Emergency Health Powers Act Reauthorization and Amendments
HF 2436 as amended by House Health and Human Services Licensing Subcommittee
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Minnesota Public Health Emergency Preparedness
The 2002 Minnesota Emergency Health Powers Act (MEHPA) clarified and strengthened the ability of the state and local public health system to develop a coordinated plan with other emergency partners. The Act increased the capacity to effectively respond to public health emergencies, including those caused by acts of terrorism. These powers are scheduled to expire in August 2004.
Global health issues demonstrate the need to continue these powers. Examples include the recent outbreak of SARS, the current avian (bird) flu in Asia, and the continuing risk of bioterrorism. SARS caused 8,098 cases and 774 deaths worldwide in 2003. In Minnesota, 11 people were evaluated as potential SARS cases. The experience of Toronto with 44 deaths, hundreds of cases, and thousands of persons in quarantine shows how quickly government must be ready to act to protect the public’s health through use of limited but significant powers.
Accomplishments since 2002
A February 2003 MEHPA report includes information and comments from health care providers, emergency responders, local government, and citizens. These groups recommended practicing the use of the MEHPA powers through local, regional and state exercises. They also raised some concerns about legal immunity and liability.
Public health emergency exercises will be held in every county in 2004. Needs identified include increased communication and coordination among all emergency responders, supporting large numbers in home isolation or quarantine, and obstacles to recruiting and managing volunteers.
A cross-border conference and conversations with neighboring states and provinces have clarified differences and similarities in approaches and powers. Work continues to understand differences, facilitate sharing resources, and build on strengths.
Discussions with local public health and public safety, county attorneys, and the court system, as well as Toronto’s SARS experience, have better focused preparedness goals.
Based on input from partners and public health experts, we recommend reauthorization of current powers and a few additional provisions:
* Public health emergency declaration and legislative oversight
* Identification and safe disposition of the deceased
* Right to refuse testing and treatment
* Due process and fair treatment protections in isolation or quarantine orders
* Provide liability protection for volunteers to state or local government
* Give Good Samaritan liability protection to responders when hospitals are overwhelmed and care is given in temporary settings
* Allow the commissioner of health to authorize additional persons to assist in providing vaccinations or medications
* Authorize sharing of security information, such as volunteer home phone numbers, with emergency response partners
* Clarify peace officer authority for enforcing isolation or quarantine
* Allow court hearings for isolation or quarantine through electronic means
* Provide job protection for employees who are in isolation or quarantine
Who is affected?
All Minnesotans are potentially affected by a public health emergency. Clarity of public health and hospital roles and responsibilities has been shown in Toronto and other areas to be critical to protecting lives, property, and the economy. The Ontario Health Minister estimated the 2003 SARS outbreak cost (in Canadian dollars) to be $945 million, including the impact on tourism and increased health care costs. (CBC Online News July 8, 2003).
Hospitals, physicians and other health care and emergency providers will have Good Samaritan liability when acting in good faith and according to emergency plans when hospital capacity is exceeded.
Volunteers acting under state or local government during a public health emergency will have the liability protection of a government employee.
Sick or exposed individuals will have rights to expedited court hearings, least restrictive isolation or quarantine, and job protection.
Local and state government personnel will have clarity about roles and responsibilities for public health emergency response.
What are the consequences if this legislation does not pass?
1. The governor will need to rely on current general emergency authority to manage a public health emergency. Communicable disease management, identification and safe disposition of the deceased, or recruitment of health care volunteers may not be addressed.
2. The commissioner of health will rely on laws written over 100 years ago to manage today’s health problems.
3. Modernized and expedited procedures of due process for managing isolation and quarantine will not be in place for individuals, their legal representatives, or the court system.
4. Individuals may have difficulty complying with recommended isolation or quarantine without employment protections.
5. Recruiting volunteers and emergency responders may be more difficult without addressing liability.
Individuals and groups providing input to date:
Task Force on Terrorism and Health
Homeland Security Advisory Committee
State Com. Health Services Adv. Committee
Minnesota Local Public Health Association
Minnesota Hospital Association
Minnesota Medical Association
Minnesota Board of Medical Practice
Minnesota Dental Association
County Attorney’s Association
Minnesota Council of Health Plans
Minnesota Public Health Association
Association of Minnesota Counties
Department of Public Safety
Ramsey County Court Administrator
Minnesota Business Partnership
Minnesota Chamber of Commerce
Minnesota Board of Nursing
Minnesota Ambulance Association
Minnesota Nurses Association