MI Food Allergy Conference August 29 at the Kensington Court Ann Arbor Hotel

From our community partners at the Food Allergy & Anaphylaxis Michigan Association:

Physicians and other health care professionals are encouraged to attend this free 1/2 day conference on food allergy.  This program applies to the MI Board of Nursing rule 2(l) and reflects 4 hours of continuing education credit for RN’s.

Interdisciplinary speakers will cover a variety of topics related to IgE mediated food allergy with risk for anaphylaxis.  Please note conference content will not include information on other forms of adverse reactions to food such as food intolerance.

For more information on speakers, topics, sponsors, exhibitors, lodging, registration and continuing education credit is available at:

The conference is produced and managed by Food Allergy & Anaphylaxis Michigan Association (www.foodallergymiassociation.com). The conference is funded through a community grant from the nonprofit Food Allergy Research & Education (www.foodallergy.org)

Washtenaw County Amends Clean Indoor Air Regulation to Include E-Cigarettes: Changes Take Effect June 18

The use of electronic nicotine delivery systems, e-cigarettes or similar devices, will no longer be allowed in indoor public areas in Washtenaw County that are already smoke free. Changes to the Washtenaw County Clean Indoor Air Regulation were approved in March and take effect today, June 18, 2015.

New language in the regulation prohibits the use of electronic nicotine delivery systems in public and private worksites and other indoor areas open to the public, such as stores, public buildings, reception areas and public transportation. The 2015 amendment also extends the regulation to Washtenaw County Parks for the first time.

“The amended regulation treats electronic devices the same as traditional tobacco products in our shared, public spaces,” says Ellen Rabinowitz, MUP, health officer for Washtenaw County Public Health. “As the local public health authority, we are pleased with the changes. Relevant, up-to-date regulations that provide everyone with cleaner air to breathe are effective ways for us to protect and promote health in our community.”

Tobacco specialty shops and retailors specializing in e-cigarettes or other electronic smoking devices are exempt. Additionally, the county regulation does not address smoking or e-cigarette use in restaurants or bars, which are governed by Michigan’s Smoke-Free Air Law and have been smoke-free since 2010.

The current state law does not cover the use of e-cigarettes. Individual bars and restaurants, however, are free to set their own policies and can choose to ban e-cigarettes in the same way as traditional tobacco products.

“I’m delighted that the Washtenaw County Commissioners are in agreement with leading health authorities and have acted to include e-cigarettes and related devices in the Washtenaw County Clean Indoor Air Regulation,” says Jim Bergman, director of the Smoke-Free Environments Law Project, based in Ann Arbor.

According to Bergman, “The dangers of e-cigarette use and of secondhand e-cigarette aerosol in the air have been recognized by the American Medical Association, the American Heart Association, the World Health Organization, the National Institute for Occupational Safety & Health, the Centers for Disease Control & Prevention and many others. All of these health authorities have called for e-cigarettes to be treated in the same manner as traditional combustible cigarettes, including prohibiting their use where cigarette use is prohibited.”

Electronic Nicotine Delivery Systems

Electronic nicotine delivery systems are battery-powered devices that provide inhaled doses of nicotine or other substances by way of a vaporized solution. These devices are commonly called e-cigarettes, but also have other forms, such as e-cigars or e-hookahs. Most contain nicotine and resemble the act of smoking. Some varieties are flavored, which may increase their appeal to younger users.

E-cigarettes are currently not approved as smoking cessation aids and are not regulated. Exposure to the aerosol, chemicals and nicotine from these devices has not been proven safe for non-users to inhale. The amended regulation will protect county residents from involuntary exposure.

“E-cigarettes and similar devices are not regulated by the FDA,” says Alice Penrose, MD, MPH, medical director with Washtenaw County Public Health. “The amount of nicotine dispensed and the additives vary from brand to brand, and we do not have long-term data about the safety of these products for the people using them or those around them.”

Enforcement

Washtenaw County Public Health is responsible for enforcing the Washtenaw County Clean Indoor Air Regulation. Enforcement is driven by complaints. Residents who observe violations of the regulation may register a complaint by contacting DeBorah Borden, Tobacco Prevention Coordinator, at 734-544-6874 or bordend@ewashtenaw.org.

The text of the amended Washtenaw County Clean Indoor Air Regulation is available online.

New WCMS Website Under Construction – Stay Tuned!

New Website Launched for Opiate and Heroin Abuse in Washtenaw County

http://www.ewashtenaw.org/government/departments/public_health/opiate-and-heroin-data/opiate-and-heroin-abuse-in-washtenaw-county

Opiate and Heroin Abuse in Washtenaw County

Washtenaw County has seen an increase in opiate overdose deaths since 2012.

Deaths related to opiate overdoses among Washtenaw County residents have increased. Opiates include both prescription painkillers and illicit drugs like heroin. Specifically, deaths involving heroin have increased steadily over the last several years.

opiate OD deaths image

Prescription painkillers are addictive and plentiful in the United States. Hydrocodone, for example, was the number one prescribed drug of any kind in the United States in 2013 according to the IMS Institute for Healthcare Informatics.

After becoming addicted to prescription painkillers, some may turn to heroin when prescription drugs become too costly or too difficult to get.

Overdose deaths involving fentanyl have also increased. Fentanyl and fentanyl-like substances that are made illegally can be up to 100 times more powerful than morphine and 50 times more powerful than heroin, according to the United States Drug Enforcement Agency.

Fentanyl may stop a victim’s breathing almost instantly. It may be found alone or in combination with heroin or other drugs.

The Opioid Project

In response, the Washtenaw County Opioid Project is a collaboration promoting effective solutions based on local data. It brings together law enforcement, public health, hospitals, community mental health, treatment facilities, other providers and community leaders to share resources, build partnerships and combat the epidemic. Washtenaw County Public Health co-leads the Opioid Project in partnership with the Washtenaw Health Initiative.

Opiate Overdose Deaths among Washtenaw County Residents

Summary by gender, age and type of opiate: Opiate Overdose Deaths among Washtenaw County Residents, 2011-2014

During the first quarter of 2015, there were 16 opiate overdose deaths among Washtenaw County residents. Fentanyl was found (alone or in combination with heroin) in seven of these deaths (44%).

2015 Jan-March April-June July-Sept Oct-Dec
Heroin 9
Fentanyl 7
Prescription opiates 3
Total Deaths*  16      

* Some individuals test positive for more than one type of opiate.

Emergency Hospital Admissions Associated with Opiate Overdoses

Washtenaw County Public Health reviews emergency room admissions from local hospitals attributed to opiate overdoses.

From April 2011 to March 2015, over 400 county residents were admitted to University of Michigan or Saint Joseph Mercy hospitals for overdoses associated with opiates. Individuals admitted for unintentional heroin overdoses tend to be younger and male (average age was 32 years and 87% were white). Individuals admitted for unintentional prescription opiate overdoses were older, female (60%) and predominately white (average age 51 was years and 81% were white).

Table by quarter April 2011 – March 2015: Emergency Department Admissions for Unintentional Opiate Overdoses – Washtenaw County Residents Admitted to University of Michigan or Saint Joseph Mercy Hospitals.

Hepatitis C

Hepatitis C is a viral illness spread through contact with contaminated blood. Washtenaw County has seen an increase of new infections among young people. New infections are almost all due to intravenous drug use. Blood transfusions are now screened for Hepatitis C and are not a potential source of infection.

Summary of 2014 Hepatitis C cases: Hepatitis C Trends 2014

Graph of Newly Diagnosed Hepatitis C Infection in 18 – 29 yr olds Washtenaw County residents* 2007-2014.

Document Actions

Childhood Obesity Profiles

The publication of the first round of childhood obesity data profiles for Washtenaw County is now available.  The data and these reports are a result of collaboration between St Joseph Mercy Health System, University of Michigan Health System and Washtenaw County Public Health.

Please take a look at this important new surveillance project for our community:

 

Washtenaw Medical Beat on Public Health Now Online

 Washtenaw Medical Beat May 2015
Dr. Allan Brown hosts a discussion on Washtenaw County public health with guest panelists Sandro Cinti, MD, Infectious Disease, University of Michigan Health Services and Alice Penrose, MD, MPH, Medical Director, Washtenaw County Public Health.

Free Hearing & Vision Screenings

Washtenaw County Public Health is pleased to announce the availability of free hearing and vision screenings now through August. Screenings are required for all children entering preschool and kindergarten this fall. Screenings are by appointment. Please call 734-544-6786 to schedule.

“Summer time is a great opportunity for children entering preschool or kindergarten to be screened free of charge,” says Deborah Thompson, lead hearing and vision technician with Washtenaw County Public Health.  “Early identification of hearing and vison problems prepares children for future academic and social success. Every child deserves to see and hear as well as possible,” continues Thompson.

Screenings are available for children and young adults up to age 21 and to special education students up to age 26. Washtenaw County Public Health is located at 555 Towner Street in Ypsilanti. The Hearing and Vision program’s summer hours are Monday through Friday from 8:00 am to 4:00 pm.

The majority of hearing and vision screenings are completed in area schools, including public, private and charter schools and preschools. Office appointments are available for children entering school for the first time, those new to the area or any child who is experiencing hearing or vision difficulties and has not already been referred for follow up services.

Regular vision screenings are scheduled during preschool, kindergarten and grades 1, 3, 5, 7 and 9. During a vision screening, each student is tested for visual acuity, farsightedness, her or his ability to use both eyes together and symptoms of eye problems.

Hearing screenings are scheduled during preschool, kindergarten, grades 2 and 4 and if a child enters the Michigan school system as a new student. Hearing screenings are performed using an audiometer and other equipment based on the child’s needs. Washtenaw County Public Health also retests all newborns in the county who fail their initial hearing screening at birth.

In 2014, Washtenaw County Public Health’s hearing and vision technicians screened 19,762 area children for hearing and 24,476 children for vision. They made over 2,000 referrals for follow up services.

2015 WCMS Bulletin 2nd Quarter Online

The 2015 WCMS Bulletin, 2nd Quarter, now online:

http://digital.turn-page.com/i/504480-april-may-june-2015/0

 

Washtenaw County Public Health 2014 Annual Report Now Online

WCMS 2015 House of Delegates Resolution Results

IMPROVING TRANSPARENCY FOR MEDICAL LEGISLATION BY DR. JAMES SZOCIK

69-15 – IMPROVING LEGISLATIVE TRANSPARENCY – AMEND

THE COMMITTEE AMENDED THE RESOLVED PORTION(S) TO READ:

RESOLVED: THAT MSMS SUPPORT AND ADVOCATE FOR FURTHER TRANSPARENCY IN THE LEGISLATIVE PROCESS, INCLUDING THE SOURCE OF LEGISLATION, LANGUAGE REVISIONS, AND EACH REPRESENTATIVE’S VOTE. BY STRIKING THE OTHER RESOLVED PORTIONS OF THE RESOLUTION, THE COMMITTEE BELIEVED THAT THE INTENT OF THE AUTHOR TO PROMOTE BETTER TRANSPARENCY FROM THE LEGISLATIVE PROCESS REMAINS WITHOUT BEING TOO PRESCRIPTIVE.

THE COMMITTEE CONCURS THAT TRANSPARENCY IS AN IMPORTANT GOAL TO HAVE BUT ONE THAT MAY BE DIFFICULT TO ACHIEVE. MAINTAINING THE GENERAL INTENT PROVIDES A CLEAR OBJECTIVE TO MSMS, WHILE RETAINING AN APPROPRIATE DEGREE OF FLEXIBILITY WITH WHICH TO ACHIEVE IT.

SUPPORT OF SUICIDE PREVENTION AWARENESS AND EDUCATION BY DR. NEIL ELKIN

70-15 – SUICIDE PREVENTION AWARENESS AND EDUCATION – AMEND

COMMITTEE AMENDED THE RESOLVED PORTION(S) TO READ:

RESOLVED: THAT MSMS SUPPORT EFFORTS TO RAISE AWARENESS ABOUT THE RISING RATE AND DEVASTATING TOLL OF SUICIDE; AND BE IT FURTHER

RESOLVED: THAT MSMS SUPPORT SUICIDE PREVENTION EDUCATION FOR ALL PHYSICIANS, RESIDENTS, MEDICAL STUDENTS, AND ALLIED HEALTH PROFESSIONALS; AND BE IT FURTHER

RESOLVED: THAT MSMS ENCOURAGE ALL PHYSICIANS TO BE ACTIVELY ENGAGED IN SUICIDE PREVENTION AWARENESS WITH THEIR PATIENTS AND COLLEAGUES; AND BE IT FURTHER

RESOLVED: THAT MSMS SUPPORT EFFORTS TO INCREASE RESEARCH ASSOCIATED WITH SUICIDES AS WELL AS SUPPORT EFFORTS TO REDUCE LIABILITY FOR THOSE WHO PROVIDE SUICIDE PREVENTION CARE.

THE COMMITTEE WAS EXTREMELY SUPPORTIVE OF THE RESOLUTION. THE COMMITTEE MOVED TO PROVIDE AN ADDITIONAL RESOLVE THAT FOCUSED ON TWO PARTS:   THE FIRST SECTION WORKS TOWARDS INCREASING RESEARCH WITH REGARDS TO SUICIDE PREVENTION. THE INTENT IS TO ENSURE WE CONTINUE TO COLLECT BETTER STATISTICS AND DATA IN ORDER TO CONTINUE TO PREVENT SUICIDES. THE SECOND SECTION AIMS TO REDUCE LIABILITY FOR THOSE WHO PROVIDE SUICIDE PREVENTION CARE.

BROADENED CONFLICT OF INTEREST BY DR. JAMES SZOCIK

40-15 – BROADEN CONFLICT OF INTEREST DISCLOSURE – AMEND

THE COMMITTEE AMENDED THE RESOLVED PORTION(S) TO READ:

RESOLVED: THAT MSMS AND THE AMERICAN MEDICAL ASSOCIATION WORK WITH ACCME AND AOA TO BROADEN THE CONFLICT OF INTEREST DISCLOSURE AND MANAGEMENT OF CONFLICT OF INTEREST TO INCLUDE ALL FORMS OF FUNDING, INCLUDING, BUT NOT LIMITED TO: EMPLOYERS, CORPORATIONS, DRUG COMPANIES, GOVERNMENTAL ENTITIES (E.G., NATIONAL INSTITUTES OF HEALTH), FOUNDATIONS, SPEAKER’S BUREAUS, SPEAKING ENGAGEMENTS, AND UNIVERSITIES.

THE COMMITTEE AGREED WITH THE AUTHOR’S INTENT, BUT WANTED TO PROVIDE A MORE SPECIFIC AVENUE SO MSMS AND AMA WILL WORK THROUGH UTILIZING THE PROPER GOVERNING BODIES OF CME.

MAINTENANCE OF CERTIFICATION CONFLICT OF INTEREST WRITTEN BY DR. SZOCIK

 37-15 – MAINTENANCE OF CERTIFICATION CONFLICT OF INTEREST – AMEND

THE COMMITTEE AMENDED THE RESOLVED PORTION(S) TO READ:

RESOLVED: THAT MSMS WORK WITH THE AMERICAN MEDICAL ASSOCIATION TO WORK WITH ANY ORGANIZATION GRANTING MAINTENANCE OF CERTIFICATION TO ENSURE THAT THE PROCESS IS THE LEAST BURDENSOME, FINANCIALLY AND TIME-WISE, ON MEDICAL PRACTITIONERS; AND BE IT FURTHER

RESOLVED: THAT MSMS WORK WITH THE AMERICAN MEDICAL ASSOCIATION TO ADVOCATE THAT ANY ORGANIZATIONS GRANTING MAINTENANCE OF CERTIFICATION RECOGNIZE THEIR INHERENT CONFLICT OF INTEREST IN PROMOTING AND MAINTAINING A COMPLICATED AND EXPENSIVE CERTIFICATION PROCESS, REQUIRING LARGE FEES AND ONEROUS EXAM SCHEDULES; AND BE IT FURTHER

RESOLVED: THAT MSMS WORK WITH THE AMERICAN MEDICAL ASSOCIATION (AMA) TO ENCOURAGE MEMBERS OF THE AMA HOUSE OF DELEGATES TO OBJECT TO ANY ATTEMPTS BY THIRD PARTIES TO REQUIRE MAINTENANCE OF CERTIFICATION AS A CONDITION OF PARTICIPATION OR PAYMENT. THE COMMITTEE SUPPORTED THE CONCEPTS CONTAINED IN THIS RESOLUTION THAT MEDICAL SPECIALTY BOARDS HAVE A SIGNIFICANT FINANCIAL CONFLICT OF INTEREST IN TERMS OF PURSUING MAINTENANCE OF CERTIFICATION (MOC) REQUIREMENTS.

THE COMMITTEE WAS INFORMED THAT THE AMA HAS ALREADY TAKEN ACTION TO OPPOSE MOC. THE RESOLUTION WAS MODIFIED TO ALLOW FOR THE CHANGE TO MSMS POLICY WHILE ALLOWING MSMS TO WORK WITH THE AMA TO ACHIEVE THIS GOAL WHILE NOT REQUIRING MSMS TO TAKE THIS RESOLUTION BACK TO THE AMA TO SIMPLY HAVE IT AFFIRMED AS EXISTING POLICY.

OTHER RESOLUTIONS SUBMITTED BY INDIVIDUAL MEMBERS OF WCMS INCLUDE:

 ELECTRONIC DATA RECORDS FOR LEGISLATORS SUBMITTED BY DR. JAMES SZOCIK, AS AN INDIVIDUAL

 39-15 – ELECTRONIC DATA RECORDS FOR LEGISLATORS – DISAPPROVE

THE COMMITTEE RESPECTS THE CONTENTION OF THE AUTHOR THAT LEGISLATORS AND ADMINISTRATORS SHOULD BE WILLING TO BE HELD TO THE SAME STANDARDS THEY HOLD THOSE WHO THEY LEGISLATE OR REGULATE. FURTHERMORE, MANY PHYSICIANS WOULD AGREE THAT POLICYMAKERS MIGHT BE LESS CAVALIER ABOUT THE REQUIREMENTS THEY IMPOSE ON OTHER PROFESSIONS IF THEY WERE HELD TO THE NAME REQUIREMENTS. HOWEVER, THE COMMITTEE REALIZES THAT THE LIKELIHOOD OF ACCOMPLISHING THIS RESOLUTION IS REMOTE. ADDITIONALLY, THE COMMITTEE CONSIDERED THAT THE NATURE OF THE LEGISLATIVE PROCESS DOES NOT ALWAYS PERMIT LEGISLATORS TO ADHERE TO THE REQUIREMENTS SET FORTH IN THE RESOLUTION. THE COMMITTEE DOES NOT WISH TO REQUIRE STAFF TO EXPEND LIMITED RESOURCES ON AN ENDEAVOR THAT IS SO UNLIKELY TO BE SUCCESSFUL.

DISCOURAGING POLITICAL ACTIVITY IN PHYSICIAN OFFICES, SUBMITTED BY DR. CHERYL FARMER, AS AN INDIVIDUAL

76-16 – DISCOURAGING POLITICAL ACTIVITY IN PHYSICIAN OFFICES – DISAPPROVE

THE COMMITTEE BELIEVES THIS WOULD BE AN INFRINGEMENT OF THE FREEDOM OF SPEECH CLAUSE OF THE FIRST AMENDMENT OF THE CONSTITUTION OF THE UNITED STATES OF AMERICA.

INFORMED CONSENT PRIOR TO ADMINISTRATION OF MEDICINE WHICH MAY HASTEN DEATH, AUTHORED BY DR. MICHAEL SIMON, AND SUBMITTED BY DR. CHERYL FARMER

77-15 – INFORMED CONSENT PRIOR TO ADMINISTRATION OF MEDICATION WHICH MAY HASTEN DEATH – DISAPPROVE

THERE WAS NO OTHER SUPPORT FOR RESOLUTION 77-15 PRESENTED TO THE COMMITTEE OTHER THAN THE AUTHOR’S TESTIMONY. THE COMMITTEE WAS CONCERNED THAT THE LANGUAGE WAS TOO VAGUE AND COULD BE EASILY MISCONSTRUED. MORE IMPORTANTLY, THE PROPOSED POLICY CONFLICTS WITH EXISTING MSMS POLICY (SEE BELOW).

MSMS STRONGLY ENDORSES THE PRINCIPLE OF INFORMED CONSENT FOR MEDICAL TREATMENT. PATIENTS HAVE A RIGHT TO PARTICIPATE IN DECISIONS REGARDING THEIR HEALTH CARE TO THE EXTENT THAT THEY WISH; AND THEY HAVE A RIGHT TO THE INFORMATION NECESSARY FOR MEANINGFUL PARTICIPATION. MSMS POSITION ON INFORMED CONSENT. HOWEVER, A RIGHT TO THE INFORMATION NECESSARY TO PARTICIPATE TO THE EXTENT THAT THE PATIENT DESIRES DOES NOT IMPLY THAT PATIENTS SHOULD BE FORCED TO ACCEPT INFORMATION DEEMED RELEVANT BY AN OUTSIDE PARTY. RESPECT FOR PATIENT’S RIGHTS ENTAILS RESPECTING A PATIENT’S DESIRES TO RECEIVE OR NOT RECEIVE PARTICULAR ITEMS OF INFORMATION. IN ORDER TO RESPECT PATIENTS’ RIGHTS IN A COMPASSIONATE MANNER, INFORMATION DISCLOSURE SHOULD BE TAILORED TO THE PARTICULAR NEEDS AND DESIRES OF THE PARTICULAR PATIENT. MSMS OPPOSES REGULATORY INTERFERENCE IN THE PHYSICIAN-PATIENT RELATIONSHIP, EITHER TO PROHIBIT THE PHYSICIAN FROM DISCUSSING CERTAIN INFORMATION, OR REQUIRING THAT CERTAIN INFORMATION BE DISCLOSED IN ALL CASES REGARDLESS OF PATIENT CIRCUMSTANCES. [EMPHASIS ADDED] MSMS ALSO BELIEVES THAT CURRENT LAW REQUIRES INFORMED CONSENT FOR ALL MEDICAL TREATMENT AND OFFERS ADEQUATE RECOURSE IF CONSENT IS NOT OBTAINED. THEREFORE, THE SOCIETY SEES NO NEED FOR SPECIFIC LEGISLATION MANDATING INFORMED CONSENT FOR PARTICULAR PROCEDURES OR DISEASES. (BOARD-SEPT 91) [EMPHASIS ADDED]

DISCOURAGING THE PROLIFERATION OF ‘CONCIERGE MEDICINE”, SUBMITTED BY DR. CHERYL FARMER, AS AN INDIVIDUAL

71-15 – DISCOURAGING THE PROLIFERATION OF “CONCIERGE MEDICINE” – DISAPPROVE

THE COMMITTEE PREFERRED LANGUAGE AS AMENDED IN RESOLUTION 23-15 THAT DIRECTS MSMS TO EDUCATE AND INFORM ITS MEMBERS ABOUT ALTERNATE PRACTICE MODELS INCLUDING DIRECTOR PRIMARY CARE CONTRACTS AND CONCIERGE MEDICINE.

A COMPLETE LIST OF THE 2015 HOUSE OF DELEGATES RESOLUTIONS CAN BE FOUND AT :

Click to access 2015_HOD_Resolutions_Final_Action_Summary.pdf