http://www.state.ma.us/legis/bills/st02194.htm

 

SENATE, No. 2194

The Commonwealth of Massachusetts

In the Year Two Thousand and One.

AN ACT PROTECTING THE PUBLIC HEALTH OF THE COMMONWEALTH FROM BIO-TERRORISM, OTHER FORMS OF TERRORISM AND ACTIVITIES RELATED TO TERRORISM, OTHERWISE KNOWN AS THE MASSACHUSETTS EMERGENCY HEALTH POWERS ACT.

EMERGENCY PREAMBLE

Whereas, the deferred operation of this act would tend to defeat its purpose, which is to protect the health, safety, and general well being of our citizens.

Whereas, new and emerging dangers-including emergent and resurgent infectious diseases and incidents of civilian mass casualties--pose serious and imminent threats.

Whereas, a renewed focus on the prevention, detection, management, and containment of public health emergencies is called for.

Whereas, emergency health threats, including those caused by bio-terrorism and epidemics, require the exercise of extraordinary government functions.

Whereas, this Commonwealth must have the ability to respond, rapidly and effectively, to potential or actual public health emergencies.

Whereas, the exercise of emergency health powers must promote the common good.

Whereas, emergency health powers must be grounded in a thorough scientific understanding of public health threats and disease transmission.

Whereas, guided by principles of justice, it is the duty of this Commonwealth to act with fairness and tolerance towards individuals and groups.

Whereas, the rights of people to liberty, bodily integrity, and privacy must be respected to the fullest extent possible consistent with the overriding importance of the public's health and security.

Whereas, this Act is necessary to protect the health and safety of the citizens of this Commonwealth.

Therefore, it is hereby declared to be an emergency law, necessary for the immediate preservation of the public safety.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1.  Title

This Act shall be known as the Massachusetts Emergency Health Powers Act.

SECTION 2:  Purpose

The purposes of this Act are-

a)      To authorize the collection of data and records, the control of property, the management of persons, and access to communications.

b)      To facilitate the early detection of a health emergency, and allow for immediate investigation of such an emergency by granting access to individuals' health information under specified circumstances.

c)      To grant state officials the authority to use and appropriate property as necessary for the care, treatment, and housing of patients, and for the destruction of contaminated materials.

d)      To grant state officials the authority to provide care and treatment to persons who are ill or who have been exposed to infection, and to separate affected individuals from the population at large for the purpose of interrupting the transmission of infectious disease.

e)      To ensure that the needs of infected or exposed persons will be addressed to the fullest extent possible, given the primary goal of controlling serious health threats.

f)        To provide state officials with the ability to prevent, detect, manage, and contain emergency health threats without unduly interfering with civil rights and liberties.

g)      To require the development of a comprehensive plan to provide for a coordinated, appropriate response in the event of a public health emergency.

h)      To educate the public regarding preventative measures to reduce the spread of communicable disease.

SECTION 3. Definitions.

For the purposes of this Act, the following definitions shall apply.

"Biological agent", a microorganism, virus, infectious substance, or biological product that may be engineered as a result of biotechnology, or a naturally occurring or bioengineered component of any such microorganism, virus, infectious substance, or biological product, to cause death, disease, or other biological malfunction in a human, an animal, a plant, or another living organism.

 “Biological waste,” includes blood and blood products, excretions, exudates, secretions, suctioning and other body fluids, and waste materials saturated with blood or body fluids

"Bioterrorism", the intentional use of any biological agent in order to influence the conduct of government or to intimidate or coerce a civilian population.

"Chain of custody", the methodology of tracking specimens for the purpose of maintaining control and accountability from initial collection to final disposition of the specimens and providing for accountability at each stage of collecting, handling, testing, storing, and transporting the specimens and reporting test results.

                                            

“Contagious disease”, an infectious disease that can be transmitted from person to person, animal to person, object to person or insect to person.

“Cultures and stocks,” includes etiologic agents and associated biologicals, including specimen cultures and dishes and devices used to transfer, inoculate, and mix cultures, wastes from production of biologicals and serums, and discarded live and attenuated vaccines.

“Health care facility”, any non-federal institution, building, or agency or portion thereof, whether public or private (for-profit or nonprofit) that is used, operated, or designed to provide health services, medical treatment, or nursing, rehabilitative, or preventive care to any person or persons.  This includes, but is not limited to: ambulatory surgical facilities, health maintenance organizations, home health agencies, hospices, hospitals, infirmaries, intermediate care facilities, kidney treatment centers, long term care facilities, medical assistance facilities, mental health centers, outpatient facilities, public health centers, rehabilitation facilities, residential treatments facilities, skilled nursing facilities, and adult day-care centers.  The term also includes, but is not limited to, the following related property when used for or in connection with the foregoing: laboratories; research facilities; pharmacies; laundry facilities; health personnel training and lodging facilities; patient, guest, and health personnel food service facilities; and offices and office buildings for persons engaged in health care professions or services.

“Health care provider”, any person or entity who provides health care services including, but not limited to, hospitals, medical clinics and offices, special care facilities, medical laboratories, physicians, pharmacists, dentists, physician assistants, nurse practitioners, registered and other nurses, paramedics, emergency medical or laboratory technicians, and ambulance and emergency medical workers.

“Infectious disease”,  a disease caused by a living organism.  An infectious disease may, or may not, be transmissible from person to person, animal to person, air to person, or insect to person.

“Infectious waste”, biological waste, cultures and stocks, pathological waste and sharps.

“Isolation”, the compulsory physical separation (including the restriction of movement or confinement) of individuals and/or groups believed to have been exposed to or known to have been infected with a contagious disease from individuals who are believed not to have been exposed or infected, in order to prevent or limit the transmission of the disease to others.

“Mental health support personnel”, includes, but is not limited to, psychiatrists, psychologists, social workers, and volunteer crisis counseling groups.

“Pathological waste,” includes biopsy materials and all human tissues, anatomical parts that emanate from surgery, obstetrical procedures, autopsy and laboratory procedures and animal carcasses exposed to pathogens in research and the bedding and other waste from such animals, but does not include teeth or formaldehyde or other preservative agents.

“Protected health information”, any information, whether oral, written, electronic, visual, pictorial, physical, or any other form, that relates to an individual’s past, present, or future physical or mental health status, condition, treatment, service, products purchased, or provision of care, and that reveals the identity of the individual whose health care is the subject of the information, or where there is a reasonable basis to believe such information could be utilized (either alone or with other information that is, or should reasonably be known to be, available to predictable recipients of such information) to reveal the identity of that individual.

“Public health authority”, means the department of public health.  The department may seek the assistance in complying with the provisions of this Act from any government agency that acts principally to protect or preserve the public’s health, or any person authorized to act on behalf of the department of public health, or the local board of health or the municipal health department.

“Public health emergency”, an occurrence or imminent threat of an illness or health condition, caused by terrorism, bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agent or biological toxin, that poses a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability and that is beyond the capacity of local government or nongovernmental organizations to resolve.  Such illness or health condition includes, but is not limited to, an illness or health condition resulting from a natural or technological disaster.

“Public safety authority”, the department of public safety, any local government agency that acts principally to protect or preserve the public safety, any person authorized to act on behalf of the department of public safety, or local agency.

“Quarantine”, see "Isolation"

“Sharps,” includes needles, IV tubing with needles attached, scalpel blades, lancets, glass tubes that could be broken during handling, and syringes that have been removed from their original sterile containers.

“Specimens”, include, but are not limited to, blood, sputum, urine, stool, other bodily fluids, wastes, tissues, and cultures necessary to perform required tests.

"Terrorism", the intentional act or threat of act of any force or threat of force in order to influence the conduct of government or to intimidate or coerce a civilian population.

“Tests”, include, but are not limited to, any diagnostic or investigative analyses necessary to prevent the spread of disease, to detect the presence or absence of any disease or protect the public’s health, safety, and welfare.

SECTION 4.  Reporting.

(a)    A health care provider, coroner, or medical examiner shall report all cases of persons who harbor any illness or health condition that may be caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins and might pose a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability.  Reportable illnesses and health conditions include, but are not limited to, the diseases caused by the biological agents listed in 42 C.F.R. § 72, app. A and any illnesses or health conditions identified by the public health authority as potential causes of a public health emergency.

(b)   In addition to the foregoing requirements for health care providers, a pharmacist shall report any unusual or increased prescription rates or purchases, unusual types of prescriptions, or unusual trends in pharmacy visits or purchases that may be caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins and might pose a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability.  Prescription-related events that require a report include, but are not limited to—  (1) an unusual increase in the number of prescriptions to treat fever, respiratory, or gastrointestinal complaints; (2) an unusual increase in the number of prescriptions for antibiotics; (3) an unusual increase in the number of purchases or number of requests for information on over-the-counter pharmaceuticals to treat fever, respiratory, or gastrointestinal complaints; and (4) any prescription that treats a disease that is relatively uncommon and has bioterrorism potential.

a.       The Board of Registration in Pharmacy, in conjunction with the department of public health shall study the feasibility of a statewide pharmacy electronic communication network to comply with the provisions of section (b) in this section.  

(c)    The report pursuant to sections (a) and (b) of this Section shall be made in writing within twenty-four hours to the public health authority and an annual summary of all such reports shall be submitted to the Council.  The report shall include as much of the following information as is available: the patient’s name, date of birth, sex, race, and current address (including city and county); the name and address of the health care provider, coroner, or medical examiner and of the reporting individual, if different; and any other information needed to locate the patient for follow-up.  For cases related to animal or insect bites, the suspected locating information of the biting animal or insect, and the name and address of any known owner, shall be reported.  Sharing of information on reportable illnesses, health conditions, unusual clusters, or suspicious events between authorized personnel shall be restricted to information necessary for the treatment, control, investigation, and prevention of a public health emergency.

(d)   Every veterinarian, livestock owner, veterinary diagnostic laboratory director, or other person having the care of animals shall report animals having or suspected of having any disease that may be caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins and might pose a substantial risk of a significant number of human and animal fatalities or incidents of permanent or long-term disability. The report shall be made in writing within twenty-four hours to the public health authority and shall include as much of the following information as is available: the suspected locating information of the animal, the name and address of any known owner, and the name and address of the reporting individual.

(e)    For the purposes of this Section, the definition of “health care provider” shall include out-of-state medical laboratories, provided that such laboratories have agreed to the reporting requirements of this Commonwealth.  Results must be reported by the laboratory that performs the test, but an in-state laboratory that sends specimens to an out-of-state laboratory is also responsible for reporting results.

(f)     The public health authority may enforce the provisions of this Section in accordance with existing enforcement rules and regulations.

SECTION 5.  Tracking

(a)    The public health authority shall ascertain the existence of cases of an illness or health condition, caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agent or biological toxin, that pose a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability; investigate all such cases for sources of infection and to ensure that they are subject to proper control measures; and define the distribution of the illness or health condition.  To fulfill these duties, the public health authority, shall identify exposed individuals as follows:

a.       Acting on information developed in accordance with Section 4 of this Act, or other reliable information, the public health authority shall identify all individuals thought to have been exposed to an illness or health condition, caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins, that poses a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability. 

b.      The public health authority shall counsel and interview such individuals as appropriate to assist in the positive identification of exposed individuals and develop information relating to the source and spread of the illness or health condition.  Such information includes the name and address (including city and county) of any person from whom the illness or health condition may have been contracted and to whom the illness or health condition may have spread.  Sharing of information on reportable illnesses, health conditions, unusual clusters, or suspicious events between authorized personnel shall be restricted to information necessary for the treatment, control, investigation, and prevention of a public health emergency.

c.       The public health authority shall, for examination purposes, close, evacuate, or decontaminate any facility or decontaminate or destroy any material when the authority reasonably suspects that such facility or material may endanger the public health.

d.      Whenever the public health authority learns of a case of a reportable illness or health condition, an unusual cluster, or a suspicious event that it reasonably believes has the potential to be caused by bioterrorism, it must immediately notify the appropriate public safety authority, tribal authorities, and federal health and public safety authorities. 

e.       An order of the public health authority given to effectuate the purposes of this Section shall be enforceable immediately by the public safety authority and whenever the public safety authority learns of a case of a reportable illness or health condition, an unusual cluster, or a suspicious event, it shall immediately notify the public health authority. 

SECTION 6.  Privacy

(a)    Sharing of information on reportable illnesses, health conditions, unusual clusters, or suspicious events without express written consent of the individual, unless pursuant to a court order or executive order of the Governor to avert a clear danger to the individual or the public health between authorized personnel shall be restricted to information necessary for the treatment, control, investigation, and prevention of a public health emergency.  Failure to comply with this section or improper disclosures under this section shall result in fines of not less than $5000 and not more than $50,000.  The fines shall be increased by the percentage by which the consumer price index for the past calendar year exceeds the consumer price index for the year preceding the past year.

SECTION 7.  Declaration of Public Health Emergency

(a)    A state of public health emergency shall be declared by the Governor upon recommendation of the Council, subject to the limitations in this section, if the Governor finds an occurrence or imminent threat of an illness or health condition, caused by terrorism, bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins, that poses a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability and that is beyond the capacity of local government or nongovernmental organizations to resolve.  To make such a finding, the Governor shall consult with the council and the public health authority and may consult with any public health, public safety and other experts as needed.  Nothing in the duty of the Governor to consult with the council or public health authority or the discretion to consult with public health, public safety or other experts shall be construed to limit the Governor’s authority to act without such consultation when the situation calls for prompt and timely action.

(b)    The state of public health emergency shall be declared by an executive order that indicates the nature of the public health emergency, the area(s) that is or may be threatened, and the conditions that have brought about the public health emergency and a copy of the executive order shall also be filed with the federal office of Homeland Security.

(c)    The declaration of a state of public health emergency shall activate the disaster response and recovery aspects of the State, local, and inter-jurisdictional disaster emergency plans in the affected political subdivision(s) or area(s).  Such declaration authorizes the deployment and use of any forces to which the plans apply and the use or distribution of any supplies, equipment, and materials and facilities assembled, stockpiled, or arranged to be made available pursuant to this Act. 

(d)   During a state of public health emergency, the Governor may:  (1) suspend the provisions of any regulatory statute prescribing procedures for conducting State business, or the orders, rules and regulations of any State agency, if strict compliance with the same would prevent, hinder, or delay necessary action (including emergency purchases) by the public health authority to respond to the public health emergency, and increase the health threat to the population; (2) utilize all available resources of the State government and its political subdivisions, as reasonably necessary to respond to the public health emergency; (3) transfer the direction, personnel, or functions of State departments and agencies to perform or facilitate response and recovery programs regarding the public health emergency; (4) provide aid to and seek aid from other states in accordance with any interstate emergency compact made with this Commonwealth; and (5) mobilize all or any part of the organized militia into service of the Commonwealth.  An order directing the organized militia to report for active duty shall state the purpose for which it is mobilized and the objectives to be accomplished.

(e)    Anyone aggrieved by this section may appeal to a single justice of the Massachusetts supreme judicial court.

SECTION 8.  Council Authority

(a)    The council pursuant to section 21 of this Act shall coordinate all matters pertaining to the public health emergency response of the Commonwealth.  The public health authority shall have primary jurisdiction, responsibility, and authority for:            

a.       Planning and executing public health emergency assessment, mitigation, preparedness response, and recovery for the Commonwealth;

b.      Coordinating public health emergency response between or among state and local authorities;

c.       Collaborating with relevant federal government authorities, elected officials of other states, private organizations, or private sector companies;

d.      Coordinating recovery operations and mitigation initiatives subsequent to public health emergencies; and

e.       Organizing public information activities regarding the Commonwealth's public health emergency response operations.

(b)   After the declaration of a state of public health emergency, special identification for all public health personnel working during the emergency shall be issued as soon as possible.  The identification shall indicate the authority of the bearer to exercise public health functions and emergency powers during the state of public health emergency.  Public health personnel shall wear the identification in plain view.

(c)    During a state of public health emergency, the public health authority may request assistance in enforcing orders pursuant to this Act from the public safety authority.  The public safety authority may request assistance from the organized militia in enforcing the orders of the public health authority.

(d)   The commissioner of the public health authority shall develop and implement statewide public health strategies to detect and respond to acts of terrorism involving chemical or biological agents, nuclear devices or radiation or any acts of mass destruction.  Such strategies shall include, but not be limited to, providing training in the recognition of dangerous communicable diseases and outbreaks of diseases known or suspected to be used as a weapon; providing certification standards for the administration of antidotes, vaccines, and antibiotics in situations related to a terrorist or military attack; establishing civil immunity for paramedics, advanced emergency medical technicians, emergency medical technicians and emergency health care personnel and exempting them from certain provisions of the medical malpractice laws when they are acting in response to a terrorist attack that has been declared a disaster emergency by the governor; requiring the department of public health to develop capabilities and procedures to identify unknown biological substances that may be weapons; and by regulation define the terms "health conditions", "reportable illness", "suspicious event" for the purpose of implementing section 4 (c) of this Act, taking into consideration the definition in section 4 (a) of this Act; and defining the term “weapon of mass destruction” for purposes of implementing this section.

SECTION 9.  Termination of Public Health Emergency

(a)    The Governor shall terminate the state of public health emergency by executive order upon finding that the occurrence of an illness or health condition caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins no longer poses a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability or that the imminent threat of such an occurrence has passed.

(b)   Notwithstanding any other provision of this Act, a state of public health emergency shall be terminated automatically thirty days after its declaration unless renewed by the Governor under the same standards and procedures set forth in this Article for a declaration of a state of public health emergency.  Any such renewal shall also be terminated automatically after thirty days unless renewed by the Governor under the same standards and procedures set forth in this Article for a declaration of a state of public health emergency.

(c)    By a majority vote, the General Court may terminate a state of public health emergency after sixty days from the date of original declaration upon finding that the occurrence of an illness or health condition caused by terrorism, bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins no longer poses a substantial risk of a significant number of human fatalities or incidents of permanent or long-term disability or that the imminent threat of such an occurrence has passed.  Such a termination by the General Court shall override any renewal by the Governor.

(d)   All orders terminating a state of public health emergency shall indicate the nature of the emergency, the area(s) that was threatened, and the conditions that make possible the termination of the state of public health emergency.

SECTION 10.  Public Health Authority Duties

(a)    The public health authority may exercise, for such period as the state of public health emergency exists, the following powers over dangerous facilities or materials—

a.       Facilities.  To close, direct and compel the evacuation of, or to decontaminate or cause to be decontaminated any facility of which there is reasonable cause to believe that it endangers the public health.

b.      Materials.  To decontaminate or cause to be decontaminated, or destroy any material of which there is reasonable cause to believe that it may endanger the public health.

(b)   The public health authority may exercise, for such period as the state of public health emergency exists, the following powers concerning facilities, materials, roads, or public areas:

a.       To procure, by eminent domain or otherwise, construct, lease, transport, store, maintain, renovate, or distribute materials and facilities as may be reasonable and necessary for emergency response, with the right to take immediate possession thereof.  Such materials and facilities include, but are not limited to, communication devices, carriers, real estate, fuels, food, clothing, and health care facilities;

b.      To compel a health care facility to provide services or the use of its facility if such services or use are reasonable and necessary for emergency response. The use of the health care facility may include transferring the management and supervision of the health care facility to the public health authority for a limited or unlimited period of time, but shall not exceed the termination of the state of public health emergency. 

c.       To control, restrict, and regulate by rationing and using quotas, prohibitions on shipments, price fixing, allocation or other means, the use, sale, dispensing, distribution, or transportation of food and other commodities as may be reasonable and necessary for emergency response and that are under the jurisdiction of the public health authority.  Anyone aggrieved by this section may appeal to a single justice of the Massachusetts supreme judicial court.

d.      To prescribe routes, modes of transportation, and destinations in connection with evacuation of persons or the provision of emergency services.

e.       To control ingress and egress to and from any stricken or threatened public area, the movement of persons within the area, and the occupancy of premises therein, if such action is reasonable and necessary for emergency response.

f.        Nothing in this section shall relieve third party payers from meeting their contractual or other legal obligations, including but not limited to the coverage of medical expenses.

(c)    The public health authority may exercise, for such period as the state of public health emergency exists, the following powers regarding the safe disposal of infectious waste:

a.       To adopt and enforce measures to provide for the safe disposal of infectious waste as may be reasonable and necessary for emergency response.  Such measures may include, but are not limited to, the collection, storage, handling, destruction, treatment, transportation, and disposal of infectious waste.

b.      To compel any business or facility authorized to collect, store, handle, destroy, treat, transport, and dispose of infectious waste under the laws of this Commonwealth, and any landfill business or other such property, to accept infectious waste, or provide services or the use of the business, facility, or property if such action is reasonable and necessary for emergency response. The use of the business, facility, or property may include transferring the management and supervision of such business, facility, or property to the public health authority for a limited or unlimited period of time, but shall not exceed the termination of the state of public health emergency.

c.       To procure, by eminent domain or otherwise, any business or facility authorized to collect, store, handle, destroy, treat, transport, and dispose of infectious waste under the laws of this Commonwealth and any landfill business or other such property as may be reasonable and necessary for emergency response, with the right to take immediate possession thereof.

d.      To identify all bags, boxes, or other containers for infectious waste and shall be clearly identified as containing infectious waste.

(d)   The public health authority may exercise, for such period as the state of public health emergency exists, the following powers regarding the safe disposal of corpses:

a.       To adopt and enforce measures to provide for the safe disposal of corpses as may be reasonable and necessary for emergency response.  Such measures may include, but are not limited to, the embalming, burial, cremation, interment, disinterment, transportation, and disposal of corpses.

b.      To take possession or control of any corpse.

c.       To order the disposal of any corpse of a person who has died of an infectious disease through burial or cremation within twenty-four hours after death.

d.      To compel any business or facility authorized to embalm, bury, cremate, inter, disinter, transport, and dispose of corpses under the laws of this Commonwealth to accept any corpse or provide the use of its business or facility if such actions are reasonable and necessary for emergency response.  The use of the business or facility may include transferring the management and supervision of such business or facility to the public health authority for a limited or unlimited period of time, but shall not exceed the termination of the state of public health emergency.

e.       To procure, by eminent domain or otherwise, any business or facility authorized to embalm, bury, cremate, inter, disinter, transport, and dispose of corpses under the laws of this Commonwealth as may be reasonable and necessary for emergency response, with the right to take immediate possession thereof.

                                                   i.                  Every corpse prior to disposal shall be clearly labeled with all available information to identify the decedent and the circumstances of death.  Any corpse of a deceased person with an infectious disease shall have an external, clearly visible tag indicating that the corpse is infected and, if known, the infectious disease.

                                                 ii.                  Every person in charge of disposing of any corpse shall maintain a written record of each corpse and all available information to identify the decedent and the circumstances of death and disposal.  If a corpse cannot be identified, prior to disposal a qualified person shall, to the extent possible, take fingerprints and one or more photographs of the corpse, and collect a DNA specimen.  All information gathered under this paragraph shall be promptly forwarded to the public health authority.

SECTION 11.  Purchase of Products

(a)    The public health authority may purchase and distribute anti-toxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies that it deems advisable in the interest of preparing for or controlling a public health emergency, with the approval of the chairs of the House and Senate Ways and Means Committees or by alternate individuals designated for this purpose by the president of the senate and the speaker of the house; provided, however that the public health authority shall submit an audited account of said purchases and distributions no later than 30 days after the termination of the public health emergency. 

a.       The department of public health and the university of Massachusetts medical school is authorized and directed to study the feasibility of state laboratory manufacturing of non-patented generic pharmaceutical supplies.

(b)   If a state of public health emergency results in a state-wide or regional shortage or threatened shortage of any product covered by Subsection (a), whether or not such product has been purchased by the public health authority, the public health authority may control, restrict, and regulate by rationing and using quotas, prohibitions on shipments, price fixing, allocation or other means, the use, sale, dispensing, distribution, or transportation of the relevant product necessary to protect the health, safety, and welfare of the people of the Commonwealth.  In making rationing or other supply and distribution decisions, the public health authority may give preference to health care providers, disaster response personnel, and mortuary staff.  Anyone aggrieved by this section may appeal to a single justice of the Massachusetts supreme judicial court.

(c)    During a state of public health emergency, the public health authority may procure, store, or distribute any anti-toxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies located within the Commonwealth as may be reasonable and necessary for emergency response, with the right to take immediate possession thereof.  If a public health emergency simultaneously affects more than one state, nothing in this Section shall be construed to allow the public health authority to obtain anti-toxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies for the primary purpose of hoarding such items or preventing their fair and equitable distribution among affected states.

SECTION 12.  Compensation

(a)    State shall pay just compensation to the owner of any facilities or materials that are lawfully taken or appropriated by a public health authority for its temporary or permanent use under this Article according to the procedures and standards set forth in Section 12 of this Act.  Compensation shall not be provided for facilities or materials that are closed, evacuated, decontaminated, or destroyed when there is reasonable cause to believe that they endanger the public health. 

(b)   When the public health authority shall deem it necessary in the interest of public health, to require a resident wage earner to be isolated or quarantined or otherwise to interfere with following of his employment, he shall be deemed eligible to receive unemployment benefits pursuant to Chapter 151A of the General Laws.

(c)    Compensation for property shall be made only if private property is lawfully taken or appropriated by a public health authority for its temporary or permanent use during a state of public health emergency declared by the Governor pursuant to this Act.

(d)   Any action against the Commonwealth with regard to the payment of compensation shall be brought in the courts of this Commonwealth in accordance with existing court laws and rules, or any such rules that may be developed by the courts for use during a state of public health emergency.

(e)    The amount of compensation shall be calculated in the same manner as compensation due for taking of property pursuant to non-emergency eminent domain procedures, as provided in Chapter 79 of the General Laws, except that the amount of compensation calculated for items obtained under Section 11 of this Act shall be limited to the costs incurred to produce the item.

SECTION 13.  Destruction of Property

(a)    To the extent practicable consistent with the protection of public health, prior to the destruction of any property under this Article, the public health authority shall institute appropriate civil proceedings against the property to be destroyed in accordance with the existing laws and rules of the courts of this Commonwealth or any such rules that may be developed by the courts for use during a state of public health emergency.  Any property acquired by the public health authority through such proceedings shall, after entry of the decree, be disposed of by destruction as the court may direct.  Any person aggrieved shall receive compensation pursuant to Section 12 of this Act.

SECTION 14.  Medical Examinations

(a)    During a state of public health emergency, the public health authority shall use every available means to prevent the transmission of infectious disease and to ensure that all cases of infectious disease are subject to proper control and treatment. 

(b)   The public health authority may exercise, for such period as the state of public health emergency exists, the following emergency powers over persons:

a.       To compel a person to submit to a physical examination and/or medical examination and/or testing as necessary to diagnose or treat the person; however, said person may request the specific gender of the physician to perform the examination or testing.

                                                   i.                  The physical examination, medical examination and/or testing may be performed by any qualified person authorized by the public health authority and the board of registration in medicine subject to the provisions of subsection a. of this section;

                                                 ii.                  The physical examination and/or medical examination and/or testing must not be reasonably likely to result in serious physical harm to the affected individual and serious physical harm shall not include physical harm as the result of emotional harm;

                                                iii.                  The physical examination and/or medical examination and/or testing shall be performed immediately upon the order of the public health authority without resort to judicial or quasi-judicial authority;

                                               iv.                  Any person refusing to submit to the physical examination and/or medical examination and/or testing as authorized in this section shall be fined pursuant to subsection (d) of this section unless exempted for religious reasons or for medical reasons as determined by public health authority regulation.  

                                                 v.                  If the public health authority is uncertain whether a person who refuses to undergo physical examination and/or medical examination and/or testing may have been exposed to an infectious disease or otherwise poses a danger to public health, the public health authority may subject the individual to isolation or quarantine as provided in this Act.

b.      To require any physician or other health care provider to perform the physical examination and/or medical examination and/or testing. 

                                                   i.                  Any person refusing to perform a medical or physical examination and/or testing as authorized herein shall be referred to the designated board of registration for appropriate disciplinary action unless exempted for religious reasons.

(c)    An order of the public health authority given to effectuate the purposes of this subsection shall be immediately enforceable by any peace officer.

(d)   Said fine shall not exceed $10,000 in each instance and any fine collected for violation of this section shall be credited fifty percent to the courts and fifty percent to the uncompensated care trust fund.

SECTION 15.  Isolation and quarantine. 

(a)    It is the policy of the Commonwealth that the individual dignity of any person isolated or quarantined during a state of public health emergency shall be respected at all times and upon all occasions.  The needs of persons isolated or quarantined shall be addressed in a systematic and competent fashion.  To the extent possible, the premises in which persons are isolated or quarantined shall be maintained in safe and hygienic manners, designed to minimize the likelihood of further transmission of infection or other harm to persons subject to isolation or quarantine.  Adequate food, clothing, medication, and other necessities, and competent medical care shall be provided. Consistent with this policy, the public health authority may exercise, for such period as the state of public health emergency exists, the following emergency powers over persons:

a.       To establish and maintain places of isolation and quarantine; and

b.      To require isolation or quarantine of any person by the least restrictive means necessary to protect the public health.  All reasonable means shall be taken to prevent the transmission of infection among the isolated or quarantined individuals.

(b)   A person subject to isolation or quarantine shall obey the public health authority’s rules and orders, shall not go beyond the isolation or quarantine premises, and shall not put himself or herself in contact with any person not subject to isolation or quarantine other than a physician or other health care provider, public health authority, or person authorized to enter an isolation or quarantine premises by the public health authority.  Failure to obey these provisions shall constitute a misdemeanor.

(c)    No person, other than a person authorized by the public health authority, shall enter an isolation or quarantine premises.  If any person enters an isolation or quarantine premises without permission of the public health authority, that person shall be liable for a misdemeanor. If, by reason of an unauthorized entry into an isolation or quarantine premises, the person poses a danger to public health, he or she may be subject to isolation or quarantine pursuant to the provisions of this Article.

a.       Isolation or quarantine of any person shall be terminated when the public health authority determines that such isolation or quarantine of such person is no longer necessary to protect the public health.

b.      Before isolating or quarantining a person, the public health authority shall obtain a written, ex parte order from a court of this state authorizing such action.  The court shall grant such order upon finding that probable cause exists to believe isolation or quarantine is warranted pursuant to the provisions of this Act.  A copy of the authorizing order shall be given to the person isolated or quarantined, along with notification that the person has a right to a hearing under this paragraph.

c.       Notwithstanding the preceding subparagraph, the public health authority may isolate or quarantine a person without first obtaining a written, ex parte order from the court if any delay in the isolation or quarantine of the person would pose an immediate threat to the public health.  Following such isolation or quarantine, the public health authority shall promptly obtain a written, ex parte order from the court authorizing the isolation or quarantine.

d.      A person isolated or quarantined pursuant to the provisions of subparagraphs (1) or (2) shall have the right to a court hearing to contest the ex parte order.  If such person or his or her representative requests a hearing, the hearing shall be held within seventy-two hours of receipt of such request, excluding Saturdays, Sundays and legal holidays.  The request must be in writing.  A request for a hearing shall not stay the order of isolation or quarantine.  At the hearing, the public health authority must show that the isolation or quarantine is warranted pursuant to the provisions of this Section.

e.       On or after thirty days following a hearing on the ex parte order or such hearing as is provided for in this subparagraph, a person isolated or quarantined pursuant to the provisions of this Section may request in writing a court hearing to contest his or her continued isolation or quarantine.  The hearing shall be held within seventy-two hours of receipt of such request, excluding Saturdays, Sundays and legal holidays.  A request for a hearing shall not alter the order of isolation or quarantine.  At the hearing, the public health authority must show that continuation of the isolation or quarantine is warranted pursuant to the provisions of this Section.

f.        A person isolated or quarantined pursuant to the provisions of this Section may request a hearing in the courts of this Commonwealth for remedies regarding his or her treatment and the terms and conditions of such quarantine or isolation.  Upon receiving a request for either type of hearing described in this subparagraph, the court shall fix a date for a hearing.  The hearing shall take place within ten days of the receipt of the request by the court. The request for a hearing shall not alter the order of isolation or quarantine.

g.       If, upon a hearing, the court finds that the isolation or quarantine of the individual is not warranted under the provisions of this Section, then the person shall be released from isolation or quarantine.  If the court finds that the isolation or quarantine of the individual is not in compliance with the provisions of paragraph (a), the court may then fashion remedies appropriate to the circumstances of the state of public health emergency and in keeping with the provisions of this Act.

h.       Judicial decisions shall be based upon clear and convincing evidence, and a written record of the disposition of the case shall be made and retained. The petitioner shall have the right to be represented by counsel or other lawful representative.  The manner in which the request for a hearing is filed and acted upon will be in accordance with the existing laws and rules of the courts of this Commonwealth or any such rules that are developed by the courts for use during a state of public health emergency.

SECTION 16.  Vaccination and treatment

(a)    The public health authority may exercise, for such period as the state of public health emergency exists, the following emergency powers over persons:

a.       To compel a person to be vaccinated and/or treated for an infectious disease.

                                                   i.                  Vaccination may be performed by any qualified person authorized by the public health authority.

                                                 ii.                  The vaccine shall not be given if the public health authority has reason to know that a particular individual is likely to suffer from serious physical harm from the vaccination and physical harm shall not mean physical harm as the result of emotional harm or if the particular individual is exempted for religious or medical reasons as determined by the public health authority regulation or does not pose a danger to the public health.

                                                iii.                  Treatment may be performed by any qualified person authorized by the public health authority.

                                               iv.                  Treatment must not be such as is reasonably likely to lead to serious harm to the affected individual.

(b)   Individuals refusing to be vaccinated or treated without a reason listed pursuant to section (a) a.ii. of this section shall be fined pursuant to section 14 (g) of this Act.  If, by reason of refusal of vaccination or treatment, the person poses a danger to the public health, he or she may be subject to isolation or quarantine pursuant to the provisions of this Article.

(c)    An order of the public health authority given to effectuate the purposes of this Section shall be immediately enforceable by any peace officer.

SECTION 17. Collections of Specimens

(a)    The public health authority may, for such period as the state of public health emergency exists, collect specimens and perform tests on any person or animal, living or deceased, and acquire any previously collected specimens or test results that are reasonable and necessary for emergency response.

(b)   All specimens shall be clearly marked.

(c)    Specimen collection, handling, storage, and transport to the testing site shall be performed in a manner that will reasonably preclude specimen contamination or adulteration and provide for the safe collection, storage, handling, and transport of such specimen.

(d)   Any person authorized to collect specimens or perform tests shall use chain of custody procedures to ensure proper record keeping, handling, labeling, and identification of specimens to be tested.  This requirement applies to all specimens, including specimens collected using on-site testing kits.

(e)    Recognizing that, during a state of public health emergency, any specimen collected or test performed may be evidence in a criminal investigation, any business, facility, or agency authorized to collect specimens or perform tests shall provide such support as is reasonable and necessary to aid in a relevant criminal investigation.

SECTION 18.  Access and disclosure of patient records.

(a)    Access to protected health information of patients under the isolation, quarantine, or care of the public health authority shall be limited to those persons having a legitimate need to acquire or use the information for purposes of providing treatment or care to the individual who is the subject of the health information, conducting epidemiologic research, or investigating the causes of transmission.

(b)   Protected health information held by the public health authority shall not be disclosed to others without individual specific informed consent, except for disclosures made directly to the individual; to health care personnel where needed to protect the health or life of the individual who is the subject of the information; pursuant to a court order or executive order of the Governor to avert a clear danger to an individual or the public health; or to identify a deceased individual or determine the manner or cause of death. 

SECTION 19.  Licensing and appointment of health personnel.

(a)    The public health authority may exercise, for such period as the state of public health emergency exists, the following emergency powers regarding licensing of health personnel:

a.       Health care providers from other jurisdictions.  To appoint and prescribe the duties of such out-of-state emergency health care providers as may be reasonable and necessary for emergency response.

                                                   i.                  The appointment of out-of-state emergency health care providers pursuant to this Section may be for a limited or unlimited time, but shall not exceed the termination of the state of public health emergency and shall be in deference to in-state health care providers, including volunteer health care providers.  The public health authority may terminate the out-of-state appointments at any time or for any reason provided that any such termination will not jeopardize the health, safety, and welfare of the people of this Commonwealth.  The public health authority shall also work with surrounding states on the out-of-state appointment issue.

                                                 ii.                  The public health authority may waive any or all licensing requirements, permits, or fees required by the State code and applicable orders, rules, or regulations for health care providers from other jurisdictions to practice in this Commonwealth.

                                                iii.                  Any out-of-state emergency health care provider appointed pursuant to this Section shall not be held liable for any civil damages as a result of medical care or treatment related to the emergency response unless such damages result from providing, or failing to provide, medical care or treatment under circumstances demonstrating a reckless disregard for the consequences so as to affect the life or health of the patient.

b.      Personnel to perform duties of medical examiner or coroner.  To authorize the medical examiner or coroner to appoint and prescribe the duties of such emergency assistant medical examiners or coroners as may be required for the proper performance of the duties of the office.

                                                   i.                  The appointment of emergency assistant medical examiners or coroners pursuant to this Section may be for a limited or unlimited time, but shall not exceed the termination of the state of public health emergency.  The medical examiner or coroner may terminate such emergency appointments at any time or for any reason, provided that any such termination will not impede the performance of the duties of the office.

                                                 ii.                  The medical examiner or coroner may waive any or all licensing requirements, permits, or fees required by the State code and applicable orders, rules, or regulations for the performance of these duties.

                                                iii.                  Any emergency assistant medical examiner or coroner appointed pursuant to this Section and acting without malice and within the scope of the prescribed duties shall be immune from civil liability in the performance of such duties.

(b)   The council, in conjunction with the Massachusetts emergency management agency, the board of registration in nursing, the Massachusetts nurses association, the Massachusetts organization of nurse executives, the American red cross and the college of emergency room physicians shall develop and design a program to certify active and retired or inactive nurses in disaster response nursing and emergency first aid. 

(c)    The public health authority and the Massachusetts emergency management agency shall maintain a database of retired and inactive nurses who have completed courses in disaster response nursing and emergency first aid for the purposes of calling nurses into volunteer service in the event of an emergency or disaster being declared by the governor.

(d)   The public health authority shall address the educational needs of the health care work force and infrastructure related to preparedness, capacity and competency to respond to acts of terrorism involving chemical or biological agents, nuclear devices or radiation and any acts of mass destruction; the training all emergency medical technicians and paramedics to the hazardous operations level and domestic preparedness EMS-technician level; any other emergency management and public health training and exercise needs of local officials and the private sector.

SECTION 20.  Dissemination of information. 

(a)    The public health authority, the media, health care professionals, public health agents and other key officers of government shall inform the people of the Commonwealth when a state of public health emergency has been declared or terminated, how to protect themselves, and what actions are being taken to control the emergency.

(b)   The public health authority, the media, health care professionals, public health agents and other key officers of government shall provide information by all available and reasonable means calculated to bring the information promptly to the attention of the general public.

(c)    If the public health authority has reason to believe there are people of the Commonwealth who lack sufficient skills in English to understand the information, the public health authority shall make reasonable efforts to provide the information in the primary languages of those people as well as in English.

(d)   The provision of information shall be made in a manner accessible to individuals with disabilities.

(e)    During and after a state of public health emergency, the public health authority shall provide information about and referrals to mental health support personnel to address psychological responses to the public health emergency.

SECTION 21.  Public Health Emergency Planning Council

(a)    There shall be a Public Health Emergency Planning Council to plan for and implement measures designed to mitigate the damages to the people of the Commonwealth, to public facilities and to private property from acts of terrorism, including the use of chemical and biological agents, nuclear devices or other violent acts ensuing in the Commonwealth and caused by any person.  The council shall consist of the attorney general, the director of the Massachusetts emergency management agency, the secretary of public safety, the secretary of health and human services, and the commissioner of public health.  The Governor shall appoint the chair of the council.

(b)   There shall be established a health emergency advisory committee.    The advisory committee shall, at the request of the chair of the council, provide such advice and counsel as it deems appropriate including, but not limited to, serving as a resource for studies and projects undertaken by the council or sponsored by the council.  The advisory committee may also review and comment on regulations and standards proposed or promulgated by the council, however, such review and comment shall be advisory in nature and shall not be considered binding on the council.

a.       The advisory committee shall consist of the following members: the director of consumer affairs and business regulation or a designee with authority, the commissioner of the department of environmental protection or a designee with authority,  the adjutant general or a designee with authority, the commissioner of mental health or a designee with authority, the commissioner of food and agriculture or a designee with authority,  the executive director of the Massachusetts biotechnology council or a designee with authority, the executive director of the Massachusetts retail pharmacy association or a designee with authority, a representative of the Massachusetts professional firefighters association, the president from the Massachusetts sheriffs association or a designee with authority, a representative of the Massachusetts call/volunteer firefighters association,  the state fire marshall or a designee with authority, a representative of the Massachusetts chapter of the American red cross, a representative of the Massachusetts hospital association, a representative of community health centers, two representatives of the Massachusetts medical society with one representing family practice, a representative of the Massachusetts nurses association, a representative from the Massachusetts organization of nurse executives, a representative of the Massachusetts Public Health Association, a representative of the Massachusetts Association of Health Boards, a representative from the Massachusetts health officers association, a representative from the center of health professions at Worcester state college, a representative of the Massachusetts association of public health nurses, a representative from a pediatric specialty hospital, a representative from the Massachusetts chapter of the academy of pediatric physicians, a representative from the Massachusetts environmental health association, a representative of the college of emergency physicians, a representative from each of the emergency medical service regions, the chancellor/dean of the University of Massachusetts Medical School or a designee with authority, the dean of a school of public health located within the Commonwealth, the dean of a school of veterinarian medicine located within the Commonwealth, and such other officers of the Commonwealth as the governor may designate.  The council by majority vote shall designate the chair of the advisory committee.

SECTION 22.  Public Health Emergency Plan. 

(a)    The Council shall, within six months of its appointment, assess the statewide preparedness of the agencies of the commonwealth, its political subdivisions, emergency responders, law enforcement personnel, and the health care providers licensed by the commonwealth to prevent or respond to natural or technological disasters, acts of terrorism involving chemical and biological agents, nuclear devices and radiation or other forms of mass destruction, to assure the coordination of their activities, and with appropriate federal agencies; and then deliver to the Governor and the General Court, a plan for responding to a public health emergency, that includes, but not limited to, provisions for the following:

a.       A means of notifying and communicating with the population during a state of public health emergency in compliance with this Act; including the readiness and adequacy of communications networks, especially Emergency-911, for receiving and broadcasting health alerts; the potential for developing a “hotline” that citizens who believe they may have been exposed can call for information and referral; the potential for developing a web site for communicating the latest and most accurate information; the readiness and adequacy of information and data systems for managing the health system response to disaster; and an evaluation and recommendation for expansion of the pilot hospital volume surveillance system to cover the entire state;

b.      Lines of authority for a communications network used to report potential or actual acts of terrorism involving chemical or biological agents, nuclear devices or radiation or any acts of mass destruction;

c.       Coordinated communications network, possibly including regular public briefings by state and local health officials, to convey the public information needs to manage the “epidemic” of fear and minimize panic relating to awareness of the threat of terrorism involving chemical or biological agents, nuclear devices or radiation or any acts of mass destruction;

d.      Centralized coordination of resources, manpower, and services, including coordination of responses by State, local, and federal agencies;

e.       The location, procurement, storage, transportation, maintenance, and distribution of essential materials, including medical supplies, drugs, vaccines, food, shelter, and beds;

f.        The continued, effective operation of the judicial system including, if deemed necessary, the identification and training of administrative law judges to serve as judges regarding matters of isolation and quarantine as described in this Act;

g.       The method of evacuating populations, and housing and feeding the evacuated populations;

h.       The identification and training of health care providers to diagnose and treat persons with infectious diseases;

i.         Laws or regulations necessary to permit the movement, assignment or transfer of any licensed physicians, nurses or other health care personnel, including the credentialing of health care professionals at institutions other than their own; and training and certification programs that could allow inactive or retired health care personnel to be activated for work in health care facilities during a public health emergency;  and that the council shall submit a report on the feasibility of expanding the patient volume assessment pilot program being performed by the office of emergency medical services to all emergency departments at health care facilities in the Commonwealth.

j.        Guidelines for the vaccination of persons, incompliance with the provisions of this Act.

k.      Guidelines for the treatment of persons who have been exposed to or who are infected with diseases or health conditions caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins, that pose a substantial risk of a significant number of fatalities or incidents of permanent or long-term disability.  The guidelines should cover, but not be limited to, the following diseases: anthrax, botulism, smallpox, plague, tularemia, and viral hemorrhagic fevers;

l.         Guidelines for the safe disposal of corpses, in compliance with the provisions of this Act;

m.     Guidelines for the safe disposal of infectious waste, in compliance with the provisions of this Act;

n.       Guidelines for the safe and effective management of persons isolated, quarantined, vaccinated, or treated during a state of public health emergency;

o.      Tracking the source and outcomes of infected persons;

p.      The ability to handle so-called “surge capacity” problems in the event of a disaster which requires the use of all available hospital beds, including the potential to utilize closed or abandoned health care facilities for use in the event of a severe health emergency or to develop hospital rooms designed to serve patients whose condition requires isolation;  and ensuring that each city and county within the Commonwealth identifies the following:

                                                   i.                  sites where persons can be isolated or quarantined, with such sites complying with the provisions of this Act regarding the least restrictive means for isolation and quarantine, and the requirements for the safety, health and maintenance of personal dignity of those isolated or quarantined;

                                                 ii.                  sites where medical supplies, food, and other essentials can be distributed to the population;

                                                iii.                  sites where emergency workers can be housed and fed;

                                               iv.                  routes and means of transportation of people and materials;

q.      Utilization of school nurses and public health nurses for monitoring, detection, vaccination and immunization;

r.        Coordination with other states and the federal government;

s.       Taking into account cultural norms, values, and traditions that may be relevant;

t.        Assess the crisis counseling capacity for emergency response personnel; health care providers; law enforcement personnel; and the general public;

u.       Designation of a state official to serve as liaison to the Office of Homeland Security and work with said office on an ongoing basis;

v.       Review the potential for the development of a state agency or public authority to manage a venture capital fund for the development of anti-bio-terrorism technologies, and for the encouragement of new companies to enter this market with representatives of the biotechnology industry and appropriate state agencies and educational institutions;

w.     Conduct an assessment of the preparedness of the telecommunications division, statewide telecommunications systems and networks and public utilities engaged in telecommunications to prevent or respond to acts of terrorism, including cyber-terrorism, and report its findings and recommendations;

x.       Capacity of laboratories across the Commonwealth to respond to acts of terrorism involving chemical or biological agents, nuclear devices or radiation or any acts of mass destruction and improving the laboratory surveillance infrastructure and the epidemiological infrastructure of the state;

y.       Public health surveillance activities and data collection and analysis in responding to acts of terrorism involving chemical or biological agents, nuclear devices or radiation or any acts of mass destruction;

z.       Preparation for receiving, distributing and administering items from the National Pharmaceutical Stockpile and the development and management of any state pharmaceutical stockpile for antibiotics, antitoxins, antidotes, ventilators, respirators and other medical/surgical supplies and equipment needed to treat patients in a mass casualty event; development of a system for tracking the available blood supply, and coordinating and distributing blood donations;

aa.   Reporting requirements of rare, unusual or unexplained illnesses that could be related to acts of terrorism involving chemical or biological agents, nuclear devices or radiation; development of an analysis of the threat of biological and chemical attacks in the Commonwealth; and a description of the procedures for holding practice biological or chemical attack drills and simulations;

bb.  Development of a plan addressing the effects of rationing equipment, personnel and supplies;

cc.   Distribution of this plan and guidelines to those who will be responsible for implementing the plan as well as distribution of a list and description of funding needs in order to comply with this act and/or implement provisions of this Act to Senate and House Ways and Means; and

dd.  Other measures necessary to carry out the purposes of this Act.

(b)   The Council shall review its plan for responding to a public health emergency every two years.

(c)    The Council shall study the feasibility of the implementation of a statewide and local public health and safety disaster informational and referral computer system including, but not limited to, local boards of health, municipal health departments and the Massachusetts emergency management agency.  Said Council shall report such findings to the Joint Committee on Health Care within 12 months of the effective date of this Act.

SECTION 23. Rules and regulations.

(a)    The public health authority is authorized to promulgate and implement such rules and regulations as are reasonable and necessary to implement and effectuate the provisions of this Act.  The public health authority shall have the power to enforce the provisions of this Act through the imposition of fines and penalties, the issuance of orders, and such other remedies as are provided by law, but nothing in this Section shall be construed to limit specific enforcement powers enumerated in this Act.

SECTION 24. Transfer of funds. 

(a)    The Governor may transfer from any state fund appropriated for an emergency reserve or other designated accounts such sums as may be necessary to meet the public health emergency with the approval of the House and Senate Chairs of the Ways and Means Committees or an alternate individual designated for this purpose by the president of the senate and the speaker of the house.

(b)   Monies so transferred shall be repaid to the fund from which they were transferred when monies become available for that purpose, by legislative appropriation or otherwise.

(c)    A transfer of funds by the Governor under the provisions of this Section may be made only when one or more of the following conditions exist:

a.       No appropriation or other authorization is available to meet the public health emergency.

b.      An appropriation is insufficient to meet the public health emergency.

c.       Federal monies available for such a public health emergency require the use of State or other public monies.

(d)   All expenses incurred by the Commonwealth during a state of public health emergency shall be subject to the following limitations:

a.       No expense shall be incurred against the monies authorized under this Section, without the approval of the Governor.

b.      The aggregate amount of all expenses incurred under the provisions of this Section shall not exceed twenty-five million dollars for any fiscal year without legislative appropriation.

c.       Monies authorized for a state of public health emergency in prior fiscal years may be used in subsequent fiscal years only for the public health emergency for which they were authorized.  Monies authorized for a public health emergency in prior fiscal years, and expended in subsequent fiscal years for the public health emergency for which they were authorized, apply toward the expense limit pursuant to subsection (b) for the fiscal year in which they were authorized.

d.      The state auditor shall conduct a review of all fund expeditures of the Governor during the public health emergency.

SECTION 25.  Liability

(a)    Neither the Commonwealth, its political subdivisions, nor, except in cases of gross negligence or willful misconduct, the Governor, the public health authority, or any other State official referenced in this Act, is liable for the death of or any injury to persons, or damage to property, as a result of complying with or attempting to comply with this Act or any rule or regulations promulgated pursuant to this Act. 

(b)   During a state of public health emergency, any person owning or controlling real estate or other premises who voluntarily and without compensation grants a license or privilege, or otherwise permits the designation or use of the whole or any part or parts of such real estate or premises for the purpose of sheltering persons, together with that person’s successors in interest, if any, shall not be civilly liable for negligently causing the death of, or injury to, any person on or about such real estate or premises under such license, privilege, or other permission, or for negligently causing loss of, or damage to, the property of such person.

(c)    During a state of public health emergency, any private person, firm or corporation and employees and agents of such person, firm or corporation in the performance of a contract with, and under the direction of, the Commonwealth or its political subdivisions under the provisions of this Act shall not be civilly liable for causing the death of, or injury to, any person or damage to any property except in the event of gross negligence or willful misconduct.

(d)   During a state of public health emergency, any private person, firm or corporation and employees and agents of such person, firm or corporation, who renders assistance or advice at the request of the Commonwealth or its political subdivisions under the provisions of this Act shall not be civilly liable for causing the death of, or injury to, any person or damage to any property except in the event of gross negligence or willful misconduct.

(e)    The immunities provided in this Subsection shall not apply to any private person, firm, or corporation or employees and agents of such person, firm, or corporation whose act or omission caused in whole or in part the public health emergency and who would otherwise be liable therefore.

(f)      The board of registration in medicine shall grant or renew a certificate of registration without payment of a fee by a physician qualified for registration or renewal of the same under this chapter in order for the physician to participate in the free care program operated by a non-profit organization. The scope of practice of physicians whose certificates of registration are granted or renewed pursuant to this paragraph may be restricted as the board may provide by regulation.  Notwithstanding any law or regulation to the contrary, physicians licensed to provide voluntary care shall not be required to carry medical malpractice insurance coverage for such care, but shall be subject to all other requirements the board has established for physicians concerning quality of care, continuing education requirements and competence to practice medicine.

(g)    An advanced practice nurse licensed to provide voluntary care shall not be required to have professional malpractice liability insurance or suitable bond or other indemnity for such care, but shall be subject to all other requirements the council has established for such advance practice nurses. The Council shall also study the method(s) to indemnify all other nurses who may not be covered by their employer when assigned to another location.  The council shall report back to the joint committee on health care with recommendations not later than 3 months after the effective date of this Act.

(h)    The council shall study the impact of the federal Volunteer Protection Act of 1997 on health care volunteers in the commonwealth. The council shall review ways in which the commonwealth may act to provide legal counsel and defense to volunteers who may be eligible for the protections afforded in the Volunteer Protection Act.  The council shall report back to the joint committee on health care with recommendations not later than 3 months after the effective date of this Act.

(i)      The board of registration in medicine shall promulgate regulations concerning the registration and insurance of physicians participating in free care programs or authorized to provide voluntary care as set forth in this section not later then 3 months after the effective date of this act.

(j)     The board of registration in nursing shall promulgate regulations concerning the registration and insurance of advanced practical nurses licensed to provide voluntary care as set forth in this section not later than 3 months after the effective date of this act.

SECTION 26.  Supply Emergency

(a)    The Governor may declare a supply emergency exists, after conferring with the attorney general and the director of consumer affairs and business regulation, as result of a natural disaster, strike, civil disorder, terrorist act, or other extraordinary circumstance.  The Governor shall support said declaration of a supply emergency by making written findings regarding the market disruption, the product is in short supply, and that the product or service is essential to the health, safety or welfare of the people.  This written declaration shall be filed with the house and senate clerks, the attorney general and the office of consumer affairs and business regulation and the supply emergency shall automatically terminate ninety days after its declaration but may be renewed once more by the Governor under the same standards and procedures set forth in this paragraph. 

(b)   By a majority vote, the general court may terminate a declaration of a supply emergency upon finding that market disruption has ended, the product is no longer in short supply, and/or that the product or service is not essential to the health, safety or welfare of the people.

(c)    The attorney general, in consultation with the office of consumer affairs and business regulation, and upon the declaration by the governor that a supply emergency exists, shall take appropriate action to ensure that no person shall sell a product or service that is at a price that unreasonably exceeds the price charged before the emergency.  The attorney general may make reasonable rules and regulations governing exceptions for the additional costs incurred in connection with the acquisition, production, distribution or sale of an energy resource, as well as rules and regulations regarding the violation of this section.  Nothing in this paragraph shall preempt chapter 93A and any rules or regulation promulgating such chapter.

(f)     Anyone aggrieved by this section may appeal to a single justice of the Massachusetts supreme judicial court.

SECTION 27.  Report

(a)    Not later than ninety days after the date of the enactment of this Act, and every twelve months thereafter, the Governor shall transmit to the House Clerk and Senate Clerk a report that shall include:

a.       A description of the detection and tracking efforts made under this Act;

b.      A description of the state(s) of public health emergencies declared under this Act;

c.       A description of the emergency powers utilized under this Act; and

d.      A description of the monies transferred and liabilities and expenses incurred under this Act.

(b)   Not later than 90 days after the termination of the public health emergency the state auditor shall submit a report of any act by the council, the Governor or the public health authority during any public health emergency and shall communicate the report to the general court and the public.

(c)    The commissioner of the public health authority shall collaborate with the director of the Massachusetts emergency management agency to submit a written report, including recommendations for executive or legislative action, not later than 6 months after the effective date of this act, and submit an updated report not later than every 3 years thereafter, regarding the findings of the assessment of the public health preparedness to respond to acts of terrorism involving chemical or biological agents, nuclear devices or radiation or any acts of mass destruction to the governor, to the public health emergency planning council established under section 21 of this act, the joint committees on public safety and health care and the house and senate committees on ways and means.

SECTION 28.  Repeals

The Public Health Emergency Planning Council shall report to the Joint Committee on Health Care not later than 180 days of the effective date of this act, any acts, laws, or parts thereof, that should be repealed with the passage of this Act.

SECTION 29.  Possession of Biological Agents

Section 2 of chapter 111 of the General Laws, as appearing in the 2000 Official Edition, is hereby amended by adding the following paragraph:-

The commissioner shall compile and publish, consistent with federal law, a roster of biological agents, which constitute banned bio-hazardous substances under section 24 of chapter 270.

            (2) Chapter 270 of the General Laws is hereby amended by adding the following section:-

            Section 24.  (a).  For purposes of this section, the following words shall have the following meanings:-

            “Banned bio-hazardous substance”, anthrax, plague, botulism bacteria, smallpox virus or any other biological agent identified by the commissioner under section 2 of chapter 111 as posing a public health risk as a result of bio-terrorism or bio-warfare.

“Commissioner”, the commissioner of the department of public health.

            “Medical or scientific research”, medical or scientific research which entails the possession and handling of an otherwise banned bio-hazardous substance if such research has been approved by the commissioner or registered with the Centers for Disease Control and Prevention.

            “Person”, an individual, proprietorship, association, partnership, company, corporation, venture or joint venture.

            (b) Except as provided in subsection (c), any person who intentionally or knowingly possesses, gives away, transfers, sells, exposes for sale, delivers, manufactures distributes, receives, releases or disperses any banned bio-hazardous substance shall be punished by a fine of not less than $25,000 and by imprisonment in the state prison for life or for any term of years.

(c) A person who is authorized by the Centers for Disease Control and Prevention to possess an otherwise banned bio-hazardous substance for the purpose of medical or scientific research pursuant to 42 USC Sections 262-271 shall not be in violation of this section if the person possesses, receives, transfers, sells, delivers or distributes the otherwise banned bio-hazardous substance pursuant to the conditions imposed under such authorization by the Centers for Disease Control and Prevention.

            (d) A person under subsection (c) who receives such authorization from the Centers for Disease Control and Prevention shall provide a copy of the Center’s authorization to the commissioner.  The copy of the authorization received by the commissioner shall not be a public record as defined in section 7 of chapter 4, shall be confidential and shall not be subject to subpoena or discovery, except as otherwise specifically provided by law, and shall be maintained in a secure location with restricted access.

(a)    The attorney general shall have exclusive jurisdiction over prosecutions for violations of this section. 

SECTION 30.  Severability 

(b)   The provisions of this Act are severable.  If any provision of this Act or its application to any person or circumstances is held invalid in a federal or state court having jurisdiction, the invalidity will not affect other provisions or applications of this Act that can be given effect without the invalid provision or application.

(c)    This Act does not explicitly preempt other laws or regulations that preserve to a greater degree the powers of the Governor or public health authority, provided such laws or regulations are consistent, and do not otherwise restrict or interfere, with the operation or enforcement of the provisions of this Act.

(d)   This Act does not restrict any person from complying with federal law or regulations.

(e)    In the event of a conflict between this Act and other State or local laws or regulations concerning public health powers, the provisions of this Act apply.        

SECTION 31.  The provisions of this Act shall take effect upon its passage. 

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.