As part of my job as the Director, I’m a member of the U.S.-Mexico Border Health Commission, whose mission is to provide international leadership to optimize health along the U.S.-México border.  The Commission is comprised of the federal secretaries of health, the lead health officers of the ten border states, and prominent community health professionals from both nations. As a member, I help to educate folks (including policy-makers) about the unique challenges at the border through outreach efforts and conduct joint collaborative public health initiatives with public and private partners in the border health community.  The primary goal of the Arizona Delegation is to strengthen and support bi-national public health projects and programs along the Arizona-Sonora border.   

I was fortunate to be able to spend this week in DC at the US Section meeting of the U.S.-Mexico Border Health Commission.  We had the opportunity to talk about the Commission’s role as the Affordable Care Act comes online, including the importance of access to care and what role community health workers will play.  We also talked about setting priorities for the next three years.

Title V programs are a little different than the other funding.  We get the money through Block Grants.  Each state decides its own priorities based on the needs of that state.  In Arizona we choose our priorities by asking you what we need to improve in the next 5 years.  Not too long ago, we completed the process and set the priorities for maternal and child health including reducing teen pregnancy, reducing the rate of injuries in our state and reducing obesity.  You can read the whole list online, but there are many that overlap with our strategic map.  Setting priorities for the block grant is an ongoing process and we are working on the next block grant application right now.  We’d love to hear your comments.

In March we turned in our Interim Compensation Plan which was later approved by ADOA. Since that time, our team of HR staff and management in each division have identified folks who are candidates for the awards. You know it takes every one of us to make this place hum….  and as I reviewed the justifications for the 20% of us who received some level of award, I realized what an amazing team we have. 

If you’re one of the recognized employees, you’ll receive a letter next week from your division management, and a  financial award will appear in your paycheck the last week of June.  If you received meritorious leave, an extra 8 hours will be available to you to use during the next year.  We made a real effort to make sure we were recognizing folks at all levels of our organization.

Depending on what happens with the state budget negotiations, the program could continue.  If this part of personnel reform is included in the signed budget, we’ll be writing a new plan for the next evaluation period (September, 2013 – June, 2014)…  which will include numerous compensation options. One example is a goal-based incentive.   A team or individual may be eligible if they complete a difficult and challenging project and meet all the deliverables.  Remember, these compensation strategies are in addition to merit pay that will be earned by employees who are evaluated (by their supervisors using the MAP system) among the top of their peers.  You can read more about all of the available options at the ADOA website on Compensation Strategies. 

Thanks again for what you bring to the table each and every day. I encourage you to work closely with your supervisor to understand the expectations of your position, and what it takes to be recognized as an exemplary employee. Celebrate your accomplishments and those of others. Together we make an incredible team!

If you’re 50 or older or at higher risk, make a pledge to yourself and your family get checked for prostate and colorectal cancer. Men’s Health Week is the perfect opportunity to schedule an appointment.   

Stress also leads to health problems in men, including depression.  If you’re suffering from depression, it’s harder to be physically active and eat well. Sometimes a chat with a professional can put you back on track or a doctor may prescribe medication to help put your life back in balance. Most employers offer an Employee Assistance Program that will offer free or low cost access to a mental health professional.  The parity law also makes your regular health insurance provide access to mental health care. 

If you’re still smoking, stop.  Every puff of a cigarette or cigar takes time off your life. Nicotine is a highly addictive substance – quitting isn’t easy, but it’s not impossible. If you need help, call the ASHLine at 1-800-556-6222. 

Finally, consider getting a physical this year to identify hidden health conditions.  If you don’t do it for yourself, do it for your family.

We know physical activity has health benefits for kids, and for all of us. We don’t often realize the academic benefits of physical activity. Studies show when students are physically active they have improved classroom behavior, improved attention span, and increased attendance at school. You can read more about this in a past blog I wrote.  Also, take a look at these tips on being more physically active and how to eat healthier meals.

The regulations outline standards what they call “health-contingent wellness programs” which basically reward employees who meet a specific standard related to their health.  For example…  worksite wellness programs could provide a reward to folks who don’t smoke (or that decrease their use of tobacco).  Employers can also reward those who achieve a health-related goal like a specified cholesterol level, weight, or body mass index. 

The rules also include what they call “participatory wellness programs”.  These are programs that reimburse for the cost of membership at a gym, that provide a reward to employees for attending health education seminars or that reward employees who complete a health risk assessment.  The final rules will be effective for health “plan years” beginning on or after Jan. 1, 2014.  Here’s the link to the “inside baseball” regulations in the Federal Register.

More and more businesses are creating stronger worksite wellness programs.  Arizona, for example, has a great benefit in place for state employees who smoke. Anyone interested in quitting can receive one of the 7 approved nicotine replacement therapies and behavioral counseling for free. Since our state employee health plan was selected as the benchmark plan for the Exchange under the Affordable Care Act… more and more Arizonans will eventually have the same opportunity for those resources to kick the habit.  Also, many businesses in AZ have been putting a focus on worksite wellness and have linked up with the ASHLine.   A few businesses have taken it so far as to not hire smokers at all. 

Research studies, and corporate wellness initiatives have shown that worksite wellness programs are a good benefit for employees and employers.  Those programs can significantly reduce employer costs and improve employee health. Healthier employees are more likely to stay in their jobs, less likely to be absent, take fewer breaks, and have lower health care costs.

• The teen pregnancy rate decreased by 33% in the last 5 years. 
• Infant mortality rates was the lowest in the State’s history.
• Car crash deaths increased 11% last year.
• The number of suicides was the highest ever recorded in State’s history (1,113). 

Our public health statistics team also went live with our new AZ Hospital Compare website this week, which (for the first time) provides an online searchable database to help Arizonans make educated decisions about their healthcare. The new website will allow patients and their families to explore the care and outcomes, costs and charges of Arizona’s licensed hospitals.  The transparency that the site provides will no doubt improve hospital performance as well.  I have a feeling that AZ Hospital Compare may eventually rival our “Big Book” as our most popular report.

Poisoning also caused more than 6,900 hospitalizations and more than 12,500 ER visits in 2011. In addition to the human toll these deaths and hospitalizations have on Arizona families, poisonings also carry a financial burden. According to the report, hospital charges for non-fatal poisoning-related inpatient hospitalizations totaled more than $127M and Arizona residents spent a total of 13,822 days hospitalized for these injuries. 

It’s no surprise that the leading cause for poisoning deaths in the state come from easily accessible things like alcohol and prescription drugs. The report shows that the most common causes of poisoning deaths were alcohol, Oxycodone or Hydrocodone, and heroin. At least these deaths are preventable- and we’re working together with our partners in the community to reduce these deaths. 

One project we’re working on is the new Arizona Prescribing Guidelines for Emergency Rooms. The guidelines were developed with several community partners and are intended help ERs establish standard practices for prescribing pain medication. Pain medication is an important tool when it used for medical treatment, but it’s deadly when abused. The guidelines will help medical providers reduce the amount of pain medication in the community, and reduce the access to these drugs to people who may abuse them and suffer from an accidental poisonings.