The W.R. Grace facility in Phoenix, Arizona, received vermiculite concentrate from the Libby, Montana, vermiculite mine. W.R. Grace Company has owned and operated the Arizona site since 1964. In 1964 W.R. Grace purchased the company that had previously occupied the site and, following the relocation of its vermiculite exfoliation furnace from Glendale, Arizona, began processing vermiculite concentrate and marketing it under the Zonolite® brand. The objective of this health consultation is to evaluate exposure pathways and potential health effects in those persons who, between 1964 and 2002, may have been exposed to Libby asbestos as a result of vermiculite concentrate processing activities and waste materials from the W.R. Grace exfoliation facility in Phoenix.

The officials of Sunnyside High School District and a United States Representative have expressed great concerns regarding the potential adverse health effects due to beryllium exposure in the vicinity of Brush Ceramic Products. The Arizona Department of Health Services was asked to determine whether beryllium released from Brush Ceramic’s plant poses a health threat to school children and employees, and residents in the vicinity of the facility.

This health consultation evaluates results of irrigation well samples collected by the Arizona Department of Environmental Quality in October 2003. Previous results obtained by the Blue Ridge Elementary School District in the summer of 2003 indicated trichloroethylene levels above the U.S. Environmental Protection Agency’s Maximum Contaminant Level. In addition, the most recent (2002) Annual Water Quality Report from the drinking water supplier, Arizona Water Company, was reviewed. A previous health consultation (Blue Ridge Elementary School, Lakeside, Navajo County, Arizona Health Consultation-April 30, 2003) reviewed environmental conditions at Blue Ridge Elementary School. Parents and school staff were concerned that environmental exposures were causing students to be absent from school. Drinking water quality reports, indoor air quality data, food safety, environmental sanitation records, student attendance rates, and the results of an annual parent satisfaction survey were evaluated in the consultation. Arizona Department of Health Services concluded that environmental conditions at Blue Ridge Elementary School posed no apparent public health hazard, and that attendance rates were similar to statewide attendance rates. As part of the 2003 health consultation, ADHS requested that the school district conduct water sampling from the on-site irrigation water wells for the school grounds. Those sampling results were not available when the 2003 health consultation was completed.

The purpose of this health consultation is to evaluate the air monitoring conducted by the Arizona Department of Environmental Quality at Mary McLeod Bethune School (Phoenix, AZ) and evaluate the potential impact on public health. The air monitoring data includes particulate matter and metals. The ADEQ’s primary objective of this air sampling is to provide an understanding of the hazardous air pollutants in the Phoenix area.

This report evaluates the potential exposure pathways associated with vermiculite concentrate processing activities at the Ari-Zonolite facility. The site is located in the near downtown area of Glendale, approximately ½ mile from the city hall, downtown shops, and other buildings. The former Ari-Zonolite facility received vermiculite from the Libby, Montana, mine. From 1951 to 1964, the site was leased the site to the Ari-Zonolite Company. Following the removal of the vermiculite concentrate processing equipment in 1964, several businesses have occupied the site. None of these businesses were involved in vermiculite processing activities. The last occupant of the former vermiculite processing building was an automotive restoration business, which vacated the site in 2002.

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.