Navigating Legal Barriers to Effective Public Health

Emergency ResponseMeredith Allen, DrPH, MS

Director, Preparedness and Strategic PartnershipsASTHO

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

ASTHO 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

Precursor to 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

Legal Barriers Project

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

For use by multiple audiences◦ 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

Focus of Toolkits

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)

Eight Toolkits Developed

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

Table of Contents Executive Overviews Fact Sheets Issue Briefs State Analysis Guides Current Issues Updates Resource Materials Supplement

Document Types in the Kits

Toolkit Overview

Table of Contents

Table of Contents

Executive Overviews

• One-page snapshots of key concepts and issues

FactSheets

• One-page documents addressing fundamental issues or legal authorities

FactSheets

• One-page documents addressing fundamental issues or legal authorities

IssueBriefs

• In-depth information and analyses of fundamental issues

State AnalysisGuides

• Aids to assist states in identifying and analyzing their own statutes, regulations, and policies

Current IssuesUpdates

• Periodic updates on new and evolving issues

Resource MaterialsSupplement

• Bibliographies and links to key agencies, organizations, laws, and other documents

Resource MaterialsSupplement

• Bibliographies and links to key agencies, organizations, laws, and other documents

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)

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

Acknowledgements