Standards of Care During a Mass Casualty Event:
Interstate and Neighboring Community Cooperation
and Coordination, The Role of Uniform State
Legislation
Institute of Medicine Regional Workshop
April 14, 2009
Raymond P. Pepe
K&L Gates LLP
Barriers to Implementing
Alternative Standards of Care
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Lack of Authority to Promulgate
Alternative Standards
Civil Immunity Standards May Not
Recognize Alternative Standards and
Apply to All Affected Practitioners
Scope of Practice Limitations May
Impede Effective Responses
Barriers to Implementing
Alternative Standards of Care

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State Laws May Impede Access to
Electronic Healthcare Records
Insurance Coverage May Not Apply
Licensing Restrictions May Impede the
Movement of Practitioners Needed to
Create Surge Capacity
Differences in State Laws and Rules
May Impede Coordination
Uniform Emergency Volunteer
Health Practitioners Act

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Helps Remove Some of the Barriers to
Implementing Alternative Standards of
Care
Provides a Model for Promoting
Interstate Cooperation
Avoids the Need for Federal
Preemption
What is NCCUSL?
The National Conference of
Commissioners on Uniform State Laws is:
 The oldest state governmental
organization in existence. Since 1892 it
has fulfilled a primary role in the U.S. for
the improvement of state law
 An organization of legal professionals
 An organization of state officials
devoted to improvement of state law
NCCUSL’s Value

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NCCUSL’s work reduces pressure for
federal preemption due to inconsistent state
law
NCCUSL has helped preserve the federal
system crafted in Philadelphia over 200
years ago
Uniform Acts enable PA to take advantage
of judicial precedent established in multiple
states interpreting the same legal provisions
Membership

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The current membership consists of 315
lawyers, who fall generally into four
categories:
Private Practitioners - 193
Governmental Lawyers - 44
Judges - 28
Educators - 50
There are 32 legislators in NCCUSL,
many of whom are also private
practitioners or educators.
Appointment
•
•
Each State determines the mode of
appointment.
Representative of State Legislative
Reference Bureaus and Law Reform
Commissions serve as ex officio
members.
The Work of
Commissioners
Commissioners represent their States,
without compensation, by:
Serving on NCCUSL study, drafting and
other committees
Representing their State at the NCCUSL
Annual Meeting
Carrying Uniform and Model Acts back to
their States and working to assist the
Legislature in its consideration.
Widely Enacted Uniform Acts
Promulgated by the ULC

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Anatomical Gift Act (36
states)
Arbitration Act (49 states)
Athletic Agents Act (38
states)
Child Custody Jurisdiction
and Enforcement Act (48
states)
Commercial Code (all
states)
Conservation Easements
(24 states)

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Determination of Death Act
(43 states)
Electronic Transactions Act
(48 states)
Enforcement of Foreign
Judgments (47 states)
Environmental Covenants
(28 states)
Federal Lien Registration
Act (36 states)
Fraudulent Transfers Act
(44 states)
Widely Enacted Uniform Acts
Promulgated by the ULC

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Interstate Family
Support Act (all states)
Management of
Institutional Funds Act
(48 states)
Partnership Act (39
states)
Principle and Interest
Act (43 states)
Prudent Investor Act
(46 states)
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Real Property
Electronic Recording
Act (20 states)
TOD Securities
Registration Act (49
states)
Trade Secrets Act (46
states)
Transfer to Minors Act
(49 states)
Trust Code (21 states)
Drafting Uniform and Model
Acts – Step 1


A proposal is submitted to the Scope
and Program Committee, which
reviews all proposals.
The Committee may recommend to
the NCCUSL Executive Committee a
drafting project or further study.
Step 1 cont’d


The Executive Committee may accept
the recommendation of Scope &
Program.
If so, the President is authorized to
appoint a drafting or study committee.
Standards
“the subject . . . shall be such that
uniformity of law among States will
produce significant benefits to the
public through improvements in the
law . . . or will avoid significant
disadvantages likely to arise from
diversity of state law…”
Step 2: The Drafting
Committee
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Drafting committee members are
appointed by the NCCUSL President
from among the commissioners.
A reporter is usually recruited for the
drafting committee. Generally a scholar
with credentials in that area of law is
recruited.
The American Bar Association appoints
advisors by agreement between the
ABA and NCCUSL.
Committee Work cont’d
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Notices of meetings and drafts are
sent to anyone on request.
Those who do not desire to participate
in meetings are invited to provide
written commentary.
The NCCUSL website maintains
calendars and allows committees to
establish bulletin boards and
listserves.
Committee Work cont’d
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The Chair of each committee is in
charge of the meeting.
Final Committee decisions are made by
committee members, but advisors and
observers actively participate.
Written comments solicited and
considered.
Step 4: Annual Meeting
Consideration of Acts

7 intensive days in July/August

Every drafting committee must read and
defend its act before the entire body of
uniform law commissioners during at least
two annual meetings.

Once the body of commissioners is
satisfied, the act is put to a vote by states
for final promulgation.
Exceptional Meetings
“ I have seen many deliberative bodies
before and since, but in none were the
discussions of the same high quality.”
William H. Rehnquist
Chief Justice of the United States
Supreme Court
NCCUSL Commissioner from
1963-69
Final Disposal
• No uniform or model act becomes law
until a state legislature enacts it and a
state governor signs it. The Uniform Law
Commissioners may propose, but the
state legislatures must dispose.
• Uniform Law Commissioners do not draft
legislation for Congress, and generally
oppose efforts to federalize subject areas in
which uniform and model acts are drafted.
New Acts Being
Developed or Considered
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Business Ownership
Reporting
Collaborative Law
Collateral
Consequences of
Convictions
Division of Income
for Tax Purposes
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Electronic
Recording of
Custodial
Interrogations
Insurable Interests
Held by Trusts
Marital and
Premarital
Agreements
Acts Being Developed or
Considered
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Intestate Succession
for Children of Assisted
Reproduction
Misuse of Genetic
Information
Model State
Administrative
Procedures
Notarial Acts
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Presidential Electors
Regulation of Charities
Real Property Transfer
on Death
Statutory Trusts
Tenancy in Common
Partition
Harmonization of
Business Entities
NCCUSL Website
www.nccusl.org is the NCCUSL website. It
contains:
• organizational information;
• current drafting committees;
• press releases;
• legislative information and enactment
status of selected acts, updated regularly;
• drafts of current projects and texts of most
final uniform acts, which can be
downloaded.
Uniform Emergency Volunteer
Health Practitioners Act

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Robust System for Interstate
Recognition of Health Practitioner
Licenses (supplements EMAC)
Extends Civil Immunity and Workers
Compensation Benefits to Emergency
Volunteers
Defines Permissible Interstate Scope
of Practice
Uniform Emergency Volunteer
Health Practitioners Act

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Permits Modifications to Scope of
Practice
Enhances State Emergency
Management Authority
Controls Spontaneous Volunteerism
Creates Interstate System for
Disciplinary Enforcement
Contact Information
Raymond P. Pepe
PA Commissioner
K&L Gates LLP
17 North 2nd Street
Harrisburg, PA 17101
717.231.5988
John A. Sebert
Executive Director
Suite 1010
111 N. Wabash Ave
Chicago, IL 60602
312.450.6603
Raymond.Pepe@KLGates.com
john.sebert@nccusl.org