An Assessment of State Laws Providing Gubernatorial Authority to Remove Legal Barriers to Emergency Response

Sunshine, Gregory; Thompson, Kelly; Menon, Akshara; Anderson, Nicholas; Penn, Matthew; Koonin, Lisa M.

doi:10.1089/hs.2018.0126

Cited by 11 publications

(7 citation statements)

References 6 publications

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“…Furthermore, legislation or executive orders expanding eligibility to administer vaccinations during an emergency, such as to dentists and emergency medical technicians, could further mitigate personnel limitations, particularly if this eligibility includes children. 29 Establishing these authorities in advance of an emergency can increase personnel availability and reduce operational delays, but executive orders, particularly those issued under emergency authority, can provide temporary authority in the absence of appropriate legislation. Finally, while establishing emergency surge capacity is important, incorporating vaccination training into onboarding and routine training for public health personnel, including nurses and immunization staff, can also help mitigate staffing shortages, particularly in situations with high staff turnover.…”

Section: Discussionmentioning

confidence: 99%

Current State of Mass Vaccination Preparedness and Operational Challenges in the United States, 2018-2019

et al. 2020

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Mass vaccination is a crucial public health intervention during outbreaks or pandemics for which vaccines are available.The US government has sponsored the development of medical countermeasures, including vaccines, for public health emergencies; however, federally supported programs, including the Public Health and Emergency Preparedness program and Cities Readiness Initiative, have historically emphasized antibiotic pill dispensing over mass vaccination. While mass vaccination and pill dispensing programs share similarities, they also have fundamental differences that require dedicated preparedness efforts to address. To date, only a limited number of public assessments of local mass vaccination operational capabilities have been conducted. To fill this gap, we interviewed 37 public health and preparedness officials representing 33 jurisdictions across the United States. We aimed to characterize their existing mass vaccination operational capacities and identify challenges and lessons learned in order to support the efforts of other jurisdictions to improve mass vaccination preparedness. We found that most jurisdictions were not capable of or had not planned for rapidly vaccinating their populations within a short period of time (eg, 1 to 2 weeks). Many also noted that their focus on pill dispensing was driven largely by federal funding requirements and that preparedness efforts for mass vaccination were often self-motivated. Barriers to implementing rapid mass vaccination operations included insufficient personnel qualified to administer vaccinations, increased patient load compared to pill-dispensing modalities, logistical challenges to maintaining cold chain, and operational challenges addressing high-risk populations, including children, pregnant women, and non-English-speaking populations. Considering the expected availability of a severe acute respiratory syndrome coronavirus 2 vaccine for distribution and dispensing to the public, our findings highlight critical considerations for planning possible future mass vaccination events, including during the novel coronavirus disease 2019 pandemic.

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Section: Discussionmentioning

confidence: 99%

Current State of Mass Vaccination Preparedness and Operational Challenges in the United States, 2018-2019

et al. 2020

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“…For example, in Idaho, a new law gg prohibits the governor from altering, adjusting, or creating any provision of the state code, a well-established emergency power in many states. 3,29 Other actions fell into two general categories: (1) limiting or prohibiting emergency orders relating to certain constitutional rights and (2) limiting executive powers to establish and enforce mitigation efforts for the prevention or control of infectious disease outbreaks, including mask protocols, vaccination requirements, vaccine verification, and isolation and quarantine requirements.…”

Section: Limitations On Government Emergency Response Capabilitiesmentioning

confidence: 99%

“…They also give states flexibility to respond to exigent circumstances and often allow governors or state health officials to temporarily modify their state's statutory, regulatory, or legal framework to respond to the changing nature of an emergency quickly. 3 While emergency powers can activate additional legal tools, these authorities may only be available for the duration of the emergency declaration.…”

Section: Introductionmentioning

confidence: 99%

Emergency powers and the pandemic: Reflecting on state legislative reforms and the future of public health response

PMP¹,

Dedon²,

Hoffman³

et al. 2023

JEM

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The first 2 years of combatting the COVID-19 pandemic necessitated an unprecedented use of emergency powers. States responded with an equally unprecedented flurry of legislative changes to the legal underpinnings of emergency response and public health authorities. In this article, we provide a brief background on the framework and use of governors and state health officials’ emergency powers. We then analyze several key themes, including both the enhancement and restriction of powers, emerging from emergency management and public health legislation introduced in state and territorial legislatures. During the 2020 and 2021 state and territorial legislative sessions, we tracked legislation related to the emergency powers of governors and state health officials. Legislators introduced hundreds of bills impacting these powers, some enhancing and others restricting emergency powers. Enhancements included increasing vaccine access and expanding the pool of eligible medical professions that could administer vaccinations, strengthening public health investigation and enforcement authority for state agencies, and preclusion of local orders by orders at the state level. Restrictions included establishing oversight mechanisms for executive actions, limits on the duration of the emergency, limiting the scope of emergency powers allowed during a declared emergency, and other restraints. By describing these legislative trends, we hope to inform governors, state health officials, policymakers, and emergency managers about how changes in the law may impact future public health and emergency response capabilities. Understanding this new legal landscape is critical to effectively preparing for future threats.

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“…In the future, expansion of the Nurse Licensure Compact (beyond the current 31 participating states and 3 states with implementation pending), use of gubernatorial executive orders to extend or remove restrictions on prescribing practice for healthcare providers during a declared emergency, and other possible mechanisms may reduce these constraints during a severe pandemic. [30][31][32] Actors reported a high level of satisfaction with the Flu on Call network. Caller satisfaction metrics for the 2018 Flu on Call simulation were comparable to other emergency call lines.…”

Section: Koonin Et Almentioning

confidence: 99%

CDC's Flu on Call Simulation: Testing a National Helpline for Use During an Influenza Pandemic

et al. 2020

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During an influenza pandemic, healthcare facilities are likely to be filled to capacity, leading to delays in seeing a provider and obtaining treatment. Flu on Call is a collaborative effort between the US Centers for Disease Control and Prevention and partners to develop a toll-free telephone helpline to reduce the burden on healthcare facilities and improve access to antivirals for people who are ill during an influenza pandemic. This study tested the feasibility of Flu on Call during a 1day simulation using a severe pandemic scenario. Trained volunteer actors placed calls to the helpline using prepared scripts that were precoded for an expected outcome (''disposition'') of the call. Scripts represented callers who were ill, those calling for someone else who was ill, and callers who were only seeking information. Information specialists and medical professionals managed the calls. Results demonstrated that Flu on Call may effectively assist callers during a pandemic, increase access to antiviral prescriptions, and direct patients to the appropriate level of care. Overall, 84% of calls exactly matched the expected call disposition; few calls (2%) were undermanaged (eg, the caller was ill but not transferred to a medical professional or received advice from the medical professional that was less intensive than what was warranted). Callers indicated a high level of satisfaction (83% reported their needs were met). Because of the high volume of calls that may be received during a severe pandemic, the Flu on Call platform should evolve to include additional triage channels (eg, through internet, chat, and/or text access).

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An Assessment of State Laws Providing Gubernatorial Authority to Remove Legal Barriers to Emergency Response

Cited by 11 publications

References 6 publications

Current State of Mass Vaccination Preparedness and Operational Challenges in the United States, 2018-2019

Current State of Mass Vaccination Preparedness and Operational Challenges in the United States, 2018-2019

Emergency powers and the pandemic: Reflecting on state legislative reforms and the future of public health response

CDC's Flu on Call Simulation: Testing a National Helpline for Use During an Influenza Pandemic

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