Legal Advisors for Medical Response to Mass Casualty Incident

• General Comments
• Assessment of State and Local Laws Regarding Management of Persons During Radiation Incident
• Emergency Declaration Authorities Across all States and DC
• HIPAA Issues

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General Comments

• Legal issues for medical planning and response to a mass casualty radiation incident will vary with
  • Nature, severity, cause, and location of the radiation incident
  • Agency through which the responder is operating and its own rules and regulations
  • Professional capacity of the responder
  • Training and certification of the responder
  • Normal scope of practice of the responder
  • "Normal" or "altered standard of care" (e.g. Crisis) existing during the response where the responder is working
  • Activity performed or not performed
• Medical practice, standards of care, and liability issues are complex and each practitioner should consult with experts in his/her venue and organization to obtain the best and most current advice.
• Inclusion of references on this page does not constitute official US government or HHS endorsement.
• Overview of federal and state laws for all-hazards mass casualty incidents (HHS/CDC)

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Assessment of State and Local Laws Regarding Management of Persons During Radiation Incidents

• Public Health Preparedness: Examination of Legal Language Authorizing Responses to Incidents Involving Contamination with Radioactive Material (PDF - 670 KB) (HHS/CDC/RSB and CDC/ATSDR; CDC/Office for State, Tribal, Local and Territorial Support; Legal Preparendess Project: collaboration between CDC and NACCHO), May 2014)
  • Designed to answer 2 questions: Do states and select jurisdictions...
    • "Possess the authority to decontaminate persons contaminated with radioactive material?"
    • "Have the authority to restrict the movement of persons contaminated with radioactive material? (e.g. quarantine)?"
  • Goals
    • "Identify and categorize the current landscape of laws that may be available to decontaminate and restrict personal movement of persons contaminated or potentially contaminated with radioactivity"
    • "Foster collaboration among stakeholders to enhance preparedness and response"
  • Conducted a legal assessment of all fifty states, New York City, Los Angeles, and Washington, D.C.
    • Text, maps and tables show comparisons among these jurisdictions

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Emergency Declaration Authorities Across all States and DC

• Links to legal authorizations for each of the 50 states and DC (The Network for Public Health Law)
  • Table provides state statutory and regulatory authorities for emergency declarations in all 50 U.S. states and the District of Columbia including
    • Emergency declarations, public health emergency declarations, and other types of declarations that may relate to the public's health.

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HIPAA Issues

• HHS information about HIPAA (HHS)
  • Emergency Situations: Preparedness, Planning, and Response (HHS)
  • Disclosure for Emergency Preparedness - A Decision Tool (HHS)
  • Public Health (HHS)
  • Health Information Technology (HHS)

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References

• Radiological Legal Preparedness: Considerations, Research, and Lessons Learned (Network for Public Health Law: 1.5 hour webinar slides from July 23, 2015)
• Chu VS, Emergency Response: Civil Liability of Volunteer Health Professionals (PDF - 144 KB) (Congressional Research Service, 7-5700, R40176, January 2011)
• New York State Public Health Legal Manual: A Guide for Judges, Attorneys and Public Health Professionals, Editor-in-Chief: Michael Colodner (PDF - 650 KB) (New York State Bar Association in Collaboration with NY State Unified Court System, State of NY Department of Health, NY City Department of Health and Mental Hygiene, 2011)
• Sherman, SE. Legal Considerations in a Nuclear Detonation. Disaster Med Public Health Prep. 2011 Mar;5 Suppl 1:S65-72. [PubMed Citation] Full Text (PDF - 87 KB)
• Hodge JG, Courtney B. Assessing the Legal Standard of Care in Public Health Emergencies, JAMA 2010; 303(4):361-362. [PubMed Citation]
• Anderson ED, Hodge JG. Emergency Legal Preparedness Among Select US Local Governments. Disaster Med Public Health Preparedness 2009;3(Suppl 2):S176-S184. [PubMed Citation]
• Hoffman S, Goodman RA, Stier D. Law, Liability, and Public Health Emergencies. Disaster Med Public Health Preparedness 2009;3:1-9. [PubMed Citation]
• Crisis Standards of Care
  • Crisis Standards of Care: A Toolkit of Indicators and Triggers (Institute of Medicine, July 31, 2013)
  • Crisis Standards of Care (CSC): A Systems Framework for Catastrophic Disaster Response (Institute of Medicine, March 21, 2012)
  • Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations, a Letter Report (Institute of Medicine of the National Academies, 2009).
    • Allocation of Scarce Resources During Mass Casualty Events (HHS/AHRQ, June 2012) (This report represents follow-up after the 2009 IOM report.)
• Hodge JG, Garcia AM, Anderson E, Kaufman T. Emergency Legal Preparedness for Hospitals and Health Care Personnel. Disaster Med Public Health Preparedness 2009;3(Suppl 1)S37-S44. [PubMed Citation]
• Barnett DJ, Taylor HA, Hodge JG, Links J. Resource Allocation on the Frontlines of Public Health Preparedness and Response: Report of a Summit on Legal and Ethical Issues. Public Health Reports 2009;124:295-124. [PubMed Citation]
• Selected lectures on Public Health Law, Sandra Day O'Connor School of Law, Arizona State University. Accessed August 18, 2012.
• Hodge JG, Anderson ED. Principles and Practice of Legal Triage During Public Health Emergencies. 64 NYU Annual Survey of American Law, 249 (2008-2009).

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