: PMC4103220.
5. Arizona Department of Transportation, Multimodal Planning Division. (2025). 2024 motor vehicle crash facts for the State of Arizona (p. 9 of 68). Arizona Department of Transportation. https://azdot.gov/...

The Reference Committee recommends amending this by striking "consistent with Parker v. Brown" from the second Resolve, and adopting this as new ArMA Policy.

Does the resolution address a current need? ArMA’s bylaws explicitly prioritize “economically sustainable medical practices,” and the strategic plan emphasizes stronger advocacy and communications around physician practice challenges, making insurer consolidation and independent physician viability directly relevant to ArMA’s present mission.

Is it directly applicable to the healthcare community?  It is directly applicable to the healthcare community because it focuses on independent physicians’ ability to remain financially viable, preserve clinical autonomy, and maintain patient access to care in Arizona.

Does it reflect emerging healthcare trends?  It reflects emerging healthcare trends because physician practice consolidation and insurer market power remain active national concerns, while policymakers and physician organizations are increasingly focused on preserving independent practice viability and exploring lawful collaborative models.

Is it within ArMA's or the AMA's scope to accomplish? Yes. It is within ArMA’s scope because ArMA’s bylaws state that the association “advocates for economically sustainable medical practices” and its existing policies already include supporting legislation and educating physicians on legal and professional issues; it is also within AMA’s scope because this resolution aligns with national physician advocacy on payment, antitrust, and practice sustainability.

WHEREAS, independent physicians in Arizona face increasing market consolidation among insurers and health systems, limiting their ability to negotiate fair payment; and

WHEREAS, federal antitrust law, including the Sherman Antitrust Act and the Supreme Court decision in Arizona v. Maricopa County Medical Society, restrict independent physicians from engaging in collective negotiation; and

WHEREAS, these constraints contribute to reduced practice viability, decreased physician autonomy, and potential impacts on patient access to care; and

WHEREAS, the American Medical Association has established policy supporting relief from antitrust restrictions to allow physicians to negotiate fair payment for services, therefore, be it

RESOLVED, that the Arizona Medical Association encourage federal legislation that provides a narrowly tailored antitrust exemption permitting independent physicians to engage in collective negotiation with health plans; and be it further

RESOLVED, that ArMA explore and support state-level frameworks consistent with Parker v. Brown to enable physician collaboration under active state supervision; and be it further

RESOLVED, that ArMA provide education to physicians regarding legally permissible collaborative and contracting models.

Reference List

1. Arizona v. Maricopa County Medical Society, 457 U.S. 332 (1982).

2. Parker v. Brown, 317 U.S. 341 (1943).

3. Sherman Antitrust Act, 15 U.S.C. §§ 1–7.

4. Federal Trade Commission & Antitrust Division. Statements of Antitrust Enforcement Policy in Health Care. 1996 (as updated).

5. American Medical Association. AMA Policy Finder: Collective Bargaining, Antitrust, and Physician Advocacy. Parker v. Brown, 317 U.S. 341 (1943), is a landmark Supreme Court case establishing that actions taken by state governments are exempt from federal antitrust laws (Sherman Act). The Court ruled that California could restrict raisin production to stabilize prices without violating antitrust statutes, creating the "state action immunity doctrine". [1, 2, 3]

FYI

Key Details:

• Case Name: Parker v. Brown, 317 U.S. 341
• Decided: January 4, 1943, by the Stone Court
• Issue: Brown, a raisin producer, argued that the California Agricultural Prorate Act of 1933, which restricted competition to stabilize prices, violated federal antitrust laws and the Commerce Clause.
• Holding: The Court held that the Sherman Act was intended to regulate private practices, not to restrain state sovereign actions. The state was acting lawfully in implementing a governmental policy, even if it restricted competition.
• Significance: This created the "Parker Immunity Doctrine," which immunizes state regulations and sometimes private actors (if acting under state compulsion) from antitrust liability. [1, 2, 3, 4, 5]

The ruling aimed to balance state sovereignty with federal antitrust policy.

Budget impact to ArMA: Likely low to modest budget impact. Most of the work fits within ArMA’s existing advocacy and education functions, but it could require some incremental staff/consultant time for policy development, legal vetting, and physician education

The Reference Committee recommends this be adopted as new ArMA Policy.

Does the resolution address a current need? Food Is Medicine interventions are increasingly recognized in clinical care, but many physicians and physicians in training may lack familiarity with their evidence-based use.

Is it directly applicable to the healthcare community? This resolution concerns physician and trainee education on healthcare-linked interventions that may support care for patients with diet-related health conditions or food insecurity.

Does it reflect emerging healthcare trends? Produce prescription programs and medically tailored meals or groceries are increasingly recognized as healthcare-linked interventions.

Is it within ArMA's or the AMA's scope to accomplish? Supporting physician and trainee education on evidence- based clinical practices is within the scope of ArMA and the AMA.

Whereas, Food Is Medicine interventions, including produce prescription programs and medically tailored meals or groceries, are used to support care for some patients with diet-related health conditions or food insecurity;

Whereas, physicians and physicians in training may lack familiarity with the evidence-based use of these interventions in clinical care; therefore, be it

Resolved, that the Arizona Medical Association supports physician and medical trainee education on the evidence-based clinical use of Food Is Medicine interventions, including produce prescription programs and medically tailored meals or groceries.

Budget impact to ArMA. Minimal to none.

The Reference Committee recommends this be adopted as new ArMA Policy.

Does the resolution address a current need? This addresses a current need because the resolution responds to an ongoing pediatric injury and mortality issue and proposes prevention strategies—safe storage counseling, locking devices, and supportive legislation—that remain directly relevant to Arizona physicians and families.

Is it directly applicable to the healthcare community?  Yes. It is directly applicable to the healthcare community because it calls on physicians and healthcare professionals to provide firearm safety counseling, supports public health distribution of locking devices, and frames safe storage as a pediatric injury-prevention issue squarely within clinical and public health practice.

Does it reflect emerging healthcare trends?  Yes. It reflects emerging healthcare trends because it treats firearm injury as a preventable public health issue, emphasizes routine clinician counseling and behavioral-risk intervention, and supports evidence-based safe-storage policies and community partnerships—approaches that align with how healthcare organizations are increasingly addressing pediatric injury prevention and upstream risk reduction.

Is it within ArMA's or the AMA's scope to accomplish? Yes. It is within ArMA’s scope because ArMA’s bylaws charge its Legislative & Government Affairs Committee and Public Health Committee with developing advocacy positions on physician, patient, and public health issues, and ArMA already has policies supporting firearm harm research, physician/public education, and legislation on comparable health issues.

Whereas, firearm-related injuries are a leading cause of death among children and adolescents in the United States, surpassing motor vehicle crashes in recent years; and

Whereas, a substantial proportion of unintentional firearm injuries and deaths among children occur in the home and involve firearms that are stored, loaded and/or unlocked; and

Whereas, studies consistently demonstrate that safe storage practices—such as keeping firearms locked, unloaded, and separate from ammunition—are associated with significantly reduced risks of unintentional injury, suicide, and unauthorized access by children; and

Whereas, children and adolescents are developmentally predisposed to curiosity and risk-taking behaviors, increasing the likelihood of accessing unsecured firearms; and

Whereas, evidence-based interventions, including the use of locking devices (e.g., trigger locks, cable locks, lockboxes, and gun safes), have been shown to increase safe storage behaviors among firearm owners; and

Whereas, counseling by healthcare professionals on firearm safety and secure storage has been demonstrated to improve safe storage practices when paired with provision of locking devices; and

Whereas, multiple professional medical organizations recommend safe firearm storage as a critical component of injury prevention and public health; and

Whereas, state-level safe storage or child access prevention (CAP) laws are associated with reductions in unintentional firearm deaths and suicides among children and adolescents; therefore, be it

Resolved that ArMA:

1. Supports legislation and policies that require safe storage of firearms, including the use of locking devices or secured storage, particularly in homes where children or adolescents are present.
2. Advocates for laws that hold firearm owners accountable for negligent storage practices that allow unauthorized access by minors.
3. Encourages healthcare professionals to counsel patients and families on safe firearm storage practices as part of routine preventive care and in cases where there are high risk individuals in the home.
4. Supports public health initiatives that promote distribution of firearm locking devices and education on safe storage.
5. Calls for continued research funding to evaluate the effectiveness of safe storage laws and interventions in reducing firearm-related injuries and deaths among children.
6. Collaborates with community organizations, schools, and policymakers to promote awareness of the importance of secure firearm storage.

References:

1.        Faust et al, Firearm Laws and Pediatric Mortality in the United States, Aug 2025, JAMA Pediatrics,

2. Cunningham RM, Walton MA, Carter PM. The major causes of death in children and adolescents in the United States. New England Journal of Medicine. 2018;379(25):2468–2475.
3. Grossman DC, Mueller BA, Riedy C, et al. Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. 2005;293(6):707–714.
4. Monuteaux MC, Azrael D, Miller M. Association of increased safe household firearm storage with firearm suicide and unintentional death among US youths. JAMA Pediatrics.2019;173(7):657–662.
5. Azad HA, Monuteaux MC, Rees CA, et al.
   Child access prevention firearm laws and firearm fatalities among children aged 0–14 years in the United States. JAMA Pediatrics. 2020.
6. Miller et al, Child Access Prevention Laws and Firearm Storage: Results From a National Survey, Am J of Prev Med 2022
7. Barkin SL, Finch SA, Ip EH, et al. Is office-based counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized trial. Pediatrics. 2008;122(1):e15–e25.
8. Rowhani-Rahbar A, Simonetti JA, Rivara FP. Effectiveness of interventions to promote safe firearm storage. Epidemiologic Reviews. 2016;38(1):111–124.
9. Chaudhary et al, Reducing Firearm Access for Youth at Risk in the Pediatric Emergency Department, Front Public Health, May 2024
10. American Academy of Pediatrics. Firearm-related injuries affecting the pediatric population. Pediatrics. Policy statement.
11. Johns Hopkins Bloomberg School of Public Health.
    Child access prevention firearm storage laws reduce youth suicide rates.
    Published January 23, 2025.
12. Giffords Law Center. Child Access Prevention Laws in the United States. Policy analysis reports.
13. Grossman et al, Gun Storage Practices and Risk of Youth Suicide and Unintentional Firearm Injuries, JAMA, Feb 9, 2005

The Reference Committee recommends amending this by striking the word "aggressively" from the third and fifty Resolves, and adopting this as new ArMA Policy.

WHEREAS, recent federal legislation (H.R. 1) imposes strict caps on federal student loan borrowing and eliminates the Graduate PLUS loan program, thereby restricting medical students’ ability to finance the full cost of attendance; and

WHEREAS, the cost of medical education and living costs frequently exceed these federal borrowing limits, creating a significant financing gap that will increasingly require reliance on private loans with less borrower protections and less favorable terms; and

WHEREAS, increased reliance on private financing disproportionately impacts students from lower- and middle-income backgrounds, thereby threatening diversity within the physician workforce and limiting equitable access to medical education; and

WHEREAS, Arizona faces ongoing and projected physician workforce shortages, particularly in rural and underserved areas and in primary care, psychiatry, and other high-need specialties; and

WHEREAS, financial barriers to medical education are strongly associated with specialty choice and practice location, with higher debt burdens discouraging entry into lower-compensated but high-need fields; and

WHEREAS, ensuring a stable and diverse physician workforce is essential to maintaining access to care and improving health outcomes for Arizona’s population, therefore, be it

RESOLVED, that the Arizona Medical Association opposes any state or federal legislation that restricts, caps, or eliminates student loan borrowing capacity specifically for medical education, unless such legislation is accompanied by equivalent, guaranteed alternative funding mechanisms; and be it further

RESOLVED, that the Arizona Medical Association (ArMA) prioritizes the development and support of public-private partnerships, actively convening Arizona's major health systems and medical schools to establish pre-funded, service-linked scholarship and gap-loan trusts; and be it further

RESOLVED, that the Arizona Medical Association aggressively advocates for the expansion and increased funding of state loan repayment and scholarship programs, particularly those tied to service in rural and underserved areas and high-need specialties; and be it further

RESOLVED, that the Arizona Medical Association formally urges all Arizona medical schools—both public and private—to implement immediate tuition freezes and expand internal institutional financial aid to prevent exacerbating the medical student debt crisis caused by federal loan restrictions, and be it further

RESOLVED, that the Arizona Medical Association supports exploration of state-level tax credits, deductions, or interest subsidies to reduce the financial burden of medical education debt; and be it further

RESOLVED, that the Arizona Medical Association aggressively advocates for expansion of graduate medical education (GME) positions in Arizona, recognizing the linkage between training program capacity, workforce retention, and the financial viability of medical education; and be it further

RESOLVED, that the Arizona Medical Association actively leverages its American Medical Association (AMA) Delegation to ensure the AMA advocates at the federal level for the protection and expansion of medical education financing and repayment programs.

The Reference Committee recommends this be adopted as new ArMA Policy.

WHEREAS, the State of Arizona has significantly expanded the scope of practice for various healthcare providers in recent years, including Naturopathic Physicians, Homeopathic Physicians, Nurse Practitioners, and Physician Assistants; and

WHEREAS, Arizona law currently consists of a "patchwork" of rules where different categories of providers are subject to vastly different requirements and definitions of unprofessional conduct. These regulations are fragmented across several chapters of A.R.S. Title 32, including:

WHEREAS, most statutory definitions of unprofessional conduct for these professions focus on provider integrity, honesty, and mandatory disclosures to help patients make informed decisions, rather than clinical scope of practice; and

WHEREAS, the general public often does not realize that different providers are governed by entirely different sets of rules, leading to significant gaps in patient protection; and

WHEREAS, as recently as 2026, HB2686 highlighted this disparity by requiring call coverage plans for surgeries in outpatient centers only for MDs and DOs, effectively exempting other licensed providers who perform the same procedures from these safety requirements; and

WHEREAS, current law under A.R.S. § 32-1401(27)(nn) requires only Medicine and Surgery Physicians to disclose the basis of "board certification" claims, even though Osteopathic Physicians, Nurse Practitioners, and others also make such claims; and

WHEREAS, because any individual can create a "board" to "certify" someone regardless of the certification's clinical merit, the Arizona Legislature enacted disclosure laws to educate the public—yet these protections currently exclude patients treated by non-MD providers; therefore, be it

RESOLVED, that ArMA support legislation to harmonize statutory requirements and definitions of unprofessional conduct across all healthcare professions, ensuring that standards for honesty, integrity, and disclosure are applied uniformly; and be it further

RESOLVED, that ArMA support legislation to require healthcare providers in all professions who claim "board certification" to provide the same transparent disclosures required under A.R.S. § 32-1401(27)(nn) so patients have the information necessary to evaluate those claims.