Archive for the ‘General’ category

Ebola Toolkits

October 20th, 2014

ebolaOne of the roles we play in any outbreak is making sure that our partners in the state have all the information they need to respond to a situation and be safe in that response. I’ve posted about our continuing education of those partners, but now we’ve created a one-page stop for partner.

Our Ebola Preparedness website contains all the information we’ve sent out through our Health Alert Network. There are toolkits for hospitals, outpatient clinics, EMS providers and laboratories.

We will continue to push information to our partners, especially as things change. We anticipate new information today about personal protective gear . So stay tuned

Plague over the Centuries

October 15th, 2014

plagueRing around the roseies, A pocket full of posies, Ashes, ashes! We all fall down!

In 1348, London was 4 million strong, but within 2.5 years a third of those had “fallen down.”  The streets were narrow and cramped, often piled ankle deep with human and animal waste. The putrid smell contaminated everything in the city. Those infected with the new and ghastly plague placed posies in their pockets and rosaries around their necks.  Their symptoms include severe fever, chills, headache, muscle weakness and pain, swollen lymph nodes, and sometimes respiratory or GI illness.  Between one third and two thirds of Europe’s population was decimated within just a few decades.

The plague was known then as the Black Death, but it’s recognized today as the bacteria Yersinia pestis.  Scientific advances have turned it from a fearsome figure to a controllable nuisance.  Arizona has not had a single plague case in the past 5 years; the last confirmed case was in 2007.

Unfortunately for our rodent brethren, this is not the case.  In the 1300s, rats of the Rattus rattus variety were the primary rodent carrier of the fleas that spread plague.  Now the burden falls to others.  Prairie dogs, squirrels, rabbits, cats, and their predators have been found to be carriers of plague in Arizona.  Most recently fleas collected in Doney Park, near Flagstaff, tested positive for Yersinia pestis.

Staying safe from plague is pretty easy – pets should have flea protection (cats are susceptible), and people should use insect repellant if they’re in flea-infested areas.  People and pets should stay away from dead animals and wild animal burrows.  Human infections are rare, but early antibiotic intervention is the key to successful treatment.  When we apply what we’ve learned about biology, sanitation, and public health over the years, the serious diseases of our ancestors become mere nursery rhymes for our children.

New Draft Medical Marijuana Regulations Out for Public Comment

October 15th, 2014

DFor the last few months we’ve been reviewing our medical marijuana rules to make changes to them in response to an Arizona Superior Court judge’s decision.  In addition to the changes needed to comply with the Court’s ruling, also proposing other changes to the medical marijuana rules that affect qualifying patients, caregivers, and dispensaries that include:

  • Reducing the fees for qualifying patients who are 65 years of age or older, under 18 years of age, veterans, receiving SSI or SSDI benefits, or receiving hospice services;
  • Reducing the fees for the caregivers of qualifying patients who are under 18 years of age or receiving hospice services;
  • Adding a process for qualifying patients who are incapacitated and have a guardian to get a registry identification card;
  • Adding palliative care of PTSD to the list of qualifying medical conditions;
  • Clarifying requirements for the cultivation of marijuana;
  • Revising procedures for allocating dispensary registration certificates;
  • Clarifying who can sign documents and make requests on behalf of a dispensary; and
  • Clarifying requirements for inventory control, dispensing and transporting medical marijuana, and accepting donated marijuana.

After posting drafts of revised rules in February and June and meeting with people affected by the rules in June and July, we’re now posting a third draft, which includes changes based on the comments we received, and an on-line survey for comments on the new draft.  Based on the comments that we receive on the third draft, we’ll submit a Notice of Proposed Rulemaking which will include official Oral Proceedings. After that, we’ll finalize the new regulations.  We plan to have the revised rules in effect by Summer 2015.  Here are the new draft rules.

Help Your Health & Wallet

October 9th, 2014

Coworkers smiling togetherIf you’re a “benefits eligible” state employee, you now have a new opportunity to improve your health and your wallet.  This week Benefit Options Wellness launched a new health initiative called the Health Impact Program (HIP).  It’s a point-based incentive program that encourages participation in a variety of wellness activities, while logging progress toward a goal of 500 “points”.  People that complete the program will be eligible for up to $200 which will be paid directly through payroll about a year from now.

Your activities will be self-reported by you through the new Mayo Clinic Healthy Living portal.  Simply visit the site to create your account and get started.  Take the Health Assessment as a way to find your starting point.  It’s a great tool to learn what you are doing well and how you can make improvements toward better health.

Qualifying activities include:  preventive health screenings, health coaching, participation in health education and wellness events, and more.  We’ll coordinate internally with our Workforce Development and Employee Wellness Teams to offer qualifying activities on site.

State employees: please consider challenging yourself to make HIP a part of your life for the upcoming year.  Stay tuned for more information as it becomes available at or email with any inquiries regarding program specifics.

Continuing Medical Education for PTSD Treatment

October 8th, 2014

CA few weeks ago I issued a Director’s Decision that will authorize the use of marijuana (under the AZ Medical Marijuana Act) for patients undergoing treatment for PTSD.  Medical marijuana certifications will be valid only for palliative care (not treatment).  I delayed the implementation date until January 1 to allow time for certifying physicians, dispensary medical directors, and dispensary agents to develop policies, procedures, and educational materials before the decision takes effect.

One good training option for physicians (and other clinicians) was recently uploaded to the Agency for Healthcare Research and Quality‘s website.  It’s entitled “Psychological and Pharmacological Treatments for Adults with Posttraumatic Stress Disorder (PTSD)”.  The CME/CE activities are accredited for a multi-disciplinary audience of health care practitioners and provides 1.0 AMA PRA Category 1 Credit as well as Certified Contact Hours for Case Managers, Certified Health Education Specialists, Nurse Practitioners, Registered Nurses, and Pharmacists.

The monograph examines various evidence-based treatments for adults with PTSD.  It covers the benefits, harms, and comparative effectiveness of various treatment strategies for adults including the comparative effectiveness of psychological treatments.

We’re reaching out to certifying physicians and other interested healthcare personnel to let them know about this resource so that they’re better informed about the latest data regarding evidence-based treatment of PTSD.

Streamlined “Delayed Birth Certificates” for Native Americans

October 6th, 2014

nativeamericansThe vast majority of Arizonans are born in hospitals.  Shortly after delivery the electronic paperwork to establish an Arizona birth certificate gets input and processed.  Even babies delivered at home attended by a midwife (about 1% of Arizona births) have their birth certificate information captured and processed.

Many years ago, especially in Arizona’s Indian Country, some folks were born at home and the paperwork to establish an Arizona birth certificate wasn’t filled out at the time.  Years later (sometimes decades) these same folks need their birth certificate – but we don’t have any information on the birth in our Vital Records database.  When people want a birth certificate like that, it’s called a “delayed birth certificate”.

There are state statutes and rules that govern what’s needed to get a delayed birth certificate.  For elder tribal members, some of the documents may be difficult to get.  However, they may have easily accessible official tribal documents that provide the information that we need to firmly establish the required birth facts to process a certificate.

Over the last few months, we’ve been working with tribal governments to develop a procedure to make it easier for elder tribal members to use their tribal documents to get a delayed birth certificate.  We crossed the finish line last week, when we adopted a new Substantive Policy Statement that outlines and streamlines the process for tribal elders.

A big shout out to Lena Fowler (County Supervisor, Coconino County), Senator Carlyle Begay (Arizona State Senate), Representative Albert Hale (Arizona State House of Representatives), Tom Ranger (Division Director, Division of Human Resources, Navajo Nation), John Lewis (Former Executive Director, Inter Tribal Council of Arizona, Inc.), and ADHS staff  Khaleel Hussaini, Krystal Colburn, Celia Nabor, Toni Miller, and Jeff Bloomberg, for helping to put together this new document.  We’re confident this new procedure will make it easier for Arizona tribal elders to get their birth certificate.  Well done team.

Arizona Community Profiles Dashboard (Part II of IV)

October 1st, 2014

reportingA couple weeks ago I wrote about our new Community Profiles Dashboards.   They’re a huge leap forward for public health professionals, city planners, non-profit organizations, medical providers and anyone interested in health data.  The data are arranged on the Dashboards – in state, county, and Primary Care Areas – to provide several options to compare and explore data.

This week we take a look at how the dashboard can help public health gather data it needs to address one of our winnable battles, reducing suicide.  More than 1,100 of those were in Arizona last year.  To develop effective public health prevention and intervention programs to prevent suicide, we have to understand our communities.  Looking at the raw numbers of suicides isn’t enough to develop new strategies.  Public health professionals need more information, including where we have higher numbers of suicides and the health and demographic indicators in that area.

In this Community Profiles Dashboards Video Tutorial we look at rural and metropolitan areas of the state to identify where suicide rates are higher than the overall Arizona rate to get a better understanding of the relationships between demographic information and the higher rates.  When we looked at the communities with higher suicide rates, we found that all of these communities either had an older population or a higher population of Native Americans, and that all of the communities had lower educations levels.  This isn’t a definitive answer to the question of why these areas have higher rates, but it gives us a starting point.  The Dashboards aren’t meant to solve public health problems; it’s a tool to help public health better target our resources and intervention strategies.

One of our key interventions has been training people across the state in Mental Health First Aid.  Since 2011, more than 7,000 people have learned the warning signs of suicide and what to do when there is a concern.  You can find out more about the free classes on our website.

National Latino Children’s Summit This Week in Phoenix

September 30th, 2014

Father And Son In Park With FootballChild-serving organizations and community leaders will be meeting at the 2014 National Latino Children’s Summit on October 3rd in Phoenix.  It’s called The State of Latino Children: Our Future – and it’ll focus on health, child safety, education and more.

At the summit, Dyanne Herrera from our Office of Women and Children’s Health will provide a data overview and bring focus to the mobilization around children’s health. Dyanne will be joined by colleagues who will update the participants about connecting children to healthcare; Parent Ambassador Programs in the schools; public private partnerships and opportunities for building positive environments.  For more information about the summit community partners and agenda, visit the website.

Arizona Health Improvement Plan Broadcast Posted

September 29th, 2014

Our most recent AzHIP  broadcast is posted to the Arizona State Health Assessment section (look under the Resources heading).  A big thank you to everyone involved for their hard work.  The next set of heavy lifting is putting together the working groups that will assemble gap analysis and the intervention ideas that will flesh out the Plan.

Trash Your Stash

September 26th, 2014

got-drugs-buttonAbuse of prescription drugs is a public health epidemic, but you can do your part in helping to curb access to prescription drugs with one simple step: get rid of your old and unused medications.  This weekend is the National Prescription Drug Take Back Day held by the DEA and state and local partners.  Removing unused prescription drugs from your home is important because it can help reduce the number of accidental poisonings and can limit the access to drugs that people abuse.  Each year in Arizona more than 2,000 kids were sent to the emergency room from accidental poisonings.

The Prescription Drug Take Back Day will be held on Saturday, Sept. 27 from 10 a.m. to 2 p.m. The service is free and anonymous, with no questions asked. There are more than 100 drop-off sites across the state, and you can find a location near you by visiting the DEA website

If you can’t get to a site on Saturday, there are other ways to properly dispose of unused medications. There are several permanent drop boxes where you can dispose of medications that you can find by visiting the Arizona Prescription Drug Misuse and Abuse Initiative.  You can also mix your unused medications in a plastic bag with undesirable materials, such as used coffee grounds or kitty litter and then throw it in the trash. If you throw the medication in the trash without destroying them, they can be retrieved and sold – if you flush them down the toilet, they can contaminate our water supply.  Take some time this weekend to go through your medicine cabinets and get rid of all your unused medications that can be a danger to our family, friends, and community.