As the spread of infectious diseases does not respect governmental boundaries, protection of the public’s health often depends on effective cross-border collaboration among public health officials. However, cross-border collaboration raises legal issues because most actions taken by public health officials to prevent the spread of disease are authorized by state or local laws and regulations, meaning that these protections can only be implemented within the boundaries of the relevant state or local jurisdiction(s). Fortunately, these legal issues can frequently be resolved to the mutual satisfaction of public health officials and public health lawyers from collaborating jurisdictions through the development of trusting relationships and careful analysis and interpretation of relevant laws on each side of the border.
A team of researchers from the University of Wisconsin—Madison School of Nursing, with legal research support from Network attorneys, analyzed cross-jurisdictional sharing and shared service agreements between local public health departments in the state of Wisconsin. The goal of the project was to explore shared service agreements as a strategy for increasing capacity to provide local public health services. This report shares findings from the analysis and offers best practices for other jurisdictions considering shared service agreements.
A request was made for information about liability protections and license reciprocity for health care providers responding to emergencies across state lines and the Uniform Emergency Volunteer Health Practitioners Act (UEVHPA).
Cross-border legal challenges vary depending on the type of public health action under consideration and on the particular laws within relevant jurisdictions. A large-scale public health emergency, for example, may prompt a declaration of emergency by a state governor under the Emergency Management Assistance Compact. This action would authorize widespread sharing of public health supplies, equipment and personnel across state borders. But effective execution of public health functions during small-scale public health emergencies, or even in non-emergency situations, might be enhanced by exchange of epidemiologic information between state or local public health departments. In those situations, public health departments are often authorized to share protected health information under the federal Health Insurance Portability and Accountability Act. Furthermore, analysis of state and local privacy laws and provisions in public records laws that exempt certain types of information from the usual disclosure requirements has revealed that health information sharing is allowed when deemed necessary to protect public health. But in any instance where cross-border sharing of information, supplies, equipment or personnel is being considered, public health officials must consult with their attorneys to ensure that they are interpreting the relevant laws properly.
Network attorneys with background and experience in cross-border legal issues are available to public health officials interested in developing sharing agreements or memoranda of understanding with their geographic neighbors.
State or local governments along the U.S.-Canada and U.S.-Mexico borders face unique legal challenges when they wish to collaborate with their cross-border counterparts. The Network includes public health officials and attorneys who have worked extensively with organizations such as the U.S.–Mexico Border Health Commission and the Great Lakes Border Health Initiative and are available to provide legal technical assistance relating to international cross-border collaboration.
For legal technical assistance and support on cross-border public health:
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The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided does not constitute legal advice or legal representation. For legal advice, please consult specific legal counsel. For more information on the type of legal assistance the Network can provide, please see frequently asked questions.