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