Achieving public health legal preparedness: how dissonant views on public health law threaten emergency preparedness and response. 2011

Anda Botoseneanu, and Helen Wu, and Jeffrey Wasserman, and Peter D Jacobson
Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA. andabm@umich.edu

BACKGROUND Effective management of modern public health emergencies requires the coordinated efforts of multiple agencies representing various disciplines. Organizational culture differences between public health (PH) and emergency management (EM) entities may hinder inter-agency collaboration. We examine how PH and EM differ in their approach to PH law and how such differences affect their collaboration towards PH preparedness. METHODS We conducted 144 semi-structured interviews with local and state PH and EM officials between April 2008 and November 2009. Thematic qualitative analysis in ATLAS.ti was used to extract characteristics of each agency's approach to PH legal preparedness. RESULTS Two conflicting approaches to the law emerge. The PH approach is characterized by perceived uncertainty regarding legal authority over preparedness planning tasks; expectation for guidance on interpretation of existing laws; and concern about individual and organizational liability. The EM approach reveals perception of broad legal authority; flexible interpretation of existing laws; and ethical concerns over infringement of individual freedoms and privacy. CONCLUSIONS Distinct interpretations of preparedness law impede effective collaboration for PH preparedness. Clarification of legal authority mandates, designation within laws of scope of preparedness activities and guidance on interpretation of current federal and state laws are needed.

UI MeSH Term Description Entries
D007373 Interinstitutional Relations The interactions between representatives of institutions, agencies, or organizations. Interagency Relations,Interagency Relation,Interinstitutional Relation,Relation, Interagency,Relation, Interinstitutional,Relations, Interagency,Relations, Interinstitutional
D011634 Public Health Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. Community Health,Environment, Preventive Medicine & Public Health,Environment, Preventive Medicine and Public Health,Health, Community,Health, Public
D002959 Civil Defense Preventive emergency measures and programs designed to protect the individual or community in times of hostile attack or natural disaster. Civil Defenses,Defense, Civil,Defenses, Civil
D003299 Cooperative Behavior The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed) Compliant Behavior,Behavior, Compliant,Behavior, Cooperative,Compliant Behaviors,Cooperative Behaviors
D004189 Disaster Planning Procedures outlined for the care of casualties and the maintenance of services in disasters. Disaster Management,Emergency Preparedness,Disaster Relief Planning,Management, Disaster,Planning, Disaster,Planning, Disaster Relief,Preparedness, Emergency,Relief Planning, Disaster
D006287 Health Planning Guidelines Recommendations for directing health planning functions and policies. These may be mandated by PL93-641 and issued by the Department of Health and Human Services for use by state and local planning agencies. Guidelines for Health Planning,Recommendations, Health Planning,Guideline, Health Planning,Guidelines, Health Planning,Health Planning Guideline,Health Planning Recommendation,Health Planning Recommendations,Planning Guideline, Health,Planning Guidelines, Health,Planning Recommendation, Health,Planning Recommendations, Health,Recommendation, Health Planning
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013219 State Government The level of governmental organization and function below that of the national or country-wide government. Government, State,Provincial Government,Government, Provincial,Governments, State,State Governments
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D060731 Emergency Responders Personnel trained to provide the initial services, care, and support in EMERGENCIES or DISASTERS. Emergency First Responders,First Responders,Emergency First Responder,Emergency Responder,First Responder,First Responder, Emergency,First Responders, Emergency,Responder, Emergency,Responder, First,Responders, Emergency,Responders, First

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