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From Health Law Daily, October 16, 2014

Ebola spreads alongside opinions about how to address it

By Bryant Storm, JD

Growing concerns about the reach of Ebola into the United States have led to strong and disparate responses from senators, hospitals, HHS, and the Centers for Disease Control (CDC). While some, like HHS Secretary Sylvia Burwell, have expressed their support for the manner in which federal agencies have addressed the issue, others, like House Speaker John Boehner (R-OH), have been critical of the administration’s response to the “Ebola crisis.” Taking a more constructive approach, Senators Barbara Boxer (D-CA) and Dianne Feinstein (D-CA) aimed to assist the CDC in managing the outbreak by asking California hospitals how protocols and procedures could be improved to better prepare providers for the threat of Ebola.

HHS. In an interview on NBC’s Today, Secretary Burwell commented on the adequacy of protocols being used to combat Ebola in the Texas hospital where Thomas Eric Duncan, the first patient diagnosed with Ebola in the United States, was treated. The protocols have come under scrutiny because two of the health care workers who treated Duncan have now been diagnosed with the virus and were being treated in the same hospital. In response to questions about what steps HHS and the CDC should take, Secretary Burwell commented that “what we have put in place are what we believe are oversight and assistance in the protocols we know can work." Secretary Burwell also said that she had confidence in the CDC and its Director, Dr. Tom Frieden.

Speaker Boehner. Speaker Boehner released a far more critical statement that expressed concerns about the administration’s handling of Ebola in the U.S. and abroad. Suggesting that the President should consider implementing a temporary ban on travel to the United States from countries afflicted with the virus, Speaker Boehner indicated that action needed to be taken to ensure the security of air travel systems. Referring to oversight from a variety of congressional committees, Speaker Boehner cautioned the administration that its actions would be “aggressively assessed” and that, in the absence of executive action, Congress would act through legislation if necessary to ensure that Ebola is effectively countered.

Hospitals. Senator Boxer took a different approach when addressing the crisis and asked the CDC to review the findings of a survey initiated by herself and Senator Feinstein. The Senators obtained their findings through a request sent, on October 3, 2014, to two major California hospital associations seeking responses about perceived gaps in the ability of California to “safely screen, diagnose and treat any potential Ebola patients.”

CHA. The California Hospital Association (CHA) responded to the Senators’ request with results that were both reassuring and concerning. Regarding patient care and planning, the CHA indicated that both the CHA and the CDC have engaged in education, training, information dissemination, and other activities to support California hospitals in being prepared for all kinds of infectious diseases. The preparedness initiatives include an emergency preparation website and disaster planning seminars. Additionally, the CHA indicated that several guidance documents, checklists, and tools had been made available by the CDC to assist hospitals in preparing for situations like the Ebola outbreak.

With respect to patient care, the CHA revealed that some California hospitals responding to the survey indicated that they experienced some difficulty in implementing CDC guidelines because of inconsistencies between federal, state, and local agency requirements. Several hospitals also expressed concerns that they were unsure of how to: dispose of Ebola waste, undertake patient transfers, dispose of the remains of infected deceased patients, manage staffing demands, and address supply shortages in the case of outbreaks.

CAPH. The California Association of Public Hospitals and Health Systems (CAPH) also responded to the request and highlighted several opinions similar to those expressed by the CHA. The CAPH indicated that its hospitals found CDC guidance to be extremely detailed and helpful. Additionally, the CAPH indicated that there were substantial precautionary measures and checklists in place to help California hospitals combat an Ebola outbreak. However, like the CHA, the CAPH did say that some facilities expressed concerns about handling waste associated with Ebola.

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