Harris County Legal Preparedness Task Force

State: TX Type: Model Practice Year: 2008

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Goals and objectives of the Harris County Legal Preparedness Task Force include the following:

Goal 1) The Task Force aims to ensure coordination of public health legal preparedness issues across the Harris County organization.

Objective 1a: Provide an ongoing forum for all Harris County entities involved in emergency preparedness to address public health legal preparedness issues.
Objective 1b: Provide updated 24/7 contact information for Harris County legal staff to all Harris County entities involved in emergency preparedness and vice versa.
Objective 1c: Develop and maintain cross-agency public health emergency response protocols that include appropriate legal activities.

Goal 2) The Task Force aims to ensure that appropriate legal authority exists to respond to public health emergencies effectively and efficiently. Objective 2: Review Texas statutes relating to public health legal preparedness, determine gaps and develop/propose appropriate legislative initiatives to address gaps.

Goal 3) The Task Force aims to ensure that continuity of operations plans are in place for Harris County legal staff.
Objective 3: Develop a continuity of operations plan for departments housing Harris County legal staff.

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Harris County Public Health and Environmental Services
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Harris County Legal Preparedness Task Force
Goals and objectives of the Harris County Legal Preparedness Task Force include the following: Goal 1) The Task Force aims to ensure coordination of public health legal preparedness issues across the Harris County organization. Objective 1a: Provide an ongoing forum for all Harris County entities involved in emergency preparedness to address public health legal preparedness issues.Objective 1b: Provide updated 24/7 contact information for Harris County legal staff to all Harris County entities involved in emergency preparedness and vice versa. Objective 1c: Develop and maintain cross-agency public health emergency response protocols that include appropriate legal activities. Goal 2) The Task Force aims to ensure that appropriate legal authority exists to respond to public health emergencies effectively and efficiently. Objective 2: Review Texas statutes relating to public health legal preparedness, determine gaps and develop/propose appropriate legislative initiatives to address gaps. Goal 3) The Task Force aims to ensure that continuity of operations plans are in place for Harris County legal staff.Objective 3: Develop a continuity of operations plan for departments housing Harris County legal staff.
The Harris County Legal Preparedness Task Force addresses the role of law in public health preparedness and response. Specifically, the Task Force addresses the legal aspects of disease control and public health emergency management, aiming to ensure that relevant county departments are equipped to work in concert with legal staff to ensure that response activities are based upon a strong legal foundation and follow appropriate legal procedures. With respect to the process used to determine the public health issue’s relevancy to the community, HCPHES and the Harris County Attorney’s Office maintain a long history of collaboration on disease control activities. Examples include issuing periodic isolation orders for persons with tuberculosis and, in 2003, quarantining a pet shop following the identification of monkeypox among animals destined for sale. However, in the wake of the September 11 terrorist attacks, the anthrax events of 2001, Hurricanes Katrina and Rita, and the continued threat of avian influenza, discussions between HCPHES and the County Attorney’s Office led to the recognition that strong coordination between the public health, emergency management and legal fields is crucial to ensuring that public health emergency response is effective, efficient, and appropriate. HCPHES and the County Attorney’s Office recognized that adequate legal preparedness is critical to safeguarding community health and minimizing societal disruption following a public health emergency. For example, the two entities concluded that enacting health authority orders in a manner that is efficient, accurate, and supportive of due process benefits the community as a whole, protecting health and preserving the rights of individuals. The Harris County Legal Preparedness Task Force aims to ensure coordination of public health legal preparedness issues across the Harris County organization, primarily by providing an ongoing forum for all Harris County entities involved in emergency preparedness to address relevant legal issues.
Agency Community RolesHCPHES serves as co-facilitator of the Task Force. The Harris County Attorney’s Office shares facilitating duties. HCPHES also provides primary staff support. For example, HCPHES served as lead author for the Harris County Disease Containment Strategies: Information and Protocols manual, and with guidance from the Harris County Attorney’s Office Legislative Relations staff, HCPHES served as lead author for the six-point legislative proposal, assembled a statewide coalition of support for the legislative proposal, conceptualized strategies for bill passage, monitored bill status, and provided background information and testimony to legislators. Each Task Force member is expected to attend Task Force meetings, participate in Task Force discussions, highlight relevant issues from his/her county department, and contribute to the development of Task Force documents and activities as necessary. The Task Force routinely collects input from a variety of community stakeholders on key issues in order to inform its deliberations. For example, HCPHES formed and co-chairs the Houston-Harris County Committee on Pandemic Influenza Medical Standards of Care. This group, which consists of leaders from the City of Houston’s health department, two area medical schools, the county’s hospital district, the Harris County Medical Society, and the Mental Health and Mental Retardation Authority of Harris County, develops recommendations for allocating scarce medical resources during a pandemic event. HCPHES liaisons between this committee and the Task Force, ensuring that issues with a policy focus are communicated to the Task Force. In addition, the Task Force periodically invites stakeholders to attend Task Force meetings in order to provide input on specific issues. For example, in fall 2007 a local judge provided perspective to the Task Force regarding challenges facing the judiciary during public health emergencies. Further, HCPHES engages Task Force members to interact directly with community stakeholders. For example, at an October 2007 forum hosted by HCPHES titled “Preparing for Pandemic Influenza: The Healthcare Perspective,” key Task Force members presented at a session dedicated to legal preparedness issues. Finally, the Task Force partners with stakeholders to further legislative initiatives. For example, HCPHES and Task Force members engaged the Texas Medical Association, the Texas Hospital Association, the Texas Association of Local Health Officials, and individual hospitals and health departments when developing and guiding the legislative proposal through the 80th Texas Legislative Session. Costs and ExpendituresThere were no implementation, start-up, or in-kind costs involved with the Task Force. ImplementationTasks undertaken to achieve Goal 1 and Objectives 1a and 1b included the following: 1) Identifying need for Task Force, determining goals, inviting participants, initiating ongoing meetings Responsible parties - Harris County Attorney’s Office, HCPHES Time Frame – Approximately two months during the winter of 2005-2006. 2) Facilitating periodic, ongoing meetings among Harris County entities involved in emergency preparedness, educating participants on public health preparedness and legal preparedness issues Responsible parties - Harris County Attorney’s Office, HCPHES Time Frame – February 2006 through present. 3) Developing 24/7 contact information, updating 24/7 contact information at each meeting, periodically disseminating updated contact information electronically Responsible parties - Harris County Attorney’s Office, full task force Time Frame – February 2006 through present. Tasks undertaken to achieve Goal 1, Objective 1c include the following: 1) Convening and facilitating HCPHES work group, developing protocols, compiling protocols into a manual, reviewing and revising manual Responsible parties - HCPHES, Harris County Attorney’s Office, general review by full task force Time Frame – June 2006 through July 2007 Tasks undertaken to achieve Goal 2, Objective 2 include the following: 1) Review of current authorities relating to public health legal preparedness as outlined in Texas statutes and from the perspective of local government, identification of gaps Responsible parties - Full Task Force Time Frame: February 2006 through May 2006 2) Development of legislative proposal (bill) containing provisions to address identified gaps Responsible parties - HCPHES, Harris County Attorney’s Office Time Frame - May 2006 through June 2006 3) Successful guidance of bill through the Texas legislative process, including obtaining support of Harris County Commissioners Court, securing bill sponsors, preparing and providing testimony and developing/maintaining broad stakeholder and policymaker support Responsible parties - Harris County Attorney’s Office, HCPHES Time Frame - June 2006 through June 2007 Tasks undertaken to achieve Goal 3, Objective 3 include the following: 1) Compilation of steps necessary to achieve 24/7 continuity of operations for the Harris County Attorney’s Office during an emergency event, including the identification and assignment of essential personnel Responsible party - Harris County Attorney’s Office Time Frame - February 2006 through May 2006
The Harris County Legal Preparedness Task Force has accomplished the following outcomes to date: Outcome 1) The Task Force serves as an ongoing forum to address public health legal preparedness issues among all Harris County entities involved in emergency preparedness activities. Participating entities include the following: Harris County Public Health and Environmental Services (HCPHES), Harris County Attorney’s Office Harris County Judge’s Office, Harris County Office of Homeland Security and Emergency Management, Harris County District Clerk’s Office, Harris County Facilities and Property Management, Harris County Medical Examiner’s Office. Representatives from HCPHES include the Health Authority, two alternate Health Authorities, the Chief of the Office of Public Health Preparedness, and the Chief of the Office of Policy and Planning. In addition to several general counsel staff, participants from the County Attorney’s Office include counsel for the Harris County Hospital District and Office of Legislative Relations staff. Outcome 2) The Task Force developed and maintains a 24/7 emergency call-down list that includes the contact information for county personnel involved with public health legal preparedness. Outcome 3) With input and review by Task Force members, HCPHES spearheaded the development of a manual titled "Harris County Disease Containment Strategies: Information and Protocols," which outlines step-by-step legal and public health procedures for enacting disease control measures such as exclusion, isolation, quarantine, social distancing, rabies quarantine, area quarantine, and quarantine of property. The manual assigns responsibility for the steps within each protocol and includes a detailed summary of current statutes relating to disease control. Outcome 4) The Task Force reviewed Texas statutes related to legal preparedness and identified key gaps. The Task Force developed a legislative proposal containing six recommended measures to address the identified gaps. The Task Force then worked with the Harris County Attorney’s Office, Office of Legislative Relations, to identify bill sponsors and successfully guide the proposal through the state legislative process. The proposal, passed as part of Senate Bill 11, was signed into law in June 2007. The six measures are as follows: Permits a health authority to order the management of a group of individuals, such as the employees of a particular office or passengers on an arriving bus, who have been exposed to or are infected with a communicable disease such as pandemic influenza. Permits a health authority to designate, in advance of a large-scale public health emergency, certain healthcare facilities that are capable of providing services for the management of persons exposed to or infected with a communicable disease during a public health disaster or area quarantine situation. Permits a condition for extending the timeframe during which a judicial hearing for the management of a person with a communicable disease must be held. This condition would be if there were a declared public health disaster or area quarantine. The extension would last until the end of a declared public health disaster or the termination of an area quarantine order. Permits a judge to conduct a hearing for the management of a person with a communicable disease by teleconference, rather than in person, or by another means that the judge finds sufficient to ensure due process while protecting the health and safety of all involved parties. Permits a judge or magistrate to sign an order of protective custody upon a court’s own motion and prior to the filing of the application for a court order management of a person, in order to accommodate after-hours events where a municipal, county, or district attorney is not available to file motions. Permits a court to order a person committed to a private healthcare facility for the management of a communicable disease if a state of disaster or
The Task Force enjoys a firm commitment from the leadership of each member department to perpetuate the practice, as well as from the leadership of Harris County. This commitment was solidified by the Task Force’s outcomes to date, particularly the successful passage of the six-point legislative initiative. The commitment to sustaining the Task Force is ensured by securing members who are “high-level” representatives of their departments, by celebrating recent successes, by dedicating meeting time to compelling issues that are of concern to all, and by ensuring that the frequency and length of meetings is not burdensome. Plans to sustain the practice over time include continuing to meet as a group, focusing agendas and discussions on relevant and timely topics. For example, Texas will convene its bi-annual legislative process again in January 2009. Therefore, the Task Force will focus upcoming meetings on reviewing current statutes and developing recommendations for legislative initiatives as needed. HCPHES will continue to provide primary staff support in order to ensure that tangible outcomes are developed and produced in a timely manner. Because the work produced by HCPHES staff is in line with current job duties, no additional staff resources are needed. Therefore, no additional resources must be leveraged to sustain the practice over time.
 
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