Federal District Court in Florida Strikes Down CDC’s Transportation Mask Requirement

The U.S. Federal District Court for Mid-Florida (Tampa) just threw out the CDC’s regulation requiring people to wear masks on public transportation. The court’s 59 page decision (see the Health Freedom Defense Fund v. Biden decision) found that CDC exceeded their statutory authority and didn’t follow the proper administrative procedures under the Administrative Procedures Act when they established the regulation.

The transportation mask requirement was definitely a needed public health intervention. We’re lucky that the lawsuit was filed late in the pandemic and that this decision came down after cases and hospitalizations had dropped precipitously. It’s likely that the CDC/Biden will appeal the decision to the appellate court system, so it’s possible that a higher court will keep the mask requirement in place pending hearing the appeal…  but they also might not take the case and if they do, they might let the lower court ruling stand during the process.

We should know the answers to those questions soon…  but in the meantime, it looks like masks will no longer be required on jets and other forms of public transport like subways and busses etc.

Meanwhile, in a separate but similar case, Arizona joined 20 other states filing a similar lawsuit in the same federal district court challenging the CDC’s 2021 emergency regulation requiring people over the age of two to wear masks on public transportation, airplanes, trains, and transport hubs like airports and train stations. [See the CDC Rules: 86 FR 8025 – Requirement for Persons To Wear Masks While on Conveyances and at Transportation Hubs 86 Fed. Reg. 8,025.].

Editorial Note: It’s curious that the plaintiffs in both cases chose to file in the same Tampa district court. It’s almost like they were shopping for a favorable judge, dontcha think?

The crux of the arguments in both cases is that CDC exceeded their statutory authority under the Public Health Service Act [42 U.S.C. § 264(a)]. Plaintiffs believe that law doesn’t authorize CDC to establish their emergency rule requiring masks in those environments. The suit also argues that CDC didn’t use proper administrative procedures when they established the rule (failing to consider lesser alternatives and not following the APA’s notice and comment requirements).

Once these two cases are fully adjudicated, we’ll get more clear information from the courts about the extent of the CDC’s authority to quickly establish rules during public health emergencies and whether there is latitude for the agency to take some shortcuts while establishing regulations during public health emergencies.

Note: According to Jennifer L. Piatt, JD, Deputy Director of the Network – Western Region Office, “…the US Supreme Court has already started to give us a sense of how broadly it views the CDC’s authority to act in times of crisis. In Alabama Association of Realtors v. HHS, the Supreme Court indicated that CDC did not have the authority to issue a nationwide eviction moratorium under the Public Health Service Act, 42 U.S.C. § 264(a). This is the same section at issue in this new case on transportation masking requirements. Alabama Realtors has thus already demonstrated that the Court is willing to limit CDC’s authority under this section of the Public Health Service Act (PHSA), and it’s possible that the Court’s language in that decision may illuminate or drive some of the lower courts’ interpretations in this case.”

Resource Note: When you have questions about public health law that come up in the course of your work, a terrific resource is the Network for Public Health Law. They are a terrific, free, resource that can help you think through your legal questions by researching laws and case law to help you make decisions. It’s not legal advice, but a terrific resource. Here’s a place to start when you have questions: How We Can Help – Network for Public Health Law.

April 18, 2022 Legislative Roundup

The bill logjam appears to be easing a bit this coming week, but not in a good way at least so far. There are two harmful bills that will be heard on the Senate floor on Monday (called 3rd read).

The most harmful is HB2616 which permanently takes universal masking away as a public health intervention in classrooms. It’s roundabout way says schools can’t require kids to wear masks ‘without the express consent of the parent‘, nullifying the intervention because classroom masking only works when it’s universal (basic masks are good at stopping particles from leaving mouths and noses but they’re poor filters except for N95’s and equivalent).

HB2498 stops cities/counties from ever requiring a COVID vaccine for staff. This one is less harmful than HB2616 in that it’s limited in scope and only applies to the COVID-19 vaccines.

We urge you to contact any Senator that you think might listen to you and urge them to vote no on both of these on Monday, but especially HB2616. List of Senators is here: Senate Member Roster.
See Our Weekly Bill Tracker
Bill Overview: Select Bills AzPHA is Supporting

Maternal/Child Health

SB1272 AHCCCS; postpartum care; eligibility; Passed Senate 26-2; Passed House Health & Appropriations; Ready for Floor Vote

Access to Care

HB2144 health insurance coverage; biomarker testing Passed House 59-0; Passed Senate Finance; Ready for Floor

Special Needs

HB2157 supplemental appropriations; community-based services SIGNED

HB2113 developmental disabilities; Down syndrome SIGNED

HB2111 appropriation; healthy families program – Passed house 40-17; Waiting for Senate Rules Committee

Social Determinants

HB2060 supplemental nutrition assistance program; Passed House 44-15; Passed Senate Health 7-1. Ready for Senate Floor

HB2484 forcible entry; detainer; filing fee Passed House 59-0; SIGNED

Environmental

HB2255 fireworks use, limitations, prohibition Passed House. Ready for Senate Floor

State Hospital/Behavioral Health

SB1716 state hospital; governing board; governance Passed Senate 27-0; Passed House Health 9-0.

SB1444 state hospital; administration; oversight Passed Senate; Passed House Health; Rules then Floor

SB1641 health care institutions; civil penalties Passed Senate 28-0. Passed House Health, Still needs Appropriations

SB1162 opioid prescriptions; intractable pain; exceptions Passed Senate 27-0. Passed House & Sent Back to Senate

SB1210 mentally ill; transportation; evaluation; treatment; Passed Senate. Passed House Health 8-0. Rules then Floor.

 

Bill Overview: Select Bills AzPHA Is Opposing

Vaccines/Disease Control

HB2086 ADHS; school immunizations; exclusions Passed House 31-28; Passed Senate Health 5-3. Rules then Floor

SB1009 state of emergency; executive powers Passed Senate 16-13; Ready for House Floor Vote

HB2453 mask requirement; prohibition Passed House 31-28. Ready for Senate Floor Vote

HB2616 mask mandates; minors; parental consent Passed House 31-28. ACTION ALERT: Senate Floor Vote Monday 

HB2161 parental rights; schools; educational records Passed House 31-28. Senate Floor Vote Monday

HB2498 COVID-19; vaccination requirements; prohibition. Passed House. ACTION ALERT: Senate Floor Vote Monday

Social Determinants

SB1164 – abortion; gestational age; limit SIGNED

Government

SB1175– noncustodial federal monies; appropriation Passed Senate 16-13; Ready for House Floor 

Incarceration and COVID-19: Practice and Research Approaches to Combat COVID-19

A Free, Online Workshop

Thursday, April 21, 8:30 a.m.–noon

The Northern Arizona University Center for Health Equity Research, in collaboration with the COVID Prison Project and the Arizona Biomedical Research Centre, is offering this free workshop.

COVID-19 has had a high impact on correctional facilities (jails and prisons). This workshop will discuss the impact of COVID-19 on correctional facilities through a tribal, local, and national lens and discuss how different players and institutions have attempted to combat COVID-19 through practice and research.

Workshop: Incarceration and COVID-19 | Center for Health Equity Research

Speakers

Lauren Brinkley-Rubenstein, PhD

COVID Prison Project

Kathryn Nowotny, PhD

COVID Prison Project

Delores Greyeyes, PhD

Director, Navajo Department of Corrections

Captain Richard Martin

Yavapai County Sheriff’s Office

Beya Thayer, MSW

Yavapai County Sheriff’s Office

Moderators

Ricky Camplain, PhD

Carly Camplain, JD

Register now

Journal Article of the Week

Changes in Life Expectancy Between 2019 and 2021 in the U.S. and 19 Peer Countries

US life expectancy decreased by 0.40 years between 2020 & 2021, adding to an historic 1.87-year reduction in 2020. As in 2020, the decrease in US life expectancy in 2021 was highly racialized, but it followed a distinctly different pattern.

Hispanic and Black populations experienced disproportionately large decreases in life expectancy in 2020, life expectancy in the Hispanic population increased negligibly in 2021. Life expectancy in the Black population increased by 0.42 years in 2021.

The non-Hispanic White population experienced a further decline of 0.34 years, which occurred disproportionately among men likely resulting in part because of low vaccination rates among while males in the US.

47th Annual Arizona Rural Health Conference June 14 in Flag

For the past 47 years, the Arizona Center for Rural Health has hosted the Annual Arizona Rural Health Conference in collaboration with the Arizona Rural Health Association, making it one of the longest continually running rural health conferences in the United States.

The Arizona Rural Health Conference provides an environment for networking and dissemination of pertinent information among professionals and community members from rural Arizona and the Southwest. Register here.

After 4 Years, Community Health Worker Certification Rules Finally in Home Stretch

Community Health Workers are frontline public health workers who have a trusted relationship with the community and facilitate access to a variety of services and resources for community members. Building CHWs into the continuum of care has been proven to both improve health outcomes and reduce healthcare costs.

For a picture of how CHWs can fit into a continuum of care, take a look at this report from the NAU Center for Health Equity Research in collaboration with the UA Prevention Research Center (AzPRC) which provides insight into innovative strategies for integrating, sustaining and scaling of the CHW workforce within Medicaid (AHCCCS).

Building CHWs into the healthcare continuum requires that a certification process be in place. The public health community tried for many years to get such a process in place, finally meeting with success 4 years ago with the passage of HB 2324 (sponsored by Representative Carter), which charged the ADHS with implementing a program for the voluntary certification of Community Health Workers.

After 4 years of anticipation (and advocacy trying to get the ADHS to write the rules) the agency is finally adopting those rules.

Notice of Proposed Rulemaking is the Administrative Rules Webpage.

The scope of practice and the core competencies of certified community health workers;

  • Qualifications for certified community health workers;
  • Requirements for community health worker’s education and training programs;
  • Standards and requirements for continuing education courses;
  • Education, training, experience and other qualifications for trainers;
  • Criteria for granting, denying, suspending, and revoking a certificate; and
  • Certification application fees.

The draft rules are open for public comment through June 6.

There’s an oral proceeding on Wednesday, May 18, 2022 from 1:00 – 4:00pm. You can join by phone at (+1 240-617-0064 PIN: 659 165 829#). Questions go to Carin Watts, carin.watts@azdhs.gov

Incarceration and COVID-19: Practice and Research Approaches to Combat COVID-19

A Free, Online Workshop

Thursday, April 21, 8:30 a.m.–noon

The Northern Arizona University Center for Health Equity Research, in collaboration with the COVID Prison Project and the Arizona Biomedical Research Centre, is offering this free workshop.

COVID-19 has had a high impact on correctional facilities (jails and prisons). This workshop will discuss the impact of COVID-19 on correctional facilities through a tribal, local, and national lens and discuss how different players and institutions have attempted to combat COVID-19 through practice and research.

Workshop: Incarceration and COVID-19 | Center for Health Equity Research

Speakers

Lauren Brinkley-Rubenstein, PhD

COVID Prison Project

Kathryn Nowotny, PhD

COVID Prison Project

Delores Greyeyes, PhD

Director, Navajo Department of Corrections

Captain Richard Martin

Yavapai County Sheriff’s Office

Beya Thayer, MSW

Yavapai County Sheriff’s Office

Moderators

Ricky Camplain, PhD

Carly Camplain, JD

Register now

Secretary Becerra Extends Federal Public Health Emergency to mid-July

Here’s What it Does & Why It’s Important

U.S. Department of Health & Human Services Secretary Becerra just extended the federal public health emergency for another 90 days [See renewal declaration here], bringing the new expiration date to mid-July. It’s likely that the federal public health emergency will end at that time.

Many policy changes are tied to the federal public health emergency like flexibilities to waive or modify certain requirements in a range of areas, including in the Medicare, Medicaid, and CHIP (KidsCare) programs, mandates for private health insurance, authorization of medical countermeasures, telehealth, providing liability immunity to providers who administer services, and authorizing the FDA to do emergency use authorizations, among other things:

The public health emergency was initially declared by HHS Secretary Azar in late January 2020 under Section 319 of the Public Health Service Act. A PHE lasts for 90 days and must be renewed to continue. It has been renewed several times, most recently today. The new expiration date is July 16, 2022.

The Kaiser Family Foundation out together this good summary of what changes are coming when the federal declaration ends: What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access

Here are the sub-categories:

The thing I’m most immediately concerned about is that once the federal emergency ends on July 16, AHCCCS will begin its redetermination processes (redetermination has been suspended during the federal PH emergency since AHCCCS accepted the 6.2% enhancement in the federal share of Medicaid in AZ). AHCCCS estimates that as many as 500,000 members have moved in the last 2 years and didn’t update their address.

Once the federal emergency ends, they’ll send out notices to members and those that don’t reply in 10 days will get kicked off (at least I think it’s 10 days). If the letter goes to their old address they’ll obviously get kicked off.

There needs to be a full-court-press by AHCCCS, their contracted Managed Care Organizations, nonprofits and others to get the word out between now and July to make sure folks that have moved in the last year update their addresses at www.healthearizonaplus.gov or 1-855-432-7587.