I didn't expect today's blog cycle to be the Thoughtless Comments from South Dakota Republicans series, but the hits keep coming.

Facebook friends share comments made at CPAC by Rapid City-born, San Diego-based former Noem intern turned conservative spokesmodel Tomi Lahren, who, in response to the charge that the GOP is the party of old, rich, white males, calls Hillary Clinton and Elizabeth Warren men:

So, I think we’ve gone through this: Old, rich, white males. I want to remind you, let’s look at the top three Democrats for 2016. You’ve got Hillary, Elizabeth Warren, Joe Biden? Old, rich, white, and if the pantsuit fits, male too? [Tomi Lahren, quoted in Tony Ortega, "CPAC Speaker Calls Hillary Clinton and Elizabeth Warren 'Old, Rich, White Males'," Raw Story, 2015.02.28].

Such absurdity warrants no rebuttal. But warranting more attention is Lahren's pro-choce declaration:

See, women like Sandra Fluke will have you believe the only way to be pro-woman is to lobby for free birth control. But, sorry, hun, I’m a Republican, and I can take care of myself. And besides that, I don’t know about you, but I don’t really want the government anywhere near my body or my health choices, because have any of you seen how Obamacare or ‘healthcare dot dud’ has been working out? [Lahren, in Ortega, 2015.02.28]

Lahren cites her South Dakota upbringing in her speech to boost her down-home cred, so she must stay in touch with South Dakota politics. She must know her Republican kin back home have passed all sorts of laws dismissing the notion that little ladies like her have the mental wherewithal to take care of themselves.

But CPAC and the conservative media don't pick speakers like Lahren for their rhetorical rigor or mental acuity.

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Last week, the Capitol Crud (the flu that's been making the rounds under the dome) kept Rep. Lynne DiSanto (R-35/Rapid City) from attending Thursday's House Health and Human Services hearing and casting the deciding vote on House Bill 1166, this year's effort to restrict minors' use of tanning beds.

I visited with Rep. DiSanto today at the Capitol. She's back in fine fettle and ready to pull HB 1166 out of limbo and cast it into perdition. Rep. DiSanto says she won't let her own kids use tanning beds (boys, go out and get some real sun!), but she prefers parental control to government regulation of fake-bakery.

So unless HB 1166 prime sponsor Rep. Scott Munsterman (R-7/ Brookings) can change one mind tomorrow morning, his youth tan-ban is toast.

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An hour and a half of riveting testimony and vigorous committee debate resulted in stalemate for the tan ban last week. House Bill 1166, a bill to ban minors from tanning beds, got its first hearing before House Health and Human Services last Thursday. The committee heard seven proponents and five opponents, including two lobbyists for the South Dakota Tanning Salon Association (yes, there is such an association). Committee members considered amendments to lower the ban age to under 14, to allow 14- to 18-year-olds to tan with consent from a parent and a physician, and to allow those teens to tan with just a note from a parent. The latter amendment came close to passing, but foundered, like the bill itself, on a 6–6 vote. Chairman Scott Munsterman, unable to secure one more vote, had to defer his bill to February 19.

Rep. Lynne DiSanto, R-35/Rapid City

Rep. Lynne DiSanto, the House needs your mild and beneficent glow!

The stalemate happened because HHS committee member Rep. Lynne DiSanto (R-35/Rapid City) skipped work Thursday. That's too bad, because Rep. DiSanto, Rapid City's maven of modeling, knows a thing or two about young women and fake tans. Rep. DiSanto surely could have shone a fierce professional light on the issue and helped the committee come to a decision.

So when Rep. DiSanto comes to committee Thursday, how will she tilt the vote? Will she pick up Teen Vogue and deem fake-baking the new smoking? Or will Rep. DiSanto stand for carcinogenic liberty with her bronzed commodities and Facebook Likes?

p.s.: Eleven states ban minor use of tanning beds. 41 states have some sort of minor-tanning regulations. South Dakota has no such regulations.

pp.s.: So if the Legislature passes both HB 1166 and HB 1212, which defines embryos as minors in an attempt to ban abortion, will that mean pregnant women won't be able to use tanning beds?

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Oh look: South Dakota's #2... in measles!

Measles map, New York Times, February 2, 2015

Measles map, New York Times, February 2, 2015.(Click to embiggen!)

Asterisk our #2: four of the cases mapped around Mitchell are folks from other states inflating our numbers.

I heard Senator Rand Paul on NPR yesterday saying he's not against vaccinations but that "it is an issue of freedom" for parents choosing how to take care of their children.

I'd tell Senator Paul that choosing not to vaccinate your kids is like choosing to smoke in the house while your kids around. You have the freedom to make that choice, but it's a stupid choice, based with few exceptions on ignorance and selfishness. And you're not making that choice in some remote Galt's Gulch utopia; you're making that choice here, in real society, surrounded by real people whose lives your choice will negatively impact.

Go ahead, exercise your freedom. But keep your cigarettes and your measles-prone children away from my child.

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Tuesday's debate in the House Health and Human Service Committee over House Bill 1058 suggests that some South Dakota lawmakers spend more time listening to the uninformed paranoia of constituent e-mails than (a) reading what the bills before them actually say or (b) trying to apply their purported ideological principles consistently

House Bill 1058 is the South Dakota Department of Health's effort to update South Dakota's statutes on managing and preventing disease outbreaks. Much of the bill clears out 1950s/1960s-era language focusing on tuberculosis and makes clear that the Department's epidemic-fighting authority applies to communicable diseases like Ebola and virulent agents weaponized for bioterrorism.

Deputy Secretary of Health Tom Martinec did a good job of explaining in committee Tuesday (listen to his testimony beginning just after timestamp 16:08) what HB 1058 does and what it does not do. Among the does-not-dos:

  • HB 1058 does not make it a crime to have a communicable disease.
  • HB 1058 does not make it a crime to expose others to a communicable disease; current statute already does that. Section 4 of HB 1058 preserves that language.
  • HB 1058 does not give the state the authority to force vaccinations; SDCL 34-22-6 outlaws forced vaccination. Section 15 of HB 1058 requires folks suspected of carrying Category I diseases or diseases declared a public health emergency to get diagnosis and treatment. Section 15 does not order preventive measures like vaccines.
  • HB 1058 does not force South Dakotans to submit to a specific government mandated treatment; Section 16 preserves language on the books since 1963 protecting individuals' right to seek diagnosis and treatment from their own doctors.

From my own reading of HB 1058, I add the following observations of things HB 1058 does not do:

  • HB 1058 does not give the Department of Health new quarantine powers. SDCL 34-22-1 already empowers the Department of Health to essentially close the state's borders to stop any communicable disease and detain any person carrying a disease threat across our borders. SDCL 34-22-9 already authorizes the Department of Health to "Prescribe methods and procedures for the control of communicable disease patients and carriers," which clause is not qualified with any restriction on quarantine. Sections 2 and 7 of HB 1058 simply clarify existing quarantine power.
  • HB 1058 does not preserve three 1963 statutes (SDCL 34-22-7, -37, and -40) that required the state to pay for tuberculosis treatments. I understand the policy distinction here: in 1963, the state was declaring war on tuberculosis, committing to eradicating the chronic public health threat, while HB 1058 makes clear the authority of the Department of Health to confront new and evolving public health threats. But I do find it a bit odd that HB 1058 does not make explicit our willingness as a community to bear the cost of implementing our own epidemic control procedures... especially when this same state government refuses expand Medicaid under the Affordable Care Act to help tens of thousands more South Dakotans be able to afford the kind of diagnosis and treatment the state might mandate.
  • Perhaps most importantly, HB 1058 does not appear to reduce any due process rights available under current law. Section 33 makes explicit the procedure the Department of Health can already follow to obtain a court order to enforce quarantines and other public health interventions. As Deputy Secretary Martinec explained in committee, a public health intervention order states that individuals have a statutory right to contest the order in court.

Contrary to the clear text of HB 1058 and the clear explanation from Deputy Secretary Martinec, a clump of conservative Republican legislators lobbed a jumble of unfounded fears and ill-formed anti-government rhetoric at this public health measure. Newly elected Rep. Steven Haugaard (R-10/Sioux Falls) asserted that the bill seems to expedite the due process of individuals, despite the absence of any language in the bill changing whatever due process surrounds court orders on quarantines or other measures. Rep. Haugaard fretted over the prospect that HB 1058 could expand to include flu (even though he himself acknowledged flu is a not a Category I disease subject to the bill text before the committee), but then fretted that flu is killing more people in South Dakota than the Ebola that motivated HB 1058.

Rep. Haugaard and Rep. Steve Hickey (R-9/Sioux Falls) both complained that HB 1058 was like the overreach of authority that government committed following the September 11, 2001, terrorist attacks, yet neither legislator proposed an amendment to repeal the public health emergency law passed overwhelmingly by the South Dakota Legislature in 2002 that gives the Department of Health some of the "overreach" power it can use with or without HB 1058.

Rep. Haugaard offered as his legislating principle a sort of arch-conservative shadow-of-a-doubt standard: he said that if anything about a bill gives legislators pause—and he noted that even the supporters of HB 1058 expressed concern about protecting individual liberties—then we should vote the bill down. Rep. Haugaard evidently wasn't paying attention in 2012, when one of the main Republican arguments defending the education reform bill that raised numerous doubts about was that we couldn't just do nothing, that we had to try some sort of change and see if it worked.

Rep. Haugaard even asserts that the Ebola epidemic in Africa was overblown. The only reason the concern may look overblown now is that African countries took steps at least as drastic as the provision of South Dakota law clarified by HB 1059 to stop Ebola in its tracks.

Rep. Lana Greenfield (R-2/Doland) said that making people take their temperature twice a day and putting them in a holding tank seems extreme to her. She said she'd rather be stoned in the town square. Baffled as to how to respond to that nuttiness, Deputy Secretary Martinec thanks Rep. Greenfield for her comment, said he "would respectfully disagree," and characterized HB 1058 as a reasonable and judicious effort to balance individual freedom with protection of the public.

Of all people, committee chair Rep. Scott Munsterman (R-7/Brookings) closed the discussion of HB 1058 with one of the most sensible comments on rights: "Think about the masses who also have the liberty to be disease free and not be exposed."

Rep. Munsterman's sentiment, a Republican embrace of the general welfare over extreme individual liberties, won the day, leading an 8–5 vote to send HB 1058 to the House floor. The bill has been deferred, as the Department of Health, far from plotting an authoritarian takeover, is working on clarifications to address the concerns it has heard.

Frankly, the only amendment it appears we need is a provision to quarantine radical conservatives from infecting the Legislature and threatening public health with their ideological nuttiness and blindness to the text on the page.

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SDFT MMBB

Sioux Falls Free Thinkers pro-medical marijuana billboard layout, January 2015.

Ryan Gaddy of South Dakotans Against Prohibition tells us that legislation promoting medical marijuana will be available for anyone who wants to take it to Pierre. Gaddy apparently has found allies among the Sioux Falls Free Thinkers, who are bankrolling thirteen billboards around Sioux Falls.

Whether Gaddy can find allies in the Legislature is another question. The only faintly pot-friendly bill in last year's session was Senate Bill 113, which eased the activities suspension period for high school students busted for drugs, and the focus of that bill was still on telling kids, "Don't do drugs." A lively but small bipartisan coalition got HCR 1017, a resolution supporting industrial hemp, through the House but not the stodgy old Senate and industrial hemp just goes on your body, not in your body. Emery medical marijuana advocate Melissa Mentele of South Dakota Family Coalition for Compassion* told the press last Friday that she still hasn't found a legislator to carry her group's proposal this year.

A few candidates (Weiland, Myers) expressed their support for medical marijuana in the 2014 election, but that issue didn't appear to translate into any major mobilization of voters. Whether that's because the pro-medical marijuana candidates didn't push the issue hard enough or because there is no broad support for the issue is an open question.

*Correction 16:23 CST: Melissa Mentele makes very clear below that she is not at all affiliated with SDAP. My original wording did not indicate her affiliation but failed to credit her group as working on a bill in search of a sponsor. I regret the error.

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Let me give credit where credit is due. Governor Dennis Daugaard has dedicated his first column of the new year to telling the anti-vaccine crowd that the resurgence of measles is their fault, that they are wrong on science and social responsibility, and that they need to get their shots:

Avoiding vaccination has been a recent trend. As the memory of these diseases fades into the past, too many people seem to forget the risk of not vaccinating children. Unsubstantiated and discredited theories about side effects have created unreasonable anxiety. Medical professionals, repeated scientific studies and organizations such as the American Academy of Pediatrics agree that vaccination is vital and safe.

I recognize that there are extreme circumstances where a child may not be able to receive specific vaccines because of a severe allergy or condition. In South Dakota, we also allow people to forgo a vaccination for religious reasons. But for the overwhelming majority of people, vaccines are safe and reliable.

Not vaccinating doesn’t just affect you and your kids. It puts others at risk as well. Just as the polio vaccine protected millions of children from disease in the 1950s, vaccines save lives today. Vaccination is just as necessary today as it was decades ago [Gov. Dennis Daugaard, "Vaccinating Saves Lives," press release, 2015.01.02].

This KSFY graphic leaves me wondering whether we've got measles or a chocolate allergy.

This KSFY graphic leaves me wondering whether we've got measles or a chocolate allergy.

I've razzed the Governor, just a little, for not raising the alarm about the anti-vaccers threat to public health. Now he's done just that. Thank you, Governor!

By the way, before the weekend, the Department of Health confirmed nine cases of measles in Mitchell, all in the same extended family, none vaccinated, and none of the children in public school.

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Last summer, Governor Dennis Daugaard expressed concern that the 21 vaccinated and screened child refugees placed in South Dakota posed a health risk to our fair state. Governor Daugaard should have been more concerned about the health risk posed by local yokels not getting their shots. Thanks to the vaccination paranoia promoted by certain members of the Governor's party, such shot-resistors have brought South Dakota its first measles outbreak since 1997:

According to health officials, the six people that have been diagnosed with the virus are in Davison County, and are made up of three adults and three children. The children range from under the age of five all the way to teenagers.

Health officials say they are all part of an extended family that came together for a holiday celebration. None of them are vaccinated against the measles.

...Several other people are showing symptoms and are being closely monitored. The state is also in contact with about 50 other people who may have been exposed to the virus [Rachel Skytta, "Six Confirmed Cases of Measles in SD," KDLT-TV, 2014.12.31].

South Dakota actually leads its federal Health and Human Services region in MMR vaccination rates at 93.1%. The national rate is 91.1%. Our neighbors in Minnesota are only at 90.8%. (Michele Bachmann is apparently infectious.) Think of those numbers this way: if one of those infected Davison County anti-vacciners walked through the food court at the Mall of America and sneezed a few times, he could have infected one out of eleven people.

The state Department of Health says measles causes brain damage in one out of a thousand cases and death in three out of a thousand cases. SDDoH says measles is highly contagious and can spread by direct contact or by airborne droplets. It is thus less deadly but more contagious than Ebola, which had Senator John Thune calling for a big-government travel ban to prevent the remote possibility of that disease spreading. Fellow blogger Larry Kurtz wonders why Thune is not now calling for a travel ban on Mitchell, but that wondering expects of our Senator logic and consistency, things to which Republicans have developed a strong herd immunity.

The Affordable Care Act has required insurance companies to cover vaccines for four years. The measly Davison County family could have taken advantage of their health plan to get their shots at no additional costs. Instead, they've chosen to become a hazard to people with allergies or compromised immune systems (like kids with leukemia undergoing chemotherapy) who cannot get the MMR shot.

Vaccination rates have been declining nationwide based on no solid scientific evidence of vaccine harms. At the same time, outbreaks of measles and other diseases for which we have vaccines are rising. We can go back to the bad old days when nearly everyone got measles, or we can knock off the vaccine paranoia and get our shots.

And for now, put off that trip to the Corn Palace.

Related Reading: Alas, I'm probably just making matters worse: recent research shows that public health messages promoting vaccines and efforts to debunk anti-vaccine myths only strengthen parents' resolve not to vaccinate their kids. There's just no communicating with some people. Might as well ship them to the FEMA camps....

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