An Example in MAHC Adoption: The Indiana State Department of Health

Not too long ago in the fall of 2014, aquatics enthusiasts far and wide celebrated the release of the Center for Disease Control and Prevention’s (CDC) first edition of the Model Aquatic Health Code (MAHC), affectionately known as the “MAC,” and MAHC the Annex, the code’s supporting materials.  The result of over three years of negotiation and debate, the code is the first of its kind acting as a guideline for those in the aquatics profession to turn to as a standard and resource in the field. Fast forward to 2016 and we have recently been provided with the 2nd editions of the code and annex with changes reflecting initial experiences and feedback. 

So now the question….how is it really being used by policy makers and professionals out in the field? One place to look to track progress would be adoption by state departments of health, such as the Indiana State Department of Health. These governing bodies can act as a litmus test for examining how groups are working with and viewing the MAHC. 

The State of Indiana, now often known for its progressive moves in state government, was actually fairly quick to begin a process of reviewing the code and deciding what would be put forth for adoption. The process included the formation of a committee consisting of state board of health officials and staff along with stakeholders from both private and public factions. 

So how is it going and what can be learned from observing the Indiana process? After over a year of meetings, review, and debate, a final updated version is now being vetted through state legal channels for any issues recommendations may bring.                 

At this point we can say that nobody involved in the process ever expected that the MAHC would be taken in its entirety but instead taken by section, phrase, or even sometimes placed in to a section labeled best practices instead of in as actual code. Other items of note included the fact that the potential fiscal burden of adopting parts of the MAHC on entities often weighed heavily on the decision to not take on parts of the guideline. 

One exception in Indiana was in regards to the requirement of a certified pool operator for facilities. The sheer positive public health impact that this was seen to bring rose above any concerns of fiscal impact. One final area that seemed to come up often, voiced from those “in the trenches,” was the feasibly and reality of monitoring items that may be adopted as code. These were often the items that were pegged to be part of a best practices statement. 

While we wait for the MAHC recommendations to clear the legal channels and arrive before Indiana politicians for official adoption, we can educate ourselves about the impact of the MAHC by observing others who have completed the adoption process, such as New Mexico. Much can be learned from observing the successes and hurdles encountered by other MAHC adopters as we move closer to the inevitable time when the MAHC will have a policy effect on everyone working with aquatic venues; ultimately leading to safer, more enjoyable aquatic facilities for all.  


About the Authors

William D. Ramos, Ph.D.
Residing within the Indiana University School of Public Health –Bloomington as an Assistant Professor, Dr. Ramos’ research is focused on examining the impact of both built and natural aquatic environments on aspects relate to public health. Behind his research is over 30 years of practitioner experience in the field of aquatic management stretching from conventional pools and waterfronts to today’s modern waterparks. His insider exposure to the field of aquatic management has provided the impetus for research questions surrounding issues such as worksite wellness, physical activity, participant perceptions, drowning prevention, and recreational water illnesses.   

Research Gate Profile        Indiana University Faculty Profile        Aquatics Institute 

Allison Lee Fletcher, PhD Candidate
Allison Lee Fletcher is a Leisure Behavior PhD Candidate and Associate Instructor at Indiana University-Bloomington. She completed an MA in Sport Management from East Tennessee State University in 2012 and has been engaged in the field of recreational aquatics for more than ten years.  Ms. Fletcher’s research interests primarily revolve recreational aquatics and the legal aspects of sport and recreation.
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