Existing State Laws Research Articles

The market for model laws: The diffusion of NAIC model laws

AbstractThe National Association of Insurance Commissioners (NAIC) issues model laws to promote uniformity in the US state‐based insurance regulatory system. In this paper, we study the diffusion of 197 NAIC model laws, examining the adoption patterns and influencing factors. Employing a network algorithm, we uncover the underlying network over which model laws spread. The NAIC plays a central role in this network, and its influence increases over time. Additionally, we explore factors affecting states' model law adoptions from three perspectives: the laws' attributes, the states' internal characteristics, and external influences. We find that a law's attributes play a key role. Model laws characterized by low complexity, distinct from existing state laws, mandated for accreditation compliance, and recently amended are more likely to be adopted. While we do not find significant impacts of various state‐internal characteristics, our results reveal that states follow geographic and ideological neighbors in adopting model laws.

Factors that impact initiation of pain management agreements for patients on chronic opioid therapy.

This analysis seeks to understand variables within our institution that impact pain management agreement (PMA) utilization for chronic noncancer pain (CNCP). Retrospective chart review. Public academic medical center. Adults prescribed an opioid for CNCP between July 2020 and October 2020. We assessed the association between patient demographics, prescription factors, and prescriber factors with the presence of a PMA. Unadjusted rates and chi-square tests were generated for each predictor. Additionally, we performed two multivariable logistic regressions: one including all variables and another utilizing a stepwise forward variable selection process to further understand the relationships between predictors and the presence of a PMA. 49.7 percent of patients who received an opioid for CNCP had a PMA on file. One significant predictor of the presence of PMA was prescriber specialty with anesthesia/pain medicine, demonstrating 88 percent compliance. Compared to anesthesia/pain medicine, patients receiving opioids from internal medicine had an odds ratio (OR) of 0.155 (95 percent confidence interval (CI), 0.109-0.220), while patients receiving opioids from family medicine had an OR of 0.122 (95 percent CI, 0.090-0.167). Additionally, patients who received schedule II opioids (as opposed to schedule III/IV opioids), patients with multiple opioid fills in 3 months, middle aged patients, and Black patients were more likely to have a PMA. Compliance with PMA within our institution was only 49 percent despite an existing state law mandating use. Our analysis suggests quality improvement interventions should target patients on schedule III/IV opioids who receive their prescriptions from primary care providers.

Proceduralising indigenous peoples’ demands: Indigenous environmental rights and legal pluralism in contemporary jurisprudence

Biodiversity, climate change and environmental protection are commonly associated with indigenous peoples’ customs and holistic cosmovisions. This paper strives to uncover the legal rationale thereof, notably by identifying the procedural dimension underlying “indigenous environmental rights”, and the importance of collective and intergenerational rights in channelling indigenous environmental rights into dominant legal orders while facilitating the exercise of these rights. Grounded in Latin American jurisprudence, we understand environmental claims from the perspective of indigenous peoples’ rights, that is, their articulations in existing State law as well as the pertinence of legal pluralism as a transformative approach including its decolonising functions. It is examined to what extent such rights undergo processes of positivization or codification amidst the wide scenery of legal pluralist orders. Given their scarce procedural foundations, the main contribution lies with approaching indigenous environmental rights theoretically, exploring the possibilities for procedures in International Human Rights Law to be applied to them, including questions of representation, translation in a wider sense, or autonomies. Alongside classical procedural principles of human environmental law – information, participation, access to justice – indigenous environmental rights are related to concepts of guardianship, parental responsibility and best interest as these have been developed in relation to the rights of the child, or questions of autonomy and representation being derived from the framework governing persons with disabilities. In that sense, indigenous environmental rights find themselves (re-)imagined, including debates on vindicating these, their qualities and attributes as well as reflections on different procedural routes available.

Engaging with the State. Illegalized migrants, welfare institutions and the law in French-Speaking Belgium

By highlighting informal strategies and solidarities on the one hand, and protests on the other, current studies of citizenship and illegalized migration describe two main forms of political subjectivities among illegalized migrants: ‘without’ the state or ‘against’ it. In contrast, this article unpacks how migrants make use of state laws and institutions, voice expectations, and pursue their claims using official venues – in short, how they act ‘with’ the state. It builds on ethnographic fieldwork on illegalized migrants’ welfare requests in French-speaking Belgium and the various sets of actors involved in assessing or furthering their cases. Migrants’ discourses and expectations of the welfare office provide insights into their understandings of the state, highlight the crucial role of immigration lawyers in brokering cases, and ultimately allow for a more nuanced reading of the idea that welfare dependency leads to deportability. On a theoretical level, this article contributes to ongoing debates in the study of statehood and in migration studies, showing how procedural fairness can be a central aspect of migrants’ relationship to and expectations of the state, and how migrants’ strategies leading towards inclusion can be formal ones, based on existing state laws and institutions.

Associations Between State Laws Governing Recess Policy with Children's Physical Activity and Health.

State-level laws governing recess policies vary widely across the United States. We characterize the presence of such laws and assess their associations with child-level outcomes. The presence of a state recess law was determined using the Classification of Laws Associated with School Students (CLASS) database. Parents of 6- to 11-year-old children reported physical activity, overall health, school absences, school-related problems, and ability to make/keep friends as part of the National Survey of Children's Health (NSCH). Logistic regression was used to compare outcomes in states with and without recess laws cross-sectionally in 2018 and between 2003 and 2011/2012 using a difference-in-differences analysis. In 2018, 20 states had a law recommending or requiring recess. Cross-sectionally, the odds of being physically active every day (odds ratio, 95% confidence interval: 2.8, 1.2-6.5) and having no difficulty making or keeping friends (2.9, 1.2-7.2) were significantly higher for children residing in states with versus without a recess law. There were no significant associations in the difference-in-differences model. Significant cross-sectional associations in 2018 were not confirmed by a difference-in-differences analysis of two waves of the NSCH. Short follow-up time and the apparent weakness of existing state laws warrant further assessment of state-level recess law.

Craniofacial Injuries From Personal Watercraft Accidents.

Personal watercraft (PWC) use is a popular leisure activity. Although injuries associated with PWCs have been examined broadly, there is a lack of investigation into craniofacial injuries within this setting. This paper reviews the literature discussing PWC incidents and PWC-related craniofacial injuries. A comprehensive literature search of the MEDLINE, EMBASE, Google Scholar, and National Library of Medicine databases was conducted for studies published through January 2021. Articles were selected if they contained information on PWC accidents and related craniofacial injuries. We also examined 3 patient cases of PWC-related craniofacial injuries. Overall, our review suggests that over the past 20 years, injuries and accidents have decreased significantly whereas fatalities have decreased to a lesser extent. Most PWC-related craniofacial injuries result from blunt trauma and a notable number of deaths and traumatic brain injuries occur in adolescents. Given the increasing number of PWC sales, PWC-related craniofacial injuries may be more prevalent, which prompts improved regulations and protective gears. Existing state laws on PWCs vary dramatically. As of now, there is no uniform policy that requires protective equipment use like helmets or instruction before PWC use. There also should be limitations on alcohol consumption as well as age of the riders. Overall, our review indicates that more research is needed to reduce the number of craniofacial injuries among PWC riders.

PERLUASAN KEWENANGAN BPK DALAM MENGAWASI KEUANGAN NEGARA DI LINGKUP PEMERINTAHAN DAERAH

State budget management is tightly related to how the existing state law regulates fiscal relationship between the central government and the regional-local governments. The authority granted to regional-local government to manage their own budgeting more or less autonomously in practice results in mismanagement, misuse of available financial resources and even corruption. Unfettered and unchecked financial leakage at the regional government level may and have resulted in failure to realize and implement projects much needed by society. In light of this situation, a justified need arise for state intervention to monitor-control planning and realization of regional-local government budget. The author proposed the expansion of the Audit Board of the Republic Indonesia’s authority. They should not passively wait for financial reports to be submitted but actively assist regional-local government in planning their own budget, monitor the spending and realization of it and lastly, provide assistance in drafting the final report.

PERLUASAN KEWENANGAN BPK DALAM MENGAWASI KEUANGAN NEGARA DI LINGKUP PEMERINTAHAN DAERAH

State budget management is tightly related to how the existing state law regulates fiscal relationship between the central government and the regional-local governments. The authority granted to regional-local government to manage their own budgeting more or less autonomously in practice results in mismanagement, misuse of available financial resources and even corruption. Unfettered and unchecked financial leakage at the regional government level may and have resulted in failure to realize and implement projects much needed by society. In light of this situation, a justified need arise for state intervention to monitor-control planning and realization of regional-local government budget. The author proposed the expansion of the Audit Board of the Republic Indonesia’s authority. They should not passively wait for financial reports to be submitted but actively assist regional-local government in planning their own budget, monitor the spending and realization of it and lastly, provide assistance in drafting the final report.

The Psychology of Nonconsensual Porn: Understanding and Addressing a Growing Form of Sexual Violence

As of 2020, legal protections for victims of image-based sexual abuse in the United States remain inadequate. For example, no federal law yet criminalizes the sharing of sexually intimate material without a person’s consent (i.e., nonconsensual porn), and existing state laws are patchy and problematic. Part of the reason for this problem may be that U.S. lawmakers and the general public have yet to grasp that nonconsensual porn is a form of sexual abuse, with many of the same devastating, recurring, and lifelong consequences for victims. This review of psychological research on nonconsensual porn includes frameworks for understating this image-based sexual abuse, correlates and consequences of victimization, victim blame, and the nature of perpetration. Then, we analyze U.S. laws on nonconsensual porn in light of this review and argue for comprehensive legislative solutions.

93. Certificate-of-Need state laws and elective posterior lumbar fusions: a Medicare trends, costs and outcomes analysis

BACKGROUND CONTEXT Certificate-of-Need (CON) state laws have been a major mandate of health policies aimed at forming centralized health planning as a key-core of the US health care system. Though the federal CON mandate was repealed in 1986, several states still continue to use it as a means of limiting health care resource utilization while attempting to provide quality care in high-volume facilities. PURPOSE The current study aimed to utilized a national Medicare claims dataset to assess whether elective posterior lumbar fusions (PLFs) performed in CON vs No CON states had lower utilization rates, lower costs, and better quality of care. STUDY DESIGN/SETTING Retrospective review of administrative claims from the 100% Medicare Standard Analytical Files (SAF100). PATIENT SAMPLE The 2005-2014 100% Medicare Standard Analytical File (SAF100) was queried to identify patients undergoing elective 1-to-3 level PLF. OUTCOME MEASURES Trends in utilization during the study period (2005-2014), average 90-day costs/reimbursements, 90-day complications and 90-day readmissions. METHODS Patients were categorized into ‘CON’ and ‘No CON’ based on existing state laws where they received the procedure. For each group (CON vs No CON), differences in per-capita utilization, 90-day reimbursements and proportion of high-volume facilities (>150 procedures/year) vs low-volume facilities (≤50 procedures/year) have been reported. Multivariate analyses were used analyze 90-day complication/readmission rates between the two groups. RESULTS A total of 188,687 patients underwent an elective 1- to 3-level PLF in a CON state and 167,642 patients received the procedure in a No CON state from 2005 to 2014. The average per capita utilization of PLFs was lower in CON states as compared to No CON states (14.5 vs 15.4 per 10,000 population; p CONCLUSIONS While the presence of CON laws was associated with lower utilization of elective 1-to-3 level PLFs, and a greater presence of high-volume facilities, the mandate's effect on enhancing quality-of-care, by reduction of 90-day readmissions and 90-day complications is minimally significant. Future research, involving other surgical subspecialties, is needed before health policy makers may consider the removal or alteration of these laws. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Knowledge and Beliefs About Pedestrian Safety in an Urban Community: Implications for Promoting Safe Walking.

As more people walk for transport and exercise, it is possible to avoid a concomitant increase in the number of pedestrian injuries. Understanding how the public views pedestrian safety can help inform the development of prevention strategies that support national efforts to promote walking and walkable communities. As part of the formative research for a community pedestrian safety health promotion campaign, we administered an online questionnaire to employees and students at a large urban medical campus, along with residents in the neighboring communities, to determine their knowledge, attitudes, and behavior regarding pedestrian safety; awareness of relevant traffic safety laws; and effective strategies that could improve pedestrian safety. Pearson Chi square Test of Independence was used to investigate differences between individuals who mainly traveled as drivers versus those who mainly traveled as pedestrians. Statistical significance was established at p < .05. A total of 3808 adults completed the online survey. More drivers than pedestrians reported that pedestrian safety was an important problem (73 and 64%, respectively; p < .001). A large proportion of respondents incorrectly reported the existing state laws addressing right of way, fines, and enforcement, with significant differences between drivers and pedestrians (p < .001). Significantly more pedestrians than drivers supported changing traffic signals to increase crossing time (p = .001), while more drivers than pedestrians supported creating structures to prevent midblock crossing (p = .003). Effective interventions to improve pedestrian safety need to tailor messages for both drivers and pedestrians, increase awareness of the laws, and implement comprehensive strategies.

'The Chatbot Will See You Now': Mental Health Confidentiality Concerns in Software Therapy

Woebot, a chatbot leveraging cognitive behavioral therapy techniques, promises to provide a new area of software therapy, in which users can use software to address feelings of anxiety or depression. Similar technologies claim to provide chat or support, but not treatment so as to avod FDA oversight. Regardless, the current privacy framework of the U.S. provides no confidentiality obligations on these apps, even though states provide similar restrictions on use and disclosure on licensed mental health professionals. This Article argues that new legislation is necessary to protect the use and disclosure of information submitted by consumers to chatbots intended for use as electronic therapists. It looks at existing state laws, the senstitivity of mental health information and need for greater confidentaility protections, as well as the Supreme Court opinions in Jaffee v. Redmond as a guide. Ultimately, it concludes that cognitive behaviorally trained therapy A.I. intended for use by consumer as such should be subject to heightened confidentiality requirements.

Is a Minimum Age of Juvenile Court Jurisdiction a Necessary Protection? A Case Study in the State of California

Several U.S. states are considering setting or raising a minimum age of juvenile court jurisdiction. However, there is scant evidence to suggest if a state minimum age law would protect children from developmentally inappropriate proceedings beyond existing capacity and competency statutes. To address this central question, this case study focuses on the state of California and considers (a) existing state laws, (b) state juvenile crime data, and (c) opinions of diverse juvenile justice stakeholders. Triangulated analysis found that a low number of California children below the age of 12 years are petitioned in juvenile court and most are referred for misdemeanor or status offenses. Existing legal protections are present yet inconsistently implemented. A minimum age law would address some of these policy gaps.

Open Records, Shuttered Labs: Ending Political Harassment of Public University Researchers

This Article confronts a dangerous contemporary trend: the political harassment of public university professors by activists on the right and left, through the mechanism of open records requests. It is timed to a moment when universities and state legislatures are grappling with the consequences of escalating public-records intrusion into scholars’ work that threatens enterprises as diverse as climate change research and biomedical experiments. Every U.S. state has an open records law — a statute that permits any person, for any reason, to access the records of public agencies. Unknown to many, these state laws typically sweep public universities within their definition of “agencies,” making professors’ draft manuscripts, e-mails, and even exam questions potentially fair game for records requesters. In the past decade, scholars in states with broad open records laws have increasingly received harassing records requests from requesters politically or economically threatened by the intellectual work they seek to reveal. Such requests undermine the peer review process and the communications through which scholars explore and contest ideas, impairing the core intellectual functions of the university. Equally worrisome, harassing record requests chill research on critical contemporary issues — a knowledge-generation role of universities that is essential to a democracy, which depends on an informed citizenry. This Article argues that professors should never have been subject to public records laws in the first instance, both because they are not engaged in public governance, and because open records laws are fundamentally incompatible with academic freedom. It further argues that the best way to stanch the present records request intrusion into scholars’ work is to create a broad scholar-records exemption from existing state laws. While some commentators have described the problem of public records harassment of university faculty, none have presented an in-depth theoretical justification for reform, nor an examination of the full range of harms stemming from public demands for scholar records. This is also the first article to propose a specific legislative fix, informed by real-world legal battles over scholar records disclosure. By presenting the most comprehensive and prescriptive issue treatment yet, this Article aims to help open records reform cross the political finish line.

Rainwater Harvesting in Colorado and the Quandary of a Taking

Although rainwater harvesting would appear to be a win-win solution to the problem of developing new sources of water, implementing rainwater harvesting in the American West has been fraught with tensions that have pitted rural farmers and other agricultural interests against urban and suburban homeowners. The water law of the western states is based on the prior appropriation doctrine, which creates a “first in time, first in right” system of water rights tied to when a user diverts surface water for beneficial use. Since water rights are property rights, state statutes and regulations that “go too far” in affecting them risk giving senior appropriators a takings claim. Based on the nature of rainwater harvesting and judicial interpretations of federal and state constitutional takings clauses, the most likely claims by downstream agricultural irrigators in the West are that state statutes authorizing rainwater harvesting are per se physical takings. Such takings require compensation, even though they do not result in the total loss of the right to use water or have a minimal economic impact on a senior appropriator. To avoid a taking, state legislatures need to draft these statutes in ways that take advantage of how existing state laws implement the prior appropriation doctrine. Colorado’s most recent rainwater harvesting statute leverages how the no-injury requirement placed on junior appropriators ultimately limits the scope of the senior appropriators’ water rights and avoids a taking.

Are advanced practice pharmacist designations really advanced?

Four states have created advanced practice pharmacist designations in state law: advanced practice pharmacist (California), clinical pharmacist practitioner (Montana and North Carolina), and pharmacist clinician (New Mexico). To attain an advanced pharmacist designation, states typically require a fee and set a minimum education requirement either through continuing pharmacy education (CPE) or through attainment of a national certification or completion of a residency. Once attained, pharmacists may practice with additional scope of practice authorities, namely the ability to order and interpret drug therapy-related tests, and initiate or adjust/modify medications under a collaborative practice agreement (CPA). Uptake of advanced practice pharmacist designations has been light (range: 0.35%-9.8%). The additional scope of practice authority is on par with, and in some instances more restrictive than, other states with fewer barriers to entry. As such, the excitement surrounding advanced pharmacist designations may be disproportionate to the actual scope of practice gains when compared to other existing state laws.

Public Records Denials

Transparency and openness in our national, state and local governments is a cardinal principle in our democratic system. Since 1967, the Freedom of Information Act has been the primary applicable law which enables citizens to obtain public information from executive branch agencies of the federal government. Essentially every state also has a freedom of information act, public records law, or similar law which allows citizen access to public documents and records. A largely unexplored area of the academic literature involving freedom of information laws relates to the sanctions or penalties which may exist for noncompliance. This Article advocates for changes and revisions to existing state laws to provide for more stringent penalties in the event a public records request is knowingly denied. Enhanced penalties and legal consequences for improper public records request denials are critical to ensure open and transparent access to public information.

Personally Identifiable Information in State Laws: Use, Release, and Collaboration at Health Departments.

Despite benefits to sharing data among public health programs, confidentiality laws are often presumed to obstruct collaboration or data sharing. We present an overview of the use and release of confidential, personally identifiable information as consistent with public health interests and identify opportunities to align data-sharing procedures with use and release provisions in state laws to improve program outcomes. In August 2013, Centers for Disease Control and Prevention staff and legal researchers from the National Nurse-Led Care Consortium conducted a review of state laws regulating state and local health departments in 50 states and the District of Columbia. Nearly all states and the District of Columbia employ provisions for the general use and release of personally identifiable information without patient consent; disease-specific use or release provisions vary by state. Absence of law regarding use and release provisions was noted. Health departments should assess existing state laws to determine whether the use or release of personally identifiable information is permitted. Absence of direction should not prevent data sharing but prompt an analysis of existing provisions in confidentiality laws.

Abstract 024: Public Access Defibrillation State Law Assessment: Do Current Laws Align With Best Available Evidence?

I. Introduction: Cardiac arrest (CA) is a leading cause of death in the U.S. An estimated 70-90% of people experiencing out-of-hospital CA die before reaching the hospital. Applying cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) within minutes of CA can dramatically raise survival rates. Public Access Defibrillation (PAD) laws can facilitate rapid AED application by lay bystanders. This study assesses whether existing state laws align with best available evidence for PAD implementation to assist decision makers in strengthening existing PAD policies. II. Methods: Two analysts applied CDC’s Quality and Impact of Component (QuIC) Evidence Assessment to appraise the strength of evidence bases for 9 PAD program “policy components,” defined as discrete requirements, provisions, or other elements within a public health policy. Analysts utilized subject matter experts (SME), PubMed, and grey literature to collect evidence and identify 9 policy components. Analysts independently coded evidence across 8 dimensions of evidence quality and public health impact. Resulting scores were used to rank the policy component evidence bases into 3 categories; best, promising or emerging. To identify policy components found in state law, two legal researchers reviewed PAD peer-reviewed and grey literature and analyzed 10 states’ laws using Westlaw. The results were used to construct variables for a legal dataset. Researchers coded and categorized the components in statutes and regulations for all 50 states and Washington, D.C, in effect as of December 31, 2015. Researchers conducted descriptive analysis of the legal dataset and examined correlations with the QuIC policy component results. III. Results: Fifty jurisdictions had PAD laws in effect as of December 31, 2015, authorizing at least one of the 9 evidence-informed PAD policy components (maximum: 8; median: 6). The QuIC assessment categorized 3 components “best”, 4 “promising” and 2 “emerging.” The most common components found in law were PAD use training (best), EMS coordination (best) and lay bystander limited liability (emerging). No state authorized all 9 components. However, 3 states authorized 8 components and 12 states authorized all 3 best components. Two states authorized only lay bystander limited liability (emerging). IV. Implications: There is strong evidence of potential public health impact for targeted AED placement, user training, and EMS PAD coordination, yet two thirds of states have not enacted all three policy components. The Institute of Medicine recommends developing policy strategies and addressing legal barriers to bystander CPR and defibrillation to improve CA outcomes. Studies directly evaluating the role of PAD law in cardiac arrest response and associated health outcomes are needed to determine the best policy approaches to meet state needs and contexts.

'They Can Have My Hose When They Pry It from My Cold Dead Hands': When California Is Faced with a Drought, Who Gets Water and Who Goes Without?

California is drying up. Rivers and lakes have become cracked patches of earth. Water tables have dropped so low that tap water is a memory in some towns. Fields that once fed the nation, the globe, lie fallow, baking in the dusty heat. What seems like a matter for the state’s environmental agencies is actually a grave concern for the entire nation. With the largest American economy and extensive food production obligations, California is too big to fail, and without water it will. Judges, lawyers, agencies, and water consumers have found that California’s water law system is poorly equipped to handle the new conditions of the drought. Some uses of water, once appropriate and reasonable, are now unconscionably wasteful. Judges may find that old, familiar precedents must be adapted to the new environment or abandoned all together. Though California prioritizes domestic water use over irrigation for commercial agriculture, the state’s courts must take care to minimize the impact their decisions may have on agriculture, staving off calamity until policy and legislative changes can ensure the state’s long-term economic and environmental viability. This Comment outlines the issues California’s courts will face, analyzes how existing state law can address those issues in the short-term, and proposes potential solutions that the courts, the state legislature, and Congress may implement.