Public Health Law News
Notice of Funding Opportunity for the New Rural Communities Opioid Response Program (RCORP) Implementation Grants.external icon Under RCORP-Implementation, the Health Resources and Services Administration will make approximately 75 awards of up to $1 million each to networks and/or consortia to enhance service delivery for substance use disorder (SUD), including opioid use disorder (OUD), in high-risk rural communities. Over a three-year period of performance, RCORP-Implementation grant recipients will implement a set of core SUD/OUD prevention, treatment, and recovery activities that align with the US Department of Health and Human Services’ five-point strategy to combat the opioid crisis pdf icon[PDF – 76KB]external icon. Grant recipients are strongly encouraged to leverage workforce recruitment and retention programs, such as the National Health Service Corps (NHSC)external icon.
Combatting and Preventing Preemption: A Strategic Action Model.external icon The Journal of Public Health Management and Practicehas published an article that examines preemptive laws and their effect on public health progress. Many public health policies begin at the local level but can be stopped by the higher authority of the federal government. The effect can be greater when public health policies address business interests, which are commonly fought for by special interest groups at the federal level through lobbying.
Reports on Overhauling Payments for Children’s Health Care.external icon Two reports published by the United Hospital Fund—Achieving Payment Reform Through Medicaid and Stakeholder Collaborationpdf icon[PDF – 962KB]external icon and its companion Guide for Actionpdf icon[PDF – 1.25MB]external icon—outline rationales and specific steps that can help children’s health champions and state Medicaid programs work together to refocus healthcare payments, which in turn can improve the health and well-being of children. The reports also provide a framework that can form the basis for collaborative efforts between nongovernmental organizations and public agencies.
What California’s 2015 Measles Outbreak Can Teach Us About Vaccine Policy.external icon Policy for Action has published an article on the recent emergence of measles and its relation to state exemption rates. The article examines the case of California and what can be learned from its new policies.
Adverse Childhood Experiences: Primary Prevention.external icon Adverse childhood experiences (ACEs) can lead to chronic physical and behavioral health issues and, ultimately, early death. This brief was created by the Association of State and Territorial Health Officials (ASTHO) and highlights examples of primary prevention strategies, including building skills and promoting social norms for positive parenting, strengthening economic supports for families, and providing quality education and enrichment early in life.
Resource: Data and Federal Privacy Laws Snapshots.external icon This collection provides an overview of requirements of federal data protection laws, such as the Family Educational Rights and Privacy Act. This resource can be used to better understand datasets collected by federal agencies, and the legal protections associated with them.
Advance Care Planning: Selected States’ Efforts to Educate and Address Access Challenges.external icon The US Government Accountability Office has published a study outlining challenges in four states regarding advance care planning documents. These legal documents are vital in ensuring that a patient’s medical decisions are met. The study identified multiple challenges, including trouble people have accessing, understanding, and completing the documents.
Increasing Access to Contraception: Infographic Series.external icon This four-part infographic series, created by ASTHO, illustrates key strategies for addressing common challenges and barriers related to increasing access to contraception and strategies for improving understanding of and access to advance care planning documents. Featured topics include expanding preventive contraceptive care in rural areas, engaging stakeholders, reimbursement for immediate postpartum long-acting reversible contraception, and integrating reproductive healthcare services in correctional and substance use disorder treatment settings.
Social Media Public Education Messaging Toolkit for Emergency Response.external icon This tool from the National Association of County and City Health Officials provides an overview of the uses of social media to communicate with and educate the public during disasters. The toolkit also includes sample messages tailored to various events, including boil water advisories, chemical evacuation, shelter-in-place, forest fires, anthrax, and flooding.
California: Mental health treatment denied to customers by giant insurer’s policies, judge rulesexternal icon
The New York Times (03/05/2019) Reed Abelson
US Chief Magistrate Judge Joseph C. Spero in Northern California ruled against UnitedHealth Group in a class action lawsuit brought by insurance policy holders who were denied coverage for treatment of mental health and substance abuse disorder. The judge found that the company intentionally created policies that denied coverage to patients with mental health and substance abuse disorders.
The decision details UnitedHealth Group’s breaches of fiduciary duty to insured patients through policies and guidelines aimed at reducing insurance claims and care options. The insurer failed to cover patients who needed long-term care, such as treatment in residential facilities. Judge Spero said, “There is an excessive emphasis on addressing acute symptoms and stabilizing crises while ignoring the effective treatment of members’ underlying conditions.”
The Mental Health Parity and Addiction Equity Act of 2008 was implemented to ensure patients receive behavioral health coverage beyond emergency care, but patient advocates assert that insurers have developed rules to provide behavioral health coverage only for acute issues, or situations involving immediate danger.
UnitedHealth Group isn’t the only insurer that has been criticized for its coverage of behavioral illnesses. The federal law passed in 2008 because patients were being denied coverage after acute symptoms were treated, but not covered for treatment of the chronic illness.
“This should put health plans on notice that they simply can’t make up the rules as they go along,” says Angela Kimball of the National Alliance on Mental Illness.
UnitedHealth Group maintains that it did not deny coverage but supplied the appropriate care.
A final judgment in the case is expected to be issued in the coming months.
[Editor’s note: Learn more about the Mental Health Parity and Addiction Equity Actexternal icon. Read Wit v. United Behavioral Health, United States District Court for the Northern District of Californiapdf icon[PDF – 811KB]external icon, Case No. 14-cv-02346-JCS, filed 03/05/2019.]
Arizona: ‘Historical trauma’: Native communities grapple with missing and murdered womenexternal icon
Cronkite News (03/04/2019) Kelsey Mo
Activists say that indigenous women in the United States are often the victims of violent crime and that some simply disappear. The exact numbers are unknown, however. Due to jurisdictional issues between tribes, states, and the federal government, many cases go unreported, uninvestigated, and unprosecuted. So, it’s difficult to get a realistic number of missing cases. The Urban Indian Health Institute of the Seattle Indian Health Board reports 506 cases of murdered and missing indigenous women, but experts say there are likely more.
April Ignacio has been collecting names of missing and murdered Native women for the past three years. So far, she’s recorded 33 women, some of whom have been missing for nearly 60 years.
Ignacio belongs to the Tohono O’odham Nation and began the list of women in her community, attempting to work with the tribal police and prosecutor’s office. She says they were little help. Her list adds to the insufficient data collected on these cases due to the limited jurisdiction of Native American tribes to indict and sentence defendants. Many cases have to go to federal court, where trials may take years to be resolved. The complex process leaves many cases open.
Beyond the issue of the legal jurisdiction of American Indian tribes, and the complex trial process, it may take authorities hours to get to a crime scene, depending on the size of the reservation. In addition, determining whether a suspect’s case will be heard in tribal or federal court can be a lengthy process. A suspect will be seen in tribal court if the accused and victim are Native American, but if the crime is murder, manslaughter, or child abuse, it will fall under federal jurisdiction. Cases can take up to two years from when the crime happened to when the trial starts, creating obstacles to effectively utilizing both evidence and witnesses.
Arizona ranks third in the country for the number of missing and murdered American Indian women. This ranking reflects cases that were filed, but the actual number remains unknown. American Indian women have become activists by organizing events, like the March for Women in Phoenix, to spread awareness of these victims and crimes.
The state is working toward implementing laws to protect Native American women. Bills have been introduced to provide more state resources. The legislation also calls for a committee of Native and non-Native government members to address these crimes and create solutions.
“(Native American women are) disappearing not once, but three times. In life, in the data, and in the media. We can’t allow our Native sisters to just disappear at this rate and not draw attention to it,” says State Senator Victoria Steele.
[Editor’s note: Learn more about criminal jurisdiction in Indian Countryexternal icon and read Arizona’s HB 2570pdf icon[PDF – 38KB]external icon.]
Connecticut: Bill would let youth get HIV prevention meds on their ownexternal icon
U.S. News (02/25/2019)
[Editor’s note: Read Connecticut’s HB 6540external icon.]
Florida: Trafficking probe that ensnared Robert Kraft began when inspector saw signs women lived at spaexternal icon
CNN (02/26/2019) Eliott C. McLaughlin
Maryland: EPA provides $202 million loan to modernize Baltimore’s wastewater infrastructureexternal icon
EPA (02/25/2019) EPA Press Office
[Editor’s note: Read the Water Infrastructure Finance and Innovation Act of 2014external icon.]
Washington: Washington House passes bill limiting vaccine exemptionsexternal icon
The Seattle Times (03/07/2019) Rachel La Corte
[Editor’s note: Read Washington’s HB 1638external icon.]
West Virginia: Why public-health experts want more states’ vaccine policies to look like West Virginia’sexternal icon
Pacific Standard (03/01/2019) Emily Moon
[Editor’s note: Learn more about West Virginia’s Division of Immunization Servicesexternal icon and state school and childcare vaccination laws.]
National: New cancer-causing toxin found in recalled blood pressure pillsexternal icon
[Editor’s note: Learn more about the recall of losartan potassium tabletsexternal icon.]
National: Miners, fearing retaliation, may skip black lung screeningsexternal icon
Roll Call (02/27/2019) Andrew Siddons
[Editor’s note: Learn more about pneumoconiosis, commonly known as CWP or black lung.]
National: A new study finds a potential risk with self-driving cars: failure to detect dark-skinned pedestriansexternal icon
Vox (03/06/2019) Sigal Samuel
National: FDA approves esketamine nasal spray for hard-to-treat depressionexternal icon
NPR (03/05/2019) Jon Hamilton
[Editor’s note: Read the US Food and Drug Administration’s release about the approval of esketamine nasal spray for treatment-resistant depressionexternal icon.]
Democratic Republic of the Congo: Assailants attacked an Ebola treatment center in Congo — again. It’s another major setback.external icon
Vox (03/11/2019) Julia Belluz
Ghana: She was fired over the phone while in labor. And she’s still fighting to get her job backexternal icon
CNN (03/08/2019) Kwasi Gymfi Asiedu
Palestine: Improving healthcare response to gender-based violence in Palestine.external icon
Nature Middle East (03/03/2019) Kira Walker
United Kingdom: She beat her husband’s head in with a hammer. Now, her murder conviction has been tossed.external icon
The Washington Post (03/01/2019) Isaac Stanley-Becker
Venezuela: The bleak and scary world inside a Venezuelan women’s hospitalexternal icon
Bloomberg (03/02/2019) Patricia Laya
Global: UK launches global fund to help end ‘period poverty’ by 2050external icon
Thomas Reuters Foundation News (03/04/2019) Lin Taylor
Title: Program Coordinator for the Northern Nevada Alliance for Health and Justice
Education: MPH and BA in Psychology, University of Nevada, Reno
Public Health Law News (PHLN):What is the Northern Nevada Alliance for Health and Justice (NNAHJ)?
Cladianos:The NNAHJ is a medical-legal partnership (MLP) between Northern Nevada HOPES, a federally qualified health center (FQHC), and Washoe Legal Services, a legal aid agency. We are the first and only MLP in the state of Nevada. Currently, we are a small program operated by two individuals. My colleague, Rita Greggio, Esq., is in charge of all the legal matters, and I am the medical partner who focuses on operations.
PHLN:What is your role at NNAHJ?
Cladianos:As the program coordinator, I have many responsibilities. I do as much as I can in terms of operations so that Rita can spend her time focusing on providing direct legal services. In a typical week at the NNAHJ, I manage program referrals, screen clients, schedule appointments, collect and manage program data, and coordinate and help develop legal education clinics.
PHLN:What is a medical-legal partnership, and how did you begin working at one?
Cladianos:Medical-legal partnerships are partnerships between a legal entity and a medical entity that come together to provide legal services to individuals in order to improve health outcomes. I began working at the NNAHJ in May 2017, the program’s inception. This was about a year after I had finished my MPH program. I saw the job listing, did some research, and decided to apply because it seemed like an interesting opportunity. At the time, I had never heard of MLPs, but I was very excited to have the opportunity to apply my public health skill set to a new and innovative program.
PHLN:How is NNAHJ unique among medical-legal partnerships?
Cladianos:Our program is unique in so many ways. We are the first and only MLP in the state of Nevada, funded through a three-year grant from the Nevada Bar Foundation. As the first in the state, we focus on creating a model that is sustainable and replicable. The fact that we are located in Reno is also unique: Although Reno is Nevada’s second largest city, it is still a small community compared to Las Vegas. Similarly, Northern Nevada HOPES is not a typical MLP partner, which is often a major hospital in a major metropolitan area. HOPES is an FQHC with deep roots in the Northern Nevada community as an HIV treatment provider that has, in recent years, expanded exponentially to serve a very diverse, yet very underprivileged population. Because of our MLP’s small size and recency, we are constantly experimenting with and improving our model. Finally, our partnership with Washoe Legal Services (WLS) functions very well because WLS’s areas of legal specialization allow us to address the most common health-harming civil legal needs of our patient population.
PHLN:What kind of cases does NNAHJ take, and what population does it serve?
Cladianos:Most MLPs limit their services either by the type of legal issue or by medical diagnosis. Unlike most MLPs, our program at this time is not limited by our funding, which means that we can at least schedule a legal consultation for most civil legal issues for any patient of Northern Nevada HOPES. However, in determining which cases to prioritize and represent beyond the initial consultation, we look for a nexus between the health-harming legal need and the client’s health condition, as our goal is improved health outcomes.
PHLN:NNAHJ will celebrate its two-year anniversary in May 2019, and you’ve been on board since the beginning. How many clients have been helped by NNAHJ?
Cladianos:We have been very busy. Since program inception, the program has received over 400 referrals. From those 400 referrals, we have opened 289 cases, the majority of which resulted in legal consultation. Additionally, through our legal education clinics, we were able to reach 232 HOPES staff and community members.
PHLN:While there are a lot of peripheral supporters in Northern Nevada Hopes and Washoe Legal Services, NNAHJ is really run by two people—you and Rita Greggio, the MLP attorney. How do you two meet the needs of so many individuals?
Cladianos:I think one of the reasons for our success is the result of our close working relationship. We have similar working styles and we are both open to constructive feedback because we are here with the same purpose—to improve health outcomes for our clients through legal aid.
PHLN:What are some of the biggest challenges your team faces, and how are you addressing those challenges?
Cladianos:One of our biggest challenges is the overwhelming need in the community for the services we offer. The need in the community will always be greater than our small team of two can accommodate. We are both very resourceful, which is extremely important in the world of nonprofit health and legal aid. As a team, we make sure that we know about the resources in the community and build good relationships with our community partners for referral and knowledge sharing. If we see a legal problem come up over and over, we will find someone in the community who is an expert on the topic and invite them to do a community education clinic.
PHLN:What kind of community education programs do you offer, and who may attend?
Cladianos:The community education clinics are done in two different ways. We have internally facing legal education clinics that are provided to HOPES employees to help providers and other staff become more proficient in spotting legal issues. This helps staff learn about trends in civil legal issues so that they are better able to identify those needs in the patient population and make referrals to our program. Then we have community education clinics that are public facing. Some public education seminars we have presented have focused on criminal record sealing, immigration, and bankruptcy. Additionally, in 2017, we hosted a continuing legal education course for attorneys entitled “Essential Elements of Trauma-Informed Law.” We leveraged the medical expertise of HOPES’s behavioral health providers to educate the legal community not only about trauma and addiction, but about our MLP, as well. Through these legal education clinics, we have reached 232 participants.
PHLN:What has been the most popular community education course NNAHJ has delivered?
Cladianos:In 2017, Rita put together an excellent panel on community resources for victims of crime. This clinic was during the lunch hour, and providers and staff came to learn about the different resources in the community for victims of crime and how to make referrals for those services. We had 53 employees attend this event and as a result, participants reported a 71 percent increase in knowledge of how to access resources for victims of crime in the community.
PHLN:Has providing more access to legal information improved your community or practice? If so, how?
Cladianos:I think that our program is the perfect complement to the services already provided at Northern Nevada HOPES. As an FQHC, HOPES provides many wraparound services to patients to improve stability and as a result, improve health. The MLP works closely with our case management and housing teams. Prior to the MLP program, case management and housing had to refer patient/clients outside of the clinic for civil legal services. Now that we are located in house, clients do not have to go to another organization to receive services where they may not have yet established a relationship of trust with those providers.
PHLN:Without violating client confidentiality, what have been some of the most meaningful cases NNAHJ has worked on?
Cladianos:Currently, our community is developing and changing a lot. Many areas of town are gentrifying, which is great for the community at large, unless, of course, you are low income. This, coupled with Nevada’s housing laws that have little to no tenant protections, leaves many tenants in a vulnerable position. We had an eviction case involving an HIV-positive single parent of two children, one of whom was severely disabled. The client’s landlord claimed, without evidence, that one of the client’s children, a teenager, had vandalized the apartment complex. The client was served with a summary nuisance eviction that contained no details as to when the alleged conduct occurred, who witnessed the conduct, or any other necessary factual detail. The eviction came at a time when the client was in the process of taking the client’s disabled child out of state for major surgery. In court, the judge agreed that the landlord’s complaint was too vague and not appropriate for summary disposition. Based on the judge’s finding, the landlord would have to refile the eviction without the benefit of the summary eviction process (which in Nevada can result in an eviction in as a little as a week). Since the client wanted to move out anyway, due to the landlord’s poor treatment of the client, we helped the client avoid further eviction proceedings by negotiating a move-out date that gave the client sufficient time for the child’s surgery and to arrange for new housing. This case was particularly significant because the client was a longtime patient of HOPES who had no access to transportation and would not have been able to receive legal help outside of HOPES. Additionally, because of the child’s disability, the client’s eviction would have had a negative impact on the health of the entire family.
PHLN:What do you see as the future of NNAHJ?
Cladianos:The program has been running for almost two years, and we have just been granted a third year of funding. Our next steps for the program are to grow our program by attaining funding beyond our third year, and eventually, attaining long-term financial sustainability. We also hope to expand our model to other agencies across the region and state interested in engaging in an MLP.
PHLN:How might individuals who are interested in NNAJH learn more about the medical-legal partnership and support its activities?
Cladianos:There are a few options. On April 12, we are doing a Public Health Echoexternal icon, which is a free webinar cosponsored by the Nevada Public Health Training Center and University of Nevada School of Medicine. We will cover broadly MLPs and our program, and then we’ll provide a little bit more detail about legal issues in housing.
And lastly, they can contact me at email@example.com.
PHLN:How can individuals learn more about medical-legal partnerships more generally?
Cladianos:A very good resource for starting an MLP program is the National Center for Medical-Legal Partnershipexternal icon. They have many resources to get started, and they are a good hub for MLP training opportunities.
PHLN:Have you read any good books lately?
Cladianos:Recently, I read The Immortal Life of Henrietta Lacksby Rebecca Skloot.
PHLN:Do you have any hobbies?
Cladianos:I really enjoy staying current in my field through reading and networking opportunities. When I have really reached the end of my ability to take in any more public health information, I like to do yoga and explore the natural environment of northern Nevada.
PHLN:Is there anything else you would like to add?
Cladianos:I never thought I would love this program as much as I do. I recently listened to a webinar on public health and policy, and one of the presenters left a huge impression on me. We need to think about policy and laws as social determinants of health. In MLPs, we get to use the law as a tool to improve health outcomes. I feel that many of our clients may not have ever had the opportunity to speak with an attorney, and because of the trusting relationship we cultivate at Northern Nevada HOPES, many clients get questions answered and problems resolved that may have otherwise gone unresolved.
The first reader to correctly answer the quiz question will be featured in a mini public health law profile in the April 2019 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!
Which state featured in the March 2019 Newshas never allowed nonmedical vaccine exemptions and also has not had a measles outbreak in 25 years?
February Question: The February 2019 edition of the Newsincludes a story about HIV patients’ records being exposed in which country?
Winning Answer: Singapore
Employment organization and job title: Professor of Law, Center for Law Health and Society, Georgia State University College of Law
A brief explanation of your job: I teach various law school courses (including Public Health Law, Human Rights and Children, Family Law, etc.); conduct research on issues related to children’s rights and child well-being; and work to support nonprofit organizations that seek to advance the rights and well-being of children. I love all three parts of the job.
Education: JD, Columbia Law School; BA, Clark University
Favorite section of the Public Health Law News:The various sections on legal tools and public health law developments are great resources, but the “Profile in Public Health Law” is my favorite. It’s great to see the diversity of talent and perspectives in our field and to learn how other professionals approach complex public health issues.
Why are you interested in public health law? Because ultimately the law is about people, and public health offers important methodologies that can help advance well-being in communities that confront multiple risks.
What is your favorite hobby? Running, if it’s just me, but that’s a distant second to “any activity with my kids.”
California: Ms. Ardith Huber, a member of the Wiyot Band of Indians, owns a tobacco smokeshop on a reservation in California. The issue of this case began over whether Ms. Huber violated the Unfair Competition Law (UCL), but it quickly evolved into whether and the extent to which California courts have subject matter jurisdiction over on-reservation activities. Specifically, the case arose out of the Attorney General’s enforcement of the UCL based on violations of the Tax Stamp Act, Directory Act, and Fire Safety Act. The Court of Appeals, First District, Division 4, applied the Williamstest as persuasive authority to find that state jurisdiction does not infringe tribal sovereignty because Ms. Huber’s operation involved selling large quantities of noncompliant cigarettes outside of the reservation, so she should have complied with California law as well as tribal law. The court concluded that enforcement of California law off the reservation was appropriate because it did not implicate the Wiyot Band of Indians’ right to self-governance. Further, the UCL was not preempted under the doctrine of Indian preemption.
People ex rel. Becerra v. Huberexternal icon
Court of Appeals of California, First District, Division Four
Case No. A144214
Opinion by Circuit District Justice Jon B. Streeter
Indiana: Mr. German Linares sued El Tacarajo, LLC, a food truck operator, and U-Pull-and-Pay, LLC (“UPAP”), an automobile salvage business where the food truck was stationed, for negligence after being injured by the food truck’s explosion. The explosion resulted from UPAP’s flammable materials igniting the food truck’s gas fumes. The primary issue was whether the business where the explosion occurred, UPAP, had a duty regarding dangerous activities on its property or was vicariously liable for the food truck operators’ negligence. Mr. Linares argued that UPAP had a duty to take reasonable steps to protect invitees from foreseeable harm and that UPAP was in a joint venture with El Tacarajo, so UPAP was vicariously liable. The Court of Appeals of Indiana affirmed the lower court’s holding granting summary judgment to UPAP. The dissent found that summary judgment was inappropriate for this negligence case because these facts should have been adjudicated using the objective reasonable person standard and heard by a jury.
German A. Linares v. El Tacarajo and U-Pull-And-Pay, LLC d/b/a Pic A Partexternal icon
Court of Appeals of Indiana
Case No. 18A-CT-276
Opinion by Justice Margret G. Robb
Indiana: In Indiana, the town of Hebron’s Plan Commission asked Mr. Jon Grdinich to remove a constructed pond from his property because it did not meet zoning requirements. While this case relies heavily on procedure for the disposition, Mr. Grdinich argued that his pond remediated the neighborhood’s increased risk of a mosquito infestation and drainage issues. The Court of Appeals of Indiana held that the inverse condemnation claim was properly dismissed, but the trial court improperly dismissed Grdinich’s counterclaims pertaining to the pond because returning the pond to the original condition would result in prior drainage and mosquito problems.
Grdinich v. Plan Commission for Town of Hebronpdf icon[PDF – 155KB]external icon
Case No. 18A-PL-1050
Opinion by Judge Roger V. Bradford
Iowa: In Des Moines, the Court of Appeals of Iowa affirmed the revocation of the Lime Lounge’s conditional use permit. The city had revoked the permit, saying sound from the Lime Lounge’s patio speakers was too loud, violating the permit and becoming a nuisance to neighboring businesses. Some reports showed sound readings more than 85 decibels. The court balanced the public health interest with the business’s “right to function without excessive regulation” and found that the city had substantial evidence to support the findings that the sound from the Lime Lounge was a nuisance.
Lime Lounge, LLC v. Zoning Board of Adjustment of the City of Des Moines, Iowaexternal icon
Court of Appeals of Iowa
Case No. 18-0155
Opinion by Judge David Danilson
“The last thing that a company wants is somebody working at their mine who can later prove that they contracted black lung at their mine.” Phil Smith, director of communications and government affairs at United Mine Workers of America
[Editor’s note: This quote is from Miners, fearing retaliation, may skip black lung screeningsexternal icon, Roll Call, (02/27/2019), by Andrew Siddons.]
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.
Public Health Law News (the 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, persons quoted therein, or persons interviewed for the News 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 websites 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.