A guest blog entry from Jay Smith, MD, MPH - Policy Committee C0-Chair

What are our highest priorities? What do we try to protect from the budget slashers?  How does the need for cleaner energy investment and higher energy efficiency rank when we are fighting to maintain services that directly serve the disabled, the mentally ill, the drug addicted, poorer seniors and anyone who has become needy enough to need some public assistance?

In addition to slashing away at services, the House approved a budget that sends no money (from what all ratepayers pay into the Regional Greenhouse Gas Initiative) to ongoing, successful efforts in low income housing weatherization and municipal energy efficiency programs.  They also have raided pretty much all the money from the Renewable Energy Fund (payments utilities must make if they can't find enough renewable energy on the open market).  This fund is used to subsidize the creation of more distributed energy generation for both electricity and heat.  Since those programs help reduce peak demand, they actually lower everyone's energy bills since utilities have less need to pay the markedly increased cost of fossil fuels that occurs when there are spikes in demand.  That isn't direct enough a benefit to average ratepayers that it is widely understood.  This allows those with big investments in fossil fuel infrastructure to deride these efforts as an unhelpful subsidy to the people who are rich enough to put up solar panels for hot water and electricity.

Each person who advocates on these issues will need to decide where to put most of their energy.  Personally, I already have my solar up on my roof but since we need massive amounts more to reduce fossil fuel pollution now and in the future, I will keep going to the legislature and testifying on the co-benefit to public health of burning less fossil fuels.  In case you haven't been aware of this, excellent studies show that burning less will lower cardiovascular disease even more than it benefits people with chronic lung diseases.

The NH Senate is likely to amend the House budget in many ways.  It isn't likely that they will restore every cut or prevent every raid on renewable energy and energy efficiency project funds.  But the more pressure on Senators and Representatives that comes from their own constituents, the more likely that the committees of conference in June will find they do need to accommodate many of the concerns that are raised on all of these issues.  If you don't know who to write, go to gencourt.state.nh.us and find the links for who your House member(s) and Senator are.  It's good to write both of them on most issues since whatever the Senate does with the budget will also have to go back and be passed by the House or changed again in committee of conference and then passed in both chambers before going to the governor.


A guest blog entry from Jay Smith, MD, MPH - Policy Committee C0-Chair

It's incredibly draining to think about the consequences of the budget that the NH House just passed.  There are so many things that are wrong about it that I don't know where to begin.  We all need to pitch in now and convince the NH Senate to change things.  That won't be easy and everyone will need to contact their own Senator about the things that they care most about and that they can detail the consequences of going along with the House's insanity.  While the House finance committee budget proposal was changed slightly on the House floor on April 1st, the terrible cuts to Health and Human Services outlined in the link below were not reversed as all the amendments failed that would have put funds back in.  Look at the analysis by the NH Fiscal Policy Institute for details of what the House finance committee passed budget would do.



A guest blog entry from Marie Mulroy, NHPHA Past President

SB 105 -- We were predicting it would have been killed; however, Senator Carson made an amendment which essentially gutted the original bill from the floor.  This version passed and the bill has now headed over to the House for a hearing this Tuesday at 10:00.   Instead of full revision of the clean indoor air act -- it is now calling for a study commission along with passing the child resistent packaging for liquid nicotine. It was heard in Health in the Senate but is coming up in House under Commerce -- which does not bode well for the bill.   I am going to go and testify again as I did in the Senate along with the rest of our partners from the Tobacco Free New Hampshire Coalition. 

Read the full testimony here



A guest blog entry from Jay Smith, MD, MPH, NHPHA Policy Committee Co-Chair

Everyone knows that prevention matters but its mostly just public health people who think about it in all of the three stages - primary (improving overall health), secondary (increasing screenings/preventive efforts), and tertiary (improving treatment and recovery).  As you all know, primary prevention involves lots of messaging and trying to change underlying conditions whether that is exposures or immunity levels or other underlying resilience factors.  Often that is not completely successful or as fully possible as would be optimal.  So we end up moving on to the secondary and tertiary levels of prevention that reduce morbidity and mortality though we may not get a full pound of cure for each ounce as we do with primary efforts.

It's probably stretching the prevention metaphor too far, but I’d like to suggest that our efforts to increase everyone’s awareness of the devastating cuts in Health and Human Services being sent to the House floor next week by the majority are akin to primary prevention.  The budget proposal will likely go through the House with all of these cuts but raising public awareness of the negative outcomes that will ensue will help in the next phases of the struggle.  There are so many lines of cuts and understanding their impact is difficult.  They include contracts for drug and alcohol treatment services and prevention efforts; cuts to emergency shelter programs for homeless housing; decreases in personal care and transportation funds and meals programs for elderly and disabled people.  I won’t try to put everything in this newsletter.  Restoring these cuts to get the needs met that contribute to a healthy New Hampshire at the next level of budget review (the Senate) or the level after that (if Governor Hassan is persuaded she needs to veto what comes from the legislature in June) is the goal.  Here are the cuts as of March 13.
Make yourself and others aware of them and vocal about the effects.  Politicians may react now or later in the process to large enough amounts of feedback from constituents so write personalized messages to your own representatives.  I will update the information about the cuts and links to other organizations’ analyses soon.  A number of these groups are having a news conference today, March 30th at 12:15 in the lobby of the Legislative Office Building.  

Concord often seems far away from people’s own lives and concerns.  And the budget seems mystifying.  As you look at the proposed cuts, link them to the lives of people that you know and make them aware of what could happen.  The total decrease from the governor’s proposed HHS budget is $119 million dollars, almost 10% of the total.  The cuts are not even across the entire HHS budget and the total the House finance committee proposed is about 9% less than what was enacted in the last biennium.  For example, the impact that would occur with these reductions to drug and alcohol treatment funding are estimated to mean 955 fewer people per year getting services.  Drug and alcohol prevention in 50 schools serving 3350 students per year would also be cut.  There is already a severe shortage of treatment available and the governor’s budget proposed additional funds. The House proposal reduces funding for these additional services in the biennium by $6 million causing loss of services for more than 500 additional people each year.  In the two years of the budget, up to 7,000 fewer students would receive targeted prevention services.  As with a number of other areas, these cuts also risk loss of Federal funds, which in this case would mean an additional 726 treatment and 1,158 prevention services not delivered.


A guest blog entry from Jay Smith, MD, MPH, NHPHA Policy Committee Co-Chair

We have been told that the Finance Committee has amended HB 357 (formerly a bill about drivers’ licenses) to require at least $40 million in budget cuts to the budget of the Department of Transportation over the next two years.  Our sources tell us that this would lead to approximately 300 layoffs in the Department.  It seems likely that this amended version of the bill, if enacted could lead to a substantial decrease in public safety in our state. 


We believe the committee needs to consider all the possible ramifications this decrease in the transportation department’s budget would cause – particularly those associated with injuries and illnesses that require prompt medical attention.  Our roads need to be made clear and passable for emergency vehicles, such as ambulances, as quickly as they now are or there will be increased numbers of premature deaths and increased disability due to delays in arrival at major hospitals.

Medical studies on re-vascularization therapies, in patients experiencing heart attacks and strokes clearly show that earlier treatment leads to less loss of heart and brain tissues.  Delays in getting to patients or getting them to treatment centers due to poor road conditions or closed roads will inevitably lead to more disability and deaths among people suffering these sudden emergencies.  It would also likely lead to poorer perinatal outcomes since women needing surgical births will take longer to arrive at the few widely dispersed hospitals in the state where this still happens.

Finally, let us remember that poorly maintained roads lead to accidents.  In this past winter, even with current budget funding, the bad conditions that occurred frequently lead to more accidents, including 19 state police cruisers hitby oncoming cars while responding to traffic accidents.  We are lucky that none of our public safety officers has been killed.  Reduce road maintenance will lead to an increased risk to them and anyone else who found themselves on the road in weather that they had not known would be that bad.

Read the language of the amendment here
 
An entry from the March issue of the NHPHA e-Newsletter

This month's member spotlight focuses on Katie Robert, incoming NHPHA President and consultant with the Community Health Institute (CHI) in Concord.  Katie first got involved in the public health field 8 years ago, skimming through the Sunday edition of the Concord Monitor and “hankering to explore new professional opportunities”.  Who finds a job in the newspaper anymore, she thought, but on that fateful Sunday, a Data Manager opportunity with CHI presented itself.Loading

In 2012, Katie was approached by NHPHA to join the Board of Directors and the Membership Committee.  "That led to a joint membership of the Communications Committee, and then a co-chairmanship of the Communications Committee, with the lovely, talented Melissa Schoemmell.”  She was then “called-up” by the HR/Nominating Committee to serve as President-Elect and said, “with the support of my husband, Chris, the go-ahead from my  boss,  Jonathan Stewart, and a huge pep talk from Laura Davie and Marie Mulroy, she jumped at the opportunity.

When asked what she most enjoyed about her work, she explains, “Since I joined CHI in 2007, I’ve had the pleasure of working with a multitude of clients both in NH and beyond, in many topic areas, and utilizing many skills thanks to the nature of the consulting work done by CHI.”  She has done a fair amount of health communications work, and is also jumping into helping coordinate technical assistance for a HRSA project working with Healthy Start grantees across the country.  Having a masters’ degree in Public Administration, she states that she particularly enjoys helping create and improve efficiencies for the projects on which she works – including her volunteer work with NHPHA!”   

During her two-year term as NHPHA President, Katie is excited to work with the Board of Directors, committees and members as NHPHA faces a bright future coming out of an arduous few years.   “Thanks to the hard work of the giants who’ve come before me (ahem, I’m looking at you, Joan, Jeanie, Marie, Laura – to name a few), NHPHA has positioned itself to strengthen and expand its advocacy work, member engagement activities, and to get out in front of NH public health in such a way to support our members, partners and stakeholders”.Loading

Among many achievements, one of Katie’s proudest thus far in her career is the huge success of the first-ever NH Get Your Rear In Gear campaign, co-led by her colleague and good friend, Sarah Moeckel.  This event was held in September of 2014 to raise money and awareness of the importance of colon cancer screenings.  Nearly 300 participants and 40 volunteers came together and raised over $20,000, of which $15,000 went directly to the NH Colorectal Cancer Screening Program to offer free screenings.  “In a field where there are so many worthy causes, I was lucky NHPHA supported me in choosing this cause, as my own mom lost a 10-year battle with colon cancer this past year.”  

In her ever-so-slightly less fast-paced home life (as she puts it), “I am married to my brilliant, college sweetheart, bridge engineer and husband, Chris, with whom I’ve been blessed with two adorable, hysterically funny, smart little girls (Madelyn aka Macabena – almost 4, Norah  aka Norahsaurus – 2).  To burn off steam, I enjoy reading, not running, Thursday night network television, fantasy football, attending Mom Prom, and contributing to the popular #PinterestFail movement.” 

Mark your calendars!  The 2nd Annual Get Your Rear and Gear Race is being held on September 26, 2015. Information about this event will be shared as it becomes available.


A guest blog entry from Jay Smith, MD, MPH, NHPHA Policy Committee Co-Chair

In the last two days, we have gotten urgent messages* out about the House Finance committee's likely plans for some critical parts of the budget that were to be worked on before the publishing of this newsletter. The budget has to originate in the House so the work of their Finance committee is critical to New Hampshire's health, environment and safety agencies and infrastructure.  Details of all the meetings are in the House Calendar.  

As most of our members are probably aware, the current leadership is treating the budget as a place to try to enforce their desire to shrink the government. We have little  chance in modifying substantially what the House leadership decides to do this coming fortnight but the process doesn't end with the budget resolutions sent to the House floor by the committee. Paying close attention to specifics and making sure your representatives now how you feel about the consequences of not funding needed services could lead eventually to better outcomes.
 
Find representatives on the Finance committee here

Find your own reps and contact information here

The Finance committee briefs the full House on their budget proposals on March 30.  If one has time and inclination, that can be heard live here starting at 10 a.m.

By April 2nd, the House has to send all of its bills, including its budget to the Senate and the process of hearings will start all over.  In June, there will be a flurry of activity as both chambers finish up work on each others bills that "crossed over".  Since the Governor also has to sign the budget (and other bills that passed both chambers), her people will be involved in the negotiations that go on in the joint committees of conference.  Expect a lot of information from NHPHA with suggestions of who in the leadership is most critical to contact in seeing that public health priorities are not neglected in the final budget or in the many bills that could still be amended even though we thought we had gotten the right outcome during the first go round.  On a positive note, any bill that has been given the thumbs down in either chamber should not come back to haunt us unless one chamber did pass it.

*Urgent Messages
Call To Action
NH Health Protection Program Under the Knife



A guest blog entry from Jay Smith, MD, MPH, NHPHA Policy Committee Co-Chair

Some ideas stir great passions that are hard to sort through to come to wise decisions.  That ought to mean legislators sit down and look at the pros and cons of policies in our NH laws that affect the way we live and die.  But even talking about such issues sounds to some like we know we want to change current laws so some legislators oppose even a study committee.  This happened on a bill that will be on the House floor on Wednesday, March 3.

HB 151, establishing a committee to study end-of-life decisions.  Majority: Ought To Pass.  Minority: Inexpedient to Legislate.

Rep. Larry R. Phillips for the Majority of Judiciary.  A bi-partisan majority supports helping citizens encounter end-of-life with personal, medical and appropriate decisons.  This bill would study innovative approaches to medical care and dying, many of which have been implemented in other states.  Through the efforts of such a committee, new initiatives could emerge. Vote: 9-7

Rep. Gary S. Hopper for the Minority of Judiciary.  The sponsor of HB 151 would like us to use taxpayer's money to study "end-of-life issues".  This is merely a eupemism for state-assisted suicide.  Although the minority has great compassion for those who are at the end of their natural lives, we believe that this issue has been studied at great length in many places around this country and there is no need for New Hampshire to pay for a study, too.  


Personally, I’m with the majority on this but it isn’t easy to see a public health implication that should have us ready to make a recommendation for this.  Maybe individual members of our association do feel that they have some important reasons to try to influence this debate.  If that is you, I urge you to write your representatives in the legislature.  And tell us what you think whether your write them or not!  We're always looking for input from members on our legislative positions, and want to ensure that we're advocating well and with careful consideration of all public health ramifications of the issues.   You can also visit our policy statement page to see if the topic is something on which we've already taken a position

No matter the political affiliation or area of expertise of our members, the NHPHA policy committee is committed to supporting smart public health policy as an organization, and through supporting our members to do the same individually.



 
A guest blog entry from Jay Smith, MD, MPH, NHPHA Policy Committee Co-Chair

As noted by my policy committee co-chair there are an overwhelming number of bills presented at the start of each legislative session.  Going through them, it is often difficult to know whether there is a health dimension.  Some seem to be obvious in their intent and what is good health policy.  But some that clearly touch on public health issues are just plain puzzling.  Here’s a recent example of why I felt it was worth going to the hearing at the committee and ended up testifying even though the NHPHA had not taken an official position.

HB 244 would have set the permissible level of methyl tert-butyl ether in drinking water at zero.  While that sounds lovely, it wasn’t clear to us how that could be accomplished and why that seemed so important to the bill’s sponsor.  After all, there are agencies that already set permissible levels in public drinking water for many things.  After reaching out to the Department of Environmental Services, we eventually learned that this was a result of a panic over a supposed cancer cluster in a community where there was some found in drinking water but below the permissible level.  We didn’t have time to have a policy committee discussion so I testified without either supporting or opposing but pointing why this might not be good policy since no real problem had been identified and the goal was likely not attainable even if we knew there was a problem with the current standard.  A companion piece of legislation, HB 248, would have directed the University of New Hampshire to do a study on this possible carcinogen but provided no funding for it.  Again, I testified neither directly for nor against but pointed how difficult such epidemiology studies are and that this is not just a NH issue and further study really belongs at a different level.  I think the committee found a public health perspective (more or less in support of our state institutions) helpful.

This echoes my experience with the bill to exempt “non-amable” species, i.e. exotic meats from needing inspection prior to sale to the public.  This was reported in our last newsletter in one of the attachments.  It clearly has health implications but without broad input from other NHPHA members we aren’t able to do a good job of finding out about such legislation in a timely enough fashion to get a bill researched and to take a position.  So, once again, please be alert for any legislation being proposed that might have health implications and help us be well-prepared to help our champions know what is good public policy.


An entry from the February Issue of the NHPHA e-Newsletter

This month's member spotlight features Lia Baroody.  Lia is the Program Coordinator for the Heart Disease and Stroke Prevention (HDSP) Program with the NH Department of Health and Human Services (DHHS), Division of Public Health Services (DPHS).  The NH HDSP Program is part of a team within DPHS that works to improve outcomes on heart disease and stroke.  Heart Disease and Stroke are listed as a priority in the 2013 State Health Improvement Plan (SHIP).  Within the plan, four (4) objectives related to heart disease and stroke are identified: Reduce Coronary Heart Disease Deaths; Improve Blood Pressure Control; Improve Cholesterol Control; and Reduce Stroke Deaths.  The DPHS has also identified six (6) goals within heart disease and stroke: Control High Blood Pressure; Control High Cholesterol;  Increase awareness of signs and symptoms of heart attack and stroke and the need to call 911; Improve Emergency Response; Improve Quality of Care; and Eliminate Disparities.  

Lia states that another important initiative has been the release of a blood pressure guide which came about as a result of the Association of State and Territorial Health Officials (ASTHO) Million Hearts (MH) Learning Collaborative that the DPHS has been a part of.  The Ten Steps for Improving Blood Pressure Control in New Hampshire - A Practical Guide for Clinicians and Community Partners has just been released in partnership with the University of NH, Institute for Health Policy and Practice and the Cheshire Medical Center/Dartmouth-Hitchcock Keene.  The guide can be found on the NH DHHSwebsite, and on the UNH, Institute for Health Policy and Practice website.

In honor of American Heart Month, DPHS offered blood pressure screenings on Go Red For Women Day - a day to raise awareness about heart disease being the number one killer of women, and organized a lunchtime heart healthy group walk. Employees of DPHS received heart healthy tips on how to reduce the risk of heart disease and many staff also dressed in observance of Go Red For Women day in which a group photo was taken to show support.  A resource table has been set up in the lobby of DPHS for the month of February and includes information on heart disease and the importance of knowing one's risk factors such as diabetes, tobacco and the importance of eating healthfully and being physically active.

Prior to joining DPHS in 2010, Lia worked at the NH DHHS, Bureau of Elderly and Adult Services (BEAS), working closely with the NH nutrition agencies and senior centers that provide home delivered meals and congregate meals to older adults.  It is during that time, that she began to partner with DPHS and also began working collaboratively throughout the year on providing important public health information to help older adults be as healthy as they possibly can. "During "flu" season, we shared information on the importance of getting the flu shot, we also provided information on West Nile Virus, food safety concerns and the Commodities Supplemental Food Service Program through Women Infants and Children (WIC) program to name a few."  It is after having developed a great partnership with DPHS, that Lia thought it would be "great to work in public health if an opportunity arose."

Two things that Lia would tell a person in NH wanting to know more  about how public health benefits them locally is that everyone should remember that how one lives can affect their health; being physically active, eating healthfully, and knowing one's risk factors is so important to being healthy.  Lia goes on to say that prevention and health education is so important and public health works hard to make this information available and easy to understand to individuals through our website, programs and sharing with community
partners.  DHHS - HDSP


Although NH is considered a fairly healthy State, LIa likes most about her job that everyone at DPHS is committed to working hard and striving to make NH an even healthier place to work and live.  "Working in the DPHS, means working with staff that are committed, work as a team and are especially nice to work with.  In addition, the DPHS has great community partners and we could not accomplish the work we do without our stakeholders and partners."

Lia would like to add that on March 26, the NH DPHS in partnership with the Cheshire Medical Center/Dartmouth-Hitchcock Keene, and the Institute for Health Policy and Practice at UNH are offering a half-day workshop modeled after the successful statewide approach to hypertension control as part of the national Million Hearts (MH) initiative. 

Click here to register.  

For questions or concerns, please contact Lia Baroody.


A guest blog entry from Jeanie Holt, NHPHA Policy Committee Co-Chair

Among the benefits NHPHA receives by being affiliated with APHA is advocacy at the federal level on behalf of public health. Like NHPHA, APHA bases advocacy on policies adopted by the Governing Council. And like NHPHA, those policies are carefully researched and based on the best evidence available.

A proposed policy that will be considered by the Governing Council is on the topic of preemption. I’m sure many of you are as unfamiliar with this concept as I was before I read this proposal. Preemption is a legislative tool whereby the federal or state government withdraws the authority of a lower level of government to act on a particular issue. Preemption can set a floor below which no state or local government is allowed to go. Minimum wage is a good example of floor preemption. Alternatively, preemption can set a ceiling and no lower entity can put in place policies that are stricter than the ceiling.

This is important for public health because so much of public health occurs at local and state levels. Once an idea gets started at a locally, it has a better chance of moving up to higher bodies of government. We see this clearly in indoor smoking bans. Many towns and cities put such bans in place before any states adopted clean indoor air laws. And we still don’t have such policies, for the most part, at the Federal level. Big tobacco companies tried for years to get national legislation passed that would have preempted the right of communities to ban indoor smoking. They knew that it would be easier to fight smoking bans (and win) in Congress than to have to work against such legislation in many towns and states. Fortunately, they lost that particular battle.

The policy being proposed to APHA’s Governing Council would authorize our public health advocates to:

·        urge federal and state legislators to avoid preempting the ability of state or local governments to act to further public health goals;

·        urge federal and state legislators to enact minimum requirements, or floor preemption, with strong public health protections;

·        urge federal and state legislators to insert savings clauses in legislation to explicitly avoid preempting lower levels of government;

·        urge federal and state legislators to consult with APHA to determine whether legislation is sufficiently favorable to public health when faced with legislation that includes preemptive language;

·        urge legislator to engage local leaders, stakeholders, and grassroots movements to gain their perspective on perspective during the legislative process;

·        urge public health and public policy education programs to educate their students about the potential negative consequences of preemption.

The NHPHA Board of Directors is considering formally endorsing this proposed policy.  Read the full proposal
here.                                            

 


A guest blog entry from Jeanie Holt, NHPHA Policy Committee Co-Chair

HB600: ". . .workers in New Hampshire can address their own health and safety needs and the health and safety needs of their families by requiring employers to provide a minimum level of paid sick and safe days including time for family care. . ."

I am in a check-out line at a store I shall not name.  As I place my tiems on the counter, the cashier couged, covering her cough with her hand. Then she picked up my first item. . .

One can view paid sick leave from several differnt perspectives.  For public health, paid sick leave is an important tool in limiting the spread of disease.  I suspect others have had similar experiences to mine.  People who come to work sick put all of us at risk.

A 2010 national survey of more than 4,300 restaurant workers, 88% of the respondents reported not having paid sick leave and 63% admitted that they cooked and served food while sick.1  Using data from the Centers for Disease Control and Prevention (CDC) Drago and Millerestimated that infected imployees who reported to work caused the infection of an additional 7 million peole during the 209 H1N1 pandemic.  Other researchers interviewed a nationally representative sample of U.S. adults and found that workplace policies such as lack of paid sick leave were correlated with higher incidence of influenza-like illness.  This study estimated 5 million additional cases of influenza-like illness in the U.S. population owing to the absence of workplace policies such as paid sick leave3.  A study that modeled influenza epidemic scenarios showed that universal paid sick days reduced workplace infections by 6%4.  Clearly, lack of paid sick days puts all of us at greater risk for contagious illnesses inlcuding the flu.

From an economic point of view, paid sick leave can be a burden for businesses and employers who will be required to pay employees who are not at work, generating income.  Even from this perspective, however, employees working sick are likely to be less productive.  And sick workers infecting other employees prolongs this diminished productivity and the resulting loss of income for the business.  Paid sick leave makes sense for keeping our communities healthy and our workforce productive.

The house hears this bill on Thursday; another opportunity for you to take action by attending the hearing, testifying on this bill, and/or writing to your state representative.  

  1. Restaurant Opportunities Centers United.  Serving while sick: high risk and low benefits for the nation's restaruant workforce, and their implact on the consumer.  Serving While Sick
  2. Drago R. Miller K. Sick at Work: infected employees in the workplace during the HINI epidemic.  Sick At Work
  3. Kumar S. Quinn SC, Kim KH, Daniel LH, Freimuth VS.  The impact of workplace policies and othe rsocial factors on self-reported influenza-like illness incidence during the 2009 HINI pandemic.  Am J Public Health.  2013; 102(1):134-140.
  4. Kumar S. Grefenstette J. Galloway D. Albert SM, Burke DS.  Polices to reduce influenza in the workplace; impact assessmetns using an agent-based model.  Am. J Public Health. 2013; 103(8); 1406-1411.                                                                                           





A guest blog entry from Jeanie Holt, NHPHA Policy Committee Co-Chair

SB135: Relative to Lead Poisoning In Children: changes the notice requirements for blood lead levels found in a child’s blood; establishes the lead screening commission to assess existing screening rates in relation to the department of health and human services’ screening guidelines; and establishes a task force to determine the feasibility of developing a program establishing essential maintenance practices to be used in pre-1978 rental housing and pre-1978 buildings containing child care to reduce exposures to lead from lead-based paints.

Public health activists joined with environmental activists to craft and submit a bill to further reduce lead poisoning in NH’s children. NHPHA has joined this team to help get this important public health measure passed. Marie Mulroy crafted testimony which Jay Smith will deliver at the Senate hearing on Tuesday. You, too, can be part of the team. We will report back on progress and let you know when letters of support will have the most impact. It takes a village…and a team!

Action by NHPHA members:  Sometimes NHPHA is unable to take a position on a bill. This most often happens because we lack the expertise to analyze the implications of the proposed policy and lack the time to find the experts among our members to supplement the Policy Committee’s knowledge. But that does not stop individual members from taking action. Jay Smith testified on HB 499, not as NHPHA’s Policy Committee Co-Chair but as a concerned public health professional.  If you’ve taken action on behalf of the public’s health, we’d love to hear about it. You can email Jay (jaycmd7699@gmail.com) or Jeanie (jeanieNHPHA@gmail.com). Include a copy of your letter, email, or testimony.



A guest blog entry from Jay Smith, MD, MPH, NHPHA Policy Committee Co-Chair

As many public health advocates know, we lost some of our legislative champions in the last election cycle and control of the legislature is now firmly in the hands of those who often see any governmental programs as inherently suspect.  This includes safety and health measures to some degree.  Yet there are thinking individuals among the new Republican majority in the House and the increased number in the Senate.  I think it would be a mistake to write them off and just concentrate on obtaining vetoes from our governor and then sustaining those vetoes in the legislature.  My recent experience with HB 288 is illustrative.  It is not a health bill per se but there are health implications involved and energy use and health are main passions for me.

This bill would allow towns and cities to opt out of the energy code for new construction.  In committee hearings, experts spoke in opposition to the misinformation being provided by the builder/legislator who is sponsoring the bill.  But the questioning from committee members made it clear that some felt that this energy code might be causing health problems from “sick buildings”.  So I sent the committee members all a letter to provide a health perspective.  I had responses from two Republicans on the committee, one saying he agreed with me and the other asking for information that I was able to supply after a small amount of research.  In the committee’s executive session, the committee didn’t send the bill on to the House for a vote but retained it for further study.  I don’t know that my letter shifted the vote at all and it doesn’t mean this is dead but we now have until next year to marshal testimony from other builders who have no problem with the code.

The legislative process is a bit mind-numbing and many important bills are being considered in many different committees at the same time so it is difficult to follow and influence.  But, if we don’t start early and get good information to our legislators about bad legislation (or good bills that we support), there may be a couple of votes that we lose that could have made a difference.  It can be quite discouraging but allowing that to sap our determination is not something the world can afford.  In future newsletters, there will be more information about bills heading in to executive session and then floor debate and votes.  This all leads up to crossover on April 2nd when every bill passed in the House goes to the Senate and vice-versa.  Then we start getting even more serious about getting everyone to understand what is at stake.


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