BIOTERRORISM BIOTERRORISM AND LEGAL ISSUES:AND LEGAL ISSUES:

THE TEXAS EXPERIENCETHE TEXAS EXPERIENCE

NGA REGIONAL NGA REGIONAL BIOTERRORISM WORKSHOPBIOTERRORISM WORKSHOP

March 15, 2004March 15, 2004

Susan K. SteegGeneral CounselTexas Department of Health

TEXAS HAS BROAD, TRADITIONAL TEXAS HAS BROAD, TRADITIONAL STATUTORY POWERS REGARDING STATUTORY POWERS REGARDING PUBLIC HEALTH ISSUESPUBLIC HEALTH ISSUES

Public health powers and duties

Communicable disease code

Health facilities and health professionals licensure

Environmental and consumer health

DECENTRALIZED PUBLIC HEALTH DECENTRALIZED PUBLIC HEALTH SYSTEMSYSTEM

In the 254 counties in Texas:

148 local public health agencies

8 TDH regional offices

141 counties with NO local public health

agency

RECENT EVENTS HAVE CAUSED RECENT EVENTS HAVE CAUSED TEXAS POLICYMAKERS TO FOCUS ON TEXAS POLICYMAKERS TO FOCUS ON PUBLIC HEALTHPUBLIC HEALTH

9/11

Anthrax

Monkeypox

SARS

Smallpox vaccination

IN TEXAS, SEVERAL SIGNIFICANT IN TEXAS, SEVERAL SIGNIFICANT LEGAL DEVELOPMENTS HAVE LEGAL DEVELOPMENTS HAVE OCCURREDOCCURRED

Legislation has passed

TDH has legal staff proactive on legal preparedness issues

Community Legal Preparedness Workshop in Houston on March 26th will be 2nd pilot of CDC’s Public Health Law Program

LEGISLATIONLEGISLATION

Model State Emergency Health Powers Act

Texas Legislation 2003

• HB 9 Homeland Security

• HB 627 Area Quarantine

• HB 2292 Communicable Disease Control

• SB 513 Liability

HB 4

HB 9

HOMELAND SECURITYHOMELAND SECURITY

Requires Governor to develop statewide homeland security strategy

Requires coordination among and between local, state, and federal agencies and the private sector

Creates Critical Infrastructure Protection Council to provide coordination for local and state implementation

Confidentiality is created for certain information collected by government agencies related to homeland security

AREA QUARANTINEAREA QUARANTINE

Expands authority of the Commissioner of Health to implement an area quarantine based upon an environmental or toxic agent in the environment

Relies on the same procedures used for communicable disease control

COMMUNICABLE DISEASE CONTROLCOMMUNICABLE DISEASE CONTROL

Amends the Communicable Disease Control and Prevention Act to clarify and allow for expeditious imposition of control measures

Defines public health disaster and gives the Governor the authority to declare a disaster based upon the Commissioner of Health determination of an immediate threat from a communicable disease

LIABILITYLIABILITY

Establishes immunity from civil liability

• for actions taken without compensation in a disaster at the request of a government agency

• for emergency care provided during an emergency

• for actions by a state or local officer or volunteer who performs a homeland security activity at the request or under the direction of a government agency

PROACTIVE LEGAL STAFFPROACTIVE LEGAL STAFF

OGC Legal Preparedness Team: Composed of seven attorneys representing communicable disease, food and drug safety, facility and professional licensure, radiation control, public health preparedness

PROACTIVE LEGAL STAFFPROACTIVE LEGAL STAFF

Produced manual for Health Authorities: “Communicable Disease Control Measures in Texas: A Guide for Health Authorities in a Public Health Emergency” www.tdh.state.tx.us/phpep/lha

Prepare and update legal opinions on liability and confidentiality of plans and data

Track open records decisions on disaster and preparedness requests

PROACTIVE LEGAL STAFFPROACTIVE LEGAL STAFF

Smallpox Vaccination Program – Workers compensation issue was barrier

OGC convened key legal staff from• Office of the Attorney General

• Texas Workers Compensation Commission

• State Office of Risk Management

• Department of Insurance

Desired outcome was achieved:Develop a unified message

PROACTIVE LEGAL STAFFPROACTIVE LEGAL STAFF

TDH’s legal preparedness initiatives

• Community Legal Preparedness

• State Agency Counsel Legal Preparedness

• Judicial Preparedness

• Legal Preparedness Directory

COMMUNITY LEGAL PREPAREDNESSCOMMUNITY LEGAL PREPAREDNESS

Enhance the readiness of members of the health care bar to play a positive role in the event of an actual or threatened healthcare emergency

Train local government officials and their attorneys in implementing emergency measures

STATE AGENCY COUNSEL LEGAL STATE AGENCY COUNSEL LEGAL PREPAREDNESSPREPAREDNESS

Establish an ongoing forum to convene agency attorneys to discuss issues and coordinate actions

JUDICIAL PREPAREDNESSJUDICIAL PREPAREDNESS

Assist in developing curricula to train judges on judicial procedures for imposing emergency measures

Develop a bench book

Identify and collaborate with judicial training programs

LEGAL PREPAREDNESS DIRECTORYLEGAL PREPAREDNESS DIRECTORY

Establish statewide database of attorneys who represent public health partners

KEY PRACTICAL OBSERVATIONSKEY PRACTICAL OBSERVATIONS

Bridge communication gaps by creating new networks within the legal community

Focus on education, legislative and regulatory changes, mutual aid agreements

Get your attorneys involved in your activities

Expect your attorneys to be proactive

RESOURCESRESOURCES

• CDC Public Health Law Programwww.phppo.cdc.gov/od/phlp/index.asp

• The Model State Emergency Health Powers Act: A Checklist of Issueswww.ncsl.org/programs/health/modelact.pdf

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

• Emergency Management Assistance Compactwww.emacweb.org

CONTACT INFORMATIONCONTACT INFORMATION

Susan K. SteegGeneral CounselTexas Department of Health

susan.steeg@tdh.state.tx.us

(512) 458-7236