Organization and Legal Basis of Public Health
Jan 14, 2016
Organization and Legal Basisof Public Health
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Objectives
• Describe legal responsibilities and limitations of the public health professional.
• Describe the general organization of public health at the federal, state, and local levels.
• Describe how your jurisdiction or job fits into the big picture.
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Public Health v. Personal Freedoms
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Public Health v. Personal Freedoms
Typhoid Mary
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Public Health v. Personal Freedoms
Vaccination
Mandatory Reporting
Inspection & Licensure
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Public Health v. Personal Freedoms
Public Nuisances
November 9, 1915
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Legal Basis
• U.S. Constitution
• Bill of Rights
• State Constitution
• Federal and State
• Statutes
• Regulations
• Case law
Responsibilities
Authorities
Limitations
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Due Process
Fair notice
Opportunity tobe heard
Clear procedures
Fairness in the procedural application of the law:
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Equal Protection
Laws must be applied evenhandedly
People in similar situations must be treated similarly
Show no favoritism
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Privacy
Governmental intrusion must be warranted
Individual Privacy vs. Protection of Population
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Government Must Act…
Fairly
According to clear procedures
Organizational Structure
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Federal Agencies
• Health Resources and Services
• Food and Drug Administration
• Centers for Disease Control and Prevention
• National Institutes of Health
• Office of Public Health Preparedness (OPHP)
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State Agencies
• Structure varies by state
• Centralized vs. local control
• NY & NJ “Home Rule” states
Main legal authority for public health
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Legal Authorities
The governmental level with highest authority has the ultimate power.
Federal RuleFederal Regulation
Local RuleLocal Regulation
State RuleState Regulation
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Duties of Local Health Agencies
• Communicable disease control
• Chronic disease prevention and control
• Environmental health
• Maternal and child health
• Vital records
• Emergency planning and response
• Community health care planning
• Community health education
How Do You Fit In?
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Functions of Law
• Regulates conduct
• Protects individual and property rights
• Defines the duties and responsibilities of government and individuals
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Legal versus Practical
• Search for the zone of agreement
• Be open, honest, and empathetic
• Negotiate & Communicate
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Functions of Public Health
• Don’t abuse your
• Power
• Authority
• Ask yourself
• Is is legal for me to do this?
• Is it ethical for me to do this?
• Understand how you fit in
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Points to Remember
• Know what you enforce
• Seek assistance
• Act in good faith
• Respect the public’s trust
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Liability
• MALFEASANCE
• The commission of an unlawful act
• MISFEASANCE
• Improper performance of an act which a person might lawfully do
• NONFEASANCE
• Nonperformance of an act which should be performed; omission to perform a required duty or total neglect of duty
Can you get sued?
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Case Study