States Examine Legislative "Lightning Rod"

Stephen Teret, Lawrence Gostin, and their colleagues at the School's Center for Law and the Public's Health expected controversy when they crafted model public health legislation for use in the event of a bioterrorist attack. So far they haven't been disappointed.

Teret, JD, MPH '79, and Gostin, JD, LLD, joint directors of the Center, have seen the model legislation, known as the Model State Emergency Health Powers Act, become something of a lightning rod. Alarmed by the legislation's provisions for quarantine and property seizure, some interest groups have denounced the legislation as a government "power grab" and a "draconian infringement on [American] liberties."

Teret notes, however, that such a law would only go into effect during the most dire of public health catastrophes. "These provisions are not going to kick in at the outset of a normal flu season," he says. "The victims of an epidemic would literally have to be dropping dead in the streets to trigger the law's most extreme sections. Hospitals would have to be completely swamped, for example, before hotels could be commandeered and used as wards."

Drafted in 14 straight days of frenzied legal scholarship by experts from the School and the Georgetown University Law Center, the model legislation has generated interest from lawmakers in about half of the 50 states. (Since not all state legislatures are currently in session, some states have not yet looked into the topic.) Lawmakers are considering the adoption of the whole law or amending existing public health legislation in light of the Center's model.

Meanwhile, Teret and James G. Hodge Jr., JD, LLM, director of the model law project, have been crisscrossing the country since October, testifying before lawmakers and strategizing with public health officials and attorneys general on how to get the law passed.

Anthony Moulton, MD, head of the program in law and health at the Centers for Disease Control and Prevention, is the one who asked Teret and Gostin to drop everything and draft the model law. He now says, "Public health laws are part of the nation's defense system, and the idea was to put a tool into the hands of states. This legislation is really a template or blueprint the states can use to look at as they reassess their public health laws." - RG


ADAPTING OLD PLANS FOR NEW CRISES


After Sept. 11, many children in America suddenly felt unsafe. Some pleaded with their parents not to fly; others reacted by wetting the bed or becoming withdrawn. But for children living in urban neighborhoods plagued with violence, such fears and reactions weren't new.

"Many of the children in East Baltimore have direct experience with the loss of life and with observing multiple shootings, which can have the same sort of randomness that the terrorist attacks had," says Phil Leaf, PhD, a professor in the Department of Mental Hygiene. "If there were a terrorist attack in Baltimore, we'd probably use the same mechanisms to respond to it that we use in the wake of a shooting. In fact, the capacity to help children respond to terrorism might be better in Baltimore because we've been forced to help them deal with violence."

Leaf is executive director of the Baltimore Child Development-Community Policing Program, an agency that trains mental health professionals, police officers, and community residents to provide crisis response intervention for children and teens exposed to urban violence. Immediately after a child has been involved in a violent crime — as victim, perpetrator, or witness — a clinician, a police officer, and a community representative respond. "The whole idea is, one, to restore a sense of safety. And, two, to help them begin to process and tell their stories," says Rev. Willie Armstrong, the program director.

After that first visit, the team creates a response plan, which often includes contacting agencies, preparing a referral, or providing additional short-term counseling. Kamala Alark, a psychological clinician with the project, reports that the children she counseled after Sept. 11 exhibited symptoms of post-traumatic stress disorder — just as they do after witnessing violence."Children are [now] easily startled by planes, just like they're startled by gunshots," she says. "They're concerned about being up high in buildings. They're fearful and paranoid. Some young people in the city who had a relationship with violence already said they feel like people can now understand what they go through every day."

Leaf notes that it's not just urban schools and communities that have crisis intervention plans that could be adapted to respond to terrorism. In the wake of Columbine and other incidents of school violence, many schools have created methods of disseminating information and resources, and have trained teachers and counselors to react to violence.

"We have a lot of things in place," says Leaf, "and now we must think about using them for situations we never dreamed of." - LW


Presidential Gratitude

President George W. Bush thanks Eric Noji, senior medical and public health adviser, White House Office of Homeland Security, after a briefing in the White House war room. Bush spoke with Noji, MD , MPH '87, prior to a mid-November presidential visit to the Centers for Disease Control and Prevention. Noji, president of the School's Socitey of Alumni, advises on health and medical national security issues in the Office of Homeland Security.

 



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