1. Unit 5 Seminar Professor Quiana Bradshaw August 31, 2011

2. Unit 5 Reading Chapter 11, “Legal Authorities for Interventions in Public Health Emergencies.

3. Chapter 11 Subtopics Historical Perspective: Sources of legal authority for public health emergency situations State public health laws and federal assistance

4. State Emergency Public Powers Disease reporting and medical surveillance Subpoena of business information customer lists Commander private buildings and seize pharmaceuticals abate nuisances Personal-control measures Legal community Dissemination of public health information

5. Executive Summary Framework Disaster preparedness plans have the potential to protect at-risk populations from harm and maintain or quickly restore the routines and functions of civil society. But even the most thorough and prescient plan will fall short if it does not reach across professional jurisdictions and agencies. A Framework for improving Emergency Response

6. Workgroup Charge and Products To make the jump across sectoral lines faster and more focused, Centers for Disease Control and Prevention’s (CDC) Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER) supported a joint initiative between CDC’s Public Health Law Program (PHLP) and the U.S. Department of Justice’s Bureau of Justice Assistance (DOJ/BJA) in 2007. The two organizations convened a 28-member Workgroup on Public Health and Law Enforcement Emergency Preparedness that included experts representing four sectors: public health, law enforcement, the judiciary, and corrections.

7. Guiding Principles As the Workgroup members considered ways to improve cross-sector coordination for emergency preparedness, they were guided by several core principles: balancing federal, state, and local power and responsibilities; balancing the common good with safeguarding of individual liberties; preserving the rule of law; and building on existing emergency response coordination mechanisms and structures wherever possible.

8. Relationships Among Sectors While the most complementary and close connection might be between law enforcement and public health, the other sectors represented on the Workgroup — the judiciary and corrections — also are key partners. For example, in a contagious disease epidemic, a public health official may request a quarantine of a group or area and law enforcement C D C / D O J P U B L I C H E A L T H / L A W E N F O R C E M E N T E M E R G E N C Y P R E P A R E D N E S S W O R K G R O U P officers would be responsible for enforcing it, but legal challenges to either public health or police authority quickly would engage the court system. Likewise, an infected person resisting an isolation order might be arrested, but could not be admitted to a crowded jail or health-care facility without endangering other inmates, staff, or patients.

9. Organizing to Implement Action Steps To optimize preparedness at any jurisdictional level (i.e., local, state, territorial, tribal, federal), agencies and organizations require a comprehensive understanding of the other sectors’ roles, responsibilities, legal authorities, and assets that relate to responses to selected public health emergencies (e.g., natural disasters, contagious disease epidemics, suspected biological or chemical terrorism). Therefore, each jurisdiction may first need to organize by establishing a framework for periodically convening senior representatives from each sector to review and address these and related considerations.

10. Organizing to Implement Action Steps Action steps include: Establishing a standing steering committee to direct the jurisdiction’s initiative for improved, coordinated, multi-sector response. Developing a detailed plan to achieve full capability to mount a coordinated, multisector response to public health emergencies. Integrating the steering committee’s plan into the jurisdiction’s NIMS- compliant emergency planning/management plans. Establishing direct linkages between the steering committee and the jurisdiction’s emergency planning and management systems. Establishing direct linkages with counterparts in adjacent jurisdictions (e.g., cities, counties, states, territories, tribes, Canadian provinces, and Mexican states).

11. Organizational Scope of Public Health Emergency Law Public health emergency laws must initially facilitate the joint efforts of local and state health department, federal agencies, and public or private health-care facilities. State public health organizational structures may have separate legal authorities for public health, mental health, Medicaid services, and emergency management services.

12. Silos of Federal, State, Local Legal Preparedness Public Health Fire/Emergency Medical Services Homeland Security/Emergency Management Law Enforcement Judicial/Legal System Food Agriculture

14. History of Federal Disaster Assistance 1950 – Public Law 80-875 o Before 1950, a comprehensive disaster program did not exist. Congress funded disaster recovery on an incident-by-incident basis. In 1950, Congress enacted the initial Disaster Assistance Program, Public Law 80- 875. 1969 – Disaster Relief Act o This law introduced the idea of the Federal Coordinating Officer (FCO), and placed the management of the federal disaster assistance under one individual whom the President appointed.

15. 1974 – Disaster Relief Act (Public Law 93-288) o In April of 1974, a series of devastating tornadoes hit six Midwestern states. This event confirmed the need to add assistance to individuals and families to the Disaster Relief Program. As a result the Disaster Relief Act of 1974 was established. 1979 – Executive Order 12127 o On March 31, 1979, Congress passed this order which established the Federal Emergency Management Agency to consolidate the nation’s emergency related programs. History of Federal Disaster Assistance

16. 1988 – Robert T. Stafford Disaster Relief and Emergency Assistance Act (Public Law 93-288 as amended) o In November 1988, Congress passed this act to provide a framework for continued disaster assistance. The Act establishes the Presidential declaration process for major emergencies, provides for the implementation of disaster assistance, and sets forth the various disaster assistance programs. It also legislated a minimum 75% federal / 25% state/local cost-sharing for the Public Assistance (PA) Program. History of Federal Disaster Assistance

17. Sec.102.(1) Definitions “Emergency” – means any occasion or instance for which, in the determination of the President, Federal assistance is needed to supplement State and local efforts and capabilities to save lives and to protect property and public health and safety, or to lesson or avert the threat of a catastrophe in any part of the United States

18. Emergency Declarations Quarantines & Isolation Travel Restrictions Contact Tracing Medical examinations and treatment

19. Federal Declarations FEMA Medicare & Medicaid

20. References Stafford, R. (n.d.). Disaster Relief & Emergency Assistance. Retrieved August 31, 2011 from www.ncs.gov/tpos/esf/.../3%20-%20Bearden- Stafford%20 Act.ppt www.ncs.gov/tpos/esf/.../3%20-%20Bearden- Stafford%20 Act.ppt