Bioterrorism and Legal Issues: Bioterrorism and Legal Issues: The New Mexico ExperienceThe New Mexico Experience

Clifford M. ReesClifford M. ReesAssistant General CounselAssistant General CounselNew Mexico Department of HealthNew Mexico Department of Health

NGA Regional Bioterrorism Workshop

San Francisco, California

May 13-14, 2004

New Mexico Has Broad Statutory Powers New Mexico Has Broad Statutory Powers Regarding Public Health IssuesRegarding Public Health Issues

Public Health Act Public Health Act (Emergency powers contained in the Act originate from the Laws (Emergency powers contained in the Act originate from the Laws

of 1919, Chapter 85, Section 10)of 1919, Chapter 85, Section 10)

Additional Powers include:Additional Powers include:

• Health Facility LicensureHealth Facility Licensure

• Disease ReportingDisease Reporting

• Involuntary Detention for Threatening Communicable Involuntary Detention for Threatening Communicable DiseasesDiseases

New Mexico Has Broad Statutory Powers New Mexico Has Broad Statutory Powers Regarding Public Health IssuesRegarding Public Health Issues

EMS ActEMS Act

Provisions include:Provisions include:• Licensure of EMTsLicensure of EMTs

• Air Ambulance CertificationAir Ambulance Certification

• Trauma Care System DesignationTrauma Care System Designation

• Other ProvisionsOther Provisions

New Mexico Has Broad Statutory Powers New Mexico Has Broad Statutory Powers Regarding Public Health IssuesRegarding Public Health Issues

Other ActsOther Acts• Primary CarePrimary Care

• ImmunizationsImmunizations

• Harm ReductionHarm Reduction

• Vital StatisticsVital Statistics

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

• 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)NM Department of Health (DOH)

Centralized Public Health SystemCentralized Public Health System

Y2KY2K

Roll out of DOH’s revised Emergency Operations Roll out of DOH’s revised Emergency Operations Plan (EOP) September, 1999Plan (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 ScenarioInfectious Disease Scenario

Events Triggering Increased Focus on Events Triggering Increased Focus on Public Health Emergency PreparednessPublic Health Emergency Preparedness

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

Anthrax Attacks – October 2001Anthrax Attacks – October 2001

Events of 9/11Events of 9/11

Smallpox Vaccination Program – 2002-2003Smallpox Vaccination Program – 2002-2003

CDC/HRSA Federal funding initiatives 2002-PresentCDC/HRSA Federal funding initiatives 2002-Present

SARS Outbreak – 2002-2003SARS Outbreak – 2002-2003

Legal DevelopmentsLegal Developments

Model State Emergency Health Powers Act Model State Emergency Health Powers Act

(Fall, 2001) (Fall, 2001) www.publichealthlaw.net/MSEHPA/MSEHPA2.pdf

www.ncsl.org/programs/health/modelact.pdfwww.ncsl.org/programs/health/modelact.pdf

NM Interim Legislative Health and Human Services NM Interim Legislative Health and Human Services Committee (November 27, 2001)Committee (November 27, 2001)

Tri-Agency Attorney Emergency Management Tri-Agency Attorney Emergency Management Workgroup (December, 2001)Workgroup (December, 2001)

2002 “Short”2002 “Short” Legislative Session Legislative Session

--Senate Bill 136Senate Bill 136 (Passed)(Passed)

Approval of in-state and out-of state licenseesApproval of in-state and out-of state licensees

--Senate Bill 149 (Passed)Senate Bill 149 (Passed)

Emergency ProcurementEmergency Procurement

-House Bill 261 (Passed)-House Bill 261 (Passed) Review and update State All-Hazard PlanReview and update State All-Hazard Plan

Conduct emergency testsConduct emergency tests

2002 “Short”2002 “Short” Legislative Session Legislative Session

Senate Joint Memorial 62/House Senate Joint Memorial 62/House Joint Memorial 34Joint Memorial 34

• DOH, Department of Public Safety, Attorney DOH, Department of Public Safety, Attorney General’s Office to convene a work group to General’s Office to convene a work group to evaluate state emergency powersevaluate state emergency powers

• Obtain input from public, other state agencies Obtain input from public, other state agencies and interested partiesand interested parties

• Report back to an interim committee of the Report back to an interim committee of the Legislature by the Fall of 2002Legislature by the Fall of 2002

SJM 62/HJM 34 Process (2002-2003)SJM 62/HJM 34 Process (2002-2003)

Senate Joint Memorial 62/House Joint Senate Joint Memorial 62/House Joint Memorial 34Memorial 34

• 8 Town Hall Public Meetings Statewide8 Town Hall Public Meetings Statewide• 2 State Agencies Meetings2 State Agencies Meetings• Interested Parties OutreachInterested 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 BarHealth Law Section of State Bar

SJM 62/HJM 34 Process (2002-2003)SJM 62/HJM 34 Process (2002-2003)

Senate Joint Memorial 62/House Joint Senate Joint Memorial 62/House Joint Memorial 34Memorial 34

• 4 Interim Legislative Committee 4 Interim Legislative Committee

HearingsHearings• Legal ConsultantsLegal Consultants

Institute of Public Law – University of New MexicoInstitute of Public Law – University of New Mexico

James G. Hodge, Jr., J.D, L.L.M.- Johns Hopkins James G. Hodge, Jr., J.D, L.L.M.- Johns Hopkins University, Bloomberg School of Public HealthUniversity, Bloomberg School of Public Health

Whom Did We Forget?

The New Mexico Trial Lawyers Association

SJM 62/HJM 34 Process (2002-2003)SJM 62/HJM 34 Process (2002-2003)

Final Report and Executive SummaryFinal Report and Executive Summary

DOH Website:DOH Website:

http://www.health.state.nm.ushttp://www.health.state.nm.us

2003 “Long”2003 “Long” Legislative Session Legislative Session

- House Bill 231 (Passed)House Bill 231 (Passed)

Public Health Emergency Response ActPublic Health Emergency Response Act

- House Bill 254 (Passed)House Bill 254 (Passed)Amend the NM Inspection of Public Amend the NM Inspection of Public Records Act to protect confidentiality of Records Act to protect confidentiality of tactical response plans and risk assessmentstactical response plans and risk assessments

- House Bill 232 (DOA)House Bill 232 (DOA)Emergency Powers CodeEmergency Powers Code

- House Bill 253 (DOA)House Bill 253 (DOA)Amend the NM Riot Control Act to explicitlyAmend the NM Riot Control Act to explicitlyprovide for forced evacuationprovide for forced evacuation

New Public Health Emergency New Public Health Emergency PowersPowers

House Bill (HB) 231House Bill (HB) 231Public Health Emergency Response Act Public Health Emergency Response Act

(PHERA), Sections 12-10A.-1., (PHERA), Sections 12-10A.-1., et seq.et seq., , NMSA 1978, (Laws of 2003, Chapter 218)NMSA 1978, (Laws of 2003, Chapter 218)

Located on Located on New Mexico Legislature’sNew Mexico Legislature’s

website - website - www.legis.state.nm.us Click on Bill Finder, 2003 Regular Session, House Bill (HB) 231,House Bill (HB) 231, Final Final Version Version

Distinct Features of the PHERADistinct 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

2004 “Short”2004 “Short” Legislative Session Legislative Session

- House Bill 22 (DOA)House Bill 22 (DOA)

Emergency Powers CodeEmergency Powers Code

- House Bill 98 (DOA)House Bill 98 (DOA)Interstate Compact on Threatening Interstate Compact on Threatening

Communicable DiseasesCommunicable Diseases

- House Bill 108 (DOA)House Bill 108 (DOA)Emergency Prescriptive AuthorityEmergency Prescriptive Authority

Current Legal FocusCurrent Legal Focus

- DOH full-time dedicated attorney for public health DOH full-time dedicated attorney for public health emergency preparedness funded through CDC emergency preparedness funded through CDC Cooperative Agreement (March 1, 2004 – Present)Cooperative Agreement (March 1, 2004 – Present)

- NM Legal Framework for Public Health Emergency NM Legal Framework for Public Health Emergency Preparedness PowerPoint (July, 2003 – Present)Preparedness PowerPoint (July, 2003 – Present)

• Based on CDC/Center for Law and the Public’s Health Based on CDC/Center for Law and the Public’s Health PowerPoint piloted at the CDC Public’s Health and the Law in PowerPoint piloted at the CDC Public’s Health and the Law in the 21the 21stst Century Conference, Atlanta, Ga., June 17, 2002. Century Conference, Atlanta, Ga., June 17, 2002. (Approximately 20 presentations statewide to 600 people)(Approximately 20 presentations statewide to 600 people)

Current Legal FocusCurrent Legal Focus

NM Emergency Preparedness Legal NM Emergency Preparedness Legal Handbook (in progress) Handbook (in progress)

• Illinois TOPOFF 2 Legal Team Handbook Illinois TOPOFF 2 Legal Team Handbook (April, 2003) (April, 2003)

• ““Communicable Disease Control Communicable Disease Control Measures in Measures in Texas: A Guide for Public Texas: A Guide for Public Health Authorities Health Authorities

in a in a Public Health Emergency” (2002)Public Health Emergency” (2002)www.tdh.state.tx.us/phpep.ilawww.tdh.state.tx.us/phpep.ila

Current Legal FocusCurrent Legal Focus

CDC Public Health Law Program Initiatives CDC Public Health Law Program Initiatives

• Forensic Epidemiology CourseForensic Epidemiology Course

• Community Public Health Legal Community Public Health Legal Preparedness CoursePreparedness Course

CONCLUSIONSCONCLUSIONS

• Bridge Communication GapBridge Communication Gap

• Interdisciplinary CooperationInterdisciplinary Cooperation

• Statutory and Regulatory ChangesStatutory and Regulatory Changes

• Be ProactiveBe Proactive

Websites

New Mexico Legislative Council Service New Mexico Legislative Council Service www.legis.state.nm.us

Centers for Disease Control and Prevention Centers for Disease Control and Prevention www.cdc.govwww.cdc.gov Public Health and Preparedness Response Public Health and Preparedness Response www.bt.cdc.gov Public Health Law Program Public Health Law Program www.phppo.cdc.gov/od/phlp

The Center for the Law and the Public’s Health The Center for the Law and the Public’s Health www.publichealthlaw.net    

Websites

Health Insurance Portability and Accountability Act of 1996 Health Insurance Portability and Accountability Act of 1996 (HIPAA) (HIPAA) www.hhs.gov/ocr/hipaa/www.hhs.gov/ocr/hipaa/

Model Intrastate Mutual Aid Legislation-National Emergency Management Associationwww.nemaweb.org

Emergency Management Assistance CompactEmergency Management Assistance Compactwww.emacweb .org

Clifford M. ReesClifford M. Rees

Assistant General CounselAssistant General Counsel

Office of General CounselOffice of General Counsel

New Mexico Department of HealthNew Mexico Department of Health

P.O. Box 26110P.O. Box 26110

Santa Fe, New Mexico 87502-6110Santa Fe, New Mexico 87502-6110

Ph: (505) 476-7725Ph: (505) 476-7725

cmrees@health.state.nm.us