There are many variations of passages of Lorem Ipsum available, but the majority have suffered alteration in some injected or words which don’t look even slightly believable. If you are going to use a passage of Lorem Ipsum, you need to be sure there isn’t anything embarrassing hidden.
Legislative Session Session PowerPoint
Here’s a Summary of the 2019 Legislative Session (PPT) and the Summary of the Legislative Session as a (PDF). It’s been updated a bit since last week as the Governor signed the medical marijuana bill this week (which will require testing of medical marijuana, gives the ADHS additional dispensary enforcement authority, allows MM data to be used for research purposes, and makes the MM cards good for 2 years (effectively reducing the card fees by half).
Many States Using State Earned Income Tax Credits as a Prevention Strategy for ACEs
Is it Arizona’s Turn?
It’s no secret that exposure during childhood to negative events called adverse childhood experiences increase a person’s likelihood of having long-term chronic or behavioral health issues like heart disease, violence, suicide, and substance use. ACEs like child abuse, neglect, parent incarceration, substance use, or separation are often clustered.
Policymakers in many states are looking for ways to prevent ACEs… which includes strategies to strengthen protective factors like social connectedness, access to healthcare and community resources, enhancing parental skills to promote healthy child development, and providing quality care and early education, and reduce risk factors before they occur. Arizona took a step forward this year by passing a budget bill that will draw down more than $60M in additional funds to support affordable childcare in Arizona.
Leading evidence-based policies to prevent ACEs before they occur are usually linked in some way to strengthening economic supports to help working families out of poverty and reduce parental stress. One well known economic support is the federal Earned Income Tax Credit.
Many states are recognizing that they can also play a role through their state-based tax codes – and implementing Earned Income Tax Credits at the state level. Arizona hasn’t done so yet.
Here’s how they work. The Earned Income Tax Credit is a refundable income tax credit that can be used to reduce the tax burden for low- to moderate-income working people. The federal government along with 29 states have established them at the local level. Arizona doesn’t.
Economic support from Earned Income Tax Credits is associated with improved infant and maternal health, better school performance for children, and increased college enrollment. Research suggests they reduce risk factors for child abuse and neglect ACEs by offsetting the costs of raising a child among working families.
This webpage from the National Conference of State Legislatures has a host of information about which states have state based Earned Income Tax Credits and how they work. They’re usually based on a reference to the federal EITC.
State Earned Income Tax Credits are a promising economic support for working families that help to raise more than six million people—half of them children—above the poverty line each year.
Arizona lawmakers have long had a zeal for reducing taxes. Perhaps next year they should look at taxes from a new angle- using tax policy to support an evidence-based policy a state based earned income tax credit- that will that prevent negative childhood events and bad public health outcomes.
Report Suggests Paternal Parental Work Flexibility Improves Maternal Outcomes
A new report published this week from the National Bureau of Economic Research found increasing a father’s work flexibility after a baby is born reduces the risk of the mother having physical postpartum health complications and also improves her mental health.
Workplace flexibility has long been key factor in improving postpartum outcomes but less has been known about how a father’s work hours flexibility influences outcomes. The paper this week examined father’s work flexibility and the affect that it has on intra-household responsibilities and the effect that that flexibility has on maternal outcomes.
The paper examined the effect that work flexibility has in the months immediately following childbirth. The authors found that a dad’s access to workplace flexibility improves maternal health. They modeled household demand for paternal presence at home in the context of a Swedish reform that granted new fathers more flexibility to take intermittent parental leave during the postpartum period.
Increasing the father’s work hours flexibility reduces the risk of the mother experiencing physical postpartum health complications and improved her mental health. The abstract concludes that “Our results suggest that mothers bear the burden from a lack of workplace flexibility–not only directly through greater career costs of family formation, as previously documented–but also indirectly, as fathers’ inability to respond to domestic shocks exacerbates the maternal health costs of childbearing.”
Interesting research in the context of what kinds of public health policy interventions are effective at improving maternal postpartum health, don’t you think?
Title X Family Planning Article
Andrew Howard from the Arizona Capitol Times wrote this informative story about the outcome of a 2017 state budget provision requiring the ADHS to apply for Title X family planning grant. Many people believe that the requirement was included in the budget in hopes that the ADHS would get Title X funds (as they’re prohibited from contracting with Planned Parenthood).
I won’t say anymore about the story… except that it’s a quick informative read about the outcome of a key public health policy decision here in AZ.
What Can You Do this Summer RE Public Health Advocacy?
Send your elected officials a short note thanking them for their service. The last few days were long and stressful for all.
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Invite them to tour your facilities over the interim.
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“Like” your elected officials on social media and follow them.
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Attend any events they are holding over the summer.
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Monthly send them a short note with interesting information about their district and those they serve (who you also serve!)
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Use this time during the interim to build relationships with your home and work district elected officials so they know who are when session starts January 13, 2020.
This spreadsheet has legislator contact information and committee assignments. Targeting legislators who serve on committees of interest to us is a good strategy to start with. This spreadsheet has our member facilities by legislative and congressional district.
Yuma County Captures 2019 Spotlight Award
Blue Cross Blue Shield of Arizona and fitness icon Jake “Body by Jake” Steinfeld have teamed up to shine a light on people and programs that are making Arizona healthier. The 2019 Spotlight Awards honor leaders across our state who are inspiring health and wellness in their communities, where it matters most.
WINNERS:
Business of the Year: Chicanos Por La Causa
City of the Year: City of Phoenix
County of the Year: Yuma County
Tribal Nation of the Year: Tohono O’odham
School District of the Year: Tempe Elementary School District #3
School of the Year: Brunson-Lee Elementary
Terrific Op-Ed Regarding Vaccine Safety and Herd Immunity
Dr. Bob wrote a really good op-ed in the Daily News Sun this week. I thought I’d include it in this week’s Policy Update because it’s so well written.
I’d like to try to offer some perspective in response to Diane Douglas’ May 24 commentary on vaccine safety.
“Herd immunity” is a medical miracle, preventing millions of cases of disease and many deaths every single year. Yet it’s a pretty simple concept.
No vaccine works perfectly. But the more people are immunized, the less likely one person’s germs are to spread to the next person. Depending on the disease, one sick person might infect several others, each of whom infect several more. That’s an outbreak. But if you keep the level of immunizations high enough that there is less than one new case of disease for each original sick person, then outbreaks simply don’t happen. Your personal immunity from your own vaccine never gets put to the test, because you are never exposed in the first place. This makes vaccines unlike any other health decision – because your action affects others.
Herd immunity results in remarkable protection. Diseases that were once nearly universal can be practically wiped out. In the example of smallpox, a disease that killed perhaps half a billion people in the 20th century alone, we were able to eliminate the disease entirely. There’s no biological reason that we couldn’t do the same with some other diseases – we’ve come close to eliminating polio, for example.
You are, right now, being protected not just from the vaccines you got, but from all the vaccines that everyone around you got. And what you do by immunizing yourself or your kids doesn’t just benefit your own family – it helps to protect everyone else, notably all those who, for medical reasons, can’t be vaccinated themselves. Similarly, choosing not to be vaccinated, yet living among others, lowers that level of herd immunity and puts others at risk. Exactly what that threshold of herd immunity is varies by disease (how infectious it is), by the vaccine (how effective it is), and by the setting (how congested and interactive people are). Among the worst settings for spreading disease are schools and childcare centers.
That concept of pitching in to benefit each other is a thoroughly American idea, from the early colonists creating a commons in nearly every town, to compulsory quarantine in the 1600s, to requiring vaccination for school attendance beginning in 1855, to early and repeated court decisions that have upheld various vaccination laws and regulations since at least 1905. This is not new, and since it has been in place for all our entire lives, it is obviously not a “slippery slope” that has led to any sort of draconian consequences.
Vaccines must meet the same safety and efficacy standards that other pharmaceutical products must reach before being licensed for use in the U.S. The benefits to an individual and to society of vaccines far outweighs the small risk, for example, of an allergic reaction. Yet recognizing the societal value of immunizations, the nation established the National Vaccine Injury Compensation Program, which requires a far lower burden of proof and a simpler process than a lawsuit, to assure that anyone who legitimately might have been harmed by vaccines is compensated. Even with these looser standards, which mean that some people are compensated even though it may be unlikely that the vaccine caused the injury, approximately one person is compensated for every 1 million doses of vaccine given in this country.
In her commentary, Ms. Douglas invoked appeals to individual liberty. All of us can relate to that. America guarantees many liberties, but we establish limits when others might be harmed. Any one of us is free to use public streets, but we don’t get to drive however fast we want, because that would put others at risk. Similarly, any one of us is free to send our kids to public schools, but we should not be allowed to deliberately put other people’s children at risk by ignoring vaccine requirements.
Bob England, MD, MPH
Former Director (2006-2018) of the Maricopa County Department of Public Health
Legislative Session Wrap Up
Another legislative session is in the books. All in all – a solid legislative session with some pretty significant public health policy gains. The main areas where progress was made were in access to care, maternal and child health, assurance and licensure and injury prevention.
There were several bills that didn’t progress which would have been a public health benefit and several really good ideas which never even got a hearing- so there were missed opportunities- but overall a solid B+ session I’d say.
We had lots of help with our advocacy efforts this year. Annissa Biggane and Timothy Giblin worked hard each and every week tracking bills, doing triage, ferreting out schedules, and writing risk/benefit analyses.
Eddie Sissions carried a lot of water as usual. She has great insight and a keen ability to figure out the nuances of session and figuring out “how the water flows”. Also a big help were our cadre of folks that called in to our bi weekly calls and strategy sessions.
The real key to our advocacy success is you – our membership. The relationships you make with our elected officials and your focused advocacy efforts are super important to our success at influencing public policy. Thank you all and well done this year!
I put together a Powerpoint summary of the 2019 legislative session to help y’all digest what happened this year. I’ve got links on the pages that’ll drive you to the actual bills. Take a look. BTW- if you open the link with an Apple product like an iPad- the PowerPoint will look weird and unprofessional- so open it on a laptop and in PowerPoint.
State Supreme Court Says Edibles are Protected by the AZ Medical Marijuana Act
The Arizona Supreme Court put to rest the question whether edibles, extracts and resins are covered in the Arizona Medical Marijuana Act and whether patients are protected from criminal charges for possessing them. The court was unambiguously clear this week that edibles are indeed covered in the Act.
The Ruling came in the form of the final decision in the State v. Jones case which was released on Tuesday.
Here’s the case in a nutshell. Back in 2013 a medical marijuana patient (who had a valid ADHS Medical Marijuana Card) was arrested for possession of a small amount of hashing (a preparation of marijuana) in Yavapai County. Even though he was a Qualified MM Patient, he was convicted by a jury of a class 6 felony and spent 2.5 years in jail.
Mr. Jones appealed his conviction in Superior Court to the Court of Appeals which upheld his conviction. He appealed to the state supreme court who heard the case about 6 weeks ago.
The Arizona Medical Marijuana Act provides qualified patients and dispensaries a number of legal protections under the voter approved Act. The Act’s definition of “Marijuana” in A.R.S. § 36-2801(8) differs from the Arizona Criminal Code’s definition of “Marijuana” in A.R.S. § 13-3401(19). In addition, the Arizona Medical Marijuana Act makes a distinction between “Marijuana” and “Usable Marijuana” A.R.S. § 36-2801(8) and (15). The basics of the case consists of a profound difference of opinion between the prosecutor, who believes that edibles are not included in the definition of Marijuana in AMMA, and the defense, who makes the common sense argument that edibles are included.
Mr. Jones’ appeal was successful and Qualified Patients can now be assured that as long as they have the allowable amount of marijuana in their possession they are protected from prosecution. That means they can have up to 2.5 ounces of dried marijuana flower or, as the court said this week, “… mixtures or preparations made from two-and-one-half ounces of dried flowers”.
Dispensaries can now be assured that their business models that rely on the production and sale of edibles and extracts are protected as well.
Case closed.
FYI- Kind Meds put together a page of the most frequently asked questions about medical marijuana at this site: : https://kindmedsaz.com/education/faqs/