Archive for the ‘General’ category
The Emergency Medical Treatment and Active Labor Act (EMTALA) is a federal law that requires hospitals that accept Medicare payments to provide emergency healthcare to anybody regardless of citizenship or immigration status or their ability to pay. Under the law, hospitals that accept Medicare payments can’t transfer or discharge patients that need emergency treatment unless there’s informed consent on the part of the patient or after the patient is stabilized. An exception is when the patient’s condition requires the patient’s transfer to a hospital that’s better equipped to administer treatment.
Because patient care for Ebola patients is so unique, we (and most other states) have been struggling to interpret EMTALA requirements when building our protocol for assessment and treatment of Ebola (or potential Ebola) patients. Last Fall the Centers for Medicare and Medicaid Services sent out a survey and certification letter to provide guidance to hospitals regarding meeting EMTALA requirements if a patient presents who was potentially exposed to Ebola.
Last week they followed up their earlier memo with a Q & A for clarification. The short story is that all Medicare-certified hospitals with an emergency department are expected (at a minimum) to screen, isolate and begin stabilizing treatment for any patient with possible Ebola symptoms. Medicare-participating hospitals with specialized capabilities (our designated hospitals) are required (within the limits of their capability and capacity) to accept appropriate transfers of individuals protected under EMTALA from other hospitals, without regard to insurance or ability to pay. CMS hasn’t published the Q & A publically yet – but we’ll make sure it gets into our Ebola website when it’s ready for broad distribution.
We’ll be taking a close look at the new clarification as we continue to build our protocols for treating Ebola and other emerging infectious diseases.
Our Community Profiles Dashboard is featured this month in the ESRI News, for State & Local Government newsletter as an example of the benefits from making health date more accessible. I’ve blogged about our Dashboard, which is a leap forward for public health professionals, city planners, non-profit organizations, medical providers and anyone who needs public health data to improve their performance.
What makes the Dashboard revolutionary is the way you can access, sort, and analyze the information. The Dashboard provides several options for looking at the state, county, or small community level data among the more than 100 Primary Care Areas in Arizona.
In addition to the news feature in ESRI, our Dashboard has received worldwide recognition this year. The Geowise Company, which built our Dashboard using Instant Atlas (IA) Software analyzed dashboards from around the world to determine what works and what doesn’t in IA dashboard creation. Based on this analysis, our Community Profiles Dashboard was voted number three in the world. This will be featured in the next Instant Atlas Newsletter.
I encourage public health professionals, city planners, and medical providers to use the Community Profiles Dashboard to look at health indicators in their communities. This information is vital in developing healthy communities and targeting resources where they’re needed most. To help you learn how to use the Dashboard, we’ve created a four part online video tutorial.
Registration is now open for the Arizona Public Health Association (AzPHA) 2015 Spring Conference. The conference titled: “It Starts Upstream: A Public Health Approach to Building a Healthy Future” will be held on Thursday, April 9, at the Phoenix Zoo.
This year’s conference will feature panel discussions on the Social Determinants of Health and Nutrition through a Cultural Lens, a presentation on preconception health and a keynote presentation on epigenetics. The afternoon will feature a World Café, which will include four 20 minutes presentations at several tables. There will be a wide variety of public health topics, including healthy aging, developing sustainable public health policies, comprehensive medical and dental program for children in foster care, and many more topics. The conference is a great opportunity to learn about emerging public health issues and network with your fellow public health professionals.
AzPHA is a key stakeholder in Arizona’s public health network of community partners that includes government agencies, medical professionals, community groups, advocates, private industry, and individual citizens – all working together to make our communities healthier. They’re a non-profit organization that’s been around since 1928.
AzPHA provides a way for members to network with other public health and medical professionals from around the state, enhance their skills by attending professional development trainings, and advocate for a better public health system in Arizona. Take a look at their website to learn about all the benefits of joining and the discounted memberships.
In mid-December (2014) we awarded contracts for the Northern and Southern regions of the state to Health Choice Integrated Care (Northern AZ) and Cenpatico Integrated Care (in Southern AZ). On January 2nd United Healthcare filed a Protest with the ADHS for the award in Southern AZ, requesting an Emergency Stay and Administrative Hearing. Last month (January 21) we denied the Protest.
United HealthCare has until tomorrow (February 20th) to file a Notice of Appeal to the ADOA Director. If United Healthcare appeals our Decision, then we would have 21 days from the date of the appeal to file an Agency Report to the ADOA Director and interested parties. After review of our Agency Report, the ADOA Director can issue a Stay, dismiss the appeal in whole or part, terminate the award, or schedule an Administrative Hearing.
The contracts for the Northern and Southern regions are scheduled to begin on October 1, 2015 and are three-year contracts with the option for two additional two-year extensions.
Stress can have a profound impact on health and affects your body, thoughts, feelings, and behavior. Symptoms like chronic headaches, insomnia, and lower productivity can be a direct result of stress. Being able to recognize common stress symptoms can give you a jump on managing them. Stress management is important, because, left unchecked, it can cause high blood pressure, heart disease, obesity, and diabetes. It can also lead to behavioral health conditions like anxiety or depression.
Each year since 2007, the American Psychological Association publishes a study called the Stress in America™ Paying With Our Health. This year’s report came out last week. It’s only 23 pages long- so it’s digestible. The survey measures stress among Americans including the leading sources of stress, things people do to manage stress, and the impact that stress has on our lives.
The Association’s annual awareness campaign educates folks about the connection between stress and physical health and how you can change your lifestyle and behaviors to better manage stress. They also have a Psychology Help Center, which is an online consumer resource featuring articles and information like Stress management: How to strengthen your social support network; Face the numbers: Moving beyond financial denial; Money and family: Creating good financial habits; and Happy couples: How to avoid money arguments.
Helping our team manage stress is one key to helping employees achieve wellness. Benefits Options are available for employees, retirees, and their spouses and dependents. In addition to an Employee Assistance Program, Benefit Options offers resources like Fact Sheet: Mental Well-Being and Learn How to Stop the Cycle of Stress.
You might recall that a few weeks ago I approved American Medical Response’s (AMR Maricopa) application to operate ambulances in Maricopa County (called a Certificate of Necessity or CON). I approved the Certificate of Necessity after reviewing a host of evidence presented to an Administrative Law Judge and her Order recommending approval. Approval of the application doesn’t mean that AMR Maricopa actually possesses the CON.
According to the administrative and due process statutes involved, we wait 30 days before physically issuing the Certificate of Necessity. A.R.S. § 12-901(2) says that decisions in administrative adjudications are not “final” until after a request for rehearing or review is denied, or the decision on a request for rehearing or review is rendered.
Rural Metro (pursuant to A.R.S. § 41-1092.09) has filed a request for rehearing or review of my prior decision. We received AMR Maricopa’s response to Rural Metro’s request. I now have until February 26 to make a final decision on this matter.
One of the services we sometimes take for granted is mail service. At ADHS we have a small mailroom, staffed by Susan Barnes and Meredith Chernov, who processes mail sent through the US Postal Department and the inter-office mail between state offices.
In 2014 our mailroom processed over 1,000,000 pieces of outgoing US mail for the first time ever. It was surprising to me that we were sending that much mail, let alone that it could be processed by only 2 people. Congratulations to the hard working staff of our ADHS Mailroom.
Tonight at 8 pm PBS American Experience will feature an episode called “The Forgotten Plague: Tuberculosis in America.” Tuberculosis was the deadliest killer in human history prior to 1900. In fact, TB (then sometimes called Consumption) killed about 14% of all the people who ever lived prior to 1900. TB rifled through the US at the turn of the century, sometimes taking out entire communities, especially in cities with crowded tenement housing.
The battle against TB in the 20th century required a multi-sectoral approach – including interventions in social habits, economic development, housing, science and medicine, and especially public health. Taken as a whole, the list of interventions that ended up quelling TB applied the principles of population health.
The public health battle against TB had a profound and long-lasting impact on the country. This episode promises to be a good one. Try to watch.