Public Health Law News

December 2017

Note from the Editor

The Public Health Law Newsteam would like to extend our warmest gratitude to ToMinh Le for the time and care she spent writing the Newsthis fall. Ms. Le is pursuing a master’s of public health (MPH) from Emory University’s Rollins School of Public Health and is scheduled to graduate in spring 2018. She will be an asset to any public health communications program.

The Newswould also like to thank Emely Sanchez, an MPH candidate at the University of Miami, for her research on legal cases this fall.


F. Abigail Ferrell, JD, MPA

Editor in Chief


Webinar: Adults Need Immunizations Too! Medicaid Coverage, Cost Sharing & Provider Reimbursement for ACIP-Recommended Adult Vaccinations.external icon This webinar, co-hosted by the American Bar Association and CDC’s Public Health Law Program (PHLP), will provide an overview of the burden of vaccine-preventable diseases among adults and discuss Medicaid’s vaccination benefit policy for adult enrollees. It will take place on January 16, 2018, 1:00–2:30 pm (EST).

CDC Externships in Public Health Law. PHLP offers externships in public health law, tribal public health, and administration and communications. The externships last 9 to 14 weeks, and consist of professional work experience at PHLP’s office in Atlanta, Georgia. With rolling start and completion dates during the academic year, unpaid externships must qualify for academic credit as authorized by law and public health schools. Applications for summer 2018 positions are due by January 31, 2018.

PHAP associate and host-site application period opening. CDC’s Public Health Associate Program (PHAP) is a two-year, competitive, paid training program for early-career professionals who have a recent bachelor’s or master’s degree and an interest in public health. Associates are employed by CDC and work in health departments, nongovernmental organizations, public health institutes and associations, academic institutions, and CDC quarantine stations. The PHAP associate application period is January 2–8, 2018, and the host site application period is January 2–18, 2018.

ChangeLab Solutions Summer 2018 Internship.external icon ChangeLab Solutions seeks legal interns for summer 2018. The position is open to current first- and second-year law students who are able to work at least 35 hours per week for a minimum of 10 weeks. (There may be an opportunity to extend summer work into the school year.) Complete internship applications are due by January 15, 2018.

MMWRAbout Electronic Cigarette Laws. The Morbidity and Mortality Weekly Report (MMWR)has published State Laws Regarding Indoor Public Use, Retail Sales, and Prices of Electronic Cigarettes — US States, Guam, Puerto Rico, and US Virgin Islands, September 30, 2017.The report discusses what is known about electronic cigarettes, how US jurisdictions are regulating their use, and what implications the use and regulation of electronic cigarettes might have on public health.

Fact Sheet: Human Trafficking and Healthcare Providers. pdf icon[PDF – 4.4MB]external icon The Human Trafficking Legal Center and HEAL Trafficking have published a fact sheet to help providers identify trafficking victims in medical settings. This fact sheet uses examples of federal criminal indictments and civil trafficking cases to teach medical professionals how to recognize red flags and risk factors for victims.

Journal Article: Falling Short: How State Laws Can Address Health Information Exchange Barriers and Enablers.external icon This article from The Journal of the American Medical Informatics Associationdescribes state laws that facilitate and block the implementation of health information exchanges. The study says that many states have not addressed critical health information exchange issues via law.

Journal Perspective: Emergency Legal Authority and the Opioid Crisis.external icon This journal perspective, published in The New England Journal of Medicine,examines the legal authority of six states that have declared their opioid overdose situation an emergency.

Legal Tools

NACCHO Policy Statement on Cannabis. pdf icon[PDF – 340KB]external icon The National Association of County and City Health Officials (NACCHO) has published a policy statement, Medical and Recreational Cannabis and Cannabinoids, to assist health departments considering approaches to medical and recreational cannabis within their communities. The policy statement was proposed by NACCHO’s Public Health Law Workgroup and approved by the NACCHO Board of Directors.

Report: Using Electronic Health Data for Community Health.external icon A new report from de Beaumont Foundation and Johns Hopkins provides public health departments with a framework that will allow them to request data from hospitals and health systems in order to move the needle on critical public health challenges. The report contains six illustrative examples of how a public health agency might use electronic health data to make progress on childhood asthma, a common and preventable chronic illness. It also provides answers to some frequently asked questions about the Health Insurance Portability and Accountability Act, better known as HIPAA.

Public Health Law Academy. This online academy created by PHLP and ChangeLab Solutions helps public health professionals understand the legal system’s role, historically and currently, in improving population health. The training offers three courses: Introduction to Public Health Law, Legal Epidemiology Review, and Hot Topics in Public Health Law. The training was created through cooperative agreement 6NU380T000141-04-02 from CDC.

Top Stories

Massachusetts: Judge rules nurses at Brigham must get flu vaccinesexternal icon

Boston Globe (11/30/2017) Priyanka Dayal McCluskey

Story Highlights

Suffolk Superior Court Judge Robert Tochka denied a request from the Massachusetts Nurses Association (MNA) to block a mandatory flu shot policy at Brigham and Women’s Hospital (BWH).

In September 2017, MNA sued BWH over the policy that requires hospital employees to receive a flu vaccine annually, with exceptions for medical or religious reasons. The union argued that the policy would unfairly punish nurses if they chose not to get vaccinated. Nurses who opt out of the policy must wear face masks around patients.

Union officials still object to the policy, but they encourage their members at BWH to get vaccinated. “We think it’s a bad decision, but we’ve had to encourage nurses to comply with the policy,” said union spokesperson, David Schildmeir.

Judge Tochka denied the union’s request for an injunction to block the hospital’s policy immediately, but the union plans to appeal the ruling.

“MNA’s speculative claim of potential harm to an unspecified nurses is not adequate to outweigh the risk of harm to the hospital, its employees, and its patients if there is an outbreak of the flu,” Tochka wrote in his decision.

(Editor’s note: Learn more about State Healthcare Worker and Patient Vaccination Laws.)

Florida: Man’s “do not resuscitate” tattoo leaves doctors debating whether to save his lifeexternal icon

CBS News (12/4/2017) Ashley Welch

Story Highlights

A 70-year-old patient arrived at a Miami hospital emergency room with the words “Do Not Resuscitate” and a signature tattooed across his chest. As the man’s condition deteriorated—and with no family or next of kin to speak on his behalf or indicate whether the man wanted to live or to die—the doctors were faced with an ethical dilemma.

Traditional do not resuscitate orders are usually presented in paper, notarized documents to physicians and detail the level of intervention a patient will consent to undergo. Often, the patient’s family members and friends are available to confirm the patient’s wishes.

The doctors consulted an ethics committee that advised the doctors to honor the “Do Not Resuscitate” tattoo. “They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference,” the doctors wrote in a report published in the New England Journal of Medicine.

The hospital also obtained a copy of the patient’s Florida Department of Health “out-of-hospital” do not resuscitate order, and the medical staff confirmed that the order was consistent with the message of the man’s tattoo.

(Editor’s note: Read the journal article An Unconscious Patient with a DNR Tattooexternal icon.)

Briefly Noted

California: Opioid litigation over insurance coverage—coming to a jurisdiction near youexternal icon
JDSupra (11/17/2017) James Bryan
(Editor’s Note: Read Travelers Prop. Casualty Co. of America v. Actavis, Inc., et alexternal icon)

California: Medical exemptions triple after California vaccine law goes into effectexternal icon
CBS Sacramento (11/17/2017) Lemor Abrams
[Editor’s Note: Read California’s SB-277external icon and learn more about state school immunization requirements and vaccine exemption laws pdf icon[PDF – 652KB].]

California: Federal judge blocks Trump’s executive order on denying funding to sanctuary citiesexternal icon
Washington Post (11/21/2017) Eli Rosenberg
[Editor’s note: Read more about the Sanctuary Jurisdiction Casesexternal icon in the United States District Court for the Northern District of California.]

Illinois: SIU professor tested herpes vaccine on people in Spring Field hotel roomsexternal icon
St. Louis Post-Dispatch (11/22/2017) Blythe Bernhard

Florida: Hundreds of nursing homes dodge Gov. Scott’s emergency generator orderexternal icon
Local 10 News (11/15/2017) Bob Norman
[Editor’s Note: Read Executive Order 16-205 pdf icon[PDF – 296KB]external icon.]

Massachusetts: Should hospitals be punished for post-surgical patients’ opioid addiction?external icon
NPR (11/27/2017)

New Hampshire: An 84-year-old doctor who refuses to use a computer has lost her medical licenseexternal icon
Washington Post (11/29/2017) Marwa Eltagouri

New York: E-Cigarettes banned in public places across New York Stateexternal icon
NY Health Department (11/22/2017)
[Editor’s Note: Read New York’s Clean Indoor Air Actexternal icon.]

Tennessee: Judge who offered inmates reduced jail time in exchange for sterilization is reprimandedexternal icon
Miami Herald (11/22/2017) Derek Hawkins

National: Big Tobacco’s anti-smoking ads begin after decade of delayexternal icon
Chicago Tribune  (11/21/2017) Matthew Perrone
[Editor’s Note: Read United States v. Philip Morris pdf icon[PDF – 557KB]external icon.]

National: Ban on Teflon chemical tied to fewer low-weight babiesexternal icon
The New York Times (11/30/2017) Nicholas Bakalar
[Editor’s Note: Read the journal article Perfluorooctanoic acid and low birth weight: Estimates of US attributable burden and economic costs from 2003 through 2014external icon.]

National: Bill to allow emergency medical responders to administer controlled substances signed into lawexternal icon
Homeland Preparedness News (11/27/2017) Kevin Randolph
[Editor’s Note: Read the Protecting Patient Access to Emergency Medications Act of 2017external icon.]

Profile in Public Health Law: Amy Dinn, JD, Lone Star Legal Aid
Photo: Amy Dinn, JD, Lone Star Legal Aid

Title: Managing Attorney, Environmental Justice Team, Equitable Development Unit, Lone Star Legal Aid

Education: University of Texas at Austin, Plan II Honors Program, BA in liberal arts, 1997; University of Texas at Austin School of Law, JD, 2000

Public Health Law News (PHLN):What drew you to law and, more specifically, public interest and environmental law?

Dinn: The opportunity to make an impact or redress a wrong for a client interested me because it provides a way to help others. With respect to environmental law, the environment concerns everyone who drinks water and breathes air. It’s a real way to make an impact that benefits entire communities.

PHLN:What is Lone Star Legal Aidexternal icon, and what population do you serve?

Dinn: It’s the fourth largest 501(c)(3) nonprofit law firm in the nation. We focus on advocacy on behalf of low-income and underserved populations. We serve the millions of people at 125% of federal poverty guidelines who reside in 72 counties in the eastern and Gulf Coast regions of Texas and four counties of southwest Arkansas. We focus our resources on maintaining, enhancing, and protecting income and economic stability; preserving housing; improving outcomes for children; establishing and sustaining family safety and stability, health, and well‐being; and assisting populations with special vulnerabilities, such as those who have disabilities or who are elderly, homeless, or have limited English language skills.

PHLN:Please describe your day-to-day practice.

Dinn:Every day is a little different, but the majority of our time is split in two service areas: 1) providing community education to empower communities facing environmental hazards, and 2) coordinating direct legal services to eligible clients or client groups in low-income areas and predominately minority neighborhoods.

PHLN:What are some of the environmental health issues threatening your community’s health?

Dinn:Environmental hazards include air pollution from industrial facilities and traffic, siting of industrial facilities creating pollution in residential areas, land contamination from superfund sites, landfills and industrial releases, groundwater contamination, access to safe drinking water, mosquito-borne illnesses like West Nile Virus, and lead poisoning.

PHLN:How is law being used to address these environmental health concerns?

Dinn:Our organization is working to raise the awareness of the communities we work with to these environmental hazards by providing education events and encouraging participation of the public at the regulatory level, including by filing complaints with regulatory authorities or initiative of private citizen suits. In addition to litigation options, we seek solutions that will empower the residents of each community to raise their voices about the environmental injustices they see in their neighborhoods. For example, we might help clients in an affected area negotiate a community benefits agreement to get specific amenities or mitigations to benefit the entire neighborhood or provide appropriate reporting information for regulatory authorities. This allows them to be environmental watchdogs for their community.

PHLN:How has Hurricane Harvey affected your community and the services your office offers?

Dinn:Our offices were directly affected during the storm when a fire broke out at our main office in Houston, dislocating our entire Houston staff for several weeks. Despite these direct impacts to our facilities, the services our organization provides to the 24 counties in our service area affected by Hurricane Harvey did not cease. Our attorneys and staff worked at disaster relief centers throughout our service area during the first several months of the disaster recovery process. We’re now transitioning to helping people with their Federal Emergency Management Agency appeals and denials and other disaster related services through our disaster relief hotline (1-866-659-0666). We have also assisted communities concerned about environmental hazards the storm caused in our service area, such as contaminated floodwaters, flooded superfund sites, releases of contaminants, increased air pollution, improper placement of temporary debris management sites, and the risks of continued exposure to mold in flooded structures.

PHLN:What are the greatest challenges you face in your practice?

Dinn:One of our challenges is connecting with communities in our service area affected by environmental hazards and working with the community to identify community benefits that can be obtained through legal advocacy.

PHLN:What is equitable development, and how does it relate to your practice?

Dinn:It’s an approach for meeting underserved populations’ needs through policies and programs that reduce disparities while fostering places that are healthy and vibrant. Increasingly, it’s considered an effective place-based action for creating strong and livable communities. Our environmental justice practice focuses on advocating for smarter siting practices and more sustainable growth to reduce environmental hazards in neighborhoods.

PHLN:How do you and your organization engage your community to address environmental health law issues?

Dinn:We reach out to community members and organize public education events centered on environmental hazards in underserved communities within our Texas service area. These activities might include serving on panels for residents looking for solutions to environmental problems in their area; researching and educating communities about a specific facility of concern contributing to pollution in their neighborhoods; or empowering these communities to engage in the processes that regulatory agencies require for facilities to obtain permits governing air and water quality in Texas.

PHLN:How can people learn more about Lone Star Legal Aid, its support of Hurricane Harvey victims, and environmental public health law?

Dinn:Our websiteexternal icon, our Facebook page, and our Twitter account all provide up-to-date information about our legal efforts within our service area and the work we do to support the Hurricane Harvey recovery efforts. Our environmental public health law efforts have been profiled through various press releases and on our Equitable Development Initiativeexternal icon page. If people are interested in learning about specific case work, they can check out some of the following stories:

PHLN:Do you have any hobbies?

Dinn:I enjoy organizing and participating in tree plantings and cleanup activities in my community and in my watershed, Brays Bayou, in Houston, Texas. I’ve been planning and building a canoe and kayak paddling trail with five launch sites on Brays Bayou for the last several years.

Public Health Law NewsQuiz

The first reader to correctly answer the quiz question will be featured in a mini public health law profile in the January 2018 edition of the News. Email your entry to with “PHL Quiz” as the subject heading; entries without the heading will not be considered. Good luck!

Public Health Law News Quiz Question December 2017

What organization is co-hosting a webinar with PHLP about adult immunizations under Medicaid in January?

Public Health Law NewsQuiz Question November 2017 Winner!
Photo: Christine Dimopoulos

Christine Dimopoulos

Question: When are applications for summer 2018 internships with PHLP due?

Answer: January 31, 2018

Employment organization and job title:

I’m currently working with CDC and the New York State Department of Health through Chickasaw Nation Industries as a field outreach nurse. I have been a nurse for 29 years, and I’m getting my master’s degree in public health law.

A brief explanation of your job:

As a public health outreach nurse, I communicate information effectively with clinicians and families within the different communities in Westchester, New York, with the ability to abstract data from medical records for comprehensive surveillance. The project I’m working on now is to improve and exchange data between the provider community Pediatricians and the New York State Department of Health’s central office. I am expanding clinical outreach to new and existing partner organizations, the American Congress of Obstetricians and Gynecologists, CDC’s National Center on Birth Defects and Developmental Disabilities, Pregnancy Registry, and March of Dimes. I work under the direction of Congenital Malformations Registry CDC, and the New York State Department of Health in the regional office to provide advice and assistance. Along with the scope of work project, I maintained knowledge of compliance with all policies.

Favorite section of the News:

Top Stories. You can’t beat them!

Why are you interested in public health law?

I’m following public health law because of my concern for the public people. Law, to me, is a tool for protecting the health of the people. Many of the public health’s greatest successes have relied heavily on law. Further, law is playing an increasingly important role in addressing emerging public health threats, such as healthcare-associated infections.

What is your favorite hobby?

My favorite hobby is reading and spending time with my daughter.

Court Opinions

California: Insurance policy covers bodily injury caused by an “accident,” not deliberate acts that had unforeseen happening, deliberate acts of marketing and selling opioids, does not constitute an accident.
Traveler’s Property Casualty Company of America v. Actavis, Inc.external icon
Court of Appeals of California, Fourth District, Division Three
Case No. G053749
Filed 11/06/2017
Opinion by Justice Richard D. Fybel

New Jersey: Two E. coli tests in one year were sufficient evidence for New Jersey Department of Environmental Protection to close well.
New Jersey Dep’t of Environmental Protection v. Cheyenne Corp.external icon
Superior Court of New Jersey, Appellate Division
Case No. A-4547-15T4
Filed 10/27/2017
Opinion Per Curiam

Federal: City of San Diego has standing to bring nuisance action against company for contamination from polychlorinated biphenyls; claim is not time barred because there is no running of any applicable statute of limitations on the face of the complaint.
City of San Diego v. Monsanto Companyexternal icon
United States District Court for the Southern District of California
Case No. 15cv578-WQH-AGS
Filed 11/22/2017
Opinion by District Judge William Q. Hayes

Quote of the Month

“It’s important to highlight the role of the Environmental Protection Agency in this. They sponsored a program with this goal in mind, acting in a good way by involving industry in the interest of public health.”  — Dr. Teresa M. Attina on the ban of Teflon in the United States

Editor’s note: This quote is from Ban on Teflon Chemical Tied to Fewer Low-Weight Babies, The New York Times, 11/30/2017, by Nicholas Bakalar

The Public Health Law Newsis published the third Thursday of each month except holidays, plus special issues when warranted. It is distributed only in electronic form and is free of charge.

The Newsis published by the Public Health Law Program in the Center for State, Tribal, Local, and Territorial Support.


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Public Health Law News (the News) content is selected solely on the basis of newsworthiness and potential interest to readers. CDC and HHS assume no responsibility for the factual accuracy of the items presented from other sources. The selection, omission, or content of items does not imply any endorsement or other position taken by CDC or HHS. Opinions expressed by the original authors of items included in the News, persons quoted therein, or persons interviewed for the News are strictly their own and are in no way meant to represent the opinion or views of CDC or HHS. References to products, trade names, publications, news sources, and non-CDC websites are provided solely for informational purposes and do not imply endorsement by CDC or HHS. Legal cases are presented for educational purposes only, and are not meant to represent the current state of the law. The findings and conclusions reported in this document are those of the author(s) and do not necessarily represent the views of CDC or HHS. The News is in the public domain and may be freely forwarded and reproduced without permission. The original news sources and the Public Health Law News should be cited as sources. Readers should contact the cited news sources for the full text of the articles.

Page last reviewed: December 21, 2017