Public Health Emergency - Leading a Nation Prepared
At the State level, authority and responsibility for emergency management typically reside within an Emergency Management Agency (EMA), although variations exist. Before 9/11 and the anthrax attacks in 2001, it was common for States to consider public health and medical emergencies to be distinct from other emergencies, thus requiring separate processes for response that were not all centrally supported by the EMA and public safety agencies. However, this approach has begun to change, as current State and Federal initiatives (including HHS bioterrorism preparedness programs) call for the development of management processes to improve coordination among State agencies, and between the State and intrastate jurisdictions.
Another issue post-9/11 has been the growth of State level homeland security agencies and how they integrate with existing emergency management and public health programs. While homeland security programs generally focus on terrorism, emergency management traditionally has taken an all-hazards approach. It is important for public health and medical emergency planners to understand how these programs are structured within their jurisdiction, and where authority lies for emergency or disaster response.
The role of States in MSCC will vary based on their individual laws and regulations. In general, however, State authorities may assume several key responsibilities during emergency preparedness and response. The following paragraphs describe four such responsibilities.
States can also assist the medical sector by providing regulatory relief during incident response (Exhibit 5-1). Relevant State laws or regulations that may need to be revised or temporarily suspended in a public health or medical emergency should be identified during preparedness planning, and processes for their revision or temporary suspension should be formally described. Some examples include:
Exhibit 5-1. Emergency Medical Regulatory Relief
In the aftermath of Hurricane Katrina, the Governor of Louisiana declared a state of public health emergency and issued an Executive Order temporarily suspending State licensure laws, rules, and regulations for out-of-State medical professionals and personnel offering medical services in Louisiana, provided that these out-of-State medical personnel possessed current State medical licenses in good standing in their respective State(s) of licensure. In addition, the Executive Order designated out-of-State medical professionals and personnel as agents of the State of Louisiana for tort liability purposes.
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