Prevention and Public Health

In health, states increasingly look to prevention and early intervention as ways to provide better health outcomes and to reduce health costs. Models of mental health care reform also are moving toward a complete behavioral health system with the goal of providing patients with early access to treatment.

CSG Midwest
New policies in three Midwestern states have the goals of boosting immunization rates among young people and preventing the spread of disease.

As classes resume across the country this fall, the University of Iowa will join nearly 1,100 colleges and universities that have declared their campuses tobacco free. The new policy adds smokeless tobacco, snuff, water pipes and electronic cigarettes—or e-cigarettes—to their list of banned substances on campus, joining cigarette and cigar smoke under the school’s previous policy.

Earlier this year, Indiana experienced an outbreak of HIV in one small rural community that was traced back to needle-sharing among individuals using and abusing prescription drugs. Public health experts warn that other communities could encounter outbreaks of HIV and hepatitis C given the rampant abuse of prescription drugs and heroin. 

CSG's FREE eCademy webcast at 2 p.m. on Aug. 18  will explore lessons from Indiana's experience, policy options that states might pursue and the latest research on effective treatment of substance abuse.

Kentucky is taking the lead, using an innovative approach, to provide its 9,000 state employees and their dependents with readily accessible primary care options. The state has established health clinics that provide primary care and treatment for allergies, acute infections, strep throat, rashes, cold and flu, and routine wellness and prevention. Since its inception in 2010, state employees have experienced reduced time away from work, increased work productivity and reduced out-of-pocket health care costs.

This week Gov. Jerry Brown signed into law SB 277 which removes the personal belief exemption parents could use to exempt their children from vaccination requirements tied to public school attendance.  When the law becomes effective in 2016, California will become the third state, after Mississippi and West Virginia, to allow vaccination exemption for medical reasons only.  

Creating and implementing effective risk-management strategies for injection drug users is a challenge around the world. Countless policies have been proposed and implemented with varying degrees of success. The World Health Organization, also known as WHO, has developed a comprehensive program comprised of nine interventions designed to mitigate the risks associated with injection drug use, including needle exchange programs; opioid substitution therapy; prevention, diagnosis and treatment for diseases related to drug abuse, and public education campaigns for injection drug users and their sexual partners. Some of these strategies have been implemented recently by Midwestern states.

Sixteen states have passed laws explicitly authorizing needle exchange programs, and there are a number of states with statutes that either decrease barriers to the distribution of clean needles or altogether remove syringes from the list of drug paraphernalia. Additionally, a recent HIV outbreak in the small town of Austin, Ind., has led more states to consider authorizing such programs.

Sixteen states have passed laws explicitly authorizing needle exchange programs, and there are a number of states with statutes that either decrease barriers to the distribution of clean needles or altogether remove syringes from the list of drug paraphernalia. Additionally, a recent HIV outbreak in the small town of Austin, Ind., has led more states to consider authorizing such programs.

CSG Midwest
In the early part of 2015, an outbreak of HIV began spreading quickly in the small, southeast Indiana town of Austin. By the end of April, the number of confirmed cases had reached nearly 150, with many of them linked to use of the opioid painkiller Opana via needle injection.
Gov. Mike Pence declared a public health emergency in Scott County to deal with the outbreak and to allow for a temporary needle-exchange program, but Sen. Patricia Miller says it was important for the legislature to act as well.

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