ABA August 10 Telecon G Matthews

Slide1: 

Gene W. Matthews, J.D. CDC Foundation 50 Hurt Plaza, Suite 765 Atlanta, GA 30303 (404) 373-1276 MatthewsPHLaw@aol.com Institute of Public Health Law INSTITUTE of PUBLIC HEALTH LAW

Historical Role of Attorneys and 21st Century Public Health Practice : 

Historical Role of Attorneys and 21st Century Public Health Practice INSTITUTE of PUBLIC HEALTH LAW ABA Center for Continuing Legal Education Understanding the Role of Public Health in Your Practice August 10, 2005

Historical Context: 

Historical Context 100 years ago, lawyers were integral to the practice of public health at the community level Example, Teddy Roosevelt and Long Island polio quarantine of 1890’s Example, in 1905 a Chicago lawyer founded the Rotary Club: --Purchased a horse for the doctor --Built the first public restroom in Chicago INSTITUTE of PUBLIC HEALTH LAW

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HISTORICAL CONTEXT 1950’s : Two Ships Passed in the Night! Salk Polio Vaccine – 1955 (END IN U.S. OF COMMUNITY-WIDE PUBLIC HEALTH CONTROL MEASURES—300 years!) Brown v. Board of Education 1954 (BEGINNING OF MODERN EVOLUTION OF PROCEDURAL PROTECTIONS OF INDIVIDUAL LIBERTIES AGAINST GOVERNMENT ACTION) INSTITUTE of PUBLIC HEALTH LAW

“A renaissance is now taking place in public health law”(…and just in time!): 

“A renaissance is now taking place in public health law” (…and just in time!) INSTITUTE of PUBLIC HEALTH LAW

Natural Events: 

Natural Events 21st Century Emerging Infections Mad Cow Disease West Nile Virus SARS Monkey Pox Avian Flu Marburg Disease?? Cascade of Communications Challenges INSTITUE of PUBLIC HEALTH LAW

Slide7: 

Population Density 21st Century: Travel Time vs. Population Density Travel Time INSTITUE of PUBLIC HEALTH LAW

Human Events : 

Human Events 21st Century Asymmetrical Terrorism Bioterrorism Events Anthrax attacks of 2001 Smallpox vaccinations of 2003 Ricin events in 2003-2004 “Conventional” Weapon Events Airliner hijackings of 9/11/2001 Madrid subway attacks of 2004 London transit attacks of 2005 Chemical & Nuclear Threats Chemical weapon concerns-(Sarin gas in Tokyo subway) “Suitcase bomb” & “dirty bomb” scenarios Communications Cascade INSTITUE of PUBLIC HEALTH LAW

Question: “Why should I care?”: 

Question: “Why should I care?” “In an outbreak situation, the private sector cannot afford for government to fail!” Governments are facing multi-level budget deficits-federal, state, & local In an outbreak, government is going to need the help of the private sector Answer: INSTITUTE of PUBLIC HEALTH LAW

Law/Policy Change in Public Health Emergency: 

Law/Policy Change in Public Health Emergency INSTITUTE of PUBLIC HEALTH LAW THE GREEN ZONE “normal time” “Emergency” THE RED ZONE (Culture temporarily Changes) Immediate Aftermath Moment of Law & Policy Change …and… “THE BLAME GAME” may begin! (Selective Amnesia Returns)

30,000 “voluntary” quarantines over 3 months  27 formal quarantine orders…and..  1 appeal (withdrawn) MORE SOCIAL COHESIONToronto experienced a temporary shift increasing social cohesionCompliance with quarantine directives was substantial One example of how a culture temporarily changes  : 

30,000 “voluntary” quarantines over 3 months 27 formal quarantine orders…and.. 1 appeal (withdrawn) MORE SOCIAL COHESION Toronto experienced a temporary shift increasing social cohesion Compliance with quarantine directives was substantial One example of how a culture temporarily changes The Toronto Example of the RED ZONE—2003 SARS NOT DIVISIVENESS & PANIC INSTITUTE of PUBLIC HEALTH LAW

A “Tipping Point” for SARS Leadership in Toronto: 

A “Tipping Point” for SARS Leadership in Toronto On the day that the large medical convention cancelled in Toronto, the center of leadership shifted: A Health Problem for An Economic Problem Government Leaders for Business Leaders To Solve To Solve INSTITUTE of PUBLIC HEALTH LAW BECAME

Initial Lessons: 

Initial Lessons Lessons from Toronto are readily understandable and are transferable to other settings. The Biggest Lesson: The “Balance of Governance” is significantly (if only temporarily) altered during an emergency. Business and Public Health need to build bridges with each other before a crisis. INSTITUTE of PUBLIC HEALTH LAW

The Green Zone: Normal Times: 

The Green Zone: Normal Times INSTITUTE of PUBLIC HEALTH LAW Normally, there is distance between these entities because of different goals, agendas, & strategies

The RED ZONE: An Emergency: 

The RED ZONE: An Emergency INSTITUTE of PUBLIC HEALTH LAW Relationships are altered during an emergency—we need to plan for it…now. Persons are more likely to follow quarantine orders Employees get their information through their employers Businesses engage & lead in economic recovery plans

An Example of One Window of Change:Rapid National Legal/Policy Changes That Followed 9/11/01: 

An Example of One Window of Change: Rapid National Legal/Policy Changes That Followed 9/11/01 Department of Homeland Security created BT Infrastructure Block Grants to states USA PATRIOT Act Enacted Select Agent Rule for control of BT pathogens Model State Emergency Health Powers Act Drafted Airline Recovery Legislation Enacted INSTITUTE of PUBLIC HEALTH LAW

Law/Policy Change in Public Health Emergency: 

Law/Policy Change in Public Health Emergency INSTITUTE of PUBLIC HEALTH LAW THE GREEN ZONE “normal time” “Emergency” THE RED ZONE (Culture temporarily Changes) Immediate Aftermath Moment of Law & Policy Change …and… “THE BLAME GAME” may begin! (Selective Amnesia Returns)

What can we do to plan for moments of legal and policy change?: 

What can we do to plan for moments of legal and policy change? Start linking businesses, governments, & civic leaders about this agenda Use civic groups, trade associations, academic centers & preparedness forums to address these obvious issues. Examine legal concerns: sick leave policies, liability limitation, compensation, insurance coverages, Good Samaritan Laws, etc. Recognize that the “normal”, risk-averse decision-making does not always work in the Red Zone INSTITUTE of PUBLIC HEALTH LAW

Slide19: 

Rediscover leadership role of community lawyers in public health Remember the model of 100 years ago Lawyers are also interested in community public health issues beyond emergency preparedness Policy reform is instinctive to lawyers A Reminder for the 21st Century INSTITUTE of PUBLIC HEALTH LAW

Slide20: 

Gene W. Matthews, J.D. CDC Foundation 50 Hurt Plaza, Suite 765 Atlanta, GA 30303 (404) 373-1276 MatthewsPHLaw@aol.com Institute of Public Health Law INSTITUTE of PUBLIC HEALTH LAW "The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.”