1. BIOTERRORISM AND LEGAL ISSUES: THE ILLINOIS EXPERIENCE BIOTERRORISM AND LEGAL ISSUES: THE ILLINOIS EXPERIENCE NGA REGIONAL BIOTERRORISM WORKSHOP January 12, 2004 Anne Murphy Chief Counsel Illinois Department of Public Health

2. OVERVIEW ILLINOIS HAS BROAD, TRADITIONAL STATUTORY POWERS REGARDING PUBLIC HEALTH ISSUESILLINOIS HAS BROAD, TRADITIONAL STATUTORY POWERS REGARDING PUBLIC HEALTH ISSUES –Public health powers and duties –Communicable disease code –Health facilities licensure –Environmental health

3. OVERVIEW STATE DPH/LOCAL HEALTH DEPARTMENTSSTATE DPH/LOCAL HEALTH DEPARTMENTS –Almost 100 counties, virtually all of which have LHDs –Some municipalities also have LHDs –Certain jurisdictions are home rule –Under state law, LHDs must comply with and implement DPH laws and rules; IDPH also a grant funder

4. OVERVIEW RECENT EVENTS HAVE CAUSED ILLINOIS POLICYMAKERS TO FOCUS ON THESE TRADITIONAL PUBLIC HEALTH LAWS, AS THEY RELATE TO PUBLIC HEALTH EMERGENCIESRECENT EVENTS HAVE CAUSED ILLINOIS POLICYMAKERS TO FOCUS ON THESE TRADITIONAL PUBLIC HEALTH LAWS, AS THEY RELATE TO PUBLIC HEALTH EMERGENCIES –9/11 –Federal grant funding –TOPOFF 2 exercise

5. RECENT EVENTS HAVE CAUSED ILLINOIS POLICYMAKERS TO FOCUS ON THESE TRADITIONAL PUBLIC HEALTH LAWS, AS THEY RELATE TO PUBLIC HEALTH EMERGENCIESRECENT EVENTS HAVE CAUSED ILLINOIS POLICYMAKERS TO FOCUS ON THESE TRADITIONAL PUBLIC HEALTH LAWS, AS THEY RELATE TO PUBLIC HEALTH EMERGENCIES –Monkeypox –SARS –Smallpox vaccination program

6. OVERVIEW SEVERAL SIGNIFICANT DEVELOPMENTS HAVE OCCURREDSEVERAL SIGNIFICANT DEVELOPMENTS HAVE OCCURRED –The Model Legislation has been introduced, but has not moved through the legislature –IDPH now has dedicated legal staff focused on emergency powers issues –An interdisciplinary legal team was created for TOPOFF 2, IDPH chaired

7. OVERVIEW –In preparation for TOPOFF 2, a detailed gap analysis was conducted and mock Executive Orders were prepared –After TOPOFF 2, the legal team has continued to meet to develop gap legislation (pending), at the request of the Governor’s Office –A draft LHD mutual aid agreement has been developed

8. OVERVIEW –Under CDC leadership, a forensic epidemiology program has been launched –In connection with the smallpox vaccination program, customized information/consent materials were prepared; injury compensation issues were addressed

9. OVERVIEW –In connection with monkeypox, intensive coordination with our Department of Agriculture, and with federal authorities –In connection with SARS, coordination regarding possible isolation/quarantine with Attorney General’s Office, county and municipal authorities, judiciary

10. AREAS OF THE LAW NEEDING CONTINUED FOCUS FEDERAL VS. STATE VS. LOCAL JURISDICTIONFEDERAL VS. STATE VS. LOCAL JURISDICTION ISOLATION AND QUARANTINEISOLATION AND QUARANTINE –Post-deprivation rights –Right to counsel –Clinical evidence –Groups of individuals

11. AREAS OF THE LAW NEEDING CONTINUED FOCUS REPORTING/RELEASE OF MEDICAL INFORMATIONREPORTING/RELEASE OF MEDICAL INFORMATION –Provider reporting to public health –Public health/law enforcement exchange of information –HIPAA issues, confusion

12. AREAS OF THE LAW NEEDING CONTINUED FOCUS LICENSURE/CERTIFICATION ISSUESLICENSURE/CERTIFICATION ISSUES –Scope of practice limitations for professionals –Out of state professionals –Use of unlicensed personnel

13. AREAS OF THE LAW NEEDING CONTINUED FOCUS –Hospital emergency privileges –EMTALA issues –Licensure of federal assets

14. AREAS OF THE LAW NEEDING CONTINUED FOCUS EMERGENCY MANAGEMENT ISSUESEMERGENCY MANAGEMENT ISSUES –Disaster declaration –Suspension of laws –EMAC Act –Liability issues

15. AREAS OF THE LAW NEEDING CONTINUED FOCUS INFORMED CONSENTINFORMED CONSENT –Emergencies –Vaccinations, experimental treatment INJURY COMPENSATIONINJURY COMPENSATION –Workers compensation –Federal law

16. AREAS OF THE LAW NEEDING CONTINUED FOCUS EXTRAORDINARY POWERSEXTRAORDINARY POWERS –Closure of facilities, control of property –Emergency purchasing authority –Disposition of human remains –Mandated testing, examinations, treatment, monitoring –Cordon sanitaire

17. KEY PRACTICAL OBSERVATIONS INTEGRATE FEDERAL/STATE/LOCAL AND INTERDISCIPLINARY LEGAL PERSPECTIVESINTEGRATE FEDERAL/STATE/LOCAL AND INTERDISCIPLINARY LEGAL PERSPECTIVES –Public health –Emergency management –Law enforcement –Agriculture

18. KEY PRACTICAL OBSERVATIONS –Professional Regulation –Attorney General’s Office –USAG –Environmental Protection –Judiciary

19. KEY PRACTICAL OBSERVATIONS CREATE AN INFRASTRUCTURECREATE AN INFRASTRUCTURE BRIDGE COMMUNICATION GAPSBRIDGE COMMUNICATION GAPS FOCUS ON EDUCATION, LEGISLATIVE AND REGULATORY CHANGES, MUTUAL AID AGREEMENTSFOCUS ON EDUCATION, LEGISLATIVE AND REGULATORY CHANGES, MUTUAL AID AGREEMENTS