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May 2015—Public Health Law News

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Public Health Law Program
Office for State, Tribal, Local and Territorial Support
Centers for Disease Control and Prevention

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In This Edition

Announcements: Webinars, New Emergency Healthcare Association, Summer Study Programs

Webinar—Health System Transformation: The Changing Legal Landscape. PHLP and the American Bar Association Health Law Section are co-hosting a webinar, Electronic Health Information: Assessing the impact of Law. Speakers will provide an overview of electronic health information and how it is transforming the US health system. They will also outline the characteristics and scope of federal and state law related to electronic health information, describe best practices in its implementation, and highlight legal tools that can be used to support its efficient use. The webinar will take place Tuesday, May 26, 2015, 12:30–2:00 pm (EDT).


Webinar—Using Social Impact Bonds to Advance Public Health Goals. This webinar, co-hosted by American Public Health Association and PHLP, will take place Thursday, May 28, 2015, 1:00-2:30 pm (EDT). Speakers will describe the structure and function of the social impact bond model and summarize new innovations that use the model to fund various public health initiatives. Speakers will also outline some of its limitations, explore recent state and the federal legislative efforts of to address them, and provide perspectives of social impact bond implementers and investors.


Webinar series on the Intersection of Public Health and Health Care—The Role of Law. The American Health Lawyers Association and PHLP are co-hosting a six-part free webinar series focused on legal issues at the intersection of public health and health care. The first webinar in the series, Part I: Legal Issues Impacting Federally Qualified Health Centers and Rural Health Clinics, will take place Friday, June 5, 2015, 1:00-2:30 pm (EDT). This webinar will provide an overview of federally qualified health centers and rural health clinics, and practical insight into the field.


Training—Arizona 2015 Public Health Law and Science: What Tribes Need To Know.
The University of Pittsburgh, Public Health Training Center is hosting a free workshop designed to improve tribal legal preparedness relating to infectious diseases and emergency preparedness. The workshop will be held June 4–5, 2015, from 8:00 am to 12:00 pm (MDT) at Talking Stick Resort in Scottsdale, Arizona. This workshop is open to tribes in Arizona, California, Colorado, Nevada, New Mexico, and Utah. The workshop is fully funded, including reimbursement for reasonable travel costs, meals, and lodging. Registration is limited to two people per tribe. The workshop is possible through a grant to the University of Pittsburgh Graduate School of Public Health from CDC’s Public Health Law Program through a sub-award from the Association of State and Territorial Health Officials.


Association of Healthcare Emergency Preparedness Professionals (AHEPP). A new professional association dedicated to advancing the field of disaster preparedness and response, AHEPP, is accepting members and announces their first national conference. The conference will take place November 17-18, 2015 in Omaha, Nebraska, and will help guide participants through the most important disaster concerns in various types of healthcare facilitates. See AHEPP’s website for early bird rates, the complete conference agenda and more information.


NACCHO Annual Conference 2015. The National Association of County and City Health Officials (NACCHO) Annual Conference will take place July 7–9 in Kansas City, Missouri. The conference theme is “Envisioning the Future: Creating Our Path.” Register on or before June 4, 2015, to take advantage of early bird rates.


2015 Health Law and Policy Summer Institute. American University Washington College of Law 2015 Health Law & Policy Summer Institute will run June 22–27, 2015, at American University in Washington, DC. The course is open to students and professionals. Applications are accepted on a first-come, first-serve basis and space is limited.


Summer Program on Infectious Diseases and the Law. The O’Neil Institute for National and Global Health at Georgetown University will host the 2015 Summer Program on Infectious Diseases and the Law June 22–26, 2015, at Georgetown University in Washington, DC. Applications are due by June 8, 2015.


Journal Article: Disparity in Naloxone Administration by Emergency Medical Service Providers and the Burden of Drug Overdose in Rural Communities. Naloxone is administered during a prescription drug overdose. This study examines the factors to be considered when Naloxone administered. Mark Faul, Michael W. Dailey, David E. Sugerman, Scott M. Sasser, Benjamin Levy, and Len J. Paulozzi. American Journal of Public Health 0 0, 0, e1–e7 (Apr. 2015).
 

Legal Tools: Federally Qualified Health Centers, School Vaccine Laws, Turtle-related Salmonellosis

Issue Brief and Presentation on Federally Qualified Health Centers (FQHC). These resources summarize FQHC’s role in the delivery of healthcare services for the expanding Medicaid population.


State School and Childcare Vaccination Laws. PHLP released a summary of state statutes and regulations regarding school vaccines. The resource includes a polar graph on state school vaccine exemption laws.


State Vaccination Requirements. CDC’s National Center for Immunization and Respiratory Diseases published a series of web pages devoted to state vaccination requirements for schools, healthcare workers, and patients. The pages include a fact sheet for improving vaccination coverage, information about vaccine requirements by disease, and other resources.


Menu of State Turtle-Associated Salmonellosis Laws. [PDF 1MB] This menu, created through collaboration between PHLP and CDC’s National Center for Emerging and Zoonotic Infectious Disease (NCEZID), provides public health practitioners and policy makers interested in the prevention of turtle-associated salmonellosis with an inventory of state laws regarding the sale and use of turtles. In tandem with this menu of laws, NCEZID released The Trouble with Tiny Turtles [PDF 5.96MB], an infographic explaining the risks associated with small turtles and other pet reptiles.


Issue Brief: Sports Related Traumatic Brain Injury and Return-to-Learn Provisions. This issue brief from the Network for Public Health Law examines the health risks associated with youth sports related TBIs and summarizes current return-to-learn provisions in seven states.


Tobacco Retailer Licensing Playbook. Developed by ChangeLab Solutions, this playbook outlines 10 strategies necessary for developing, implementing, and enforcing comprehensive tobacco retailer licensing policy. It also includes examples and key resources to help communities create a strong local policy that improves public health.

Job Announcements: Chair in Global Health Ethics, ASTHO Director and Senior Director of State Health Policy

Hilton Chair in Global Health Ethics. The Hubert Department of Global Health of the Emory University Rollins School of Public Health, in partnership with the Emory University Center for Ethics, is searching for the inaugural Hilton Chair in Global Health Ethics. The Hilton Chair is a tenured position at the professor or associate professor level. Candidates should be distinguished scholars in public health ethics or bioethics with strong interests or accomplishments in global health. The position is open to any discipline and any area of public health. Screening of applications will begin in June, 2015, and continue until a sufficient pool of qualified candidates is identified.


ASTHO Director of State Health Policy. The Association of State and Territorial Health Officials (ASTHO) is accepting applications for the director of state health policy position. The director collaborates with key staff from across the organization to track timely policy issues in the states; identify model state health policies and strategies for passing and implementing them; and share tools for adoption of model polices among the US states and territories.


Yale Clinical Fellowship in Global Health. The Yale Global Health Justice Program seeks applications for the Yale Clinical Fellowship in Global Health Justice. The fellowship is a two-year position for graduates of law and public health schools as well as other health professionals with experience in domestic or international health policy and advocacy who are interested in preparing for a career in global health justice or interdisciplinary clinical teaching. The fellow will supervise the experiential learning component of the Global Health Justice Partnership and help coordinate its activities. Applications are due July 1, 2015.

Top Story: Emergency Measures to Protect Nail Salon Workers

Cuomo orders emergency measures to protect workers at nail salons

New York Times   (05/11/2015)   Sarah Maslin Nir

New York’s Governor Andrew Cuomo announced a multi-agency enforcement task force to investigate—and new rules to address—abuse of nail salon industry workers. The rules follow a New York Times investigation of nail salons published May 7, 2015. The Times’ investigation found widespread exploitation of manicurists, including wage theft and unfair labor practices.

The new rules include protocols to protect manicurists from the potentially dangerous chemicals found in nail products. Manicurists will be required to wear gloves and masks, and salons must be better ventilated. A campaign in six different languages will accompany the investigation and rules to educate nail workers of their rights.

“New York State has a long history of confronting wage theft and unfair labor practices head on, and today, with the formation of this new Enforcement Task Force, we are aggressively following in that tradition. We will not stand idly by as workers are deprived of their hard-earned wages and robbed of their most basic rights,” said Mr. Cuomo in a statement.

Though the governor’s plan is still being finalized, the state’s health department has been tasked with studying the most effective safety practices, which could redirect the scope and requirements of the news rules.

[Editor’s note: Learn more about New York’s multi-agency enforcement task force to tackle abuse in the nail salon industry.]

Briefly Noted: School Vaccine Exemption Bill, National Nurse, New Orleans Smoking Ban

California: California vaccine exemptions: Law makers dilute legislation to ease passage
San Jose Mercury News   (05/11/2015)   Tracy Seipel
[Editor’s note: Read California’s SB 277.]


California: Man who knowingly spread HIV sentenced to six months. Judge calls it a ‘travesty’
Washington Post   (05/05/2015)   Michael E. Miller


Indiana: Rural Indiana struggles to contend with HIV outbreak
New York Times   (05/05/2015)   Abby Goodnough
[Editor’s note: Read about the extension of Public Health Emergency in response to the HIV epidemic in Scott County, Indiana, and the governor’s emergency order.


Louisiana: New Orleans bars issue last call for smoking
New York Times   (04/22/2015)   Campbell Robertson
[Editor’s note: Learn more about New Orleans’ smoking laws.]


Pennsylvania: Government weighs into Pennsylvania issue with ticks, Lyme disease
The Times Herald   (05/05/2015)   Jim Hook
[Editor’s note: Learn more about Lyme disease and other tick-borne diseases.]


National: Bill would create ‘national nurse’ position
The Hill   (05/06/2015)   Sarah Ferris
[Editor’s note: Read House Bill HR 379 [PDF 247KB].]


National: Come 2017, states can obtain waivers from some divisive requirements of Obama’s health law
US News   (04/19/2015)   Ricardo Alonso-Zaldivar


National: HHS says it will shield maker of Ebola therapy ZMapp from legal liability
Regulatory Affairs Professional Society   (04/23/2015)   Alexander Gaffney


National: Judge approves settlement—at least $900M—to NFL concussion lawsuits
USA Today   (04/22/2015)   Gary Mihoces and Rachel Axon


National: New bill would require FDA approval for cosmetics
New York Daily News   (04/21/2015)  
[Editor’s note: Read Senate Bill S.1014, the Personal Care Products Safety Act.]


Navajo Nation: The Navajo Nation just passed a junk food tax. Too bad junk food is all you can buy. 
Talking Points Memo   (04/23/2015)   Tristian Ahtone

[Editor’s note: Read the Navajo Nation’s Junk Food Tax.]

Profile in Public Health Law: Mathew Swinburne, staff attorney, Network for Public Health Law

Interview with Mathew Swinburne

Title:
Staff Attorney, Network for Public Health Law—Eastern Region

Education:
BA Biology, Tufts University; JD University of Maryland Francis King Carey School of Law


Public Health Law News (PHLN): What motivated you to become an attorney?

Swinburne: Originally, I wanted to practice law to help address the environmental challenges facing the world today.

PHLN: Environmental law and public health law are pretty closely related; how did you make the jump from the former to the latter?

Swinburne: It was really by chance. A close friend from law school who worked for the Network for Public Health Law contacted me. They needed an attorney to work on a series of food safety projects related to the Food Safety Modernization Act. It was a great opportunity to work on interesting legal issues with a wonderful group of people.

PHLN: Can you please tell us about the Network for Public Health Law (the Network)—what is it and what is its mission?

Swinburne: The Network comprises public health attorneys and practitioners located at a national coordinating center and five regional offices—Northern, Eastern, Mid-States, Southeastern and Western—housed at respected academic institutions. We provide leadership to the field and support to state, tribal, local, and federal officials, as well as public health practitioners, attorneys, policy-makers, and advocates across the country with legal technical assistance, resources, and training.

PHLN: What kind of technical assistance does the Network provide and how do individuals receive it?

Swinburne: We provide technical assistance on a broad range of public health laws, regulations, and policies—this includes everything from raw milk regulations and other food safety measures, to infectious disease response and drug overdose prevention, to health data sharing and health reform. We perform legal research, identify relevant resources, and connect requesters with subject matter experts. All at no cost!

To contact us for technical assistance, visit the Network’s website. You can submit questions there, and phone numbers are listed for the regional offices.

PHLN: Please describe your day-to-day job responsibilities as one of the Network’s staff attorneys.

Swinburne: On an average day, I could do any of the following: conduct legal research for a technical assistance request, develop legal resources for public health practitioners, discuss research findings with a customer, or mentor law students.

Actually, one of the most enjoyable parts of my job is the opportunity to work with law students. The Network’s Eastern Regional Office, where I work, is associated with the University Of Maryland Francis King Carey School Of Law and its public health law clinic. Through this partnership we are able to use our technical assistance requests as teaching tools, and the students can work on practical legal problems under a staff attorney’s supervision.

PHLN: You recently participated in a Network webinar regarding raw milk regulations. What is raw milk?

Swinburne: Raw milk is milk from cows, goats, sheep, or other milk-producing animals that is unpasteurized. Pasteurization is a heat-treating process that removes harmful contaminants from milk, including bacteria (E. coli, Listeria, and salmonella), viruses (norovirus), and parasites (giardia) that are responsible for many foodborne illnesses. 

PHLN: Why is raw milk a potential public health threat?

Swinburne: Because raw milk is not pasteurized to kill harmful bacteria, viruses, and parasites, it is linked to increased foodborne illness. CDC reported 82 percent of all outbreaks linked to dairy products were caused by raw dairy products between 1973 and 2009. They also reported 1,676 illnesses linked to raw milk between 1998 and 2008. These numbers are likely conservative, given that many people do not report foodborne illness.   

And it appears that things are getting worse. A recent CDC report shows that foodborne illness outbreaks linked to raw milk are on the rise. The report revealed that between 2007 and 2009 there were 30 reported outbreaks linked to raw milk. Shockingly, the number increased to 51 during the three-year period of 2010 to 2012. That’s a 70 percent increase in the number of outbreaks. The report also reveals that the sale of raw milk is legal in the states with the highest number of outbreaks: Minnesota, New York, Pennsylvania, South Carolina, Utah, and Washington.

PHLN: If I had my own cow, could I drink my cow’s raw milk?

Swinburne: Yes. It is a misconception that it is illegal to drink raw milk. Federal and state regulation of raw milk does not prohibit its consumption directly; they focus on regulating the sale of raw milk. The federal government prohibits the sale of raw milk in interstate commerce. So raw milk produced in New York could not be sold for human consumption in Pennsylvania.

States have chosen different legal approaches to regulating this product within their borders. For example, some states have banned the sale; others allow it to be sold through retail establishments; and some allow it to be sold only to consumers directly from a farm. Two states even require a doctor’s prescription to purchase raw milk.

PHLN: How did you begin researching raw milk laws?

Swinburne:We received a technical assistance request inquiring about the different approaches states had taken to address the public health challenges presented by raw milk.

PHLN: For something as mild as milk, this can be a somewhat sour topic. Why do you think that is?

Swinburne:I think proponents of raw milk are particularly passionate about this topic because, despite the health risks, they perceive its regulation as government overreaching. It is the traditional “nanny state” argument that public health advocates confront on a wide range of interventions.

PHLN: What other projects are you working on?

Swinburne: One of the nice things about my job is the diversity of projects. I’ve recently worked on issues related to local health officials’ public nuisance authority, health data privacy, access to healthy housing, and the Food Safety Modernization Act. The largest project on my desk relates to legal and policy interventions for the problem of food deserts.

PHLN: What are food deserts?

Swinburne:They are neighborhoods with poor access to healthy and affordable food. The USDA estimates that 23.5 million Americans live in food deserts.

PHLN: Why are food deserts a public health challenge?

Swinburne: We all know that our diet is critical to remaining healthy. Food deserts make it difficult for people in these communities to make healthy choices. Studies have linked food deserts to obesity.  This is particularly concerning because obesity is connected to a variety of health conditions, including heart disease, stroke, diabetes, and certain types of cancer and diabetes.

PHLN: How are law and policy makers addressing food deserts?

Swinburne: Food deserts are complicated and require a wide range of interventions to address the environmental and behavior aspects of the challenge. A lot of effort has been focused on bringing supermarkets to food deserts, through a combination of federal, state, and private incentives. 

There have been a lot interesting programs that seek to increase healthy food access through farmer’s markets, urban agriculture, mobile healthy food vendors, and healthy corner stores. These efforts have primarily focused on changing the physical “food environment” of a community. Once food resources are in place, it’s critical to encourage people to take advantage of these healthier options. One area I’m particularly interested in is the use of the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as food stamps, to incentivize healthy eating. There have been many innovative local efforts to provide SNAP users additional funds for the purchase of fruits and vegetables. These programs will often match every dollar spent on produce up to a certain level. To support these programs, the federal government recently passed—as part of the 2014 Agriculture Bill— the Food Insecurity Nutrition Incentive rant program. This program has set aside $100 million  to fund state supported SNAP incentives programs.

PHLN: How can people learn more about raw milk and food deserts?

Swinburne: A great place to start is the Network’s website. Also, Change Lab Solutions has done a lot of interesting work regarding food deserts and has some great online resources.

PHLN: If you weren’t working in public health law, what would you likely be doing?

Swinburne: Occasionally, I fool myself into believing that I’d enjoy opening my own restaurant.

PHLN: Have you read any good books lately?

Swinburne: I’m currently reading two books: Wool by Hugh Howey and Travels with My Aunt by Graham Greene.

PHLN: What are your hobbies?

Swinburne: I really enjoy cooking for friends. Growing up, it was really important for my family to share dinner together. As a result, my siblings and I have all turned into respectable cooks. I’m also a fan of British murder mysteries and motorcycles.

[Editor’s note: Learn more about raw milk laws by watching “Legal Aspects of Raw Milk,” a webinar hosted by the Network and the National Association of County and City Health Officials.]

Public Health Law News Quiz May 2015

The first reader to correctly answer the quiz question will be given a mini public health law profile in the June 2015 edition of the News. Email your entry to PHLawProgram@cdc.gov with “PHL Quiz” as the subject heading; entries without the heading will not be considered. Good luck!


Public Health Law News Quiz Question: May 2015

According to Mathew Swinburne’s interview, in which states is the sale of raw milk legal?

Public Health Law News Quiz Question April 2015 Winner!

Vernette Dow

March Question: What is Profile in Public Health Law Interviewee Sarah Happy currently making for her nephew?

Winning response: 
She is making a quilt for her nephew, Ali.

Employment organization and job title: City of Philadelphia Law Department, Health and Adult Services Unit, Divisional Deputy City Solicitor

Brief explanation of your job: Along with other attorneys in my unit, I represent the City of Philadelphia’s Department of Behavioral Health Intellectual Disabilities Services in various ways, including seeking the involuntary civil commitment of the mentally ill. I’m also counsel to the City of Philadelphia’s Department of Public Health in a variety of ways, including petitioning the court to compel persons to receive treatment for communicable diseases and represent the Office of Supportive Housing, which provides shelter to homeless individuals.

Education: LaSalle University, BA in foreign languages; Temple University, JD

Favorite section of the News: Although I can appreciate reading the Public Health Law News, I most appreciate the “Legal Tools” section.

Why are you interested in public health law? I’m interested in public health law because it is one way through which I can use my legal skills to impact the public in a positive way. Additionally, the public health field is never boring because new ideas, programs, and issues surface regularly.  

What is your favorite hobby?  Right now my favorite hobby is translating koine Greek. However, I also like Zumba and spinning/cycling classes.

Court Opinions: Nursing Home Advertising, Data Breach Suit, Waived ERISA-based Claims

Georgia: No notice of final injunctive relief in law firm’s nursing home advertising case
McHugh Fuller Law Group PLLC v. PruittHealth-Toccoa LLC [PDF 69KB]
Supreme Court of Georgia
Case nos. S15A0362 and S15A0641
Filed 05/11/2015
Opinion by Justice Carol W. Hunstein


Federal: Data breach suit falls under Class Action Fairness Act, stays in federal court
Manuel Vasquez et al. v. Blue Cross of California et al.
US District Court for the Central District of California
Case No. CV-15-2055-MWF (AGRx)
Opinion by US District Judge Michael W. Fitzgerald


Federal: Court overturns ERISA based claims that were waived by employee benefits management company
Humana Health Plan, Inc. v. Patrick Nguyen, David Abney and Crady, Jewett & McCulley LLP [PDF 234KB]
US Court of Appeals for the Fifth Circuit
Case no. 14-20358
Filed 05/11/2015
Opinion by Circuit Judge Edith Brown Clement

Quote of the Month: Dr. Diane Janowicz, Infectious Disease Specialist at Indiana University

Quotation of the Month: Dr. Diane Janowicz, an infectious disease specialist at Indiana University

“There are still a significant proportion of people in Austin [Indiana] who have biases about HIV and are contributing to the stigma and subsequent fear. I have to reassure them: If your grandkid wants a sip of your drink, you can share it. It’s OK to eat at the same table. You can use the same bathroom,” said Dr. Diane Janowicz, an infectious disease specialist at Indiana University, who is treating HIV patients in Austin, Indiana.

About Public Health Law News

The Public Health Law News is published the third Thursday of each month except holidays, plus special issues when warranted. It is distributed only in electronic form and is free of charge.

The News is published by the Public Health Law Program in the Office for State, Tribal, Local and Territorial Support.

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News content is selected solely on the basis of newsworthiness and potential interest to readers. CDC and HHS assume no responsibility for the factual accuracy of the items presented from other sources. The selection, omission, or content of items does not imply any endorsement or other position taken by CDC or HHS. Opinions expressed by the original authors of items included in the News, or persons quoted therein, are strictly their own and are in no way meant to represent the opinion or views of CDC or HHS. References to products, trade names, publications, news sources, and non-CDC Web sites are provided solely for informational purposes and do not imply endorsement by CDC or HHS. Legal cases are presented for educational purposes only, and are not meant to represent the current state of the law. The findings and conclusions reported in this document are those of the author(s) and do not necessarily represent the views of CDC or HHS. The News is in the public domain and may be freely forwarded and reproduced without permission. The original news sources and the Public Health Law News should be cited as sources. Readers should contact the cited news sources for the full text of the articles.

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