Recent Papers - Speeches
Hospitals Drop the Ball on Physician Oversight (HRG Publication #1873), Public Citizen, 27 May 2009
Psychiatric emergency qualifies for EMTALA - Moses v. Providence Hospital and Medical Centers, Inc., No. 07-2111 (6th Cir. 04/06/2009)- damages were murder by released patient, court also found that EMTALA did not provide for private remedy against the physician.
Matt A. Mayer, An Analysis of Federal, State, and Local Homeland Security Budgets, Heritage Foundation 2009 - a critique of the federally dominated homeland security effort in favor of a more state-driven effort.
Far from Home: Deficiencies in federal disaster housing assistance after hurricanes Katrina and Rita and recommendations for improvement. Special Report Prepared By The Ad Hoc Subcommittee On Disaster Recovery Of The Committee On Homeland Security And Governmental Affairs United States Senate, Feb 2009.
CRS - Closing the Guantanamo Detention Center: Legal Issues.
January 22, 2009
Project on National Security Reform, Forging a New Shield, November 2008. A sweeping review of the current national security system and recommendations for reform.
Review of Detention Policy Options, January 22, 2009.
Ensuring Lawful Interrogations, January 22, 2009. Replacing: Interpretation of the Geneva Conventions Common Article 3 as Applied to a Program of Detention and Interrogation Operated by the Central Intelligence Agency, Executive Order 13440, July 20, 2007
Review and Disposition of Individuals Detained at the Guantanamo Bay Naval Base and Closure of Detention Facilities, January 22, 2009.
Center for American Progress, “After Midnight: The Bush Legacy of Deregulation and What Obama Can Do,” January 2009.
Happy New Year!
FEMA - National Incident Management System, December 2008
Homeland Security - National Response Framework, January 2008
PHS officers can be sued under Bivens - Castaneda v. United States, 546 F.3d 682 (9th Cir. 2008) - This is an excellent discussion of the interplay between FTCA actions for negligence and Bivens actions for intentional acts. A INS detainee with an obvious serious medical condition was denied care until he had untreatable cancer. He sued under Bivens, rather than the FTCA, and the Public Health Service argued that the FTCA was the sole remedy. The Court disagreed and allowed the Bivens claim.
Court holds neonatal screening laws do not infringe religious freedom - In re Interest of Joel Anaya, Supreme Court of Nebraska, No. S-07-1136, Filed December 5, 2008
WORLD AT RISK: The Report of the Commission on the Prevention of WMD Proliferation and Terrorism, November, 2008
New Hampshire Supreme Court upholds authority of fire department to order evacuations in floods - State v. Bernard, 2008 WL 4810025 (N.H. Nov 06, 2008)
MMWR, Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection. The CDC finally recommends a uniform approach to STIs, including HIV.
MMWR, Subpopulation Estimates from the HIV Incidence Surveillance System — United States, 2006 September 12, 2008 / Vol. 57 / No. 36. - Critical data on the prevelance of HIV produced from the new HIV reporting data.
Hurricane and Disaster Preparation Guide
Left Behind Black America: A Neglected Priority in the Global AIDS Epidemic, Black AIDS Institute, August 2008 - original link: http://www.blackaids.org/image_uploads/article_575/08_left_behind.pdf
Recommendations for Postexposure Interventions to Prevent Infection with Hepatitis B Virus, Hepatitis C Virus, or Human Immunodeficiency Virus, and Tetanus in Persons Wounded During Bombings and Other Mass-Casualty Events Recommendations of the Centers for Disease Control and Prevention (CDC) United States, 2008 - MMWR Volume 57, No. RR-6.
HCQIA provides immunity for temporary suspension of privileges - Poliner v. Texas Health Systems, No. 06-11235 (5th Cir. 2008)
National Flood Insurance Program: Financial Challenges Underscore Need for Improved Oversight of Mitigation Programs and Key Contracts. GAO-08-437, June 16.
September 11: HHS Needs to Develop a Plan That Incorporates Lessons from the Responder Health Programs. GAO-08-610, May 30.
Emergency Management: Observations on DHS's Preparedness for Catastrophic Disasters, by William O. Jenkins, Jr., director, homeland security and justice, before the Subcommittee on Management, Investigations, and Oversight, House Committee on Homeland Security. GAO-08-868T, June 11.
Office of the Director of National Intelligence, Office of General Counsel – “Intelligence Community Legal Reference Book” (2007) - An extremely handy desk reference with excerpts from key statutes and guidelines.
Congressional Research Service recently released Genetic Information: Legal Issues Relating to Discrimination and Privacy - 10 March 2008.
Natural Catastrophe Insurance: Analysis of a Proposed Combined Federal Flood and Wind Insurance Program. GAO-08-504, April 25.
Bioterrorism Lecture for Public Administration Students
Status of Implementation of GAO Recommendations on Evacuation of Transportation-Disadvantaged Populations and Patients and Residents of Health Care Facilities. GAO-08-544R, April 1.
LA Supreme court rules that homeowns policies do not cover Hurricane Katrina flood damage - Sher v. Lafayette Ins. Co., --- So.2d ----, 2008 WL 928486, 2007-2441 (La. 4/8/08) (La. Apr 08, 2008) (NO. 07-C-2441, 07-C-2443)
Review of the DOJ opinion opposing Congressional revision of the state secrets act - April, 2008.
"Federalism, State Sovereignty and the Constitution: Basis and Limits of Congressional Power," updated February 1, 2008.
"The War Powers Resolution: After Thirty-Four Years," updated March 10, 2008.
Military Interrogation of Alien Unlawful Combatants Held Outside the United States - 2003 memo (the torture memo)
Nuremburg Trials - Trial of the Major War Criminals before the International Military Tribunal
The Association of State and Territorial Health Officials (ASTHO) has released “2007 State Public Health Workforce Survey Results,” reporting on the shrinking number of staff working in public health departments across the country.
Ass'n of Am. Physicians & Surgeons, Inc. v. Food & Drug Admin., --- F.Supp.2d ----, 2008 WL 564942 (D.D.C. Mar 04, 2008) - Good standing analysis, including informational standing, in a challenge to an FDA regulation on Plan B
Court approves FDA review of anthrax vaccine, allows military to continue vaccinations - Rempfer v. Eschenbach, Civil Action No. 06-2131, District Court, DC (February 29, 2008)
The Downer Cow Case - Humane Society v. Secretary of Agriculture
Property/Casualty Insurance In 2008: Overpriced Insurance And Underpaid Claims Result In Unjustified Profits, Padded Reserves, And Excessive Capitalization January 10, 2008 J. Robert Hunter
Supreme Court strengthens federal preemption of state products liability law in medical device cases - Riegel v. Medtronic, Inc., No. 06-179 (2008)
CRS - "Instances of Use of United States Armed Forces Abroad, 1798-2007," updated January 14, 2008.
CRS - "The Emergency Alert System (EAS) and All-Hazard Warnings," updated January 28, 2008
Joint Advisory Committee on Communications Capabilities of Emergency Medical and Public Health Care Facilities - Report to Congress
"Homeland Security: Roles and Missions for United States Northern Command," January 28, 2008.
Court dismisses most Katrina levee breach claims against the Army Corps of Engineers - 30 Jan 2008
Hurricane Katrina: Ineffective FEMA Oversight of Housing Maintenance Contracts in Mississippi Resulted in Millions of Dollars of Waste and Potential Fraud. GAO-08-106, November 16.
National Flood Insurance Program: Greater Transparency and Oversight of Wind and Flood Damage Determinations Are Needed. GAO-08-28, December 28, 2007.
Influenza Pandemic: Efforts Under Way to Address Constraints on Using Antivirals and Vaccines to Forestall a Pandemic. GAO-08-92, December 21.
"Data Mining and Homeland Security: An Overview," updated December 5, 2007
New Jersey passes opt-out HIV testing law for pregnant women - 2007.
Natural Disasters: Public Policy Options for Changing the Federal Role in Natural Catastrophe Insurance. GAO-08-7, November 26.
"A Broken Promise to Our Children: The 1998 State Tobacco Settlement Nine Years Later," was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Lung Association and American Cancer Society Cancer Action Network.
Coastal Wetlands: Lessons Learned from Past Efforts in Louisiana Could Help Guide Future Restoration and Protection. GAO-08-130, December 14.
Fusion Centers: issues and options for Congress, by Todd Masse and others, Congressional Research Service, July 6, 2007. Report on how intelligence networks set up to share information on terrorism have drifted into conventional law enforcement, and the effect that has on civil liberties.
"Health Disparities in HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis in the US: Issues, Burden and Response."
Influenza Pandemic: Opportunities Exist to Address Critical Infrastructure Protection Challenges That Require Federal and Private Sector Coordination. GAO-08-36, October 31.
"Survival," U.S. Army Field Manual FM 3-05.70, May 2002 (676 pages in an extremely large 21 MB PDF file)
"Limitation of Authority to Deputize DoD Uniformed Law Enforcement Personnel by State and Local Governments," DoD Instruction 5525.13, September 28, 2007
Civil Support by the Military - This publication provides overarching guidelines and principles to assist commanders and
their staffs in planning and conducting joint civil support operations. Department of Defense Joint Publication 3-28, 14 September 2007.
Mayfield v. United States (D. Or. Sep. 26, 2007) - Oregon Federal District Court strikes Patriot Act provisions adopting the signficant purpose test for warrants under FISA, which allows warrantless searches when the primary purpose of the search is collecting criminal evidence, rather than collecting evidence of national security threats.
Natural Hazard Mitigation: Various Mitigation Efforts Exist, but Federal Efforts Do Not Provide a Comprehensive Strategic Framework. GAO-07-403, August 22.
“The 2007 XDR-TB Incident: A Breakdown at the Intersection of Homeland Security and Public Health.”
Mass Shootings at Virginia Tech April 16, 2007, which addresses, among other things, the adequacy of mental health laws and emergency preparedness at the school.
Wilkie v. Robbins, 127 S.Ct. 2588 (2007) - Court rejects RICO and other novel claims against the government - interesting discussion of exhaustion of administrative remedies.
CRS - "P.L. 110-55, the Protect America Act of 2007: Modifications to the Foreign Intelligence Surveillance Act," August 23, 2007
"Operational Law Handbook," The Judge Advocate General's Legal Center and School, July 2007 (667 pages, 6 MB PDF file)
CRS: "Clinical Trials Reporting and Publication," updated July 12, 2007.
Abigail Alliance v. FDA - appeals court rejects a constitutional right to access to unapproved drugs.
In re Katrina Canal Breaches Litigation, --- F.3d ----, 2007 WL 2200004 (5th Cir.(La.) 2007) - Court rules that even if flooding was due to negligence, flood coverage was still excluded from property insurance policies.
National Animal Identification System: USDA Needs to Resolve Several Key Implementation Issues to Achieve Rapid and Effective Disease Traceback. GAO-07-592, July 6
Homeland Security: Observations on DHS and FEMA Efforts to Prepare for and Respond to Major and Catastrophic Disasters and Address Related Recommendations and Legislation, by William O. Jenkins, Jr., director, homeland security and justice issues, before the House Committee on Oversight and Government Reform. GAO-07-1142T, July 31.
Emergency Management Assistance Compact: Enhancing EMAC's Collaborative and Administrative Capacity Should Improve National Disaster Response. GAO-07-854, June 29.
"U.N. Convention Against Torture (CAT): Overview and Application to Interrogation Techniques," updated January 12, 2007
In re Washington, 2007 WI 104 (Wis. 2007) - Court upholds jailing of uncooperative tuberculosis carrier.
"Federal Sentencing Guidelines: Background, Legal Analysis, and Policy Options," updated June 30, 2007
White House, National Strategy for Pandemic Influenza Implementation Plan One Year Summary, July 2007.
Preparing for Pandemic Influenza: The Hospital and Community Perspective, Stephen V. Cantrill, MD, Associate Director, Department of Emergency Medicine, Denver Health Medical Center, 2007 Great Lakes Homeland Security Training Conference & Expo. (These slides are an excellent review of preparations a community can take for pandemic flu preparation.)
Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007
CDC. Compendium of Measures to Prevent Disease Associated with Animals in Public Settings. Recommendations and Reports Volume 56, No. RR-5 (2007)
Military Health: DOD's Vaccine Healthcare Centers Network. GAO-07-787R, June 29.
Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007
Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007
The Pandemic and All-Hazards Preparedness Act (P.L. 109-417): Provisions and Changes to Preexisting Law, Congressional Research Service, Updated January 25, 2007, Document RL33589.
Florida Supreme Court Benchbook on Quarantine and Isolation
The 2007 Great Lakes Homeland Security Training Conference & Exposition
Public Health and Hospital Emergency Preparedness Programs: Evolution of Performance Measurement Systems to Measure Progress. GAO-07-485R, March 23.
Climate Change: Financial Risks to Federal and Private Insurers in Coming Decades Are Potentially Significant. GAO-07-285, March 16, 2007.
Phillips SJ, Knebel A, eds. Mass Medical Care with Scarce Resources: A Community Planning Guide. Prepared by Health Systems Research, Inc., an Altarum company, under contract No. 290-04-0010. AHRQ Publication No. 07-0001. Rockville, MD: Agency for Healthcare Research and Quality 2007.
Cicin-Sain, Biliana, R.W. Knecht, N. Foster, Trends and Future Challenges for U.S. National Ocean and Coastal Policy, Silver Spring, MD, National Oceanic and Atmospheric Administration, National Ocean Service, Special Projects Office, 1999.
Chapter on Coastal Populations
Radiation Event Medical Management - HHS
Children's Health Insurance: State Experiences in Implementing SCHIP and Considerations for Reauthorization, by Kathryn G. Allen, director, health care, before the Senate Committee on Finance. GAO-07-447T, February 1.
Children's Health Insurance: States' SCHIP Enrollment and Spending Experiences and Considerations for Reauthorization, by Kathryn G. Allen, director, health care, before the Subcommittee on Health, House Committee on Energy and Commerce. GAO-07-501T, February 15
"Legal Support to Military Operations," Joint Publication JP 1-04, March 1, 2007 - "Military lawyers were true combat multipliers in Iraq," said General David H. Petraeus, who is now U.S. commander in Iraq. "I tried to get all the lawyers we could get our hands on -- and then sought more."
"A Review of the Federal Bureau of Investigation's Use of National Security Letters," DoJ Office of Inspector General, March 2007 (199 pages in a very large 35 MB PDF file)
Homeland Security: Preparing for and Responding to Disasters, by William O. Jenkins, Jr., director, homeland security and justice issues, before the Subcommittee on Homeland Security, House Committee on Appropriations. GAO-07-395T, March 9.
Supplement - Volume 55, No. Supplement, December 22, 2006
60 Years of Public Health Science at CDC - In 2006, CDC celebrates its 60th anniversary. From the agency's relatively humble beginnings in 1946 as a malaria-control agency through its rapid growth in mission and expansion of staff and public health partnerships by 2006, science has been the foundation for everything CDC does. Public health science comprises numerous disciplines that, combined, are more than simply the addition of their parts. This synergy is public health's unique scientific strength. This supplemental issue of MMWR celebrates CDC's scientific strength and diversity by describing the public health contributions of 11 disciplines. It begins with the fundamental, cross-cutting disciplines of laboratory sciences and epidemiology, then focuses on disciplines new to public health, yet essential to CDC's success. Although this supplement only partially illustrates the variety of disciplines contributing to public health, the 11 articles provide a flavor of public health's scientific diversity and strength. They highlight contributions of many disciplines to each of CDC's health protection goals and emphasize how synthesizing scientific information is essential to impact health and maximize scientific investments.
Hurricanes Katrina and Rita Disaster Relief: Continued Findings of Fraud, Waste, and Abuse, by Gregory D. Kutz, managing director, forensic audits and special investigations, before the Senate Committee on Homeland Security and Governmental Affairs. GAO-07-252T, December 6.
Seattle King County WWW site - lots of useful info and forms.
The Role of Law Enforcement in Public Health Emergencies: Special Considerations for an All-Hazards Approach. DOJ Guide. September 2006
CDC finally recommends routine HIV testing!
CDC History of Tuberculosis Control (large PDF)
Hurricane Katrina: Strategic Planning Needed to Guide Future Enhancements Beyond Interim Levee Repairs. GAO-06-934, September 6 (2006)
Disaster Preparedness: Limitations in Federal Evacuation Assistance for Health Facilities Should Be Addressed. GAO-06-826, July 20.
New York City Pandemic Flu Plan - July 2006
Court allows discovery of previous sexual contacts in HIV transmission case - John B. v. Superior Court of Los Angeles County, No. S128248 (Cal. 07/03/2006)
Protection of National Security Information, CRS, June 30, 2006
Hamdan v. Rumsfeld
Smallpox Vaccine Injury Compensation Program: Administrative Implementation, 42 CFR Part 102, 29808 Federal Register 71, No. 100 / Wednesday, May 24, 2006.
Smallpox Vaccine Injury Compensation Program: Smallpox (Vaccinia) Vaccine Injury Table, 42 CFR Part 102, 29805 Federal Register 71, No. 100 / Wednesday, May 24, 2006.
JCAHO requires hospitals to offer flu vaccine in response to the low levels of flu vaccination in health care workers.
A framework for an Australian Influenza Pandemic Plan: (Communicable Diseases Intelligence Technical Report Series No 4) Endorsed by the Communicable Diseases Network Australia New Zealand Published by Commonwealth Department of Health and Aged Care June 1999
Homeland Security plan for bird flu pandemic - this is a plan to plan, not an operational document. It raises good questions and has a excellent collection of references and legal authorities.
Hurricane Katrina: Status of the Health Care System in New Orleans and Difficult Decisions Related to Efforts to Rebuild It Approximately 6 Months After Hurricane Katrina. GAO-06-576R, March 28.
Federal hazardous materials regs preempt local pipeline regulation - Olympic Pipe Line Co. v. City of Seattle, No. 04-35307 (9th Cir. 2006)
8 Feb 2006
Probable Cause, Reasonable Suspicion, and Reasonableness Standards in the
Context of the Fourth Amendment and the Foreign Intelligence Surveillance
Act: CRS, January 2006.
Names of hospital patients are protected from discovery - Kinsella v. NYT Television, 887 A.2d 1144, No. A-3308-04T5 (N.J.Super.App.Div. 2005)
Sarah A. Lister, Pandemic Influenza: Domestic Preparedness Efforts, CRS Report for Congress Order Code RL33145, November 10, 2005
Understanding Martial Law
Does the state owe compensation when property is destroyed to protect the public in a disaster? - Surocco v. Geary, 3 Cal. 69, 1853 WL 639, 58 Am.Dec. 385 (Cal. Jan Term 1853)
Human Tuberculosis Caused by Mycobacterium bovis --- New York City, 2001--2004, MMWR, June 24, 2005 / 54(24);605-608 - TB from unpasteurized milk
Testimony before the Presidential Advisory Council on HIV/AIDS
Legal Frameworks for Preventing Chronic Disease: Developing a Preventive Law Approach, to be presented at the CDC Public Health Law Conference, 14 June 2005.
Public Health Law Revision and the Model Law Process: The Case of Emergency Quarantine and Isolation, to be presented at the CDC Public Health Law Conference, 14 June 2005.
Congress may preempt state medical use marijuana laws - Gonzales v. Raich, No. 03-1454 (U.S. 06/06/2005)
THE SARS COMMISSION, SECOND INTERIM REPORT SARS AND PUBLIC HEALTH LEGISLATION, The Honourable Mr. Justice Archie Campbell, Commissioner, April 5, 2005
Emergency Preparedness, Response, & Recovery Checklist. The American Health Lawyers Association (AHLA) has posted a new emergency preparedness checklist. The checklist is designed to help identify key legal and operational issues arising in a public health crisis, terrorist threat, environmental disaster, or other emergency situation.
Century Fund Report Calls for National Public Health Standards on Bioterrorism Preparedness
Health inspector has immunity for defamation claims about restaurant - Sadallah v. City of Utica, 383 F.3d 34 (Cir2 2004)
Supreme Court Establishes the Reach of the Commerce Clause - Gibbons v. Ogden, 22 U.S. 1 (1824)
Emerging Infectious Diseases: Review of State and Federal Disease Surveillance Efforts. GAO-04-877, September 30.
State Operations Manual Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals (Rev. 1, 05-21-04)
Court Rejects Handgun Sales as Public Nusiance - City of Chicago v. Beretta U.S.A. Corp., No. 95243 (Ill. 11/18/2004)
Physician non-profit organization found to violate antitrust laws - In the Matter of North Texas Specialty Physicians, FTC Docket No. 9312 (2004)
Patient and Physician Attitudes and Behaviors Associated With DTC Promotion of Prescription Drugs — Summary of FDA Survey Research Results Final Report November 19, 2004
It is ironic that the FDA is being criticized, in the same week, for being too hasty in approving Vioxx and not hasty enough in approving new techniques to make flu vaccine. The FDA represents a classic public policy choice: you can either have drugs approved quickly or carefully. No amount of fiddling with the law can change this because the only way to get good date on low level risks, which is the problem with Vioxx and antidepressants in children, is that you have to look at a lot of people taking the drug for a long time. Smart physicians do not prescribe new drugs for several years after they hit the market, unless they have real benefits and no alternatives because of this. Had Vioxx only been prescribed for the relatively small number of patients for which it gave relief and who could not take other drugs because of the side effects, the cardiovascular risk would have still been a problem, but the befit of using the drug would have weighed against it.
Short-circuiting flu vaccine approval is very dangerous for two reasons. First, you give flu vaccine to a lot people in a very short time, giving no chance to find risks until everyone has taken it. Second, if you spook the public, even with fears of risks that do not exist, then you undermine the entire vaccination effort for all diseases. Better to be conservative with vaccine approval than feed the lawyer and anti-vaccination nut driven hysteria over vaccine injuries.
Syndromic Surveillance: Reports from a National Conference, 2003
Flu shortage information page updated:
Ironically, the Washington State Nurses Association filed suit just before the shortage was announced to block a hospital plan to require manditory immunizations for the nursing staff. This highlights an ironic problem in the midst of the hysteria over access to flu vaccine: many health care worker who should be vaccinated for their own and their patient's protection have historically refused the flu and other vaccinations.
Emergency Rules for vaccine allocation page (Oregon) updated
Michigan passes a law protecting manufacturers and sellers of food against obesity related lawsuits.
Administrative law provides for emergency rules which go into effect at once. Oregon used this power to ration flu vaccine. This page collects the relevant law, rules, and the plan - Oregon emergency rule limiting access to flu vaccine.
Health Information: First-Year Experiences Under the Federal Privacy Rules. GAO-04-965, September 3, 2004
Shepard v. Hill, 151 Mass. 540, 24 N.E. 1025 (Mass. 1890) - Classic case on standards for whether a business is a nusiance.
Boom v. City of Utica, 2 Barb. 104 (N.Y.Sup.Gen.Term, 1848) - Court finds that a person who is infected with a communicable disease is not a nuisance and has to be regulated through other police powers.
Com. v. Pear, Com. v. Jacobson, 67 L.R.A. 935, 183 Mass. 242, 66 N.E. 719 (Mass. 1903) - the Mass Supreme Court Case which lead to Jacobson v. Mass.
Ohio Supreme Court requires hearing to contest administrative determination of dangerousness of a dog before prosecution of the owner - State v. Cowan, 103 Ohio St.3d 144 (Ohio 2004)
The police power cannot be used to protect nuisance owners - Gacke v. Pork Xtra, L.L.C., 684 N.W.2d 168 (Iowa 2004)
Materials on the history of Medicare
Kentucky AG Opinion 04-ORD-143, August 24, 2004, In re: The Kentucky Enquirer/Covington Police Department, Open Records Decision, The question presented in this appeal is whether the Covington Police Department properly relied on KRS 61.878(1)(a) and the Health Insurance Portability and Accountability Act of 1996 in partially denying The Kentucky Enquirer’s requests for specifically identified accident and incident reports generated by that public agency. For the reasons that follow, we find that the department’s partial denial of these requests was procedurally deficient and substantively incorrect.
Beta version 1.0 - Public Health Law Map / Graphic Map / Printing Version
Text of the Federal 1813 vaccination agent act, appointing a vaccination agent to preserve the genuine vaccine matter and allowing it to be sent through the post for free.
HHS's Efforts to Promote Health Information Technology and Legal Barriers to its Adoption. GAO-04-991R, August 13.
Expert Witness Malpractice - Update
Improving Health Care: A Dose of Competition: A Report by the Federal Trade Commission and the Department of Justice (July 2004)
The Supreme Court provides broad new protections to health plans in Aetna Health Inc. v. Davila, No. 02-1845 (U.S. 2004) - click here for more detailed information and the case.
Council of State and Territorial Epidemiologists (CSTE) releases the report: Public Health Practice vs. Research: A Report for Public Health Practitioners Including Cases and Guidance for Making Distinctions. A copy of the report is currently available online in Adobe Acrobat format at CSTE's website at http://www.cste.org.
Comptroller General's Forum on Health Care: Unsustainable Trends Necessitate Comprehensive and Fundamental Reforms to Control Spending and Improve Value. GAO-04-793SP, May 2004
The WHO releases proposed revisions to the Current International Health Regulations.
The "Domestic WMD Incident Management Legal Deskbook," published by the Defense Threat Reduction Agency (DTRA) - this is a mirror site that also fixes some of the broken links on the DOD site.
Terrorism Insurance: Implementation of the Terrorist Risk Insurance Act of 2002. GAO-04-307 , April 28, 2004 - Terrorism Insurance: Effects of the Terrorism Risk Insurance Act of 2002, by Richard J. Hillman, GAO-04-720T, April 28
Emerging Infectious Diseases: Asian SARS Outbreak Challenged International and National Responses. GAO-04-564 , April 28, 2004
SARS and Public Health in Ontario , Interim Report of the SARS Commission (Canada), April 15, 2004
Lessons from the Anthrax Attacks: Implications for U.S. Bioterrorism Preparedness by David Heyman, CSIS, under contract to the Defense Threat Reduction Agency, April 2002 (2 MB PDF file), as redacted by the DOD and releasedon March 15, 2004)
Radiological Dispersal Devices: Select
Issues in Consequence Management,
CRS Report for Congress,
Order Code RS21766, March 10, 2004
(Thanks to the Federation of American Scientists)
CDC releases primer on food borne illness
Seventh Circuit rules in the DOJ suit (Northwestern Hospital v. Ashcroft) to get abortion records, finds that HIPAA does not import state medical records privacy protections into federal law claims in federal court.
Top Officials (TOPOFF) Exercise Series: TOPOFF 2 - After Action Summary Report For Public Release, December 19, 2003 PDF TOPOFF 2000 US Army MARS Emergency Operations Information Page
Tobacco Settlement: States' Allocations of Fiscal Year 2003 and Expected Fiscal Year 2004 Payments. GAO-04-518, March 19. - (it is not going to health and anti-smoking efforts.)
FEMA - Emergency Response to Terrorism Job Aid - Feb 2003 - Released Feb 2004
Public Health Preparedness: Response Capacity Improving, but Much Remains to Be Accomplished, by Janet Heinrich, director, health care-public health issues, before the House Committee on Government Reform. GAO-04-458T, February 12.
HHS Bioterrorism Preparedness Programs: States Reported Progress but Fell Short of Program Goals for 2002 Briefing for Congressional Staff Senate Committee on Health, Education, Labor, and Pensions Senate Committee on Appropriations House Committee on Energy and Commerce House Committee on Appropriations January 14, 2004
ANALYSIS - How much should we worry about ricin in the Senate Office Building?
On 2 Jan 04 traces of ricin were found in a white power in a letter sent to Senator Frist at the Senate Office Building. By the next day the building was closed and mail had been disrupted to the House as well. A little over years ago, the Senate Office Building was closed for many weeks when it was the target of a letter laced with anthrax.
First, how dangerous is ricin? Ricin is a natural toxin found in the seeds of the castor bean plant, a common garden ornamental. (Ricin info) As little as a milligram of ricin can kill, if it is injected into the body, as was done in the 1978 murder of a Bulgarian journalist. Yet a milligram is quite a lot compared to la ethal dose of anthrax spores. If it is distributed as a trace in some white power such as artificial coffee creamer, it would only be dangerous to someone who ate most of the power. Since the tests used for screening potential bioterrorism agents are very sensitive, they have many false positives, and this may yet turn out to be a hoax. Or it may be ricin, but nothing more than the scrapings of a castor bean seed. Enough to show positive, but no real threat.
The real threat is the disruption caused by the letter. The anthrax letters disrupted government functions, mail delivery on a wide area, frightened millions of people, and cost billions of dollars. Some of these costs were due to an overreaction to a real risk, but they convinced the public and the congress that any area exposed to even tiny amounts of anthrax must be closed and disinfected, inch by inch. (Since we had not measured background levels of anthrax spores before the attack, there was no way to know if some of them were from horse hair stuffing in antique sofas and chairs - a known source of anthrax.)
After the anthrax letter, police departments in all major cities were inundated with "white power" calls. Some cities saw hundreds of these over a few months, draining police resources and disrupting the businesses that were targeted. (Los Angles started sending trained officers to the scene with a microscope, which allowed them to rule out the most common substances used.) Police departments still respond to these threats, as they must, and can expect to have a new round of them after this ricin attack. All of these have been hoaxes, but they have very effectively gummed up the works of government.
How much disruption can we stand? Have the terrorists and pranksters won? We must decide on a correct level of response based on the threat these "white powder" attacks really pose. If we do not, then we will not be able to deal with a real attack. If there was a serious attack with a bioterrorism agent such as anthrax, we could not afford to disinfect every inch of a city, nor could we be promise that there would be no risks to the citizenry. People might die, but many more would die if unreasonable fears lead to panic. We are stoking those fears when we overreact to minor threats.
COMBATING TERRORISM Evaluation of Selected Characteristics in National Strategies
Related to Terrorism Statement of Randall A. Yim, Managing Director Homeland
Security and Justice Issues, For Release on Delivery Expected at 10:00 a.m.
EST Tuesday, February 3, 2004, GAO-04-408T
42 CFR Part 102 Smallpox Vaccine
Injury Compensation Program: Administrative Implementation;
Interim Final Rule, 16 Dec 2003 (PDF)
HHS announces the regulations for the smallpox compensation program.
Catastrophic Bioterrorism - What is to be done? By Richard Danzig, Center for Technology and National Security Policy, National Defense University, Washington, D.C. (August 2003)
QUARANTINE AND ISOLATION:
LESSONS LEARNED FROM SARS, A Report to the Centers for Disease Control and
Prevention, Institute for Bioethics,
Health Policy and Law
University of Louisville School of Medicine. Original Link
Smallpox Vaccination: Review of the Implementation of the Military Program, GAO-04-215R, December 1, 2003
CDC posts draft of SARS response plan
GAO - INFECTIOUS DISEASES: Gaps Remain inSurveillance Capabilities of State and Local Agencies, testimony Wednesday, September 24, 2003
Maryland Attorney General's Opinion on compensation for public workers who are injured by the smallpox vaccine. This is good analysis of the federal vaccination compensation law and how it fits with one state's worker's compensation laws.
HOSPITAL PREPAREDNESS Most Urban Hospitals Have Emergency Plans but Lack Certain Capacities for Bioterrorism Response - August 2003
CDC releases guidelines on prevention of HIV transmission for health care providers taking care of persons with HIV: Incorporating HIV Prevention into the Medical Care of Persons Living with HIV. These are a great step forward in that they recognize the value of reporting HIV, tracing the contacts of persons with HIV, and warning those contacts that they are at risk of contracting HIV. Unfortunately, many state health departments still do not do named reporting, contact tracing, and partner notification for HIV.
CDC reports that millions are bitten by dogs each year and that nearly 1,000,000 require medical treatment - Nonfatal Dog Bite–Related Injuries Treated in Hospital Emergency Departments — United States, 2001
30 June 2003
GAO Releases - BIOTERRORISM - Information Technology Strategy Could Strengthen Federal Agencies’ Abilities to Respond to Public Health Emergencies - June 2003
Yet another call for whizbang technology for public health, with no discussion of the underlying infrastructure problems due to budget cuts and increasing demands for basic services. While the technology would be useful, it always comes at the expense of the other activities and staffing.
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