2. Bioterrorism and Legal Issues: The New Mexico Experience Clifford M. Rees Assistant General Counsel New Mexico Department of Health NGA Regional Bioterrorism Workshop San Francisco, California May 13-14, 2004

3. New Mexico Has Broad Statutory Powers Regarding Public Health Issues Public Health Act (Emergency powers contained in the Act originate from the Laws of 1919, Chapter 85, Section 10) Additional Powers include: Health Facility LicensureHealth Facility Licensure Disease ReportingDisease Reporting Involuntary Detention for Threatening Communicable DiseasesInvoluntary Detention for Threatening Communicable Diseases

4. New Mexico Has Broad Statutory Powers Regarding Public Health Issues New Mexico Has Broad Statutory Powers Regarding Public Health Issues EMS Act Provisions include: Licensure of EMTsLicensure of EMTs Air Ambulance CertificationAir Ambulance Certification Trauma Care System DesignationTrauma Care System Designation Other ProvisionsOther Provisions

5. New Mexico Has Broad Statutory Powers Regarding Public Health Issues New Mexico Has Broad Statutory Powers Regarding Public Health Issues Other Acts Primary CarePrimary Care ImmunizationsImmunizations Harm ReductionHarm Reduction Vital StatisticsVital Statistics

6. Public Health Law Modernization Model State Public Health Privacy Act (October,1999) www.critpath.org/msphpa/privacy.htm Model State Public Health Act (September, 2003) www.turningpointprogram.org/Pages/MSPHAfinal.pdf

7. Central Office (Santa Fe)Central Office (Santa Fe) 4 District Health Offices4 District Health Offices 53 Local Health Offices53 Local Health Offices All staffed by State employeesAll staffed by State employees NM Department of Health (DOH) Centralized Public Health System

8. Y2K Roll out of DOH’s revised Emergency Operations Roll out of DOH’s revised Emergency Operations Plan (EOP) September, 1999 Plan (EOP) September, 1999 Tour of State Emergency Operations Center (EOC) Tour of State Emergency Operations Center (EOC) Introduction to Incident Command System (ICS) Introduction to Incident Command System (ICS) Infectious Disease Scenario Infectious Disease Scenario Events Triggering Increased Focus on Public Health Emergency Preparedness

9. Cerro Grande Fire - Los Alamos, NM May, 2000 First Use of ICS by DOH First FEMA grant for Crisis Counseling Assistance under the Stafford Act administered by DOH

10. Anthrax Attacks – October 2001 Events of 9/11 Smallpox Vaccination Program – 2002-2003 CDC/HRSA Federal funding initiatives 2002-Present SARS Outbreak – 2002-2003

11. Legal Developments Model State Emergency Health Powers Act (Fall, 2001) www.publichealthlaw.net/MSEHPA/MSEHPA2.pdf www.ncsl.org/programs/health/modelact.pdf NM Interim Legislative Health and Human Services Committee (November 27, 2001) Tri-Agency Attorney Emergency Management Workgroup (December, 2001)

12. 2002 “Short”Legislative Session 2002 “Short” Legislative Session -Senate Bill 136 (Passed) Approval of in-state and out-of state licensees - Senate Bill 149 (Passed) Emergency Procurement Emergency Procurement -House Bill 261 (Passed) Review and update State All-Hazard Plan Review and update State All-Hazard Plan Conduct emergency tests

13. 2002 “Short”Legislative Session 2002 “Short” Legislative Session Senate Joint Memorial 62/House Joint Memorial 34 DOH, Department of Public Safety, Attorney General’s Office to convene a work group to evaluate state emergency powers DOH, Department of Public Safety, Attorney General’s Office to convene a work group to evaluate state emergency powers Obtain input from public, other state agencies and interested parties Obtain input from public, other state agencies and interested parties Report back to an interim committee of the Legislature by the Fall of 2002 Report back to an interim committee of the Legislature by the Fall of 2002

14. SJM 62/HJM 34 Process (2002-2003) Senate Joint Memorial 62/House Joint Memorial 34 8 Town Hall Public Meetings Statewide 8 Town Hall Public Meetings Statewide 2 State Agencies Meetings 2 State Agencies Meetings Interested Parties Outreach Interested Parties Outreach NM ACLU, NM Health and Hospital Systems NM ACLU, NM Health and Hospital Systems Assn., NM Foundation for Open Government, Assn., NM Foundation for Open Government, NM Press Assn., Five Sandoval Tribes, NM Press Assn., Five Sandoval Tribes, Health Law Section of State Bar Health Law Section of State Bar

15. SJM 62/HJM 34 Process (2002-2003) Senate Joint Memorial 62/House Joint Memorial 34 4 Interim Legislative Committee 4 Interim Legislative Committee Hearings Hearings Legal Consultants Legal Consultants Institute of Public Law – University of New Mexico James G. Hodge, Jr., J.D, L.L.M.- Johns Hopkins University, Bloomberg School of Public Health University, Bloomberg School of Public Health

16. Whom Did We Forget? The New Mexico Trial Lawyers Association

17. SJM 62/HJM 34 Process (2002-2003) Final Report and Executive Summary DOH Website: DOH Website: http://www.health.state.nm.us http://www.health.state.nm.us

18. 2003 “Long”Legislative Session 2003 “Long” Legislative Session - House Bill 231 (Passed) Public Health Emergency Response Act - House Bill 254 (Passed) Amend the NM Inspection of Public Records Act to protect confidentiality of tactical response plans and risk assessments - House Bill 232 (DOA) Emergency Powers Code - House Bill 253 (DOA) Amend the NM Riot Control Act to explicitly provide for forced evacuation

19. New Public Health Emergency Powers House Bill (HB) 231 Public Health Emergency Response Act (PHERA), Sections 12-10A.-1., et seq., NMSA 1978, (Laws of 2003, Chapter 218) Located on New Mexico Legislature’s Located on New Mexico Legislature’s website - www.legis.state.nm.us Click on Bill Finder, 2003 Regular Session, House Bill (HB) 231, Final Version website - www.legis.state.nm.us Click on Bill Finder, 2003 Regular Session, House Bill (HB) 231, Final Versionwww.legis.state.nm.us

20. Distinct Features of the PHERA Enhanced Public Health Advisory Rights of Household and Family Members Mental Health Counseling Compensation Job Protection Memorandum of Understanding with Tribes and Pueblos Cross References to Public Health Act

21. 2004 “Short”Legislative Session 2004 “Short” Legislative Session - House Bill 22 (DOA) Emergency Powers Code - House Bill 98 (DOA) Interstate Compact on Threatening Communicable Diseases Communicable Diseases - House Bill 108 (DOA) Emergency Prescriptive Authority

22. Current Legal Focus - DOH full-time dedicated attorney for public health emergency preparedness funded through CDC Cooperative Agreement (March 1, 2004 – Present) - NM Legal Framework for Public Health Emergency Preparedness PowerPoint (July, 2003 – Present) Based on CDC/Center for Law and the Public’s Health PowerPoint piloted at the CDC Public’s Health and the Law in the 21 st Century Conference, Atlanta, Ga., June 17, 2002. (Approximately 20 presentations statewide to 600 people)Based on CDC/Center for Law and the Public’s Health PowerPoint piloted at the CDC Public’s Health and the Law in the 21 st Century Conference, Atlanta, Ga., June 17, 2002. (Approximately 20 presentations statewide to 600 people)

23. Current Legal Focus NM Emergency Preparedness Legal Handbook (in progress) Illinois TOPOFF 2 Legal Team Handbook (April, 2003) Illinois TOPOFF 2 Legal Team Handbook (April, 2003) “Communicable Disease Control Measures in Texas: A Guide for Public Health Authorities in a Public Health Emergency” (2002)“Communicable Disease Control Measures in Texas: A Guide for Public Health Authorities in a Public Health Emergency” (2002)www.tdh.state.tx.us/phpep.ila

24. Current Legal Focus CDC Public Health Law Program Initiatives Forensic Epidemiology CourseForensic Epidemiology Course Community Public Health LegalCommunity Public Health Legal Preparedness Course Preparedness Course

25. CONCLUSIONS Bridge Communication Gap Bridge Communication Gap Interdisciplinary Cooperation Interdisciplinary Cooperation Statutory and Regulatory Changes Statutory and Regulatory Changes Be Proactive Be Proactive

26. Websites New Mexico Legislative Council Service www.legis.state.nm.us Centers for Disease Control and Prevention www.cdc.gov Public Health and Preparedness Response Public Health and Preparedness Response www.bt.cdc.gov www.bt.cdc.govwww.bt.cdc.gov Public Health Law Program Public Health Law Program www.phppo.cdc.gov/od/phlp www.phppo.cdc.gov/od/phlpwww.phppo.cdc.gov/od/phlp The Center for the Law and the Public’s Health www.publichealthlaw.net The Center for the Law and the Public’s Health www.publichealthlaw.net www.publichealth

27. Websites Health Insurance Portability and Accountability Act of 1996 (HIPAA) www.hhs.gov/ocr/hipaa/ Model Intrastate Mutual Aid Legislation-National Emergency Management Association www.nemaweb.org Emergency Management Assistance Compact www.emacwebwww.emacweb.org www.emacweb

28. Clifford M. Rees Assistant General Counsel Office of General Counsel New Mexico Department of Health P.O. Box 26110 Santa Fe, New Mexico 87502-6110 Ph: (505) 476-7725 cmrees@health.state.nm.us