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WED: Heatwave slams the southwest, 60,000 purged from medicaid in two months, + More

Janice Edwards listens to a podcast on her phone as she walks at sunrise Tuesday, July 11, 2023, in Yuma, Ariz. Edwards takes her walks starting before dawn to avoid the heat. Even desert residents accustomed to scorching summers are feeling the grip of an extreme heat wave smacking the Southwest this week. Arizona, Nevada, New Mexico and Southern California are getting hit with 100-degree-plus temps and excessive heat warnings. (AP Photo/Gregory Bull)
Gregory Bull/AP
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AP
Janice Edwards listens to a podcast on her phone as she walks at sunrise Tuesday, July 11, 2023, in Yuma, Ariz. Edwards takes her walks starting before dawn to avoid the heat. Even desert residents accustomed to scorching summers are feeling the grip of an extreme heat wave smacking the Southwest this week. Arizona, Nevada, New Mexico and Southern California are getting hit with 100-degree-plus temps and excessive heat warnings. (AP Photo/Gregory Bull)

Across the US Southwest, people in desert cities like Phoenix are enduring an extreme heat wave — Terry Tang, Associated Press

Even Southwestern desert residents accustomed to scorching summers are feeling the grip of an extreme heat wave smacking Arizona, Nevada, New Mexico and Southern California this week with 100-degree-plus temps and excessive heat warnings.

To add insult to injury, the region has been left high and dry with no monsoon activity, which can help offset the blazing temperatures. In Arizona, the monsoon season officially begins June 15 and can bring powerful storms with high winds, lightning and heavy bursts of rain.

The heat has made parts of Phoenix feel like a ghost town. Sunset concerts were canceled, and covered restaurant patios equipped with cooling misters sit empty.

On Monday, Martin Brown and his black Labrador, Sammy, escaped the heat in Phoenix by going to the lobby of Circle the City, an air-conditioned walk-in health clinic for homeless people that is also a designated hydration station. Anyone can come in to sit, to get bottled water, and to find snacks like a burrito or ramen.

"We're homeless, so we don't have a choice. Well, we have a choice: We can sit at the park and swelter in the heat, but no thank you. This is much better," Brown said.

He spends five days a week at the center during business hours to escape the "jungle hot" time of day outside. He then takes the bus back to the park at night.

In recent years, Phoenix has taken various actions to limit risks for heat-related illness. When the National Weather Service issues an excessive heat warning, three of the city's most popular hiking trails close from 11 a.m. to 5 p.m.

In 2016, officials voted to ban hiking with dogs on trails when the temperature exceeds 100 degrees Fahrenheit (38 degrees Celsius). City park rangers oversee enforcement and citations for violations, said Adam Waltz, a city spokesperson.

On Tuesday, Phoenix reached 110 degrees F (43 degrees C) for the 12th consecutive day, according to the National Weather Service. The longest recorded stretch so far was 18 days in 1974.

The high pressure needed to generate monsoon storms just isn't in the right position, according to state climatologist Dr. Erinanne Saffell, so metro Phoenix is left with below normal precipitation levels and dry conditions that facilitate hotter temperatures. Also, some experts believe this year's heavier snowpack in the West took more energy to melt, prolonging the progression of a high-pressure system this summer.

"It just kind of delayed everything," Saffell said.

Stepping outside is like walking into a giant hair dryer. Accidentally brushing metal and other surfaces can feel like touching a hot stove.

All the concrete and pavement in sprawling Phoenix contributes to the misery, as sidewalks and buildings bake all day and release accumulated heat slowly overnight. During the current wave, the temp isn't dipping below 90 degrees F (32 C). This cycle makes Phoenix an urban heat island.

"Phoenix in the early 1900s would average about five days a year where they had 110 degrees or higher. Now you count the last 10 years, it's about 27 days a year. That's five times more," Saffell said.

The city is in its third year of implementing a Cool Pavement program. Pavement that reflects heat and sunlight has been installed on over 100 miles (161 kilometers) of asphalt. The new surface is supposed to lower ground temperature.

Las Vegas could also see the mercury reach between 110 and 115 degrees F (43 and 46 C) this weekend, according to the National Weather Service. In Albuquerque, New Mexico, temperatures were forecast to be between 100 and 103 F (38 and 39 C) on Tuesday with a heat advisory in effect all day. Inland areas of Southern California are predicted to see conditions peak between 100 and 113 F (38 and 45 C) from Friday through Sunday.

Every summer, libraries, churches and other facilities in Phoenix serve as cooling centers or hydration stations for those who need refuge.

Isaiah Castellanos spent Monday morning inside the city library's downtown branch and planned to return after grabbing lunch. A liver transplant recipient, Castellanos said his medications make him sunburn easily. He can't afford to go to the movies or to a museum, so the free public library is his go-to place to escape his home, which doesn't have strong air conditioning.

"It's quiet. I'll turn on my music and read a book or watch YouTube with my headphones, but also stay cool," Castellanos said.

Melody Santiago, who oversees the front office of the Circle the City clinic, said some people are so grateful they return with thank-you cards or cookies. She is certain more people will come into the center over the next week.

"It's getting really hot, and they have nowhere else to go," Santiago said. "It's an eye-opener: You never know, you could be there too."

'Walter White' enters race for New Mexico's 2nd Congressional District — KUNM News, Albuquerque Journal

One of the Duke City’s most infamous and notorious characters apparently got cold feet, failing to show up to a campaign announcement officially filed with the Federal Election Commission.

The Albuquerque Journal reports, Walter White, the protagonist of the television show “Breaking Bad,” was set to announce his candidacy for New Mexico’s 2nd Congressional District in the U.S. House on Monday night.

That would put the meth kingpin in a hotly contested race currently featuring former Congresswoman Yvette Herrell, a Republican from Alamogordo who held the seat from 2020-2022, and democratic State Representative Gabe Vasquez.

According to the filing, White is registered as a republican, is legally represented by Saul Goodman and Associates, and his “vice-president” is listed as Jesse Bruce Pinkman.

The FEC has not released a statement in regards to the filing.

It’s not clear how long the joke filing will be allowed to stay up.

Downed trees from Calf Canyon/Hermits Peak Fire now available as free firewood — KUNM News, Albuquerque Journal

Officials assisting with the recovery efforts of the Calf Canyon Hermit’s Peak fires hope to turn some of the leftover destruction into a resource for New Mexicans.

The Albuquerque Journal reports the U.S. Forest Service and the State’s forestry division said in a press release dead and downed trees across the burn scar can be picked up and used as firewood for free.

The trees were deemed hazardous, and teams cut them down and piled them by roadsides, where they can be picked up.

Those interested in getting up to 5 cords, each about the size of a pickup bed, can get a permit from any of the three ranger stations in the Santa Fe national Forest.

Shaun Sanchez, forest supervisor for Santa Fe National Forest said “this is the first step in restoring safe access to the…forest.”

Nearly 60,000 New Mexicans purged from the Medicaid rolls (so far) - Austin Fisher, Source New Mexico

In the first two months since New Mexico started disenrolling people from the state’s safety-net health insurance program for the very poor, nearly 60,000 New Mexicans lost their health insurance.

And almost every one of them lost their only way to afford health care, not because their income changed and they became ineligible, but because of paperwork.

That’s according to data for April and May released by the New Mexico Human Services Department (HSD), which oversees the state’s Medicaid program.

A requirement for continuous health care coverage during the public health emergency helped stop the periodic Medicaid “churn,” where people get kicked off the rolls but quickly reapply because they still need care.

That requirement ended when state and federal officials declared the public health emergency for SARS-CoV-2 over. At that time, there were 990,982 New Mexicans enrolled in Medicaid.

The federal government gave the state one year to check whether all of those people still qualify for Medicaid.

In the first two months, the state human services department processed renewals for 138,080 people, deemed 79,258 of them still eligible, and let them keep their health insurance.

BREAKDOWN OF THOSE WHO KEPT THEIR INSURANCE

In April and May, HSD renewed 57,382 people’s benefits automatically by using existing data from the Social Security Administration and the state Department of Workforce Solutions. Another 21,876 people renewed their benefits by sending in their applications.

In that same period, HSD purged 58,822 people from the rolls, leaving them uninsured.

Importantly, out of all the renewals the human services department reviewed, it found only 768 people to actually be no longer eligible. In general, Medicaid eligibility is based on income, residence and citizenship.

The remaining 58,054 people — more than 98% — had their benefits “terminated for failure to respond,” according to data provided by the NM Human Services Department.

All of those people have been disenrolled from Medicaid, said HSD Spokesperson Timothy Fowler.

However, if someone who has been disenrolled resubmits their application within 90 days, they can get retroactive benefits to pay for any health care they got after their effective termination date, Fowler said.

For example, someone who lost their health insurance effective May 1 has until July 31 to resubmit, and they will get retroactive benefits for any health care they receive after May 1, he said.

But if those people do not resubmit by July 31, then they will pay out of pocket for any of that health care they received after May 1, he said.

WHAT TO LOOK FOR

After a Medicaid application has been processed, people will receive a Notice of Case Action letter, which lets them know the status of their application. The letter is in a plain white envelope with the HSD logo on the outside.

The department released data for April and May in response to a request from Source New Mexico. Fowler said he would send the June data “as soon as it is published.”

The number of people losing their health insurance is unprecedented in the history of New Mexico’s Medicaid program, according to Gabriella Rivera, policy and communications director for Health Action New Mexico.

“I don’t think we’ve seen anything like this,” Rivera said. “It’s an unprecedented drop of people being covered, it really is.”

Nationally, at least 1.6 million people have been purged from the rolls as of July 5, according to data from 28 states and the District of Columbia collected by KFF.

As many as 17 million people could eventually lose coverage, KFF has projected.

“HSD’s customers are our highest priority, and we are processing renewals as quickly as possible,” Fowler said. “Any individual who has submitted a renewal maintains their coverage until their application is fully processed.”

SOME WIGGLE ROOM FROM THE FEDS

New Mexico’s Medicaid program is overseen by the federal government through the Centers for Medicare and Medicaid Services (CMS).

A CMS spokesperson said the agency is working with states to ensure they comply with all federal rules and keep people on their insurance, based on eligibility.

So far, CMS has approved six waivers for New Mexico’s Medicaid program, allowing for people to keep their health insurance if they already receive food benefits, have no income, have no verifiable assets, are also enrolled in a managed care plan, have moved and their address can be verified through USPS, or ask for a fair hearing.

“CMS cares about keeping all people covered through any health insurance option for which they are eligible,” the spokesperson said. “The agency will not hesitate to take compliance action and to use all the levers that Congress has given to ensure compliance with federal Medicaid requirements.”

U.S. Health and Human Services Secretary Xavier Becerra wrote to governors on June 12 urging them to do everything they can to minimize avoidable insurance losses.

“CMS remains deeply concerned with the numbers of individuals losing coverage due to red tape, and is calling upon states to adopt the full range of strategies CMS has offered to prevent or mitigate avoidable coverage losses,” the agency said.

CHURN HARMS PEOPLE

Medicaid is the public health insurance program of last resort. It is meant for the poorest residents of the United States who otherwise cannot afford coverage.

Besides the fact that COVID-19 continues to hospitalize, disable and kill people, how many are purged from the rolls and why are important because numerous studies, before and during the pandemic, have shown a gap in health care coverage has disastrous social effects.

Researchers last month found when more people are enrolled in Medicaid, fewer who get out of prison end up back in a cell, more have jobs and people use more health care. Earlier research has shown getting kicked off Medicaid results in delayed medical care, fewer preventive visits and periods of uninsurance.

New Mexicans dropped from the rolls will now have to pay for their own medications, said Barbara Webber, executive director of Health Action New Mexico.

“We’re right in the middle of a heat crisis, where people need their asthma inhalers more than ever,” she said. “If you’ve got three kids with asthma, and you’re having to pay full price for three inhalers, you can’t do it.”

Fewer people going to private plans than anticipated

Webber said she met with staff from BeWellNM, the state’s Affordable Care Act exchange, who told her that out of the 58,822 people purged from the rolls, only 1,000 have found new insurance plans through the exchange.

“They were anticipating much higher numbers,” Webber said. “That’s the other option, and that’s not being utilized as well.”

BeWellNM did not respond to an email and a voice message seeking comment. We will update with any response.

Fowler said people who lost Medicaid coverage should contact the exchange by going to bewellnm.com or calling 1-833-862-3935 to learn what private health insurance is available to them.

Only 3% of people nationwide who were disenrolled from Medicaid or CHIP in 2018 enrolled in exchange coverage within a year, according to the Medicaid and CHIP Payment and Access Commission, a nonpartisan congressional policy and data analysis agency.

BACKLOG PREDATES END OF PUBLIC HEALTH EMERGENCY

Rivera said she’s concerned the proportion of uninsured New Mexicans will spike, however, she said it is difficult to calculate because the redeterminations are ongoing and the state government was already behind.

There are 74,827 applications that the state could not get to in April and May, according to HSD’s data.

The agency has 153 contract staff processing Medicaid applications and renewals, Fowler said, with more in training.

“We are working to have 250 contract staff by the end of July to support the existing workload as well as exercising overtime for state employees to tackle the backlog,” he said.

New Mexico has been under a consent decree since August 1990 requiring it to process Medicaid applications accurately and on time.

A federal court assigned a special master who continues to monitor New Mexico’s Human Services Department for compliance. U.S. District Court Judge Kenneth Gonzales wrote on May 22 that the state agency “still has compliance issues in need of resolution.”

The state is supposed to renew people’s Medicaid without requiring paperwork to the very greatest extent possible, according to Sovereign Hager, legal director at the New Mexico Center on Law and Poverty, one of the plaintiffs in the case.

“We do think the state has made some strides in improving the automated renewal process,” Hager said in an interview.

However, she said before the public health emergency ended, the state was already behind in processing renewals, apparently because of a lack of caseworkers.

The state is understandably overwhelmed with the renewal processing, she said, but it did not cause the backlog.

“It predated any of this, even with the state being able to extend Medicaid and not process paperwork because of the public health emergency,” Hager said. 

UPDATE:
This story originally stated that some HSD data could not be found online. After publication New Mexico Human Service Department officials emailed Source New Mexico a link to where Medicaid enrollment data can be found online. To access the data the public should visit HSD’s website, then scroll to and click the link that reads “Learn more about HSD’s Social Impact Measures.” From there access the data by clicking “PHE Unwinding.” The link to the data is also available here.

Federal disaster recovery aid for acequias in southern NM depends on officials paying upfront - Megan Gleason, Source New Mexico 

Historic acequias in southern New Mexico are still recovering from the fires and floods disrupting life since the Black Fire in 2022.

A new source of federal help could be available for acequia stewards in southern New Mexico. That money is dependent on local counties and districts finding some dollars on their own to cover 25% of costs to even qualify, experts told the New Mexico interim Water and Natural Resources Committee on Tuesday.

THE BLACK FIRE

The Black Fire burned over 325,000 acres in the Gila National Forest in 2022. It was the second-largest fire in the state’s history. Flooding that followed the wildfire damaged Grant, Sierra, Catron and Hidalgo Counties.

Acequia stewards monitor and maintain historic irrigation channels across New Mexico, mostly on a volunteer basis. Many of these spaces suffered heavy damage from the fire and subsequent floods.

The federal Natural Resources Conservation Service has an emergency watershed protection program meant to help communities recover from disasters like the fires and floods New Mexico had in 2022.

The agency offers assistance in cleaning up debris and preventing future soil erosion or flooding.

Those affected by the state’s disasters in 2022 are eligible under a waiver for the program, which normally only covers land with property like houses or other built structures.

State lawmakers on the committee heard about this program on Tuesday from Kenneth Branch, assistant state conservationist for the federal Natural Conservation Resources Service. He said southern New Mexico acequia communities, which could use this sort of aid, want to get work done through the program.

However, the acequia stewards need help to pay some upfront costs.

The federal conservation program covers a majority of funding for any approved assistance requests and requires that a sponsor like a local county or city pay for a quarter of the work.

Branch said Grant County and the Sierra Soil and Water Conservation District agreed to sponsor the acequias. He said those local officials are now trying to scrounge together the necessary funds.

A spokesperson from the U.S. Department of Agriculture said those sponsors have to cover over $70,000, which is 25% of the total $287,560 that the program would cost.

“They’re willing to help the acequias, but they need to find that match on the back end,” Branch said.

Paula Garcia is the executive director of the New Mexico Acequia Association. Previously, no entities had stepped up to sponsor the program for the Black Fire acequia victims because nobody could find the money, she said, leading to a gap in providing services to southern New Mexico acequias.

“There’s no reason why Black Fire (victims) shouldn’t be able to get some support,” she said.

Branch said the federal natural resources agency is currently taking applications for the emergency watershed program.

No acequias affected by the Black Fire have applied yet, Garcia said.

Garcia said 52 acequias in northern New Mexico recovering from the Hermits Peak-Calf Canyon Fire — a 2022 wildfire, the largest in state history — have already applied to be part of the watershed program.

It’s not as challenging for those stewards, she said, because the federal government is picking up the full tab for the damage from the disaster that the U.S. Forest Service caused, and thus, has money to cover upfront costs the southern New Mexico stewards need to raise.

LEARNING LESSONS

In February, the New Mexico Department of Transportation removed debris from acequias in southern New Mexico. The agency also got work done in the northern part of the state.

Garcia made a proposal to the state’s interim Water and Natural Resources Committee that the state could formalize an acequia disaster recovery process for future reference based on that work. She said it could be an inter-agency process so it’s not always dependent on the transportation agency.

John Romero, a director at the state’s transportation department, said that’s a good idea. He said his agency developed the process to help the disaster-ridden acequias on the fly but it worked well.

“This has been a tremendous learning lesson for a lot of us,” Romero said.

Similar to Garcia, he said guidelines should be developed at a state level so this repair work can be a model for future disasters.

“So when this happens, we know exactly where to mobilize, how we do things,” he said. “And that way, we can be even more nimble for any future disasters that may occur.”

Romero said it would also be helpful for the state to give its transportation department more authority to support acequias in disaster recovery. He said the agency has to sign agreements with every single acequia currently to get work done, but the state could allow the transportation department to bypass that.

“This would help us to be more efficient,” he said.

It’s difficult for the state to even track all the acequias across New Mexico and their information. Garcia is working with state officials to create a map of all the systems, something that the 2022 disasters boosted a need for.

Garcia told lawmakers her association has mapped and inventoried 75 acequias damaged by the Hermits Peak-Calf Canyon Fire. She said they’ve gotten that same work done for 20 acequias hit by the Black Fire.

Former NM Congresswoman Torres Small confirmed as USDA deputy secretary -  By Nash Jones, KUNM News

The U.S. Senate Tuesday confirmed New Mexico’s Xochitl Torres Small as the next deputy secretary of the Department of Agriculture.

Torres Small worked as a water rights attorney before representing the state’s southern congressional district. After losing re-election, she became USDA under secretary for rural development in 2021.

USDA Sec. Tom Vilsack credited Torres Small with what he called “record progress” in improving access to affordable energy and housing, as well as high-speed internet in rural communities across the country.

In her hearing before the Senate Agriculture Committee in May, Torres Small highlighted her upbringing as the daughter of educators and granddaughter of farmworkers in southern New Mexico. Chair, Democratic Senator Debbie Stabenow, described Torres Small as a “staunch advocate for our rural communities.”

Stabenow said Torres Small’s unanimous support in committee and 84-8 confirmation by the full Senate helps show bipartisanship is possible in Congress.

As deputy secretary, Torres Small will oversee around 100,000 USDA employees across more than 4,500 locations. In her hearing, she said she’d focus on recruitment and retention of the agency’s aging workforce and streamlining processes for farmers and ranchers.

She takes over for Jewel Bronaugh, who resigned earlier this year.

House GOP encourages parents to ask schools to notify before providing info on gender identity, abortion, contraception Albuquerque Journal, KUNM News

New Mexico’s House Republicans Monday released a form for parents to request prior notice before a school gives their children access to or teaches them what they call“controversial topics.” Those include primary and mental health care, contraception, abortion, gender identity and transition-related medical care.

The Albuquerque Journal reports the caucus says the form responds to two new laws — one that protects access to reproductive and gender-affirming health care, and another that creates school-based health centers.

The caucus says onits websitethat the bills “sever parental notification” on the topics. However, neither bill increases student confidentiality or restricts parental consent.

House Bill 7 sponsor, Democratic Rep. Linda Serato, told the Journal that the form “definitely misleads individuals on what this bill does.” She says the legislation only aims to protect those who access the stigmatized medical services from persecution or prosecution.

Republican Rep. Luis Terrazas couldn’t point to where the law restricts parental notification, but told the Journal that it’s ambiguous and the form helps clarify the matter.

Its cover letter tells parents that, “A minor child cannot consent to his/her own educational decisions or medical treatment.” However, New Mexico law allows minors 14 years old and up to consent to sexual and mental health care on their own. And those 14 and up with children or who live away from home can consent to all medical care, according to the New Mexico Alliance for School-Based Health Care.

Terrazas told the Journal that, even if the law doesn’t lack clarity, it shouldn’t be a problem for parents to ask to be notified and he hopes school districts will honor their requests.

New Mexico jury awards $485 million in damages in case of girl sexually assaulted in foster care - Associated Press

A jury has awarded $485 million in damages in a civil case brought on behalf of an 8-year-old girl who was repeatedly sexually assaulted in a New Mexico foster care program.

The verdict came late Friday after Rio Arriba County jurors heard nearly two weeks of testimony that focused in part on allegations of corporate negligence.

The program allegedly placed the girl in the home of a foster parent despite knowing that he had been accused of sexual assault, according to the lawsuit, which was filed in 2019. It was one of more than a half-dozen cases arising from sexual assaults of children in the program.

Clarence Garcia, 66, pleaded guilty in January to seven counts of criminal sexual contact with a minor and was sentenced to up to 20 years of probation. Court records show Garcia was accused of sexually abusing six children under his care over six years.

In April, probation officers found that Garcia allegedly violated his probation after they searched his property and found bags of stuffed animals, a yoga book "with young children in suggestive poses" and accessories for firearms.

He faces an Aug. 3 sentencing hearing that could send him to prison for up to 42 years.

The jury awarded $80 million in compensatory damages and $250 million in punitive damages against Acadia Healthcare, the operator of a now-defunct licensed residential treatment facility in New Mexico, the Albuquerque Journal reported.

Acadia said in an email that the victim was not in the direct care of any facility operated by the company but was in a treatment foster care program managed by Familyworks, a nonprofit.

Familyworks and defunct Acadia subsidiary Youth and Family Centered Services of New Mexico Inc. will pay $75 million apiece with $5 million in punitive damages connected to Garcia's conduct.

"I think the jury's award and verdict show the little girl she is valued and that what happened to her shouldn't have happened," Josh Conaway, an attorney who represented the child told the Santa Fe New Mexican.

The state Children, Youth and Families Department revoked a license for Acadia-owned Desert Hills in 2019 amid reports of sexual abuse and violence at the residential treatment facility, which served children with intellectual and developmental disabilities as well as behavioral issues.

The state had ordered the Albuquerque center's operators to shut it down. Desert Hills had run Familyworks, Conaway said.

Across the US Southwest, people in desert cities like Phoenix are enduring an extreme heat wave - By Terry Tang Associated Press

Even Southwestern desert residents accustomed to scorching summers are feeling the grip of an extreme heat wave smacking Arizona, Nevada, New Mexico and Southern California this week with 100-degree-plus temps and excessive heat warnings.

To add insult to injury, the region has been left high and dry with no monsoon activity, which can help offset the blazing temperatures. In Arizona, the monsoon season officially begins June 15 and can bring powerful storms with high winds, lightning and heavy bursts of rain.

The heat has made parts of Phoenix feel like a ghost town. Sunset concerts were canceled, and covered restaurant patios equipped with cooling misters sit empty.

On Monday, Martin Brown and his black Labrador, Sammy, escaped the heat in Phoenix by going to the lobby of Circle the City, an air-conditioned walk-in health clinic for homeless people that is also a designated hydration station. Anyone can come in to sit, to get bottled water, and to find snacks like a burrito or ramen.

"We're homeless, so we don't have a choice. Well, we have a choice: We can sit at the park and swelter in the heat, but no thank you. This is much better," Brown said.

He spends five days a week at the center during business hours to escape the "jungle hot" time of day outside. He then takes the bus back to the park at night.

In recent years, Phoenix has taken various actions to limit risks for heat-related illness. When the National Weather Service issues an excessive heat warning, three of the city's most popular hiking trails close from 11 a.m. to 5 p.m.

In 2016, officials voted to ban hiking with dogs on trails when the temperature exceeds 100 degrees Fahrenheit (38 degrees Celsius). City park rangers oversee enforcement and citations for violations, said Adam Waltz, a city spokesperson.

On Tuesday, Phoenix reached 110 degrees F (43 degrees C) for the 12th consecutive day, according to the National Weather Service. The longest recorded stretch so far was 18 days in 1974.

The high pressure needed to generate monsoon storms just isn't in the right position, according to state climatologist Dr. Erinanne Saffell, so metro Phoenix is left with below normal precipitation levels and dry conditions that facilitate hotter temperatures. Also, some experts believe this year's heavier snowpack in the West took more energy to melt, prolonging the progression of a high-pressure system this summer.

"It just kind of delayed everything," Saffell said.

Stepping outside is like walking into a giant hair dryer. Accidentally brushing metal and other surfaces can feel like touching a hot stove.

All the concrete and pavement in sprawling Phoenix contributes to the misery, as sidewalks and buildings bake all day and release accumulated heat slowly overnight. During the current wave, the temp isn't dipping below 90 degrees F (32 C). This cycle makes Phoenix an urban heat island.

"Phoenix in the early 1900s would average about five days a year where they had 110 degrees or higher. Now you count the last 10 years, it's about 27 days a year. That's five times more," Saffell said.

The city is in its third year of implementing a Cool Pavement program. Pavement that reflects heat and sunlight has been installed on over 100 miles (161 kilometers) of asphalt. The new surface is supposed to lower ground temperature.

Las Vegas could also see the mercury reach between 110 and 115 degrees F (43 and 46 C) this weekend, according to the National Weather Service. In Albuquerque, New Mexico, temperatures were forecast to be between 100 and 103 F (38 and 39 C) on Tuesday with a heat advisory in effect all day. Inland areas of Southern California are predicted to see conditions peak between 100 and 113 F (38 and 45 C) from Friday through Sunday.

Every summer, libraries, churches and other facilities in Phoenix serve as cooling centers or hydration stations for those who need refuge.

Isaiah Castellanos spent Monday morning inside the city library's downtown branch and planned to return after grabbing lunch. A liver transplant recipient, Castellanos said his medications make him sunburn easily. He can't afford to go to the movies or to a museum, so the free public library is his go-to place to escape his home, which doesn't have strong air conditioning.

"It's quiet. I'll turn on my music and read a book or watch YouTube with my headphones, but also stay cool," Castellanos said.

Melody Santiago, who oversees the front office of the Circle the City clinic, said some people are so grateful they return with thank-you cards or cookies. She is certain more people will come into the center over the next week.

"It's getting really hot, and they have nowhere else to go," Santiago said. "It's an eye-opener: You never know, you could be there too."