Posts Tagged ‘Health and Human Services’

Sequestration and Our Mission

March 12th, 2013

No doubt the word “ Sequestration” is front and center in your vocabulary these days.  This is just a quick note to forecast how it might impact our mission.  For starters… the main impacts from federal sequestration (i.e. the federal budget reduction for some programs) will be related to the services that we provide and the planning that we do related to our federal cooperative agreements and grants.  The primary agencies that award us funding are within HHS (CMS, HRSA, CDC, SAMHSA) and USDA (WIC).  Not all federal programs are subject to the federal budget reduction that will go into effect shortly. 

For example, the behavioral health services that we provide via Medicaid are largely exempt from the reductions… but most of our cooperative agreements and federal grants are subject to the reductions. We receive a total of about $255M in federal funds that look like they’ll be subject to reductions for the remainder of this federal fiscal year.  WIC is the biggest chunk, at about $161M (or 63% of our total grant funds affected). 

How we manage these reductions will vary depending on how much flexibility the parent federal agency gives us.  As we make these decisions, we’ll consider grant variables…  like how much of the award we’ve spent so far this fiscal year and whether the grant is mainly service dollars or strategic planning etc.  For some programs we may be able to identify under-performing areas of the grant or agreement and focus our adjustments there.  

For example: Karen Sell’s WIC team has done a fair amount of planning already to mitigate the immediate and even mid-term impact…  like changing the food package starting July 1 (adopting less expensive brands) and identifying some current unspent funds.  We won’t need to put WIC applicants on a waiting list for at least a month…  but depending on how things go, we may need to start a list later in the year. 

I’ve asked the executive management team to work with each of the programs that look like they’ll be affected and start the planning process for making the reductions- focusing on identifying ways that we can make reductions that will minimize impacts in the field (like the way WIC will be moving to less expensive food brands).  Anyway…  stay tuned.  Things at the federal level look like they’re still in flux.  The more nimble and creative we are the better off our mission will be.

The Silent Breakthrough

November 26th, 2012

Until last week, influenza vaccine makers were limited to producing flu vaccines using a 40-year-old technology that depends on using fertilized chicken eggs to grow virus strains- meaning that it takes several months to make an influenza vaccine.  Makers needed to organize sterile egg supplies and incubate the virus in them before the vaccine could be made and delivered.  That’s why it took 6 months or so to develop the H1N1 vaccine during the 2009 pandemic.

Public health has known for a long time that relying on this 40-year-old egg-based technology poses a huge response and public health risk- especially if a severe pandemic strain were to break loose.  That’s why the US Department of Health & Human Services invested more than $1B in the development of a new cell-culture technology to develop the influenza vaccine.  A cell-culture technology will allow the public health system to make a brand-new influenza vaccine in a matter of weeks rather than months.

That investment paid off a couple of days ago- when the FDA  approved the first seasonal flu vaccine produced using cultured animal cells, instead of fertilized chicken eggs.  The vaccine is called Flucelvax and it’ll be available for people 18 and older.  The new vaccine isn’t in large scale production yet…  but it will be as soon as Novartis gets its manufacturing facility up and running.   

This breakthrough will also have another side benefit.  If you have an egg allergy and have always wanted to do the right thing for your community and get vaccinated for influenza, but couldn’t…  this new technology will allow your day to finally come.  Like I said…  it’s not widely available yet, but I’m sure it will be for next season. 

This new cell-culture technology will likely become the new standard for influenza vaccine production- and importantly- it adds an important layer of protection for pandemic readiness.

Implementing Our Strategic Plan- Prepare for and Respond to Public Health Emergencies

April 24th, 2012

Over the past several months our Public Health Emergency Preparedness team has been integrating 2 big federal disaster preparedness grants- the Public Health Emergency Preparedness program from the CDC and the Hospital Preparedness Program from HHS.  The initiative involves coordinating emergency planning between healthcare facilities, local public health departments, emergency management agencies, tribal partners and a whole slew of other stakeholders across the state.  

One innovative project involves a partnership between our preparedness program and the Arizona Statewide Independent Living Council.  We used federal hospital preparedness funds to buy durable medical equipment and supplies capable of supporting up to 1,000 people with disabilities in general population shelters.  Not only is it important to keep families together during a disaster, it’s a good idea to keep folks who aren’t having a medical emergency out of the healthcare system.  

Another key piece that bridges the gap between healthcare system and public health preparedness is the Arizona Emergency System for the Advanced Registration of Volunteer Professionals.  Our Volunteer Coordinator, Antonio Hernandez, has been working nonstop (in addition to his wellness ambassador duties) with public health and healthcare system stakeholders to prepare our state for all types of emergencies.  Thanks to Antonio for his enthusiasm and dedication.

Own your Own Health Data

September 12th, 2011

For years, you’ve heard that you should take your health care into your own hands  It may soon be easier – the federal Health and Human Services Secretary wants you to be able to access your electronic health care records. One key argument to give people access is if they know what is there, they will ask better questions or even make notes about problems in your file before meeting a health care professional.  If this happens, it could be really good for folks with chronic diseases like diabetes, heart disease or cancer.  Stay tuned – it takes awhile to get changes like this through the system.  In the meantime, you can follow the progress on Health IT

Public Health Law Resources

July 13th, 2011

Public health and the law are intertwined- and you can’t really be effective at developing public health policies and interventions without understanding how the law interfaces with public health.  We’re fortunate to have a fantastic local resource right here in Arizona.  The Public Health Law and Policy Program at the Sandra Day O’Connor College of Law Center for Law, Science & Innovation brings together scholars, practitioners, students, and others to focus on critical issues at the intersection of law, ethics, and the public’s health. They have a diverse group of faculty, scholars, fellows, and collaborative partners. 

 They leverage funds from the HHS and the Robert Wood Johnson Foundation to: 1) Conduct legal research and analysis in targeted areas relevant to public health through core projects on select public health law topics; 2) Work with international, federal, state, tribal, and local public health leaders to provide technical assistance on public health law and policy issues; 3) Develop innovative public health law tools and training/education materials; 4) Serve as an interactive resource for practical and scholarly information on public health law and ethics; and 5) Develop practice-based resources and other tools in public health preparedness and other topics. 

They’re putting together an October 6 event at ASU that will bring together leading public health officials, attorneys and practitioners across the 11 states of the Western Region of the Public Health Law Network to examine and discuss areas of law and policy.  Participants will have opportunities to provide their input on key public health law topics, build partnerships among colleagues across states and learn about core areas of legal technical assistance capacity.  You can check out more at their registration website.

The University of Washington has also posted an online training module on Practical Law for Public Health Officials. The objectives of this module include: recognizing legal issues; implementing effective strategies for working with legal counsel; and identifying key public health laws that govern leadership’s responsibilities, authority, and limitations. Click here to access the module.

Finally, the CDC has recently revamped their public health law resource website.  The site includes a variety of helpful public health law resources including opinions and statutes other states have provided or implemented.   The CDC Public Health Law News is another monthly e-mail digest of current, worldwide news stories, court opinions, announcements and special features related to public health law and legislation. The News is free and available to anyone with an interest in public health law.

Health Homes Planning Grant Approved

April 5th, 2011

Last week I wrote about how we and AHCCCS applied for a Health Homes Planning Grant from the US Dept. of Health & Human Services to improve the health status of folks with serious mental illnesses by improving case management, care coordination, health promotion, transitional care, individual and family support, referral to necessary services, and the use of health information technology.  HHS approved the grant request this week.  In the coming months, we will work closely with AHCCCS and our community stakeholders to plan for and pursue integrated health homes for the SMI population across the state.  By improving coordination of care and increasing access to primary care and prevention services, we expect to see meaningful improvements in quality of life and health status.  This is a very exciting opportunity that can result in significant health gains for a vulnerable population in Arizona.

Child Nutrition Act of 2010

December 20th, 2010

The Healthy, Hunger-Free Kids Act of 2010 became law this month.  This reauthorization of the federal school nutrition program includes a number of elements that will help move the needle on childhood obesity.  The Act recognizes the importance of school meals to the health and academic success of kids and gives school nutrition programs new responsibilities and resources to bring more fresh produce, whole grains and low-fat dairy products into school cafeterias.  More than 31 million school kids participate in the National School Lunch Program and 11 million qualify for the School Breakfast Program. Many children get ½ of their daily calories at schools,  making this program a great leverage point to improve nutrition for kids by placing more rigorous nutrition standards on the foods that are served in the program.

We were actually able to get elements of our childcare Empower Pack included in the new law.  When the Request For Information came out several months ago we turned in our Empower program as a best practice and it ended up being included in Section 222 of the Act.  That part of the law directs the Secretaries of Agriculture and Health and Human Services to develop programming that encourages state licensing agencies to include wellness criteria within state licensing standards to ensure that licensed and regulated child care centers and family child care homes provide physical activity opportunities, limit screen time and offer food consistent with the healthy meals patterns and nutrition standards.