Posts Tagged ‘vital records’

Our Most Popular ADHS Website

February 14th, 2013

Guess which one of our ADHS Websites consistently has the most hits.  Our influenza pages during flu season?  Medical marijuana during our rulemaking?  Questions about WIC eligibility?  Nope.  It’s our Genealogy website.  The site has had more than 5,100,000 queries in the last 2 years.

Our Vital Records team has been keeping data on birth and death certificates since 1855.  A few years ago, our easy to use Genealogy website was put together so folks can do research on their family history.   The data on the site includes AZ births before 1938 and deaths before 1963.  The public records statute says that birth certificates need to be at least 75 years old and death certificates 50 years ago in order to be loaded on the site.  The information was extracted from photo reproductions of the original certificates by volunteers from the Mesa Regional Family History Center.

We don’t have a budget top maintain the site… but we recently put up a feature so that folks can donate funds to the ADHS Public Genealogy Website for future enhancements.

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New Electronic Birth Certificate ‘Round the Corner

December 26th, 2012

Our Vital Records shop does a lot more than manage the State’s birth and death certificate system (which we’ve been doing since 1885).  We’re also an integral part of the Nation’s Vital Statistics System, which serves as the backbone of national data sharing in public health. The data collected under the National Vital Statistics System works in partnership with the National Center for Health Statistics to produce critical information on public health topics like teenage births and birth rates, prenatal care and birth weight, risk factors for adverse pregnancy outcomes, infant mortality rates, leading causes of death, and life expectancy.  All these data are retrieved from the nation’s network of Vital Records shops like ours. 

There have been two birth certificate standards that the states are currently following – the 1989 and the 2003 standard. We’ve been one of the states that had been following the 1989 standard- but not anymore.  Beginning the first week in January, we’ll be turning the key on the new 2003 Standard.  The new Electronic Birth Registration System that we’ll be using will collect a lot more public health surveillance data.  It’s also an electronic system- which will make things much faster and efficient.  The new system will have impacts all throughout our Strategic Plan.  Here are a couple examples: 

  • A1 – Reduce Obesity – The former 1989 standard had zero data on the mother’s height and weight- meaning we couldn’t calculate the mom’s BMI.  Starting next week, we’ll be able to collect this data- which will give us better surveillance- and in turn, help us identify more targeted public health interventions- helping us to make progress in reducing critical risk factors for poor maternal and child health outcomes.
  • A2 – Reduce Tobacco Use and Substance Abuse –  The old system only captured generic measures about maternal smoking during pregnancy.  The new system will have specific cigarette smoking data before and during pregnancy- providing rich data for prevention activities- helping us to improve birth outcomes. 

Other important data elements include information on breastfeeding, whether mother received food during pregnancy from the WIC program (helping us to better evaluate our WIC program), critical medical data elements like congenital anomalies, and fertility treatments (Assisted Reproductive Technology)…  all of which provide newer opportunities for prevention.  The public health applications that the new system will provide are too long to list in a short blog like this… but they’re substantial- believe me.  We’re even going to be able to incorporate the data we’ll be collecting in the new system into our new Midwife rules. 

From a customer service perspective, the new system has improved security for fraud prevention and will provide speedier transactions for printing birth certificates at the county level.  Thanks to all the IT and vital records team that put in the endless hours to make this new application possible.

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New Laws Related to our Mission

April 25th, 2011

The Legislature completed the Regular Session last week.  They’ve passed numerous bills.  The Governor has signed many of them, but some are still waiting for her consideration and signature.  Below are the new laws that have been signed by the Governor that are related to our mission:

  • HB 2585: Controlled Substances; Marijuana; Monitoring

This law requires the ADHS to share our list of current Medical Marijuana Registration Cardholders with the Arizona Board of Pharmacy’s Controlled Substances Prescription Monitoring Program database.  The Board will then add the data to their monitoring database, which includes data regarding the other controlled substances.  It would allow doctors (who are considering prescribing patients medication) to check if the patient is a medical marijuana registration card-holder.  The idea is to help doctors determine the best course of treatment for patients.  It basically would treat medical marijuana just like all the other controlled substances by including the information in the Pharmacy Board’s database.

This new law will allow baked food (not that’s not considered “potentially hazardous” as defined by our rules) to be prepared in a home kitchen and sold for commercial purposes beginning July 20.  It’ll provide self-employment opportunities to folks that might not otherwise be able to find work, and for supplemental income for others.  For example, the more than 900 or so group homes for folks that have developmental or intellectual disabilities would be able to start up a home cottage industry like a small oatmeal cookie business and sell their food to local grocers.  We’ll be helping to facilitate the use of healthy recipes as part of the program as well as set up an electronic registration database that we can use to communicate electronically with participants.

  • HB 2213: Intellectually Disabled Terminology

This bill was long overdue in Arizona.  The bill replaces the “the R-word” in state statutes with more appropriate terms.  A special shout-out to Special Olympics Arizona for making this happen.

The bill charges us with establishing rules and protocols to coordinate a state-wide stroke system of care.  We’ve already established some stroke centers in AZ and we’ll be developing various rules and protocols regarding the transportation of patients to hospitals based on several criteria.  These protocols help transport patients to the closest appropriate hospital for treatment based on the severity of the injuries.  Currently, there are no stroke specific guidelines for suspected stroke victims.

  • HB 2634: Health Care Institutions

This legislation will help kick off a serious effort at ADHS to better integrate behavioral health and primary care for patients by giving us exempt rulemaking authority (until July of 2013) to change our licensing rules (exempt rulemaking is the “diamond lane” for rules).  The bill directs ADHS to revise rules to reduce regulatory and monetary burdens and to facilitate the integration of healthcare.

  • SB 1248: Dual Licensure for Hospitals

This is another helpful law that will streamline our rules by enhancing integrated care by reducing the licensing burden on health care institutions. Right now, hospitals that provide psychiatric services need 2 licenses.  After we’re done revising our rules they’ll only need 1 license.

This new law expands the definition of abortion to include “any means,” among other changes to statute.  ADHS will now license about 12 additional abortion clinics as a result of the definition change.  These 12 clinics are already licensed as outpatient treatment clinics- so our job will be to ensure that they also comply with our abortion clinic rules.

  • SB 1025: Arizona State Hospital Fingerprinting Requirements

This new law prohibits people that have been convicted of certain criminal offenses from working at the AZ State Hospital. It also requires that all ASH employees and volunteers get a “Level 1” fingerprint clearance card in order to ensure compliance with the new restrictions.  The list of offenses that make an employee or volunteer ineligible are located in ARS 41-1758.07.  The new law states, “A state hospital employee or volunteer must have a valid fingerprint clearance card issued pursuant to section 41-1758.07 OR must apply for a fingerprint clearance card within seven working days after beginning employment or performing volunteer work.”  Level 1 Clearance Cards are good for 6 years. DPS routinely runs cardholders through their database to check for new convictions, and we’re automatically notified when there’s a conviction of one of the disqualifying offenses.

We’ll need to move quickly because the new law takes effect at the end of July.  We’ll be hiring a vendor to collect the fingerprints while our team is at work.  We’re also working a way to pay for collecting and running the prints so there won’t be an out-of-pocket expense.

  • Budget Highlights: SB1612: General Appropriations; SB1614: State Budget Procedures; SB1615: Consolidation of State Agencies; SB1616: Budget Reconciliation; SB1619: Health Budget Reconciliation

I won’t go into the details for these- but here are the basics:

1.     Mandatory furloughs are eliminated in 2011 and 2012.  Agencies can still use them to meet budget requirements.

2.     Employee/Employer retirement contribution rates go to 53%/47% from the current 50:50.

3.     The Arizona Biomedical Disease Research Commission will be transferred to the ADHS.

4.     Children’s Rehabilitation Services (CRS) is officially transferred to AHCCCS.

5.     Vital Records will become self-funded.

6.     County contributions for residents of the Sexually Violent Persons unit at the Hospital increases to 50% from the current 25%.

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Death Certificates In-House Now

March 31st, 2011

Lots of people know that our Office of Vital Records is the statewide data hub for birth certificates, but we’re also in charge of death certificates.  The program we use for death certificates is called the “Vital Statistics Information Management System”. The system used to be supported by a contractor in Utah, but no more.  We set a goal a couple of years ago to bring the system in-house, and we achieved our goal this month, as a result of careful planning and elbow grease.  For the past 5 months our IT and vital records teams have been testing and addressing several issues related to this migration. The extra time and effort IT staff have put in were certainly commendable & worthwhile especially for an application of this magnitude and technical challenges.

Thanks to our team members that made this happen including Raghu Ramaswamy, Mike Harris, Bianca Soto, Ellen Rayer, Mike Shaw, Michael Conklin, Dough Leach, Erik Kleist, Deborah Heemstra and James Reid. In addition, we also appreciate the support & contribution from the IT contractor Lee Collins, Gold Systems staff, Mark Wolinski (Accordex), & Bao Huynh (SSA).  Nice.  I love being in control of our own destiny.

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Next Fiscal Year’s Budget Series – pt 2

January 25th, 2011

On January 15, 2011, the Governor released her proposed budget for next fiscal year, which begins July 1, 2011. Our part of the budget in the link above is on pages 105 through 111.  You kinda need to be a budgeteer to understand some of it, so I’ll try to distill it down a little in several posts this week.

Behavioral Health Provider Reimbursement Reduction

Beginning on April 1, 2011, we’ll be reducing the amount that we reimburse our providers of behavioral health services by 5%.  We won’t be reducing our payments for some things like prescription drug costs or inpatient treatment, so the overall reduction will be about 3%.  We plan on continuing that same reduction through next fiscal year, so the Governor’s proposed budget reduces our budget by about $14M as a result of those savings.

Vital Records Self-Funding

The Governor’s proposed budget also recommends that we begin self-funding Vital Records (like we did our Licensing programs last year).  Our Vital Records general fund budget would be reduced by $1.2M, but we would be allowed to increase our fees to $19 for the birth and death certificates that we sell at our shop and we’d be able to charge the counties a $4 surcharge on the certificates that they sell (they use our database for their Vital records system).

We’d be able to keep most of the money that we collect, which will allow us to pay for our staff and invest in our computerized vital records system, including Internet‐based death registry and an internet‐based birth registry as well. Our current system is largely out of date because the software we use is no longer supported by the developer.  We’d be able to use up to $3.6M of our new revenue to update and maintain the Vital Records System and anything we collect after that would be deposited into the state’s General Fund.

There are several benefits to self‐funding Vital Records. In addition to saving over $1.2 million General Fund each year, we’d generate additional revenues to the General Fund of approximately $400K per year.  Most importantly, we’d be able to upgrade our system software/hardware and meet new standards for getting federal grants. Finally, the system will become more centralized, allowing clients to access records with more timeliness and accuracy.

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All Systems Go for Friday

December 10th, 2010

Our preparation for the implementation of the AZ Medical Marijuana Act is on track.  We’ve made a great deal of progress on all fronts over the last couple of weeks.  The informal draft of the Administrative Code that we’ll release next Friday is really starting to gel.  We’ve got the key elements hammered out and our Rules team will be doing the cross matching with the initiative as well as the internal rule indexing over the coming week.  Once our Medical Officers team reviews the draft rule next Wednesday, I’ll check out their recommendations and we’ll put the finishing touches on the informal draft Rule.

IT has made tremendous progress on the “front end” of the database for the qualified patient and caregiver electronic application.  They’ve started work on the “back end” and relational pieces.  Our Webmaster and Marketing Committee helped polish the website for next Friday when you’ll see our re-vamped website including FAQs for the general public and Stakeholders.  Out IT team has also finished development of the electronic tool that we’ll use to solicit electronic comments from the public from December 17 through January 7.

Vital Records and Environmental Health have begun developing workflow templates and resource needs assessments.  Procurement and finance have done some background work on their pieces too.  Communications has begun writing the media release for next Friday and is putting the finishing touches on the FAQ for the general public that we’ll post next Friday.

All in all, it’s been a very productive couple of weeks.  Thanks for stepping up everyone!

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Are Medical Marijuana Cards a Vital Record?

September 24th, 2010

Maybe. I’ve read the Arizona Medical Marijuana Act several times with an eye toward how we’d execute it’s requirements in case it passes.  One of the key decisions is figuring our which of our areas is in the best position to get the job done.  I think the best place is Vital Records- at least for issuing the cards.  Why?  Because their business operations, work flow, verification policies, and their cash management systems most closely match the business requirements in 203 for processing medical marijuana cards.  They’ve also demonstrated that they can handle high volume and more than a dozen different kinds of vital records.  For example, they sold 93,662 birth certificates and 13,867 death certificates last fiscal year, all while ensuring that each sale met very specific criteria.  All of which will be critical when issuing medical marijuana cards given that fact that we could be issuing 100,000 cards/year by 2013.

Vital Records would most likely be issuing the cards (if it passes), but our IT , Rules, and Procurement Teams (with help from our Attorney General team) will be absolutely critical in order to hit the ground running.  We’d only have 120 days to get the program going, which means that we’ll need rock-solid rules (Administrative Code) and a completely functioning (and paperless) IT system on day one in order to manage the workflow by the end of March.

If Prop 203 passes, the only way we could possibly handle the workload is to make the application process completely electronic from beginning to end. If we do it right, we may be able to do it almost all on-line and without window service.

P.S. I haven’t figured out who’s in the best position to regulate the dispensaries yet, but Environmental Health’s in the lead.

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ADHS Status

July 21st, 2010

We’ve got a lot to be proud of over the last year and an half.  It’s been hard, I know because of all of the budget reductions and the lower staffing level.  On the other hand, we’ve got an incredible mission and we’re doing a good job.  I often tell people that we work in the most interesting agency in state government.  Why?  Because we touch the lives of Arizonans in dozens of different ways everyday.  We:

 

  • Make sure that Arizonans are healthy and protected from infectious diseases like the flu and foodborne illnesses- and prevent diseases in the first place through our Vaccine for Children Program  

 

  • Provide families with young kids access to nutritious blend of foods www.azwic.gov.

 

  • Make sure that the kids at Child Care facilities are safe and sound and that they get some exercise thanks to our Empower Pack program.

 

 

  • Help save lives by doing things like developing Cardiac Arrest Centers and Primary Stroke
    Centers across the state that are dramatically improving outcomes for folks that have a cardiac arrest or a stroke and are leading the national shift to continuous chest compression CPR from the old compression/breathing method .

 

  • Are building a new Trauma System from the ground up- which saves lives every day.

 

  • Are leading the state’s anti tobacco efforts like the prevention activities in our youth tobacco campaign (called Venomocity)  and helping thousands of Arizonan’s Kick the Habit through our www.ashline.com services.

 

  • Are improving the performance of the state’s mental health system by giving choice and voice to folks with mental health and substance abuse needs- improving their ability to better participate in their path to Recovery from  Mental illnesses.  Over this past year, we have developed the new Nine Adult Guiding Principles to compliment our Children’s 12 Principles. We developed an RFP, went out for bid, and issued awards for all Geographic Service Areas outside of Maricopa County. We also planned for and implemented the most severe budget reductions in the behavioral health system in Arizona’s history.

 

  • Make a difference in hundreds of peoples lives at the Arizona State Hospital-  by helping them in their road to recovery by treating them with dignity, care and respect.

 

  • Run one of the state’s most well respected public health laboratories- providing the backbone for Arizona’s public health system.  For example, we find hundreds of kids with metabolic disorders and hearing and helped their doctors conduct interventions to help them avoid serious complications from their condition through our newborn screening program. 

 

  • Administer the Office of Children with Special Healthcare Needs (OCSHCN) program, which includes the Children’s Rehabilitative Services (CRS) program.  CRS provides family-centered medical treatment, rehabilitation, and related support services for children under age 21 with qualifying chronic and disabling conditions such as congenital heart disease,  neuromuscular conditions, spina bifida, cleft lip, cerebral palsy, and many others.

 

  • Test 1000s of biological samples for all kinds of viruses and bacteria including H1N1, tuberculosis, West Nile virus, rabies, and literally dozens of other diseases so that counties and doctors can help slow the spread of disease and help people get better in our Public Health Microbiology program.

 

 

  • Ensure that hundreds of clinical and environmental laboratories across the state are doing things right and providing good results through our Laboratory Licensure & Certification program.

 

 

And that’s just a fraction of the incredibly interesting and important things that we do.  Do you have any doubt now that this is the most fascinating place to work in state government?

 

We’re successful at all of these things because of your commitment to the folks of Arizona and to each other.  It takes a wide range of help from everyone including our IT, Human Resources, Rules, Procurement, Auditing, Financial Services and other Operations Teams to make these things happen.

 

Thank you all for rowing in the same direction.  I really appreciate your can-do attitude.  Thanks…  and make sure that you take the time to thank the folks around you from operations that make this place tick.

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New ADHS Chief Medical Officer

July 14th, 2010

I’m happy to announce that Laura Nelson, M.D. will be taking on some additional responsibilities in her expanded role as the ADHS’ Chief Medical Officer.  She will continue in her role as the Deputy Director for Behavioral Health Services as well (notice the “Acting” label is gone now).  As is the case with many of you over the last year, she’s willing to take on these additional responsibilities without asking for a salary increase.

The role of Chief Medical Officer was previously handled by a Medical Committee which hasn’t been operational for some time.  I decided we needed to have a medical chief for a few reasons, including our new requirements in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and the recent adoption of the Patient Protection and Affordable Care Act (health care reform).

She’ll be contacting all of the MDs in the Department soon to begin work on developing and implementing the Department’s medical policy and goals including public health prevention, public health preparedness, vital records and statistics, behavioral health, special health care needs for children, licensing, clinical laboratory, and state hospital care.

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A Year of Progress at ADHS

February 4th, 2010

We started on this journey together a year ago.  Thanks for being such good traveling companions.  We’ve been through a lot.  We’ve had challenges, fears, anxiety, good times, laughs, & fun.  We’ve sacrificed some of our programs, but we’ve made a great deal of progress too.  Overall- the year was a net plus.  I say that because we maximized our progress in areas that we have control.

We’ve made a great deal of progress in many areas and have just done a plain old good job with most everything this year.  I jotted down a few things the came to mind below.  We:

  • Overhauled the WIC program to focus on a much more nutritious blend of foods www.azwic.gov, and started a nationwide movement to change the food stamp program (SNAP) from a calorie program to a nutrition program;
  • Created the new Empower Pack program for preschools that improve physical activity and nutrition for our youngest- an idea that came out of our licensing fee increase;
  • Developed a network of more than 20 new Cardiac Arrest Centers and Primary Stroke
    Centers across the state that are dramatically improving outcomes for folks that have a cardiac arrest or a stroke;
  • Led the national shift to continuous chest compression CPR from the old compression/breathing method http://www.azshare.gov/;
  • Figured out a way to vaccinate underinsured kids through our Vaccine for Children Program even though our state vaccination funds were completely eliminated;
  • Began development of Arizona’s TRAUMA SYSTEM- adding 8 new Level IV Trauma Centers and 1 new nationally recognized pediatric trauma center;
  • Helped develop a state of the art on-line Outcomes Dashboard to give choice and voice to folks with serious mental illnesses in Maricopa County- improving their ability to better participate ion their path to Recovery (Download the Dashboard);
  • Made a difference in hundreds of peoples lives at the Arizona State Hospital-  by helping them in their road to recovery by treating them with dignity, care and respect;
  • Converted our licensing programs to become self sufficient, and sharpened our surveys to focus on the most important elements of care, and allowing folks to review the latest scores using our Facility Search tool;
  • Identified hundreds of kids with metabolic disorders and hearing and helped their doctors conduct interventions to help them avoid serious complications from their condition through our Newborn Screening program;
  • Tested thousands of biological samples for all kinds of viruses and bacteria including H1N1, tuberculosis, West Nile virus, rabies, and literally dozens of other diseases so that counties and doctors can help slow the spread of disease and help people get better in our Public Health Microbiology program;
  • Ensured that hundreds of clinical and environmental laboratories across the state are doing things right and providing good results through our Laboratory Licensure & Certification program;
  • Created an inter-disciplinary team from around the Department to develop an integrated tobacco prevention program together- expanding our tobacco prevention efforts way beyond it’s former borders- integrating tobacco control into programs throughout AZ’s behavioral health system.

Holy smokes… who did all this stuff?  ADHS did.  Thanks to the staff for rowing in the same direction together this year- forward.  Next year will have challenges just like this past year— but as long as we work and collaborate with one another we will  continue to press ahead and make progress next year too.  Thanks, and take a second this week to thank the folks around you, and let them know you appreciate their help this year.

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