Valerie
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the bills have been written..
It's a medical RECOMMENDATION not a legal mandate.
Use of Influenza A (H1N1) 2009 Monovalent Vaccine
Flu Facts: What You Need to Know
And there are preparations in place for pandemic flu.
Influenza Pandemic Preparedness PlanSECTION 10
- LEGAL CONSIDERATIONS FOR PANDEMIC INFLUENZA -
The Legal Considerations Section includes the following subsections:
Legal Issues
Describes substantive legal issues that are likely to arise in a pandemic and how they are being addressed.
Legal Resources
Lists available legal resources and indicates where they may be found. These include model documents such as legal orders that the Commissioner might issue; background documents on websites; etc.
Partnerships and Outreach
Describes committees and advisory groups that have legal components and/or are addressing legal issues.
Training
Describes past, current and future training programs on legal issues.
Other Agencies
Lists legal issues that are the responsibility of other state agencies.
Miscellaneous
Addresses additional minor legal issues.
LEGAL ISSUES
1. Emergency Declarations
There are two statutes in Massachusetts that allow the Governor to declare an emergency.
Public Health Emergency. Under M.G.L. c. 17, § 2A, if the Governor declares that an emergency exists which is detrimental to the public health, the DPH Commissioner may, with the approval of the Governor and the Public Health Council, take such action and incur such liabilities as he may deem necessary to assure the maintenance of public health and the prevention of disease. In addition, with the approval of the Public Health Council, the Commissioner may establish procedures to be followed during such emergency to insure the continuation of essential public health services and the enforcement of the same.
Pandemic Period: The Commissioner and senior DPH staff will be in continuous close touch with the Governors office. If the Commissioner determines that the situation warrants a declaration of public health emergency based on epidemiological information, speed of disease spread, etc., he would request that the Governor issue such a declaration. Once the declaration is made, the Commissioner would have all necessary authority to issue orders; waive statutes and regulations that impede emergency response; seize property if necessary, etc.
State of Emergency. Under Chapter 639 of the Acts of 1950, the Governor may declare a state of emergency due to (among other circumstances) the occurrence of any disaster or catastrophe resulting from attack, sabotage or other hostile action; or from riot or other civil disturbance; or from fire, flood, earthquake or other natural causes. Because an influenza pandemic can be considered a catastrophe resulting from natural causes, the Governor might decide to declare a state of emergency concurrent with declaring a public health emergency, or without declaring a public health emergency.
By the terms of the statute, a state of emergency confers upon the Governor extraordinary powers to protect the lives and property of the citizens of the Commonwealth and to enforce the laws. In practice, if a state of emergency were declared during a pandemic, MEMA would activate the State Emergency Operations Center and DPH would be a crucial participant in emergency response under ESF-8. It is expected that the Governor would delegate broad health-related powers to the DPH Commissioner, with the result that there would be little if any practical difference between a declared public health emergency and a declared state of emergency.
DPH legal counsel are familiar with the powers available under both types of emergency declarations, and would advise policy makers on appropriate legal means to achieve policy goals.
2. Restrictions on Personal Liberty
Isolation and Quarantine. Legal preparations have been and are continuing to be made to isolate or quarantine individuals or groups of people, should DPH policy makers decide that such measures are necessary to protect the public health during the Pandemic Alert Period and/or the Pandemic Period.
Massachusetts statutes and regulations authorize isolation and quarantine for diseases dangerous to the public health.
Legal materials for isolation and quarantine of individuals, originally developed for SARS, have been modified for pandemic flu. These are complied into a set of documents known as Legal Nuts and Bolts of Isolation and Quarantine, available from the DPH Office of General Counsel and the Health Education Unit, Division of Epidemiology and Immunization. They include documents that state and local health authorities would use for stepwise enforcement of isolation and quarantine, beginning with letters requesting voluntary cooperation, up to court pleadings and related documents to compel isolation.
Due process protections have been considered in drafting these documents, guided by the principle that whatever measure is used should be the least restrictive of personal liberty while protecting public health. Non-custodial orders (e.g. home isolation) may be appealed by a telephone call to a health official, while custodial measures (e.g. isolation in a hospital) would in most cases require a court order. Efforts will be made to ensure that people who are subject to court proceedings for mandatory isolation or quarantine have access to attorneys. Judges may be contacted at any time, day or night, through the State Police.
Other Restrictions on Personal Liberty. It is possible that a wide variety of other measures might become necessary to protect the public health during a Pandemic Alert Period or Pandemic Period, some of which impose certain restrictions on personal liberty. Examples include requiring people to self-monitor for medical conditions; requiring medical evaluations and/or vaccinations, prophylaxis, or medical treatment; closing businesses, public transportation; etc.
Templates have been drafted for orders that the DPH Commissioner could issue during a public health emergency, and additional templates are in process. The templates include findings or statements that the measures being ordered are the least restrictive alternative or the most reasonable way to address the threat to public health.
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LEGAL RESOURCES
1. Model Documents
During the Pandemic Period and possibly during the Pandemic Alert Period, it may become necessary for the Commissioner to issue various orders to protect the public health. Various templates for such orders have been drafted, which are located in the DPH Office of General Counsel.
2. Documents for Isolation and Quarantine
The Legal Nuts and Bolts of Isolation and Quarantine package includes model health letters, health orders, court pleadings, and related documents. It is available from the DPH Office of General Counsel and the Health Education Unit, Division of Epidemiology and Immunization.
3. Other Legal Information
A summary document and PowerPoint presentation dealing with liability protections for Massachusetts health care volunteers responding to a disaster may be found at Emergency Preparedness - Health and Human Services
Additional legal resources and tools include:
Draft Model State Emergency Health Powers Act www.publichealthlaw.net/MSEHPA/MSEHPA2.pdf
Emergency Management Assistance Compact as adopted in Massachusetts CHAPTER 339 OF THE ACTS OF 2000 MA INFLUENZA PANDEMIC PREPAREDNESS PLAN October 2006
129
International Emergency Management Assistance Memorandum of Understanding as adopted in Massachusetts
CHAPTER 300 OF THE ACTS OF 2002 (See section 58)
Model Memorandum of Understanding for Establishment of Local Public Health Mutual Aid and Assistance System www.publichealthlaw.net/Resources/ResourcesPDFs/MOU.pdf
American Bar Association Draft Checklist for State and Local Government Attorneys to Prepare for Possible Disasters Welcome to the Center for Law and the Public's Health
CDC: Legal Authorities for Isolation and Quarantine (links to information on federal authority for isolation and quarantine) CDC | Legal Authorities for Isolation and Quarantine
Quarantine and Isolation: Lessons Learned from SARS (A report to CDC) http://www.louisville.edu/medschool/ibhpl/images/pdf/SARS REPORT.pdf
Checklists on Legal Preparedness for Bioterrorism and other Public Health Emergencies (from the Center for Law and the Publics Health at Georgetown and Johns Hopkins Universities) Welcome to the Center for Law and the Public's Health
Legal Materials Related to Public Health Legal Preparedness from CDCs Public Health Law Program Public Health Legal Response and Preparedness - CDC
Additional materials and resources may be posted at Public Health Law