States Leverage Executive Authority to Address Severe Flu Season

February 01, 2018|3:34 p.m.| ASTHO Staff

With this year’s flu season still going strong, activities to prevent the spread of flu remain key. From handwashing to limiting contact with others when you are sick, each individual plays a role in reducing spread. It is not too late to get a flu vaccine and important to recognize flu symptoms and know when to seek treatment. Governors in Alabama and New York addressed expanding access to treatment and vaccines when they recently issued emergency declarations to address the flu in their states.

Alabama Gov. Kay Ivey issued a state public health emergency declaration on Jan. 11. The declaration broadly directed state agencies to exercise “statutory and regulatory authority to assist communities and entities affected” with the influenza virus, and specifically tasked the Alabama Department of Public Health and Alabama Emergency Management agency to seek assistance from the federal government. In addition, the declaration authorized healthcare facilities operating under emergency operations plans to implement “alternative standards of care plans” in order to efficiently treat the high volume of patients seeking care at those facilities. Finally, the declaration deemed “healthcare professionals and assisting personnel executing in good faith under the ‘alternative standards of care’ to be emergency management workers of the state of Alabama,” which provides additional flexibilities and immunities.

In addition to sponsoring flu shot clinics, the Alabama Department of Public Health has taken specific steps to address the flu. The department now receives reports of potential adult flu-related deaths in addition to pediatric flu-related deaths. This will allow the department to better track the spread and impact of the disease. The department also recommends that individuals with flu symptoms call healthcare or insurance providers to see if they can obtain antivirals without an appointment and encourages schools and employers to waive requirements for doctors’ notes to excuse absences so that sick individuals can limit contact with others by remaining home to recover. Alabama’s declaration will remain in effect until modified or rescinded by the governor.

In New York, Gov. Andrew M. Cuomo issued a disaster emergency declaration on Jan. 25. The declaration temporarily suspends provisions of state law and regulations to allow pharmacists who meet training and other requirements to administer influenza vaccines to patients older than two years of age. Complementing the order, the governor tasked the New York State Department of Health with continuing to surveil hospitals to determine capacity and supply of vaccines and antiviral medications, coordinating with health associations to ensure capacity, collaborating with federal partners to ensure adequate supplies of flu vaccines, and encouraging New Yorkers to get a flu vaccine. This declaration will also remain in effect until modified or rescinded by the governor.

Executive orders and other emergency or disaster declarations can provide important tools and flexibility for state agencies to nimbly respond to public health threats and crises such as the flu. According to a CDC presentation at the 2016 NACCHO Preparedness Summit, at least 22 executive orders or other mechanisms have been issued to address influenza across 12 states from 2004-2014. While the slides highlight the variation that occurs across states as emergency declarations are tailored to the unique legal landscape and events unfolding, they also identify similar areas of focus such as enhancing access to vaccines and improving coordination across government entities.

Beyond executive actions, state legislatures can play a key role in advancing policies to encourage flu vaccinations, particularly among vulnerable populations. For example, a current bill in Alabama (HB 60) would require daycare centers to provide parents or guardians with information about the flu and vaccine recommendations. Also, a bill in Indiana (HB 1058) would require operators of certain assisted living facilities to provide residents with information about the flu’s causes and symptoms and the availability, effectiveness, and contraindications of the flu vaccine. As the year unfolds, ASTHO will continue to follow these and other bills that support the development and implementation of sound public health policies and programs. For more information about the bills mentioned above and other proposed vaccination legislation, please visit ASTHO’s legislative tracking page.