legal_basis_of_public_health

legal_basis_of_public_health - Legal Basis and Governmental...

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Unformatted text preview: Legal Basis and Governmental Roles of Public Health James Crucetti, MD, MPH Albany County Health Department Objectives Overview of local public health mission and essential services Describe legal basis and enforcement powers of public health agencies to achieve mission. Case studies to illustrate responsibilities and action to protect public health. New York New Jersey Public Health Training Center 2 What Is Public Health? New York New Jersey Public Health Training Center 3 Institute of Medicine Report: "Future of Public Health" The mission of Public health is defined as fulfilling society's interest in assuring conditions exist in which people can be healthy. Three core functions identified: Assessment Policy Development Assurance New York New Jersey Public Health Training Center 4 The three "P's" of Public Health P revention of chronic & communicable diseases and injuries P rotection against hazards which threaten health and safety P romotion of health and well-being New York New Jersey Public Health Training Center 5 10 Essential Public Health Services Monitor health and diseases to identify trends Diagnose and investigate health problems and hazards Inform, educate, and empower people about health issues Mobilize community partnerships to identify and solve health problems Develop policies and plans that support individual and community health efforts New York New Jersey Public Health Training Center 6 10 Essential Public Health Services, continued Enforce laws / regulations that protect health & safety Link people to needed health services and provide care when otherwise unavailable Assure a competent public health and health care workforce Evaluate effectiveness, accessibility, and quality of personal and population-based health services Research for new insights and innovative solutions to health problems New York New Jersey Public Health Training Center 7 Public Health Affects You. Expect your restaurant to be clean and safe? That's public health. Want to know what to eat to stay healthy? That's public health. Want to know how to avoid getting a tick bite? That's public health. New York New Jersey Public Health Training Center 8 Public Health Affects You. Are you protected from measles and chickenpox? That's public health. Did you ever get screened for cancer? That's public health. Expect your community to be ready for a bioterroist attack? That's public health. New York New Jersey Public Health Training Center 9 Federal Public Health Agencies Food and Drug Administration Centers for Disease Control and Prevention Health Resources and Services National Institutes of Health Office of Public Health Preparedness (OPHP) New York New Jersey Public Health Training Center 10 Federal Public Health Powers Authority to tax and spend Tax on tobacco, alcohol, firearms; Grant funds to state with conditions Authority to regulate interstate commerce FDA centrally regulates foods, drugs, medical devices that cross state borders New York New Jersey Public Health Training Center 11 State Agencies - NYS DOH Main legal authority for public health New York New Jersey Public Health Training Center 12 Local Health Departments AGPALL A Governmental Presence At Local Level New York New Jersey Public Health Training Center 13 So how does public health work get done? Governmental roles and legal basis of public health New York New Jersey Public Health Training Center 15 NYS CRR New York New Jersey Public Health Training Center 16 Public Health Laws Provides foundation for legal intervention to prevent disease and injury and protect public health Public Health Regulations Provides specificity, based upon the enabling legislation (laws), to describe actions, authority, penalties, etc. New York New Jersey Public Health Training Center 17 Governmental Authorities The governmental level with highest authority has the ultimate power. Federal Rule Federal Regulation State Rule State Regulation Local Rule Local Regulation New York New Jersey Public Health Training Center 18 NYS Public Health Law, Article 6 Provides funding formula for reimbursement to LHD for core public health service delivery Requires NYS DOH approval Broadly describes core services to be delivered Outlines penalty if fail to maintain effort to deliver core public health services New York New Jersey Public Health Training Center 19 NYS CRR, Part 40 "Regulations" Outlines specifically the requirements for completing core public health services essential public health services. Specifies content of the Municipal Public Health Services Plan Requires NYS DOH approval New York New Jersey Public Health Training Center 20 ACHD enforces the NYS Public Health Laws, NYS Codes, Rules and Regulations, and NYS & Albany County Sanitary Codes New York New Jersey Public Health Training Center 21 Functions of Law Regulates conduct Protects individual and property rights Defines the duties and responsibilities of government and individuals New York New Jersey Public Health Training Center 22 Police Powers Describes the authority of governments to regulate private interests for public good New York New Jersey Public Health Training Center 23 Police Powers, defined ...the inherent authority of the state and through delegation, local government, to enact laws and promulgate regulations to protect, preserve, and promote the health, safety and general welfare of the people. Gostin et. al. New York New Jersey Public Health Training Center 24 Police Powers of Public Health Compulsory vaccination and testing Isolation and quarantine Inspection and monitoring Issuance of permits and licenses Abatement of unsanitary conditions and public health "nuisances" Mandatory reporting of certain diseases Regulation of persons, professionals New York New Jersey Public Health Training Center 25 Public Health v. Personal Freedoms New York New Jersey Public Health Training Center 26 Public Health v. Personal Freedom Example: Compulsory Vaccination New York New Jersey Public Health Training Center 27 Court Order - necessary police power to protect public xxxxxxxxxxxxxxx New York New Jersey Public Health Training Center 28 Public Health v. Personal Freedoms Broad discretionary Authority to abate "Public Health Nuisances" November 9, 1915 New York New Jersey Public Health Training Center 29 Nuisance: a condition that violates requirements of health and safety New York New Jersey Public Health Training Center 30 New York New Jersey Public Health Training Center 31 1918 Influenza Pandemic Social Distancing Measures to slow the spread of disease. New York New Jersey Public Health Training Center 32 Pandemic Influenza - Disease Control and Community Prevention Sick travelers at Airport, Port of Albany and Bus Station Community-level containment measures (closing schools, work; cancellation of public events and gatherings) Home Isolation and Quarantine demands: patient monitoring, provision of many support services like food, water, medicine, etc. New York New Jersey Public Health Training Center 33 Legal Authority to Isolate and Quarantine The legal authority to isolate and quarantine persons (and their contacts) who are diagnosed or suspected of having a communicable disease is found in: The New York State Public Health Law, Article 21 (entitled, "Control of Acute Communicable Disease"), and Part 2 of the New York State Sanitary Code (10-A NYCRR, Part 2, entitled, "Communicable Diseases"). New York New Jersey Public Health Training Center 34 Example of Community Containment: Measles on Campus New York New Jersey Public Health Training Center 36 1989: Public gathering restricted! New York New Jersey Public Health Training Center 37 Public Health Police Power TB in emergency room, TB in community Restriction of personal freedom Compulsory medical testing New York New Jersey Public Health Training Center 38 ORDER DIRECTING ISOLATION AND CONFINEMENT OF PATIENT SUSPECTED OF HAVING A SERIOUS COMMUNICABLE DISEASE Pursuant to Public Health Law Section 2100(2) and Section 2.29 of the New York State Sanitary Code (10-A NYCRR 2.29), you are hereby directed to isolate and confine the above patient, __________________, for evaluation and/or treatment of ___________________, a reportable communicable disease that has the potential to adversely affect the health of the public. Confinement is to continue until further notice from the undersigned or until service upon ___________________________ Hospital/ Health Center of a judicial mandate directing the patient's release or delivery before a judge or magistrate. Evaluation and treatment is to be administered in accordance with the directives of the patient's attending physician, ____________________, and consulting specialists. New York New Jersey Public Health Training Center 39 Police Powers Public Well Being Personal Freedoms New York New Jersey Public Health Training Center 40 Government Must Act... Fairly According to clear procedures New York New Jersey Public Health Training Center 41 Due Process Fairness in the procedural application of the law: Fair notice Opportunity to be heard Clear procedures New York New Jersey Public Health Training Center 42 Due Process Compulsory isolation and quarantine of persons implicates the Due Process Clause of the 14th Amendment. Appellate review of the I/Q proceedings will focus primarily upon two (2) issues: whether the respondent was afforded those procedural safeguards implicit in the concept of "fundamental fairness"; and whether the Department proved its case by "clear and convincing evidence". New York New Jersey Public Health Training Center 43 Equal Protection Laws must be applied evenhandedly People in similar situations must be treated similarly Show no favoritism New York New Jersey Public Health Training Center 44 Privacy Governmental intrusion must be warranted Individual Privacy vs. Protection of Population New York New Jersey Public Health Training Center 45 Public Health Police Power: TB in emergency room, TB in community Restriction of personal freedom Compulsory medical testing Balance individual freedoms and rights with good for the community New York New Jersey Public Health Training Center 46 Vision: Healthy People in Healthy Communities Mission: Promote Physical and Mental Health and Prevent Disease, Injury, and Disability New York New Jersey Public Health Training Center 47 Credits, Thanks NYNJ Public Health Training Center Module 3: Organization and Legal Basis of Public Health. Developed by Continuing Education, School of Public Health and the Professional Development Program, Rockefeller College, University at Albany Introduction to Public Health/ Mary-Jane Schneider New York New Jersey Public Health Training Center 48 http://www2a.cdc.gov/phlp/publaw.asp New York New Jersey Public Health Training Center 49 Contact Information and links James Crucetti, MD, MPH Commissioner of Health Albany County Department of Health 175 Green Street Albany, NY 12201 [email protected] Phone 447-4691 Fax 447-4698 www.albanycounty.com New York New Jersey Public Health Training Center 50 The end New York New Jersey Public Health Training Center 51 ...
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This note was uploaded on 04/13/2008 for the course HSPH 201 taught by Professor Williams during the Spring '08 term at SUNY Albany.

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