Editorials (blog)

Andy Hyer, JD, Policy Communications, Idaho Public Health Association

During this fourth week of Idaho's 2010 Legislative Session, lawmakers took a variety of actions relating to public health issues.  Pieces of legislation introduced this week include a bill to convert Idaho’s immunization reminder system to an “opt-out” system and a bill to help address the issue of unused pharmaceuticals polluting ground water supplies.  Lawmakers also moved forward on the Vaccination Assessment bill and the Idaho Health Freedom Act.  Additionally, the House Health and Welfare Committee confirmed extending the waiver of the food stamp “asset test” until May 2010.  On Monday, February 8, this Committee will then review the Board of Pharmacy’s rules implementing the Legend Drug Donation Act.

In this week’s update, we provide an explanation of these and other public health related legislative issues.  As always, please feel free to leave a comment or email me (andyhyer@gmail.com) if you have additional insights on these issues, or if you are aware of other legislative actions that may be of interest to the public health community.  

Public Health Legislation Introduced this Week:

RS 19228 - IRIS Registry: “Opt-Out” Instead of “Opt-In” (Sponsored by Sen. Patti Anne Lodge (R)-District 13, Huston). This bill would allow all vaccination information to be entered into the Immunization Reminder Information System (IRIS) registry unless there is a specific request to opt out of the program. Currently, the only information gathered is from those who opt-in to provide data to the IRIS. The Idaho Immunization Program cites this as one of their most important tools in increasing immunization rates in Idaho.  (Idaho’s immunization rate is 57.6%, nearly 20% below the national average of 77.2%.) Status: Approved by the Health Care Task Force on Nov 30; Awaiting a print hearing in the Senate Health & Welfare Committee

Adult Cystic Fibrosis Program Funding - The Governor’s budget recommendation is for $150,000 for the next fiscal year. This is a decrease from last year’s $205,000 appropriation. Status: JFAC received DHW’s budget presentation and will soon make its own recommendations to the Legislature as a whole.

SB 1310 - Personal Care Services (PCS) for Children.  This bill would make several changes in relation to PCS for children, including amending existing law to distinguish such PCS for child provided by Family Alternate Care provider from personal assistance services for adults.  The bill would also establish annual uniform reimbursement rates for such services.  Status: The bill is in the Senate Health & Welfare Committee.  

RS 19135 – Addressing Pharmaceutical Water Pollution. This bill would allow unused medications to be delivered to authorized individuals for disposal.  This bill is one step in part of a solution to address the problem of water supplies being polluted by chemicals contained in un-used medications and other personal care products.  There have been legislative proposals at the federal level to create a system to more safely dispose of polluting medications.  This bill would put state policies in-line to more effectively implement the federal disposal system, if and when it is created.  For additional information on the environmental health risks related to so-called pharmaceutical pollution, please see the EPA's summary on the subject or this New York Time's Article . Status: The Board of Pharmacy presented this bill to the House Health and Welfare Committee on February 4, and the Committee voted to print the bill.

Progress on Health Related Legislation

HB 432 – Insurer Assessment for Child Vaccines.  This bill would allow the state to assess health insurance carriers for the cost of purchasing vaccines for children covered under the insurance plans.  If passed, this legislation would allow all children in Idaho to receive vaccinations purchased by the state at a discounted rate through the federal Vaccine for Children (VFC) Program. The original version of the legislation contained a provision for a Vaccine Selection Committee, but the insurance industry representatives carrying the bill agreed to remove it because of objections from the pharmaceutical industry. The bill is sponsored by Senator Dean Cameron and a bipartisan group of 6 other senators and 7 representatives. Status: This week this bill was referred from the House Health & Welfare Committee to House Business Committee, where it passed on February 3.

HB 391 : Idaho Health Freedom Act (Sponsored by: Rep. Jim Clark (R) – Dist. 3, Hayden Lake). Codifies Idahoans’ freedom from government compulsion in the selection of health insurance options and tasks the Idaho Attorney General to challenge any statute that forces Idahoans to select their insurance. Primarily supports Governor Otter’s pledge to challenge any individual insurance mandates contained in federal health care reform legislation.

An amendment was offered that created a distinction between the actions of the federal and state government. The original bill would have outlawed a certain state laws, including a requirement that all Idaho college students to have health insurance. Status: Approved by House State Affairs; Amended on the House floor. Awaiting a vote by the full House.

Committee Review of Agency Rules 

Waiver of “Asset Test” for Food Stamps Extended through May 2010. A 300 page report of study by the Idaho Foodbank and “Feeding America” was released this week. The study revealed that 142,200 Idahoans received emergency food last year. That was an increase of 59% from 2006. Only 36% of the households receiving food from the food banks were on food stamps. On February 2, the House Health & Welfare Committee extended the “asset test waiver” implemented earlier in the recession to let people with more than $2000 in assets receive food stamps through May 2010. The “asset test” was temporarily removed last year when unemployment rose. Currently, there are about 179,000 people receiving food stamp benefits in Idaho. The Associated Press’s summary of this action is available here.  A one-page summary of the study’s findings is available here.

House Health & Welfare Committee to Review Legend Drug Donation Act Rules (Docket No. 27-0101-0904 ) on Monday February 8. The Board of Pharmacy’s Rule implementing the Idaho Legend Drug Donation Act, Idaho Code § 54-1762 is on the agenda to be reviewed by the House Health & Welfare Committee on Monday February 8, at 1:30 p.m. This proposed rule is to provide procedures and standards for transferring, receiving, storing and dispensing donated drugs under the Drug Donation Act. The intent of the Act (passed as SB1109 in the 2009 session), is to create asystem under which prescription drugs that would otherwise be destroyed could be donated by pharmacies, hospitals nursing homes and manufactures could be donated to community health centers and free clinics. Please click here for information on the Board of Pharmacy’s and legislature's efforts in creating these rules during the interim between the 2009 and 2010 Sessions.

Federal-Level Health Issues Update:

There was no Congressional action on health care reform this week. The House and Senate may be working out compromise legislation. CMS has released Health Information Technology (“HIT”) regulations, which clarify the criteria which must be met in order for a health care provider to receive stimulus dollars for the adoption of HIT systems. The rules define “meaningful use” of HIT and other criteria to receive such funding.  Please click here for more on federal stimulus funding for HIT.

Throughout the duration of the legislative session, IPHA provides periodic updates on legislation relating to public health issues.  IPHA provides these updates not to advocate particular points of view, positions or pieces of legislation.  Rather, as part of IPHA’s nonprofit mission, we provide these updates to be a resource of objective, nonpartisan information regarding the Legislature’s work in relation to issues of interest to the public health community. We thank Margaret Henbest of the Idaho Alliance of Leaders in Nursing for her collaboration in preparing these updates.

Andy Hyer, JD, Policy Communications, Idaho Public Health Association

During the third week of this Session, a lot has happened in the Legislature relating to public health, including: (1) six new health related bills, (2) a committee vote on the "Idaho Health Freedom Act," (3) budget presentations from Idaho's medical residency programs, and (4) committee review of midwife and daycare provider license rules. This update provides a brief summary of each of these issues. 

Please contact us or leave a comment if you have additional insights or input on these or other issues.  Thank you for reading and for your involvement with the public health issues important to you.

 

(1) Newly Introduced Health Related Legislation

•  H0430 – Model Third Party Administrator Law . This bill would replace the current statute governing third-party administrators (“TPAs”) for health insurance plans with a law patterned after a model law created by the National Association of Insurance Commissioners.  The intention is to have more uniformity in the state laws regulating TPAs, which in theory will help decrease the administrative costs associated with TPA health plans.  This bill will be taken up in the House Business Committee.
• H0432 – Insurer Assessment for Child Vaccines.  This bill would allow the state to assess health insurance carriers for the cost of purchasing vaccines for children covered under the insurance plans.  If passed, this legislation would allow all children in Idaho to receive vaccinations purchased by the state at a discounted rate.  (See IPHA's January 15 Legislative Update  for more information on this legislation.) This bill is in the House Health & Welfare Committee.
•  S1270 – Freedom of Conscience for Health Professionals.  This bill would allow licensed health professionals to conscientiously refuse to provide, counsel or offer referrals for certain services, including abortions, assisted suicide, human embryonic stem-cell research, and dispensing abortifacient drugs. This bill will be taken up to the Senate State Affairs Committee.
• SCR113 - Idaho Children and Nature Network.  This bill, in the Senate Health and Welfare Committee, simply commends the Idaho Children and Nature Network for its work in encouraging children to engage in outdoor physical activity.
• S1272 – Insurance Coverage for Oral Chemotherapy.  This bill would require health insurers to cover chemotherapy as part of the major medical coverage, regardless of whether it is delivered orally, intravenously or through another method.  Currently, some insurers provide oral chemotherapy as part of prescription benefits, which often offer less coverage.  This Bill is in the Senate Health and Welfare Committee.
• S1301 – Permitting Public Health Nurses to Refill Certain Prescriptions. This legislation would allow nurses employed by health districts to label and deliver refills of a limited number of preventative health medications.  This legislation would reportedly save taxpayer-supported public health districts an estimated $65,000 to $100,000 annually.

(2) Committee Vote on "Idaho Health Freedom Act"

On Wednesday the House State Affairs Committee voted, 13-5, in favor of moving forward on H0391, the “Idaho Health Freedom Act.”  This Act, if enacted, would codify “as state policy that every person in the state of Idaho is and shall continue to be free from government compulsion in the selection of health insurance options.”  The proposed Idaho Health Freedom Act would also task Idaho’s Attorney General’s Office with pursuing litigation against federal laws which violated the Act’s stated policy.  According to the bill’s fiscal impact statement, this legislation could cost as much as $100,000, in order for the Attorney General’s Office to hire additional personnel to pursue the above described litigation.  For reporting on this action by news media, click here.

(3) Medical Residency Budget Presentations to JFAC

On Monday, the Joint Finance and Appropriations Committee  (“JFAC”) heard budget presentations from the Psychiatry Residency, the Family Medicine Residency of Idaho, and the ISU Family Medicine Residency (click on the hyperlinks for the slides accompanying each presentation).  The presenters discussed the Residencies’ various funding sources and emphasized the benefits the Residencies provide to Idaho and its citizens, including the role the Residencies play in attracting physicians to practice medicine in Idaho. Additional reporting by news media on these presentations is available here.

 

(4) Administrative Rules Review

The House Health and Welfare Committee reviewed several licensure rules of interest to the public health community.

Midwifery Licensure Rules (Docket No. 24-2601-0901) – Committee Voted to Approve

Pursuant to a statute enacted last year, the Board of Occupational Licenses created draft rules governing the licensure of midwives practicing in Idaho.  The legislation was enacted to create a mandatory licensure system for midwives in Idaho (with certain exceptions, for including certified nurse midwives and religious practices where no fee is charged).  Pursuant to this statute, the draft rules create such a system by setting forth licensing fees, creating continuing education requirements, specifying the types of medications midwives may use and how such medications are to be stored, etc.  The Committee voted to approve the proposed rule.

Daycare Provider Licensure Rules (Docket No. 16-0602-0901) – Committee Voted to Reject

Pursuant to a statute enacted by Senate Bill 1112  from the 2009 Legislative Session, daycare providers in Idaho are required to be licensed (with certain exceptions).  Through the negotiated rulemaking process, the Board of Occupational Licenses prepared draft rules to implement this daycare licensing system.  The Health and Welfare Committee, however, voted to reject the proposed daycare licensure rules.  At the hearing, Committee members expressed concern that the draft rules go beyond simply implementing the statute, and possibly contradict the statute.  Representative Lynn Luker (R-District 15, Boise), who is an attorney, most vocally expressed concern that neither public members nor courts would be able to determine whether parts of the draft rules were legally binding.

Get Involved

We will continue to provide updates throughout the Session as public health related bills are introduced and progress.  As always, please leave a comment on IPHA's blog or email me at andyhyer@gmail.com to provide your input or if you know of other legislation that may be of interest to the public health community.  Similarly, we encourage you to become involved in the legislative process and to make your voice heard on issues important to you.

Throughout the duration of the legislative session, IPHA provides periodic updates on legislation relating to public health issues.  IPHA provides these updates not to advocate particular points of view, positions or pieces of legislation.  Rather, as part of IPHA’s nonprofit mission, we provide these updates to be a resource of objective, nonpartisan information regarding the Legislature’s work in relation to issues of interest to the public health community. We thank Margaret Henbest of the Idaho Alliance of Leaders in Nursing for her collaboration in preparing these updates.

Andy Hyer, JD, Policy Communications, Idaho Public Health Association

This week marks the end of the second week of the 2010 Legislative Session.  The majority of the work in most of the committees--including the Senate and House Health & Welfare Committees--involved reviewing administrative rules.  Additionally, this week Department of Health & Welfare and other public health-related state agencies made budget-needs presentations to the Joint Finance and Appropriations Committee (“JFAC”).

In this week’s legislative update, we summarize the public health related agency budget proposal to JFAC and discuss a couple of the administrative rules under review that may be of particular interest to the public health community.  We also provide a brief overview of the two health-related bills introduced this week and several other pieces of proposed legislation that may make it onto the legislative agenda later on.

Public Health Budget Proposals to JFAC

This week, the Department of Health & Welfare and other public health-related state agencies made budget proposals to JFAC. (Click here for JFAC’s Budget Hearings Calendar and here for the slides from the agency presentations to JFAC.)  Public health related agencies are no exception to the major cuts to be made to the budgets of many state agencies. 

The Department of Health & Welfare made a two-and-a-half day budget presentation beginning Tuesday and concluding Thursday morning. H&W’s budget is the second largest in the state (Education is the largest). The Department is anticipating a shortfall of about $150 million, at the same time as it is seeing a significant increase in applications for services. For example, the number of persons receiving food stamps has doubled in the last year, and the number of persons enrolling in Medicaid is projected to increase by 13%. This is not unusual in a time of economic distress and high unemployment.  Tough decisions will have to be made about any cuts in these budgets. In H&W Director Dick Armstrong’s wrap up at the conclusion of H&W’s presentation on Thursday, he asked legislators for “flexibility” in appropriations to allow the Department to shift funds between divisions and programs as issues arise.  For additional coverage of H&W’s proposals to JFAC by news media, click here or here. 

Thursday and Friday other health-related agencies--including the Idaho Commission on Aging and the State Independent Living Council--made their budget proposals to JFAC. The Revenue Forecast Committee also completed its work and delivered a forecast to the Legislature that is below the Governor's revenue forecast by about $70 million. The Finance and Appropriations Committee will now vote to accept a forecast and will use this figure to set the budgets of Fiscal Years 2010 and 2011.

Health Related Administrative Rules under Review

Unlike in most other states and the federal government, administrative rules in Idaho generally must be approved by the Legislature before going into effect.  (For a helpful explanation of the legislative process in Idaho, including administrative rule review, prepared by the Idaho Council on Developmental Disabilities, click here.)  In the coming weeks, the Health & Welfare Committees in the Senate and House will review close to 1000 pages of such administrative rules.   Additionally other committees in the legislature will review a number of other rules with public health implications (i.e., certain environmental regulations, education, etc.)  Copies of the rules to be reviewed this Session are available here.    

Of the numerous rules under review, here’s a summary of just a couple rules that may be of particular interest to the public health community. Please feel free to comment about other pertinent rules under review.  

Idaho Rural Physician Incentive Program (Docket No. 08-0114-0901)

In 2003, the Legislature created a loan repayment assistance program to encourage new physicians to practice in Idaho’s underserved rural areas (See Idaho Code Sections 33-3723 through -3725.) Under this program, all medical students who receive state funding to go to medical school through an interstate compact (i.e., WWAMI) have, since the legislation was passed, been assessed an amount equal to 4% of the financial support the state provides and this money has been placed in a fund.  Now that money has been collecting into the fund for several years, under the proposed Rule, beginning in October 2010, rural physicians who paid into the fund will be able to apply for loan repayment assistance.  Under the proposed Rule, the program will be able to provide up to $10,000 per year (with a lifetime maximum of $50,000) to a qualifying physician. (Please click here for the text of this proposed rule.)

Consumer-Friendly, Transparent Billing by Residential Care and Assisted Living Facilities (Docket No. 16-0322-0901)

These proposed amendments to IDAPA 16.03.22 are intended to make it easier for consumers to understand how much assisted living or residential services will cost.  Under these proposed amendments, such service providers must, shortly after a private-pay patient begins receiving care, conduct an assessment of the patient and present a contract specifying how much the services will cost to the patient, patient’s family or other responsible party.  Considering the aging population, how long-term care is provided and financed will continue to be a major public health issue.  These proposed Rule amendments represent a policy effort to make it easier for family members to determine just how much nursing home or in-home care for aging relatives will cost.

Health Related Bills Introduced This Week

Alzheimer’s Disease Strategic Plan Task Force (S1258)

S1258, if enacted, would create a task force to assess the public health impact of Alzheimer’s disease in Idaho, to review current state policies and practices, and to work with various stakeholders to develop a strategic plan to address Alzheimer’s disease care and treatment in Idaho.  A stated need for such a task force is the increasing prevalence of this disease among Idahoans due to the aging population.

Idaho Health Freedom Act (H0391)

This Act, if enacted, would codify “as state policy that every person in the state of Idaho is and shall continue to be free from government compulsion in the selection of health insurance options.”  The proposed Idaho Health Freedom Act would also task Idaho’s Attorney General’s Office with pursuing litigation against federal laws which violated the Act’s stated policy.  According to the bill’s fiscal impact statement, this legislation could cost as much as $100,000, in order for the Attorney General’s Office to hire additional personnel to pursue the above described litigation.

Other Possible Legislation

In addition to these bills that have been formally introduced, various community members or organizations have brought to our attention other legislation that may be introduced in the legislature in the coming weeks.  Specifically, one piece of legislation that health districts in Idaho have been working on and brought to our attention by the Central District Health Department, RS 19230, would allow nurses employed by health districts to label and deliver refills of a limited number of preventative health medications.  This legislation would reportedly save taxpayer-supported public health districts an estimated $65,000 to $100,000 annually.  Another piece of legislation brought to our attention by the Idaho Women’s Network would prohibit (except in very limited circumstances) the shackling of women in custody during childbirth.  Additionally, we have received several comments expressing interest in potential legislation that would convert the Idaho Immunization Reminder Information System (IRIS) from an “opt-in” to an “opt-out” program, and otherwise update/revamp the System.  

We will continue to provide updates throughout the Session as public health related bills are introduced and progress.  As always, please leave a comment or email me at andyhyer@gmail.com to provide your input or if you know of other legislation that may be of interest to the public health community.  Similarly, we encourage you to become involved in the legislative process and make your voice heard on issues important to you.

Throughout the duration of the legislative session, IPHA provides periodic updates on legislation relating to public health issues.  IPHA provides these updates not to advocate particular points of view, positions or pieces of legislation.  Rather, as part of IPHA’s nonprofit mission, we provide these updates to be a resource of objective, nonpartisan information regarding the Legislature’s work in relation to issues of interest to the public health community. We thank Margaret Henbest of the Idaho Alliance of Leaders in Nursing for her collaboration in preparing these updates.

Andy Hyer, JD - Idaho Public Health Association Policy Communications

This week the Idaho State Legislature convened for its 2010 Session.  Throughout the duration of this legislative session, IPHA will provide periodic updates on legislation relating to public health issues.  IPHA provides these updates not to advocate particular points of view, positions or pieces of legislation.  Rather, as part of IPHA’s nonprofit mission, we provide these updates to be a resource of objective, nonpartisan information regarding the Legislature’s work in relation to issues of interest to the public health community.  We hope that you will find these updates to be helpful resource, and appreciate your comments.  Our hope is that IPHA’s Blog will become a forum for informed and constructive exchanges on public health related legislative issues during this Session.  

The 2010 Idaho State Legislature got underway this week in the newly remodeled Statehouse, beginning Monday with Governor C.L. “Butch” Otter’s State of the State address on Monday.  Later in the week, members of the Legislature’s Interim Task Force on Health Care held several meetings discussing various health-related legislative proposals.

     1. The Governor’s State of the State Address

In his address, Governor Otter outlined five “fundamental principles” that illustrate his approach to the economic challenges facing policy makers this session.  First, he advised policymakers that “we must not raise taxes.”  Second, he stated that “we must continue to maintain some level of cash reserve against the prospect of our economic recovery taking longer and being less robust than we hope” and instructed that  “prudence demands that we act with caution.”  Third, the Governor advised that “we must do whatever we can to protect the educational opportunities and safeguard the potential of the next generation of Idahoans – our children and grandchildren.”  Fourth, he stated to lawmakers that “we must do whatever we can to protect the health, safety and well-being of our citizens--especially the neediest and most vulnerable among us.”  Finally, the Governor charged that “we must do whatever we can to avoid any duplication of effort or any waste of the taxpayers’ hard-earned dollars.”  The Governor announced an additional $40 million in holdbacks for the current year, the elimination of 400 jobs (375 are currently vacant), and proposed spending some of the non-endowed money in the Millenium (Tobacco Settlement) Fund. The text of Governor Otter’s complete State of the State address is available here .

B.     Legislation Proposed by the Health Care Task Force

On Wednesday afternoon the 2009 Interim Health Care Task Force convened and discussed several pieces of health legislation that will likely be introduced this Session.  The Health Care Task Force, which consists of seven Senators and seven Representatives from both political parties, met a half-dozen times during the interim with stakeholders to develop legislation to address health related issues. Though the Task Force actually voted on these bills, the vote is best interpreted as a non-binding vote in general support of the draft legislation being introduced to the germane committees. It can be seen as a “testing the waters” vote.  We can expect the following to be among the health-related bills to be introduced during this Session:

1.     Health Insurance Carrier Assessment for Child Vaccine Acquisition (DRPAP054) (Sponsor Sen. Dean Cameron (R)).

This piece of legislation is perhaps the most significant undertaking of the Health Care Task Force and is intended to assure the availability of affordable vaccinations for all children in Idaho. Under federal programs, the federal government pays for vaccinations of uninsured children and the State can purchase vaccinations at significantly discounted rates.  The intent of this legislation is to set up an assessment mechanism through which insured children would also be able to receive vaccinations purchased by the State at these discounted rates--thus reducing the overall amounts spent to vaccinate children in Idaho.

This legislation would resolve the current problem of either requiring the families of children with insurance to pay significantly more for vaccinations or requiring the State to pay for these vaccinations without any form of reimbursement from private insurers. This legislation also relieves providers from the burden of having to maintain 2 separate stocks of vaccines in their clinic. 

Specifically, the legislation would create a Vaccination Assessment Board that would be create a system through which to assess health insurance carriers and third-party administrators (for self-funded employer plans) amounts which would then be used to purchase vaccines that could be provided to insured children.  The proposal would also codify the Vaccine Selection Committee, and provide this Committee with specific statutory authority to select the vaccines to be purchased by the State.  Because of immediate vaccination funding concerns, the legislation would be passed as emergency legislation to go into effect on February 1 upon being signed by the Governor.  The proposal also contains a three year sunset clause.

The Task Force unanimously voted in support of moving the legislation forward.

2.     Health Care Planning (DRPAP032) (Sponsor Rep. John Rusche (D))

This piece of proposed legislation relates to the Health Quality Planning Commission (“HQPC”), which was created by the Legislature in 2006 to both develop a health data exchange for Idaho and to facilitate health planning at the state-level.  As a result of HQPC’s efforts, the Idaho Health Data Exchange, Inc. (“IHDE”) has been created.  (For more information regarding IHDE, please see www.idahohde.org.)  This piece of legislation would modify the role of HQPC in relation to IHDE so that HQPC would heretofore simply monitor IHDE’s activities.

The legislation would also make the HQPC permanent, which is set to dissolve in July 2010 under current law.  Moreover, this proposed legislation would further broaden the types of data the HQPC may consider in conducting health planning. 

The Task Force voted unanimously to move this legislation forward.

3.     Health Quality Planning Commission Study of Strokes (RS19264) (Sponsor Rep. John Rusche (D)).  

This legislation proposes a resolution that would “encourage” the Health Quality Planning Commission to study the prevention and treatment of strokes.  Rep. Rusche noted that strokes are significant causes of morbidity and mortality and stroke care is not uniform throughout the state.  He further noted that the nursing/assisted living care for individuals who have suffered strokes is a significant drain on Medicaid’s budget. 

The Health Task Force voted to move this legislation forward

4.     Idaho Childhood Immunization Policy Commission (DRPAP052) (Sponsor Rep. John Rusche (D))

This piece of proposed legislation would create the Idaho Childhood Immunization Policy Commission.  The purpose of this Commission would be to research and analyze ways to increase child immunization rates in Idaho.  The Commission would be made up of nine members appointed by various stakeholder organizations (i.e., the Department of Health & Welfare, Idaho Association of Public Health Districts, the Idaho Primary Care Association, the Idaho Hospital Association, etc.). 

The legislation sets forth that the Commission’s duties would include reviewing existing law regarding childhood immunizations and making recommendations to the Department of Health and Welfare for rulemaking on improving Idaho’s childhood immunization rates, immunization requirements for attending daycare and school, and the Idaho Immunization Reminder System.

The Health Care Task Force voted to move this legislation forward.     

5.     Concurrent Resolution Opposing Federal Health Care Reform (DRPA057) (Sponsor Sen. Dean Cameron (R))

This proposed legislation is a resolution that would state the Legislature’s opposition to the federal health reform proposals currently being considered by Congress and expresses various concerns in relation to this proposed legislation. 

The Task Force voted to move this legislation forward with recommendation on a 7 Aye-5 Nay roll call vote. Further reporting on this action by journalist Betsy Russell, with The Spokesman Review, is available here.   

6. Psycho-Social Rehabilitation Specialist Licensure (DRPAP056) (Sen. Nicole LeFavour (D))

This proposed legislation would create a state licensure system for Psycho-Social Rehabilitation (PSR) Specialists working in Idaho. The purpose of this legislation would be to provide an in-state licensure system to assess the necessary qualifications for PSR Specialists and provide ongoing training. The licensure system would be run through the Bureau of Occupational Licensure and would be self-sustaining from the collection of PSR Specialist licensure fees.

The Task Force unanimously voted to move the legislation forward, without recommendation, apparently due to concern that some stakeholders (including Medicaid) had not yet had a sufficient opportunity to provide input on the legislation.    

In Sum

Although there will certainly be a number of other pieces of proposed legislation to be introduced in the coming weeks, the proposals brought forth by members of the Health Care Task Force provide a glimpse of some of the public health-related issues the Legislature will address this year. We appreciate your comments and encourage you to regularly refer to IHPA's Website and Blog during the Session for updates on these and other public health issues.  Furthermore, we encourage you use your voice and become involved legislative process this Session.  (Please click here to go to the Idaho State Legislature’s website for information on how bills, agendas and how contact legislators.)  Likewise, if you know of legislative proposals of interest to the public health community, please leave a comment on the Blog or email me directly at andyhyer@gmail.com.   

Sunday, Jan. 10, 2010 marks the beginning of the annual observance of National Influenza Vaccination Week (NIVW).  This flu season has presented our community with a unique challenge to fight a new type of influenza -- the 2009 H1N1 influenza virus.  

 

The H1N1 flu is a serious disease.  The Centers for Disease Control and Prevention estimates that between mid-April and November 14, 2009, 47 million people in the United States were infected with the 2009 H1N1 flu, more than 200,000 people were hospitalized, and over 9,800 people died.

 

Influenza is unpredictable and we do not know the likelihood of a future wave of H1N1 flu, but we do know that vaccination is the most important step in protecting against influenza.  

 

Protect yourself, your family and your community by getting vaccinated. Visit www.flu.gov to find the closest vaccination clinic and learn more facts about the H1N1 flu.  Show your love to your family and our community by keeping yourself and those close to you healthy; get yourself and your family vaccinated.

by Minnie Inzer Muniz, Idaho Women's Health Check

Cervical Cancer Screening Saves Lives, yet...
11% of women living in the United States report that they do not have their regular Pap test screenings. In the United States, about 10,000 women are diagnosed with cervical cancer each year and approximately 3,700 women die each year from this disease. High-Risk HPV Types are directly related to cervical cancer, yet many women are unaware of what HPV is or the relationship it has to cervical cancer. In the majority of developing countries, cervical cancer remains the number-one cause of cancer-related deaths among women.

In Idaho, 23.1% of women report not receiving a regular Pap test during the previous three years. Women residing in Health District 7 were significantly more likely to have not had a cervical screening than women in the rest of the state, 33.7% reporting they have not had a Pap test. The majority of women not receiving Pap tests were between 18-24 years old and greater than 65 years old, Idaho’s youngest and oldest.

Idaho women without healthcare coverage were significantly more likely to have not had a Pap test than those with coverage (35% compared with 20.1%). Programs like Women’s Health Check are vital to Idaho women without healthcare.

For free educational publications available from the Centers for Disease Control follow the link below to their website.

http://www.cdc.gov/cancer/dcpc/publications/online.htm

Resources are also available in Spanish.

April Dunham, Program Manager
Idaho Heart Disease and Stroke Prevention Program

“Know your Numbers” is the catch phrase I start with today but, there are a lot of numbers we need to remember every day.  There are phone numbers, account numbers, social security numbers, house numbers … but the set of numbers I’m writing about are important numbers for your health.  One of the most important among them is your blood pressure.  It’s not important you completely understand anatomy and physiology and how the body works, but your blood pressure is a set of two numbers that can change your life. 

 

High blood pressure (also known as hypertension) is often referred to as the “silent killer.”  You don’t know you have it until someone takes your blood pressure correctly and lets you know what it is.  If you are one of the 76,000 Idahoans with diabetes, your blood pressure becomes even more important.  Individuals with diabetes are at higher risk for heart disease and stroke as a result of their diabetes.  Adding high blood pressure in addition to diabetes further increases the individual’s risk for heart disease and stroke.

 

The healthy blood pressure range is systolic (the top number) to be 120 or less and the diastolic (the bottom number) to be 80 or less.  If those numbers are higher you are either pre-hypertensive [if your systolic is 120-139 or your diastolic is 80-89] or you are hypertensive [if your systolic is 140 or higher or your diastolic is 90 or higher].  It is important to track your blood pressure over time. 

 

If you have blood pressure over the healthy range, it is vital that you talk with your healthcare provider.  There are lifestyle changes that can help someone lower their blood pressure, which include dietary changes, increasing physical activity and maintaining a healthy weight.  Your healthcare provider may also prescribe medication to help you get to a healthy blood pressure.  It is important to take medication as prescribed and to talk about your health goals with your healthcare provider.

 

If you would like to receive a wallet card to track your blood pressure, you can email April Dunham from the Idaho Department of Health and Welfare, Heart Disease and Stroke Prevention Program at dunhama@dhw.idaho.gov.  She will send you a wallet card to help you track your blood pressure, cholesterol and weight.  The wallet tracker also has a space to set your personal goals with your healthcare provider at your next visit.

by Cherie Nelson, Diabetes Program Coordinator

Southeastern District Health Department

 

Diabetes is the leading cause of non-traumatic lower-extremity amputations in the United States, about 86,000 amputations annually.  Fully 15% of people with diabetes will develop an open sore, or foot ulcer, on their feet, and 20% of diabetics with foot ulcers will have a limb amputated.  Over half of those who have one limb amputated will have a second amputation within five years. 

Neuropathy and poor circulation are factors that contribute to foot problems for people with diabetes.  Neuropathy or nerve damage leaves the legs and feet without feeling.  When an injury occurs to the foot, there is no pain response, no evaluations, and no intervention.  Without care, the injury can progress to a major infection, tissue loss, and possibly amputation.  Poor circulation caused by calcification begins in the small vessels of the toes and progresses up the leg.  Poor circulation prevents adequate blood from reaching the wound to heal. 

People with diabetes can help protect themselves from amputation by checking their feet every day.  Check for cuts, sores, red spots, swelling and infected toenails.  Use a mirror to look at the bottom of your feet if you have trouble bending.  Wash your feet every day and keep the skin soft and smooth.  Wear shoes and socks at ALL times – even indoors.  Make sure your shoes fit well and protect your feet.  Also, ask your doctor to check your feet at every visit.  Ask him or her to check for pulses and your sense of feeling.  Your physician should refer you to a foot care doctor or podiatrist if needed. 

The Southeastern District Health Department, Idaho State University (ISU) Nursing, and Jeff Bray, DPM, have partnered to provide foot exams for people with diabetes.  Dr. Bray trains the nursing students to provide the 2-minute foot exam and to provide foot care for people with diabetes.  The ISU nursing students have provided foot exams and foot care education for people at senior centers in every county in Southeastern Idaho.  Over the past year, 71 nursing students have been trained and those students provided foot exams for 325 people.  ISU College of Pharmacy students also come to the foot exam clinics to provide medication reviews, glucose tests, blood pressure checks, and diabetes education. 

Carol Moehrle, NACCHO President Elect

District Director, Idaho North Central District Health

 

It is with a heartfelt “Thank You” that I send this message to the dedicated Public Health workers in our state. We thank you for dedicating your careers to preventing disease, promoting health, and protecting our citizens. 

 

Often times the work of Public Health is invisible and taken for granted by many. Only when it is not there, or if it fails, do we see the importance. This season, a very special recognition goes to those in Local Public Health as they tirelessly work to vaccinate our at  risk populations against H1N1. Your efforts are definitely visible in our communities.

 As we all work together to improve the health of our communities and state, I say “Thank You” to each and every one of you for your ongoing dedication to Public Health in Idaho.

 

By Elizabeth Hannah, DVM, MS, MPH

 

Just like humans, pets can get diabetes. And again, just like humans, the importance of good nutrition and physical activity can’t be overstated. The body condition score, a measure of lean to fat body types, is used by veterinarians to help counsel owners on their pet’s weight.

 

In an effort to highlight the growing epidemic of overweight and obesity in companion animals, the American Animal Hospital Association (AAHA) has designated November as Pet Diabetes Month to create awareness for this disease and to educate pet owners about appropriate veterinary care.

 

An educational website, PetDiabetesMonth.com, serves an online resource for learning about the condition, providing tips on early detection and living with the disease.

 

About 1 in 200 cats and 1 in 500 dogs are afflicted with diabetes globally. Experts suggest that those numbers are growing. If left untreated, diabetes can be terminal for dogs and cats.

 

For dogs, the cause of canine diabetes is largely unknown, but experts believe genetics plays a role. Research indicates that diabetes has a tendency to afflict middle-aged to older dogs, especially unspayed females.

 

In cats, obesity, inactivity, and an indoor lifestyle can contribute to the development of diabetes, but genetics and other insulin-resistant disorders like pancreatitis or hyperthyroidism may also play a part.

 

The good news is that dogs and cats with diabetes can live a healthy, active life with proper care that includes insulin therapy and an appropriate diet. And just like humans, the disease may be prevented or delayed with healthy lifestyle habits.

 

If there is any concern that a pet may have diabetes, have him or her tested during a regular examination by a veterinarian. To find out more about pet diabetes month, visit PetDiabetesMonth.com.