Top 10 Public Health Stories in 2019

Medicaid Expansion
On December 23, 2019, the Utah Department of Health received approval from the Centers for Medicare and Medicaid Services (CMS) to implement full Medicaid expansion in the state. Known as the “Fallback” plan, this expansion will extend Medicaid eligibility to Utah adults whose annual income is up to 138% of the federal poverty level ($16,753 for an individual or $34,638 for a family of four). The federal government will cover 90% of the costs of these services, with the state covering the remaining 10%.

This announcement, along with a smaller-scale expansion known as the “Bridge” plan implemented in April, means up to 120,000 Utah adults who didn’t qualify for Medicaid at the beginning of 2019 qualify today. Enrollment and coverage for the newly eligible individuals will begin on January 1.

To learn more or to apply for Medicaid, visit https://medicaid.utah.gov/apply-medicaid/.

Center for Medical Cannabis Established
The Utah Department of Health established and staffed the Center for Medical Cannabis as a result of the Utah Medical Cannabis Act (House Bill 3001, 2018). During its first year of existence, the Center established a staff, appointed members of the Compassionate Use Board, developed the Electronic Verification System and Inventory Control System, selected vendors to operate medical cannabis pharmacies, and developed criteria for issuing patient cards and registering physicians.

Vaping-related Lung Injury Outbreak
In August, the Utah Department of Health initiated a response to an outbreak of lung injuries that appeared to be associated with vaping. Staff at the Utah Department of Health led the response, but coordinated closely with healthcare providers, local health departments, law enforcement, and partners in federal agencies such as the CDC and FDA.

Utah experienced one of the highest caseloads of any state in the nation, and was at the forefront in investigating the causes of the outbreak. As of Monday, December 23, 2019, there were 125 cases of e-cigarette, or vaping, product use associated lung injury or EVALI reported in Utah and one death associated with the outbreak.

Through laboratory analysis of samples collected from ill patients, and from interviews with those patients, it was determined early in the investigation that vaping illicit THC products was the likely cause of the outbreak. The Utah Department of Health was one of the first agencies in the nation to come to this conclusion and to start warning residents of the likely cause.

For updates on the outbreak, visit https://health.utah.gov/lung-disease-investigation.

Standing Order for Birth Control
On March 27, 2019, under the authority of Senate Bill 184, the executive director of the Utah Department of Health issued a statewide “standing order” for hormonal contraceptives. The standing order allows women to receive contraceptive medications at participating pharmacies without needing a doctor’s prescription.

The order effectively increases access to these medications by removing barriers that many women face while trying to obtain these family planning services. Women will now be able to receive birth control pills, contraceptive patches, or vaginal rings from participating pharmacists after they complete a health history form, have their blood pressure taken, and talk with the pharmacist about which contraceptive method will work best for them.

For more information as well as a list of participating pharmacies, visit https://mihp.utah.gov/birthcontrol.

Serving Utah Moms and Babies for 35 Years: Pregnancy Risk Line provides expert guidance on pregnancy and breastfeeding concerns
When a question comes up during pregnancy about what pain medications are safe to take or whether you can paint your soon-to-be baby’s nursery room, whom do you ask? In Utah, women, healthcare providers, and even pharmacists turn to the Utah Department of Health MotherToBaby Utah program for answers.

May 17, 2019 marked 35 years of providing specialized teratology services to nearly 300,000 Utah moms and babies. The MotherToBaby Utah program, formerly known as the Pregnancy Risk Line, is a free, anonymous service that uses telephone, texting, online chat, and email to respond to questions from women and healthcare providers about potentially harmful exposures during pregnancy and while breastfeeding.

Utah’s Statewide Hepatitis A Outbreak is Officially Over
In February, Utah public health officials announced a hepatitis A outbreak that spanned nearly two years, infected 281 people, and killed three had ended. The outbreak began on May 8, 2017 and the last case was reported on October 26, 2018. To declare an end to the outbreak, no new cases had to be reported in the last 100 days.

Public health officials expect to receive additional reports of outbreak-associated hepatitis A cases, however, their focus will be on monitoring cases and prevention activities, such as vaccinating high-risk populations. The UDOH would like to acknowledge the monumental efforts of private and community partners, and federal, state, and local government partners, especially local public health departments, to control this large hepatitis A outbreak. Partners are encouraged to continue providing hepatitis A vaccination for people experiencing homelessness, along with other high-risk groups, including people using illicit substances and men who have sex with men.

Utah Public Health Laboratory Designated an Antibiotic Resistance Lab
The Utah Public Health Laboratory was recently designated an Antibiotic Resistance Laboratory Network (AR Lab Network) Regional Lab for the Mountain Region (Texas, Arizona, New Mexico, Colorado, Wyoming, Montana, and Idaho). As part of the AR Lab Network, the AR Regional Labs are a critical component in building comprehensive laboratory capacity to detect and better characterize antibiotic-resistant pathogens. The laboratory will implement a regional approach to generate real-time, actionable data to prevent and combat antibiotic resistance threats. Through these efforts, we help close the gap between local capabilities and data needed to fight bacterial resistance in food, healthcare facilities, and the community.

Mountain West Mothers’ Milk Bank Receives Accreditation
On October 16, 2019, the Mountain West Mothers’ Milk Bank received accreditation status and is now the 28th fully-accredited milk bank under the Human Milk Banking Association of North America (HMBANA). This is an amazing accomplishment for the state of Utah and the surrounding states in the region. Many may not know the history behind the development of this milk bank. Staff with the Utah Department of Health Women Infants and Children (WIC) program as well as the EPICC program were instrumental in the development of a task force formed in 2011 to encourage breast milk donations which were then sent to Denver, CO for pasteurization. Eventually, through funding from the University of Utah, a physical location for the milk bank was secured to serve the needs of Utah families.

More information on the milk bank can be found at https://giveyourmilk.org.

Landmark Report Looks at Health Disparities by Utah State Legislative District
At the beginning of 2019, the Utah Department of Health Office of Health Disparities (OHD) released the Health Disparities by Utah State Legislative District report. A product of an informal request by Utah state legislators, the report became the first of its kind in Utah. The report showed most legislative districts experienced health disparities (76% of Senate district and 57% of House districts) and some districts shouldered a high burden of health disparities.

Since its release, the UDOH has shared the report with all state legislators and the OHD presented it to the Lieutenant Governor at the Multicultural Commission. The report has generated much interest and been featured at the UDOH Health Disparities Advisory Council, the Utah Public Health Association Conference, Get Healthy Utah Stakeholder Retreat, Wasatch Front Regional Council, Utah Health Policy Project’s Annual Conference, Comagine’s Utah Partnership for Value Meeting, new articles, etc. Local health districts, constituents, and organizations have shared using the report to apply for grants as well as raise health concerns with local officials.

The report is a crucial step to understanding health disparities in Utah and making informed decisions around policy and programing to advance health equity.

Utah Resident Dies Following Medical Procedure in Tijuana, Mexico
A Utah resident died after traveling to Tijuana, Mexico to undergo weight-loss surgery and testing positive for an antibiotic-resistant form of Pseudomonas aeruginosa bacteria (VIM-CRPA). Eight Utahns, including the patient who died, have been infected or colonized with VIM-CRPA after traveling to Tijuana for similar surgical procedures. All of the other patients recovered.

The UDOH first announced the outbreak of VIM-CRPA infections in January and recommended Utah residents not travel to Mexico to undergo such surgeries. The Utah cases are linked to similar cases nationwide, and the Centers for Disease Control and Prevention is assisting in investigating the outbreak.