May 2014—Public Health Law News

CDC Public Health Law Program Externship. The CDC Externship in Public Health Law consists of 9–14 weeks of professional work experience, for academic credit, with CDC’s Public Health Law Program in Atlanta, Georgia. The program features rolling start and completion dates throughout the academic year. It exposes law students to the public health field, allowing for exploration of the critical role law plays in advancing public health goals. The unpaid externship is open to second and third year law students who are interested in exploring careers in public health law. Participants must receive academic credit. Applications for the fall 2014 program must be submitted by May 31, 2014, and spring 2015 applications must be submitted by November 1, 2014. Find more information and apply for the externship program.

Health Law & Policy Summer Institute at American University Washington College of Law. The Seventh Annual Health Law & Policy Summer Institute will run from June 16–28, 2014, at American University Washington College of Law in Washington, DC. The flexible curriculum offers day and evening courses on health care law and bioethics. In addition, the university is offering a partially online course on the intersection between epidemiology and the law that will run June 14–July 25. Many of the courses are open to non-attorneys. Register by June 1. Find more information by contacting Matt Pierce by email or phone at 202-895-4518, or by visiting the Washington College of Law website.

O’Neill Institute summer programs. The O’Neill Institute for National and Global Health Law at Georgetown University will present two summer 2014 programs: 1) Emerging Issues in Food and Drug Law and 2) U.S. Health Reform—The Affordable Care Act. The summer programs convene leading practitioners, policymakers, advocates and academics in food and drug law, and U.S. healthcare reform for a series of interactive lectures, panel discussions, and case studies. Held during consecutive weeks, July 14–18 (Emerging Issues in Food and Drug Law) and July 21–25 (U.S. Health Reform—The Affordable Care Act), interested participants may attend one or both programs. The final registration deadline is June 15, 2014. Find more information and apply for the summer 2014 programs.

2014 Public Health Law Conference. The 2014 Public Health Law Conference will take place October 16–17, 2014, in Atlanta, Georgia. The conference will gather public health and legal experts from across the country to examine and discuss today’s critical challenges in public health law. Find more information about the conference and learn how to get the early bird registration rate.

The Public Health Law Program, in partnership with the CDC’s National Center for Injury Prevention and Control, has created menus summarizing some legal strategies states have used to address prescription drug misuse, abuse, and overdose. The Public Health Law Program has added the following new menu to its prescription drug menu library:

Menu of Tamper-Resistant Prescription Form Requirements: An inventory of various state laws aimed at inhibiting diversion of prescription drugs by establishing requirements for tamper-resistant prescription forms[PDF 506KB]

Social impact bonds (SIBs) are pay-for-success arrangements that can be used to address public health issues such as asthma and infant mortality. SIBs are used as financing mechanisms to raise upfront funding from private investors for social and public health preventative interventions. The Public Health Law Program has released the SIBs Resource Package to provide public health practitioners and individuals interested in healthcare finance with an overview of SIBs and how they can be used to promote public health.

Social Impact Bonds Issue Brief. A descriptive overview of social impact bonds, new financing mechanisms used to attract private investment for public health initiatives. Find more information and download Public Health Law and Policy Innovations: Social Impact Bonds.

Research Anthology. This Public Health Law Program Research Anthology is intended to provide a starting point for further exploration of SIBs. The Research Anthology includes articles, technical guides, and other materials selected to account for the different perspectives, roles, and responsibilities of parties involved in SIBs, existing and potential applications of SIBs, and issues raised by SIBs. Find more information and download the SIBs research anthology[PDF 299KB].

Presentation on Social Impact Bonds. This presentation provides a detailed introduction of SIBs. It includes an explanation of social impact bond structure and function, an outline of important considerations involved in SIB programs, examples of existing SIB applications for issues such as recidivism, homelessness, asthma, and early childhood outcomes, and a selection of current and proposed laws related to social impact bonds or other pay-for-success programs. Find more information and download the SIBs presentation.

Webinar on tribal public health law resources. Public Health Law Program and the Network for Public Health Law will co-host “Advancing Tribal Public Health Through Law: Legal Technical Assistance and Resources for Tribes and Tribal-Serving Organizations,” a webinar on tribal public health law resources on Thursday, May 29, 2014, 2:00–3:00 p.m. (EDT). The speakers include staff from the National Indian Health Board, CDC’s Public Health Law Program, the Network for Public Health Law, and the National Congress for American Indians. Participants will be able to ask questions of the speakers about public health law-related issues and needs of tribal communities. Find more information and register for the webinar.

Selected federal legal authorities pertinent to public health emergencies. The Selected Federal Legal Authorities Pertinent to Public Health, originally published in 2009, has been updated to reflect the legislative and regulatory changes of the past five years. Public health professionals can use this document as a brief overview of the types of legal authorities granted to the federal government to prepare for and respond to public health emergencies. Find more information and read Selected Federal Legal Authorities Pertinent to Public Health Emergencies[PDF 362KB].

Affordable Care Act website for local health departments. The National Association of County and City Health Officials has launched a new health reform Website for local health departments (LHDs) to help LHD leaders and staff better understand exactly how changes resulting from the Affordable Care Act will impact them and their work. Find more information and access the website.

Webinar on law enforcement exceptions to HIPAA privacy. Council of State and Territorial Epidemiologists will host a webinar led by the Federal Bureau of Investigation (FBI) titled Joint Law Enforcement—Public Health Investigations: The HIPAA Privacy Rule and Law Enforcement Exceptions to the Rule. The webinar will take place on Tuesday, May 20, 2014, from 2:00 p.m. to 3:30 p.m. (EDT). The webinar will describe FBI roles and responsibilities for investigating the possibility of a criminal or terrorism nexus for patients with unusual diagnoses (e.g., anthrax, plague, brucellosis). The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule protects patient information; however the Department of Health and Human Services specifies certain law enforcement exceptions to the Rule. An overview of the law enforcement exceptions to HIPAA will be provided as well as discussion about when it is appropriate to contact law enforcement and who to contact. Find more information and register for the webinar.

Tennessee: Tennessee enacts law to incarcerate pregnant women
Huffington Post   (04/30/2014)   Laura Bassett

Beginning July 1, 2014, Tennessee may bring criminal charges against women who use drugs during pregnancy, if the drugs cause harm to their babies.

The law is intended to encourage mothers to seek treatment; mothers who seek treatment from one of the state’s treatment programs would avoid criminal charges. While Tennessee has 177 addiction treatment facilities, it is unclear how many are equipped to provide prenatal care.

The bill incited national outcry from advocates for pregnant women. “Today the Tennessee governor has made it a crime to carry a pregnancy to term if you struggle with addiction or substance abuse. This deeply misguided law will force those women who need health care the most into the shadows. Pregnant women with addictions need better access to health care, not jail,” said Alexa Kolbi-Molinas, a staff attorney with the American Civil Liberties Union Reproductive Freedom Project.

Tennessee Governor Bill Haslam says the effects of the law will be closely monitored. I understand the concerns about this bill, and I will be monitoring the impact of the law through regular updates with the court system and health professionals,” said Haslam.  

[Editor’s note: Find more information about Tennessee’s SB 1391[PDF 34KB].]

Minnesota: Minn. House passes newborn-blood sample bill
CBS   (05/01/2014)  

The Minnesota House passed a bill allowing the state to retain infant blood samples that are collected at birth to test for more than fifty-six illnesses, including congenital heart disease and sickle cell anemia. Until 2011, the blood samples were stored pursuant Minnesota Screening Program.

In 2011, the Minnesota Supreme Court found that the state’s policy of keeping newborn blood samples violated the state’s genetic privacy act because parent’s had not given permission for the state to retain their child’s genetic material. More than one million blood samples stored under the Minnesota screening program were destroyed in adherence with that court opinion and a derivative settlement.

Under the proposed law, which passed the Minnesota House 69–58, sale of the genetic data is prohibited and parents would be allowed to opt-out of the program.

Patient privacy advocates fear the proposed law is not protective enough. “This is about who owns a baby’s DNA; who has first dibs on it; who has primary control over it. Our genetic privacy hangs in the balance,” said Twila Brase, co-founder of Citizens’ Council for Health Freedom and registered nurse specializing in public health.

Dr. Robert M. Jacobson, president of the Minnesota Chapter of the American Academy of Pediatrics and a pediatrician at the Mayo Clinic in Rochester, feels the bill is critical to public health and patient care. “This bill positions Minnesota to save as many lives as possible while upholding parents’ rights to refuse testing, request destruction of test results, or both,” Jacobson said. “Restoring the program protects the health of children born now and in the future.”

[Editor’s note: Find more information about Minnesota’s SF 2047 and read Bearder v. State of Minnesota, 806 N.W.2d 766 (Minn. 2011) (Minnesota Supreme Court decision finding state newborn-blood sample archive violated the state’s genetic privacy act.]

National: Justices back rule limiting coal pollution
New York Times   (04/29/2014)   Coral Davenport

On April 29, 2014, the United States Supreme Court upheld the Environmental Protection Agency’s (EPA) authority to regulate coal plant smog that drifts across twenty-eight state lines to the East Coast in EPA v. EME Homer City Generation, LP.

The ruling, written by Justice Ruth Bader Ginsburg, bolsters President Obama’s efforts to reduce pollution from coal-fired power plants and is one in a series of legal opinions affecting the coal industry. Also on April 29, 2014, another federal court ordered the EPA to produce a new nationwide regulation to lower smog pollution from coal-fired power plants and other sources of large-scale pollution.

The EPA is expected to release proposed changes to the Clean Air Act regulation to cut emissions of carbon dioxide, the greenhouse gas scientists have linked to global climate change. In the United States, coal plants release the majority of greenhouse gas emissions.

The opinion received criticism from some representatives. “This is just the latest blow to jobs and affordable energy,” Representative Fred Upton, of Michigan and the chairman of the House Energy and Commerce Committee, and Representative Edward Whitfield, of Kentucky, said in a statement.

Others are more hopeful for the opinion’s precedent and effect on the environment. “Today’s Supreme Court decision is a resounding victory for public health and a key component of EPA’s efforts to make sure all Americans have clean air to breathe. The Court’s finding also underscores the importance of basing the agency’s efforts on strong legal foundations and sound science.” Gina McCarthy, the EPA administrator, said.

[Editor’s note: Find more information and read EPA v. EME Homer City Generation, LP[PDF 266KB] (U.S. Apr. 29, 2014).]

Arizona: State changes definition of “breech birth” allowing midwives’ attendance
Role of Arizona’s midwives expanding, with some controversy, under new rules
Cronkite News   (05/02/2014)   Rachel Leingang
[Editor’s note: Find more information and read Arizona’s HB 2247[PDF 21KB].]

California: Woman’s fifty-nine homelessness-related arrests call law into question
She’s homeless and likes it that way
Los Angeles Times   (04/29/2014)   Gale Holland

Florida: New law requires children under five must ride in safety seat
Following years of debate, Senate approves car seat bill; awaits governor’s signature
Miami Herald   (04/29/2014)   Mary Ellen Klas
[Editor’s note: Read Florida’s House Bill 225.]

Iowa: New HIV law would create tiered criminal sentencing for HIV transmission
Iowa Legislature passes repeal of law criminalizing HIV
RH Reality Check   (05/02/2014)   Teddy Wilson
[Editor’s note: Read Iowa’s SF 2297.]

Massachusetts: State seeks to make new prescription drug illegal
Massachusetts cannot ban FDA-approved painkiller, judge rules
Washington Post   (04/15/2014)   Brady Dennis
[Editor’s note: Find more information and read Zogenix, Inc. v. Patrick[PDF 17KB], CIV.A. 14-11689-RWZ, (D. Mass. Apr. 15, 2014) (holding state cannot ban drug deemed safe and effective by the U.S. Food and Drug Administration).]

Pennsylvania: Seventeen-year-olds allowed to use tanning beds with parent permission
Pa. tan ban comes with ‘prom carve-out’
News Works   (04/29/2014)   Mary Wilson
[Editor’s note: Find more information and read Pennsylvania’s HB 1259.]

West Virginia: EPA investigates inhalation precautions after chemical spill
EPA to gauge safety of inhaling WVa spill chemical
Intelligence News-Register   (05/01/2014)

National: FDA releases proposed e-cigarette rules
Where there’s smoke
The Economist   (05/03/2014)  
[Editor’s note: Find more information and read the U.S. Food and Drug Administration’s proposed rules for electronic cigarettes (e-cigarettes). On May 5, 2014, the National Conference of State Legislatures (NCSL) released Alternative nicotine products: electronic cigarettes, reporting that thirty-three states have banned the sale of e-cigarettes to minors. Find more information and read NCSL’s report.]

National: FDA approves new test for detecting cervical human papilloma virus
Alternative to pap test is approved by FDA
New York Times   (04/24/2014)   Andrew Pollack

Robert G. Blake

Title: Health Scientist, Environmental Health Services Branch, part of the National Center for Environmental Health at CDC

Education: 
Diploma in Environmental Health, London UK, 1980
Master of Public Health, University of Michigan, 1987

PHLN: Please describe your career path to the Environmental Health Services Branch, part of the National Center for Environmental Health at CDC.

Blake: I am a health scientist in the Environmental Health Services Branch. Our group is focused on providing guidance, training, technical assistance, and practice-based research to improve the practice of environmental health.

My career path started out in Croydon, London, England, as a trainee environmental health officer (EHO). After studying at college and qualifying to practice environmental health, I became a district EHO and senior EHO looking after the environmental health needs for regions of the London Borough of Croydon. I met my wife, who was doing an internship from Central Michigan University, and we decided to move to Michigan.

I was fortunate to land a job with Saginaw County Health Department as an environmental health specialist and learned new aspects of environmental health, particularly related to rural living such as septic fields and water wells. From there we moved to Ann Arbor, Michigan so that I could study for an M.P.H. I worked part-time for the University Environmental Health (EH) unit while in school, and on graduation began work for Washtenaw County Health Department in Ann Arbor. I began in the food service inspection program and then worked in a new program addressing toxic and hazardous materials in the community.

In 1994 we moved south to warmer weather and new job responsibilities in the DeKalb County Board of Health (BOH) in Georgia, where I became the assistant director of EH. The whole region was preparing for the arrival of the Olympics to Atlanta, and we did not want any major environmental health issues such as foodborne or waterborne outbreaks to occur. As a region we did very well in our public health protections during the Games to prevent these adverse outcomes. The regional approach also served well after the Games as we addressed new public health challenges such as West Nile virus and outbreaks associated with bacteria in recreational water, including pools. As a result of our work related to recreational water, DeKalb County updated codes governing the county’s pools. We invested hundreds of hours in creating the proposed code language. Afterwards, we asked the BOH to hold a public hearing. They approved the new language and then it went before the Board of Commissioners for approval to adopt the new language into county code.

From DeKalb BOH, I moved to the State of Georgia as branch chief for EH and Injury Prevention. My main tasks related to the adoption of the most recent version of the U.S. Food and Drug (FDA) Model Food Code and the implementation of a statewide database system to capture EH program details from around the state. 

After a short stint at the State of Georgia, I began work at CDC as chief of the Environmental Health Services Branch, which exists to serve the state, tribal, and local EH departments around the country. One of the products that the Branch has been developing is the Model Aquatic Health Code (MAHC). I recently stepped down as branch chief into the health scientist position due to some health concerns that necessitated some lifestyle changes on my part, but have continued to spend time on the MAHC.

PHLN: Can you please describe your day-to-day job responsibilities?

Blake: In addition to my role as a health scientist in the Environmental Health Services Branch, I serve as the Emergency and Environmental Health Services Division’s emergency coordinator. I respond to regular requests for document reviews, participate in all types of emergency response exercises, and give technical advice in emergency and outbreak situations. A good portion of my remaining available time is used for the development of the MAHC and the associated products that state and local public health agencies will need to successfully use the code in their communities.

PHLN: What is the MAHC?

Blake: It is a monumental multi-year effort of many stakeholders, spearheaded by CDC, to construct evidence-based guidance that can be used by state, tribal, and local public health departments. The MAHC is designed to reduce the number of waterborne disease outbreaks, drowning, injuries, and chemical poisoning incidents associated with pools and other aquatic environments.

PHLN: What need does the MAHC fill?

Blake: In recent years, the number of illness outbreaks associated with recreational water has increased significantly. Many of these illnesses can be prevented by proper maintenance and water treatment and by updated disease prevention practices. In the United States, there is no federal regulatory agency responsible for aquatic facilities. State or local public health officials develop, review, and approve all pool codes governing the design, construction, operation, and maintenance of swimming pools and other aquatic facilities. Therefore, requirements for preventing and responding to recreational water illnesses, injuries, and drowning can vary significantly among state and local agencies. In addition, maintaining and updating requirements to reflect the latest science requires a great deal of time and resources.

In 2005, CDC sponsored a workshop—Recreational Water Illness Prevention at Disinfected Swimming Venues—to discuss ways to minimize recreational water illnesses spread through disinfected swimming venues. The workshop brought together experts from different disciplines working in state, local, and federal public health agencies, the aquatics industry, and academia. A key recommendation from the group was to develop a model aquatic health code that state and local agencies could use as a guide for science-based practices to promote healthy swimming. The group suggested the code be free, accessible, evidence-based, and updated regularly. The group suggested that in addition to waterborne diseases, the code should address drowning, chemical injuries, and other public health concerns associated with recreational water.

The MAHC was recently published on the CDC Healthy Water website, and public comments will be accepted until May 27, 2014.

PHLN: How has your background and experience working on the state and local levels supported your work on the MAHC?

Blake: When working at the state and local levels, I was involved in efforts to help manage the inspections of a large number of outdoor public pools by recruiting students from local universities’ environmental health programs and other science-based programs. As a result of my background, I understood that pool codes need to be updated with new science as we learn more about outbreaks and other public health issues associated with recreational water. Such codes also need to keep pace with changes in how aquatic facilities are constructed and operated. Until recently, updating or creating new codes at the local and state level often required a significant investment of time and resources. It is our hope that the MAHC will provide the state, tribal, and local public health practitioners model language to create a science-based code for their jurisdictions.

PHLN: Do you consider yourself a public health law practitioner? If so, in what ways is your job related to public health law?

Blake: At CDC I am in a non-regulatory role. However, I’ve worked alongside many others to create language that can be used in state and local codes. Directors of EH at the state and local levels should regularly consider creating codes where none exist (some don’t have a pool program at all), and updating existing codes as part of the core public health function of policy development.

PHLN: How is the MAHC related to public health law?

Blake: Although the MAHC is not a federal law, it is related to public health law because it contains legal language for possible adoption and enforcement by state, tribal, local, and territorial programs. It’s a great example of public health professional collaboration across environmental health, infectious disease, injury, and law. We are very grateful for the assistance that colleagues in the CDC Public Health Law Program have given to us in this work.

PHLN: The latest version of the MAHC includes expert data from a variety of public, private, and governmental groups. Can you please describe the process behind writing the MAHC?

Blake: A MAHC Steering Committee, consisting of representatives of the aquatics industry, state and local public health agencies, and CDC representatives, has been overseeing the process, which includes fourteen technical committees reporting on various aspects the MAHC’s development. Each technical committee produced a module that was posted for an initial round of public comment. Public comments were considered by the technical committees, which included large numbers of diverse volunteers with expertise in aquatic venues health or safety, and then by the steering committee. In many cases, revisions were made to the original module and re-posted so that everyone could see them. 

The most recent version of the MAHC weaves together the fourteen individual modules. We are now inviting public comments that have new science or data that should be considered. Once the May 27, 2014, deadline passes, we will consider the new public comments and make changes for the first edition of the MAHC, which we hope will be published in late summer 2014.

PHLN: What have you found to be the most challenging aspects of writing the MAHC?

Blake: There is an incredible amount of detail in each of the modules, and now in the latest version out for public comment. At times, some items have been controversial during the public comment process. One example of this was a proposal to increase the diving depth in front of racing blocks. Currently, there is not much data available about the possibility of head, neck, and back injuries from diving into relatively shallow water from a racing block. More research is needed to answer this question.

We received more public comments as each subsequent module was posted, which meant many more proposed changes had to be individually considered.

We have also worked closely with organizations which create building codes, such as the International Code Council and the International Association of Plumbing and Mechanical Officials. For example, we submitted public comments on their draft code language and attended their hearings. All organizations have adjusted their codes to eliminate code collisions and minimize duplication. Memoranda of Understanding between the organizations have been signed, and there are now opportunities to work on other public health issues, including in other building codes.

PHLN: Other than the Public Health Law Program, what other programs or centers have you partnered with to research and write the MAHC?

Blake: This effort has had expertise from different Centers at CDC, including the National Center for Emerging Zoonotic and Infectious Diseases, the National Center for Injury Prevention and Control, and the National Center for Environmental Health/Agency for Toxic Substances and Disease Registry, as well as hundreds of hours of volunteer donated time from many stakeholders around the country with various expertise and interests in the aquatics environment.

PHLN: What are the FDA’s Model Food Code and Conference for Food Protection (CFP) and how are they related to the MAHC?

Blake: FDA updates the Model Food Code through an organization called the CFP. This organization solicits issues about the current food code from stakeholders and the issues are then assigned to councils for discussion and recommendation. The CFP votes on these issues and submits them from the formal board to FDA, which considers whether to adopt them into the new version of the Model Food Code. This means that new science and new food protection methods can be considered for codification.

A non-profit organization called the Conference for the Model Aquatic Health Code (CMAHC) has been created by stakeholders to function like the CFP. The CMAHC will likely hold its first meeting in 2015 to consider items raised by stakeholders about the first version of the MAHC. These issues and others that follow in future years will ensure that the MAHC stays current and protects public health.

PHLN: Unlike the FDA that regulates food for human consumption, CDC does not regulate recreational water facilities. What does that mean and how has CDC’s non-regulatory function played out in writing the MAHC?

Blake: As a federal agency, CDC tracks illnesses and injuries associated with recreational water nationally through reports it receives from state and local partners. When state and local public health agencies detect an outbreak associated with treated recreational water, they might ask CDC to investigate or help control the outbreaks. Data collected during outbreak investigations and through research are then used to inform CDC recommendations and policy decisions made by state and local regulators. CDC has been committed to aquatic health since the 1950s when it issued the first of a series of aquatic health and safety guidance documents to public health agencies and the aquatics industry. CDC has continued to issue assistance and guidance since that time, culminating in the creation of CDC's Healthy Swimming Program in 2001, which leads the MAHC effort.

PHLN: How could state and local health authorities use the MAHC?

Blake: In the United States, there is no federal regulatory authority responsible for design, construction, operation, and maintenance of aquatic facilities. State or local legislatures or agencies develop, review, and approve all pool codes. These codes are implemented by state or local public health officials and, in some cases, building code officials.

PHLN: What do you find the most interesting or important aspects of CDC’s work on environmental health as it relates to aquatic health?

Blake: Having been involved with pool inspection programs at the state and local levels, I have been extremely impressed with the incredible stakeholder volunteers, and the devoted CDC staff, who have systematically pulled together the needed science to update the various versions of the MAHC. We are on the verge of being able to announce a landmark in public health and aquatic health!

PHLN: What positive changes might occur if state and local jurisdictions adopt and implement the MAHC?

Blake: Use of the MAHC may help reduce the risk of diseases and injuries and promote healthier and safer swimming.
 

• Short-term outcomes: Use of the MAHC should help reduce the risk of diseases and injuries and promote healthy and safe swimming. We anticipate that the practices promoted in the MAHC will initially lead to the following system improvements:
  • Fewer pool and facility closures
  • More-meaningful inspection and surveillance data
  • An established research agenda to drive future iterations of the MAHC
  • Enhanced collaboration among stakeholders
• Long-term outcomes: By adopting the practices outlined in the MAHC, jurisdictions should also be able to improve the long-term health and safety of aquatic facilities. This should include a reduced risk of the following health threats:
  • Outbreaks of waterborne illnesses
  • Drowning incidents
  • Injuries from pool chemicals, disinfection by-products, and other causes
  • Swimming-related emergency room visits

PHLN: If you weren’t working in environmental public health, what would you likely be doing?

Blake: I currently volunteer in various church activities serving people, so would likely seek to work in church ministry.

PHLN: Have you read any good books lately?

Blake: A colleague loaned me Foyles War video series about a detective in World War II. The story line is good, but the quaint English countryside brings back fond memories. I’m about to travel to England and France for the 70th anniversary of D-Day landings with my dad; he was in the Royal Marines and ferrying troops and supplies in on landing craft. He wants his sons with him, and I’ll be proud to be there with him.

PHLN: As an avid swimmer, what is your favorite swimming stroke?

Blake: I let my work hours get out of balance and quit my prior exercise regimen. After experiencing health warning signs, I made a fundamental shift in diet and re-instituted an exercise regimen to regain my health. I’m now swimming four to five times a week, completing at least a mile each time. My favorite strokes are to go up the pool with breast stroke and then come back down the pool with back stroke. As an asthmatic, I find those strokes less stressful for breathing, and swimming is easier for me than running, which is hard on my knees and ankles.

PHLN: Is there anything you would like to add?

Blake: THE MAHC has been a monumental effort, but the end product has the support of many stakeholders across the country. It is something CDC is rightfully proud of and should positively impact public health in the years to come.

It also raises the possibility that other environmental health codes that are used in patchwork style across the nation could be unified. For example, other codes in play in many jurisdictions could be considered, such as

• On-site water wells
• On-site sewage
• Hotel and motel
• Housing
• Schools
• Tattoo and body art
• Zoning and the intersection of environmental health and public health

Additionally, there is a good opportunity to learn from the work by building and public health officials on pool codes. Public health may be able to be included in various other building codes.

The first reader to correctly answer the Quiz question will be given a mini-public health law profile in the July 2014 edition of the News. Entries should be emailed to PHLawProgram@cdc.gov with “PHL Quiz” as the subject heading. Entries without the heading will not be considered. Good luck!  

Public Health Law News Quiz Question: May 2014

What Illinois county allows operation of feral cat colonies and is mentioned in the May 2014 edition of the Public Health Law News?

William Mitchell

Response to the March 2014 Public Health Law News Quiz: According to the Gallup survey featured in the April 2014 Briefly Noted section, 14.7% of U.S. adults are currently without health insurance.

Employment organization and job title: Director, San Joaquin County Public Health Services in Stockton, California

A brief explanation of your job: I am administratively responsible for programs and services within San Joaquin County Public Health Services, and I perform those functions associated with management of a complex organization, including overseeing the planning, organizing, and directing of the department’s programs and services; participating with the senior leadership team in establishing policies, procedures, and standards for conducting public health services; directing and participating in the preparation and administration of the budgets and operating objectives; directing the development and implementation of programs and services to assure compliance with legal regulations and requirements; selecting, assigning, supervising, and evaluating immediate subordinates. It is anticipated that the department’s 2014–2015 budget will be just over $26 million and include 202 allocated full-time positions and about 19 full-time equivalent temporary positions.

Education: B.A., California State University, Sacramento in health and safety; M.P.H., University of Michigan in public health education

Favorite section of the News: I enjoy the Briefly Noted section. I find it interesting to see opinions from around the country on topics of public health significance.

Why you are interested in public health law? Laws are a driver of public health policy and practice, and policies are an important factor in shaping the public’s attitudes, beliefs, and behaviors about health. Reading Public Health Law News helps to keep me abreast of current and potentially future trends in public health practice.

Illinois: Operation of feral cat colonies allowed within Cook County, Illinois
County of Cook v. Village of Bridgeview
Appellate Court of Illinois, First District, Sixth Division
Case No. 1-12-2164
Opinion by Justice Shelvin Louise Marie Hall

New York: No rational basis for $0.06 per taxi fare tax to navigate health act
Ahmed v. City of New York
Supreme Court, New Your County
Case Nos. 101692/13, 101762/13, 100019/14, Motion Seq. No 001
Filed 04/11/2014
Opinion by Judge Margaret A. Chan

Pennsylvania: ‘Sewage sludge’ not necessarily ‘normal agricultural operations’
Gilbert v. Synagro Central, LLC
Superior Court of Pennsylvania
Case No. 119 MDA 2013
Filed 04/15/2014
Opinion by. Judge Christine L. Donohue

Tennessee: State regulatory authority can order self divestment of water utility
Laurel Hills Condominiums Prop. Owners Assoc. v. Tennessee Regulatory Authority
Court of Appeals of Tennessee, at Nashville
Case No. M2013-01392-COA-R12-CV
Filed 04/14/2014
Opinion by Judge Andy D. Bennett

Federal: Farm’s safety auditors may owe duty to listeria outbreak victims
Gilbert v. Frontera Produce, Ltd.
United States District Court, W.D. Louisiana, Shreveport Division
Case No. 12-2754
Filed 02/28/2014
Opinion by Judge Tom Stagg

Jody Freeman, director of the Environmental Law Program at Harvard

“It’s a big win for the EPA and not just because it has to do with this rule. It’s the fact that it’s setting the stage and creating momentum for what’s to come.” said Jody Freeman, director of the Environmental Law Program at Harvard, of the U.S. Supreme Court’s decision EPA v. EME Homer City Generation, LP[PDF 261KB] (U.S. Apr. 29, 2014).