Emergency Management Law 101

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Emergency Management Law 101
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• Gene Matthews
• 21st Century Preparedness Issues for Government
  Lawyers
• Mike Vincent
• Emergency Management Law 101
• Marla Decker
• Ethical Considerations for Emergency Services
  Managers
• Gene Matthews
• CDC Public Health Emergency Law Course

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Institute of Public Health Law

• Gene W. Matthews, J.D.
• CDC Foundation
• 50 Hurt Plaza, Suite 765
• Atlanta, GA 30303
• [phone]
• MatthewsPHLaw_at_aol.com

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PUBLIC HEALTH EMERGENCY LAW IN THE 21st CENTURY
REINVENTING THE HISTORIC ROLE OF LAWYERSNAAG
Training ConferenceEast Lansing, MichiganApril
19, 2005
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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 1890s
• Example, in 1905 a Chicago lawyer founded the
  Rotary Club
• --Purchased a horse for the doctor
• --Built the first public restroom
• in Chicago

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• HISTORICAL CONTEXT
• 1950s Two Ships Passed in the Night!
• Salk Polio Vaccine 1955
• (END IN U.S. OF COMMUNITY-WIDE PUBLIC
• HEALTH CONTROL MEASURES300 years!)
• Brown v. Board of Education 1954
• (BEGINNING OF MODERN EVOLUTION OF PROCEDURAL
  PROTECTIONS OF INDIVIDUAL LIBERTIES AGAINST
  GOVERNMENT ACTION)

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Federal, State and Local Legal Preparedness
The Silos
Public Health
Law Enforcement
Emergency Management
Medical Services
Agriculture
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A renaissance is now taking place in public
health law(and just in time!)
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Natural Events

• 21st Century Emerging Infections
• Mad Cow Disease?
• ?West Nile Virus?
• ?SARS?
• ?Monkey Pox?
• ?Avian Flu?
• ?Marburg Disease???

Cascade of Communications Challenges
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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
• Chemical Nuclear Threats
• Chemical weapon concerns
• Suitcase bomb dirty bomb scenarios
• OR Biocontainment Error
• In 2005, a test strain of 1957 Flu was sent
  to labs by mistake

Communications Cascade
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The Guns Of August Analogy

• Great Tragedies Occur When Technology Leaps
  Ahead of Strategy and Doctrine.
• - Barbara Tuchman
• Our 21st Century Global Communication Technology
  Has Jumped Ahead of Our 20th Century Strategy and
  Doctrine.

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Human Events
Asymmetrical Terrorism

• COMMUNICATION

EVENT
Audience
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21st Century Travel Time vs. Population Density
Population Density
Travel Time
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The 21st Century WorldNew Triangulation on
Public Health
Guns of August Leap The Global Access to
Communications Technology
Communication Technology
HUMANs Challenges
NATUREs Challenges
PUBLIC HEALTH
Natural Events
Human Events
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The 21st Century World

• You dont need a weatherman,
• to know which way the wind blows.
• (1965 Bob Dylan)
• ----------------------------------------
• It is going to rain, folks,
• in this 21st Century.

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Question Why should I care?
Answer

• 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

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Changing Global Business Environment

• Multi-national Corporations Are NOW In the
  Business of Public Health
• (Just as 40 years ago employers became part of
  the health care delivery systems to their
  employees.)

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Thinking Beyond the Red Zone Overview
Emergency THE RED ZONE (The
culture temporarily changes)
Key Moment of Law Policy Change
(Immediate Aftermath) GREY ZONE
Then return to normal time again selective
amnesia
THE GREEN ZONE normal time
Yet, some never forget!
and THE BLAME GAME may begin!
Stages of a Community Emergency
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The Green Zone

• Most of the time, communities and individuals
  proceed as though things are normalthis can be
  called the green zone

normal time
Stages of a Community Emergency
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The Red Zone

• When a serious emergency happens, social cohesion
  may increase in a community
• Individuals, business, and institutions may all
  behave differently
• Examples
• Tokyo after the 1995 Sarin gas attacks
• NY City after 9/11/01 events
• Madrid following 2004 subway bombings
• Florida following hurricanes in fall 2004

Emergency THE RED ZONE (The
culture temporarily changes)
Stages of a Community Emergency
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30,000 voluntary quarantines over 3 months
27 formal quarantine ordersand..
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
The Toronto Example of the RED ZONE2003 SARS
NOT DIVISIVENESS PANIC
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The Grey Zone

• Frequently, for a short time immediately
  following a disaster or emergency, rapid changes
  can take place in both law and policy
• This may be due to both the social cohesion and
  the need to take action that has build up during
  an emergency
• Policy makers, lawyers, and elected officials
  should anticipate this key window of opportunity
  that can open up
• This window should be planned for in advance
  during the normal time of the GREEN
  ZONE.

Key Moment of Law Policy Change
(Immediate Aftermath) GREY ZONE
Stages of a Community Emergency
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An Example of One Window of ChangeRapid
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

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Return to Normal Time The Green Zone Again

• --Unfortunately, after the event is over, we can
  quickly forget the lessons learned
• --Some scholars call this a selective amnesia
  that takes place, perhaps due to the constant
  information overload in our modern society
• --This trend makes it very important to take
  advantage of those brief windows of opportunity
  that permit laws and policies to be improved

Then return to normal time again selective
amnesia
Stages of a Community Emergency
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Yet, Some People Never Forget!

• --On the other hand, long after the event is
  over, some individuals, who were significantly
  impacted by the emergency, always remember the
  lessons learned
• --These cohorts can become important partners to
  improve preparedness laws, plans, and policies in
  anticipation of the next emergency
• --EXAMPLES
• --The health care workers of Toronto who handled
  the SARS epidemic of 2003
• --The workers of office buildings in Lower
  Manhattan in September 2001

Yet, some never forget!
Stages of a Community Emergency
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Finally, The Blame Game Might Take Place

• After the emergency is over, you
• should expect or prepare for the
• following
• --Media Investigations
• --Oversight Commissions
• --Demands for OIG Audits
• --New Legislation
• --Lawsuits

And THE BLAME GAME may begin!
Stages of a Community Emergency
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The Long Term Challengeof The Blame Game
Emergency THE RED ZONE (The
culture temporarily changes)

• During the emergency response
• Everyone pitches in to save lives, protect
  property, and promote public health and safety
• Federal, state, local governments
• non-profit sector
• businesses
• Individualsall tend to cooperate.
• Procedures and paperwork seem secondary

And THE BLAME GAME may begin!
Stages of a Community Emergency
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The Long Term Challengeof The Blame Game
(cont.)
Emergency RED ZONE (The culture temporarily ch
anged)
Then returned to normal time again selective
amnesia

• It is only later that questions are raised about
  who did what? when, and why?"

And THE BLAME GAME begins
Stages of a Community Emergency
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Conclusions?
Emergency THE RED ZONE (The
culture temporarily changes)
Key Moment of Law Policy Change
(Immediate Aftermath) GREY ZONE
Then return to normal time again selective
amnesia
normal time
Yet, some never forget!
And THE BLAME GAME may begin!
Stages of a Community Emergency
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Conclusion
Always Remember and Prepare For The Potential
for Changes in Law, Policy, and Litigation That
Can Occur During and After a Public Health
Emergency
Yet, some never forget!
Stages of a Community Emergency
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Institute of Public Health Law

• Gene W. Matthews, J.D.
• CDC Foundation
• 50 Hurt Plaza, Suite 765
• Atlanta, GA 30303
• [phone]
• MatthewsPHLaw_at_aol.com