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

*** Tobacco Legal Update. The March/April issue of “Legal Update,” the newsletter of the Tobacco Control Legal Consortium, is available at http://www.tclconline.org/documents/Legal-Update-Apr-2008.pdf.

*** National Air Quality Report. The American Lung Association has issued State of the Air: 2008 its ninth annual ranking of cities most affected by different types of air pollution. Visit http://www.stateoftheair.org/ to download the report.

*** Industrial Farm, Public Health Report. The Pew Commission on Industrial Farm Animal Production has released a report examining risks of industrial farming on public health, entitled Putting Meat on the Table: Industrial Farm Animal Production in America. Visit http://www.ncifap.org/ to access the report.

*** Food Safety Report. The Trust for America’s Health has released Fixing Food Safety: Protecting America’s Food from Farm-to-Fork, available at http://www.rwjf.org/files/research/20080428tfahfoodsafety.pdf.

*** Teen Driving Safety Survey. The current issue of Pediatrics includes an article entitled “National Young-Driver Survey: Teen Perspective and Experience with Factors that Affect Driving Safety.” The article is available at http://pediatrics.aappublications.org/cgi/content/short/121/5/e1391 (subscription required).

*** Mercury Hearing (5/13). The U.S. Senate Committee on Environment and Public Works will hold a hearing on mercury legislation on May 13, 2008, at 10:00 a.m. ET, in Dirksen Room 406. For more information, visit http://epw.senate.gov/public/index.cfm?FuseAction=Hearings.Hearing&Hearing_ID=c099d793-802
a-23ad-4896-c8721e1ebc89.

*** Public Health Grand Rounds (5/29). Public Health Grand Rounds will host the satellite broadcast and Webcast, “Standards, Accreditation, and Improvement -- Raising the Bar of Public Health Performance,” from 2:00 to 3:00 p.m. ET, on May 29, 2008. More information is available at http://www.publichealthgrandrounds.unc.edu/performance2/index.htm.  

*** National Environmental Health Conference (6/22-6/25). The National Environmental Health Association will hold its 72nd Annual Educational Conference and Exhibition June 22-25, 2008, in Tucson, Arizona. For more information, visit http://neha.org/AEC/2008/index.html. 

*** Save the Date (10/21-10/22). Loma Linda School of Public Health will host its 5th Annual American Health Care Congress October 21-22, 2008, in Ontario, California. For more information, visit http://americanhealthcarecongress.org.

Top Story

1. Connecticut: Agreement is reached on Lyme disease

States and Localities

2. California: 734 businesses sign up for S.F. health program

3. California: Hungry Angelenos rally around the taco

4. Florida: Jury awards $24.2 million in asbestos lawsuit

5. Illinois: New state law mandates public schools begin green cleaning

6. Kentucky: Inmates exposed to ‘superbug,’ lawsuits say

7. New York: 5 restaurants in Manhattan get citations over calories

National

8. Across USA, anxiety over access to patient records

9. Care-rationing rules offered

Briefly Noted

Arizona prison health · School diabetes law · California public health director · Florida health department junk food · Kansas newborn blood screening · Kentucky peanut allergy case · Maryland lead poisoning research ethics · Massachusetts bioterror lab ruling · Michigan prison mental illness · New York cigarette trafficking suit · Diabetes, HIV initiatives · National nutrition and school revenue · Genetic discrimination bill · Immunity and tort · Philippines transplant ban

Quotation of the Week

Jason Newsom, Bay County Florida Health Director

This Week’s Feature

Monthly Quiz. Gentle readers, do you remember what happened in the world of public health law last month? Prove it by trying your hand at the April Quiz, below.

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“Agreement is reached on Lyme disease”

Hartford Courant     (05/02/08)     Hilary Waldman

http://www.courant.com/news/health/hc-ctlyme0502.artmay02,0,5245299.story

Connecticut Attorney General Richard Blumenthal and the Infectious Diseases Society of America have reached an agreement to establish an independent review of the organization’s guidelines for treating Lyme disease. The Society’s treatment standards downplayed a belief by many that the tick-borne bacteria can remain for years in the bloodstream and cause debilitating chronic symptoms. The agreement came after Blumenthal launched an antitrust investigation to look into complaints that the treatment guidelines were biased. Blumenthal also said his office found evidence that some members of the Society had personal and professional financial stakes in companies that make or develop Lyme disease tests and treatments. “What happened in this process, what made it so flawed, is it excluded information. The cause of that excluding of evidence was financial concern,” he said. Under the agreement, the Society will name an independent panel of experts to review the guidelines. The new board will comprise members who were not on the original guidelines panel, and they will be approved by an ombudsman who is an expert in medical ethics. Dr. Donald Poretz, the Society’s president, said he agreed to the settlement in an effort to clear the air.

[Editor’s note: To read the agreement between the Connecticut Attorney General and the Infectious Diseases Society of America, visit http://www.ct.gov/ag/lib/ag/health/idsaagreement.pdf.]

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“734 businesses sign up for S.F. health program”

San Francisco Chronicle     (05/02/08)     Wyatt Buchanan

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/05/02/BAKC10FB3C.DTL

As of last week, more than 700 businesses had signed up for Healthy San Francisco, a program which aims to provide health care for all 73,000 of the city’s uninsured residents. Businesses that do not offer health insurance and that employ 20 to 49 people had until last Wednesday to meet a minimum-spending requirement for their employees’ health care; businesses with 50 or more employees had a January deadline. One way businesses could meet the requirement was by joining the program, which is open to uninsured, adult residents who are ineligible for Medicaid or Medi-Cal. Employees of the regulated businesses who do not qualify for the program are eligible for employer-funded accounts that reimburse employees’ medical costs. The program is also open to city residents who do not work for regulated businesses, as long as they do not earn more than three times the federal poverty line (about $31,000). Program participants are assigned to primary-care facilities at health-care centers or clinics that stress preventive care, and they have access to urgent care, emergency care, mental health care, substance abuse services, radiology, pharmaceuticals, and other medical services. Last year, the restaurant industry filed a lawsuit challenging the program and a federal district court issued an order last December holding that the federal Employee Retirement Income Security Act (ERISA) preempted the state regulation creating Healthy San Francisco. But the U.S. Circuit Court of Appeals for the Ninth Circuit stayed the order in January and heard oral arguments on the issue last month. A decision is pending.  

[Editor’s note: For more information about Healthy San Francisco and eligibility requirements, see www.healthysanfrancisco.org. To read the order explaining how ERISA preempts the Program, see Golden Gate Restaurant Ass'n v. San Francisco, No. 06-06997 (N.D. Cal. Dec. 26, 2007), at http://www2a.cdc.gov/phlp/docs/Golden-Gate-Restaurant-Association_v_San-Francisco.pdf. Visit http://www.ca9.uscourts.gov/ca9/Documents.nsf/4aedeb59128b486888257242007e1223/aff
372e2cbda965a882573cb0070d2ca/$FILE/0717370o.pdf to read the Ninth Circuit opinion.] 

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“Hungry Angelenos rally around the taco”

New York Times     (05/03/08)     Jennifer Steinhauer

http://www.nytimes.com/2008/05/03/us/03taco.html?_r=1&partner=rssuserland&emc=rss&oref=slogin

A controversial new Los Angeles County ordinance restricting taco trucks takes effect this week, and residents who have come to rely on the quick, inexpensive food are outraged. Nearly 5,000 people have signed an online petition opposing the new rules, and some taco cart owners have hired lawyers. But some residents find the carts eyesores, and some restaurant owners believe the trucks undermine their businesses. “They are a blight,” said Omar Loya, a resident of East Los Angeles, who brought his complaint to County Supervisor Gloria Molina. “Businesses with a fixed place of business complain about unfair competition and the spillover effects mobile vendors have on the surrounding area,” said Gerry Hertzberg, Molina’s policy director. Hertzberg cited litter, noise, public urination, and excessive parking space hoarding as typical complaints. The ordinance requires carts in a commercial zone to change location every hour; carts in a residential area will have to move every 30 minutes. The trucks are required to move at least one half mile from their initial location, and not return for three hours. Violators will be charged with a misdemeanor and will be fined $100 for the first offense and up to $500 for subsequent violations. The city of Los Angeles has a similar ordinance on the books, but it is rarely enforced. “Taco trucks are iconic here,” said Aaron Sonderleiter, one of the petition founders. “You go to one and you see black people, white people, old people, young people. They really capture a microcosm of L.A.”

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“Jury awards $24.2 million in asbestos lawsuit”

Miami Herald     (04/29/08)     Patrick Danner

http://www.miamiherald.com/business/story/513199.html

Last week, a Miami-Dade County jury found Honeywell International negligent for selling asbestos brake pads, awarding one man and his family almost $24.2 million. Honeywell is the parent company of brake maker Bendix. Nine other defendants named in the suit, brought by Stephen E. Guilder, reached settlements before the case went to trial. Guilder was exposed to the asbestos brake pads as a teen in the 1970s and 1980s, when he worked on vehicles on his stepfather’s farm. Last September he was diagnosed with peritoneal mesothelioma, a cancer that affects the abdominal lining, and he has been given a less than 10 percent chance of surviving beyond the fall of 2009. The jury awarded $10.1 million to Guilder personally, $3 million for future lost earnings, $6.78 million for pain and suffering, and the remainder to his wife and children. According to a company filing with the Securities and Exchange Commission (SEC), Honeywell has prevailed in the majority of the asbestos claims against Bendix that have gone to trial. The SEC filing also indicates that Honeywell has settled 113,000 claims, although almost 52,000 asbestos claims remained unresolved at the end of 2007.

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“New state law mandates public schools begin green cleaning”

Daily Gazette     (04/28/08)     Malinda Osborne

http://www.saukvalley.com/articles/2008/04/28/news/local/5a001b84c1949f78e93a1deda653bde4.txt

This week, custodians in many Illinois schools will trade traditional cleaning supplies for state-approved, “green” materials under the requirements of the Green Cleaning Schools Act. The Act is intended to prevent the spread of disease, allergens, and asthma-inducing elements in schools. The move was needed because students have developing immune systems and are prone to putting things in their mouths, said Mark Bishop, deputy director of the Healthy Schools Campaign in Chicago. The legislation is also intended to protect custodians, who soon will be using vacuums with high-efficiency particulate air filters, and recycled, non-bleached paper hand towels. “We define green cleaning as cleaning for health while protecting the environment,” said Bishop, whose organization lobbied for the legislation. The Act allows school districts to apply for an exemption if green cleaning is determined to be financially burdensome, and districts may deplete their existing supplies before switching over to green supplies. “The purpose is not to create something punitive and difficult, but to create a market incentive to really promote green cleaning,” Bishop said. Critics say the law does not contain an enforcement mechanism, leaving enforcement up to regional education offices. “They’ve set the guidelines and specifications but we don’t know what the rules are, so they can’t say if we’re in compliance or not,” said Sterling Schools Facilities Manager Loren Swartley. But according to Bishop, the enforcement requirements will be incorporated into the Illinois Health/Life Safety Code for Public Schools. With the passage of the new law, Illinois became the second state (after New York) to  require green cleaning in schools.

[Editor’s note: To read the Illinois Green Cleaning Schools Act, Public Act 095-0084 (2007), see http://www.ilga.gov/legislation/publicacts/95/PDF/095-0084.pdf. To learn more about the Act, visit http://www.healthyschoolscampaign.org/campaign/green_clean_act_2007/.]

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“Inmates exposed to ‘superbug,’ lawsuits say”

Courier-Journal     (05/04/08)     Andrew Wolfson

http://m.courier-journal.com/news.jsp?key=249447&rc=lo

Lawsuits filed in Kentucky and Southern Indiana on behalf of inmates attest to the increasing threat of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in overcrowded jails. Jails in the two states are not required to report infections, but 112 inmates in one Kentucky county jail alone have been treated for MRSA or MRSA-like symptoms since 2004, with 80 confirmed infections. MRSA infections in inmates have public health ramifications, said Greg Belzley, an attorney involved in five lawsuits filed on behalf of infected prisoners. “When inmates are released they go home, they go back to work,” Belzley said. “Do you want somebody with MRSA flipping your burgers? Or infecting his child, who sits next to your child in school?” The lawsuits allege that county jails have failed to identify, treat, and isolate inmates with the infections, which can lead to deep abscesses and painful boils or the development of necrotizing toxins that consume flesh. The Kentucky jails have denied the allegations, saying they have implemented a 2004 Kentucky Corrections Department protocol to prevent and treat infections. The protocol includes isolating infected inmates, culturing sores to confirm infection, and identifying appropriate antibiotics. Attorneys representing the jails say inmates will have difficulty proving MRSA exposure during incarceration, since about one percent of the population carries the bacteria harmlessly in their noses or under fingernails and can go months before transferring the bacteria to an open wound. However, lawyers in other jurisdictions have found that juries can make the connection if an inmate can show that he was diagnosed after six months of incarceration and was exposed to another infected inmate.

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“5 restaurants in Manhattan get citations over calories”

New York Times     (05/06/08)     James Barron

http://www.nytimes.com/2008/05/06/nyregion/06calorie.html?partner=rssnyt&emc=rss

This week, New York City health inspectors began issuing violation notices to restaurants that had not posted calorie counts on their menu boards. The calorie rules, issued by the New York City Department of Health and Mental Hygiene, affect more than 2,000 restaurants, or about 10 percent of all restaurants in New York City. Calorie postings are required only in restaurants with more than 15 outlets nationwide. Challenged by the New York State Restaurant Association, enforcement of the regulations was delayed while the case was pending, but U.S. District Court Judge Richard J. Holwell ruled against the Association and allowed enforcement of the regulations to go forward. He prevented the city from levying fines until mid-July, which  gives the city time to “work with the food establishments to answer their questions and make sure that everyone is compliant,” said health department spokeswoman Jessica Scaperotti. Fines will range from $200 to $2,000. On Monday, the first day of enforcement, five Manhattan restaurants were issued citations that were little more than warnings. A restaurant’s failure to post calorie counts will not affect whether it passes or fails its regular food safety inspection, and violation notices are issued on separate forms from those used to cite the restaurant for food safety violations. “This is pass-fail,” said restaurant inspector Corey Williams, who issued violation notices to Dunkin’ Donuts, McDonald’s, and Sbarro.

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“Across USA, anxiety over access to patient records”

USA Today     (04/29/08)     Robert Davis

http://www.usatoday.com/news/health/2008-04-29-medical-records_N.htm

Complaints registered on USA Today’s  Patient Safety Web site have illustrated the difficulties some hospital patients and their families encounter trying to access medical records. Under the Health Information Portability and Accountability Act (HIPAA), patients or their designated representative may see and copy the patient’s medical records, although the law does allow health care providers to withhold records in some circumstances. Yet according to USA Today, failure to provide requested records in a timely or accurate manner was the most common complaint posted on the Web site. In one instance, a woman was precluded from filing a lawsuit because the record she needed was not provided until after the state’s statute of limitations for medical malpractice had expired. Another woman claimed that a hospital purposefully gave her someone else’s records to avoid liability. According to Dr. Sidney Wolfe of the consumer advocacy group Public Citizen, a double standard exists for accessing records. “If you are in the medical system, it works perfectly fine. If it’s just the patient who wants the records or the patient’s family if the patient died, it’s a whole different story.” But a spokesman for the American Health Information Management Association said most missing records are honest omissions caused by staff members who provide summaries of what they think are the documents relevant to information requests. The best way for patients to avoid problems with medical records, according to some health specialists, is to routinely ask for copies of all records pertaining to care.

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“Care-rationing rules offered”

Associated Press     (05/04/08)     Lindsey Tanner

http://www.inrich.com/cva/ric/entertainment.apx.-content-articles-RTD-2008-05-05-0056.html

The Task Force for Mass Critical Care has issued recommendations to guide hospitals in prioritizing who should receive lifesaving care during pandemic influenza or other widespread disasters. The Task Force comprises physicians representing universities, medical organizations, the military, and federal government agencies. “If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing,” said the Task Force report. Hospitals should use the guidelines when making disaster preparedness plans, so that everyone will be on the same page during an actual disaster, according to Dr. Asha Devereaux, lead author of the report. Prioritization should ensure that scarce resources, such as ventilators, medicine, doctors, and nurses are used in a uniform, objective manner, the report said. Certain elderly patients, and those with severe trauma, mental impairment, or chronic disease are among those at high risk of death who are not recommended to receive life-sustaining care during a disaster when casualties exceed the capacity of hospitals and caregivers. Although the guidelines are an important initiative, they may violate federal laws against age and disability discrimination and they raise “real ethical concerns,” said Lawrence Gostin, Director of the Center for Law and the Public’s Health at Johns Hopkins and Georgetown Universities. But the proposed health care rationing, albeit unpleasant, may help the public understand what will be necessary during a disaster, said James Bentley, vice president of the American Hospital Association.

[Editor’s note: To read the guidelines, published in this month’s Chest, the medical journal of the American College of Chest Physicians, see http://www.chestjournal.org/content/vol133/5_suppl/.]

_____________________BRIEFLY NOTED______________________

Arizona: Deaths, health complaints raise concerns about treatment, liability

“Health and death behind bars”

East Valley Tribune     (05/04/08)     Mary K. Reinhart

http://www.eastvalleytribune.com/story/115427

Arizona: Monitoring blood-sugar levels will no longer require trip to nurse’s office

“New law gives diabetic students control”

Arizona Republic     (05/02/08)     Ray Parker

http://www.azcentral.com/community/mesa/articles/2008/05/02/20080502mr-diabetes0502.html

California: State’s first director of Department of Public Health confirmed by legislature

“California Senate committee confirms first public health director”

Sacramento Bee     (05/01/08)     Aurelio Rojas

http://www.sacbee.com/111/story/904018.html

Florida: Health department director’s nutrition “obsession” elicits complaint

“Health department director bans junk food, angers staff”

News Herald     (05/02/08)     Tony Bridges

http://www.newsherald.com/headlines/article.display.php?id=1815

Kansas: Routine blood testing now to test for 29 diseases, including cystic fibrosis

“State expands genetic testing for newborns”

Wichita Eagle     (04/30/08)     Jeannine Koranda and Karen Shideler

http://www.kansas.com/690/story/388799.html

Kentucky: Boy charged with wanton endangerment for exposing classmate to peanuts

“13-year-old charged with felony”

Lexington Herald-Leader     (04/19/08)     Steve Lannen

http://www.kentucky.com/779/story/380893.html

Maryland: Scientist fights claim he put children at risk in lead poisoning studies

“Research faces outcry”

Baltimore Sun     (05/01/08)     Jonathan Bor and David Kohn

http://www.baltimoresun.com/news/local/bal-te.md.farfel01may01,0,5583293.story

Massachusetts: Court finds city council excluded public from meetings on bioterror lab

Kevin McCrea v. Michael F. Flaherty

Appeals Court of Massachusetts

No. 07-P-224

Decided May 1, 2008

Opinion by Judge Andrew R. Grainger

http://www.socialaw.com/slip.htm?cid=18134&sid=119 

Michigan: State witness in federal suit defends prison care

“Mentally ill Michigan inmates not being treated, expert says”

Grand Rapid Press     (04/30/08)    

http://www.mlive.com/news/grpress/index.ssf?/base/news-41/1209561353232840.xml&coll=6

New York: Motion to dismiss violation of Contraband Cigarette Trafficking Act claims denied

City of New York v. Milhelm Attea and Bros., et al

U.S. District Court for the Eastern District of New York

06-CV-3620 (CBA)

Decided April 30, 2008

Opinion by U.S. District Judge Carol Bagley Amon

http://www.narf.org/nill/bulletins/dct/unreported/milhelmattea.pdf

New York: Authors explore implications of two innovative programs

“New York City’s initiatives on diabetes and HIV/AIDS”

American Journal of Public Health     (05/08)     Janlori Goldman and others

http://www.ajph.org/cgi/content/abstract/98/5/807 (subscription required)

National: Study finds few data to support concern that nutrition changes lead to loss of revenue

“Changing nutrition standards in schools: the emerging impact on school revenue”

Journal of School Health     (05/08)     Christopher M. Wharton and others

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1746-1561.2008.00296.x (subscription required)

National: Measure expected to be signed by President

“House overwhelmingly approves anti-genetic discrimination bill”

Associated Press     (05/01/08)    

http://ap.google.com/article/ALeqM5g9PKo1Dr67gVSZWb-B4tOfMvmgDwD90CVGBO0

National: Authors discuss federal agency immunity from tort actions

“The FDA, preemption, and the Supreme Court”

New England Journal of Medicine     (05/01/08)     Leonard H. Glantz and George J. Annas

http://content.nejm.org/cgi/content/short/358/18/1883?rss=1&query=current (subscription required)

Philippines: Ban seeks to protect poor Filipinos

“Philippines bans kidney transplant ‘tourism’”

Guardian     (04/29/08)     Ian MacKinnon

http://www.guardian.co.uk/world/2008/apr/29/philippines?gusrc=rss&feed=worldnews

__________PHL NEWS QUOTATION OF THE WEEK___________

“There is no right to have a honeybun in the machine.”

-- Jason Newsom, Bay County Florida health director, on his office-wide ban on junk foods. An employee recently complained of Newsom’s push for healthy food offerings in Health Department vending machines. [See Briefly Noted item, above.]

______THE MONTHLY QUIZ: APRIL 2008______

Welcome to the Monthly Quiz! To win, be the first reader to answer all the quiz questions correctly. The winner will be recognized in the News (if you prefer not to be recognized, please let us know).

Each quiz contains questions from News stories and other content published in April 2008 (for past issues, visit http://www2a.cdc.gov/phlp/dailynews/default.asp). Check next week’s issue of the News for the correct answers. Submit your answers by email to cseely@cdc.gov.

For each of the following questions, choose the one best answer.

1. A 2006 study conducted at the University of Utah found that drivers tested on simulators performed better in braking and avoiding rear-end collisions when alcohol-impaired than when ___________________________________. (April 2, 2008 issue)

A. they were driving on four hours of sleep

B. they were singing along to music

C. they were talking on hand-held or hands-free phones

D. none of the above

2. The U.S. Court of Appeals for the Second Circuit dismissed an $800 billion class-action lawsuit about __________. (April 9, 2008 issue)

A. light cigarettes

B. menu calorie labeling

C. taco trucks

D. pesticides

3. Virginia Governor Timothy Kaine signed legislation that broadens the standard used by the state to determine if a person should be involuntarily committed, and extends the time period allowed for emergency custody and temporary detention orders. True or False? (April 16, 2008 issue)

A. True

B. False

4. Canada recently announced its intention to list __________ as toxic. (April 23, 2008 issue)

A.bisphenol A

B. thimerosal

C. nicotine

D. both A and B

5. The U.S. Senate unanimously passed legislation that prevents employers from asking employees about ________, and from using such information in the hiring or firing process. (April 30, 2008 issue)

A. whether they smoke

B. their genetic background

C. their eating habits

D. their exercise regimen

___________________________________________________________

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.