# Presentation: 698194

## Multnomah and Lane County Health Departments, Oregon

**Multnomah and Lane County Health Departments, Oregon**

- Gary Oxman, MD, MPH
- Multnomah Health Officer Sarah Hendrickson, MD
- Lane County Health Officer
- Christine Bernsten
- MRC Project Coordinator

## Liability for Emergency Health Care Providers: Oregon’s Public Health Approach

- Presentation Objectives

- Give participants...
- Knowledge of Oregon’s approach to protecting volunteer emergency health care providers from liability
- An appreciation of benefits and limits of this approach

## Oregon’s ApproachA Confluence of Laws – 1Emergency Management (ORS 401)

- Governor may declare a state of emergency...
- at the request of a county governing body
- or after determining that an emergency has occurred or is imminent
- Governor may also suspend provisions of any state agency rule that would hinder response to an emergency

## Oregon’s ApproachA Confluence of Laws – 2Public Health Crisis (HB 2251)

- Governor may declare a state of impending public health crisis when...
- threat to the public health is imminent and likely to be widespread, life-threatening
- threat requires immediate medical action
- Declaration activates
- Liability protections for volunteers
- Expanded public health powers

## Oregon’s ApproachA Confluence of Laws – 3Public Health Laws (ORS 431 & 433)

- Establishes state Department of Human Services (DHS) as state public health agency
- Delegates authority and responsibility for public health laws and programs to counties (“local public health authority”)
- Recognizes authority and responsibility of state & local public health to prepare for and respond to emergencies

## Oregon’s ApproachA Confluence of Laws – 4 Tort Claims Act (ORS 30.260 – 30.300)

- Establishes state tort claims system as exclusive remedy for governmental negligence (no other civil action is permitted)
- Claim against public body (includes local government)  is substituted for claim against individual
- Award limits:
- $100,000 for individual
- $500,000 multiple individuals in single event

## Oregon’s ApproachA Confluence of Laws – 5 Tort Claims Act (ORS 30.260 – 30.300)

- Covers:
***Negligence*** claims based in agent’s performance of duties
- Failure to perform a discretionary duty, whether or not the discretion is abused

- Does NOT Cover:
- Acts of malfeasance
- Acts done or omitted in bad faith or with malice

## Oregon’s ApproachA Confluence of Laws – 6 Emergency Mgmt Revisions (HB 2410)

- Defines “emergency health care provider” (EHCP)
- Licensed, certified, or otherwise authorized to provide health care
- Gives DHS authority to establish registry of EHCPs. Registry addresses:

- Licensure or certification
- Credentialing

- Identification
- Clinical expertise
- Required training

## Oregon’s ApproachA Confluence of Laws – 7 Emergency Mgmt Revisions (HB 2410)

- Requires DHS to set criteria for health care response plans
- Gives DHS and counties power to declare facilities as “emergency health care centers” (EHCCs)
- Evaluation, triage, referral
- Treatment
- Preparation for transport

## Oregon’s ApproachA Confluence of Laws – 8 Emergency Mgmt Revisions (HB 2410)

- Makes EHCPs and other medical volunteers “agents” of the state for liability purposes
- Serve without compensation
- Provide services per health care response plan
- Applies only to emergency or impending public health crisis declared by governor

## Oregon’s ApproachA Confluence of Laws and Agreements:Local County Response

- Makes Lane Medical Reserve Corps members County volunteers
- Serve under direction of the Health and Human Services Administrator
- Requires completion of County volunteer sign up process
- MRC volunteers may be requested from Public Health by local hospitals and emergency response

## Slide 12

## A Confluence of Laws - Summary

- Basic Disaster Declaration Authority  ORS 401

- Impending PH          Crisis            HB 2251

***Expanded Declaration Authority***

**Coverage for Volunteer Providers**

- Basic Tort Claims Protection  ORS 30

- Providers = Agents of State HB 2410

- Basic PH Authority   ORS 433

- HC Provider Registry      HB 2410

- EHC Centers HB 2410

***Expanded PH Authority***

## Bottom Lines

- Oregon’s Approach:
- Provides strong liability protection for ***certain*** health care volunteers

- Licensed/certified
- Credentialed
- Providing defined services per plan

- Serving in declared emergency

## Limitations/Un-answered Questions

- Willingness of governor to declare emergency/PH crisis
- Willingness of counties to extend their Tort Claims liability (alternate approach)
- Willingness of providers to accept Tort Claims liability protection
- Status of retired health care professionals
- Status of unlicensed personnel
- Other (for discussion)

## Liability for Emergency Health Care Providers: Oregon’s Public Health Approach Questions

## Law and Bill Resources

- HB 2410
- http://www.leg.state.or.us/03reg/measures/hb2400.dir/hb2410.a.html
- HB 2251
- http://www.leg.state.or.us/03reg/measures/hb2200.dir/hb2251.a.html
- ORC 30
- http://www.leg.state.or.us/ors/030.html
- ORS 401
- http://www.leg.state.or.us/ors/401.html
- ORS 431
- http://www.leg.state.or.us/ors/431.html
- ORS 433
- http://www.leg.state.or.us/ors/433.html

## Contact Information

- Gary Oxman, MD, MPH
- Multnomah County Health Department
- 1120 SW Fifth Avenue, 14th floor    Portland, OR 97204
- 503-988-3663 x22640
- gary.l.oxman@co.multnomah.or.us
- Christine Bernsten, BA
- 503-988-3663 x28751
- christine.g.bernsten@co.multnomah.or.us
- Sarah Hendrickson, MD
- Lane County Health Department
- 135 East 6th Avenue, Eugene OR 97401
- 541-682-3956
- sarah.hendrickson@co.lane.or.us