If Arizona Public Service hadn't cut off her electricity last September, Stephanie Pullman might still be alive today.
On August 23, 2018, the utility mailed a warning letter to the 72-year-old’s home in Sun City West, where she lived with her cat, Cocoa. Pullman owed APS $176.84, it said. She had five days to pay in full. Otherwise, APS would disconnect the electricity. Outside, temperatures were in the triple digits.
Pullman lived on less than $1,000 a month in Social Security, according to one of her daughters, Jeanine Smith. Her children regularly chipped in to help with expenses. When their mother’s air conditioner broke in April 2018, they made sure it was fixed. Smith, who lives in Ohio, paid her mother’s phone bill; her sister, Chris Hotes, covered the internet.
APS didn’t cut off Pullman’s electricity on August 28. Pullman’s final electric bills show that on September 5, 2018, the day after her Social Security check normally arrived, she paid APS $125.
It wasn’t enough. Two days later, on September 7, APS disconnected her electricity. That day, temperatures hit at least 105 degrees Fahrenheit, instruments recorded in nearby Youngtown showed. Smith recalled it was 107 degrees.
One week later, alarmed that she and her sister hadn’t heard from their mother, Hotes called the Sun City West Posse, a local group that conducts wellness checks. The posse alerted people at the Maricopa County Sheriff's Office, who entered the house to find Pullman in her bed.
The house had no air conditioning, because it had no electricity. Pullman's body was already decomposing, the coroner’s report said. The medical examiner wrote that her death occurred by "environmental heat exposure in setting of significant cardiovascular disease."
People from the sheriff's office noticed signs of a cat, but Cocoa was nowhere to be found.
Smith said she believed her mother did not know that her electricity was about to be disconnected. If Pullman had known, she would have asked for help paying the bill, and her children would have freely given it, Smith said.
“We would’ve never let her power go out,” said Smith. “Never.”
Dr. Vjollca Berisha, senior epidemiologist with the Maricopa County Department of Public Health, calls heat “a silent killer.”
“You never know when it’s going to strike you,” she said. “You never know how much you can take.”
Heat is not destructive in the dramatic manner of a tornado or an earthquake. Nor is its damage as visible or as stunning. If an elderly person’s air conditioning breaks in the middle of July, who, from the outside, can tell?
The danger of heat is also the kind of complex problem that, by virtue of being everybody’s responsibility, somehow becomes no one’s responsibility.
“What can we do as a society?” Berisha mused. “As a society, we have to get organized.”
Community-based groups need to figure out how to target and reach people who need help, she said. “I know a lot of people are working on it, but they are working in silos,” Berisha added.
In 2015, the Department of Public Health took the lead on a coalition called Bridging Climate Change and Public Health, a collection of 28 different groups aimed at addressing climate-related health risks, including heat. So far, it has produced a strategic plan. Its long-term impact remains to be seen.
The group has no funding, Berisha said. “We are just operating based on goodwill and people who are really ready to donate their time,” she said.
Since the county began tracking heat-related deaths in 2006, the data, spread out annually, resemble a roller coaster that arches a little higher with each successive hill. In the last three years, the number of people in Maricopa County who died because of heat has exploded. In 2016, 154 died from heat-related causes. In 2017, that rose to 179.
Last year, 182 people died, in some way or another, because of the heat. Of those, 119 deaths were caused directly by the heat. In the remaining 63, heat was a contributing factor.
But whether heat is the direct cause or not, the data also shows that socioeconomic factors are equally powerful predictors of death by heat. People who are older, poorer, or isolated are at the greatest risk, county data shows.
In 2018, 35 percent of heat-related deaths were among homeless people. Heat-related deaths among Native Americans (4 out of every 100,000 people) is twice the rate of such deaths among whites (1.8 out of 100,000); the rate among African-Americans is also extremely high, at 2.8 people per 100,000. Both of these communities have higher rates of poverty than others, Berisha noted.
In Maricopa County, temperatures usually start to eclipse 100 degrees Fahrenheit in mid-May, maintaining that oven-like feel sometimes well into October. A typical summer will see 26 days with temperatures pushing past 110 degrees.
With climate change and urbanization, the heat in Maricopa County is worsening. State data shows that in the Phoenix area, average minimum nighttime temperatures rose by approximately 9 degrees from 1948 to 2000, with average daytime temperatures rising by about 5.5 degrees Fahrenheit.
As the county began analyzing the data it collected, something surprising came up. About 40 percent of the heat-related deaths were happening indoors.
“Initially, we thought whatever [death] is heat-related is associated with the outdoors,” Berisha said.
As they parsed medical examiner reports, death certificates, and hospital discharge and other public health statistics, they found that of the deaths indoors, 80 percent were because a person’s house, apartment, or condo was too hot, because air conditioning did not exist, or because it didn't work. In the remaining 20 percent, the air conditioning status was unknown.
In 12 percent of the cases with nonfunctional air conditioning, homes simply had no air conditioning, Berisha said, sitting at her desk and scrolling through the slides of a recent presentation she had given on heat-related deaths. Behind her was a bulletin board, tacked with printouts of graphs and charts on Maricopa County’s silent killer.
In the remaining 88 percent of cases, the air conditioning wasn’t functioning. The causes: no electricity (11 percent), AC turned off (28 percent), or broken AC (61 percent). Overall, 83 percent of indoor heat-related deaths happened in a home where the air-conditioning wasn't running.
Crunch the numbers, and a broken air conditioner, perhaps left unrepaired due to a lack of money, is a factor in 17 percent of all heat-related deaths. A shuttered air conditioner, perhaps turned off in an attempt to save money, is responsible for 7.8 percent. And a lack of electricity, perhaps because a utility disconnected a person over an unpaid bill, unpaid for lack of money, caused 3 percent of the total heat-related deaths.
After record heat-related deaths were seen in 2016, a group of local researchers, including Berisha and scientists at Arizona State University, analyzed a decade’s worth of data, trying to figure out why deaths had spiked. They discovered that high temperatures could not explain the surge.
“Our results indicate that factors other than the weather were predominantly responsible for the surge in heat-associated deaths in 2016,” they wrote. They couldn’t explain those factors but instead called for “further clarification of the complex iterations between the many social and physical determinants of risk of heat-related illness and death.”
“It seems like more and more people are not able to afford to keep the air conditioning on,” Berisha said. Utility companies need to cut people a break, especially during peak summer months, she said.
Stephanie Pullman moved to Arizona from Ohio in 1988, after her four children had graduated high school. She followed her best friend from high school out west, in part to escape the harsh Midwestern winters.
“We tried to get her to come home,” Smith said. “She loved Arizona. She loved the weather.”
In Arizona, Pullman continued working for a hospital in the dietary department, as she had when she was raising her kids in Ohio as a single mom. She loved Cocoa, the cat, and she adored her grandchildren, Smith said.
Pullman also loved to garden and kept flowers all around her two-bedroom, 1,100-square-foot house in Sun City West, Smith said. Bougainvillea grew in front, and she decorated outside her house with rocks, wind chimes, and figurines of the Native American deity Kokopelli.
One of Pullman’s favorite pastimes was visiting garage and yard sales. “We used to speed up whenever we saw one, so we didn’t have to stop,” Smith remembered with a chuckle.
Pullman retired in 2011, a month after she turned 65, switching to a fixed income. The Social Security check that arrived on the fourth of every month was less than $1,000, and her electric bill consumed a startling amount of that, according to Smith.
In the summer, “her utility bill would be pushing $200,” Smith said. Everything in the house ran on electricity, she added. “That’s what hurt her.”
Although her mother was “very independent, she asked for help when she needed it,” Smith said.
The last time Smith heard from her mother was on September 5, 2018. In an email, Pullman thanked her daughter for paying for repairs to her phone. It said, “The phone is fixed, thank you very much, love you, bye,” Smith recalled.
Her sister, Chris Hotes, had spoken to their mother by phone a day earlier. Pullman asked for help paying a water bill, and Hotes said she’d send money. She called her mother again on September 7 and left her a message telling her to keep an eye out for money in the mail.
The exact date Pullman died is unclear from the medical examiner’s report. Smith said their family never received a specific date of death.
From what she and Hotes could piece together from the respective bills they paid for their mother, it was sometime between September 7 and September 14. Pullman last used her phone and internet on September 7. A week later, the Sun City West posse called the sheriff's office to enter her home.
A medical examiner determined that Pullman died of cardiovascular disease, with heat and diabetes acting as “significant contributing factors,” according to the coroner’s report. It noted, too that APS had cut off electricity on September 7. It did not include the exact temperature in the house but mentioned that Pullman was found "in [an] uncooled residence during period of markedly elevated environmental temperatures."
Twelve days after the sheriff’s office discovered Pullman, Cocoa turned up. She had been hiding under the bed.
Smith took the cat home with her to Ohio. She started going through her mother’s paperwork, trying to find out what had happened, when she noticed the disconnection notice from APS. It was the only notification Smith found.
APS sent one shutoff warning to Stephanie Pullman, dated August 23, 2018. It gave her five days to pay her bill or lose power to her home.
“Dear STEPHANIE PULLMAN,” the letter read. “We value your business and are committed to keeping you informed about the status of your account.”
“Our records indicate your payment has not been received. Because of the delinquent status of your account, your service is scheduled for disconnection on August 28, 2018. You can avoid paying disconnection by paying $176.84 prior to that date,” it said.
If APS did end up disconnecting her electricity, and Pullman wanted to reconnect it, she would have to pay up to $135 in reconnect charges, the letter said. She'd also owe tax, perhaps a deposit, and all of her delinquent charges. That bill also tacked on new electricity charges totaling $155.90, for a total of $335.57 owed to APS.
It’s not clear why APS did not cut off Pullman’s service on August 28, as threatened, and instead terminated her service 10 days later.
Smith said that on September 5, Pullman paid $125 of the $176.84 APS demanded in order to avoid shutoff, leaving $51.84 unpaid. The $125 payment shows up, without a date, on Pullman’s final APS bill, dated September 14.
The final bill said Pullman still owed APS $287.86. That amount was a combination of her remaining balance and additional electricity charges, plus a $10.65 “field call charge” from September 5.
A field call charge is what APS charges customers in the process of turning off their electricity, according to a schedule filed by APS with the Arizona Corporation Commission in September 2017 and company terms and conditions.
It is incurred “when an authorized Company representative travels to the Customer's site to accept payment on a delinquent account, notify of service termination, make payment arrangements, or terminate the service,” the schedule explains.
Smith said she called the Arizona Corporation Commission, which called APS and told the utility to call Smith. “They did verify that Mom was $51 short, and that’s why they had shut it off,” she said.
“I told APS, ‘You ended my mom’s life for $51,’” Smith said. The person on the other end, who failed to comprehend that Smith’s mother was no longer alive, replied that if she was ever having trouble paying her bill, she could call and notify them, Smith said.
In October, she left a heart-wrenching review for APS on the website Consumer Affairs. She gave the utility one star; zero stars is not an option.
“It’s not like she didn’t pay anything,” Smith said. “She paid $125. She still had to eat. She still had to buy toilet paper. She had to pay her mortgage.”
The Arizona Administrative Code lays out when a utility can or cannot shut off service to a customer, but those rules offer few actual protections for people like Stephanie Pullman.
If a residential customer cannot pay a bill, a utility can’t cut off service if the customer can provide medical documents showing that “termination would be especially dangerous” to their health, the code says. The utility also can’t cut off service “where weather will be especially dangerous to health as defined or as determined by the [Corporation] Commission.”
How the Corporation Commission defines these vague circumstances — weather that “will be especially dangerous to health” — is unclear. The code doesn’t contain specific temperatures or dates.
The code also states that utilities can’t shut off residential service to “ill, elderly, or handicapped persons” who can’t pay their bills unless the customer “has been informed of the availability of funds from various government and social assistance agencies of which the utility is aware.”
From that carefully couched phrase, it’s not clear who is responsible for informing a customer “of the availability of funds.” Nor does the code provide clear definitions of “ill, elderly, or handicapped.”
At 72, Stephanie Pullman might have qualified as elderly. She also had heart disease and Type II diabetes, which might have qualified her as “ill.” But the only information APS sent her about paying her bill was a warning that she was about to be cut off.
A spokesperson for the Corporation Commission did not respond by deadline to Phoenix New Times' questions about how the Arizona Administrative Code is enforced and whether utilities ever face consequences of any kind for failing to follow the rules, however little protection they provide to real people.
Of the two major power providers in Maricopa County, the Corporation Commission regulates — and state code applies to — only one: APS. The other, Salt River Project, is a quasi-municipality and thus considered a political subdivision of the state.
Asked to provide a written policy of when it will or will not cut off a person's electricity, APS cited rules from the Arizona Administrative Code, including those described above. Jill Hanks, a spokesperson for the company, also said in an email, "APS does not disconnect service for non-payment on extreme heat days as determined by weather experts."
"We use multiple third-party weather services, including the National Weather Service, to alert us when weather conditions may be dangerous to a person's health," Hanks added. The conditions she provided as examples included temperature and consecutive days of heat, but they did not include specific figures or temperatures.
The National Weather Service issues excessive heat warnings, a regionally tailored advisory when heat is forecast to exceed local norms. The criteria vary considerably from place to place. In Maricopa County, the National Weather Service will issue an excessive heat warning when temperatures are predicted to eclipse 110 degrees Fahrenheit.
Which means that if the forecast says a high of 109, and a person's electricity is about to be terminated, there will be no excessive heat warning to — ironically — save them.
APS's terms and conditions on termination loop back to Arizona Administrative Code. "APS may, without liability for injury or damage, and without making a personal visit to the site, disconnect service to any Customer ... if Company has met the notice requirements established by the Arizona Corporation Commission." Nowhere in those terms and conditions are any exceptions for extreme weather.
This year, a bill at the Arizona Legislature sought to change that, by creating a law that would cover all utilities and protect people from shutoffs during extreme cold and heat. Its author, Stacey Champion, is a local activist who recently led a consumer complaint lodged at the Corporation Commission over excessive rate hikes by APS in 2017.
"Arizonans currently have no date- or temperature-based protection for utility shutoffs during extreme heat or cold, and this needs to be viewed as the public health crisis it is," Champion said. Especially in Maricopa County, air conditioning isn't a luxury, she said. "It is literally a matter of life or death."
Senate Bill 1542, sponsored by 15 Democratic state senators and representatives, would have barred utilities in Arizona from disconnecting service when outside temperatures were forecast to fall below 32 degrees Fahrenheit or exceed 90 degrees. It also stipulated that utilities had to make "reasonable payment arrangements" with a customer before cutting service; if the customer didn't honor that arrangement, then the utility could disconnect service only when temperatures were above 32 degrees or below 90, depending on the season.
It also would have unconditionally prohibited utilities from disconnecting service to a person or family if their household income fell below 200 percent of the federal poverty line and they made a minimum payment, or if an elderly person, pregnant person, child under the age of 5, or person on life support lived in the home. The bill also contained other stipulations aimed at protecting people with low incomes from being disconnected.
"Seniors on fixed incomes, folks with disabilities, pregnant women, those suffering from serious medical issues, and households with infants and young children especially need to be protected," Champion said. APS is not the only utility that is responsible for these cutoffs, she added.
Every summer, APS and SRP disconnect the electricity of tens of thousands of people living in the Valley of the Sun.
Data from SRP, which Champion obtained through a public records request and shared with New Times, show that from May through September 2018, SRP had 29,474 shutoffs. Records from SRP also showed that last year saw just 19 days when SRP did not disconnect residential customers “due to temperature.”
SRP spokesperson Scott Harelson said that SRP does not disconnect customers on days with excessive heat warnings.
In 2018, APS cut off power to customers more than 110,000 times, representing 79,872 unique accounts, according to the company's own data. Of those, more than 39,000 cutoffs took place during the particularly scorching months of May through September.
In response to questions about Pullman, Jenna Rowell, a spokesperson for APS, said that by law the company could not share anything about her account. She said that APS was required to send, at a minimum, one written shutoff warning to a customer, but that it typically went "beyond that" with a phone call and a door hanger. Depending on whether or not they can get through, they'll delay the disconnect date.
Smith said she found only the single written notice from APS, and no door hanger. It's not clear if APS called Pullman, whose phone was broken for a period prior to her death. Smith was adamant that if her mother had known her electricity was about to be cut off, she would have asked for help.
Rowell expressed "empathy for the family" and said that APS' "top concern was that [New Times] heard from somebody about a family member who died." APS would be reaching out Jeanine Smith to express condolences, she added.
Asked why APS would be doing that now, after Smith had already spoken with someone at APS shortly after her mother's death, Rowell acknowledged that Smith had filed an informal complaint at the Corporation Commission and that "we worked with her through that process."
“There’s nothing they can do or say to change it," she said. "I just want policy change.”
On Wednesday, APS began a temporary suspension of all disconnections for customers behind on their bills, so it could take a step back and re-examine its practices. The company planned to tell customers on Wednesday night and send out a media release shortly thereafter, Rowell said.
The company already had been looking at its shutoff procedures in situations with unpaid bills and extreme heat, but learning about Pullman "factored into our decision to put that [temporary suspension] into effect," Rowell said.
That temporary suspension is, for now, indefinite. As this story was going to publication, Phoenix was in the midst of its first extreme heat warning. APS spokesperson Jill Hanks said that due to the heat, the company was already holding off on disconnecting customers with unpaid bills this week.
Champion said the temperatures in her bill grew out of poring over medical examiner cases and noticing that people who lose air conditioning or electricity in their homes start to die when outdoor temperatures hit 90 degrees Fahrenheit.