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The Turning Point Model State Public Health Act (MSPHA)
The Uniform Emergency Volunteer Health Practitioners Act (UEVHPA)
The Center's Model State Emergency Health Powers Act (MSEHPA)
The Model State Public Health Privacy Act (MSPHPA)
The
Turning
Point Model State Public
Health Act
The
Turning Point National Collaborative on Public Health Statute
Modernization seeks to transform and strengthen the legal
framework for public health through a collaborative process to
develop a model state public health law to better protect and
promote the public's health. Funded by the Robert
Wood Johnson Foundation as part of its Turning
Point Initiative, the Collaborative is a multi-disciplinary
group comprised of representatives from five states (lead state,
Alaska, and Colorado, Nebraska, Oregon, Wisconsin), nine national
organizations and government agencies, and experts in specialty
areas of public health.
Released on September 16, 2003 after three years of development
and a national commentary period, the Turning
Point Model State Public Health Act is designed to serve as
a tool for state, local, and tribal governments to use to revise
or update public health statutes and administrative regulations.
On June 15, 2004, the Turning Point Public Health Statute Modernization
Collaborative received the 2004 Distinguished Achievement in
Public Health Law Award at the CDC/ASLME Public Health Law Conference.
The annual award is given by the Public
Health Law Association to acknowledge outstanding achievement
in the development, use or application of law as a means to promote
healthy people in healthy communities.
Legislative
Status Update: From January 1, 2003 - August 15, 2007, the subject matter
or specific language from the Turning Point Act has been featured or introduced
in whole or part through 133 bills or resolutions
in thirty-three (33) states, of which forty-eight (48) have passed. The extent to which the Act's provisions
are featured in these bills varies extensively. For
more information, please refer to the following tables:
Turning
Point Act State Legislative Update Table [as of August 15, 2007] - this table provides a summary of key state legislative bills or resolutions featuring statutory provisions that either used actual language from the Turning Point Act, or are based on all or some part of its subject matter; and
Turning Point Act State Legislative Matrix Table [as of August 15, 2007] - this table organizes the legislative areas that relate to major sections or corresponding themes in the Turning Point Act. It indicates those bills that were introduced, passed, and vetoed, and provides summary counts of these bills.
For additional information about the Collaborative,
its work products, and the Turning Point Model State Public Health
Act, and existing or emerging case studies please see the links below:
Turning
Point Collaborative Brochure (April 2001)
State Public
Health Law Assessment Report (April 2002) - Lawrence O. Gostin
and James G. Hodge, Jr.
State
Public Health Law - Assessment Report (May, 2002) (Power Point
Presentation) - James G. Hodge, Jr.
National Association
of Attorneys General (NAAG) Resolution "Urging States to
Review Their Public Health Laws" (December 2003)
Reforming
Public Health Laws in the 21st Century: The Turning Point Model
State Public Health Act (June 2004) (Power Point Presentation)
- James G. Hodge, Jr.
Michigan
Briefing on Turning Point and Public Health Law Reform (October, 2004)
(Power Point Presentation) - Mark Bertler and Karen Krzanowski.
Anchorage
Daily News: Quarantine Quandary - Experts Try to Balance Privacy
and Safety, March 15, 2005 - story discussing Alaska state
public health bill based on the Turning Point Act.
Creating Tribal Public Health Law (November, 2005) (Power Point Presentation) - Teresa Wall, National Indian Health Board Public Health Workshop
Hodge, JG , Gostin, LO, Gebbie, K, Erickson, DL. Transforming public health law: The Turning Point Model State Public Health Act. Journal of Law, Medicine, and Ethics 2006 ; 34:1: 77-84.
Alaska: A Case Study in Public Health Law Reform and the Turning Point Model State Public Health Act (June 2006) - Benjamin Mason Meier, Kristine M. Gebbie, and James G. Hodge, Jr.
South Carolina Public Health Law Reform Pursuant to the Turning Point Model State Public Health Act (December 2006) - Benjamin Mason Meier, Kristine M. Gebbie, and James G. Hodge, Jr.
Meier, BM, Gebbie, K, Hodge, JG. Contrasting experiences of state public health law reform pursuant to the Turning Point Model State Public Health Act. Public Health Reports 2007; July-August 122: 559-563.
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Uniform Emergency Volunteer Health Practitioners Act
As noted during the aftermath of Hurricanes Katrina and Rita in 2005, and many other emergencies in the nation's history, volunteer health practitioners are essential to meeting surge capacity in public and private sectors. Underlying the successful deployment and use of volunteer health practitioners during emergencies is the need for a legal environment that supports their efforts. However, there are major legal gaps and deficiencies that may stymie, rather than encourage, volunteer health practitioner activities during emergencies. Following Katrina, the U.S. Congress introduced several bills to address some of these gaps since September, 2005.
Many state governments have recognized the need to grant emergency licensing recognition on an interstate basis and to afford disaster relief workers (which may include volunteer health practitioners) with protection from civil liability. Every state has ratified the Emergency Management Assistance Compact (EMAC), which provides for licensing reciprocity, relief from civil liability, and workers’ compensation protections to “state forces” deployed to respond to emergencies. The provisions of EMAC, however, are limited. In most jurisdictions, EMAC's provisions only apply to state employees or local employees incorporated into “state forces” pursuant to mutual aid agreements. Many state laws underlying the declaration of public health emergencies (including many recently enacted laws based on the Model State Emergency Health Powers Act of 2001 developed by the Center) recognize interstate health licensure or provide broad authority to waive other legal or regulatory requirements during emergencies.
There is, however, no uniform system exists to efficiently and expeditiously recognize licensing privileges for health practitioners on an interstate basis. The lack of a uniform, well-understood system able to function automatically even during periods of emergencies when communications systems are disrupted and governmental officials are preoccupied with pressing responsibilities.
Developed by the National Conference of Commissioners on Uniform State Laws (NCCUSL) the Uniform Emergency Volunteer Health Practitioners Act (UEVHPA) provides uniform legislative language to facilitate organized response efforts among volunteer health practitioners. Center Executive Director James G. Hodge, Jr., served as Reporter (i.e., Drafter) for the project with NCCUSL.
UEVHPA’s provisions address the following:
- Application of its coverage to declared states of emergency, disaster, or public health emergency (or like terms at the state or local level);
- The coverage of volunteer health practitioners who are registered with ESAR-VHP, MRC, or other similar systems;
- Procedures to recognize the valid and current licenses of volunteer health practitioners in other states for the duration of an emergency declaration;
- Requirements for volunteer health practitioners to adhere to scope of practice standards during the emergency (subject to modifications or restrictions);
- Reduction of the exposure of volunteer health practitioners, or those who employ, deploy or host them, to significant disciplinary sanctions based on actions (or failures to act) during a declared emergency.
At the 2007 annual NCCUSL conference in Pasadena, CA, Conference commissioners voted to approve 2 new sections of the UEVHPA. focused on:
· Civil liability protections (Sec. 11) for volunteers and potential the entities that send, coordinate, or host them during declared emergencies; and
· Workers’ compensation benefits (Sec. 12) for volunteers who may otherwise lack such benefits while providing volunteer health or veterinary services during declared emergencies.
Section 11 offers two alternatives for states considering passage of the Act. Alternative A offers clear immunity for volunteers from civil liability for acts that occur while providing health or veterinary services during an emergency. It also protects the entities that send or host volunteers from vicarious liability. Alternative B essentially replicates the existing liability protections found in the federal Volunteer Protection Act to the specific volunteers addressed in the UEVHPA. Both Alternatives also (i) except from liability protections those acts of a volunteer that are willful, wanton, or grossly negligent in nature, or that occur in operating motor vehicles, among other exceptions; and (ii) provide a limited exemption from liability for persons who operate, use, or rely upon information provided by a volunteer health practitioner registration system.
Section 12 provides that a volunteer health practitioner who provides health or veterinary services during an emergency and who is not otherwise eligible for workers’ compensation benefits of the host or sending state may elect to be deemed an employee of the host state for the purpose of receiving such benefits. The objective is to create a path for volunteers who may lack workers compensation protections to seek such protections in the state where they provide services during an emergency.
The approved versions of these sections will undergo final, stylized edits and ultimately be included with Official Commentary as part of the entire Act later this year. Legislative activity based on the UEVHPA across the states is projected by NCCUSL to continue in 2007 and beyond.
For more information about the Act and its legislative activity, please see www.uevhpa.org, and additional references below:
Hall, Mimi. States seek to cut disaster red tape. USA Today, October 9, 2007 @ A1.
Hodge, JG , Pepe RP, Henning, WH. Voluntarism in the wake of hurricane Katrina: The Uniform Emergency Volunteer Health Practitioners Act. Disaster Medicine and Public Health Preparedness 2007; 1:1: 44-50.
“New law allows medical workers to aid victims of disasters in other states” - Lexington Herald-Leader (03/31/07) - Kentucky became the first state to adopt model legislation to allow health professionals from other states to offer assistance during a major disaster or public health emergency. The UEVHPA was adopted by the Kentucky General Assembly, and signed by Gov. Ernie Fletcher in late March.
Interview with Reporter James G. Hodge, Jr. by the Johns Hopkins Bloomberg School of Public Health
The
Model State Emergency Health Powers Act
The Model State Emergency Health Powers Act (MSEHPA) grants public
health powers to state and local public health authorities to
ensure a strong, effective, and timely planning, prevention, and
response mechanisms to public health emergencies (including bioterrorism)
while also respecting individual rights.
Developed
through the Center with additional funding support from
the Alfred P. Sloan
Foundation, MSEHPA has been used by state and local legislators
and health officials nationwide as a guide for considering public
health law reform in their states. An initial draft of
the Act (as of October 30, 2001) was superceded by the Act's final
version (as of December 21, 2001).
Legislative
Status Update: Since its completion on December 21, 2001, the Center has been tracking state legislative activity related to MSEHPA. As of July 15, 2006, the Act has been introduced in whole or
part through 171 bills or resolutions in forty-four (44) states,
the District of Columbia, and the Northern Mariannas Islands.
Thirty-eight (38) states [AL, AK, AZ, CA, CT, DE, FL, GA, HI, ID,
IL, IN, IA, LA, ME, MD, MN, MO, MT, NV, NH, NJ, NM, NC, OK, OR, PA,
RI, SC, SD, TN, TX, UT, VT, VA, WI, and WY] and DC have passed a total of 66 bills
or resolutions that include provisions from or closely related
to the Act. The extent to which the Act's provisions are incorporated
into each state's laws varies. For
more information, please refer to the specific legislative bills
or resolutions referenced in the MSEHPA State
Legislative Activity Table and the MSEHPA
State Legislative Surveillance Table (both documents include information as of July 15, 2006).
For
additional information about the MSEHPA, please see the
links below:
Lawrence
O. Gostin, et al. The Model State Emergency Health Powers Act:
Planning for and Response to Bioterrorism and Naturally Occurring
Infectious Diseases, 288 JAMA 622 (2002).
James G.
Hodge, Jr., Lawrence O. Gostin, The
Model State Emergency Health Powers Act - A Brief Commentary (January
2002).
National
Conference of State Legislatures, The Model State Emergency Health
Powers Act: A Checklist of Issues (June 2002).
Model State Emergency Health
Powers Act - Media Coverage (October 2002).
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