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October 2018

Public Health Law News Banner

In This Edition

Announcements

Webinar—Operationalizing Legal Preparedness for Disease Outbreaks: Incorporating Legal Requirements into Health System Readiness. CDC’s Public Health Law Program (PHLP) and the American Bar Association’s Health Law Section and Committee on Disaster Preparedness and Response will cosponsor a webinar about putting legal preparedness into effect for disease outbreaks. It is the second webinar in a three-part series called Emergency Preparedness and Response in the 21st Century: Legal Lessons Learned. This webinar will highlight how health departments and health system partners must innovate to turn complex legal requirements into actionable processes for practitioners to use in their everyday and emergency response activities. This free webinar will take place October 23, 2018, from 1:00 pm to 2:30 pm (EDT) and will include a live question and answer session.


Taking Opportunity Costs Seriously in Public Health Law. This article in Public Health Reports,by Scott Burris, JD, discusses the importance of evaluating opportunity costs in the realm of public health. Opportunity costs are the loss of benefits associated with alternate options when a particular option is selected. Burris urges the reader to consider the limited resources that exist, as they carry significant weight in the success of public health endeavors.


APHA Conference 2018. Registration is open for the American Public Health Association’s (APHA’s) annual meeting and expo. The meeting will take place November 10–14, 2018, in San Diego, California.


O’Neill Institute Colloquium 2018. The O’Neill Institute for National and Global Health Law is hosting its annual Colloquium on Wednesdays at 1:20 pm (ET) from August 29 to November 28, 2018, at the Georgetown University Law Center. This Colloquium aims to provide an engaging environment to discuss current topics in global health policy, administration, and law. This year, the Colloquium offers four modules: 1) health coverage and equity, 2) drug policy, 3) populism and policy change, and 4) sustaining multilateral approaches to health promotion.

Legal Tools

Launch of the Legal Epidemiology Center. How do laws affect public health? The transdisciplinary field of legal epidemiology gives us a way to answer this question scientifically. Using the tools of legal epidemiology, however, requires new skills and competencies. Developed through a partnership between CDC, ChangeLab Solutions, and the Policy Surveillance Program at Temple University’s Center for Public Health Law Research, the Legal Epidemiology Center features trainings and resources to teach you those skills. The center provides a brief introduction to legal epidemiology and includes resources for researchers, educators, students, and practitioners at health departments. Check out these free resources today!


FERPA vs. HIPAA. PHLP is proud to announce a new section on its website comparing the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The section describes both laws and contains an easily downloaded graphic comparing them. This resource is a handy reference for healthcare providers, school personnel, and others interacting with FERPA and HIPAA.


Legal and Ethical Framework to Use Centers for Disease Control and Prevention Data for Patient-Centered Outcomes Research. [PDF – 109KB] Patient-centered outcomes research (PCOR) is a type of comparative effectiveness research (CER) that prioritizes consideration of outcomes important to individual patients: risks and potential benefits of treatment, quality of life, the range of treatment options, etc. However, allowing CDC’s data to be used for PCOR introduces some specific legal and ethical challenges. This paper offers a framework to navigate those challenges. It organizes the tools CDC needs to make decisions about how its data can best serve the public and advance the agency’s mission to support safer, healthier people.


New Publication: Exploring Tax Policy to Advance Population Health, Health Equity, and Economic Prosperity. The Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine has published a resource that explains how tax policies can affect population health objectives.


Preemption Watch Tools. Grassroots Change has published a series of tools that allow for tracking and countering preemption in public health, with the support of the Laura and John Arnold Foundation.


Surgeon General’s Call to Action: “Community Health and Prosperity.” CDC is inviting interested persons or organizations to submit written views, recommendations, and data about the connection between community health and prosperity, business investment in local community health, investment strategies, the role of a healthy workforce in business success, and contributions of local policy makers toward community development.

Top Stories

National: Percentage of young U.S. children who don’t receive any vaccines has quadrupled since 2001
The Washington Post   (10/11/2018)   Lena H. Sun

Story highlights

Within the last 17 years, the number of children below age 2 who failed to obtain any vaccinations has quadrupled. According to CDC, though vaccination rates remain high nationally, clinicians and health officials worry about the growing number of preschool and kindergarten-age children who have no immunity against vaccine-preventable diseases, including whooping cough and measles. In the 2017–2018 school year, 2.2 percent of US kindergartners obtained immunization exemptions, a .3 percentage point increase in kindergarten immunizations from the 2015–2016 school year.

Some states allow for nonmedical exemptions from vaccinations based on religious and philosophical beliefs. Conversely, other states, including West Virginia and Mississippi, forbid nonmedical vaccine exemptions. According to Mobeen Rathore, a pediatric infectious disease physician and spokesman for the American Academy of Pediatrics, states that forbid nonmedical exemptions have higher childhood vaccination rates.

Amanda Cohn, a pediatrician and CDC’s senior advisor for vaccines, states, “This is something we’re definitely concerned about. We know there are parents who choose not to vaccinate their kids . . . there may be parents who want to and aren’t able to” get their children vaccinated.

The reason for this increase in unvaccinated children remains unclear. In some instances, parents refuse to vaccinate their child. In other cases, insurance coverage and urban-rural disparity may be contributing factors. Social circumstances, including child care, transportation, or shortages of pediatricians in rural areas, could also play a role.

[Editor’s note: Learn more about state school and childcare vaccination laws and read Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2017–18 School Year and Vaccination Coverage Among Children Aged 19–35 Months — United States, 2017]


Alaska: Alaska declares emergency for Native American languages
The Guardian (09/26/2018)

Story highlights

Alaska Governor Bill Walker has signed an order declaring an emergency for Native American languages, in an effort to protect all 20 recognized indigenous tongues in Alaska. The order, signed on September 23, 2018, also calls for the state education commissioner to promote native languages in public education.

Last April, Alaska’s legislative body brought light to this issue by passing a resolution urging the governor to take action. According to the Alaska Native Language Preservation and Advisory Council, these indigenous languages could die out before the end of the century.

Governor Walker applauded the efforts of the legislature, remarking, “You know there’s not a lot of times I stand up in front of a microphone and thank the legislature, and I certainly do on this.”

He also acknowledged the state’s part in discouraging the use of tribal languages generations ago. He noted, “I know we need to celebrate where we are but, boy, if you don’t reflect on where you’ve been, it really is only part of the discussion, part of the celebration.”

Richard Peterson, president of the Central Council of Tlingit and Haida Indian Tribes and one of the signing witnesses, said he hopes the order will help communities meaningfully reconnect with their cultures.

Since the 1960’s, there have been more efforts to preserve tribal languages. For example, while such tongues were traditionally not written down, many are now being recorded and archived.

[Editor’s note: Read Alaska’s Administrative Order No. 300 and the legislative document that preceded it, House Concurrent Resolution 19. Also, learn more about public health law in Indian Country.]

Briefly Noted

California: California’s newly minted health care laws: doctor misconduct, drug prices, kids’ meals and more
California Healthline   (10/01/2018)   Ana B. Ibarra


Florida: Use of Florida drug database increases amid opioid fight, new law
Orlando Sentinel   (09/20/2018)   New Service of Florida
[Editor’s note: Read Florida’s law. [PDF – 438KB]]


New Jersey: Despite contrary law in other states, New Jersey employers not required to accommodate medical marijuana use
Day Pitney Employment and Labor Quarterly Update   (09/26/18)   Francine Esposito and James M. Leva
[Editor’s note: Read about New Jersey’s Medical Marijuana Program.]


New York: A horrific crime on the subway led to Kendra’s law. Years later, has it helped?
The New York Times   (09/11/2018)   Ali Watkins


New York: Male, female or ‘x’: The push for a third choice on official forms
The New York Times   (09/27/2018)   Andy Newman


National: Flu vaccine rates could drop, raising public health concerns
Bloomberg Law   (09/27/2018)   Jeannie Baumann
[Editor’s note: Learn more about state healthcare worker and patient influenza vaccination laws.]


National: Analyzing new bipartisan federal legislation limiting surprise medical bills
Health Affairs   (09/25/2018)   Loren Adler, Paul B. Ginsburg, Mark Hall, and Erin Trish


National: FDA seizes Juul e-cigarette documents in surprise inspection of headquarters
The Washington Post   (10/02/2018)   Laurie McGinley


National: Legal barriers are limiting telehealth’s reach, experts say
FierceHealthcare   (10/05/2018)   Rose Meltzer


National: The Violence Against Women Act (VAWA) expires September 30, leaving indigenous women especially vulnerable
Teen Vogue   (09/20/2018)   Rory Taylor
[Editor’s note: The VAWA was reauthorized through December 7, 2018 under the National Defense Act for Fiscal Year 2019, which was passed in September 2018. If not reauthorized in December, the act will expire.]


National: 10 ways the new opioids bill could help address the epidemic
AMA Wire   (10/11/2018) Kevin B. O’Reilly
[Editor’s note: Read the SUPPORT for Patients and Communities Act, passed by the Senate October 4, 2018. Also, learn more about the act’s potential impact in Indian Country.

Global Public Health Law

Democratic Republic of Congo: Ebola likely to spread from Congo to Uganda, W.H.O. says
The New York Times   (09/28/2018)   Donald G. McNeil Jr


England: London is going to treat knife crime as a public health issue—here’s what that means
iNews   (09/19/2018)   Florence Snead


Hong Kong: In Hong Kong, hepatitis E strain jumps from rats to humans
The New York Times   (09/28/2018)   Daniel Victor and Tiffany May


India: Women are not ‘chattel,’ says India’s Supreme Court in striking down adultery law
NPR   (09/27/2018)   Lauren Frayer and Scott Neuman


World: New U.N. climate report says put a high price on carbon
The New York Times   (10/08/2018)   Brad Plumer

Profile in Public Health Law: Tara Ramanathan Holiday JD, MPH

Tara Ramanathan, JD, MPH

Title: Public Health Analyst; Lead, Research and Translation Team, CDC’s Public Health Law Program

Education: BA, Wellesley College; MPH, Johns Hopkins Bloomberg School of Public Health; JD, Emory University School of Law


Public Health Law News (PHLN):Please describe your career path and what drew you to public health law.

Ramanathan:I went to work in New York City after college, and 9/11 happened about three months later. While most of the city stood still, I noticed that public health workers worked around the clock to support the individuals and institutions around me. I wanted to contribute to that larger purpose, so I started by volunteering at Ground Zero with emergency responders. Then I assisted a health department with screenings in elder care settings in my free time, and eventually I joined the Peace Corps to work on basic health development in rural Senegal. It didn’t become clear to me until the first policy course of my master’s program that law was fundamental to all of these experiences—and that public health lawyers existed! The first one I got to know was Lainie Rutkow, the teaching assistant for my public health law course who lent me In A Nutshell,a book on becoming a lawyer. She talked to me about her career, work, and research interests. I was sold. That path brought me to CDC in 2009 as an intern for Montrece Ransom, whose guidance and mentorship are two of the main reasons I am part of this field today.

PHLN:What is legal epidemiology, or legal epi, and how did you become interested in it?

Ramanathan:In 2010, I was at a meeting in Washington, DC, with CDC’s Division for Healthcare Quality Promotion (DHQP), for which I was tracking new laws aimed at preventing infections and outbreaks in healthcare facilities. At the table of health department nurses, epidemiologists, lawyers, and others, someone asked, “Which state’s law works best?” None of us knew it at the time, but legal epi helps to answer that question. Legal epidemiology is the scientific study of law as a factor in the cause, distribution, and prevention of disease and injury. Legal epi allows us to understand what the law says, how it works in the jurisdiction or population in which it operates, and what its health consequences or outcomes are.

About 6 months after that meeting, Scott Burris, professor of law and public health at Temple University and director of the Center for Public Health Law Research, came to Atlanta to talk about how to measure law and policy for scientific studies, and a light bulb went off. I submitted a proposal to CDC’s evaluation office to study the impact of healthcare-associated infection (HAI) laws in states. The proposal was funded in mid-2011. That initial project led me and PHLP’s new director, Matthew Penn, to work with DHQP scientists, as well as Scott and his colleagues at Temple University, for more than 5 years, learning how to collect, analyze, and interpret data on HAI laws and policies and what they mean for national prevention efforts.

PHLN:How is legal epi applied at CDC?

Ramanathan:Since those initial HAI studies, PHLP’s team of talented and prolific staff attorneys has grown to support CDC programs in almost every part of the agency, using legal epi. From these efforts, CDC now applies legal epi to dozens of emerging topics of public health importance through comparative law studies, historical analyses, quantitative studies, and qualitative evaluations. CDC also supports a pilot program (the STLTs Legal Epi Project) to introduce legal epi into state, tribal, local, and territorial health departments around the country. CDC also supports a pilot program (the STLTs Legal Epi Project) to introduce legal epi into state, tribal, local, and territorial health departments around the country. With our partners at ChangeLab Solutions and Temple University, PHLP has coached health departments through guided trainings, practice-based tools, and topic-specific technical assistance to help frontline practitioners better understand, use, and improve on their own laws. We all have learned what it takes to use, incorporate, and institutionalize legal epi, and it is incredibly exciting to watch this field grow and take root across the nation.

PHLN:How can applying scientific methods to legal research improve public health outcomes?

Ramanathan:I think we are still learning the answer to this question, but public health practitioners are increasingly asked to provide evidence for laws that work well. For complex, emerging public health issues linked to social determinants of health, the role that law plays in addressing health outcomes is still poorly understood and characterized. Public health has relied on cases like Jacobson v. Massachusettsto justify decades of public health laws covering everything from tobacco and nutrition to intentional and unintentional injuries to antibiotic-resistant infections. Yet we see more local- and state-level litigation and lobbying challenging public health laws as being too broad or too punitive, and many laws are struck down in courts because the evidence doesn’t show why they are effective.

Conceptually, we know that a lot happens between a law being passed and human behavior changing. If we systematically study the impact of a law on the administration of a public health initiative, downstream costs, enforcement activities, or even attitudes about an issue—and then link those effects to behavioral or organizational changes and health outcome data—we can fill in the picture of how the law helps to address a health problem. Rigorous, scientific studies that link different kinds of data, including legal data, can help us understand the relationships between these factors and how to craft the most effective laws to support public health.

PHLN:Do you have to be a lawyer to use legal epi?

Ramanathan:No, but it helps to have a lawyer on hand to find, read, and parse legal language, and apply it to public health issues. PHLP attorneys work daily with scientists, evaluators, policy analysts, communication professionals, and other practitioners to conduct and use legal epi studies to inform public health practice. We have found that these varied perspectives contribute to thorough, well-defined analyses and the translation and dissemination of findings to a wider audience. For those public health professionals who are interested in legal epi, but don’t have a lawyer to collaborate with, don’t hesitate to send a request to PHLP’s legal epi team at PHLawProgram@cdc.gov!

PHLN:The Legal Epidemiology Center (LEC)was launched at the 2018 Public Health Law Conference in October 2018. What is the LEC?

Ramanathan:The LEC is an online resource that helps users to teach and inform the use and understanding of  law and policy through the a legal epidemiology lens. As part of the Public Health Law Academy, the LEC hosts trainings, teaching tools, background research and papers, guidance documents, communities of practice, and other resources to bring new practitioners and emerging leaders into the fold.

PHLN:How was the LEC created?

Ramanathan:In 2013, CDC formally funded development of legal epidemiology as a field through a cooperative agreement with ChangeLab Solutions. That funding has brought professionals across disciplines together to examine diverse legal and policy research agendas, develop standardized methods for analyzing and translating legal text, and tailor resources to public health practice.

PHLN:Can anyone access and use the LEC?

Ramanathan:Yes! The LEC is a learning portal for anyone interested in legal research and translation that serves public health purposes. It is a free resource for public health practitioners, educators, researchers, and students—and anyone can access and use the website.

PHLN:How do you hope the LEC will improve public health practice?

Ramanathan:As we began to disseminate LEC materials around the country at various conferences and meetings, people started to approach me and other colleagues to say, “I didn’t know I was a legal epidemiologist until today!” In this way, I expect the LEC will bring professionals from various parts of the country together to share, discuss, and collaborate on new initiatives. I hope it will expand our ability to work together to address social determinants of health and growing health disparities. I also hope it will help us fill needs and gaps in public health practice that are best achieved through law and policy.

PHLN:What is the most challenging part of legal epi?

Ramanathan:I think it is the amount of time it takes to complete a study. It is difficult for many resource-strapped public health practitioners to fit legal epi work into their busy workloads. That said, we are trying to make it an easier task. For one, we are learning through our other work with health departments about how to scope and streamline research so that it complements existing work and takes fewer resources to complete. We also have been thinking through how to tailor methods to be most accessible and how to produce guides specifically for those practitioners who need to create legal data easily and quickly—and translate it for different purposes. Finally, we are trying to increase the number of researchers and practitioners who know how to do this work and can collaborate across organizations or jurisdictions to share the burden. My goal is to give people access to the legal epi tools and community with the hope that they are better able to meet the challenges of public health practice.

PHLN:What other projects are you currently focused on?

Ramanathan:I am really excited about building a national community of practice around legal epidemiology in the coming year. Starting with the three cohorts of STLTs Legal Epi Project jurisdictions, I hope we can incorporate more voices from the field to achieve a better understanding of how legal epi informs practice. So much work in public health and public health law is reactive to new and urgent needs. Having the space to think about novel and strategic uses for legal data will hopefully allow us to plan solutions, and ways to communicate those solutions, to decision makers more effectively.

PHLN:What do you hope will come of this body of work?

Ramanathan:I hope that legal epi is more than an educational tool or even a way to promote collaboration across disciplines. I hope it will help us to tackle systemic problems of disparities and increase civic engagement on issues related to health.

PHLN:What advice would you give to other jurisdiction or individuals interested in undertaking a legal epi project?

Ramanathan:Check out the Legal Epi Center! And please don’t hesitate to reach out to PHLP with questions.

PHLN:Have you read any good books lately?

Ramanathan:Lately, less so, but one of those books I can always come back to for a laugh is Hullaballoo in the Guava Orchardby Kiran Desai.

PHLN:What’s your favorite part of your job?

Ramanathan:The fabulous team at PHLP—hands down, they make coming to work a privilege and something I look forward to every week!

PHLN:Do you have any hobbies?

Ramanathan:I have a newborn daughter, who makes sure that my favorite hobby right now is napping!

PHLN:Is there anything else you’d like to add?

Ramanathan:Thank you for taking the time to read about legal epidemiology!

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 November 2018 edition of the News.Email your entry to PHLawProgram@cdc.gov with “PHL Quiz” as the subject heading; entries without the heading will not be considered. Good luck!

Public Health Law NewsQuiz Question October 2018

In which state did Kendra’s Law originate?

Public Health Law NewsQuiz Question September 2018 Winner!

Margaret Power

September Question:

Which state’s hospital recently fired a nurse for posting about a patient with measles on social media?

Winning Answer: Texas

Employment organization and job title: Associate Attorney, Dinsmore & Shohl, LLP

A brief explanation of your job: At Dinsmore, I am a member of the healthcare practice group, where I provide counsel to healthcare providers of all sizes on transactional, regulatory, and compliance matters. I also help with our government relations practice and assist with litigation. The range of issues that I see is broad: from fraud and abuse, to privacy and technology and 340B compliance and everywhere in between. Practicing in West Virginia, a largely rural state, I am very interested in issues of rural health. And as a public health school graduate, I am always eager to get my hands into public health law.

Education: West Virginia University College of Law (JD, 2017); West Virginia University (MPH, 2014); West Virginia University (BMDS, 2012)

Favorite section of the Public Health Law News:Court Opinions! As a healthcare attorney, I am bombarded with newsletters on traditional health law topics. This is the only update I receive on public health law court opinions, and it provides me with an opportunity to catch up on recent opinions.

Why are you interested in public health law? As former HHS Assistant Secretary Karen DeSalvo recently reiterated, so many successes in reducing morbidity and mortality in the past decades were as attributable to legal interventions as they were to scientific findings. It is this opportunity to use law as an effective tool to create changes in people’s health that continues to drive my interest in it. It also doesn’t hurt that I am a self-proclaimed “health policy nerd.” I can’t get enough!

What is your favorite hobby?  Cheering on my West Virginia Mountaineers!

Court Opinions

Louisiana: Certification of class upheld for Cajuns for Clean Water, LLC, plaintiffs, who filed suit against Cecelia Water Corporation and the water corporation’s insurer, American Alternative Insurance Corporation, alleging damages as a result of poor water quality, no and low water pressure, arsenic contamination, bacterial contamination, and insufficient water supplied to meet ordinary daily needs of plaintiffs.
Cajuns for Clean Water v. Cecelia Water Corp.
Court of Appeal of Louisiana, Third Circuit
Case No. 18-185
Filed 10/03/2018
Opinion by Judge Sylvia R. Cooks


Federal: In a suit against the DC water authority for sewage in homes and remediation thereof, court held that plaintiffs did not satisfy the procedural requirement of the statute, which requires plaintiffs to provide notice to a list of entities prior to commencing a civil action, including each alleged violator and various enforcement authorities. The Court noted that “Congress clearly intended for each violator to have the opportunity to solve the problem and thereby avoid being sued.” Additionally, plaintiffs’ federal environmental claims failed because none of the statutes plaintiffs relied on pertain to sewage, and the plaintiffs’ issue is no longer “imminent and ongoing.” Plaintiffs did not seek damages pursuant to statutes that actually pertain to the harms they are alleging. As a result, the allegations of plaintiffs’ complaint do not state a claim upon which relief can be granted under federal law.
Miller v. D.C. Water and Sewer Authority
United States District Court, District of Columbia
No. 17-cv-0840 (KBJ)
Opinion by District Judge Ketanji Brown Jackson


Federal: Health department employees did not violate plaintiff’s rights under the Sixth, Seventh, and Eight Amendments when they entered plaintiff’s property to inspect for possible health violations. Because a state court’s order authorizing an inspection of a trashed property did not state the scope of the search with particularity, it did not necessarily serve as the functional equivalent to an administrative inspection warrant. Therefore, plaintiff’s case was allowed to proceed beyond summary judgment on his Fourth Amendment claim as to the defective order.
Hamilton v. Floyd County Indiana
United States District Court, S.D. Indiana, New Albany Division
Case No. 4:16-cv-00210-SEB-DML
Filed 09/28/2018
Opinion by District Judge Sarah Evans Barker


Federal: In case where plaintiff with PTSD service dog was rejected from entering a plasma donation center, the center must meet the requirements of Title III of the ADA. Such compliance does not, however, require the plasma center to allow individuals with a disability to donate if those individuals would endanger themselves, cause harm to a staff member of CSL, or cause CSL to violate FDA regulations.
Matheis v. CSL Plasma Inc.
United States District Court, M.D. Pennsylvania
Case No. 1:17-cv-00785
Filed 09/27/2018
Opinion by District Judge Sylvia H. Rambo


Federal: Plaintiff’s suit against the Kroger Company claimed that the company sold Kroger Bread Crumbs that included misleading labels that violate California’s Unfair Competition Law, False Advertising Law, Consumer Legal Remedies Act, and common law claims for breach of warranty. The court found that the plaintiff’s complaint adequately alleged that she relied on the label’s misrepresentations, stating that Kroger’s “0g trans-fat” claim was a “substantial factor in her purchases.”
Hawkins v. The Kroger Company
United States Court of Appeals, Ninth Circuit
Case No. 16-55532
Filed 10/04/2018
Opinion by Judge Frederic Block

Quote of the Month

“Colonialism used sexual violence during war, land removal, and at boarding schools. In order to start to undo this multigenerational trauma, we need tribally and community-based prevention and justice.” Abaki Beck, a member of Blackfeet Nation

[Editor’s note: This quote is from The Violence Against Women Act (VAWA) expires September 30, leaving indigenous women especially vulnerable. Teen Vogue   (09/20/2018)   Rory Taylor.]

About Public Health Law News

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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Subscribe to Public Health Law News or access past issues. To make comments or suggestions, send an email message to PHLawProgram@cdc.gov.

Disclaimers

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,or persons quoted therein, 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 Web sites 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 Newsis in the public domain and may be freely forwarded and reproduced without permission. The original news sources and the Public Health Law Newsshould be cited as sources. Readers should contact the cited news sources for the full text of the articles.

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