March 11th, 2014 by Will Humble
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We were served Wednesday with a lawsuit seeking declaratory and injunctive relief from our new Abortion Clinic Regulations that are scheduled to go into effect on April 1. The new regulations were in response to HB 2036, which was passed and signed during the 2012 legislative session… tasking us with several things related to the regulation of abortions. Among them was a requirement that we adopt new Rules for abortion clinics and outpatient treatment centers that provide abortion services. The statute was very prescriptive, so our Rules basically mirror the Law.
The primary complaint from Planned Parenthood of AZ, Inc. is centered around our upcoming requirement that any medication used to induce an abortion be administered in compliance with the FDA protocols as outlined in the printed label instructions (many clinicians currently use the medication “off label”).
The new regulations are scheduled to apply to the 4 abortion clinics (3 in Phoenix and 1 in Tucson) and 5 outpatient treatment clinics authorized to perform abortion services (2 in Phoenix, 1 in Glendale, 1 in Tempe, and 1 in Tucson) beginning April 1, 2014.
March 10th, 2014 by Will Humble
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Our Licensing & Rulemaking teams have spent the past two years working with numerous associations and stakeholders from various licensed facilities as part of our regulatory reform initiative. The last legislative session extended our “exempt” rulemaking authority through April of 2014. This gave us the unique opportunity to live with the new rules for a little while to find out what worked and what didn’t. Our integrated rules officially went into effect on October 1, 2013, but since then, we’ve been continuing to work on incorporating stakeholder and surveyor feedback into the 18 Articles of regulations for Healthcare Institutions and Court Ordered Program Approvals and ensure consistency throughout the packages.
Our teams have been busy going through the comments to develop the new draft Rules, which are now posted online for our final comment period. The drafts and comment surveys will remain up for the next 30 days, giving our team a chance to review and incorporate appropriate feedback before the rules become final in April. We’ll file the final rule packages on April 30, 2014 and have a July 1 implementation date on each of the packages. That’ll give our licensees a chance to learn the new rules and changes before they’re expected to comply with them, and it’ll give our surveyors time to learn the new rules so we can survey to them properly. It’s been a long road- and we’re in the (final) final-stretch now.
March 7th, 2014 by Will Humble
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March 1 was the kickoff of the new Arizona Farmers’ Market Nutrition season for women and children who participate in the AZ Women, Infants and Children program. WIC participants are beginning to receive their Farmers’ Market checks to spend for fresh, locally grown, fruits and vegetables at farmers’ markets.
WIC moms and their kids receive $30 worth of Arizona Farmers’ Market Nutrition Program checks to spend at an approved farmers’ market. Coconino, Maricopa, Pima, and Yavapai counties participate in the Program. This is an important part of our obesity prevention efforts and will help 10,000 WIC participants eat more fruits and vegetables this year. Check out what it is like to go to a market in the great videos on the WIC Farmers Market website. Be sure to check out the list of WIC Farmers’ Markets in AZ.
March 6th, 2014 by Will Humble
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Data collection and analysis is public health’s most valuable renewable resource- which is why we’ve made data analysis such a high priority. Yesterday, the Office of the Inspector General for HHS published a document that highlights the fact that disciplined data analyses can identify key factors that result in poor outcomes- giving us the information we need to intervene and improve results.
Yesterday’s report is entitled Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries, and it examines “adverse events” that occurred in skilled nursing facilities nationwide between 2008 and 2012. “Adverse events” are basically events related to medication, ongoing resident care, or infections.
The study found that about 22% (of Medicare beneficiaries) had an “adverse event” while at a skilled nursing facility. Of course, not all of these were preventable, but the study found that almost 60% of the adverse (and temporary harm) events were preventable. The report attributes much of the preventable harm to substandard treatment, inadequate resident monitoring, or a delay in administering necessary care.
Part of our core mission as an agency is to protect public health and safety by addressing quality of care issues in our licensed healthcare institutions. As part of that mission, we license and inspect 147 skilled nursing facilities statewide. The facilities range in size from as few as 10 to as many as 200 patients.
Today’s study will be a valuable as a tool for us because it’ll help us focus our inspections and facility surveys on areas where we can have the biggest impact on improving care and outcomes. Over the coming weeks, our skilled nursing survey team will be diving into the details of the report so we can become more familiar with the areas that we should focus on while we’re in the field- including updating our focused reviews of nursing home practices to identify and reduce adverse events.
Additionally, the Affordable Care Act requires nursing homes to develop Quality Assurance and Performance Improvement (QAPI) programs to address quality problems and improve facility performance. Our survey teams will be including an assessment of adverse event identification and reduction in our evaluations of Arizona’s skilled nursing facilities QAPI plans with a focus on the elements of care identified in today’s report.
March 5th, 2014 by Will Humble
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Have you ever wondered — Why do people get sick? How can we prevent the spread of disease? What do doctors REALLY do? If so, the U of A College of Medicine in Phoenix has a summer program for you!
Be a part of Med-Start Phoenix, a two-week day program with a fast paced curriculum sure to help confirm your healthcare interest. The Program is designed to inspire Arizona high school students to explore their existing interest in the health professions. Each of the three Med-Start Phoenix summer sessions include hands-on activities, field trips, community service projects, simulation and related lab experiences, culminating projects and lectures from medical students, faculty and community members.
The unique sessions will highlight three healthcare themes: Scientific Research, Arizona’s Healthcare Needs and the Healthcare Team. There are separate sessions for current 9th and 10th grade and 11th and 12th grade students. Applications are electronic and are due March 15. There are limited slots, so interested students better get on the stick.
March 5th, 2014 by Will Humble
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The latest CDC obesity data published in this week’s Journal of the American Medical Association found a significant decline in obesity among kids aged 2 to 5. Obesity prevalence for this age group declined by 43% in the last 8 years (from 14% in 2004 to 8% in 2012. While the precise reasons for the decline in obesity aren’t clear, many child care centers have started to improve their nutrition and physical activity standards over the past few years (like our (EMPOWER Program). In addition, CDCs data shows a decrease in consumption of sugar-sweetened beverages among kids in recent years. Another possible factor might be the improvement in breastfeeding rates- which helps stave off obesity.
March 4th, 2014 by Will Humble
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Our Licensing team promotes and protects public health and safety by addressing quality of care issues. Last week we hosted a forum for our licensed midwives to learn more about our programs and resources to bring them up to speed on our newest initiatives related to maternal and child health so they’ll have the latest tools in their practice toolkit. About 50% of our licensed professional midwives attended.
The Bureau of Special Licensing’s Don Gibson took the lead and coordinated presentations on various topics related to maternal and fetal health. Vital Records presented on how to file a birth certificate, time-frames, and birth data. Our Birth Defects Program shared data and resources on the prevalence of various asymptomatic congenital conditions. Newborn Screening covered the various statutory requirements that all newborn children and families are required to be counseled on, and our Immunization Program, Breastfeeding Program, Nutrition and Physical Activity, and Women’s and Children’s Health shared a host of free resources, 24-hour hotlines, and best practices.
Claudia Montes presented an updated online reporting form. Special thanks to the presenters: Bianca Soto, Dianna Contreras, Sondi Aponte, Gidget Carle, Fran Altmaier, Dana Goodloe, Anne Whitmire, Mary Ellen Cunningham, Claudia Montes, and Don Gibson.
March 3rd, 2014 by Will Humble
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Maybe you heard news reports this week about kids in California with a “polio-like syndrome.” Here’s a synopsis: Over the last 18 months, 5 kids have been identified by California’s Department of Public Health with a paralysis in one or more limbs. Multiple tests have been run on them. Poliovirus wasn’t found, but enterovirus-68 was isolated in 2 of the cases. There are hundreds of enteroviruses (poliovirus is one of them). Enterovirus-68 was first isolated back in the 1960s, but it usually causes cold-like symptoms instead of a paralysis. CA continues to run studies to determine if enterovirus-68 is the true cause of this exceedingly rare paralysis syndrome.
There aren’t any documented cases of enterovirus-68 causing paralysis in Arizona, but we’re continuing to monitor the situation closely. Other enteroviruses are commonly seen here, causing “summer colds” and mild respiratory illnesses. To prevent catching an enterovirus, you should wash your hands and keep sick children away from others. There’s no vaccine for enterovirus-68, although there is for polio. All kids should receive the polio vaccine to prevent its recurrence in this country.
March 1st, 2014 by Will Humble
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There’s widespread agreement within the public health community that the percentage of women who deliver by Cesarean Section these days is too high. In fact, 1/3 of women in the US have cesarean deliveries these days (up from 9.5% in 1990 and 23% in 2008).
Last week the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine collaborated to produce an Obstetric Care Consensus document entitled Safe Prevention of the Primary Cesarean Delivery, which provides new research analyses and interpretation to help “…health care providers to understand the short-term and long-term tradeoffs between cesarean and vaginal delivery, as well as the safe and appropriate opportunities to prevent overuse of cesarean delivery, particularly primary cesarean delivery.” The consensus seems to be that it’s safe to let someone labor longer than had been previously recommended.
When we amended our regulations that govern the practice of licensed professional midwives in AZ, we allowed for the new guidelines that we hoped were coming out. This long awaited document will provide clinicians and our licensed midwives with evidence-based information they can use to help more of their patients have a successful vaginal delivery.
February 28th, 2014 by Will Humble
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Tomorrow Rural/Metro will hold two events in the East Valley to help parents make sure they have the right seat for their kids and the seats are properly installed. They will also collect gently used and new car seats so the state can donate them to families in need in Mexico. Rural/Metro is a partner in our child safety seat program that was established as cooperative partnership at the Arizona-Mexico Commission last summer. All child safety seats donated by Arizonans for transfer to Sonora will be inspected using the Used Car Seat Check List.
The safety seat checks are from 9 a.m. to 2 p.m. Saturday at the Fountain Hills Fire Station 1, 16426 E. Palisades, and Wal-Mart, 1725 W. Hunt Highway, San Tan Valley.
If you can’t attend this weekend’s events, you can always drop off car seats you no longer need at several Rural/Metro locations around the state, at the Department of Health Services building in Phoenix, 150 N. 18th Avenue, and at Courtesy Chevrolet, located at1233 East Camelback Road, through March 17. For more information, visit A Safe Ride Home .