In a rule published July 2, 2002, EPA found the Arizona Department of Environmental Quality’s "Plan for Attainment of the 24-Hour PM10 Standard – Maricopa County PM10 Nonattainment Area" (May 1997), inadequate to achieve attainment of the 24-hour National Ambient Air Quality Standards for particulate matter 10 microns or fewer in aerodynamic diameter (PM10) at the Salt River monitoring site. The 1997 ADEQ SIP revision included attainment and Reasonable Further Progress demonstrations for the 24-hour NAAQS at the Salt River air quality monitoring site of the Maricopa County PM10 Serious Nonattainment Area, as well as at three other monitoring sites in the Phoenix area, - the Maryvale, Gilbert, and West Chandler sites. On August 4, 1997, EPA approved ADEQ’s attainment and RFP demonstrations for the Salt River monitoring area, which showed that the 24-hour PM10 NAAQS would reach attainment in the area by May 1998. Due to continuing violations of the 24-hour PM10 NAAQS at the Salt River air quality monitoring site since May 1998, EPA subsequently required Arizona to submit a revision to correct SIP inadequacies. This document consists of Arizona’s revisions to the state implementation plan for the Maricopa County PM10 Serious Nonattainment Area as described by EPA in its Federal Register notice of disapproval.

The Arizona Health Care Cost Containment System has provided home and community-based services to long-term care beneficiaries through a waiver from the Centers for Medicare and Medicaid Services since 1989. Through its Arizona Long Term Care System, AHCCCS provides comprehensive coverage for members residing in their own homes or approved alternative residential settings, such as assisted living facilities or group homes. Covered services include care such as home health nursing, attendant or personal care, and home-delivered meals. Members may designate a family member or friend to provide attendant care; after completion of training, these caregivers can be paid by AHCCCS.

The potential impact of diabetes on the Arizona Long Term Care System is of significant concern to AHCCCS. Based on this and previous studies conducted by AHCCCS, the prevalence of diabetes among ALTCS members is approximately 20 percent. With the number of Arizonans age 65 and older increasing 40 percent in the last decade, the proportion of ALTCS members with diabetes is likely to increase as well.

This report includes data on preventive health and chronic disease management services provided to members enrolled with nine publicly and privately operated managed care organizations, referred to as Contractors, that contract with AHCCCS to provide services under the AHCCCS ACUTE-care program. Performance measure results for services provided through the Department of Economic Security’s Division of Developmental Disabilities are reported in a separate section of the report. Results should be viewed as indicators of utilization of services, rather than absolute rates. These data allow AHCCCS and its Contractors to identify areas for improvement and implement interventions to increase the use of preventive and evidence based chronic disease management services.

The Arizona Health Care Cost Containment System (AHCCCS) is the State's Medicaid and KidsCare program offering the following behavioral health services: Title XIX (Medicaid) Acute and Long Term Care, Acute Care, Arizona Long Term Care Services (ALTCS), Federal Emergency Services Program (FESP), and Title XXI (KidsCare).

For more information concerning comprehensive medical services and additional information regarding behavioral health services refer to the AHCCCS Medical Policy Manual.

The Clean Air Act states that an area can be redesignated to attainment if specific conditions are met. This document demonstrates that all CAA requirements for attainment have been met, summarizes the progress of the area in attaining the PM10 standard, demonstrates that the Bullhead City area qualifies for EPA’s Clean Data Policy and Limited Maintenance Plan option, and includes a maintenance plan to assure continued attainment for ten years after the redesignation. This document includes a formal request to the U.S. Environmental Protection Agency to redesignate the Bullhead City, Arizona PM10 nonattainment area to attainment for the health-based 24-hour average and annual average PM10 National Ambient Air Quality Standard.

In addition, this document includes a formal request to revise the nonattainment area boundary, as currently defined in 40 CFR 81.303, to exclude three townships (108 square miles) in the east and south of the nonattainment area. The rationale for eliminating the three townships is that the land contains undisturbed desert terrain. The majority of the three townships is federal land managed by the Bureau of Land Management and state land managed by the Arizona State Land Department. Analyses included in this document show that ambient air quality measurements have remained below the NAAQS for PM10, and both the 24-hour average design value and annual average PM10 design value are below EPA’s LMP allowable limits. This document also demonstrates that the emission reduction control measures responsible for the air quality improvement are both permanent and enforceable.

This document consists of the attainment demonstration, maintenance plan, and redesignation to attainment request for the Douglas Sulfur Dioxide (SO2) Nonattainment Area. The purpose of this document is to demonstrate how the State of Arizona has met the National Ambient Air Quality Standards for SO2 and intends to maintain compliance with the NAAQS in the Douglas area. Air quality standards are divided into two types: primary standards based on health effects and secondary standards based on environmental effects such as damage to property, plants, visibility, etc. Both standards are established by EPA for criteria air pollutants such as sulfur dioxide.