February 2016—Public Health Law News

Thank you to Dr. Judith Monroe, MD, for her service to the Office for State, Tribal, Local and Territorial Support (OSTLTS). I wish her continued success in her new role as the president and CEO of the CDC Foundation. Dr. Monroe joined CDC as the OSTLTS director in 2010. Since then, she has led CDC’s efforts to strengthen America’s health departments and empower state, tribal, local, and territorial (STLT) public health professionals. Dr. Monroe is an engaging and compelling leader. Her diverse and unique experiences with STLT communities and the public and private sectors have been an incredible asset to OSTLTS and the public health law community, and I am sure her talents will create similar public health successes for the CDC Foundation.

Best wishes and many thanks,

Matthew Penn, JD, MLIS
Director
Public Health Law Program, CDC

Job Opportunity: Director of CDC’s Office for State, Tribal, Local and Territorial Support (OSTLTS). CDC is seeking applicants for the position of director of OSTLTS. Applicants should apply through USAJOBS.gov. The application period is open from Wednesday, February 10, 2016, to Thursday, March 10, 2016.

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Summer 2016 Internships and Externships with PHLP. PHLP is accepting applications for summer 2016 internships and externships, which offer entry-level experience for rising and current third-year law students who are interested in exploring careers in public health law. PHLP’s public health lawyers and analysts work to advance the use of law as a public health tool. PHLP provides services and resources, such as technical assistance, publications, and workforce development, to CDC programs and state, tribal, local, and territorial health departments. The program is open only to rising and current third- year law students. Applications for summer 2016 are due by midnight (EST), February 28, 2016.

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Webinar: Partnering with Lawyers to Address Social Determinants of Health. Healthy People 2020, ChangeLab Solutions, Cincinnati Child Health-Law Partnership, Cincinnati Health Department ,and the National Center for Medical-Legal Partnerships are hosting a webinar, “Partnering with Lawyers to Address Social Determinants of Health: A Healthy People 2020 Spotlight on Health Webinar.” The webinar will be held March 10, 2016, from 1:00 to  2:00 pm (EST) and will explore innovative approaches to address social determinants of health at the individual and community levels.

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Policies for Action Call for Proposals. The Robert Wood Johnson Foundations (RWJFs) program, Policies for Action: Policy and Law Research to Build a Culture of Health (P4A), has launched its first call for proposals to help build an evidence base for policies that can lead to a Culture of Health. P4A seeks to engage long-standing health and healthcare researchers, as well as experts from fields that include housing, education, transportation, and the built environment, who have not previously worked in the public health field. The research funded under this call for proposals should inform the significant gaps in our knowledge about policies that can improve population health and well-being and increase health equity. Deadline: March 15, 2016.

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2016 Policy Surveillance Summer Institute. The RWJF Policy Surveillance Program is hosting its inaugural Policy Surveillance Summer Institute, June 9–10, 2016, at Temple University in Philadelphia, Pennsylvania. The Summer Institute will teach policy surveillance and legal mapping techniques. It will provide hands-on lab training with software tools and classroom instruction. It will also provide opportunities to network with other law and policy professionals and engage with Policy Surveillance Program staff during the Institute and afterward. By the end of the experience, participants will have learned the entire process—conceptualizing a dataset through web-deployment tools for visualizing policy over jurisdictions and time.

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Emergency Declarations and Tribes: Mechanisms Under Tribal and Federal Law. This article summarizes several types of emergency declarations, including tribal declarations, Stafford Act declarations, and federal public health emergency declarations, and their implications for tribes. Sunshine G, Hoss A. Emergency declarations and tribes: mechanisms under tribal and federal law. Michigan State International Law Review 2015;24:33–44.

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Job Opening: Program Development Officer. Georgia State University (GSU) College of Law, through the Center for Law, Health & Society, is developing a master of jurisprudence in health law (MJ). The degree will be an online program for healthcare and public health professionals interested in learning more about law as it applies to health. GSU’s College of Law seeks qualified applicants for the program development officer position to help translate program content into online courses, ready the program for launch, and advertise the program to potential audiences. To view the full position details and apply, visit GSU’s employment website and search requisition #16000150.

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2016 Public Health Law Conference. The Public Health Law Conference will take place September 15–17, 2016, at the Grand Hyatt, in Washington, DC. The conference, hosted by the Network for Public Health Law, is for public health lawyers, practitioners, officials, policy makers, researchers, and advocates. Conference attendees will learn about laws and policies affecting critical public health issues, such as disease prevention, drug overdose, health data sharing, and access to care. Early bird registration and a preliminary agenda are available now.

Issue Brief: Senators Introduce Bill on Tribal Healing to Wellness Courts. [PDF - 178KB] This issue brief, published by PHLP, provides information on Tribal Healing to Wellness Courts and describes a recent US Senate bill authorizing funding to help tribes establish them.

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Model California Ordinance Regulating Tobacco Waste. ChangeLab Solutions has released a model ordinance to assist California cities and counties that want to address the problem of tobacco waste littered in public spaces. The model ordinance prohibits any brand of filtered tobacco products to be sold in a city or county, unless the manufacturer or distributor of a brand either takes responsibility for the collection and disposal of tobacco waste or pays an in-lieu-of fee to the local jurisdiction to cover the reasonable costs of litter mitigation.  

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US Government Accountability Office (GAO) Report on State Marijuana Legalization. The GAO has released a report encouraging the US Department of Justice (DOJ) to document its approach to monitoring the effects of marijuana legalization. The report includes a podcast on state marijuana laws, summary documents, and information about DOJ’s marijuana enforcement priorities.

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Mental Health First Aid State Policy Tracking Chart and State Policy Toolkit. The National Council for Behavioral Health (NCBH) released a state mental health first aid state policy toolkit. According to NCBH, “mental health first aid is a public education program that can help individuals across the community to understand mental illnesses, support timely intervention, and save lives.”

California: Doctor convicted of murder for patients’ drug overdoses gets 30 years to life in prison

In October 2015, a California doctor, Dr. Hsiu-Ying “Lisa” Tseng, was found guilty of second-degree murder of three of her patients who fatally overdosed on prescription painkillers she prescribed. On February 5, 2016, Los Angeles County Superior Court Judge George G. Lomeli sentenced Tseng to 30 years to life in prison. This is the first time in the United States that a doctor has been convicted of murder for overprescribing.

Before reading the sentence, Judge Lomeli cited Tseng’s failure to take responsibility for her actions, saying “It seems to be an attempt to put the blame on someone else. Very irresponsible.”

During the trial District Attorney John Niedermann told the court that more than a dozen reports—from a coroner or law enforcement official—of patients who had died from prescription overdoses made no difference or impression on Tseng. Niedermann further argued that Tseng’s motivations were financial, pointing to tax returns showing that her office made $5 million between 2007 and 2010.

Medical experts in the field worry that Tseng’s conviction and sentencing will hurt physicians and patients. “When you use the word ‘murder,’ of course it’s going to have a chilling effect,” said Dr. Peter Staats, president of the American Society of Interventional Pain Physicians. Staats also indicated that physicians should be wary of abuses.

Another physician, Dr. Francis Riegler, has discussed Tseng’s case with physicians across the country. “We agree that if you’re doing the right thing—if you’re one of the good guys, if you will—you don’t need to worry about being prosecuted for murder,” said Riegler.

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California: Childhood vaccination rates climb in California
NPR   (01/21/2016)   Lisa Aliferis

Childhood vaccination rates went up in 49 of 58 California counties since last year. This increase resulted in 92.9 percent of kindergartners being current on their shots for the 2015–2016 school year, up 2.5 percent from the 2014–2015 school year.

California was arguably the epicenter of the vaccine debate in 2015, after a California amusement park was linked with the 2015 measles outbreak. In the aftermath of the outbreak, the California legislature passed a bill eliminating California’s personal belief exemption, which allowed parents to opt out of mandatory school vaccines because of personal reasons unrelated to religious beliefs or medical necessity. The repeal of the exemption will take effect on July 1, 2016. So, the new law does not fully account for the increased vaccine rates.

“I can only assume that this is in part a response to . . . the measles outbreak and the publicity that it received. It’s unfortunate that fear or outbreaks of disease are necessary to get people to do what we’d like them to do, but I think that’s human nature” said Dr. Art Reingold, head of epidemiology at the University of California, Berkeley School of Public Health.

According to James Watt, chief of the communicable disease division of California’s Department of Public Health, the increase in vaccine rates could also be attributed to fewer schools allowing “conditional admissions.” Such admissions occur when children are partially but not fully vaccinated and are allowed to enter school at the beginning of the year under the understanding that the child will be vaccine-compliant as soon as possible. This allowance is not compliant with California’s vaccine laws and can lead to conditional admissions, foregoing the vaccines interminably.

The health department has been working with school districts and parents to explain the rules; the overall percentage of conditional admissions has dropped from 6.9 percent in the 2014–2015 school year to 4.4 percent in the 2015–2016 school year. 

[Editor’s note: Read California’s SB 277, which was signed into law on June 30, 2015, and will become effective on July 1, 2016.]

Florida: Florida beachgoers cling to a right to make the sand their driveway
New York Times   (01/26/2016)   Lizette Alvarez

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Massachusetts: Jury denies cancer screening in Phillip Morris class action lawsuit
Top Class Actions   (02/10/2016)   Melissa La Freniere

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Washington DC: DC bill would pay people stipends not to commit crimes
WTOP   (02/02/2016)   Ben Nuckols
[Editor’s note: Read the Neighborhood Engagement Achieves Results Amendment Bill.]

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National: Centene can’t find hard drives with 950,000 medical records
Modern Healthcare   (01/25/2016)   Joseph Conn

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National: Circumcision proposal by CDC drawing detractors
The Washington Times   (01/15/2016)   Cheryl Wetzstein
[Editor’s note: Read CDC’s proposed Recommendations for Providers Counseling Male Patients and Parents Regarding Male Circumcision and the Prevention of HIV Infection, STIs, and Other Health Outcomes.]

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National: FDA announces overhaul of approach to opioid painkillers
The Day   (02/05/2016)   Brady Dennis
[Editor’s note: Learn more about FDA’s comprehensive action plan to reduce the impact of opioid abuse on American families and communities.]

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National: Panel calls for depression screenings during and after pregnancy
New York Times   (01/26/2016)   Pam Belluck
[Editor’s note: Read Screening for Depression in Adults US Preventative Services Task Force Recommendation and learn more about the task force.]

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National: Pentagon to offer plan to store eggs and sperm to retain young troops
New York Times   (02/03/2016)   Michael S. Schmidt

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National: Some officers bristle at recall of military equipment
New York Times   (01/26/2016)   Timothy Williams

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National: USDA announces new food safety standards
Farm Futures   (02/5/2016)  
[Editor’s note: Read the USDA’s Salmonella Action Plan.]

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National: US Regulator: A Google computer could qualify as a car driver
Computer World   (02/10/2016)   John Ribiero

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International: For sugar tax supporters, 2016 may be the sweet spot
Reuters   (02/08/2016)   Martinne Geller

Interview with Judith Monroe, MD, President and CEO, CDC Foundation

Title: President and CEO, CDC Foundation

Education: BS, Eastern Kentucky University; MD University of Maryland

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CDC Public Health Law News (PHLN): What sparked your interest in public health?

Monroe: I did not plan a career in public health but when then Indiana Governor Mitch Daniels asked me to be Indiana’s state health commissioner in 2005, I had to accept. I had practiced medicine for several years and became increasingly concerned about the number of patients with preventable diseases caused by environmental and behavioral factors beyond my office walls. I saw public health as the avenue to make a difference.

PHLN: Please describe your career path.

Monroe: I started my career as a medical technologist working in blood banking and then kidney transplant at Walter Reed Army Medical Center in Washington, DC. Although I loved the laboratory and working at the cellular level, I soon learned that I liked working with people more, so I went to the University of Maryland for medical school. Following my residency in family medicine at the University of Cincinnati, I served a four-year National Health Service Corps commitment in rural Tennessee practicing frontline medicine. From there, I joined the faculty in the Department of Family Medicine at Indiana University and led the department’s work in rural communities. I then joined St. Vincent Hospital in Indianapolis in a dual administrative role as director of the Family Medicine Residency Program and the Primary Care Center. Then, Governor Daniels called me to public service. After five years as state health commissioner, I became the deputy director for CDC and director of the new Office for State, Tribal, Local and Territorial Support (OSTLTS). For the past six years, I’ve been in this national position supporting public health practice across the system from within CDC, and now I’m leading the CDC Foundation.

PHLN: This month you began your new position as president and CEO of the CDC Foundation. How will your career experiences, specifically your time as the director of OSTLTS, support your new role?

Monroe: In OSTLTS, I had the opportunity to drive its mission to advance US public health agency and system performance, capacity, agility, and resilience. Strengthening relationships and communication among CDC staff, health officials at all levels, public health partners, and broader health system stakeholders was integral to my role. Through my work, I supported CDC priorities and programs and learned how those translate on the ground through health departments’ and partners’ work. This experience is invaluable to my new work supporting CDC through the CDC Foundation. The Foundation has more flexibility and can move faster than government programs often allow, thus paving the way for innovation and filling funding gaps that CDC programs experience. I believe my deep relationships with the public health field and with CDC leaders will advance my effectiveness in my new role.

PHLN: What is the CDC Foundation? How is it and its mission different from CDC?

Monroe:The CDC Foundation is an independent, nonprofit organization, existing solely to support CDC. The Foundation’s mission is to help CDC do more, faster through public-private partnerships and philanthropy aimed at protecting the health, safety, and security of America and the world. The CDC Foundation was authorized by Congress in 1992, and it began operations in 1995. The Foundation is led by a board of directors with members from the private sector, academia, public health, and philanthropy. The CDC Foundation connects CDC with the right partners, information, and technology to address and solve priority health challenges. By aligning diverse interests and resources, the Foundation’s focused collaborations with private and philanthropic partners help CDC accelerate public health protection priorities.

PHLN: Where do you hope to take the Foundation under your leadership, and what innovations do you hope to fund?

Monroe: During the past two decades, the CDC Foundation has become a key partner in helping CDC extend the agency’s public health protection work. So, my goal is to build on the solid work that has already occurred at the CDC Foundation. Looking ahead, I believe there are opportunities to build on CDC priorities in areas ranging from infectious diseases, such as combatting antibiotic-resistant bacteria, to chronic diseases, like cardiovascular disease, to global health security, where you focus on building capacity to assist developing nations in spotting and addressing diseases before they spread to other countries. I believe public-private partnerships among the government, private, and philanthropic sectors are crucial to improving health outcomes. Together, we can do so much more than any of us can do alone. 

PHLN: How does CDC Foundation’s work relate to public health law?

Monroe: There are many ways the CDC Foundation’s work with CDC can be used to inform policy. For instance, the CDC Foundation has worked with CDC to conduct surveys related to tobacco use around the world. This work has included the development and implementation of comparable data across countries and using that information to enhance a country’s ability to design, implement, and evaluate tobacco control initiatives, including policies and regulations. There is also a domestic program with CDC focused on public health policy and law. That program is funded through a grant to the CDC Foundation from the Robert Wood Johnson Foundation, and ties into the Healthy People 2020 initiative from the US Department of Health and Human Services. In this program, a team works with subject matter experts and federal partners to develop evidence-based reports on a variety of important public health topics. These reports will be widely disseminated to encourage a national dialogue about the potential impact of legal and policy interventions in improving communities’ health.

PHLN:What has been your experience of public health law and working with attorneys, both as state health commissioner and as the director of OSTLTS?

Monroe:My experience with public health law and working with attorneys has been overwhelmingly positive. As state health commissioner, I learned very quickly to have the attorneys nearby for advice and analysis of emerging situations. I hired a nurse attorney, Mary Hill, when given the chance to hire a new deputy health commissioner. During my tenure as the OSTLTS director, I turned to public health law professionals for questions emerging around emergency situations, health reform, and the daily practice of public health.

PHLN:How can lawyers support public health research at CDC, given that they are not counsel to state health commissioners or public health departments?

Monroe: Not everyone who has a law degree acts as legal counsel advocating for a specific client. For example, there are attorneys all over CDC who don’t represent CDC as legal counsel but who analyze policy and legal information related to public health for CDC programs. Such unbiased and expert analysis helps public health practitioners who are less familiar or comfortable with law and policy understand the legal landscape surrounding specific public health issues. This provides a more complete picture of public health concern and interventions.

PHLN:Legal epidemiology, the study of law as a factor in the cause, distribution, and prevention of disease and injury, has contributed to providing rigorous evidence on legal strategies to improve public health. How can legal epidemiology be leveraged to help support health outcomes in state, tribal, local, and territorial (STLT) communities?

PHLN: How can legal researchers make legal research more influential to people who make decision about public health?

Law is an integral part of public health practice; many public health interventions depend on law, such as seatbelt and tobacco cessation laws. The better we understand and explain how law and policy affect public health, the better and more consistent public health interventions we will create.

PHLN: How might the CDC Foundation collaborate more closely with STLT communities under your leadership?

Monroe: I believe there are opportunities for closer collaboration and potential partnerships between the CDC Foundation, CDC, external partners, and STLT communities. However, there are some specific aspects about the CDC Foundation that should be considered when exploring partnerships with us. One is that the CDC Foundation exists to support CDC and projects that it wants to pursue. So, CDC must have an interest in and play a lead role in the effort. Another aspect is that the CDC Foundation is not an endowed foundation. In other words, we don’t have a pool of funding to disburse to organizations for programs. Instead, when CDC is interested in pursuing a program, we must find partners and raise funds to support the potential program. With that understanding, there are definitely opportunities for collaboration, and I’m excited about being able to explore these in my new role.

PHLN: How does the CDC Foundation partner with other organizations to improve public health?

Monroe: Many times, a partnership begins at CDC with a scientist who has a great idea and wants to collaborate with an outside partner to make it happen. At other times, organizations in the private or philanthropic sectors recognize they can better accomplish their own public health goals by working with CDC through the CDC Foundation. By collaborating with outside organizations and CDC, the CDC Foundation establishes partnerships and manages programs so CDC’s experts can focus on the science. Our partnerships help CDC launch new programs, expand existing programs that show promise, or establish a pilot project to determine if a health program should be scaled up.

PHLN: How can people learn more about the CDC Foundation and its work?

Monroe: The easiest place to start is by going to the CDC Foundation’s website where they can follow the Foundation’s blog and media releases and find out about some of the innovative ways the CDC Foundation is working with CDC. From the site, people can also sign up for blog and media updates. Or, if they’re interested in learning how to connect with the CDC Foundation to discuss partnerships, they can get that information there as well.

PHLN: Do you have any hobbies you care to share with PHLN?

Monroe: I love to bike, hike, and kayak. This summer, I joined the growing fans of stand up paddle boarding and it might become my overall favorite activity! I also oil paint and love to experiment on new dishes in the kitchen with ingredients from my garden. 

PHLN: Have you read any good books lately?

Monroe: I just started to read “The End of Power,” and I enjoyed reading “All the Light We Cannot See” and “The Goldfinch.”

PHLN: Is there anything else you'd like to add?

Monroe: I’m very appreciative of the support and expertise I have received from my colleagues in public health law over the years. I look forward to continued collaboration in my new role.

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

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Public Health Law News Quiz Question: February 2016

What is the title of the issue brief CDC’s Public Health Law Program published and announced in February 2016?

Justin Walker

December Question: What is the closing date for PHLP’s summer 2016 internship and externship applications?

Winning response: February 28, 2016

Federal: Explosion claims outside insurance policy coverage, summary judgment granted 
Crum & Forster Specialty Insurance Co. v. Explo Systems, Inc.
United States District Court, Western District of Louisiana, Shreveport Division
Civil Action No. 12-3080
Filed 01/15/2016
Opinion by District Judge Donald E. Walter

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Federal: Negligence claims barred by Premises Liability Act in ski lift fall suit
Raup v. Vail Summit Resorts, Inc.
United States District Court, District of Colorado
Case No. 1-cv-00641-WYD-NYW
Filed 02/01/2016
Opinion by Senior District Judge Wiley Y. Dainel

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Federal: Sex offender’s mandatory ankle bracelet monitor does not violate 4th Amendment
Belleau v. Wall
United States Court of Appeals, Seventh Circuit
Case No. 15-3225
Decided 01/29/2016
Opinion by Judge Richard A. Posner

Quotation of the Month: Greg Gimbert, Daytona Beach, Florida, beachgoer

“We have a millionaire’s-level privilege, and the price of admission is a car and the cost of gas for locals, but now we feel they are taking away the one thing that any of us is here for: access to our beaches,” said Mr. Gimbert of proposals to ban driving on beaches in Daytona Beach, Florida.