The construction on our new Forensic Unit at the Hospital is moving right along. The plumbing and electrical systems, heating and cooling systems, and the wall/ceiling trim are now complete in all the new buildings. Hot and chilled water pump controllers were recently installed which allowed the air handler to start up. Once the kinks are worked out of the air handling system, we can begin the climatization process- allowing the construction team to finish the millwork, flooring, and wood door installation. May was a busy month for the Support Building as well. The electrical and air handling systems were finished, the exterior metal windows and aluminum storefronts were installed. For the past few months, the project has been tracking for an early completion date (around August 3, 2011) meaning that it’s possible we could move our patients and staff into the new facility during the first week of October.
. The Arizona cases are in the Yuma area. It’s a rare condition that rarely (but occasionally) happens several days after a person has been sick with diarrhea- often from a foodborne bacteria called Campylobacter jejuni. The illness happens when person’s own immune system damages the nerves, causing muscle weakness and sometimes paralysis. Most people recover fully from it but some people have nerve damage that doesn’t go away.
Our epidemiology team is working with folks from the CDC and Yuma County to track down the cause. Most of the work is gumshoe type epidemiology and includes reviewing medical records to confirm diagnoses meeting with hospital staff and neurologists to discuss clinical signs and symptoms (they have already reviewed 3 records and are currently reviewing a fourth case at a second hospital), and interviewing patients and family members to determine exposure history, particularly related to foodborne illnesses.
The U.S. Department issued new guidance for federal prosecutors last week. We had been anticipating a new memo from Justice for some time- hoping that it would clarify whether the dispensary portions of the Arizona Medical Marijuana Act are legal under federal law (the Controlled Substances Act). We were also hoping it would help us figure out how risky it would be for us to issue dispensary applications. Unfortunately, the new guidance didn’t help much.
The guidance makes it clear that folks that facilitate large scale cultivation are at risk for prosecution. People that “facilitate” cultivation are also at risk for prosecution. But, a key remaining question is what the word “facilitation” means. Could it mean that issuing state approved licenses for cultivation and dispensing would put us at risk for prosecution? We’re hoping that the upcoming Declaratory Judgment will answer this question (and others) once and for all. You can check out the new memo from Justice on our website.
This week’s giant dust storm (technically called a haboob) blew through the valley leaving dust hovering in the air for days. The ADEQ said one Phoenix testing station recorded an astronomical reading of over 6,000 micrograms per cubic meter (of PM 10) on Tuesday evening (the federal EPA standard is 150 averaged over a day). PM 10 is a measurement of the concentration of particles in the air that are smaller than 10 microns in size. We’re most interested in particles smaller than 10 microns because they actually make it into the lungs (larger particles get trapped in your throat and nose and don’t make it to the lungs where the damage can be done).
The dust storm also blew in concerns about Valley Fever. Valley Fever is caused by a fungus and its spores that grow in the top layers of the desert soil (below 4,000 feet elevation). Strong winds may be able to disrupt it and pick up the fungus. ADHS does a little research into Valley Fever cases by interviewing and reviewing case files of those who have been diagnosed. We have a video on our website to help people understand the disease and how to talk to their doctors about it. The truth is that we don’t really know for sure whether dust storms actually make people sick with Valley Fever- but we’ll be following our surveillance data after this extraordinary event to see whether the storm had an impact on rates. To learn more, visit the ADHS valley fever website at www.valleyfeverarizona.org.
If you’re my age, you probably walked or biked to school- it was a basic part of our culture. Unfortunately the tradition has been lost (for now). In 1969 half of all kids walked or bicycled to and from school and almost 90% of kids that lived within a mile of school walked or biked. Today only 15% of kids walk or bike, and the number of trips made by cars has skyrocketed (I’m guilty with my kids too).
We’re trying to change that. We just launched our new online assessment tool called the Active School Neighborhood Checklist as a first step. We’re partnering with the Arizona Department of Transportation Safe Routes to School Program to develop a tool that generates a score which represents the walkability, bikeability and safety of schools. The results of this assessment will help communities, school facilities professionals, schools, and city officials identify barriers that prevent students from walking and biking to school each day and create solutions to encourage neighborhoods to be more physically active.
Many thanks go to the WIC Information Technology team for creating this first-of-its-kind instrument. We’re very proud of its partnership with ADOTs Safe Routes to School Program — a key connection between the built environment and health.
A couple of years ago (when the financial crisis was just starting), we brainstormed about how we could bring down the utility bills in our State Laboratory. The Lab has always been electricity intensive, partly because of the workplace safety requirements etc. (e.g. the “hoods”) require more air exchange than a normal building. That means constantly bringing in 115 degree air and cooling it down to 78.
Since our initial assessment 3 years ago we’ve implemented several energy saving interventions. Some of the changes were operational (reprogramming exhaust fans) and adjusting the building settings when unoccupied to save energy. Last year these changes saved about $230,000, including a 17% reduction in electricity usage, 71% less in natural gas and a 30% drop in water. APS rewarded us with a check for $73,300 from their energy incentive program.
Our building management folks in the Lab figured out that the biggest energy efficiency enhancement of all would be if we could install an evaporative cooler in front of the air intake for the A/C unit, but that would have cost about $180K. So we used the $73K from APS and some other (non-state) Lab funds and ordered a swamp cooler for the Lab a few months ago. Last week our dream became a reality, and a crane hauled the large swamp cooler up to the roof of the Lab. The new cooler will have a sensor that knows when it’s more energy efficient to run the 20 HP cooler motor or the normal A/C system, depending on the dew point (the swamp will generally kick in when the dew point is in the mid 50′s and below). The project also includes temperature recovery coils which basically use the energy in the cool air leaving the building to reduce the temperature of the incoming air (reducing the electricity needed to cool the air).
The engineers estimate that the new swamp cooler and temperature recovery coils will save an additional $72,000 in annual utility costs (bringing our annual efficiency improvement to over $300,000 per year). Next, we’ll apply for another rebate from APS from the cooler and coil savings. If we get another rebate, we’d like to invest in the next efficiency item on the list- solar panels on the roof of the Lab. Good creative thinking and execution!
The Pew Children’s Dental Campaign released the State of Children’s Dental Health Report that grades each state’s policy responses to the crisis in dental health among America’s children. Arizona raised its grade to a “B” for 2011. We made improvements in the share of high-risk schools that participate in the school-based sealant program. This can partly be attributed to our policy changes that expanded eligibility to schools at 50% and greater Free and Reduced School Lunch status.
While we’re moving in the right direction of implementing demonstrated policies to improve oral health, there’s still much more needed to move the oral health status of our population toward the Healthy People 2020 targets. Our Office of Oral Health addresses the prevention and control of oral disease through the Arizona School-based Sealant Program; the School Fluoride Mouthrinse Program; and developing workforce practice models.
We made more progress filling our key positions in behavioral health this week. We’re delighted that Ashraf Lasee, MPH, Dr.PH, M.B.B.S has agreed to serve as our new Division Chief for Quality Management. Ashraf has a keen respect for data and understands the importance of solid data collection and analysis in driving quality improvement. She recognizes the importantance of data integrity, understands its importance in program performance assessment- and knows how to execute. She served as the Division Chief of the Medical and Utilization Management in the Children Rehabilitative Services program a few years back, and during her tenure her team greatly improved our CRS compliance performance across the board. We’re putting her skills to work right away in our initiative to improve the Quality & Utilization Management assessment elements in behavioral health. Khush amdeed!
Ann Froio has been the Department’s “Fix-it” specialist for the last several years. Most recently, Ann has served as Interim CEO for the Arizona State Hospital while the Department conducted a national search for a new CEO. For the year prior to that, Ann served as the Interim Director at the Arizona Community Protection and Treatment Center (ACPTC). She’s also served as the ADHS Assistant Director for Operations/Organizational Development- while in that position, she rolled up her sleeves and helped us to improve efficiency and Stakeholder relations in various programs.
So, it’s a delight that Ann has agreed to share her talents with us as the new Assistant Director for behavioral health. Ann’s experience in both state government and the private sector is amazing and includes multiple aspects of behavioral health and health care administration and service delivery. She has broad experience in health care leadership, management and direct service including organizational change; licensing; quality management, utilization and medical management in managed care organizations, outpatient and inpatient settings; medical records; medical coding; training and education; risk management; grant, contract and proposal writing; procurement; contract administration and monitoring; HIPAA implementation; drafting administrative rules; strategic planning; business informatics; developing policies, procedures; building rates and budgets; research and evaluation; and the provision of direct services as a clinician.
This is a perfect fit. Thanks Ann!