The Legal
Considerations Section includes the following subsections:
Describes substantive legal
issues that are likely to arise in a pandemic and how they are
being addressed.
Lists available legal resources
and indicates where they may be found. These include model
documents such as legal orders that the Commissioner might
issue; background documents on websites; etc.
-
Partnerships and Outreach
Describes committees and
advisory groups that have legal components and/or are addressing
legal issues.
Describes past, current and
future training programs on legal issues.
Lists legal issues that are the
responsibility of other state agencies.
Addresses additional minor legal
issues.
LEGAL ISSUES
1.
Emergency Declarations
There are two statutes in
Massachusetts that allow the Governor to declare an emergency.
Public Health Emergency.
Under M.G.L. c. 17, § 2A, if the Governor declares that an
emergency exists which is detrimental to the public health, the
DPH Commissioner may, with the approval of the Governor and the
Public Health Council, “take such action and incur such
liabilities as he may deem necessary to assure the maintenance
of public health and the prevention of disease.” In addition,
with the approval of the Public Health Council, the Commissioner
may “establish procedures to be followed during such emergency
to insure the continuation of essential public health services
and the enforcement of the same.”
-
Pandemic Period:
The Commissioner and senior DPH staff will be in continuous
close touch with the Governor’s office. If the Commissioner
determines that the situation warrants a declaration of
public health emergency based on epidemiological
information, speed of disease spread, etc., he would request
that the Governor issue such a declaration. Once the
declaration is made, the Commissioner would have all
necessary authority to issue orders; waive statutes and
regulations that impede emergency response; seize property
if necessary, etc.
State of Emergency.
Under Chapter 639 of the Acts of
1950, the Governor may declare a state of emergency due to
(among other circumstances) “the occurrence of any disaster or
catastrophe resulting from attack, sabotage or other hostile
action; or from riot or other civil disturbance; or from fire,
flood, earthquake or other natural causes.” Because an
influenza pandemic can be considered a catastrophe resulting
from natural causes, the Governor might decide to declare a
state of emergency concurrent with declaring a public health
emergency, or without declaring a public health emergency.
By the terms of the statute, a
state of emergency confers upon the Governor extraordinary
powers to protect the lives and property of the citizens of the
Commonwealth and to enforce the laws. In practice, if a state
of emergency were declared during a pandemic, MEMA would
activate the State Emergency Operations Center and DPH would be
a crucial participant in emergency response under ESF-8. It is
expected that the Governor would delegate broad health-related
powers to the DPH Commissioner, with the result that there would
be little if any practical difference between a declared public
health emergency and a declared state of emergency.
DPH legal counsel are familiar
with the powers available under both types of emergency
declarations, and would advise policy makers on appropriate
legal means to achieve policy goals.
2.
Restrictions on Personal Liberty
Isolation and Quarantine.
Legal preparations have been and are continuing to be made to
isolate or quarantine individuals or groups of people, should
DPH policy makers decide that such measures are necessary to
protect the public health during the Pandemic Alert Period
and/or the Pandemic Period.
-
Massachusetts
statutes and regulations authorize isolation and quarantine
for diseases dangerous to the public health.
-
Legal
materials for isolation and quarantine of individuals,
originally developed for SARS, have been modified for
pandemic flu. These are complied into a set of documents
known as “Legal Nuts and Bolts of Isolation and Quarantine,”
available from the DPH Office of General Counsel and the
Health Education
Unit, Division of Epidemiology and Immunization.
They include documents that state and local health
authorities would use for stepwise enforcement of isolation
and quarantine, beginning with letters requesting voluntary
cooperation, up to court pleadings and related documents to
compel isolation.
-
Due process
protections have been considered in drafting these
documents, guided by the principle that whatever measure is
used should be the least restrictive of personal liberty
while protecting public health. Non-custodial orders (e.g.
home isolation) may be appealed by a telephone call to a
health official, while custodial measures (e.g. isolation in
a hospital) would in most cases require a court order.
Efforts will be made to ensure that people who are subject
to court proceedings for mandatory isolation or quarantine
have access to attorneys. Judges may be contacted at any
time, day or night, through the State Police.
Other Restrictions on Personal
Liberty. It is
possible that a wide variety of other measures might become
necessary to protect the public health during a Pandemic Alert
Period or Pandemic Period, some of which impose certain
restrictions on personal liberty. Examples include requiring
people to self-monitor for medical conditions; requiring medical
evaluations and/or vaccinations, prophylaxis, or medical
treatment; closing businesses, public transportation; etc.
·
Templates have
been drafted for orders that the DPH Commissioner could issue
during a public health emergency, and additional templates are
in process. The templates include findings or statements that
the measures being ordered are the least restrictive alternative
or the most reasonable way to address the threat to public
health.
3. Use of
Volunteers
During the Pandemic Period,
there will almost certainly be a shortage of doctors, nurses,
and other health care workers to care for patients. Using HRSA
funds, DPH is creating the Massachusetts System for Advance
Registration of Volunteer Health Professionals (MSAR), a
database of registered and pre-credentialed volunteers who can
be called up by the Commissioner when the need arises. The
database will initially contain various categories of health
care volunteers, and will later be expanded to include others
(translators, etc.).
Three legal documents underlie
MSAR:
·
MSAR Program
Policy
·
Participation
Agreement (to be signed by participating organizations)
·
Individual Terms
and Conditions (to be signed by individual volunteers)
Credentialing
Pre-credentialing will be
accomplished either by hospitals that sign the Participation
Agreement with DPH, or by other organizations, through a
contract with DPH, for practitioners who are not affiliated with
a hospital. DPH legal
counsel are working with the health care licensing boards and
hospitals to ensure that credentialing and license restriction
issues are handled consistently and in accordance with the HRSA
guidelines and state law.
The many locally-based Medical
Reserve Corps (MRCs) around the Commonwealth also provide a
potential source of volunteers. MRC members are being
encouraged to join the MSAR system, and DPH has contracted with
a vendor who is providing coordination between the MRC system
and MSAR.
Liability
Protection from malpractice
liability for MSAR volunteers when they are working in other
than their regular place of employment is an important
consideration. While there are no liability statutes or
regulations specific to MSAR, depending on the circumstances
MSAR volunteers may be able to take advantage of various
existing laws. A summary document and PowerPoint presentation
dealing with liability protections for Massachusetts health care
volunteers responding to a disaster may be found at
http://www.mass.gov/dph/bioterrorism/advisorygrps/index.htm
Worker’s
Compensation
Currently there is no Workers’
Compensation coverage for MSAR volunteers, unless the volunteer
is considered by his or her employer to be within the scope of
employment when activated under MSAR. The MSAR Statewide
Advisory Committee will continue to study this issue.
4. Mutual
Aid
Local Mutual Aid
Through the Center for Emergency
Preparedness and the Regional Coordinators, DPH is encouraging
city and town boards of health and health departments to enter
into agreements to assist neighboring communities with public
health resources in times of need. A template has been
developed that can be used and modified by local government
officials to fit their particular legal structure and needs. A
significant number of communities across the Commonwealth have
signed mutual aid agreements to date.
Interstate Mutual Aid
Massachusetts is a member of the
Emergency Management Assistance Compact (EMAC), which allows
states to share personnel and material resources in times of
disaster, pursuant to a Governor’s request for assistance. MEMA
is the coordinating agency for EMAC in Massachusetts. DPH would
work closely with MEMA if Massachusetts required public health
assistance from other states, or if Massachusetts received an
out-of-state EMAC request for public health assets.
International Mutual Aid
Massachusetts is a member of the
International Emergency Management Assistance Memorandum of
Understanding, also known as IEMAC (International Emergency
Management Assistance Compact). This agreement covers the six
New England states and five Eastern Canadian provinces (Quebec,
New Brunswick, Nova Scotia, Prince Edward Island and
Newfoundland & Labrador). DPH legal counsel is actively
involved in identifying and addressing legal issues in the
implementation of IEMAC, towards the goal that Canadian public
health assets would be available to Massachusetts if needed.
5. Data
Sharing
For obvious reasons, sharing of
information is crucial to efforts to predict, prevent, and
contain a pandemic during all phases (Interpandemic, Pandemic
Alert, and Pandemic Periods). Also, during the Pandemic Alert
and Pandemic Periods, there may be a need for sharing of more
personal health information than is the case under normal
circumstances. The following summarizes legal authorities and
issues related to data sharing.
Provision of Data to
Governmental Authorities
DPH will need identifying
information about cases, suspect cases, and contacts in order to
track the disease outbreak and implement containment measures.
Current law gives the Department broad authority to require
health care providers and organizations to report dangerous
diseases, through M.G.L. c. 111, § 7 and its implementing
regulations, 105 CMR 300.000. This statute and regulations also
authorize DPH to undertake broad disease surveillance
activities.
Many diseases, including
influenza, are reportable to local boards of health, which are
then required to report to DPH within 24 hours. If a disease is
not among those listed as reportable, 105 CMR 300.150 allows the
Commissioner to require reporting of and surveillance for
diseases or conditions which are newly recognized or recently
identified or suspected as a public health concern.
The federal Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule contains
a broad public health exception to its confidentiality requirements. It allows health care providers
and organizations to disclose protected health information to a public health authority for
purposes of disease reporting, public health surveillance, public health investigations, and
public health interventions. 45 CFR § 164.512(b).
The HIPAA Privacy Rule also
contains an exception which allows disclosure of protected
health information when the provider or organization believes
that the disclosure is necessary to prevent or lessen a serious
and imminent threat to the health or safety of a person or the
public, and the disclosure is made to a person or persons
reasonably able to prevent or lessen the threat. 45 CFR §
164.512(j)(1). For example, this exception would allow a
hospital, provider, or DPH to release identifying information to
the police, if law enforcement assistance were needed to enforce
an isolation or quarantine order against an individual.
Dissemination of Data by DPH and
other Governmental Authorities
Under M.G.L. c. 111, § 5, DPH is
directed to “conduct sanitary investigations and investigations
as to the causes of disease, and especially of epidemics,” and
to “disseminate such information relating thereto as it
considers proper.” This gives DPH very broad authority to
disseminate appropriate information during all pandemic phases.
During the
Pandemic Phase, patients will receive medical treatment in a
variety of settings and are likely to be transferred among
settings. MDPH plans to track their whereabouts, in order to be
able to notify family members and friends of their location at
any particular time. To enable this to happen, it is expected
that hospitals will provide identifying information to MDPH
under a HIPAA waiver (explained in section 6.G. below), or under
HIPAA’s “required by law” exception in the event that the MDPH
Commissioner issues an order requiring patient tracking. MDPH
is not bound by HIPAA in connection with its public health
activities, and therefore can release a patient’s location to
family members and friends in the interests of public health and
safety (restoring calm, avoiding panic, etc.).
6. Waivers of
Federal CMS Requirements (“Section 1135 Waivers”)
Waivers of a variety of federal
requirements under the federal Medicare, Medicaid, and
Children’s Health Programs may become necessary during the
Pandemic Period. The Statewide Surge Committee is working with
representatives of CMS to identify and plan for all potentially
necessary waivers.
Under 42 U.S.C. § 1320b-5
(section 1135 of the Social Security Act), the Secretary of
Health and Human Services has authority to waive certain
requirements of CMS programs in an emergency area during a
federal emergency period. An
“emergency area” is a geographical area in which, and an
“emergency period” is the period during which, there exist two
types of declared emergencies:
an emergency or disaster declared by the President under the
National Emergencies Act or the Stafford Act, and a
public health emergency declared by the Secretary of HHS.
42 U.S.C. §
1320b-5(g)(1).
At the Secretary’s discretion, waivers that are authorized after
the emergency has occurred may be made retroactive to the
beginning of the emergency period.
42 U.S.C. § 1320b-5(c).
With 2 exceptions noted below (EMTALA and HIPAA), the waivers
generally last for the duration of the emergency period or until
CMS determines that the waiver is no longer necessary. However,
if a hospital
regains its ability to comply with a waived requirement before
the end of the declared emergency period, the waiver of that
requirement no longer applies to that hospital.
Requirements authorized to be
waived under section 1135 of the Social Security Act are listed
below. These are sometimes referred to as “Section 1135
Waivers.”
Available
Waivers
A. Conditions of
Participation: Subsection (b) (1)
The Secretary of HHS may waive:
a.
Conditions of participation or other certification requirements
for an individual health care provider or types of providers,
b.
Program participation and similar requirements for an individual
health care provider or types of providers, and
c.
Pre-approval requirements.
42 U.S.C. § 1320b-5(b)(1).
B. Licensure of Health Care
Professionals: Subsection (b)(2)
The Secretary of HHS may waive “requirements
that physicians and other health care professionals be licensed
in the state in which they provide services, if they have
equivalent licensing in another state and are not affirmatively
excluded from practice in that state or in any state a part of
which is included in the emergency area.”
42 U.S.C. § 1320b-5(b) (2).
C. EMTALA: Subsection (b)(3)
The Emergency Medical Treatment
and Labor Act (EMTALA) prohibits hospitals from transferring a
patient with an emergency condition, or a woman in labor, out of
the emergency room without screening the person and medically
stabilizing him or her. The Secretary of HHS may waive actions
under EMTALA (1) if a hospital transfers a person who has not
been stabilized, if the transfer is necessitated by the
circumstances of the emergency, or (2) if the hospital directs
or relocates a person to receive medical screening in an
alternate location pursuant to a state emergency preparedness
plan. 42 U.S.C. § 1320b-5(b)(3).
An EMTALA waiver will only be in
effect if the hospital does not discriminate among individuals
that it transfers or relocates on the basis of their source of
payment or their ability to pay. It is also limited to the
72-hour period beginning when a hospital implements its
disaster protocol. 42 U.S.C. § 1320b-5(b).
D. Physician Referrals:
Subsection (b)(4)
The Secretary of HHS may waive
sanctions under 42 U.S.C. § 1395nn(g), relating to limitations
on physician referrals. 42 U.S.C. § 1320b-5(b)(4).
E. Deadlines and
Timetables: Subsection (b)(5)
The Secretary of HHS may modify,
not waive, deadlines and timetables for the performance of
required activities. 42 U.S.C. § 1320b-5(b)(5).
F. Payments under a
Medicare+Choice Plan: Subsection (b)(6)
The Secretary of HHS may waive
limitations on payments under 42 U.S.C. § 1395w-21(i)
for health care items and services furnished to individuals
enrolled in a Medicare+Choice plan by health care professionals
or facilities that are not included under that plan.
42 U.S.C. §
1320b-5(b)(6).
G. HIPAA:
Subsection (b) (7)
The Health Insurance Portability and Accountability Act (HIPAA)
Privacy Rule requires health care providers to maintain patient
confidentiality in a variety of ways. Under this subsection,
the Secretary of HHS may waive sanctions for noncompliance with
the following requirements of the HIPAA regulations:
-
Requirements to obtain a patient’s agreement to speak with
family members or friends;
-
The
requirement to honor a patient’s request to opt out of the
facility directory;
3. The requirement to distribute a notice of the uses and disclosures of protected health
information that the hospital may make, and of the individual's rights and the hospitals’ duties
with respect to protected health information; and
4. The patient’s right to request certain privacy restrictions, and to request communications
of protected health information from the hospital by alternative means or at alternative locations.
42 U.S.C. § 1320b-5(b)(7).
As with EMTALA, a HIPAA waiver
will only be in effect if the hospital does not discriminate
among individuals on the basis of their source of payment or
their ability to pay, and it is limited to the 72-hour
period beginning when a hospital implements its disaster
protocol. 42 U.S.C. § 1320b-5(b).
Additional Waivers Needed
The
following types of waivers may also be needed during the
Pandemic Period. MDPH is working with regional HHS staff to
determine whether and under what authority these waivers may be
possible.
-
Waivers to allow reimbursement for facilities/practitioners
under circumstances where practitioners are being utilized
who would not normally be utilized. Examples:
-
Practitioners not privileged by the facility within
which they are working or do not meet the CMS
credentialing criteria
-
Volunteer (unpaid) people
-
Students & other categories of people who may not fit
the CMS conditions of participation for reimbursement
NOTE:
These MAY be allowed under Section 1135 (b) (1) allowing HHS to
waive conditions of participation
-
Waivers to allow Influenza Specialty Care Units (ISCU) or
other non-traditional facilities operating under state
"special project" licensing waivers to be recognized by CMS
for reimbursement purposes.
-
Waivers to allow facilities and practitioners to provide
care that does not meet CMS approved guidelines while
operating under State Alternate Standards of Care waivers.
-
Waivers to allow facilities to discharge or transfer
patients "against their will" during surge, including
discharging patients to home care or an ISCU.
-
Waivers that would allow facilities to refuse to admit
veterans and require them to seek treatment at Veterans
Administration facilities.
-
Waivers for EMS agencies to seek reimbursement for patients
not transported but examined/triaged/treated at home or
transported to an ISCU or physician’s office rather than a
hospital.
-
Waivers to allow EMS/hospital agencies and practitioners
that are CMS participants to act under authority of State
Alternate Standards of Care waivers and triage patients via
telephone to home care or a physician’s office.
Procedures for Requesting
Waivers
DPH will be in continuous
contact with hospitals during the Pandemic Period to determine
if a waiver or waivers are necessary, and will work with the
appropriate federal officials to expedite the process of
requesting them.
During the TOPOFF 2 exercise,
the legal office of the Illinois DPH requested an EMTALA waiver
through the Regional Counsel of HHS. It went up the chain of
command and was granted.
7. Use of Alternate Care Sites
During the
Pandemic Period, it may become necessary for patients to be
treated in non-traditional health care settings. Plans are
underway to create Influenza Specialty Care Units (“ISCUs”),
which will be satellites of existing hospitals. Each ISCU will
serve the communities identified by a hospital to be within its
catchment “cluster”, as well as the surge patients discharged
from the affiliated hospital. The ISCU will be stood up
following MDPH approval of a specific request by the hospital,
in a pre-identified and pre-approved facility in a community.
Each ISCU will be licensed as a satellite of the hospital under
a temporary special project waiver.
Legal staff
are involved in planning for the ISCUs so that they may operate
under appropriate legal authority and with any necessary
waivers. Issues to be addressed include tiered staffing
protocols, standing orders, admission and discharge criteria,
altered standard of care policies, activation protocols, and
others.
8. Altered Standards of Health Care
During the
Pandemic Period, it may be necessary to alter prevailing
standards of medical care. There may be insufficient health
care personnel to deliver optimum care, as well as a shortage of
material resources (e.g. ventilators). Legal and ethical
guidelines need to be developed to aid decision-making in these
circumstances. An official relaxation of the standard of care
may become necessary, in order to relieve health care providers
and institutions from liability for failure to adhere to
prevailing standards under dire circumstances.
At the
request of MDPH, the Harvard School of Public Health has
convened a working group to analyze these issues and develop
guidance. The group includes ethicists and representatives from
MDPH, the Harvard School of Public Health, several Massachusetts
hospitals, and the American Society of Law, Medicine and
Ethics. Hypothetical scenarios have been developed and
community-based discussions will be held, which ideally will
lead to the development of clear standards.
9. Use of Private Sector Resources
Voluntary loans
Private
businesses and individuals may be willing to loan materials or
space in buildings to the Commonwealth in the event they are
needed, but they may question whether they would be liable
should the materials malfunction or should the buildings have
defects.
Liability
protection for loan of materials by corporations, but not
individuals, may exist if the Governor has declared an
emergency under Chapter 639 of the Acts of 1950, 33 App. § 13-1
et seq. Section 13-12 of this statute provides that after the
Governor declares an emergency under § 13-5, no “person engaged
in any civil defense activities while in good faith complying or
attempting to comply with this act . . . shall be civilly liable
for the death of or any injury to persons or damage to property
as [a] result of such activity except that the individual
shall be liable for his negligence [emphasis added].”
“Civil defense” is defined
to include “the preparation for and the carrying out of all
emergency functions, . . . for the purpose of minimizing and
repairing injury and damage resulting from disasters caused by .
. . hostile action . . . or . . . natural causes.” Under this
definition, responding to a flu pandemic would be considered a
civil defense function. However, it is uncertain whether the
word “person” includes corporations.
The loan of
space in buildings is even more problematic. Section 13-12A of
Chapter 639 only provides protection from negligence for the
loan of real estate when the real estate is provided “for the
purpose of sheltering persons during an actual, impending or
mock enemy attack.” There does not appear to be any other legal
protection for a person who loans real estate.
Governmental takings
It is a
basic premise of constitutional law that the government may take
private property for public use, but it must provide just
compensation. U.S. Constitution, Amendment V; Massachusetts
Constitution, Article X. Section 13-5 of Chapter 639 of the
Acts of 1950 specifies this authority in detail. It states that
when the Governor has declared a state of emergency, he may take
possession of real estate, machinery, equipment, modes of
transportation, food, and fuel. Section 13-5 also specifies
procedures by which property owners may have compensation
assessed for the taking of their property.
MDPH also
has broad powers in situations that threaten public health. If
the Governor has declared a public health emergency under
chapter 17, s. 2A, the Commissioner may, with the approval of
the Governor and the Public Health Council, “take
such action and incur such liabilities as he may deem necessary
to assure the maintenance of public health and the prevention of
disease.” This is very broad authority and is sufficient to
allow MDPH to take private property (e.g. medical supplies) if
necessary.
Furthermore, M.G.L. c. 111, § 5A allows the Commissioner to
determine that it is essential in the interest of the public
health to provide the general public with a vaccine or
medication and that an emergency exists by reason of a shortage
of such product. When the Commissioner makes this
determination, DPH may "purchase, produce and distribute such
product under such conditions and restrictions as it may
prescribe" and may establish rules and priorities for the
distribution and use of the product. During a public health
emergency, this statute and c. 17, § 2A together allow MDPH to
take necessary vaccines, etc. from the private sector and
control their distribution.
LEGAL
RESOURCES
1.
Model Documents
During the Pandemic Period and
possibly during the Pandemic Alert Period, it may become
necessary for the Commissioner to issue various orders to
protect the public health. Various templates for such orders
have been drafted, which are located in the DPH Office of
General Counsel.
2. Documents for Isolation and
Quarantine
The “Legal Nuts and Bolts of
Isolation and Quarantine” package includes model health
letters, health orders, court pleadings, and related documents.
It is available from the DPH Office
of General Counsel and the Health Education Unit,
Division of Epidemiology and Immunization.
3. Other Legal Information
A summary document and
PowerPoint presentation dealing with liability protections
for Massachusetts health care volunteers responding to a
disaster may be found at
http://www.mass.gov/dph/bioterrorism/advisorygrps/index.htm
Additional legal resources and
tools include:
-
International Emergency
Management Assistance Memorandum of Understanding as adopted
in Massachusetts
Additional materials and resources may be posted at
http://www.cdc.gov/phlp/index.htm
PARTNERSHIPS/OUTREACH
-
In 2003-2004,
an Emergency Powers Working Group was convened by the
Governor’s office and the Attorney General’s office. It
included attorneys from many state agencies including MDPH,
the Executive Office of Public Safety, the State Police,
Environmental Protection, Agriculture, Fire Services, and
others. The group completed a tabletop exercise based on a
hypothetical release of a mysterious toxic substance, and
wrote memos summarizing the authority of each agency.
-
There are legal
representatives on the following groups that are currently
meeting and that include many stakeholders:
-
Statewide Surge
Committee: Addresses a wide variety of pandemic surge
issues
-
Surge Clinical
Workgroup: in process of being formed. Will
address legal issues related to the Influenza
Specialty Care Units (ISCUs) including guidance on
the care to be delivered, tiered staffing protocols,
standing orders, altered standard of care protocols,
etc.
-
Massachusetts System for
Advance Registration (MSAR) Advisory Committee:
Planning group for the statewide advance registration
system for health care volunteers
-
Altered Standards of
Care Working Group, chaired by the Harvard School of
Public Health: Explores how standards of medical care
would be altered in a pandemic
-
New England Regional
HRSA Group: Shares information and works on regional
issues involving hospital preparedness
-
International Emergency Management Group: Shares
information and works on mutual aid issues for the New
England states and Eastern Canadian provinces
TRAINING ON
LEGAL ISSUES
1. Training for
Local Health Authorities
-
The training program
entitled “Legal Nuts and Bolts of Isolation and Quarantine”
has been presented to local health authorities around the
state numerous times, and two more of these trainings will
take place by the fall of 2006.
-
A training session on
liability protections for local health authorities and
volunteers has been presented twice.
2. Training for
Law Enforcement
-
Approximately 1200 state
police officers were trained in advance of the Democratic
National Convention in the summer of 2004 by counsel to the
State Police. Among other things, this training covered the
law enforcement community caretaking function and the
authority of the police to enforce orders from health
officials.
-
Some local law enforcement
officers have attended the “Legal Nuts & Bolts of Isolation
and Quarantine” trainings.
-
A training program for state
police is being planned for summer 2006, to cover infectious
diseases and the use of isolation and quarantine for
individuals, groups, and areas. This may be extended to
local police at a later date.
3.
Training for the Judiciary
-
Superior Court
judges received materials from the “Legal Nuts and Bolts of
Isolation and Quarantine” several years ago. These include
health orders and court pleadings, motions, etc.
LEGAL ISSUES
WITHIN PURVIEW OF OTHER AGENCIES
-
Issues
relating to overtime and/or flexibility of hours for staff:
The Human Resources Division is working on these.
-
Environmental remediation of buildings:
This is the responsibility of the Department of
Environmental Protection.
-
Issues relating to schools:
As necessary, MDPH will work with the Department of
Education to ensure that school-related issues such as
school closures and use of schools as alternate care sites
are handled according to law.
MISCELLANEOUS
ISSUES
-
Use of
faith-based
organizations:
There should be no legal problem if MDPH decides to partner
with faith-based organizations to assist or provide services
to people during the Pandemic Period. A group called the
“Interfaith Alliance” assisted with Hurricane Katrina
evacuees on the Cape in the fall of 2005. During that
period, the Governor’s office also worked with
a
coordinated interfaith effort called “MassFaithHelps,”
spearheaded by the Black Ministerial Alliance.
-
Reintegration
of persons subject to isolation/quarantine orders:
If necessary, MDPH will issue documents designed to assist
with reintegration of persons after isolation or quarantine
(e.g., letters to employers or schools explaining that
people are no longer infectious), and would assist local
health authorities in this effort.
