March 2016—Public Health Law News

Zika Preparedness and Response: A Public Health and Legal Perspective Webinar. This webinar will describe the public health problem Zika poses, including disease characteristic basics and current guidance for healthcare providers. The webinar will discuss the domestic legal framework for addressing the virus, including the executive powers for mosquito abatement. It will also highlight ways to coordinate healthcare and public health legal preparedness efforts. The webinar will take place Friday, March 18, 2016, from 1:00 to 2:00 pm (EDT) and will be hosted by CDC’s Public Health Law Program (PHLP), in partnership with the Network for Public Health Law, Partnership for Public Health Law, American Bar Association (ABA), and American Health Lawyers Association.

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Infectious Disease Reporting and American Indian and Alaska Native Populations: Law and Practice. Cross-jurisdictional issues between tribes, states, and the federal government can affect infectious disease management and reporting in practice. This webinar will discuss how law can affect infectious disease reporting, including a discussion on tribal, federal, and state law. The webinar, co-sponsored by PHLP and the ABA, will take place Monday, March 28, 2016, from 1:00 to 2:30 pm (EDT).

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Prevention Status Reports. CDC's Prevention Status Reports highlight the status of state-level policies and practices to address critical public health problems. Reports are available for all 50 states and the District of Columbia on the following 10 health topics: alcohol-related harms; healthcare-associated infections; heart disease and stroke; HIV; motor vehicle injuries; nutrition, physical activity, and obesity; prescription drug overdose; teen pregnancy; and tobacco use. As many of the PSR topics are relevant to public health law, CDC’s Public Health Law News will be featuring different PSR topics in the announcements over the coming months. Read the reports and check out the new food safety indicator on state adoption of selected foodborne disease-related provisions from the 2013 Food and Drug Administration Food Code.

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2016 Policy Surveillance Summer Institute. The Robert Wood Johnson Foundation Policy Surveillance Program is hosting its inaugural Policy Surveillance Summer Institute, June 9–10, 2016, at Temple University in Philadelphia. The Summer Institute will teach policy surveillance and legal mapping techniques. It will provide hands-on lab training with software tools, classroom instruction, and opportunities to network with other law or policy professionals and engage with Policy Surveillance Program staff. Participants will learn the entire process from conceptualizing a dataset through web-deployment tools for visualizing policy over jurisdictions and time.

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Job Opening Program: Development Officer. Georgia State University 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. Georgia State Law seeks qualified applicants for the position of program development officer to help translate program content into online courses, readying the program for launch and advertising the program to potential audiences. To view the full position details and apply, visit the Georgia State University 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, policymakers, 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.

Executive Orders and Emergency Declarations for the West Nile Virus: Applying Lessons from Past Outbreaks to Zika. A brief analysis of select uses of local, state, and federal executive powers to combat the West Nile virus. Examining the use of executive powers to address the West Nile virus may inform actions taken to address the threats posed by other mosquito-borne diseases, such as the Zika virus.  

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Zika Virus Microsite. CDC has created a Zika Virus Microsite, an easily embeddable collection of Zika virus information about developments in the current outbreak, including prevention, symptoms, treatment, and materials for travelers and pregnant women.

Judge grants delay of sodium warnings for New York City restaurants
New York Times   (02/29/2016)   Marc Santora

New York City’s Board of Health unanimously passed a measure in September 2015 requiring some chain restaurants to post menu warnings for items with high sodium content. Affected restaurants will be required to place a small saltshaker next to menu items that have the daily limit of sodium, at least 2,300 milligrams. Failure to comply with the law would result in fines.

Enforcement of the rule and fines, which the National Restaurant Association is seeking to block in state appellate court, was scheduled to take effect March 1, 2016. Justice David Friedman of the Appellate Division of New York Supreme Court granted an injunction to prohibit enforcement of the measure while it is still under judiciary review. A final opinion is expected March 18, 2016.

[Editor’s note: Learn more about New York City’s Sodium Initiative [PDF 254KB].]

California: At $2 million a day, Porter Ranch residents get to keep their temporary housing
Los Angeles Times   (03/02/3016)   Alice Walton

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California: Will California follow French model-health law?
Vogue UK   (02/24/2016)   Lauren Milligan
[Editor’s note: Read California Assembly Bill 2539.]

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Hawaii: Native Hawaiian group adopts constitution at convention
The Washington Post   (02/27/2016)  

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Iowa: Hy-Vee recalls Maytag raw milk blue cheese
Food Poison Journal   (03/04/2016)   Anthony Marangon

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Michigan: The law that poisoned Flint
The Daily Beast   (03/04/2016)   Alec MacGillis
[Editor’s note: Learn more about lead and lead in water in Flint, Michigan.]

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National: Ensuring the safety of compounded drugs
Route Fifty   (02/23/2016)   Elizabeth Jungman

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National: Tattoo removal takes tiny step forward
New York Times   (02/23/2016)   Courtney Rubin

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National: White House to convene Zika summit next month
Washington Post   (03/04/3016)   Juliet Eilperin
[Editors’ note: Learn more about the Zika Action Plan Summit, which will take place April 1, 2016.]

Interview with Jennifer Ibrahim, Associate Dean for Academic Affairs and Associate Professor, Temple University College of Public Health

Title:

• Associate Dean for Academic Affairs and Associate Professor, Temple University College of Public Health
• Associate Director, Policy Surveillance Program at the Temple University Center for Health Law, Policy and Practice

Education:

• PhD: Graduate program in health services and policy analysis, School of Public Health, University of California, Berkeley
• MA: Department of Political Science, University of California, Berkeley
• MPH: Concentration in health policy and management, University of Massachusetts, Amherst
• BS: Biology and pre-medical, Boston College

 

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Public Health Law News (PHLN): Can you please describe your career path?

Ibrahim:I pursued an undergraduate degree in biology at Boston College because I knew I wanted to have a career in health but was unsure of what direction I wanted to take. While I was interested in clinical aspects of health and well-being, I knew I didn’t want to be a doctor. I wanted to work with people rather than on people. I wanted to tackle major health issues and feel that I could make a significant difference, not just one person at a time. I began looking into graduate schools my senior year and applied to the University of Massachusetts, Amherst, for my MPH in 1997. While completing my MPH, I also worked at the Massachusetts Department of Health on a teen pregnancy prevention program in Greenfield and Orange, Massachusetts—a rural area of western Massachusetts. The combination of policy classes at UMass, particularly with Dr. Paula Stamps, and seeing opportunities for population-level intervention at work got me hooked on policy. I saw that a policy or a population-level program could affect many lives and improve health faster.

I considered opportunities to work in the field, but one advisor, Dr. David Buchanan, encouraged me to pursue a PhD with an eye toward evidence-based policy. In 1999, I pursued a PhD in health services and policy analysis and an MA in political science at the University of California, Berkeley. The policymaking process and how the science of epidemiology and the analytics of biostatistics could be more effectively brought to bear on policymaking was engrossing. For my dissertation, I worked on analyzing Medicaid policy decisions about coverage for smoking cessation. This led me to pursue a postdoctoral program in 2002. I was fortunate enough to work with the preeminent researcher in tobacco policy, Dr. Stanton Glantz, at the University of California, San Francisco. My work there was a mix of qualitative and quantitative analysis of the policymaking process related to state-level tobacco policymaking.

In 2005, after two years in the postdoctoral position, I was offered a faculty position at Temple University where there was an interest in building the health policy coursework and research. Finding collaborators is one challenge of building a new program and area of research in policy. I was fortunate to find Scott Burris, an esteemed member of the faculty in the Beasley School of Law. Scott helped me look at opportunities for systematically organizing and evaluating the effects of policy and laws on population health. In fall 2007, Scott transferred to the Robert Wood Johnson Foundation to build a center on health law, and he asked me to be part of his team. After the Public Health Law Research (PHLR) program was funded in 2008—and we began to grow the methods and the evidence base through work within the center and through funding external teams—I focused on the law’s role in health departments. I was fascinated by the relationship between lawyers and health officials and the way the public health workforce in general understands law—this is the focus of my research to date. 

PHLN: What are your day-to-day activities in your current position?

Ibrahim: There is no typical day for me. I love my job; it is anything but routine. My days are usually filled with a mix of meetings with faculty and administrators about course and curriculum development to program evaluation and individual meetings with students about careers opportunities, research opportunities, funding questions, and more. I remain actively engaged in research, formerly with the PHLR program, and now with the Policies for Action program. I also enjoy teaching, though I don’t currently have time to teach each semester. I enjoy interacting with so many different people and thinking about how the different aspects of my position—administrative, research and teaching—can all fit together. I appreciate my position’s interdisciplinary nature, being able to work with faculty and researchers from law, public health, social work, nursing, etc. My position helped me meet people from across the nation and globe doing amazing work, both in practice and research, to advance policy and legal efforts to improve population health.

PHLN: What drew you to public health law and policy?

Ibrahim: While I was interested in improving health, I knew it wasn’t at an individual approach. I sought a way to make a larger impact and move the needle on a population’s health. Law and policy interventions are a key way to do that but also an approach that is not clearly understood. Unlike behavioral interventions that we examine closely to understand the theory behind a behavior change, for a long time, there was much less research on policy and law. It’s important to understand how a law can change a behavior and improve an outcome, evaluate the law to see if it did what it was intended to do, and more generally, to understand the process that plays out when developing policies. The gap I saw between policy intervention and a systematic approach to evaluating and understanding a policy intervention inspired me to get involved in that field.

PHLN: What is the LawAtlas Policy Surveillance Portal? How does it relate to your work?

Ibrahim: In epidemiology, we track data on various diseases and health conditions to monitor the incidence and distribution of a disease or condition. Then we try to figure out how to address the problem. Policy surveillance builds on the same idea. We’re trying to track policies and laws across time and jurisdictions to better understand what policies are being considered or enacted to address various health issues. Building a policy surveillance database allows us to merge our legal datasets with existing behavioral or health outcome datasets and conduct evaluations. We can use such data to evaluate existing policies or build models to predict the effects for future policies if certain types of provisions were included.

PHLN: What kinds of datasets are in LawAtlas? What makes the LawAtlas datasets different from other collections of legal or public health data?

Ibrahim: The LawAtlas website has a range of legal datasets ranging from environmental health to reproductive health, from alcohol and substance use to transportation and more. To date, researchers within the PHLR program and PHLR grantees have created the legal datasets based on individual interest areas or if there was a need or a demand for a dataset in a particular topic area due to current policy debate. The data in LawAtlas differ from many other legal data sources in two key ways. First, many existing sources on public health laws only capture a snapshot in time and does not give a more historical context. Many of our legal datasets are longitudinal, allowing users to see the change across a range of jurisdictions, but also over time. Such a dataset can be used to study diffusion of innovations and why some jurisdictions were early adopters and others were late to enact a law, particularly if there was an evidence-base to support the law. Second, our legal datasets move beyond a dichotomous view of “Is there a law or not?” and even beyond a categorical, “Is it this type of law or that type of law?” The LawAtlas datasets get to the level to document the individual provisions and give a full depiction of the law, including restrictions, exceptions, enforcement fines or penalties, etc. The idea is to make users understand the full nature of the law in a numerical dataset the same way lawyers could understand the law by reading the text of the law itself.

PHLN: Are all of the topics in LawAtlas related to public health?

Ibrahim: All of the topics in LawAtlas are related to health, but not all are directly related to health outcomes. For example, we know that wealth is related to health, but is not a direct cause of injury or illness. We have a dataset on minimum wage laws as a means to look at the relationship between wealth and health. It is not a dataset on a specific health topic, but it can be used to evaluate health.

PHLN: How are LawAtlas policy surveillance datasets created?

Ibrahim: The creation of a legal dataset involves a series of steps, including scoping the focus of the law, developing a system for collecting all of the specified laws, and creating and implementing a system of coding them. Each dataset includes a codebook and protocol outlining the steps used to create the legal datasets. The process can take a few months for a very narrow legal dataset to a few years for a more comprehensive dataset, like what we did in Nebraska. Lindsay Foster and David Presley at the PHLR program are the masters of this work and are phenomenal at devising and executing these dataset projects. For people who want to learn more about the methodology, I suggest reading Public Health Law Research: Theory and Methods, a book that Scott Burris and Alexandar Wagenaar co-edited.

PHLN: What is the Nebraska Public Health Laws Project? How did you become involved in it?

Ibrahim: It is an inventory of the laws that govern public health authority to act in the state of Nebraska, at the state and local levels. We developed a system to collect and code all of the laws that have an effect on public health practice in the state. The project focused on all state and local laws in the two largest jurisdictions—Lincoln and Omaha—but we hope to collect all of the remaining local laws. After the data were collected and coded, we presented the data in a user-friendly webpage that practitioners in the field can use, as well as access to the legal datasets for conducting evaluations

The idea came from another project in which I was interviewing state health officials and their legal counterparts to better understand the nature of that relationship and what institutional factors could contribute toward strengthening the relationship. During that project, I had the good fortune to meet Mr. Darrell Klein, senior counsel for the Nebraska Department of Health and Human Services, and then Commissioner, Dr. Joanne Schaeffer. They were very organized and proactive in their thinking about law in public health practice. So, Darrell and I started to talk about the project and next thing, we were submitting an application to the Public Health Systems and Services Research (now known as Systems for Action) call for proposals.

PHLN:  How did your team determine that Nebraska was a good state for this project?

Ibrahim: When I first began talking with Darrell Klein, it was clear that there was a culture within the Nebraska Department of Health and Human Services that was open to thinking about and using public health law. Dr. Schaeffer was supportive of the work that Darrell was doing and was very supportive when we first raised the idea of the project with her. Nebraska was already thinking about how to make the laws more accessible to more people, but it was the legal consciousness that was a deciding factor for me. I’m currently working to find additional state partners and funding opportunities to be able to complete this work in other states as I am convinced that this type of resource is needed to better use law as a tool in public health practice.

PHLN:  What topics are included in the collection? How did you determine which to include?

Ibrahim: Within the LawAtlas project, we include a range of topic areas and we tried to use a taxonomy that would be familiar to the public health community in Nebraska. Topics include: alcohol, tobacco and other drugs; chronic disease and injury; disabilities; disasters and emergencies; environmental health; foodborne illnesses; health professions licensure; maternal health, children and families; mental and behavioral health; seniors and aging, structure and governance, and vital statistics.

PHLN: What are the challenges around creating and curating policy surveillance collections like the Nebraska Public Health Laws Project?

Ibrahim: The biggest challenge is setting the parameters for the legal datasets. There is so much that can be covered, so it is important to define the project and stay within those bounds. People might look at our Nebraska project and ask why certain things were not covered—this is why we include a protocol, so that users can understand our thinking. Nebraska was the first project of this kind, but I hope to pursue this work in other states and learn more. As we learn, we can go back and make modifications to previous datasets. My aspiration is to create such a page for every state to facilitate a better understanding of laws across jurisdictions and over time. I believe that this is a potentially powerful resource for state legislators and state legislative researchers to quickly assess what legal interventions are in place to address a given health topic. Additionally, researchers will have the data available to them, which can facilitate timely evaluations that can provide feedback to legislators to understand which policies are effective and which need to be amended.

PHLN: How can people interested in legal epidemiology or policy surveillance learn more?

Ibrahim: There are a range of resources available on our program’s websites: www.publichealthlawresearch.org  and www.policiesforaction.org. Researchers from across PHLR participated in developing a textbook called Public Health Law Research: Theory and Methods, which is also a great resource. Finally, we are offering a summer institute in early June to learn more and to get some hands-on experience with policy surveillance.

PHLN: What other projects are you currently working on?

Ibrahim: I’m working to expand the work in Nebraska to other states. I truly believe that by making the laws more accessible to more people in the public health workforce, we can use the law proactively as a tool to advance health. There is often a stigma about law being only for lawyers or only about litigation, but I want to change that mindset for public health practitioners and see greater engagement with the law.

PHLN: If you could travel anywhere in the world, where would you go and what would you do?

Ibrahim: Someone asked me that question years ago, and it made me wonder why I don’t travel more—that was how I got the travel bug. I’ve been across a majority of Europe, including the United Kingdom, France, Spain, Italy, Greece, Turkey, Denmark, and Norway. I’m eager to visit the Middle and Far East. I enjoy learning about the culture and, of course, the different foods. I’m definitely a foodie and try to come home and replicate the amazing foods from other countries.

PHLN: Do you have any hobbies?

Ibrahim: My kids. If I’m not working, then I’m usually with them and my husband at soccer, baseball, or basketball. I love my family, and they keep me grounded and remind me of what is important and why I do what I do. I work to improve the health of our population so that it is a better world for my kids.

[Editor’s note: This is the first of two interviews about the Nebraska Public Health Laws Project. The second interview will be published in the April 2016 edition of the News, and will feature Darrell Klein, Assistant Agency Counsel, State of Nebraska Department of Health and Human Services.]

The first reader to correctly answer the quiz question will be given a mini public health law profile in the April 2016 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: March 2016

What state did Jennifer Ibrahim work with Darrell Klein on for the Public Health Laws Project?

Question:

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

Answer:

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.

Oklahoma: Law barring workers’ comp. claims for employees with fewer than 180 days with company violates Oklahoma Constitution
Torres v. Seaboard Foods, LLC
Supreme Court of Oklahoma
Case No. 113649
Decided 03/01/2016
Opinion by Justice James E. Edmonson

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Federal: Defendant failed to fill out forms and prove disability, student loan repayment collection may proceed.
Pennsylvania Higher Educ. Assistance Agency v. Hoh
United States District Court, Southern District of West Virginia, Charleston Division
Civil Action No. 2:14-cv-00748
Filed 02/29/2016
Opinion by District Judge Thomas E. Johnston

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Federal: Employee Retirement Income Security Act of 1974 express pre-emption clause requires invalidation of the Vermont reporting statute as applied to ERISA plans.
Gobeille v. Liberty Mut. Ins. Co.
Supreme Court of the United States
Case No. 14-181
Decided 03/01/2016
Opinion by Justice Anthony Kennedy
[Editor’s note: Read more about Goebielle v. Liberty Mut. Ins. Co. and how it relates to tracking healthcare quality and cost in Supreme Court Strikes at States’ Efforts on Health Care Transparency, by Charles Ornstein, published by NPR, Mar. 2, 2016.]

Quotation of the Month: Dr. S. Tyler Hollmig, assistant professor of dermatologic surgery at Stanford University

“You can teach a monkey to push a button. It’s judgment. That’s why you want a physician,” said Dr. S. Tyler Hollmig on whether non-physicians should be allowed to perform laser tattoo removal.