An Emergency Preparedness Response to Opioid-Prescribing Enforcement Actions in Maryland, 2018-2019

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 9S-17S
Author(s):  
Jessica C. Acharya ◽  
B. Casey Lyons ◽  
Vijay Murthy ◽  
Jennifer Stanley ◽  
Carly Babcock ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Data Access ◽  
Opioid Use Disorder ◽  
Lessons Learned ◽  
Mitigation Strategies ◽  
Federal State ◽  
Opioid Use ◽  
Time Data ◽  
Enforcement Action ◽  
State And Local

Federal and state enforcement authorities have increasingly intervened on the criminal overprescribing of opioids. However, little is known about the health effects these enforcement actions have on patients experiencing disrupted access to prescription opioids or medication-assisted treatment/medication for opioid use disorder. Simultaneously, opioid death rates have increased. In response, the Maryland Department of Health (MDH) has worked to coordinate mitigation strategies with enforcement partners (defined as any federal, state, or local enforcement authority or other governmental investigative authority). One strategy is a standardized protocol to implement emergency response functions, including rapidly identifying health hazards with real-time data access, deploying resources locally, and providing credible messages to partners and the public. From January 2018 through October 2019, MDH used the protocol in response to 12 enforcement actions targeting 34 medical professionals. A total of 9624 patients received Schedule II-V controlled substance prescriptions from affected prescribers under investigation in the 6 months before the respective enforcement action; 9270 (96%) patients were residents of Maryland. Preliminary data indicate fatal overdose events and potential loss of follow-up care among the patient population experiencing disrupted health care as a result of an enforcement action. The success of the strategy hinged on endorsement by leadership; the establishment of federal, state, and local roles and responsibilities; and data sharing. MDH’s approach, data sources, and lessons learned may support health departments across the country that are interested in conducting similar activities on the front lines of the opioid crisis.

Experiences of HIV/STD Providers in New York State During Hurricane Sandy: Strengths, Challenges, and Recommendations

2020 ◽  
pp. 1-6
Author(s):  
Kristen Vacca ◽  
Asante Shipp-Hilts ◽  
Stephanie Mack ◽  
Yunshu Li ◽  
Millicent Eidson ◽  
...  
Keyword(s):  
New York ◽  
Key Words ◽  
Natural Disaster ◽  
Emergency Preparedness ◽  
New York State ◽  
Hurricane Sandy ◽  
Lessons Learned ◽  
Federal State ◽  
York State ◽  
State And Local

ABSTRACT Objectives: The aim of this study was to assess strengths and challenges experienced by HIV/STD providers in providing care during the response to Hurricane Sandy (Sandy) in New York State, and their recommendations for future preparedness. Methods: A mixed methods approach, including a focus group (n = 3), interviews (n = 3), and survey (n = 31) of HIV/STD providers, was used. Key words identified by means of open coding methodology from collected data were organized into strengths, challenges, and recommendations and then grouped into federal and study-associated preparedness capabilities. Results: Key words were organized into 81 strengths (38.8%), 73 challenges (34.9%), and 55 recommendations (26.3%). Services most interrupted during Sandy were related to HIV/STD outreach and education. While providers reported challenges with external agency communication, the ability to still connect clients to needed resources was reported as a strength. Strengthening partnerships with federal, state, and local agencies was among the major recommendations made by these providers. Conclusions: This study presents unique information about challenges experienced by HIV/STD providers in providing services during a natural disaster and the use of national public health emergency preparedness capabilities to address and overcome those challenges. Lessons learned and recommendations regarding inter-agency communications emerged as an important priority during a natural disaster to minimize or reduce service interruption.

Continuity of Operations planning: Meeting the standard of care

2008 ◽  
Vol 6 (5) ◽  
pp. 17
Author(s):  
Robin J. Clark, JD ◽  
Megan H. Timmins, JD
Keyword(s):  
Local Government ◽  
Emergency Preparedness ◽  
Local Governments ◽  
Planning Process ◽  
World Trade Center ◽  
Standard Of Care ◽  
Federal State ◽  
Continuity Of Operations ◽  
State And Local Government ◽  
State And Local

Recent disasters have increased the public’s awareness of the lack of emergency preparedness of state and local governments. The attacks on the World Trade Center in 2001 highlighted failures in government agency coordination, while the anthrax attacks that followed and the more recent natural disasters of Hurricanes Katrina and Rita in 2005 have deepened concerns that our government is unprepared for emergencies. Partially in response to the public’s concern, the federal government has encouraged Continuity of Operations (COOP) planning at the federal, state, and local government levels.Public attention, government engagement, and the promulgation of federal directives and guidance are leading to an increase in the standard of care for all public sector planning efforts, thus creating potential liabilities in the areas of COOP planning, testing, training, and maintenance. At this point, COOP planning is becoming the norm for state and local government agencies, and while the process of COOP planning may itself expose agencies to certain liabilities, there is also an increase in the potential liability for agencies that do not undertake COOP planning efforts. Further, it appears that the potential liability of agencies that do not engage in COOP planning far exceeds any liabilities incurred through the planning process.

scholarly journals Addressing the Opioid Crisis through an Interdisciplinary Task Force in Cincinnati, Ohio, USA

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 116
Author(s):  
Neil J MacKinnon ◽  
Ellena Privitera
Keyword(s):  
Local Governments ◽  
Task Force ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Access To Treatment ◽  
Opioid Crisis ◽  
Comprehensive Health ◽  
Recovery Resources ◽  
State And Local

Opioid use has been a topic of concern in recent years in the United States, causing thousands of deaths each year. Ohio is one of the states hit hardest by the epidemic, and its state and local governments have responded with comprehensive health policies. Cincinnati, located in the southwest region of Ohio, is one of the epicenters of the state’s opioid crisis. Responding to the needs of their community, the University of Cincinnati (UC) and its affiliate health system, UC Health, have brought together leaders in research, clinical practice, and education to form the UC/UC Health Opioid Task Force. By encouraging interdisciplinary partnerships, the Task Force is pioneering new ways to understand, prevent, and treat opioid use disorder, while preparing the next generation of healthcare professionals. Additionally, collaboration across departments in UC Health has improved access to treatment and recovery resources for hundreds of patients. Leading educational events, supporting local agencies, and participating in government initiatives have further solidified UC and UC Health’s role as a stakeholder in this crisis, showcasing how academic health centers are critical to promoting public health.

The Pediatrician's Role in Public Law 94-142

1982 ◽  
Vol 4 (6) ◽  
pp. 191-197
Author(s):  
Gregg F. Wright
Keyword(s):  
Public Schools ◽  
School Districts ◽  
Case Law ◽  
Public Law ◽  
Lessons Learned ◽  
Federal State ◽  
Handicapped Children ◽  
The Law ◽  
State And Local ◽  
Local Levels

In the seven years since it was passed, Public Law 94-142, The Education for All Handicapped Act of 1975, has generated new services for handicapped children and in the process has raised many difficult financial, political, educational, medical, and ethical questions. It has changed the scope of public schools and the personnel within them, and it has changed the expectations of parents, physicians, and educators alike. There is currently much talk of the possible repeal of PL 94-142. This review will emphasize the importance of a pediatric voice in this future. The changes that have come about as a result of PL 94-142 will not easily disappear even if the bill were to be repealed. On the other hand, a strong voice of advocacy for handicapped children will be needed to ensure that the positive lessons learned from PL 94-142 will be continued. PL 94-142 itself, as a law, is only one component of a constellation of surrounding issues affecting handicapped children. One must consider separately the actual provisions of the law, the constitutional and case law on which it was based, the federal regulations that have been published and updated to interpret the law, the state plans formulated by each state to comply with the law and regulations, the funding that may or may not be appropriated at federal, state, and local levels to support the programs, and the actual practices within local school districts attempting to comply (or circumvent) these state requirements.

scholarly journals Partnering with State Health Departments to Address Injection-Related Infections during the Opioid Epidemic: Experience at a Safety Net Hospital

2021 ◽  
Author(s):  
Rebecca H Burns ◽  
Cassandra M Pierre ◽  
Jai G Marathe ◽  
Glorimar Ruiz-Mercado ◽  
Jessica L Taylor ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Medical Center ◽  
Safety Net ◽  
Opioid Use Disorder ◽  
Lessons Learned ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Persons Who Inject Drugs ◽  
Curative Therapy ◽  
Safety Net Hospital

Abstract Massachusetts is one of the epicenters of the opioid epidemic and has been severely impacted by injection-related viral and bacterial infections. A recent increase in newly diagnosed human immunodeficiency virus (HIV) infections among persons who inject drugs in the state highlights the urgent need to address and bridge the overlapping epidemics of opioid use disorder (OUD) and injection-related infections. Building on an established relationship between the Massachusetts Department of Public Health (MDPH) and Boston Medical Center (BMC), the Infectious Diseases section has contributed to the development and implementation of a cohesive response involving ambulatory, inpatient, emergency department and community-based services. We describe this comprehensive approach including the rapid delivery of antimicrobials for the prevention and treatment of HIV, sexually transmitted diseases, systemic infections such as endocarditis, bone and joint infections, as well as curative therapy for chronic hepatitis C virus (HCV) in a manner that is accessible to patients on the addiction-recovery continuum. We also provide an overview of programs that provide access to medications for opioid use disorder (MOUD), harm reduction services including overdose education and distribution of naloxone. Finally, we outline lessons learned to inform initiatives in other settings.

Regional Institutions for Transportation Sustainability and Economic Development

2019 ◽  
pp. 72-92
Author(s):  
Mark A. Pisano ◽  
Richard F. Callahan
Keyword(s):  
Economic Growth ◽  
Construction Projects ◽  
Institutional Design ◽  
Lessons Learned ◽  
Federal State ◽  
Regional Institutions ◽  
Fiscal Constraints ◽  
Transportation Funding ◽  
Transportation Projects ◽  
State And Local

The lessons described in this chapter outline the mechanisms for cooperation through building new institutional designs for governance to build transportation construction projects. The scale of these projects included billions of federal, state, and local dollars invested in the 1970 through current day. Funding of transportation projects in Southern California during the period 1975 through 2010 addressed a range of challenges to economic growth. The chapter proceeds in four parts: one, a discussion of the environmental context; two, description of the institutional design for governance that developed; three, an overview of the projects developed and economic impact; four, applying the lessons learned to the emerging challenges of fiscal constraints, demographic change, and institutional re-design for transportation funding.

POLLUTION RESPONSE DURING NATIONAL SPECIAL SECURITY EVENTS: STRIKING A BALANCE BETWEEN SECURITY AND RESPONSE.

2005 ◽  
Vol 2005 (1) ◽  
pp. 943-948
Author(s):  
Joseph Gleason
Keyword(s):  
United States ◽  
Homeland Security ◽  
The United States ◽  
Lessons Learned ◽  
Coast Guard ◽  
Federal State ◽  
Department Of Homeland Security ◽  
National Convention ◽  
State And Local ◽  
The U.S

EXECUTIVE SUMMARY During the summer of 2004, the First Coast Guard District in Boston, Massachusetts supported both Presidential political nominating conventions for the 2004 election. The Democratic National Convention was held in Boston, Massachusetts on July 26–29, 2004, and the Republican National Convention was held in New York City from August 30th to September 2, 2004. This was the first time both conventions have taken place within the geographic area of responsibility of a single Coast Guard District. The Secretary of the U.S. Department of Homeland Security declared both of these events as National Special Security Events under Presidential Decision Directive 62 (PDD-62). PDD-62 formalized and delineated the roles and responsibilities of federal agencies in the development of security plans for major events. The 2004 Democratic and Republican Conventions were the first political conventions held in the United States since the terrorist attacks of September 11, 2001. In the months before the Democratic National Convention, the U.S. Department of Homeland Security and the Department of Justice stated that there was credible intelligence from multiple sources indicating that al-Qaeda planned to attempt an attack on the United States during the period leading up to the election. (Joint Statement of Homeland Security Secretary Tom Ridge and Attorney General John Ashcroft on May 28, 2004) The terrorist attacks on the Madrid rail system were a direct attempt by AI Qaeda to influence the elections in Spain, and the U.S. Department of Homeland Security was going to take all appropriate steps to prevent a similar attack in the United States. (Schmidt and Priest, Washington Post May 26, 2004; Page A02) The 2004 Conventions offered a significant challenge for the Coast Guard and other federal, state, and local agencies that had dual responsibility for coordinating security operations while being prepared to respond to a disaster including oil spills and hazardous substance releases—the combination of what was previously designated as crisis and consequence management under PDD-39. This paper will examine lessons learned from planning and operations in support of the conventions. Having served as the First District Project Officer for the Democratic and Republican National Conventions, this paper is written as my observations of the lessons learned and offers some insight into what went well and possible areas for improvement as I observed throughout the more than 18 months of planning for these events of national significance. The Coast Guard planning and operational support for the Democratic and Republican National Conventions demonstrated the importance of a team approach to planning, interagency coordination and partnerships, pre-event preparedness activities, and pre-deploying personnel and resources for response. It is my hope that the observations contained in this paper can benefit federal, state, and local agencies as they prepare for large significant events in the future including National Special Security Events.

Emergency planning and people with disabilities: Massachusetts’ lessons learned

2009 ◽  
Vol 7 (3) ◽  
pp. 68 ◽  
Author(s):  
Erin McGaffigan, MSW, MS, Public Policy ◽  
Chris Oliveira, BS ◽  
Diane Enochs, BA, MA
Keyword(s):  
Emergency Management ◽  
Emergency Preparedness ◽  
Large Scale ◽  
Local Level ◽  
Functional Limitations ◽  
People With Disabilities ◽  
Lessons Learned ◽  
Accessibility Barriers ◽  
State And Local ◽  
Hurricanes Katrina And Rita

Continued challenges responding to large-scale emergencies are recognized in the aftermath of events such as Hurricanes Katrina and Rita. Elders and people with disabilities often included under the label of “vulnerable” or “special populations,” are especially hard hit given communication and accessibility barriers often faced even prior to an emergency. Approximately 15 percent of those living within our communities have disabilities, which jumps to 41 percent for those 65 years or older.1 The prevalence of functional limitations due to age or disability indicates the need for these factors to be accounted for in planning, response, recovery, and mitigation efforts at the national, state, and local level to ensure a truly effective emergency response system that meets the needs of all residents. To achieve this effort emergency management, public health, disability and elder stakeholders within Massachusetts joined together to identify the existing planning gaps and to explore potential solutions to support emergency preparedness so that emergency management systems are responsive to all individuals in the community, regardless of age or disability. The Commonwealth’s process and lessons learned are discussed later.

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