May 24th, 2013 by Will Humble
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This week there were about 120 home-birth enthusiasts demonstrating in front of our building for about 3 hours. The crowd was expressing their unhappiness about our draft regulations for Licensed Midwives. You might have also seen the Arizona Republic article on the demonstration.
As I’ve written before, we started the process of revising the rules for Licensed Midwives about a year ago and we’re coming near the end of the process. My main goal has been to improve the entire system- including coordination with EMS and hospitals as well as data collection and analysis, oversight, and emergency planning… with the goal of ensuring (to the extent we can) the health and safety of moms and newborns.
Anyway- one of the issues the demonstrators were discussing is the administration of medications like oxygen and Pitocin by Licensed Midwives. The current rules outline several emergency measures to be performed before emergency personnel arrive in cases where the health of the mother or newborn is at risk. These rules outline guides for the administration of some medication (oxygen, Pitocin). The rules currently in effect require a Licensed Midwife to identify a physician that has agreed to provide back up, consultation, and a prescription for these medications.
Some in the midwifery community would like the ADHS to grant the authority for midwives to obtain and administer medications on their own (without consulting a physician)… however that would require a change in state law that I have no authority to make because it requires a statutory change. When I explained that I don’t have the authority to permit midwives to obtain and administer medications without consulting a physician, a member of the committee (a midwife) asked us to remove all references to medications. I’m inclined to keep the current medication rule language so at least these meds will be in scope (in consultation a physician).
Another provision that’s controversial in the current and proposed new rule asks women to take certain blood and urine tests as a condition of having a licensed midwife attend their homebirth. In the draft rules, there are a handful of tests that women need to take if she wants to have Licensed Midwifery services. These tests (HIV, Hepatitis B, blood glucose, and blood Rh factor) are the only way for the midwife to establish that the birth will be low risk and safe for the health of the newborn and mom. The mom-to-be can still refuse the tests, but that means she wouldn’t be able to have a Licensed Midwife present during the home-birth because it wouldn’t be possible to determine if the birth is low-risk and suitable for a home delivery.
The parties on the Advisory Committee still don’t agree on several points. Hopefully, the draft final rules for public comment that we publish next week will get the parties closer to at least grudging consensus. If there’s still gross disagreement about the final regulations, we could always just scrap the entire effort and keep using the existing scope of practice.
May 22nd, 2013 by Will Humble
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Our Lab just finished a major website makeover. Check out the new Laboratory landing page which will lead you to Newborn Screening, Microbiology, Chemistry, and Lab Licensure and Certification.
May 21st, 2013 by Will Humble
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Summer is almost here and the kids are wrapping up the school year. Let’s challenge families to end the school year on the right foot. Why not try walking or biking to school? The mornings are still nice enough to walk. Make it a family activity; role model healthy behavior, leave the car keys at home, and walk or bike as a family to drop your kids off at school. It’ll wake you up much more than a morning cup of coffee, and get your heart pumping and blood moving!
I’ve talked a lot recently about how where you live impacts your health. ADOT and ADHS teamed up to produce the Active School Neighborhood Checklist. This handy tool helps bring together teams (which might include public works, parents, teachers and health professionals) to assess routes to school and decide what major challenges exist for the students who wish to walk or bike. These teams provide a really great opportunity for bringing health into the conversation.
Research is really producing many new tools to assess the built environment and how that impacts health. An easy tool to use is WalkScore, where you simply input an address and get a score output on a scale of 0-100, with 100 being “Walker’s Paradise.” In fact, check out what ASU is doing to examine the relationship between Walk Score and urban housing.
May 17th, 2013 by Will Humble
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National Recreational Water Illness and Injury Prevention Week is coming up next week. Healthy swimming depends on paying attention to basic health, hygiene, sun-safety, and what swimmers bring into the pool (and what they don’t). For starters, remind your kids to take a sunscreen, hydration, and bathroom break every hour when swimming. You might also want to start the summer off right by getting your kids a UV protective swim shirt. After all… 90% of lifetime sun exposure happens before you’re 20- so you can have a big influence on your kid’s lifetime risk for skin cancer. And remember- there’s no substitute for adult supervision especially for rookie swimmers.
Hygiene tips include not swimming when you (or your kids) have diarrhea, reminding your kids not to swallow pool water, and practicing good hygiene (shower before swimming and wash your hands after changing diapers). And remember- little kids should have a swim diaper… and always change diapers in the bathroom or diaper-changing areas (not poolside). You can visit our Waterborne Disease site and a new CDC report about fecal contamination in pools to learn more.
This year we’ll be holding a healthy swimming video contest to build awareness of safe swimming. Kids can create a 2-minute healthy swimming video to help educate people about safe swimming including sun safety, staying hydrated while swimming, and preventing the spread of germs at pools, lakes, and water parks. The deadline for submission is June 16th and the website has the complete details and contest rules. The winning video will be used in a statewide water safety campaign. Last year’s winning video is up on YouTube.
May 15th, 2013 by Will Humble
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I’ve been writing quite a bit about population health and the importance of creating healthy environments for communities. Some of those innovations take creativity and cash to make them work. Help is on the way – today, the feds announced the Healthcare Innovation Awards – Round 2.
The Centers for Medicare and Medicaid Services put up $1 billion to entice better care and lower costs in healthcare. CMS will award money to projects that specifically improve comprehensive health and wellness; improve care for people with special needs; reduce the cost for patients on AHCCCS and in Medicare; and for providers to change financial and clinical models.
For example – a program that helps a population fight diabetes or one that helps integrate behavioral health care with primary care might be selected. Funds are available to non-profits, communities, healthcare providers, provider groups, faith-based organizations – almost every type of company, government or partnership.
Folks who are interested have to send in a Letter of Intent by June 28th. You can find out more on the CMS Frequently Asked Questions page.
May 15th, 2013 by Will Humble
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Now that Cory Nelson has officially been appointed as our Deputy Director for Behavioral Health, we’re moving full steam ahead to recruit for the Chief Executive Officer of the Arizona State Hospital. The CEO is a critical member of our team and has the responsibility of managing the day-to-day operations of the civil, forensic and sex offender units located on the campus. This is a great opportunity for someone interested in being part of some of the most exciting changes happening at the hospital in years.
Recently the hospital hit ten-month lows in the use of seclusion, restraint and patient falls… all as a result of new efforts that have been put in place to create culture change that engages patients and staff in the overall success of treatment. The focus on Recovery, Trauma Informed Care using evidenced-based are all coming into full swing and present opportunities to even further improve the lives of patients on the campus. Anyone interested in applying of for the position should submit an application through the State of AZ Jobs Site and look under the Department of Health in the agency section.