Recommendation 3: Seek Community and Provider Engagement

State, local, and tribal governments should partner with and work to ensure strong public engagement of community and provider stakeholders, with particular attention to the needs of vulnerable populations and those with medical special needs, in:

  • Developing and refining crisis standards of care protocols and implementation guidance;

  • Creating and disseminating educational tools and messages to both the public and health professionals;

  • Developing and implementing crisis communication strategies;

  • Developing and implementing community resilience strategies; and

  • Learning from and improving crisis standards of care response situations.

LEGAL ISSUES IN EMERGENCIES

Significant legal challenges may arise in establishing and implementing crisis standards of care. Questions of legal empowerment of various actions to protect individual and communal health are pervasive and complicated by interjurisdictional inconsistencies. The law must inform prevailing standards of care and create incentives for actors to maximize individual and communal health, while also respecting both individual and community rights as much as possible.

Distinguishing Medical and Legal Standards of Care and Scope of Practice

Modern studies and assessments improve our understanding of how healthcare services change during emergencies to ensure optimal health outcomes (AHRQ, 2005b; GAO, 2008; AMA, 2007; Romig, 2009; Christian et al., 2006; Kanter, 2007). Various actors must be able to organize and effectively use limited medical resources consistent with “cri-



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