AZ Office of Administrative Hearings Speaks

November 26th, 2013 by Will Humble No comments »

The formal protest process regarding our award of the Regional Behavioral Health Authority contract in Maricopa County is finally winding down.  The proceedings at the Office of Administrative Hearings (OAH) were completed a few weeks ago, and the Administrative Law Judge (ALJ) issued her recommendation on Monday, concluding that: “Based on the foregoing, it is recommended that ADHS’s award of the 2013 RBHA contract to MMIC shall be affirmed and that Magellan’s appeal shall be dismissed.” 

The Recommendation (at the end) says: “In the event of certification of the Administrative Law Judge Decision by the Director of the Office of Administrative Hearings, the effective date of the Order will be five days from the date of that certification”…  which suggests that the ALJ’s recommendation still needs to be certified by the OAH Director- and that the effective date of the recommendation would be 5 days after that.  At that point the certified recommendation would go to the Arizona Department of Administration for a final determination.


Chronic Disease Calculator E-tool.

November 25th, 2013 by Will Humble No comments »

The CDC just developed a great new Cost Calculator that provides state-level annual medical expenditure and absenteeism estimates for 10 chronic conditions.  The tool provides medical expenditures for all of AZ for all payers as well as specific payers Medicaid, Medicare, and commercial insurers.  The 10 chronic conditions are arthritis; asthma; cancer; cardiovascular diseases (congestive heart failure, coronary heart disease, hypertension, stroke, and other heart diseases); depression; and diabetes.  Graphs and charts are provided to visually communicate the cost estimates. 

The Cost Calculator estimates were derived from state- and national- level data from the Medical Expenditure Panel Survey and National Nursing Home Survey so the estimates may differ from estimates generated directly from analysis of claims data.  However, folks can do a customized analysis using other data sources including Medicaid or Medicare claims data. Technical support can be requested at the website or at

Healthy Thanksgiving

November 25th, 2013 by Will Humble 1 comment »

Whether you’re hosting a Thanksgiving celebration or attending as a guest, you can help make the healthy choice the easy choice for your friends and family.  Consider making a healthier version of an old favorite to share. This recipe for Corn Bread Crusted Turkey would go great served with this slightly modified recipe for a classic Green Bean Casserole.  

More common Thanksgiving recipes might use ingredients like cream, butter, and canned soups, but these recipes feature low fat dairy, low sodium- basically healthier ingredients.  Once the meal is prepared, you can help keep portions in check by turning off the TV, eating slowly, and filling half of your plate with fruits and vegetables. Stay active after your meal by playing some football with family or friends or taking the pets for a walk. 

If you’ve got multiple holiday celebrations to attend or host, you can check out these 10 tips from to help plan a gathering that supports healthy eating and active living. Most important, don’t forget to enjoy the holiday food, festivities, and fun. Happy Thanksgiving!

Draft New Abortion Clinic Regulations

November 22nd, 2013 by Will Humble No comments »

A state law (HB 2036) was passed and signed awhile back that tasked us with several things related to the regulation of abortions in AZ.  Among them were provisions directing us to develop a parental informed consent form for minors and establish a website with a host of information identified in the statute. 

Our next task is to conduct a Rulemaking to update our abortion clinic regulations so that they’re consistent with Arizona law.  The statute was prescriptive, so the rulemaking should be pretty straightforward.  We’ve posted our first swipe at the new draft regulations – which are now out for public comment.  We’ll be going through a couple of rounds of public input…  and we expect to establish the final new abortion clinic rules by early Summer. 

By the way…  we publish a comprehensive annual report with abortion statistics and demographic characteristics every year.  The report includes data compiled from reports of elective abortions and complications resulting from an abortion among other data.  Last year’s report found a 7.4% year-to-year decrease in overall abortions.


Rural Metro’s October Update

November 21st, 2013 by Will Humble No comments »

We’ve been monitoring the response times for the big ambulance service provider – Rural Metro – since they went into bankruptcy in August.  They have 13 different ambulance services in Arizona and we want to make sure that they’re meeting the grade during their reorganization.   We asked them to send us monthly reports on their response times in each ambulance district.  We’ve seen some progress in the first two months… and the October data we got this week continues to look OK. 

But remember…  response times are only one component of the performance puzzle.  In order to look at system quality we encourage ambulance companies and fire departments to join the Premier EMS Agency Program  and SHARE/EPIC and to collect data on some targeted performance measures relating to heart attack, stroke, trauma and cardiac arrest. You can check here to see if your local ambulance service provider has joined up.


This is An Exercise

November 20th, 2013 by Will Humble No comments »

Arizona’s public health and healthcare system teamed up with the ADHS including our Bureau of Public Health Emergency Preparedness and the Arizona Division of Emergency Management last week in one of the largest preparedness exercises of the year. The objective was to test and build preparedness capabilities across the emergency management system in AZ.

More than 3,000 public health players tested the ability to communicate and coordinate under a long term power outage scenario. It was also a great opportunity for us to open our Health Emergency Operations Center and exercise our incident command system. We tested our ability to maintain continuity of operations and support public health and our healthcare partners in a disaster scenario. The exercise helped us achieve key deliverables for our preparedness grant programs and really moved us forward along our strategic map (to Promote and Protect Public Health and Safety) with the goal of preparing for and responding to public health emergencies. 

We explored some innovative preparedness strategies as we partnered with Local EMS, FEMA, the Department of Defense and the HHS as we coordinated patient movement requests, and tested information sharing systems to help best coordinate and integrate public health support across all levels (local, county, tribal, national). In all it was a great success and learning opportunity in that it validated our preparedness plans and identified key areas we can continue to strengthen and build upon for next year. You can do your part in keeping up to date on some basic online preparedness training courses (ICS100,700).


Empowering the El Congreso Internacional de Promoción de la Salud

November 19th, 2013 by Will Humble No comments »

I was fortunate to attend the 2nd annual “ECongreso Internacional de Promoción de la Salud (CIPS)” last week in Hermosillo.  There were more than 400 public health attendees from 17 countries at the conference.  I presented our pre-school Empower program….  which empowers kids to make good choices about nutrition, physical activity, and tobacco using age-appropriate vehicles including costumed characters and a coloring book.  

My presentation focused on 10 Sample Policies including links to implementation resources.  I brought a 1-foot stack of Spanish Empower brochures which were completely gone after the first day.  Hopefully Empower will become a pre-school best-practice all the way from the Nogales border to Tierra del Fuego!

Trans Fats on the Way Out?

November 18th, 2013 by Will Humble 2 comments »

The FDA made a preliminary determination that partially hydrogenated oils (the primary dietary source of trans fat in processed foods) are not “generally recognized as safe” for use in food.  Their review of the research has led them to conclude that consuming trans fat raises LDL, or “bad” cholesterol, and increases the risk of coronary heart disease. The FDA opened a 60-day comment period this week.  Folks can submit electronic comments and scientific data and information until January 7.

Newborn Screening Rulemaking

November 16th, 2013 by Will Humble 1 comment »

Our Newborn Screening Program ensures that each newborn is tested for 28 inherited disorders and hearing problems.   The goal is to help kids avoid illness, developmental delays and even death by quickly identifying problems and swiftly letting their doctors know so they can implement interventions.  On any given day our newborn screening team tests from 600 to 1,500 bloodspot samples for each of the 28 disorders.

Our demographics team verifies the results and ensures that results are sent out.  Our case management team follows up on about 140 potentially positive results (including hearing) each week and works with pediatricians, clinical specialists and families. The program allows hundreds of families have the opportunity for their newborn to receive the early treatment, intervention and support services that will allow them to lead normal lives.

We published new proposed rules for the program back in August, updating the fees that we charge for these services.  The fee for a first specimen is $30 and we’re proposing to keep that the same.  We’re proposing to change the fee for the 2nd specimen from $40 to $65. We’re still accepting comments  on the proposed Rules electronically.  We’ve gotten a fair number of comments asking us to add Critical Congenital Heart Defects to the panel.  While that condition isn’t included in the proposed rules, we’re seriously considering adding it to the list.  The procedure uses pulse oximetry (measuring oxygen levels in the blood through the skin) to identify some infants with critical structural heart defects.

Last year the CDC recommended that all newborns be screened for critical congenital heart disease using pulse oximetry.  Congenital heart disease occurs in approximately eight in every 1,000 live births…  and if left undetected, kids are at risk for the development of serious complications within the first few days or weeks of life.  For more info, check out CDC’s latest  Morbidity and Mortality or MMWR report which highlights Newborn Screening and Critical Congenital Heart Disease.

Please let us know if you’d like us to add Critical Congenital Heart Defects to the panel by commenting on-line during November.

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.