Public Health and Medical Preparedness and Response: Issues in the 110th Congress Page: 5 of 6
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CRS-5
Health emergencies often involve scarcities of resources, including personnel,
equipment, drugs, and vaccines. Prioritizing the use of these resources to maximize
benefit requires careful study of scientific and medical evidence, and raises complex legal
and ethical questions that are best considered before emergencies arise.14 Also, many are
concerned that the nation's health care system, which is often overburdened by routine
demands, would not be able to handle surges in demand that could result from some types
of disasters. The PAHPA requires the HHS Secretary to assess national medical response
capability in a quadrennial National Health Security Strategy, and authorizes HHS to
acquire mobile medical assets, such as field hospitals.5 Finally, Congress may consider
the effectiveness of programs to deliver mental health counseling services to disaster
victims, and whether these services are well coordinated and well targeted.16
Authorities to Control Communicable Diseases. The response to
communicable disease threats may involve movement restrictions, business and school
closures, compulsory treatments, and other constraints. While state and local governments
have the primary authority over these domestic containment measures, a comprehensive
response to a public health emergency may involve overlapping governmental authorities
and attendant legal and economic issues. Recent incidents have expanded Congress's
longstanding interest in the security of U.S. borders to include concerns about
communicable diseases in travelers, which is a matter of federal jurisdiction. These
incidents have brought into question the divisions of authority and effectiveness of
coordination among federal agencies that are responsible for disease control, and for the
security of the borders and the transportation infrastructure. Policy makers have noted that
if these systems are unable to respond to common and expected infectious disease threats
such as tuberculosis, they may also be unable to respond to more serious threats such as
pandemic flu or bioterrorism. Effective solutions are elusive, but would ideally address
scientific, technical, and economic constraints; the balance of individual and collective
rights; and the roles of federal, state, and local authorities, and foreign governments."
Workforce Surge Capacity. The health workforce is aging into retirement, yet
is strained by new homeland security duties. HHS manages several health professions
programs geared toward alleviating shortages and maldistributions of physicians, nurses,
and others who provide individual health care services. The public health workforce has,
in contrast, received little federal attention until recently. The PAHPA authorized a loan
repayment demonstration project for individuals who serve in state or local health
departments in defined areas of need. Other efforts to bolster the ranks of health
14 See CRS Report RL33381, The Americans with Disabilities Act (ADA): Allocation of Scarce
Medical Resources During a Pandemic, by Nancy Lee Jones.
15 See CRS Report RL33589.
16 See CRS Report RL33738.
" See CRS Report RL33201, Federal and State Quarantine and IsolationAuthority, by Kathleen
S. Swendiman and Jennifer K. Elsea; CRS Report RL34144, Extensively Drug-Resistant
Tuberculosis (XDR-TB): Emerging Public Health Threats and Quarantine and Isolation, by
Kathleen S. Swendiman and Nancy Lee Jones; CRS Report RL33609, Quarantine and Isolation:
Selected Legal Issues Relating to Employment, by Nancy Lee Jones and Jon O. Shimabukuro;
CRS Report RS22219, The Americans with Disabilities Act (ADA) Coverage of Contagious
Diseases, by Nancy Lee Jones; and CRS Report RS21414, Mandatory Vaccinations: Precedent
and Current Laws, by Kathleen S. Swendiman.
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Public Health and Medical Preparedness and Response: Issues in the 110th Congress, report, February 13, 2008; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc805711/m1/5/: accessed April 18, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.