We were sued this week by a group of same-gender couples in Arizona- challenging Arizona’s ban on gay marriage. The lawsuit challenges Arizona’s marriage criteria which excludes same-gender couples from marriage. The lawsuit was filed in U.S. District Court in Phoenix by seven same-gender couples and two people whose partners had died. We haven’t analyzed all of the details of the suit, but it looks like we’re linked in because of the laws and regulations governing our issuance of death certificates.
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Alan Oppenheim was an excellent leader and manager- but much more importantly- he was a really good person. He always cared about others and asked lots of questions about what was going on. He was a team player- he had everybody’s and the team’s best interests in mind… and was wholeheartedly committed to our mission of serving the folks of Arizona. We will truly miss Alan as a friend and a colleague.
We’ll be having a drop-in open-house brown-bag celebration of Alan’s life Wednesday from noon to 1:30 p.m. in the Lab Igloo (250 N. 17th Ave, Phoenix). We’re crafting the event in a way that we think Alan would have liked. Come by and share if you can.
The voter approved language in the AZ Medical Marijuana Act directs us to periodically accept and evaluate petitions to add new debilitating medical conditions. We’ve made it through the first phase of considering whether to add 4 new debilitating conditions… 1) Post Traumatic Stress Disorder; 2) Generalized Anxiety Disorder; 3) Migraines; and 4) Depression. You’ll be able to give us your thoughts about these four conditions at a public hearing next month (May 25th from 1 – 4 p.m. at our State Lab). You can read the information we already have about these four starting next week.
If we decide to add PTSD or any other debilitating conditions, we want to make sure we’re on solid medical ground. I’m heading down to a conference in Tucson next weekend where physicians can get Continuing Medical Education credits for learning about medical cannabis.
As you know from earlier blog posts a judge ruled in a state case that had challenged our dispensary applicant selection criteria. The judge’s decision basically struck down several of the selection criteria we had been planning to use to for competitive areas of the state (areas where there will be more than 1 applicant per Community Health Analysis Area.
Our teams are busy dotting the Is and crossing the Ts right now on an express rule package that would remove the dispensary selection criteria struck down (AZ residency, child support, previous bankruptcies etc.) and to set new dates to accept dispensary applications. Our rule changes will focus solely on making adjustments to comply with the judge’s decision and to set a new timeline for accepting dispensary applications.
Our team is making good progress on the Rule package, and we expect to be finished this month (February). I’ll keep you posted here, and I’ll let you know when the rule package is filed- including a link to the final set of rules. We’re still on track to be able to accept dispensary applications in April. We’d then have about 45 days to review and award dispensary certificates- so we could potentially award up to 125 dispensary certificates by mid- to late-June. If someone is pretty much ready to go at that point, we could see medical marijuana dispensaries operating in July or August.
The Phoenix National Disaster Medical System conducted a successful Full-Scale Exercise on Thursday. We sponsored the exercise (with our federal cooperative agreement funds) along with the Phoenix Veterans Affairs Health Care System. The NDMS is a federally coordinated system that supplements the Nation’s medical response capability when local resources are overwhelmed during disasters. The exercise tested several important areas of disaster response that affect the healthcare system in the Phoenix area, including the ability of hospitals to receive, triage, and transfer patients. Our team’s role was to assist with patient tracking, communications, and emergency operations center management. Well done.
A couple of weeks ago I planned to open the docket to overhaul the Administrative Code (Rules) that we use to evaluate and monitor health and safety in licensed behavioral health facilities in AZ. That plan was based on the assumption that the Medical Marijuana Act was going down to defeat because at that time it was trailing by several thousand votes. The unexpected turnaround means we’ll need to devote substantial resources to the rule development and administrative infrastructure to implement the law.
We’ll only have 120 days (from the certification date of the election) to get the program up and running (including a substantial rulemaking), all of which means we’ll need to postpone the plan to rewrite the behavioral health licensing rules until early 2011. This is not something I want to do, because everyone agrees the behavioral health licensing rules need work, but we just can’t handle both jobs at once. Of course, if something strange happens and the election somehow turns direction during the canvass, we’ll proceed with the behavioral health rules. Otherwise, we’ll start the behavioral health licensing rule package as soon as we complete the 203 package- which will be late March.
Ever since our Arizona Community Protection and Treatment Center (on the grounds of the Arizona State Hospital) opened in 1998, we’ve been providing treatment to sexually violent persons who have a mental disorder and who have been convicted (or found guilty except insane) of a sexually violent offense or were charged with a sexually violent offense and determined incompetent to stand trial. Through the years, our treatment has consisted mostly of therapies to address the persons’ offense history, analyze their own cycle of behavior, to develop self-management techniques in order to reduce the risk of re-offending, and to develop empathy for their victims.
While our historic approach has been solid, it doesn’t really help them to eventually successfully reintegrate into the community, because they also need to know how to get (and keep) a job, budget & pay bills, prepare (balanced) meals, navigate public transportation, interact with people in socially acceptable ways, form healthy relationships, maintain social and personal boundaries, and eliminate addictions- you get the idea- they also need skills to live in society. Many of our ACPTC residents come from impoverished, traumatic backgrounds and haven’t lived successfully in society, so a lot of work is needed to prepare them to (eventually) live in the community.
This month, we kicked off our new therapeutic program which will help residents gain and practice skills that will help them to (eventually) function in the community. While the psychosexual treatment remains the cornerstone of our therapeutic approach, residents are now being offered therapies for social and living skills, educational and vocational assessment and exploration, addictive behavior therapy, anger management, therapeutic recreation and structured daily therapeutic schedules that include self-directed leisure and work. The new program goals help them on their way to forming healthy social relationships with guidance of trained staff. In other words, the whole person is being treated with the goal of helping the person lead a productive life and affording protection to the community when they’re eventually transitioned to the community.
Ann Froio and her team at the ACPTC have been working on this new therapy design for the last few months and it’s great to see it actually being executed. This new approach doesn’t really cost any additional money, rather, it’s a re-design of the daily activities. It’s actually a lot like the Empower Pack, a redesign of daily activities to achieve a goal but without requiring a huge financial investment.
Suicide is one of the most challenging and sensitive public health issues that we face, partly because so many folks have a hard time talking about the subject. It’s especially challenging for families that experience suicide first hand. 1,060 Arizonans died from suicide in 2009 the highest number ever, making it the 6th leading cause of death among men and 9th for women. The age-adjusted suicide rate increased by 8.8% from 14.8 suicides per 100,000 residents in 2008 to 16 per 100,000 in 2009, which is the highest suicide rate since 1998. There were 7,979 suicide attempt-related ER visits in 2009, 71% more than in 2007. The rate is much higher for men 24.6 per 100,000 compared with 8.1 per 100,000 for women.
Every part of the state has a suicide hotline that’s linked to 911 operators etc. Also, each of our RBHA’s have suicide prevention resources and have training in how to spot high risk folks ahead of time. You can see more in out Strategic Plan. We also have a Substance Abuse and Mental Health Services Administration Cooperative Agreement for State-Sponsored Youth Suicide Prevention and Early Intervention. The total award is $500K per year for 3 years- and it’s geared toward preventing suicide among young people.
The majority of the grant goes toward not-for-profit prevention organizations for direct suicide prevention services in the community. Most of the remainder of these grant funds will be awarded to not-for-profit prevention organizations for direct suicide prevention services in the community (for all populations). Additionally, a portion is being used to prepare emergency department staff to identify persons with substance abuse disorders and/or suicidal thoughts and make referrals to behavioral health and other community resources.
Now that the weather has finally broken here in the desert you can visit your local farmers market without having to get up at the crack of dawn. Check out our Farmers’ Market Locator to find the nearest farmers market. Simply go to the application link and put in any address and city and push “Find Market”. The program will list all the markets including links that give you the time of year, dates and times that the market is open. It’ll also give you a map of the market’s location, provided on a printer friendly page.
Thanks to the 2009 Vital Statistics report, we also know that AZ residents went to the ER more than 1.8 million times. The top reasons (about 25%) for those visits were abdominal pain, acute upper respiratory infection, chest pain, cuts, mental disorders, and spinal disorders. More than 1,300 Arizonans were treated in an emergency room for exposure to excessive natural heat, more than 2/3 of them male- and 338 were hospitalized as inpatients for the heat related illnesses.