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Navigating Legal Barriers to Effective Public Health Emergency Response
Meredith Allen, DrPH, MS
Director, Preparedness and Strategic Partnerships
ASTHO

2. ASTHO Legal Barriers Project
Objective
To develop and share with the practice community sets of tools that all public health officials can use to improve their understandings of critical legal barriers to effective infectious disease response and devise approaches to eliminating those barriers that reflect useful practices

3. Precursor to Legal Barriers Project
H1N1 Policy Barriers Project
Environmental scan, survey, state-based field assessments, advisory workgroup input
Report: Assessing Policy Barriers to Effective Public Health Response, June 2010
200 barriers identified
31 prioritized as frequent, significant, and/or pressing

4. Legal Barriers Project
Advisory Committee ranked legal topics identified in Policy Barriers project
Topics prioritized for the development of tools:
Statutory Authorities and Liability Protections
Emergency Use Authorizations
Public Health & Schools
Expanded Scope of Practice

5. ASTHO Legal Preparedness Toolkits
Project has its genesis in responses to H1N1 and prior infectious disease and other emergencies
Found that two types of legal issues arose:
Some unique to or arising in that event (“new”)
Others perennial with each event (“old”)
Wanted a way to address “old” and “new” issues for different and changing audiences

6. Focus of Toolkits For use by multiple audiences Meet different needs
State and local health officers
Program staff
Legal counsel
Meet different needs
Learning or refreshing
Accessing additional resources
In preparation and response situations
Provide quick references

7. Eight Toolkits Developed
Emergency Authority & Immunity (EAI)
Emergency Use Authorization (EUA)
Public Health & Schools (Schools)
Scope of Practice (SOP)
Public Health & Information Sharing
Emergency Volunteers
Drug Shortage (in development)
Altered Standards of Care (in development)

8. Toolkit Overview
Each kit contains a mix of document types with different levels of detail about the issues covered in the toolkit
Access kits through a project introductory webpage on ASTHO’s website
Presented in multiple formats
Online at ASTHO website
Printable in PDF format

9. Document Types in the Kits
Table of Contents
Executive Overviews
Fact Sheets
Issue Briefs
State Analysis Guides
Current Issues Updates
Resource Materials Supplement

10. Toolkit Overview

11. Table of Contents

12. Table of Contents

13. Executive
Overviews
One-page snapshots of key concepts and issues

14. Fact
Sheets
One-page documents addressing fundamental issues or legal authorities

15. Fact
Sheets
One-page documents addressing fundamental issues or legal authorities

16. Issue
Briefs
In-depth information and analyses of fundamental issues

17. State Analysis
Guides
Aids to assist states in identifying and analyzing their own statutes, regulations, and policies

18. Current Issues
Updates
Periodic updates on new and evolving issues

19. Resource Materials Supplement
Bibliographies and links to key agencies, organizations, laws, and other documents

20. Resource Materials Supplement
Bibliographies and links to key agencies, organizations, laws, and other documents

21. Next Steps on Toolkits Evaluation of the toolkits
Link to survey on legal barriers website
Updates to first 4 toolkits
Reauthorization of Pandemic All-Hazards and Preparedness Act (PAHPA)

22. Acknowledgements CDC Office of Public Health Preparedness and Response
CDC Public Health Law Program
Pat Elliott, Logan Circle Policy Group
Members of the ASTHO Legal Barriers Advisory Workgroup
The Network for Public Health Law- Mid-States Regional Center, University Of Michigan