From the Public Health Law Program, Office of the Chief of Public Health Practice, CDC
http://www2a.cdc.gov/phlp/

*** NIOSH Mine Safety Report. The National Institute for Occupational Safety and Health (NIOSH) Office of Mine Safety and Health recently released a report on the benefits and challenges of rescue chambers and in-place shelters in mines. The "Research Report on Refuge Alternatives for Underground Coal Mines" is available at http://www.cdc.gov/niosh/mining/mineract/pdfs/Report_on_Refuge_Alternatives_Research_12-07.pdf.

*** Pandemic Influenza Guide. The Association of State and Territorial Officials has released the "Privacy and Pandemic Flu Guide," available at http://www.astho.org/pubs/Privacyandpanfluguide1.pdf.

*** Columbia Research Position. Columbia University is accepting applications for a public health law grant-funded research position to design and administer a Web-based survey, conduct data searches for local ordinances, contact local health departments, and complete other research-oriented tasks. To apply, see https://jobs.columbia.edu/applicants/jsp/shared/frameset/Frameset.jsp?time=1201709404344.

*** Connecticut Assistant Professor Position. A full-time faculty position as Assistant Professor in Law and Biomedical Ethics is available in the Division of Medical Humanities, Health Law and Ethics in the Department of Community Medicine at the University of Connecticut. For more information, contact Sally Jett at jett@nsol.uchc.edu or at 860-679-5491.

*** Harvard Research Associate Position. The Program in Law and Public Health at the Harvard School of Public Health has a research position available. The research associate will work with faculty on projects relating to the relationship between law and health. For details, see http://jobs.harvard.edu/jobs/summ_req?in_post_id=36801.

*** Tobacco Control Conference (3/26-3/28). Access 2008: Building a Tobacco-Free Future will take place on March 26-28, 2008, in Seattle, Washington. For more information on the conference, which will highlight "what's new and next in tobacco control," see http://www.accessconference.org/.

*** Law and Obesity Conference (9/19-9/21). Save the Date! The Fifth Conference on Public Health, Law, and Obesity will take place on September 19-21, 2008, at Northeastern University School of Law, in Boston, Massachusetts. For more information, see http://www.phaionline.org/obesityconference2008.

Top Story

1. A CDC review of school laws and policies concerning child and adolescent health

States and Localities

2. Louisiana: N.O. demolition rules overhauled

3. Minnesota: After 10 years, smoke clears on state's tobacco lawsuit

4. Virginia: House panel moves to ease commitment laws

National

5. Expedited partner therapy for sexually transmitted diseases: the legal environment

6. Navajo Nation: Navajo lawmakers to vote on proposed tribal Superfund law

International

7. South Africa: Rights dilemma as South Africa faces drug resistant TB epidemic

8. International: A pandemic that wasn't but might be

Briefly Noted

California school air pollution · Prison health overseer · Cross-border tobacco control · Pesticide rules · Maryland lead paint award · Asbestos suits · Mississippi FEMA maps · New York nicotine therapy petition · Ohio prison asbestos suit · Language barrier · Oregon circumcision ruling · Virginia ADA smoking claims · Sangria ban · West Virginia energy firm suit · National EPA waiver hearing · Mine citations · Safe injection facilities · Switzerland IHR amendment · United Kingdom smoking breaks

Quotation of the Week

Edgar Terry, of California's Terry Farms

This Week's Feature

Law Behind the News. This week, we feature a petition filed by the New York State Health Commissioner regarding U.S. Food and Drug Administration restrictions on sales of nicotine replacement therapies. See below for more.

_____________________________1_____________________________

"A CDC review of school laws and policies concerning child and adolescent health"

Journal of School Health     (02/08)     Sherry Everett Jones and others

http://www.ashaweb.org/pdfs/josh782.pdf

The authors of this study sought to provide an overview of the legal and policy landscape in the United States designed to protect the health and safety of children and adolescents in schools. The study describes the facets of a coordinated school health program (CSHP) model, adopted by state and local education agencies nationwide. CDC also utilizes the model "as an organizing framework for its school health guidelines, surveillance systems, and recommendations for promising practices." The eight CSHP components include health education, physical education, health services, nutrition services, mental health and social services, healthy and safe school environment, health promotion for staff, and family and community involvement. The report describes the legal framework for education, which "includes a complex network of federal, state, and local laws and regulations," before examining the legal framework for each of the eight CSHP components. For example, a section on physical education and activity examines federal, state, and local legal requirements concerning providing physical education; "federal incentives to encourage physical education;" the "role of national physical education standards and required physical education curriculum;" "teacher preparation and professional development programs;" and "the required use of protective gear." A section on health services explores the legal requirements to provide testing, screening, and treatment for health conditions; student consent requirements; the use of identifiable health data; and funding for school health services. According to the authors, many legal and policy themes emerge from the review, including the integration of public health and education services, division of responsibilities, national primacy over state and local laws, and state and local innovation.

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"N.O. demolition rules overhauled"

Times-Picayune     (01/26/08)     Michelle Krupa

http://www.nola.com/timespic/stories/index.ssf?/base/news-8/120133081317840.xml&coll=1

New Orleans signed a federal consent decree last week to overhaul its procedures for demolishing properties that pose an imminent threat to public health, safety, and welfare. Also signing the decree were fair housing advocates, who filed a federal lawsuit against New Orleans claiming that the city illegally demolished structures under an "imminent health threat" law that allows for the removal of mold-ridden, rat-infested properties. The fair housing advocates represented five home owners and a pastor who alleged that they never received proper notice that their property would be demolished. Under the new consent decree, demolition notices must be mailed to property owners' newest addresses and the city must post notices on its Website. According to the decree, the notices must state "particular actions the property owner must remedy to avoid demolition," in addition to making clear owners' rights to object to the demolition. The decree also requires the city to process owners' objections by establishing procedural mechanisms to receive written appeals and to hold appeal hearings. It remains unclear how the consent decree will affect the pace of demolitions ordered by New Orleans, which is slated to demolish 1,800 properties damaged by Hurricanes Katrina and Rita. The consent decree, approved by U.S. District Judge Martin Feldman, also states that it does not settle the dispute filed by the five home owners and pastor, who want New Orleans to rebuild their properties or to compensate them for their losses.

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"After 10 years, smoke clears on state's tobacco lawsuit"

Start Tribune     (01/26/08)     David Phelps

http://www.startribune.com/business/14424046.html

Ten years after Minnesota won a $6.1 billion tobacco settlement, it has used the funds to help thousands of Minnesota adults quit smoking and to persuade middle and high school students not to start. The settlement has also laid the groundwork for a statewide smoking ban, and $1 billion was used -- to the chagrin of some public health advocates -- to balance the state's budget in 2003. Whereas prior cases had been filed by individual smokers, Minnesota v. Phillip Morris marked the first Big Tobacco case filed on behalf of institutions that paid for treatment of smoking-related ailments. Part of the first settlement payments went to endowments at the Minnesota Department of Public Health, which created a campaign called "Target Market" that advertised a don't-smoke message to teens. When Target Market was in effect, from 1998-2004, smoking among high school seniors declined from 42 percent to 26.6 percent, according to Department numbers. Last year's smoking ban and the 2005 increase in cigarette tax have also decreased smoking rates, say health and business advocates. The state Department of Revenue reported that per-pack sales dropped 19 percent in the two years after the tax was increased from 48 cents per pack to $1.48. "When you talk to people, there's a different attitude now about smoking. Smoking is more the exception than the rule," said former Attorney General Hubert Humphrey III, whose office began pursuing the tobacco industry in 1994. "That wouldn't have happened at nearly the pace it did without the settlement."

[Editor's note: For information on how to access documents in the Minnesota Tobacco Document Depository, see http://www.tobaccoarchives.com/doc.html. The Depository contains more than 26 million pages of tobacco company documents unearthed during the discovery phase of Minnesota's lawsuit, relating to research, manufacturing, marketing, advertising, and sales of cigarettes. Governments and groups, such as the World Trade Organization, have used the documents to craft tobacco-control policies.]

_____________________________4_____________________________

"House panel moves to ease commitment laws"

Washington Post     (01/26/08)     Chris L. Jenkins

http://www.washingtonpost.com/wp-dyn/content/article/2008/01/25/AR2008012503096.html?hpid=
sec-health

Last week the Virginia House of Delegates took a major step toward legislation that would ease the standard by which mentally ill people can be involuntarily committed to hospitals. Under Virginia's involuntary commitment law, people can be committed against their will if they pose an "imminent danger to self or others." But under a change approved by legislators on the Courts of Justice Committee, a magistrate or special justice could commit someone to treatment if there is "a substantial likelihood" that the person would cause "serious physical harm to himself or herself" in the near future or could "suffer serious harm due to substantial deterioration of his capacity to protect himself from harm or to provide for his basic human needs." Supporters of the measure say it would make the process of assessing mental health more efficient and comprehensive. However, opponents of the new standard say it is as vague as the old one and fear that too many people would be brought in for involuntary commitment hearings. "It's a massive deprivation of civil liberty, and it should only be done in limited circumstance," said Colleen Miller, executive director of the Virginia Office for Protection and Advocacy. The new standard follows recommendations of the independent commission that investigated the shootings by Seung Hui Cho at Virginia Tech last April. The House action also mirrors Gov. Timothy Kaine's recommendations, and a state Senate subcommittee is considering legislation on a version of the new involuntary commitment standard. 

[Editor's note: For more on HB 499, which was unanimously passed by the Virginia Courts of Justice Committee, see http://leg1.state.va.us/cgi-bin/legp504.exe?081+sum+HB499.]

_____________________________5_____________________________

"Expedited partner therapy for sexually transmitted diseases: assessing the legal environment"

American Journal of Public Health     (02/08)     James G. Hodge Jr. and others

http://www.ajph.org/cgi/content/abstract/98/2/238 (subscription required)

The authors of this study investigated the legal framework in states relevant to the uptake of expedited partner therapy (EPT), a means for treating the partners of sexually transmitted disease (STD) patients. Sexually transmitted diseases, including chlamydia and gonorrhea, continue to be significant public health challenges; over 2.8 million new cases of chlamydia and 700,000 new cases of gonorrhea are diagnosed each year, according CDC data. Traditionally, clinical management of patients with sexually transmitted diseases includes treatment of current sexual partners. EPT, however, relies on the delivery of medications or prescriptions by the infected person to their sexual partner without clinical assessment of the partner. CDC recommended EPT as a treatment option in August 2006, based on available scientific evidence, finding it a "useful option" to promote partner treatment. But providing prescriptions or medications to people who have not been examined by a clinician may be viewed as illegal or unethical. The authors analyzed the laws of all 50 U.S. states to "identify legal provisions that affect a clinician's ability to provide treatment for an STD patient's sexual partner without prior evaluation of that partner." The authors assessed laws, regulations, and other legal decisions in the areas of medical licensing and liability, public health and safety, and pharmaceutical practices. They found that in 12 jurisdictions, EPT is expressly allowed by law or other governing authority; EPT is probably precluded in 13 jurisdictions; and in 28 jurisdictions, EPT is "potentially allowable" because of different possible interpretations of legislative, regulatory, or policy statements or provisions. The authors conclude by offering recommendations to facilitate the practice of EPT.

[Editor's note: For more on expedited partner therapy from CDC, visit http://www.cdc.gov/std/ept/.]

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"Navajo lawmakers to vote on proposed tribal Superfund law"

Associated Press     (01/25/08)     Felicia Fonseca

http://www.lcsun-news.com/ci_8078384

A bill designed to allow officials to monitor and remove hazardous substances that could endanger the public's health is making its way through the Navajo Tribal Council. The bill mirrors the U.S. Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), also known as the "Superfund" law. Adoption would grant the Navajo Environmental Protection Agency (Navajo EPA) "authority similar to what the state and federal government have in response to hazardous waste," said Executive Director Stephen Etsitty. The Nation has already adopted the list of chemicals used by the federal government to determine whether a site is hazardous. The bill would further allow Navajo EPA to identify and take remedial action on contaminated sites that are not being addressed by the U.S. government. The tribal bill would also hold property owners or people who bring hazardous substances onto the Navajo Nation responsible for cleanup. According to a U.S. EPA spokeswoman, the agency plans to test 75 water sources and 100 structures this spring, and contaminated sites will be considered for cleanup under the federal Superfund law. Navajo EPA officials are particularly concerned about the cleanup of more than 1,000 abandoned uranium mining sites that have sickened many on the reservation, which extends over parts of New Mexico, Arizona, and Utah. The Navajo Nation is working with U.S. EPA and other federal agencies to develop a five-year action plan to address the effects of uranium mining.

[Editor's note: To learn more about the Navajo Nation Environmental Protection Agency, visit http://navajonationepa.org/.]

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"Rights dilemma as South Africa faces drug resistant TB epidemic"

Agence France Presse     (01/27/08)     Mariette le Roux

http://afp.google.com/article/ALeqM5jxwLa1Lr6VCEZOE4BCsuu9gTD5SA

As the number of patients diagnosed with extensively drug resistant tuberculosis (XDR TB) rises, healthcare providers and government officials worry about the conflict between individual rights and the risk to the public's health. Between January and October 2007, 391 cases of XDR TB were diagnosed, compared to just 74 in all of 2004, according to the South African Department of Health. XDR TB is resistant to most antibiotics, and can develop when patients with more treatable strains of TB fail to take their medication as prescribed. Those diagnosed with XDR TB are virtually untreatable, and many are kept in isolation at Cape Town's Brooklyn Chest Hospital. A fence 6.5 feet tall was recently erected around the XDR TB ward to dissuade patients from fleeing the hospital after four such patients repeatedly ran away last year. Doctors are hindered in their efforts to treat XDR TB patients and protect the public, as no legal mechanism allows them to confine patients involuntarily or compel them to take medication. "We encourage them not to leave -- by law, you can't force them," said Dr. Simon Moeti, senior medical superintendent at Brooklyn Chest. Instead, doctors are forced to apply for individual court orders, which are both costly and time-consuming. "It is a process that takes a lot of time and energy. We are looking at whether we can find clauses in our legislation that will allow a general approach to the matter," said Health Department Director-General Thami Mseleku.

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"A pandemic that wasn't but might be"

New York Times     (01/22/08)     Donald G. McNeil Jr.

http://www.nytimes.com/2008/01/22/science/22flu.html?_r=1&oref=slogin

Last year, the number of human cases of avian influenza was down from the year before -- for the first time since the virus emerged as a global threat. According to the World Health Organization, there were 86 confirmed human cases and 59 deaths in 2007, compared with 115 cases and 79 deaths in 2006. Yet despite the decreases, avian influenza has not become less lethal or widespread in birds, and experts say preparation efforts must continue. Dr. David Nabarro, senior United Nations coordinator for human and avian influenza, said he worried somewhat less than three years ago, "not because I think the threat has changed, but because the response to it has gotten so much better." Since the warnings of a catastrophic pandemic began: vaccines were developed; stockpiles of Tamiflu and surgical masks increased; many government entities and companies wrote pandemic plans; laboratories in affected nations became faster at influenza tests; veterinarians moved more quickly to cull infected poultry; and some hospitals created wards for infected patients. Dr. Paul A. Offit, a vaccine specialist at Children's Hospital in Philadelphia, cautioned that the announcement might spur a "boy who cried wolf" reaction. "When the next pandemic comes, people will say, 'Yeah, yeah, we heard that last time." But according to Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, the fact that human cases fell in 2007 is "pretty much meaningless," in part because the virus is still circulating and has evolved 10 taxonomic groups and hundreds of variants.

[Editor's note: The Cumulative Number of Confirmed Human Cases of Avian Influenza A/ (H5N1) Reported to WHO is available at http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_01_29/en/index.html.]

_____________________BRIEFLY NOTED______________________

California: Restriction to keep kids from sources of air pollution

"Board acts to limit new schools near freeways"

Los Angeles Times     (01/23/08)     Evelyn Larrubia

http://www.latimes.com/features/health/la-me-freeways23jan23,1,6337700.story?coll=la-headlines
-health

California: Receiver ousted by court order for slow pace of change

"Judge gives state prison health overseer the boot"

Medianews     (01/24/08)     Barbara Feder Ostrov and Brandon Bailey

http://www.insidebayarea.com/ci_8063740?source=rss

California: Study finds association between program and tobacco-related behaviors

The impact of the California Tobacco Control Program on both sides of the U.S.-Mexico border

American Journal of Public Health     (02/08)     Ana P. Martínez-Donate and others

http://www.ajph.org/cgi/content/abstract/98/2/258 (subscription required)

California: Fumigant rules could thwart strawberry crops

"Ventura County growers brace for strict pesticide rules"

Los Angeles Times     (01/25/08)     Marla Cone and Gregory W. Griggs

http://www.latimes.com/news/local/la-me-fumigants25jan25,1,3291881.story

Maryland: 8 year-old sues realty company, property manager for failing to remove lead hazards

"Baltimore City Circuit Court awards $6M in lead paint case"

Daily Record     (01/24/08)     Liz Farmer

http://www.mddailyrecord.com/article.cfm?id=4104&type=UTTM

Maryland: Chemical company asks bankruptcy judge to declare 100,000 asbestos claims invalid

"Grace bets on winning asbestos lawsuits"
Washington Post     (01/28/08)     Zachary A. Goldfarb

http://www.washingtonpost.com/wp-dyn/content/article/2008/01/27/AR2008012701656.html

Mississippi: Flood advisory standards said to require impossible heights, unaffordable insurance

"Officials: FEMA maps may wipe Bay off map"

Sun Herald     (01/27/08)     J.R. Welsh

http://www.sunherald.com/201/story/326847.html

New York: FDA petitioned to relax policies limiting access to nicotine patches, gum, lozenges

"Health commissioner seeks easier access to nicotine therapy"

Associated Press     (01/29/08)    

http://www.wcax.com/Global/story.asp?S=7788140&nav=4QcS

Ohio: Lawsuit accuses Rehabilitation and Correction Department of deliberate indifference

"Inmates accuse prison officials of lying about asbestos"

Columbus Dispatch     (01/22/08)

http://www.ohio.com/news/ap?articleID=351811&c=y

Ohio: Police looking to address language needs as immigrant populations grow

"Language barrier still in the way"

Columbus Dispatch     (01/28/08)     Alayna Demartini

http://www.dispatch.com/live/content/local_news/stories/2008/01/28/Language.ART_ART_01-28-08
_B1_MO96C2P.html

Oregon: Court rules boy's opinion to be taken into account for elective surgery

"Ore. Court: boy has say in circumcision"

Associated Press     (01/25/08)     Sarah Skidmore

http://ap.google.com/article/ALeqM5hauz0PI_3kYdqBNezvr9DhlBbwLwD8UD4N1O0

Virginia: Suit is latest in line of suits seeking smoking bans as "reasonable accommodation"

"Virginia smoking suit cites ADA"

Washington Times     (01/28/08)     Jen Haberkorn

http://www.washingtontimes.com/article/20080128/BUSINESS/556065262/1006

Virginia: 75 year-old law bans mixing of wine or beer with spirits

"Virginia's sangria ban at issue in 2 hearings"

Washington Post     (01/24/08)     Anita Kumar

http://www.washingtonpost.com/wp-dyn/content/article/2008/01/23/AR2008012303400.html

West Virginia: Court tosses $75 million verdicts over allegations of bias and impropriety

"West Virginia Supreme Court to rehear case of energy firm"

Pittsburgh Post-Gazette     (01/25/08)     Len Boselovic

http://www.post-gazette.com/pg/08025/852078-28.stm

National: Administrators says California's purported global warming threat not unique

"EPA chief won't budge on waiver"

Sacramento Bee     (01/25/08)      David Whitney

http://www.sacbee.com/111/story/660988.html

National: MSHA director says inspection and assessment process have improved over past year

"Mine operators often go unpunished for citations"

Associated Press     (01/28/08)    

http://www.washingtonpost.com/wp-dyn/content/article/2008/01/27/AR2008012702311.html

National: Study finds SIFs face legal uncertainty; must rely on planning, sustained political effort

"The law (and politics) of safe injection facilities in the United States"

American Journal of Public Health     (02/08)     Leo Beletsky and others

http://www.ajph.org/cgi/content/abstract/98/2/231 (subscription required)

Switzerland: Text reaffirms commitment to 'timely and effective and universal implementation'

"WHO board passes Chinese amendment to IHR-related draft bill"

Central News Agency     (01/23/08)    

http://www.cnanews.gov.tw/eng/cepread.php?id=200801230051

United Kingdom: City Council staff must make up time taken for smoking breaks

"Staff will not be paid while they smoke"

Bristol Evening Post     (01/25/08)    

http://www.thisisbristol.co.uk/displayNode.jsp?nodeId=144913&command=displayContent&
sourceNode=145402&contentPK=19660033&folderPk=83733&pNodeId=145393

__________PHL NEWS QUOTATION OF THE WEEK___________

 "Vegetables have moved out."

-- Edgar Terry, of California's Terry Farms, on the costly ramifications of the state's new pesticide regulation. Facing a court-ordered deadline to combat smog, the California Department of Pesticide Regulation has cracked down on the use of poisonous gases that are injected into fields to kill insects, weeds, and pathogens before crops are planted. Growers may be forced by the strict rules to move to other states, said Terry. [See Briefly Noted item, above.]

__________________LAW BEHIND THE NEWS___________________

New York State Health Commissioner Richard Daines filed a petition this week with the U.S. Food and Drug Administration (FDA) requesting increased availability of over-the-counter (OTC) nicotine replacement therapies (NRT) such as patches, gum, and lozenges. "Under the current system, a smoker generally cannot buy [NRT] in the same store where cigarettes are sold, and, even though most smokers buy cigarettes one day at a time, those who purchase [NRT] must buy a one- or two-week supply costing $20 to $40," Daines said.

The petition, filed pursuant to 21 CFR § 10.30, requests the FDA Commissioner to make three changes to current NRT rules: 1) allow the sale of OTC NRT "in all retail locations where cigarettes are sold," including convenience marts, gas stations, tobacco specialty stores, grocers; 2) allow OTC NRT to be sold in "units containing an amount of OTC NRT product that would typically be consumed in a 24-hour period;" and 3) modify labeling requirements to disclose that "OTC NRT is safe for use by smokers and safer for use than continued cigarette use."

The FDA policy to which Daines objects can be found in an FDA Center for Drug Evaluation and Research (CDER) letter (dated December 23, 1998) that approves the new drug application for Nicorette Gum. In the letter, CDER permits the sale of Nicorette with conditions, including: "Restriction of distribution to drugstores, mass merchandisers and supermarkets where other OTC drugs are sold. The products will not be distributed to other channels, including convenience stores or vending machines." Also, the CDER letter states: "'Trial size' or 'sample' packs will not be offered." See http://www.fda.gov/cder/foi/nda/98/18-612S025_Nicorette_Approv.pdf to read the letter.

Daines' petition was based on four grounds: 1) OTC NRT should be more widely available to bolster use of OTC NRT, quit attempts, and quit success; 2) adolescents will not abuse OTC NRT; 3) OTC NRT is safer than cigarettes; and 4) OTC NRT used for "temporary smoking restriction in order to moderate transient withdrawal, as a substitute for smoking, and concomitantly with cigarette use in order to reduce consumption ... is safe and even desirable to advance public health."

To read the petition, see http://www2a.cdc.gov/phlp/docs/Code%20of%20Federal%20Regulations.pdf.

___________________________________________________________

The CDC Public Health Law News is published each Wednesday except holidays, plus special issues when warranted. It is distributed only in electronic form and is free of charge.  News content is selected solely on the basis of newsworthiness and potential interest to readers. CDC and DHHS assume no responsibility for the factual accuracy of the items presented. The selection, omission, or content of items does not imply any endorsement or other position taken by CDC or DHHS. Opinions expressed by the original authors of items included in the News, or persons quoted therein, are strictly their own and are in no way meant to represent the opinion or views of CDC or DHHS. References to products, trade names, publications, news sources, and non-CDC Websites are provided solely for informational purposes and do not imply endorsement by CDC or DHHS. Legal cases are presented for educational purposes only, and are not meant to represent the current state of the law. The findings and conclusions in this document are those of the author(s) and do not necessarily represent the views of CDC. The News is in the public domain and may be freely forwarded and reproduced without permission. The original news sources and the CDC Public Health Law News should be cited as sources. Readers should contact the cited news sources for the full text of the articles.

For past issues or to subscribe to the weekly CDC Public Health Law News, visit http://www2a.cdc.gov/phlp/cphln.asp. For help with subscriptions or to make comments or suggestions, send an email to Rachel Weiss at rweiss@cdc.gov.

The News is published by the Public Health Law Program, Office of the Chief of Public Health Practice, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (DHHS). Rachel Weiss, J.D., Editor; Christopher Seely, J.D., Associate Editor; Karen L. McKie, J.D., M.L.S., Editorial Advisor.