Medicaid to Schools Technical Assistance Guide

Purpose: The purpose of this Medicaid to Schools (MTS) Technical Assistance Guide is to memorialize in one document the formal existing rules and guidance approved by New Hampshire Department of Health and Human Services for the Medicaid to Schools program. The administrative rules (He-W) and formal guidance in the form of “Information Bulletins” is referenced and categorized by topic. The user can link internally to sections for clarification and can link to external sources for clarification. Scope: This Technical Assistance Guide includes only those resources that have been formally adopted by DHHS. Contents: Each section of this Technical Assistance Guide includes a summary of the applicable administrative rules promulgated by the Department for Medicaid to Schools services, as well as a reprint of the relevant portion of the rules. Please refer to the rules directly if you seek more information. This MTS Technical Assistance Guide also includes the guidance and Q&A documents published by the Department. The Department’s guidance is quoted directly in each section to ensure fidelity to the regulatory interpretations provided, although sections may have been moved and paragraphs numbered or renumbered. Please refer to the original guidance linked herein if you have questions. Each section includes a summary of the rule, the guidance, a restatement of the rule and a link to the Information Bulletin. Many subjects are linked, so a review of the table of contents is important

Enhancing Credibility of Chemical Safety Studies: Emerging Consensus on Key Assessment Criteria

Objectives: We examined the extent to which consensus exists on the criteria that should be used for assessing the credibility of a scientific work, regardless of its funding source, and explored how these criteria might be implemented. Data sources: Three publications, all presented at a session of the 2009 annual meeting of the Society for Risk Analysis, have proposed a range of criteria for evaluating the credibility of scientific studies. At least two other similar sets of criteria have recently been proposed elsewhere. Data extraction/synthesis: In this article we review these criteria, highlight the commonalities among them, and integrate them into a list of 10 criteria. We also discuss issues inherent in any attempt to implement the criteria systematically. Con c l u s i o n s: Recommendations by many scientists and policy experts converge on a finite list of criteria for assessing the credibility of a scientific study without regard to funding source. These criteria should be formalized through a consensus process or a governmental initiative that includes discussion and pilot application of a system for reproducibly implementing them. Formal establishment of such a system should enable the debate regarding chemical studies to move beyond funding issues and focus on scientific merit

THE TREND TOWARDS IMPLEMENTING THE PRECAUTIONARY PRINCIPLE IN US REGULATION OF NANOMATERIALS

The precautionary principle provides a framework for regulating emerging technologies in general and nanomaterials in particular. It counsels action in the presence of uncertainties about risk instead of assuming that nanomaterials are safe unless proven hazardous. Nanomaterials are regulated under different statutory programs depending on whether they are drugs, pesticides or other commercial chemicals. Recent developments in the regulation of nanomaterials that are not drugs or pesticides have demonstrated a trend towards application of the precautionary principle. This is a paradigm shift away from the requirement built into past interpretations of the Toxic Substances Control Act (“TSCA”) that manufacturing, processing and use of chemical substances cannot be restricted unless the regulatory authority proves an unreasonable risk. This same paradigm shift is incorporated into recent legislative proposals to amend TSCA

Suicide risk in long‐term care facilities: a systematic review

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109565/1/gps4142.pd

Mono- versus polydrug abuse patterns among publicly funded clients

To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category–other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse

Children's exposure to second hand smoke at home : a cross-sectional study in Portugal

Second-hand tobacco smoke (SHS) is a major indoor pollutant that causes serious health problems for all exposed, especially children. Children are often exposed to SHS at home, due to parental or other households’ or guests’ smoking. This study describes Portuguese children's exposure to SHS at home (total and by Portuguese main regions). In 2010/2011, a questionnaire was applied to a sample of Portuguese children in the 4th grade (N = 3187, mean age 9.05 ± 0.7 years, 51.1% male). Descriptive analysis, chi-square tests and crude odds ratios were performed. Of the participants, 62.9% of those with smoking parents and 19.2% of those with non-smoking parents were exposed to SHS at their home. Parental smoking varied significantly among regions and was significantly associated with children's exposure to SHS at home. Children's exposure to SHS at home was high, especially if their parents smoke. Children living in Lisbon Region presented the highest SHS exposure rate. The association of SHS exposure with geographic regions suggests the influence of social and contextual factors on smoking behaviour and on tobacco control effectiveness. Our findings highlight the need to effectively prevent children's SHS exposure at their home and to develop tailored tobacco control measures by region.This work was supported by FEDER through the Programa Operacional Factores de Competitividade - COMPETE (FCOMP-01-0124-FEDER-009117), and by FCT - Fundacao para a Ciencia e a Tecnologia (Ref. PTDC/CPE-CED/098281/2008)

Scientific and Legal Perspectives on Science Generated for Regulatory Activities

This article originated from a conference that asked “Should scientific work conducted for purposes of advocacy before regulatory agencies or courts be judged by the same standards as science conducted for other purposes?” In the article, which focuses on the regulatory advocacy context, we argue that it can be and should be. First, we describe a set of standards and practices currently being used to judge the quality of scientific research and testing and explain how these standards and practices assist in judging the quality of research and testing regardless of why the work was conducted. These standards and practices include the federal Information Quality Act, federal Good Laboratory Practice standards, peer review, disclosure of funding sources, and transparency in research policies. The more that scientific information meets these standards and practices, the more likely it is to be of high quality, reliable, reproducible, and credible. We then explore legal issues that may be implicated in any effort to create special rules for science conducted specifically for a regulatory proceeding. Federal administrative law does not provide a basis for treating information in a given proceeding differently depending on its source or the reason for which it was generated. To the contrary, this law positively assures that interested persons have the right to offer their technical expertise toward the solution of regulatory problems. Any proposal to subject scientific information generated for the purpose of a regulatory proceeding to more demanding standards than other scientific information considered in that proceeding would clash with this law and would face significant administrative complexities. In a closely related example, the U.S. Environmental Protection Agency considered but abandoned a program to implement standards aimed at “external” information