November 2017—Public Health Law News

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In This Edition

Medicaid Prior Authorization Policies for Medication Treatment of Attention-Deficit/Hyperactivity Disorder in Young Children, United States, 2015.external icon This article, published in Public Health Reports,describes the legal epidemiology methods used to assess Medicaid prior-authorization policies related to attention-deficit/hyperactivity disorder medication prescriptions for young children. The article also explains the results of the assessment.


CDC Externships in Public Health Law. PHLP offers externships in public health law, tribal public health, and administration and communications. The externships consist of 9–14 weeks of professional work experience with PHLP in Atlanta, Georgia. With rolling start and completion dates during the academic year, unpaid externships must qualify for academic credit as authorized by law and public health schools. Applications for summer 2018 positions are due by January 31, 2018.


Human Rights Exhibit at Georgia State University College of Law.external icon Health Is a Human Right examines historical health equity challenges over the past 120 years in the United States. The exhibit, which includes interactive, online distance learning resources, will be at Georgia State College of Law until April 25, 2018. The exhibit is provided by the David J. Sencer CDC Museum at CDC and supported by the National Library of Medicine and the National Institutes of Health under cooperative agreement UG4LM012340 with the University of Maryland, Health Sciences and Human Services Library.


Perspective: Using Medicare Prices—Toward Equity and Affordability in the Affordable Care Act Marketplace.external icon This perspective from the New England Journal of Medicine evaluates the indirect and direct effects of reducing out-of-network markups on Affordable Care Act marketplace enrollees.


Policy Report: The Evidence for Pre-Hospital Emergency Medical Service Systems Policy Interventions Addressed in Existing State Laws. pdf icon[PDF – 489KB] This report assesses whether seven pre-hospital emergency medical service systems respond to strokes effectively.


National Title VI Program Survey: Serving Tribal Elders Across the United States. pdf icon[PDF – 2.73MB]external icon The National Association of Area Agencies looks to understand the needs of tribal elders and improve Title VI programs across the United States.

Public Health Law Academy. This online academy created by PHLP and ChangeLab Solutions helps public health professionals understand the legal system’s role, historically and currently, in improving population health. The training offers three courses: Introduction to Public Health Law, Legal Epidemiology Review, and Hot Topics in Public Health Law. The training was created through cooperative agreement 6NU380T000141-04-02 from the Centers for Disease Control and Prevention.


Hepatitis C: State of Medicaid Access.external icon This report and interactive project grades all 50 state Medicaid programs, as well as those in the District of Columbia and Puerto Rico, based on beneficiaries’ access to curative treatments for hepatitis C. More than half of Medicaid programs (52 percent) received a “D” or “F” for restricting access to hepatitis C cures.

National: Trump administration declares opioid crisis a public health emergencyexternal icon
NPR (10/26/2017) Greg Allen and Amita Kelly

Story Highlights

President Donald Trump declared the opioid crisis a public health emergency on October 26. The declaration directed public health agencies to expand access to telemedicine services, allow doctors to prescribe treatments such as methadone to people in rural communities, expedite the hiring process for medical professionals who specialize in opioid addiction treatment. It also funds recovery programs for dislocated workers and people with HIV/AIDS.

“We are currently dealing with the worst drug crisis in American history,” Trump said, adding, “We can be the generation that ends the opioid epidemic.”

Federal public health emergency declarations expire after 90 days. They also allow the administration to access to the Public Health Emergency Fund, but that fund is very limited.

Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaboration at Brandeis University’s Heller School for Social Policy and Management, was disappointed with the declaration. Declaring a public health emergency will do little to help without funding for treatment, he says.

The President’s Commission on Combating Drug Addiction and the Opioid Crisis, led by New Jersey Governor Chris Christie, formally urged Trump to declare a national public health emergency under the Public Health Service Act.

[Editor’s note: Read the Presidential Memorandum for the Heads of Executive Departments and Agenciesexternal icon.]


California: $417 million talcum powder verdict overturnedexternal icon
Drug Watch (10/23/2017) Elaine Silvestrini

Story Highlights

A California judge cited insufficient evidence in a $417 million case involving talcum powder and ovarian cancer.

Eva Echeverria was diagnosed with ovarian cancer in 2007. Before her death on September 20, she testified that she started using Johnson & Johnson baby powder and Shower to Shower talcum powder on her genitals in 1965. After Echeverria died, her daughter, Elisha, became the plaintiff in the case.

Judge Maren E. Nelson ruled that Echeverria “failed to meet her burden of proof to show that her use of Johnson’s Baby Powder and Shower to Shower were the probable cause of her ovarian cancer.”

California: Why dockless bikes may spell the end of the old bike-share-modelexternal icon
The PEW Charitable Trust (10/18/2017) Rebecca Beisch


California: California moves against unlicensed stem cell treatments—but is it doing enough?external icon
Los Angeles Times (10/31/2017) Michael Hiltzik
[Editor’s note: Read California’s Senate Bill 512external icon]


Colorado: Expired prescriptions and leftover drugs are the low-hanging fruit of combating abuseexternal icon
Colorado Public Radio (10/26/2017) John Daley


Colorado: Denver approves a smoking and vaping ban for the 16th Street Mallexternal icon
Denver Post (10/30/2017) Jon Murray


Hawaii: Reading this while walking? In Honolulu, it could cost youexternal icon
The New York Times (10/23/2017) Tanya Mohn
[Editor’s note: Read Hawaii’s Bill for an Ordinance Relating to Mobile Electronic Devicesexternal icon]


Kansas: ‘Something is eating my brain,’ an inmate said. A lawsuit claims he was left to dieexternal icon
Washington Post (10/30/2017) Kristine Phillips


New Jersey: New Jersey suing Purdue Pharma for fueling sate’s opioid crisis with deceptive marketing strategyexternal icon
New York Daily News (10/31/2017) Dustin Racioppi
[Editor’s note: Read the complaint in New Jersey v. Purdue Pharma, LPexternal icon]


New York: US states, cities moving to restrict vapingexternal icon
Ars Technica (10/25/2017) David Kravets
[Editor’s note: See data on US e-cigarette regulationsexternal icon from the Public Health Law Center at Mitchell Hamline School of Law.]


National: Judge denies emergency request to force Trump administration to resume paying Obama insurers reimbursementsexternal icon
CNBC (10/25/2017) Dan Mangan

Photo: Aila Hoss, JD

Title: Visiting Assistant Professor, Indiana University Robert H. McKinney School of Law

Education: JD


Public Health Law News (PHLN):What inspired you to go to law school?

Hoss:I wish I’d been inspired by a calling to the profession! But, like many law students, I attended law school because of a desire to pursue public interest work. Law school felt like a good choice because a JD is a versatile but skill-based degree that I could leverage in both practice and public policy work. Fortunately, this turned out to be accurate!

PHLN:How did you become interested in public health and tribal public health law?

Hoss:I attended the University of Oregon School of Law, which has a nationally ranked environmental law program. While there, it became apparent to me that environmental issues resonated most with me when discussed in the context of population health. With this new awareness, I began to explore public health law as a potential career. I interned with a small obesity prevention nonprofit my first summer of law school. During my time there, I learned about how American Indian and Alaska Native populations were burdened disproportionately by negative health outcomes. This led me to take classes in federal Indian law and tribal law. I was fortunate enough to be at a law school that offered these courses but even more fortunate that tribal leaders, attorneys, and judges from the area were guest speakers in these classes. Learning about their experiences promoting and protecting tribal sovereignty in their communities inspired my interest in the intersection of public health law and Indian law.

PHLN:Will you please describe your career path?

Hoss:After law school, I worked with nonprofits on legal and public health policy issues in Indiana before joining the Public Health Law Program (PHLP) at CDC as a fellow and then contractor. At PHLP, I worked on various public health law projects in collaboration with colleagues throughout the agency as well as tribal, state, and local government partners. The most rewarding part of my work was traveling to and learning from tribal communities about how law can both support and hinder public health. My time at PHLP also cemented my love of researching, teaching, and working with young professionals, and I felt called to pursue legal academia. This past August, I joined the faculty at Indiana University Robert H. McKinney School of Law as a visiting assistant professor.

PHLN:What courses are you teaching?

Hoss:I teach Health Policy Analysis and Development and Legal Communications and Analysis I courses this semester. Next semester, I’ll be teaching Food and Drug Law and Legal Communications and Analysis II courses. McKinney houses the nationally ranked Hall Center for Law and Health, so I also work closely with the school’s health law faculty and student organizations.

PHLN:What advice has helped you the most in your career so far?

Hoss:I spend a lot of my time advising law students these days, so I love this question! First, although there will be a time in your career when it will be vitally important for you to learn how and when to say no, young professionals should aspire to say yes to all the opportunities that come their way. Trying new things and leaving your comfort zone is the fastest way to develop and refine your skills.

Second, it’s important to create opportunities for yourself and establish your own measures of success in the workplace. Have an agenda on what you want to accomplish during each chapter of your career, and take the initiative to ensure you can cross each item off your list. This gives you opportunities to celebrate your successes even if your career path looks different from your peers’.

Finally, conduct regular self-assessments of your strengths and weaknesses. Figuring this out and taking ownership of it makes it much easier to navigate your career and decide which opportunities to pursue. Self-assessments can also translate to being more confident, authentic, and approachable in the workplace.

PHLN:What public health law and tribal public health law projects are you working on currently?

Hoss:On the public health law side, I’m working with some CDC colleagues to finish up a legal epidemiology study about the impact of healthcare worker influenza laws on vaccination rates.

One project I’m wrapping up is a framework article about tribal public health law. In general, public health law scholarship focuses on federal, state, and local public health authorities. Tribes are sovereign nations, so the same legal principles are not transferable. Instead, I proposed a framework for addressing public health law issues that affect tribes and their communities. I featured this research at the American Public Health Association’s Annual Meeting earlier this month. The feedback I received there demonstrated the need for this research. I hope the framework will lead to more public health law research and resources that are tailored for tribes.

PHLN:Why is working with tribal governments different from working with other US federal, state or local governments?

Hoss:One of the biggest failings of the legal education in the US, and the public education system in general, is that most Americans are completely ignorant of the fact that there are sovereign nations located within the boundaries of the United States that have their own distinct governments, histories, and cultures. Tribes have rights unique to them as sovereign nations, including the right to protect the welfare of their citizens in the manner most appropriate for their unique communities. Tribes have been exercising these sovereign rights since time immemorial and they also have histories, cultures, and practices unique to each individual tribe.

Additionally, the United States has a moral and fiduciary trust responsibility to tribes, which is based on history, treaties, agreements, legislation, and case law. This trust responsibility permeates every part of the federal government and can include the responsibility of the federal government to protect tribal trust lands, protect tribal trust funds, and consult with tribes on actions that will affect their communities, among other responsibilities. Federal law further outlines the rights, relationships, and responsibilities between tribes, states, and the federal governments. As a potential tribal partner or as a state, local, or federal government engaging in policymaking that can affect tribes and their communities, it’s essential to understand not only the unique legal status that tribes maintain but also to respect the histories and cultures of each tribe.

PHLN:How can jurisdictions learn more about working with tribal governments?

Hoss:First and foremost, jurisdictions could reach out to the tribes and tribal-serving organizations in their area. No other organization or individual will be better equipped to share their perspectives on successful partnerships and the uniqueness of their communities. Even if there are no federal- or state-recognized tribes in your area, there are still American Indian and Alaska Native people and often organizations that serve them in jurisdictions across the United States. National tribal-serving organizations can also be a great resource. Many federal agencies, including CDC, offer courses, taught by faculty from tribal communities, about working effectively with tribal governments.

PHLN:Do you have any hobbies?

Hoss:If eating and enjoying craft beer are considered hobbies, then yes! I’m an avid exerciser, mostly barre, spinning, and hiking these days. My partner and I also love traveling abroad and try to visit a country we have not been to every year.

PHLN:Do you have anything you’d like to add?

Hoss:I would really love to thank my former CDC colleagues Matthew Penn, Montrece Ransom, and Annabelle Allison for supporting my work in tribal public health law. Good mentors can change your career. I was, and still am, quite lucky to have them.

The first reader to correctly answer the quiz question will be featured in a mini public health law profile in the December 2017 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 November 2017

When are applications for summer 2018 internships with PHLP due?

Photo: Danielle Chatelain

Danielle Chatelain

Question: Name the three courses the Public Health Law Academy is currently offering.

Answer: Introduction to Public Health Law, Legal Epidemiology Review, and Hot Topics in Public Health Law

Employment organization and job title: I work with the National Association of County & City Health Officials (NACCHO) as a senior program assistant.

A brief explanation of your job: I support a variety of project work within NACCHO’s Public Health Preparedness team.

Education: I received my bachelor of science in biology and bachelor of arts in Spanish (2010) and my master of public health (2014) from Indiana University in Bloomington.

Favorite section of the News:I enjoy the Global Public Health Law section and, of course, the PHL Quiz.

Why are you interested in public health law? Public health law is a powerful tool in improving population health and has served as a foundational component of public health practice. Learning how public health laws and policies can be used to prevent health issues and promote improved health outcomes across populations is important for anyone working within the public health arena.

What is your favorite hobby? My favorite hobby would have to be traveling. I love discovering new places, and I especially enjoy trying new foods!

Federal: Judge denies emergency request to force Trump administration to resume paying Obama insurers reimbursements, plaintiff fails to meet requirements for preliminary injunction.
State of California v. Trumpexternal icon
United States District Court Northern District of California
Case No. 17-cv-05895-VC
Filed 10/25/2017
Opinion by District Judge Vince Chhabria


Federal: Michigan Department of Environmental Quality’s permanent injunction compelling the City of Flint to enter a long-term water supply contract, consistent with the Environmental Protection Agency’s Emergency Administrative Order; plaintiffs motion for summary judgment granted in part.
Michigan Department of Environmental Quality v. City of Flint, Michiganexternal icon
United States District Court, Eastern District of Michigan, Southern Division
Case No 17-12107
Filed 10/17/2017
Opinion by District Judge David M. Lawson


Federal: Plaintiff suffered no injury-in-fact under First Amendment’s Free Exercise of Religion Clause when she objected to her child’s mandatory vaccination and was subsequently given a waiver
Nikolao v. Lyon pdf icon[PDF – 92KB]external icon
United States Court of Appeals for the Sixth Circuit
Filed 11/07/2017
Opinion by Judge Richard F. Suhrheinrich

Zirui Song, Harvard Medical School

“Reducing the disparity between commercial and Medicare prices could enhance competition in the marketplace, as well as help improve equity and, ultimately, affordability.”
— Zirui Song, MD, PhD, Harvard Medical School, Department of Health Care Policy

[Editor’s note: This quote is from Using Medicare Prices—Toward Equity and Affordability in the ACA Marketplace, the New England Journal of Medicine,10/18/2017, by Zirui Song]

About Public Health Law News
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The Public Health Law Newsis 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 Newsis published by the Public Health Law Program in the Center for State, Tribal, Local, and Territorial Support.

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Page last reviewed: December 21, 2017