Archive for the ‘General’ category

New ASTHO Presidential Challenge: Healthy Aging

September 17th, 2014

HI was at the Association of State and Territorial Health Officials Annual Meeting and Policy Summit most of last week.  This year’s meeting was entitled Achieving Population Health in Evolving Systems.  We shared best practices with each other about different ways states are approaching population health.  We heard from the Acting Surgeon General Rear Admiral Boris D. Lushniak, MD, MPH, who provided a federal perspective.  We also covered the progress that the US has made addressing this year’s ASTHO Presidential Challenge to address the prescription painkiller epidemic through Prevention Strategies, Monitoring and Surveillance, Control and Enforcement, and Treatment and Recovery.

ASTHO’s 2015 Presidential Challenge is to promote the health of older adults by collaborating across sectors.  The challenge aims to galvanize support for state health officials, public health teams, state and local experts in aging and a broad network of partners, to implement evidence-based strategies for increasing the number of older adults who are living well in our communities.  More on this in the coming weeks and months.

Community Integrated Paramedicine Taking Shape in AZ

September 16th, 2014

PCommunity Integrated Paramedicine programs are beginning to come together in two primary business models in Arizona.  The first one has EMS (emergency medical services) agencies partnering with hospitals to reduce the frequency that patients are re-admitted to hospitals.  In the second, EMS agencies are cultivating social service referrals to reduce the frequency that folks use emergency departments for non-emergency events.

Here in Arizona, EMS agencies have really jumped on board, highlighted by the Mesa Fire and Medical Department’s $12 million grant from the Federal Government, Rio Rico Fire District’s Community Paramedicine Program and Golder Ranch Fire District’s Community Paramedicine Program.

There are two possible reasons for the increased interest in Community Integrated Paramedicine programs.  Federal law provides financial incentives to hospitals to reduce the number of readmissions among patients discharged within 30 days.  There’s also been a national focus on conducting community health needs assessments.  Many community needs assessments have exposed large gaps in the availability of preventative health care services needed to improve the health and well-being of residents.

A new piece of the community paramedicine puzzle became available this week with the publication of a document called “Expanding the Role of Emergency Medical Services Providers: A Legal Analysis” by the Association of State and Territorial Health Officials.  The document examines the legal perspective and provides guidance on several topics including scope of practice, emergency calls, payment, liability and medical direction for community integrated paramedicine programs.

Community Integrated Paramedicine touches our Bureau of EMS and Trauma System, the Bureau of Tobacco and Chronic Disease and the Health Care Institution Licensing Branch.  Our job over the coming months is to help Community Integrated Paramedicine Programs to navigate regulatory waters and manage the risks associated with a new business model for EMS providers – our Team is finalizing work on a guidance document right now.

Enterovirus D68

September 15th, 2014

enterovirusArizona joined the states asking CDC for laboratory testing for Enterovirus D68 on Friday.  We’ve had an increase in the number of children hospitalized and treated for upper respiratory illness.  Enterovirus is in the family with the common cold and illness is usually limited to cold symptoms (stuffy or runny nose and cough).  There seem to be groups of children who need more intense care because of difficulty breathing…most of them have asthma or another respiratory condition, but not all.  The CDC sent out information about specific outbreaks in two states earlier this week in a special Morbidity and Mortality Weekly Report.

We work with our local public health partners to monitor for any outbreaks.   We will continue to stay in contact with local health offices, doctors and hospitals across the state to monitor for any changes.

In the meantime, you can help prevent the spread of Enterovirus and lots of other illnesses – keep your kids home when they’re sick, cover your coughs and sneezes, and wash your hands regularly and well.

2013 AZ Abortion Annual Report

September 12th, 2014

abortionreportWe publish several reports every year that are required by Arizona law…including our annual abortion surveillance report.  We published our 4th Abortion Surveillance Report this week.  Overall, the abortion rate in Arizona was stable from 2012 to 2013, however, the rate of abortions among 18-19 year old women decreased more than 30% between 2012 and 2013…the lowest in a decade.  The majority of women who received abortions were between 20 and 29.  In 2013, about 70% of Arizona abortions were handled surgically.

The complete report also contains information about the number and kinds of complications as a result of abortion procedures and a host of other demographic analyses.  The report is compiled using a secure, web-based reporting system from facilities and providers across the state.

The Legal Mechanics of State Government & PTSD

September 11th, 2014

gavelState government authority and policy is driven by laws that are established by the Legislature and carried out by the Governor through the Executive Branch.  Sometimes laws are passed directly by the voters (called a voter initiative).  Many state laws require state agencies to develop regulations to “flesh out” the laws they pass by  giving state agencies “Rulemaking” authority to provide the details.  The Rulemaking process is governed by the Arizona Administrative Procedure Act.  Some laws (like the Arizona Medical Marijuana Act) allow agency directors to modify laws on their own, and then follow up later with rule changes.

Sometimes state agencies decide that the Rules they’ve adopted can use some extra clarification to help people understand them better.  Agencies can develop what are called Substantive Policy Statements – which advise the public about the procedures the agency will follow as they interpret and implement the rules that they’ve officially adopted.

You can think of state laws as the “skeleton”, agency rules as the “muscle and other tissue”, and a substantive policy statement as an “outfit”.

For example, this week we filed a Substantive Policy Statement clarifying my Decision to authorize medical marijuana for registered patients that are currently undergoing conventional treatment for PTSD beginning January 1.  Certifying physicians will be required to attest that they have reviewed evidence documenting that the patient is currently undergoing conventional treatment for PTSD before signing the medical marijuana certification.

The new Substantive Policy Statement provides the public with clarification of our interpretation of what constitutes treatment for PTSD, allowing a qualifying patient to get a medical marijuana registry identification card.  The Statement clarifies that treatment could include, but isn’t limited to, psychotherapy (counseling); participation in support groups to help the qualifying patient feel less isolated or alone; or the use of medications to help the qualifying patient with reducing depression, relaxing, or sleeping.

Awesome ASH Teamwork

September 10th, 2014

ASH-feature_homeThanks for all your hard work in changing our culture of care at the Hospital.  It’s been 2 years since we implemented new processes to change how we work with patients.  We’ve revised roles and responsibilities for unit staff and campus support, trained all our staff in Non-Violent Crisis Intervention, which is an evidence-based, best practice for early intervention and de-escalation created by the Crisis Prevention Institute.

Non-Violent Crisis Intervention is a tool that provides a better therapeutic environment for patients and residents to live and improves safety for everyone.  It has guided us as we implemented a new code response process, enhanced the environment, improved nursing processes, improved program delivery focused on recruitment and retention and committed ourselves to Quality Care.

Our efforts are producing promising results – with demonstrated reductions in seclusion and assaults.  This progress wouldn’t be possible without the dedication of each and every one of you.  We still have milestones to achieve…and we’ll continue to work towards them every day.  Thanks to Team ASH for your hard work and commitment to accomplish our goals.

Celebrating National Payroll Week

September 10th, 2014

bAs one of the largest departments in Arizona State Government,  ADHS is joining in the salute to payroll professionals by participating in National Payroll Week.  National Payroll Week recognizes professionals who support the American system by not only processing your wages, but also reporting your earnings and withholding employment taxes, which keep America running.

Our payroll department is staffed with a small but dedicated team of highly skilled professionals who are experts at meeting deadlines, answering employee inquiries, and who are aware of local, state and federal tax rules and regulations. They are the ones who shoulder the responsibility for paying you correctly – a task that is not as simple as it sounds.  Why?  Because payroll is one of a few business functions where 99.9% accuracy is simply not good enough.  Payroll operations are highly regulated and scrutinized by a myriad of local, state and federal agencies, auditors, collection agents, and of course, by ADHS employees.

Thanks to Michael Johnson, Payroll Manager, and our Team: Rosalie Gonzales, Evelyn Clark, Donna Eberhard, Juanita Gano, Jane Griggs, Donna Wilson, Eileen  O’Connell.  Patricia Frank and our Controller Cindy Smith for making sure we all get paid correctly and on time!

Making the Healthy Choice the Easy Choice

September 9th, 2014

FoodAssistance2Arizona is focused on making affordable fruits and vegetables easy-to-find in communities throughout the state.  In Arizona, more than 40% of Farmers’ Markets accept Arizona Farmer’s Market Nutrition Program coupons so WIC moms and seniors on the Commodity Supplemental Food Program can purchase fruits and vegetables at Farmers’ Markets, compared to just 21% of the Farmers’ Markets across the US accepting these coupons.

We’re working with Maricopa County to pilot a project to increase the number of Farmers’ Markets that accept Supplemental Nutrition Assistance Program (food stamp) benefits.  The project will help those with a limited income have better access to locally grown produce close to home.  Currently, there are 19 Farmers’ Markets  in Arizona that take SNAP benefits.  The Arizona Farmer’s Market Nutrition Program  has maps showing which markets accept SNAP benefits.

The feds are the Farmers’ Market folks too. is a one-stop information center where farmers markets and farmers can find out how to participate in SNAP.   Installing wireless technology at farmers markets expands the customer base for markets and increases the share of the SNAP dollar that goes directly back to local farmers, strengthening local economies.

Arizona Community Profiles Dashboard (Part I of IV)

September 5th, 2014

StatisticsWe collect all kinds of surveillance about prevalence of disease, birth, causes of death, reasons for hospital visits, smoking rates and hundreds of other indicators to help us assess health indicators and design interventions to improve outcomes.

For the first time ever, we now have a tool to explore this data and visualize it in several different ways.  Our new Community Profiles Dashboard is a huge 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 new Community Profiles 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.

If you’re a community planner and you want to see where there are higher rates of diabetes, heart disease, and hypertension – you can compare data from the last four years to see how different areas have changed.  As a community planner, this information can be very useful in how you plan for the future.  Knowing this information could help you make a more informed decision about where the new community park will be built, or where to locate a new bike and walking path. To improve the overall health of our communities, access to these kinds of services is vital.

If you run a non-profit, you can zero in on key indicators related to your mission and drill down to the community level to determine where to focus your resources.

The site is user friendly and will work on a desktop or mobile device, like an iPad.  If you want to take a quick tour of the Community Profiles Dashboard and learn about a few of the functions, take a look at our video tutorial.  The video gives an overview of how to access the dashboard and a few of the functions.  It’s the first in a series of four videos that will highlight data and different functions of the dashboard.

In the upcoming weeks I’ll be blogging about some of the other unique and interesting data that you can gather from the site.  Thanks go out to Dr’s Khaleel Hussaini and Nicholas Bishop, Patricia Tarango, Tracy Lenartz, Jeff Burgess, the staff from GeoWise Ltd., and especially Wes Kortuem and Marvis Kisakye - their leadership and help developing the site.   More to come over the next few weeks.

e-Book Edition of the “Guide to Clinical Preventive Services”

September 4th, 2014

Businessman with laptop computerFor the first time, the US Preventive Services Task Force has released an e-book version of its Guide to Clinical Preventive Services which helps primary care clinicians and patients decide together what preventive services are right for a patient’s needs.

The 2014 Guide includes all active Task Force evidence-based recommendations including 28 new and updated recommendations since the 2012 version.  The e-book is compatible with many readers, including Kindle, Nook, iBook, and Kobo.  As a reminder, in addition to the e-book, you can view and download the Guide online or order a print copy of the guide at the AHRQ Publications Online Store.  For more information about the Guide and other Task Force resources, visit