title: Connecting silos: the legal bases for public health emergency response in Pennsylvania.
abstract: Emergency response in the United States rests on legal authorities deriving from separate levels, branches, and departments of government, and they originate with different goals and priorities from law enforcement, the judiciary, public health, agriculture, environmental protection, and other areas of expertise. Nevertheless, effective responses require clarity and coordination. The question is whether existing laws and policies leave "disconnects" or gaps that are likely to require decision making and action but that are untested in actual experience and uncertain in law. Through the phased process described here, the authors explored such possible disconnects as identified by Pennsylvania officials and professionals. First, individuals with official operational authority described through in-person interviews how each would respond to a fictional disease-outbreak scenario. Next, these officials met together to compare individual responses and to discuss their concerns. Finally, their observations were analyzed and listed as legal and policy disconnects in four areas: governmental powers, civil liberties, information sharing among agencies, and information dissemination to the public. These results will guide future meetings among local, state, and federal officials in Pennsylvania for the purpose of revising and updating laws and policies to improve the state's capacity for effective and well-coordinated emergency response.
authors.affiliation: Center for Public Health Practice, Center for Public Health Preparedness, Graduate School of Public Health, University of Pittsburgh, 3109 Forbes Avenue, Pittsburgh, PA 15260, USA. potterm@edc.pitt.edu
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Potter
authors.forename: Patricia
authors.initials: P
authors.lastname: Sweeney
authors.forename: Clarke
authors.initials: C
authors.lastname: Thomas
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Miller
authors.forename: Tyler
authors.initials: T
authors.lastname: Gourley
mesh_terms: D023482:Bioterrorism; D003142:Communication; D004189:Disaster Planning / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D004196:Disease Outbreaks; D006077:Government Agencies / Q000331:legislation & jurisprudence*; D006292:Health Priorities; D006801:Humans; D010414:Pennsylvania; D011634:Public Health / Q000331:legislation & jurisprudence*