Organization and Legal Basis
of Public Health
Objectives
• Describe legal responsibilities and
limitations of the public health professional.
• Describe the general organization of public
health at the federal, state, and local levels.
• Describe how your jurisdiction or job fits into
the big picture.
2 of 23
Public Health v.
Personal Freedoms
3 of 23
Public Health v.
Personal Freedoms
Typhoid Mary
4 of 23
Public Health v.
Personal Freedoms
Vaccination
Mandatory Reporting
Inspection & Licensure
5 of 23
Public Health v.
Personal Freedoms
Public Nuisances
November 9, 1915
6 of 23
Legal Basis
• U.S. Constitution
Responsibilities
• Bill of Rights
• State Constitution
Authorities
• Federal and State
• Statutes
Limitations
• Regulations
• Case law
7 of 23
Due Process
Fairness in the procedural
application of the law:
Fair notice
Opportunity to
be heard
Clear procedures
8 of 23
Equal Protection
Laws must be applied
evenhandedly
People in similar
situations must be
treated similarly
Show no favoritism
9 of 23
Privacy
Governmental
intrusion must be
warranted
Individual Privacy vs.
Protection of
Population
10 of 23
Government Must Act…
Fairly
According
to clear
procedures
11 of 23
Organizational Structure
Federal Agencies
• Health Resources and Services
• Food and Drug Administration
• Centers for Disease Control and
Prevention
• National Institutes of Health
• Office of Public Health
Preparedness (OPHP)
13 of 23
State Agencies
Main legal authority for public health
• Structure varies by
state
• Centralized vs. local
control
• NY & NJ “Home
Rule” states
14 of 23
Legal Authorities
The governmental level
with highest authority has
the ultimate power.
Federal Rule
Federal Regulation
State Rule
State Regulation
Local Rule
Local Regulation
15 of 23
Duties of Local Health
Agencies
• Communicable disease control
• Chronic disease prevention and control
• Environmental health
• Maternal and child health
• Vital records
• Emergency planning and response
• Community health care planning
• Community health education
16 of 23
How Do You Fit In?
Functions of Law
• Regulates conduct
• Protects individual and property rights
• Defines the duties and responsibilities of
government and individuals
18 of 23
Legal versus Practical
• Search for the zone of agreement
• Be open, honest, and empathetic
• Negotiate & Communicate
19 of 23
Functions of Public Health
• Don’t abuse your
• Power
• Authority
• Ask yourself
• Is is legal for me to do this?
• Is it ethical for me to do
this?
• Understand how you fit in
20 of 23
Points to Remember
• Know what you
enforce
• Seek assistance
• Act in good faith
• Respect the public’s
trust
21 of 23
Liability
Can you get sued?
• MALFEASANCE
• The commission of an unlawful act
• MISFEASANCE
• Improper performance of an act which a
person might lawfully do
• NONFEASANCE
• Nonperformance of an act which should be
performed; omission to perform a required
duty or total neglect of duty
22 of 23
Case Study
23 of 23