December 06, 2002
In this issue:
- Smallpox Pre—Event Vaccination Update
- Emergency Health Powers Act Study—Public Meeting on Liability, Immunity and Insurance Issues
- Martin County Pandemic Flu Table Top
- Commissioner’s Terrorism and Health Mental Health & Emergency Preparedness Subgroup
- SCHSAC Local Public Health Preparedness Review Group
MDH Office of Emergency Preparedness just received the following information on the effective date of the liability protections in the federal Homeland Security Act late in the day on December 5, 2002. MDH will be following up with additional information as it becomes available.
The Department of Health and Human Services has determined that January 24, 2003 is the current effective date for whatever liability protections are actually provided under the recently enacted Homeland Security bill. The Administration will seek urgent Congressional action on an amendment to move that date forward as soon as the Congress convenes on January 6. Preliminary indications are that there will be little, if any, opposition to the rapid adoption of that amendment by both Houses of Congress. HHS has indicated that unless an actual case of smallpox should occur, no state will be asked to actually initiate civilian vaccination until these liability protections are in effect.
HHS has also indicated that the promised additional information concerning questions about liability and compensation will be forthcoming in the very near future.
The 2002 Minnesota Legislature passed the Emergency Health Powers Act. One provision in the Act requires the Minnesota Department of Health to study the adequacy of the liability and immunity provisions that were enumerated in Section 20. On October 31, 2002, the Minnesota Department of Health held a half-day public meeting on liability, immunity, and insurance issues that might arise in a public health emergency. These issues are already appearing in early stages of the federal government's planning to vaccinate certain health care and other key personnel so that they would be ready to perform mass vaccinations and care for smallpox cases in the event of a bioterrorist incident.
After an introduction by Aggie Leitheiser, the MDH Assistant Commissioner participants heard from Kris Ehresmann, Manager of the Immunization, Tuberculosis and International Health Section, on federal smallpox preparedness planning and from Dr. Harry Hull, State Epidemiologist, on the difficult ethical decisions physicians and other emergency personnel would confront when a public health emergency overwhelms the capacity of the health care system and necessitates rationing of care. Beth Devine and Mike McClure of the Minnesota Joint Underwriting Association, assisted by their legal counsel, explained the role of the Association as an insurer of last resort and the application of current insurance to smallpox preparedness efforts. Dennis Walter of the Minnesota Division of Emergency Management spoke on the Medical Reserve Corps and other volunteer efforts under the President's Citizen Corps initiative. Steve Shakman, OEP Legal Affairs Coordinator, addressed federal, Minnesota and other states' laws protecting volunteers from liability. Ken Kohnstamm, Manager of the Attorney General's tort claims and employment law division, discussed defense of legal claims against the state, legal immunities encountered in this work, and the trend in the courts to treat claims against public health care providers the same as those against private providers. The meeting concluded with suggestions from participants relating to mutual aid pacts, volunteer utilization, workers compensation and furlough issues arising in smallpox planning, activation and off-site use of personnel in an emergency, and other concerns.
On November 21, 2002 Martin County conducted a pandemic flu tabletop with approximately 100 participants from the local community. Carmen Reckard, Faribault/Martin County Public Health Director organized the tabletop. A diverse group of participants attended the event including individuals from the National Guard, law enforcement, firefighters, emergency management, MDH staff, clergy, health care workers and the news media.
The objective of the tabletop was to bring the community together to discuss how it would respond to a public health emergency and to determine the next steps to improve the community response to a public health emergency. The tabletop format consisted of an education portion and an interactive scenario designed to elicit discussion about the Martin County response to pandemic flu.
Shelly Feaver, MDH Epidemiologist, gave an overview presentation on the pandemic flu and Robert Meschke, the Martin County Sheriff described the Martin County emergency management system. The remainder of the tabletop focused on a pandemic flu scenario that was presented in three modules. Participants were assigned to seven discussion groups. At the end of each module four questions were posed for the groups to discuss. In module I an outbreak of flu occurs in China and the small groups answered questions on how Martin County should prepare for the arrival of pandemic flu. Module II describes the impact of the pandemic flu on Martin County and posed questions on how the community will respond to a widespread public health emergency. Module III dealt with long-term recovery issues for Martin County.
The second meeting of the mental health subgroup was held on November 12, 2002. The group discussed mental health planning that provides coping strategies and planning for future mental health needs of the community. In future meetings, the group will discuss the mental health response system that is currently in place throughout Minnesota and examine long-term recovery issues for mental health.
The SCHSAC Local Public Health Preparedness Review Group met for the first time on November 22. This group is charged to: Clarify the activities, outcomes, and reporting mechanism for the local Community Health Board bioterrorism grants so that local grantees and MDH are successful in meeting the benchmarks established by the CDC.
At this first meeting, the group focused on the planning requirements related to the local public health preparedness grant funds. Staff from the Office of Emergency Preparedness updated the group on planning efforts related to the National Pharmaceutical Stockpile, mass clinics, and smallpox (pre-event and post-event). The group reviewed the template for public health annex to county emergency plans (which all local public health departments were required to submit to MDH last year). The group suggested that MDH staff should update this template so that it could be used for local public health preparedness planning. The group also reviewed the planning requirements in the project agreements and discussed accountability for those items.
Membership of the group includes SCHSAC representatives, local public health staff and elected officials. The group is co-staffed by the Office of Emergency Preparedness and the Community Health Division.