AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES

Resolution: __(I-03)

Introduced by:      American College of Preventive Medicine

Subject:                Improving regional terrorism and disaster preparedness and response

Referred to:           Reference Committee __

Whereas, Our American Medical Association acknowledges that the national security of the United States is dependent to a significant degree on the scientific, medical and public health community’s actions (BOT Report 26-1-01); and

Whereas, the United States is relying on the entire healthcare system as much as or more than it has relied on the armed forces in the past to achieve and maintain security in the face of terrorism and disaster preparedness (BOT Report 26-1-01); and

Whereas, Our American Medical Association has been a strong advocate to improve the nation’s medical preparedness in the event of a national emergency, including collaboration with the Department of Defense, implementation of the National Disaster Medical System, and various educational and collaborative meetings with national experts and commissions (BOT Report 26-1-01); and

Whereas, Our American Medical Association is uniquely positioned to bridge the gap between private sector medicine, academic institutions, state and local public health agencies, non-governmental organizations, and Federal agencies; and

Whereas, the General Accounting Office has found that regional planning for public health emergencies and bioterrorism is lacking between states (GAO-03-654T) and that hospital, public health and laboratory staff surge capacity will likely be exceeded in a large-scale disease outbreak (GAO-03-1058T); and

Whereas, local, state and Federal public health officials struggled with the degree of coordination required to provide a rapid and effective response to the anthrax attacks of 2001 (GAO-04-152); and

Whereas, the Federal role in preparedness, planning and emergency response to bioterrorism and public health emergencies needs to be clarified (Biosecurity and Bioterrorism 1(2):97-110, 2003); and

Whereas, proactive information dissemination to the professional healthcare community and to the public via the media is critical to maintain public confidence in an effective response (Biosecurity and Bioterrorism 1(2):97-110, 2003); therefore be it

RESOLVED, that our AMA call on the Department of Homeland Security and the Department of Health and Human Services to assure a multi-state coordinating capacity that would provide for more effective local, state, and interstate response to terrorist incidents, including planning, mass casualty care, and risk communication efforts (New HOD Policy); and be it further

RESOLVED, that our AMA call on the Department of Health and Human Services and the United States Public Health Service to expand the Medical Reserve Corps, a branch of the Citizen Corps, to include regional and nationwide organization of volunteer healthcare professionals to provide additional personnel surge capacity in a national level medical response, including organizational requirements, educational and training needs, and credentialing and liability issues (New HOD Policy); and be it further

RESOLVED, that our AMA call on Federal and state agencies to develop a common credentialing standard with liability protection mechanisms to rapidly credential healthcare providers from other states to facilitate a regional or national level response (New HOD Policy); and be it further

RESOLVED, that the AMA send letters to the President, Secretary of Homeland Security, Secretary of Health and Human Services, Surgeon General, and appropriate members of Congress urging such action (Directive to Take Action).

Fiscal Note:  No significant fiscal impact.

Existing AMA Policy

H-130.946 AMA Leadership in the Medical Response to Terrorism and Other Disasters

Our AMA: (1) condemns terrorism in all its forms and provide leadership in coordinating efforts to improve the medical and public health response to terrorism and other disasters;

(2) join in working with the Office of Homeland Security, the Department of Health and Human Services, the Department of Defense, the Federal Emergency Management Agency, and other appropriate federal agencies; state, local, and medical specialty societies; other health care associations; and private foundations to (a) ensure adequate resources, supplies, and training to enhance the medical and public health response to terrorism and other disasters; (b) develop a comprehensive strategy to assure surge capacity to address mass casualty care; (c) implement communications strategies to inform health care professionals and the public about a terrorist attack or other major disaster, including local information on available medical and mental health services; (d) convene local and regional workshops to share "best practices" and "lessons learned" from disaster planning and response activities; (e) organize annual symposia to share new scientific knowledge and information for enhancing the medical and public health response to terrorism and other disasters; and (f) develop joint educational programs to enhance clinical collaboration and increase physician knowledge of the diagnosis and treatment of depression, anxiety, and post traumatic stress disorders associated with exposure to disaster, tragedy, and trauma;

(3) urges Congress to appropriate funds to support research and development (a) to improve understanding of the epidemiology, pathogenesis, and treatment of potential bioweapon agents and the immune response to such agents; (b) for new and more effective vaccines, pharmaceuticals, and antidotes against biological and chemical weapons; (c) for enhancing the shelf life of existing vaccines, pharmaceuticals, and antidotes; and (d) for improving biological and chemical agent detection and defense capabilities;

(4) believes all physicians should be (a) alert to the occurrence of unexplained illness and death in the community; (b) knowledgeable of disease surveillance and control capabilities for responding to unusual clusters of diseases, symptoms, or presentations; and (c) familiar with the clinical manifestations, diagnostic techniques, isolation precautions, and chemotherapy/prophylaxis of chemical and biological agents likely to be used in a terrorist attack; and

(5) believes physicians and medical societies should participate directly with state, local, and national public health, law enforcement, and emergency management authorities in developing and implementing disaster preparedness and response protocols in their communities, hospitals, and practices in preparation for terrorism and other disasters. (BOT Rep. 26, I-01; Reaffirmed: BOT Rep. 3, I-02)

D-435.991 Bioterrorism – Protection from Liability

Our AMA shall continue to work with the Congress to protect physicians from liability arising from providing medical care in an organized governmental response to bioterrorism. (Res. 409, A-02)

D-130.992 Medical Preparedness for Terrorism and Other Disasters

(1) Our AMA will call for the creation of a public-private entity (including federal, military, and public health content experts) that will collaborate with medical educators and medical specialty societies to: (a) develop audience-specific medical education curricula on disaster medicine and the medical response to terrorism, with a first charge to develop curricula on bioterrorism, and disseminate these to medical students, physicians in training, and physicians in practice; (b) develop information resources on disaster medicine and the medical response to terrorism for civilian physicians and other health care workers; (c) encourage and work with state and specialty societies, the Centers for Disease Control and Prevention, the Office for Emergency Preparedness, the Agency for Healthcare Research and Quality, the pharmaceutical industry, and other appropriate federal, military and private organizations to develop model plans for community medical response to disasters, including terrorism; (d) address the issue of reliable, timely, and adequate reporting of dangerous diseases by community physicians to public health authorities; and. (e) our AMA report back to the House of Delegates on the status of this public-private entity as appropriate.

(2) Our AMA will encourage the Federation of Medicine to become involved in planning for the medical component of responses to disasters, including terrorism, at levels appropriate to the Federation component: (a) county/local medical societies and organized medical staffs are encouraged to become involved in local public health and community planning and physician education; (b) state societies are encouraged to become involved in state response planning and physician education; and (c) specialty societies are encouraged to take the lead in conducting and encouraging education of their members in essential components of disaster medicine, as well as encouraging their members to participate in local response planning.