Collaborating Across the Pacific

November 16th, 2013 by Will Humble No comments »

You may have noticed some new faces around the ADHS the past few months as we have been hosting visiting Professors from Korea, Japan, and this coming year from Singapore.  The two Professors who are currently working with us are Dr. Sungwoo Moon from Korea University and Dr. Taro Irisawa from Osaka University in Japan.  They’re Emergency Physicians who have funding from their Universities to come here and work with us.  They’re both interested pre-hospital care and the work we have been doing here at the ADHS the past several years with the SHARE and EPIC programs.

 Dr. Moon has been studying placement and usage of Automated External Defibrillators (AEDs) in Arizona.  As you know, AEDs are incredibly effective at saving lives from cardiac arrest but are infrequently used.  He’s working to understand where AEDs are located in the community, where cardiac events are occurring and trying to link the two together.

 Dr. Taro Irisawa is here for the next 2 years and is studying new ways to improve bystander response to cardiac arrest.  He’s been implementing an effective, large scale public CPR campaign in Osaka, Japan and is now interested in learning about our Telephone CPR program with the goal of bringing that back to Japan.  It’s great to have them here with us, to see this international collaboration, and to know that our public health work is having such incredibly far reaching impact!

 Please continue to welcome our visiting public health colleagues and learn about their fascinating cultures.

AZ Food Safety Report

November 16th, 2013 by Will Humble No comments »

Our core environmental health responsibilities include administering the statewide public health sanitation program for food safety, bottled water, hotels and motels, children’s camps, public schools, and public and semi-public swimming pools.  We delegate most of the actual inspection work to the county health departments.  We finished our 2012 statewide Annual Report last week.  Last fiscal year the AZ system did 108,315 food safety inspections among the 41,985 food establishments in Arizona- for an average of about 2.5 inspections/year. 

 Our statewide goal is to do an average of 2 inspections per year at food establishments…  but we separate facilities into complex, moderate and limited categories with the goal of inspecting complex places more frequently than simple ones.  That’s because the public health return on investment is higher in places with complex menus or that serve high-risk populations (like assisted living centers).  This year’s report shows that we met this benchmark- as the system completed about twice as many inspections at complex facilities compared to simple ones.

New Foster Care Toolkit

November 16th, 2013 by Will Humble No comments »

The ADES & Magellan of Arizona have developed a new Foster Care Toolkit to help foster families navigate the support system that’s available for foster families.  It’s a one-stop guide connecting them to resources to make their job a little easier.  The Toolkit includes information to help current and prospective foster parents connect with community resources like child care, health services, mental health services, clothing and more.  ADES and Magellan joined together to gather content for the tool kit based upon research and participation in orientation seminars and interviews.  They designed and printed more than 2,400 hard copies for physical and online distribution.

Reviewing Child Fatalities Provides Critical Information

November 15th, 2013 by Will Humble No comments »

One of the ways we create good public health interventions is by studying outcomes.  This week, the 20th Annual Child Fatality Review report came out- which examines all 854 deaths of children under the age of 18 in 2012.  The Report reviews the circumstances of each child’s death, determines preventability and makes recommendations to save children’s lives moving forward. 

Although the number of deaths this year is up from last year, Arizona has had a 26% decline in child deaths over the last 8 years.  The decrease we’ve seen over the years in AZ can be partially attributed to many of the initiatives recommend by the Annual Child Fatality Review Reports.  This year’s report makes recommendations to families, law enforcement, health care providers, social service agencies, and the communities in which children live.  

One area we’re going to focus on is the sleeping environment.  Fifty one children died in unsafe sleeping environments.  Every child under one should have his or her own sleeping space and always be put to sleep on his or her back.  Ideally that space can be in the parents’ room to make it easier to breastfeed.  The idea of co-sleeping has been around for many years, but it’s not a good idea until a child is able to easily move on its own.  We have a safe sleep task force starting working on this right now.  Our home visiting and WIC folks also help to spread the word about safe sleep to new parents and families.

Another area we’re going to focus on is reducing prematurity – almost 25% of the children who died last year were born too early.  We’ve had success in reducing the number of babies born early by working with partners across the state and parents – and we’ll continue fighting that with our preconception health campaigns, the March of Dimes programs and our home visiting program. 

Here’s a fact sheet and a document of community recommendations that everyone can use to help keep our children safe.

Valley Fever Awareness

November 14th, 2013 by Will Humble 1 comment »

Guest blog by Jessica Rigler, Bureau of Epidemiology and Disease Control

11th Annual Valley Fever Awareness Week

Valley Fever is a lung infection caused a fungus in the soil here in Arizona.  People get it by breathing in Valley Fever spores in the air. Most people will have no symptoms or recover after a few weeks of flu-like symptoms – cough, fatigue, and fever. About 6% of people will end up with a serious pneumonia or an infection of the brain, skin, joints or bone. These folks will need antifungal treatment, sometimes for life, and may need to be hospitalized or have surgery.

The first or second week of November each year is Valley Fever Awareness Week, which started this year on Saturday, November 9th. For more than a decade now, we’ve been working closely with the Valley Fever Center for Excellence at the U of A to promote awareness about this disease during Valley Fever Awareness Week and throughout the year.  The Center held a free training for doctors at St. Joseph’s Hospital on October 26th.  A free public event with talks by scientific experts and doctors will be held at U of A this Saturday, November 17th

We’re also releasing our 2012 Valley Fever report this week, which includes the following findings:

  • More than 1,000 people were hospitalized with Valley Fever in 2012.
  • Charges for these hospitalizations were more than $68 million.
  • Over the last 10 years, charges for Valley Fever hospitalizations have increased and totaled more than $650 million.
  • A special investigation on how Valley Fever affects Arizonans under 25 years old found that most were sick for at least a month and 20% had to be hospitalized.

Our staff in the Office of Infectious Diseases monitors rates of Valley Fever in Arizona and carries out investigations to better understand the disease. Check out our new website,, for more information.

MM “Declaratory Judgment”

November 13th, 2013 by Will Humble 24 comments »

A Complaint was filed against the ADHS and others last week.  It’s called a “Request for Declaratory Judgment and Permanent and Preliminary Injunction”.  It basically asks the Court to declare that: 1) extracts and resins from the marijuana plant are protected in the definition of “Useable Marijuana” under the Arizona Medical Marijuana Act; and 2) dispensaries, patients, caregivers, and agents are from criminal prosecution for violations of the Title 13 (criminal code) “Cannabis” statutes.  Of course, it’s more complicated than that, but that’s the thumbnail sketch of the Complaint.  This relates to one of my previous posts entitled Marijuana v. Cannabis  In a related matter, a Superior Court judge dismissed a complaint this week that argued that the 25 mile provision should be thrown out.

AZ Medical Marijuana @ 2

November 12th, 2013 by Will Humble 4 comments »

Our Vital Health Statistics team along with our partners at the UA College of Public Health completed our Year 2 Annual Report for the Arizona Medical Marijuana Program last week. You’ll find a wide range of information in the report including data about the demographics and kinds and qualifying conditions of our cardholders, geographic distribution and rates as well as background information on the budget and fund, the various lawsuits, and de-identified information about physicians that are writing certifications.

Perhaps the most striking thing in the report is that 25 doctors have signed about 70% (about 25,000) of the 36,000 or so certifications in Year 2… and a handful of doctors wrote more than 2,000 certifications. That doesn’t necessarily mean that these doc’s aren’t acting in the best interests of their patients- but it does give us some insight into which ones we should be focusing on to ensure that they’re meeting our certification expectations. The report goes into more detail if you’re interested.

You can see some of the recommendations at the end of the report. Of course… the info in the Annual Report is just a sub-set of all of the data we have about the program… and you can see the full array of data and information including our summary monthly reports on our hub website.

Undy 5000

November 8th, 2013 by Will Humble 1 comment »

Colon cancer is the second leading cause of cancer-related deaths in Arizona.  Most of the new diagnoses of the disease are late stage.  Discovery in late stage reduces the chance of survival. There’s really no reason for people to die from it – research shows colonoscopies that find polyps can dramatically reduce the chance of dying from colon cancer.  So why aren’t people getting screened earlier?  One of the reasons may be is people are afraid of the test.  In reality, it’s a pretty simple screening – I got mine when I turned 51.  Probably the worst part of it was the preparation.  I blogged about it and shared a good tip about my screening at a local Undy 5000 race.  

The annual Phoenix Undy 5000 helps raise awareness about the importance of the screening and gets people moving in an interesting way!  The Colon Cancer Alliance is hosting this year’s race on Saturday, November 16 at the State Capitol District. This event is unlike any others because a portion of the proceeds directly benefit our FIT at Fifty HealthCheck ProgramLast year, the event raised more than $130,000 and had 1,435 participants. This is the sixth year the ADHS has a team participating in the Undy 5000. So if you’re around town on November 16th, come on by the Capitol Mall…. You just don’t know what you’ll see.

Regulatory Reform Revolution Continues

November 7th, 2013 by Will Humble 1 comment »

One of the things I’m most proud of over the last 5 years has been the way we successfully overhauled our regulation licensed healthcare institutions in AZ.  Very few government entities could have accomplished such an all-encompassing regulatory reform effort that creates a new outcome-based system that will improve public health- while maintaining support from the vast majority of our Stakeholders.

Now we’re in the implementation phase. Our Licensing team has been attending association meetings and conducting and provider trainings for each of the new rule sets.  Licensing has also partnered with our Web and New Media team to make the most of our limited resources.  For example, our trainings have been “live-streamed” during the training so providers didn’t have to come all the way down to our building.  They’re also recorded so they can be viewed whenever the providers have time.   You can see some of the trainings our staff provided by visiting our implementation page and selecting provider trainings. There are still many more to come!

Our team is also improving some of the rule packages. For example, we’re still hard at work on improving rules for Adult Therapeutic and Behavioral Health Respite Homes. Since October 1st, we’ve continued to meet with stakeholders and the most recent drafts of these articles should be posted this week. Providers can give feedback and comments about the rules through our online survey. We’ll also have the surveyors working with providers and giving us their own feedback on issues they find in the field or rules that could be improved.

Hydrocodone Combination Products Moving to Schedule II?

November 7th, 2013 by Will Humble 1 comment »

Poisoning (including alcohol and prescription drugs) causes more deaths than car crashes in AZ.  Committed folks across the state are taking action on this issue.  We’re part of the Arizona Prescription Drug Misuse and Abuse Initiative, a multi-agency, multi-systemic approach to addressing the epidemic.  As part of this initiative, new guidelines have been issued for prescribing controlled substances in Emergency Departments and dispensing of controlled substances by pharmacists.  We are also one of four states that will be working with the Association of State and Territorial Health Officials over the next year to receive technical assistance to bolster our efforts to prevent and reduce prescription drug misuse in Arizona.  Now, a new tool may be on the horizon 

Last week the FDA announced that they’ll recommend to the US Department of health and Human Services that  hydrocodone combination products (like Vicodin) be reclassified from “Schedule III” to a the more restrictive “Schedule II” category.  The FDA will submit their formal recommendation package to HHS to reclassify hydrocodone combination products into Schedule II in December  They believe the National Institute on Drug Abuse will concur with their recommendation- which would begin a process that will lead to a final decision by the DEA on the scheduling change- which would better ensure that these products are properly prescribed and appropriately used by the patients who need them most.