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April 2014—Public Health Law News
In This EditionAnnouncementsThe Network for Public Health Law names Donna Levin new national director. Donna Levin, General Counsel, Massachusetts Department of Public Health, has been named the new national director of the Network for Public Health Law. The Network provides assistance and resources to public health lawyers and officials on legal issues related to public health, including health reform, emergency preparedness, drug overdose prevention, health information privacy, and food safety. Find more information about the Network and their new national director. CDC Public Health Law Program Externship. The CDC Externship in Public Health Law consists of 9–14 weeks of professional work experience, for academic credit, with CDC’s Public Health Law Program in Atlanta, Georgia. The program features rolling start and completion dates throughout the academic year. It exposes law students to the public health field, allowing for exploration of the critical role law plays in advancing public health goals. The unpaid externship is open to second and third year law students who are interested in exploring careers in public health law. Participants must receive academic credit. Applications for the fall 2014 program must be submitted by May 31, 2014 and spring 2015 applications must be submitted by November 1, 2014. Find more information and apply for the externship program. O’Neill Institute fellowship program. The O’Neill Institute for National and Global Health Law is seeking exceptionally qualified candidates to serve as O’Neill Institute Law Fellows. Housed at Georgetown University Law Center in Washington, D.C., the O’Neill Institute is a leading research institute for health law. The final application deadline is Friday, April 25, 2014. Find more information and apply for the fellowship program. Book on global health law. Georgetown University Law Center Professor and internationally acclaimed health scholar, Lawrence O. Gostin, offers an in-depth work on a burgeoning field with his new book, Global Health Law (Harvard University Press). Find more information about the publication. O’Neill Institute Summer Program. The O’Neill Institute for National and Global Health Law at Georgetown University will present two summer 2014 programs: 1) Emerging Issues in Food and Drug Law and 2) U.S. Health Reform—The Affordable Care Act. The summer programs convene leading practitioners, policymakers, advocates and academics in food and drug law, and U.S. healthcare reform for a series of interactive lectures, panel discussions, and case studies. Held during consecutive weeks, July 14–18 (Emerging Issues in Food and Drug Law) and July 21–25 (U.S. Health Reform—The Affordable Care Act), interested participants may attend one or both programs. The final registration deadline is June 15, 2014. Find more information and apply for the summer 2014 programs. 2014 Public Health Law Conference. The 2014 Public Health Law Conference will take place October 16–17, 2014, in Atlanta, Georgia. The conference will gather public health and legal experts from across the country to examine and discuss today’s critical challenges in public health law. Find more information about the conference and learn how to get the early bird registration rate. Legal ToolsSelected federal legal authorities pertinent to public health emergencies. The Selected Federal Legal Authorities Pertinent to Public Health, originally published in 2009, has been updated to reflect the legislative and regulatory changes of the past five years. Public health professionals can use this document as a brief overview of the types of legal authorities granted to the federal government to prepare for and respond to public health emergencies. Find more information and read Selected Federal Legal Authorities Pertinent to Public Health Emergencies [PDF - 372KB]. Guide for sharing laboratory test services. The Association of Public Health Laboratories published the new Laboratory Efficiencies Initiative “Policy Guide for Public Health Laboratory Test Service Sharing,” a resource that public health laboratory directors and their legal counsel can use in exploring legal questions related to public health laboratories’ sharing test services across states and other jurisdictions. Find more information and access the policy guide [PDF - 889KB]. Webinar on promoting healthy communities and complying with federal restrictions. ChangeLab Solutions is offering the Providing Technical Assistance to Government Bodies under a Federal Grant webinar on May 14, 2014, (10:00 a.m. (PDT)/1:00 p.m. (EDT)). The in-depth webinar will provide practical information on how to comply with Office of Management and Budget circulars regarding allowable technical assistance. It will help attendees and their organizations comply with federal law regarding impermissible lobbying. State and local legal counsel are especially encouraged to attend. The webinar fee is $75.00. Find more information and register for the webinar. Fact sheet of state pharmacist collaborative practice laws. CDC’s National Center for Chronic Disease Prevention and Health Promotion, Division of Heart Disease and Stroke Prevention released a fact sheet of state pharmacist collaborative practice laws. The fact sheet includes details about how many states authorize collaborative drug therapy management by physicians and pharmacists, whether pharmacists can prescribe drugs or order and interpret laboratory tests, whether the Board of Pharmacy must approve collaborative practice agreements, and whether specialized training or continuing education is required. Find more information and read the fact sheet [PDF - 227KB]. Local health department accreditation resources. The National Association of County and City Health Officials has collected examples of documentation that local health departments use to meet Public Health Accreditation Board (PHAB) standards and measures. The Example Documentation Library is organized by PHAB measures and is a reference for local health departments working toward accreditation. Find more information and access the accreditation resources. HIPAA security risk assessment tool. A new security risk assessment tool to help guide health care providers in small to medium sized offices conduct risk assessments of their organizations is now available from the Department of Health and Human Services. Find more information and access the security risk assessment tool. Top StoriesNational: U.S. drug firms move to bar antibiotic use in livestock growth On March 26, 2014, drug makers selling antibiotics used in livestock feed agreed to follow new guidelines that will make it illegal to use their products to create oversized animals. Under the new agreement, to which 25 of the 26 companies selling antibiotics for livestock agreed, growth promotion claims will be removed from the product labels. While farmers and ranchers will be able to continue using the antibiotics to treat sick animals, it will be illegal to use the drugs to promote livestock growth. The agreement comes after the U.S. Food and Drug Administration’s (FDA) release of new guidelines aimed at stemming the rise in human resistance to antibiotics. Public health experts are worried the resistance to antibiotics is linked to the use of antibiotics in livestock feed and, subsequently, food products created from antibiotic-fed livestock. Though the FDA’s guidelines are voluntary, the agency expects drug makers to narrow their products’ use in full adherence to the new guidelines. Under the agreement, pharmaceutical companies will also require a veterinarian’s prescription or feed directive status for antibiotics that have been commonly added to food or water supply. Such prescriptions will no longer be sold over the counter at feed stores or retail outlets. Some feel the agreement is simply sidestepping the issue, however. “This plan is likely to lead to label changes, not a reduction in use,” said Avinash Kar, health attorney with the Natural Resources Defense Council. Critics are concerned the guidelines give companies too much discretion without any external mechanism for enforcement. Others are more hopeful about the guidelines long-term effects. “The FDA and drug makers appear to have passed the first big test of the agency’s voluntary approach. There’s still a lot more to do,” said Laura Rogers, director of human health and industrial farming for The Pew Charitable Trusts. [Editor’s note: Find more information about the pharmaceutical companies’ agreement and the FDA’s plan to reduce antibiotics in food animals.] National: FDA approves device to combat opioid drug overdose The U.S. Food and Drug Administration (FDA) approved the first naloxone treatment designed to be used by laypeople and non-professional medical care providers. The treatment, a device named Evzio, is designed to administer the exact dose of Naloxone to patients who are known or suspected of overdosing on opioids such as OxyContin, Vicodin, and heroin. Naloxone, the standard treatment for opioid overdose, reverses the effects of opioid overdose. The new, pocket-sized device gives the user verbal prompts for use when activated. Symptoms of opioid overdose are changes in heart rate, extreme fatigue, and slowed breathing. Regulators and officials warned that the device should not be used in lieu of medical care for opioid overdose and that victims and care givers should still seek emergency care. Because opioid overdose symptoms usually appear and worsen quickly, allowing family members and care takers to administer Naloxone may save valuable time and therefore save more patients. The FDA estimates that the new device could prevent 16,000 deaths from prescription drug overdose annually. “For years, the lack of a lay-friendly delivery system has made it difficult to make naloxone broadly available to the public and to foster its use in non-medical settings, where it is often most urgently needed. [Evzio is] . . . an extremely important innovation that will save lives,” said FDA Commissioner Margaret A. Hamburg. [Editor’s note: Find more information and read the FDA’s press release about the first naloxone treatment specifically designed to be given by family members or care givers.] Iowa: HIV transmission bill moves through house committee with revised criminal penalties Iowa House Bill H8118 seeks to update Iowa’s criminal penalties for unknowingly exposing someone to HIV. Currently, exposing another to HIV without his or her consent is a felony crime punishable by up to twenty-five years in prison, even if the non-consenting individual is not infected with HIV. House Bill 8118 would create three classes of felonies and would consider whether the infected individual intended to infect another person. The new bill would also apply criminal penalties to transmission of meningitis, hepatitis, and tuberculosis. Iowa’s current law has come under fire because of Nick Rhoades’s conviction and twenty-five-year sentence for not telling a partner he was HIV positive when they had sex in 2008, despite the fact that Rhoades’ partner did not become infected with HIV from their low-risk encounter. Rhoades’ case is on appeal with the Iowa Supreme Court. Some Iowa lawmakers are tentatively hopeful about the proposed amendments to the law, while others, like Senator Matt McCoy, who has led efforts to change the law, are disappointed in the current proposal. “It needs substantial work in order to be something meaningful for those individuals that had worked on this. We need to focus on the issues that initially brought us to the table and that was individuals through no fault of their own being convicted of Class V felonies for engaging in safe sex practices and following their doctors’ consent,” McCoy said. [Editor’s note: Find more information about disease transmission criminalization laws in Prevalence and Public Health Implications of State Laws that Criminalize Potential HIV Exposure in the United States [PDF - 599KB], Aids and Behavior, published online March 15, 2014.Read Iowa House Bill H8118.] Briefly NotedKentucky: Law allows cannabis oil to treat children who suffer from seizures Massachusetts: Prescription Drug Take-Back Day April 26, 2014 Texas: $3.75 million Medicaid billing settlement raises human error questions Vermont: Governor issues emergency prescribing rules for opioids Washington: Newborns to have faster disease screening under new law Wisconsin: New law puts cap on monthly charges for oral chemotherapy National: Repeal of helmet laws linked to more fatalities National: Fast food ads may target and mislead kids, despite industry promises National: Only 14.7 percent of U.S. adults without health insurance Feature Profile in Public Health LawInterview with Andrew R. Roszak, Senior Director, Environmental Health, Pandemic Preparedness & Catastrophic Response, and Gabriella B. Klaes, ORISE Fellow, Public Health Law Program, Centers for Disease Control and PreventionAndrew R. Roszak Title: Senior Director, Environmental Health, Pandemic Preparedness & Catastrophic Response Education: Southern Illinois University, Juris Doctorate, Masters of Public Administration Gabriella B. Klaes Title: ORISE Fellow, Public Health Law Program, Centers for Disease Control and Prevention Education: Georgia State University College of Law, Juris Doctorate; University of Georgia, Bachelor of Journalism in public relations PHLN: Please describe your career path to your current respective positions and responsibilities. Roszak: Well, it certainly wasn’t something I had planned. My professional career began in the southern suburbs of Chicago where I served as a firefighter/paramedic/hazmat technician for seven years. In 2005, I decided to pursue graduate/law school at Southern Illinois University where I ended up receiving my J.D. and M.P.A. During my time at Southern, I had numerous opportunities to learn more about health law. I was also given the opportunity to work at the Illinois Department of Public Health in the Office of Health Protection. After graduating, I was selected as a 2008–2009 David Winston Health Policy fellow. I served as a Winston fellow during the healthcare reform efforts of the 110th and 111th Congresses, serving on the Budget and Health, Education, Labor, and Pensions Committees. After the fellowship, I served as a senior advisor at the U.S. Department of Health and Human Services (HHS) at the Health Resources and Services Administration and at HHS’s Emergency Care Coordination Center. In 2012, I had the opportunity to join the National Association of County and City Health Officials (NACCHO) and now serve as their senior director for Environmental Health, Pandemic Preparedness and Catastrophic Response. NACCHO serves as the voice for the country’s 2,800 local health departments and helps advance public health by providing tools, resources, technical assistance, and support to the health departments throughout the country. Klaes: I studied public relations in the Grady College of Journalism and Mass Communication at the University of Georgia. I had some great experiences honing my writing and communications skills through various internships, including being an account intern for Sony Pictures at Allied in Atlanta. I always had a passion for political science and the legal system, so I went on to receive my juris doctorate from Georgia State University College of Law. While in law school, I externed for CDC’s Office of General Counsel and never wanted to leave. I am currently an ORISE Fellow in the Public Health Law Program and Radiation Studies Branch. PHLN: What drew you to public health law and, more specifically, emergency preparedness public health law? Roszak: Given my background as a firefighter and paramedic, I was naturally drawn to preparedness law. I often think back to my time as a first responder and recall the many questions that seemingly had no answers—liability concerns, issues surrounding duty to act, guardianship, right to refuse medical treatment, privacy concerns around sharing of data, etc. As I experienced firsthand, many times our first responders do not have ready access to legal counsel, thus leaving many questions unanswered. What I enjoy best about my current position is the opportunity to help fill this gap. Klaes: My grandfather was one of the first individuals to contract the West Nile virus and survive. My family’s experience during his recovery sparked my interest in public health and medicine. During my legal education, I became fascinated with the intertwined relationship between public health and legal rights, and their impact on general welfare and disease prevention. I believe public health law is a catalyst to make positive change, which drew me to emergency preparedness law. PHLN: Do you consider yourself a public health law practitioner? If so, in what ways is your job related to public health law? Roszak: I do consider myself a public health law practitioner. As we’ve seen over the past few decades, the definition of legal practitioner has drastically expanded to include more than just our colleagues who practice law day-to-day in the court room. We enjoy an outstanding public health law program here at NACCHO. As the national organization for local public health, we have the privilege of being able to look out across the country, identify trends, and see what legal issues and trends are facing local public health departments. One of the ways that we’re able to keep a pulse on the legal public health landscape is through our Public Health Law Workgroup. The Workgroup is made up of public health law practitioners from across the country. We meet monthly to discuss new and emerging issues, provide situational awareness, and provide technical assistance. Klaes: Yes, I do consider myself a public health law practitioner. For example, the Radiation Legal Preparedness project, which I’m currently working on with CDC and NACCHO, focuses on issues that have never been addressed before in legal research: the ability to restrict the movement and decontaminate individuals contaminated or potentially contaminated with radioactive materials. Understanding a jurisdiction’s public health laws prior to a radiological incident may help legally confine the spread of radioactive contamination, quicken response and recovery efforts within authorized parameters, and save lives. PHLN: What projects are you currently working on and how did you begin working together? Roszak: I’m very privileged to have such a wide array of topics under my portfolio. I am also very fortunate in that I get to work daily with subject matter experts at the local level, along with experts at CDC, Federal Emergency Management Agency (FEMA), U.S. Food and drug Administration (FDA), and the National Library of Medicine (NLM). My current portfolio includes a wide range of topics, including radiation and chemical, biological, radiological and nuclear (CBRNE) incidents, climate change, health and disability, medical countermeasures, pandemic preparedness and food safety to name a few. Recently, we just held the 2014 Preparedness Summit, a yearly event that brings together 1,800 preparedness professionals from across the world. This year the Summit featured at least one session each day examining radiological incidents, a reflection on how important this topic has become to the preparedness community. In addition, many of our public health law workgroup members were involved in a session which examined hot legal topics in preparedness, which examined Health Insurance Portability and Accountability Act, volunteer liability, radiation legal preparedness, training judges on public health principles and practice and offered a sneak peak at CDC’s Public Health Emergency Law Competency Model. Klaes: We are currently working on a radiation legal preparedness educational facilities study. The project focuses on school legal liabilities and response efforts following a release of radioactive material. Recently, we held an exercise in El Paso, Texas, where we met with school personnel, emergency responders, health department officials, and other stakeholders to hold a tabletop exercise. The exercise focused on the response and recovery efforts during the first three hours following a nuclear detonation. PHLN: What is a radiological incident? Roszak: A number of different types of incidents could be considered radiological incidents—acts of terrorism, such as a dirty bomb or a radiological exposure device, nuclear power plant incidents, and localized transportation incidents. These events are typically small in scale, especially when compared to a nuclear incident. Klaes: A radiological incident is any incident that involves the release of radioactive material. It can be a large-scale incident such as a nuclear power plant emergency, dirty bomb, or terrorist attack. Also, a radiological release can result from a small-scale incident such as spilled waste or a faulty medical treatment. PHLN: What is the difference between a radiological incident and a nuclear or radiological emergency? Roszak: A nuclear incident involves a nuclear detonation; all other incidents are called radiological incidents. For example, an incident at a power plant would be called a radiological incident, because there is not a detonation. A detonation is a true catastrophic event, which would overwhelm first responders and cause severe disruptions to our critical infrastructure and society. Elevating an incident to an emergency normally requires a formal declaration by a government entity. Depending on who declares an emergency, certain legal requirements may disappear or be relaxed. Klaes: A nuclear or radiological emergency differs from a radiological incident in that an emergency must be formally declared by the appropriate authority within the affected jurisdiction as either a state emergency declaration or public health emergency declaration. In some jurisdictions, an emergency declaration or public health emergency declaration may trigger laws that expand or clarify the authority to involuntarily decontaminate or restrict the movement of individuals. PHLN: What was the impetus behind studying laws related to responding to radiological incidents? Roszak: There is a growing recognition of the amount of radiological materials in our lives every day. Each day, nearly 60,000 individuals receive nuclear medicine treatments, and radiation sources can be found in a wide array of locations, from hospitals to trains, planes, and automobiles. As recent incidents in Brazil, China, Japan, and Mexico have shown, preparedness officials need to be aware of the potential for radiological accidents, thefts and terrorism. Klaes: After a recent incident in Japan involving the release of radioactive material, CDC determined the need to examine current legal authority concerning the management of and response to incidents involving radioactive contamination. Specifically, CDC had questions about state and local government authority within the United States to decontaminate and restrict the movement of individuals posing a potential threat to public health as a result of being contaminated with radioactive material. PHLN: How are radiological incident laws related to public health? Roszak: We recognize that any radiological incident will prompt a multi-disciplinary response. Each responding agency will have their particular role, from Emergency Medical Services (EMS) with medical treatment to fire with suppression and search and rescue activities, to law enforcement with securing the scene and conducting criminal investigations. Public health also has a key role to play: ensuring that the public’s health, water, and food are as safe as possible. Many public health organizations are first responders in hazardous materials incidents. In particular, during radiation incidents many local health departments will work closely with their Medical Reserve Corps units to set up and establish community reception centers, locations where the public can be screened for and decontaminated from radiation. Klaes: Individuals who are contaminated with radioactive materials can spread the material to others, simply by coming into contact with another individual. Depending on the jurisdiction, radioactive contamination control laws may grant the authority to restrict the movement of these individuals and decontaminate individuals who refuse to comply with first responders. PHLN: Can you give an example of how these laws would be used? Roszak: As with everything in the law, advance planning and knowledge is key. Imagine a scenario where you need to wake up a judge to sign an isolation order at 3 a.m. for someone who is contaminated with radiation. Clearly, you had better be able to point to where your authority for this order derives from. Unfortunately, our findings indicate that some states do not have this authority; the isolation authority is limited to only to communicable or biologic diseases. Having this advanced knowledge and working proactively with state legislators to address these gaps will ensure a more prepared community. Klaes: If a radiological incident were to occur, responders could rely on authorities granted to prevent ingress and egress within a certain area contaminated with radioactive material. Further, laws may provide the authority to involuntarily decontaminate those who came in contact with the contaminated material. PHLN: What are some unique issues that should be considered when planning for radiological incident response? Roszak: Like in other areas of preparedness, pre-planning is key. The time for exchanging business cards is not during a disaster. Communities that are well prepared strive to build and maintain partnerships on a daily basis. While we should all strive to an all-hazards approach, we do recognize that there will be some unique considerations around radiological incidents. Radiation is scary to many people—you can’t see it, taste it, eat it, touch it—this creates a lot of anxiety among the public. Therefore, we recognize that most of our unique challenges will revolve around communicating with the public. Fortunately, there have been a few guides developed by the federal government to examine how best to communicate with the public. For example, in June 2013, FEMA produced Improvised Nuclear Device Response and Recovery: Communicating in the Immediate Aftermath [PDF - 1.1MB] and “Communicating During and after a Nuclear Power Plant Incident [PDF - 4.22MB].” Klaes: In terms of legal issues, many states and local jurisdictions use isolation and quarantine laws to authorize decontamination and restriction of movement of individuals. These provisions are historically embedded with infectious and contagious disease control language and may not be applicable to incidents involving radiation because radiation is not a biologic. Therefore, these provisions may not survive judicial review. PHLN: How do you foresee this area of public health law changing in the future? Roszak: It is our hope that this project will increase awareness of the potential gaps that currently exist in state laws. Through this knowledge, we anticipate state legislatures proactively amending state statutes to provide the legal authority necessary to isolate, decontaminate or restrict the movement of individuals contaminated or potentially contaminated with radiation. Klaes: A response to an incident involving contamination with radioactive material is a multidisciplinary effort involving law enforcement personnel, local health department representatives, radiation subject matter experts, legal representatives, and other stakeholders. It will be important for state and local jurisdictions to have comprehensive conversations about their legal authorities with stakeholders before a radiation incident occurs to help ensure a successful response. PHLN: If you weren’t working in public health law, what would you likely be doing? Roszak: If I weren’t working in public health law, I would likely be working in a related field, such as emergency preparedness or planning. Klaes: I like working with people and problem solving, so I would probably be using my communications background in public affairs or in a court room litigating. PHLN: Have you read any good books lately? Roszak: A few months back, I read the book Five Days at Memorial by Sheri Fink. The book examined Memorial hospital’s response to Hurricane Katrina. Many legal and ethical lines were blurred, as healthcare providers sought to provide care with scarce resources and failing infrastructure. The book was very moving and I had a chance to meet the author at the 2014 Preparedness Summit where was the keynote speaker. Klaes: I recently read The Alchemist by Paulo Coelho. It is a thought-provoking fable and a great book for anyone who likes to travel. PHLN: Is there anything you would like to add? Roszak: Radiation doesn’t have to be a scary subject. There are many wonderful resources to help educate you on radiation. CDC’s Radiation Studies Branch recently launched an entirely redesigned website that contains a wealth of knowledge—everything from videos on radiation basics to infographics. Public Health Law News QuizThe first reader to correctly answer the Quiz question will be given a mini-public health law profile in the July 2014 edition of the News. Entries should be emailed to PHLawProgram@cdc.gov with “PHL Quiz” as the subject heading. Entries without the heading will not be considered. Good luck! Public Health Law News Quiz Question: April 2014 According to the Gallup survey featured in the April 2014 Briefly Noted section, what percentage of U.S. adults are currently without health insurance? Public Health Law News Quiz Question March 2014 Winner!Linda StotskyResponse to the March 2014 Public Health Law News Quiz: Parasitic wasps Employment organization and job title: A brief explanation of your job: Education: University of New Mexico and Furman University (psychology and university studies degrees) Favorite section of the News: Why are you interested in public health law? Public Health Law News Quiz Question February 2014 Winner!Dawn HunterEmployment organization and job title: A brief explanation of your job: Education: Favorite section of the News: Why you are interested in public health law? Court OpinionsNew York: Penal law does not give rise to private right of action against EMT Massachusetts: Boston Church not negligent under Architectural Access Board rules Federal: Common-law battery “misdemeanor crime of domestic violence” Federal Agency: Proposed Medigap contract could violate anti-kickback statute Quotation of the MonthBob Rappaport, M.D., Director, Division of Anesthesia, Analgesia, and Addiction Products in the FDA’s Center for Drug Evaluation and Research“Overdose and death resulting from misuse and abuse of both prescription and illicit opioids has become a major public health concern in the United States,” said Bob Rappaport, M.D., director of the Division of Anesthesia, Analgesia, and Addiction Products in the FDA’s Center for Drug Evaluation and Research. “Evzio is the first combination drug-device product designed to deliver a dose of naloxone for administration outside of a health care setting. Making this product available could save lives by facilitating earlier use of the drug in emergency situations.” Syndicated Content Details:
Source URL: http://www.cdc.gov/phlp/news/2014/2014-04-17.html Source Agency: Centers for Disease Control and Prevention (CDC) Captured Date: 2016-05-23 22:40:49.0
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