Health Policy Tracking Service

As of March 12, 45 states and the District of Columbia are in regular session. These states are Alabama, Alaska, Arkansas, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Nevada, North Dakota, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Washington and Wisconsin.

Louisiana, Utah, Virginia, West Virginia and Wyoming.

As businesses and schools practice emergency drills for tornado and fire during the next several weeks, the Missouri Department of Health and Senior Services urges them to go one step further and practice what to do if faced with a biological, chemical or radiological event.

"These are different times and every employer, school and family should do what it can to be better prepared," said Richard Dunn, director of the Missouri Department of Health and Senior Services. "Emergency plans must include steps that would be taken to protect employees and students in the event of a terrorist attack."

The department urges businesses and schools to review and update their current emergency plans and then conduct practice drills. Action steps that should be taken include:

"The most important part of any emergency plan is regular drilling and practice," Dunn said. "It is essential that persons remain calm during a crisis and know what they should do under the different situations."

Source: The Missouri Department of Health and Senior Services, http://www.health.state.mo.us/NewsReleases/BusinessesSchoolsPrepare.htm

 WORKFORCE DEVELOPMENT

Measures in two states-Mississippi and Oklahoma-moved forward to establish vaccination programs for first responders in their states. Both states place responsibility for development of the programs with their state Departments of Health. In Oklahoma, the measure specifically adds that vaccinations must include:

Participation for both programs will be voluntary on the part of the emergency responder.

March 5th, Health and Human Services (HHS) Secretary Tommy G. Thompson proposed a plan to create a smallpox vaccination compensation program to provide benefits to public health and medical response team members who are injured as a result of receiving the smallpox vaccine. The program is based on a similar compensation package that is currently available to police officers and firefighters.

In December, President Bush announced a plan for public health and medical response teams to be voluntarily vaccinated against smallpox as part of an overall effort to better prepare the nation against terrorism. Smallpox is a disease that is very contagious and can spread rapidly, so it is important to have medical response teams prepared to respond and protect the American people should an outbreak occur.

"I commend all of the public health and medical response team members who have already volunteered to be vaccinated against smallpox so we as a nation will be better prepared to protect the public," Secretary Thompson said. "A smallpox release is possible and we therefore must prepare by offering vaccine to those most likely to respond. By preparing our emergency responders and giving them assistance with this compensation program, we are better able to protect the American people, which is our highest priority."

"We are asking these health professionals to perform a vital public duty, so we are proposing to provide them the same sort of benefits that we provide our public safety officers when they are injured on the job," said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC). "We are truly grateful for their commitment and willingness to take part in this vital program."

The proposed compensation program - which the department will continue to work with Congress on addressing - includes four elements similar to the benefits package currently available to police officers and firefighters. Under the Public Safety Officers Benefit (PSOB) program, administered by the Department of Justice, the federal government currently pays a $262,100 death and a $262,100 permanent and total disability benefit to police officers and firefighters. State and local governments provide short-term disability benefits and health care benefits.

The benefits package would be administered by HHS and be retroactive to cover those who already have been vaccinated under the program.

Additionally, HHS would provide compensation to third parties who contract vaccinia from public health and medical response team workers who have been vaccinated. Vaccinia is an infection, primarily local and limited to the site of inoculation, induced in humans by inoculation with the vaccinia virus in order to confer resistance to smallpox.

HHS and CDC are working with state and local governments to vaccinate health care workers and other crucial personnel - as part of Smallpox Response Teams - to volunteer to receive the smallpox vaccine. All states have submitted smallpox response plans and as of March 4, 45 jurisdictions have vaccinated nearly 12,404 individuals - up from 7,354 one week earlier and 4,213 two weeks ago.

Pre-attack vaccination of these teams will allow them to vaccinate the American public in the event of an attack. If there is a release of smallpox, HHS will immediately make vaccine available to the general public. HHS currently has enough unlicensed vaccine to protect every American. HHS will have enough licensed vaccine sometime in 2004.

"We do not, however, recommend that the general public get the vaccine at this time because the risk of the vaccine outweighs the risk of a potential exposure to smallpox," Secretary Thompson said. This compensation plan does not cover the general public, as it is not recommended that they receive the vaccine.

The existing smallpox vaccine is very effective in preventing the disease, but it carries a risk of serious health consequences - including death in 1 or 2 out of every 1 million people vaccinated. Between 14 and 52 out of every 1 million may experience potentially life-threatening reactions when given the existing smallpox vaccine.

Source: U.S. Department of Health and Human Services, http://www.os.dhhs.gov/news/press/2003pres/20030305.html.

Lawmakers in two states-Indiana and Virginia-have considered measures to provide immunity to a hospital for personal injury to health care workers resulting from the administration of a smallpox vaccine. The Indiana Senate measure states that if a hospital has been requested to provide these immunizations by the State Department of Health, its employees and agents are immune from civil liability for any personal injury that results, excluding injuries from acts of negligence. In Virginia, lawmakers passed a measure that provides freedom from civil liability for hospitals administering the smallpox vaccine. Senate Bill 897, was eligible for the governor's desk as of February 20, 2003.

An Ohio Senate Bill, Senate Bill 6, moved forward to the House March 12th and contained provisions requiring special reporting by trauma centers on their capacity to respond to disasters. The provision requires the Public Health Council to adopt rules that will outline the specifics of required reporting. The bill includes facilities outside the state with the capabilities of providing for the medical needs of patients within Ohio.

Other provisions in the measure grant the Director of Health the authority to purchase and distribute pharmaceutical agents they deem advisable in preparing for public health emergencies.

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