The NYC Department of Health and Mental Hygiene (DOHMH) has requested NYC hospital CEOs to inform DOHMH of their plans regarding participation in the Federal pre-event smallpox vaccination program by January 13, 2003. The program, which was announced by President Bush on December 13, 2002, calls for the vaccination of approximately 450,000 health care and public health workers across the country for the purpose of developing smallpox response teams, which will consist of 100-200 workers in each hospital. The teams are intended to ensure the availability of health care workers in every hospital to care for the first one to five smallpox patients who might present to the hospital as well as to provide vaccination to the public should mass vaccination be needed in the future.
In order to implement the plan in NYC, DOHMH has requested that hospitals notify it by January 13, 2003, as to whether they will participate in the program. For those hospitals planning to participate, DOHMH also asks hospitals to provide, by January 17, 2003, information concerning the planned composition of their teams by category and what resources the hospital is able to provide in connection with the implementation of the program. To facilitate implementation, DOHMH has also distributed template letters that hospitals can use to introduce the program to hospital staff, as well as an information sheet regarding smallpox, the vaccine and its contraindications, and the vaccination plan. "Train the trainer" sessions will be provided by DOHMH in late January.
Separately, the NYS Department of Health (DOH) is sending letters to CEOs outside NYC outlining implementation of the plan, information to be supplied to local health departments, and the expected timelines.
RESOLUTION
WHEREAS, the Executive Committee of the GNYHA Board of Governors strongly believes that hospital participation in Phase I of the Federal pre-event smallpox vaccination program, which calls for the development of a vaccinated Smallpox Response Team in each hospital, is important to a hospital's ability to serve and protect its patients and its community; and
WHEREAS, the Executive Committee strongly believes that hospital participation in Phase I is important to a hospital's ability to protect its workers who may be called upon to care for suspect or actual smallpox cases; and
WHEREAS, the Executive Committee strongly believes that hospital participation in Phase I is important to the country's public health defense and emergency response systems;
NOW, THEREFORE, it is
RESOLVED that, the Executive Committee of the GNYHA Board of Governors expects that each hospital will participate in Phase I of the Federal pre-event smallpox vaccination program. The Executive Committee requests GNYHA staff to work with local, state, and Federal authorities to attempt to address specific concerns identified by hospitals with respect to implementation of the plan. The Executive Committee applauds those hospitals that have already agreed to create such teams and gives special recognition to health care workers who volunteer to participate on the teams.
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To facilitate member decision-making about participation, DOHMH Commissioner Thomas Frieden, M.D., M.P.H.; DOH Director of the Office of Health Systems Management Wayne Osten; and DOH Director of the Center for Community Health Guthrie Birkhead, M.D. attended GNYHA's Executive Committee meeting on January 9. As a result of the discussion at the meeting, GNYHA's Executive Committee adopted a resolution (see box) strongly encouraging all hospitals to participate in the program. Also on January 9, GNYHA held a meeting conducted by representatives of DOHMH and DOH to respond to members' questions about participation.
Vaccination Liability Protection: The Homeland Security Act, which becomes effective January 24, 2003, contains a provision that provides liability protection to smallpox vaccine manufacturers and distributors; health care entities under whose auspices the vaccination program is offered; the practitioners providing the vaccine; and the agents, employees, and officers of the manufacturers, health care entities, and the vaccinating practitioners. The provision applies to injuries arising from the primary vaccination as well as from the secondary transmission of the vaccine. Claims are to be filed with the Federal government pursuant to the Federal Torts Claims Act, which requires that the claimant show that negligence caused the injury. With respect to injuries to workers covered by a facility's Worker's Compensation policy, DOH has indicated that the State Worker's Compensation Board has stated preliminarily that such claims would "likely" be covered, subject to Worker's Compensation program requirements and limitations.
Foreground, left to right: Wayne M. Osten, Director, NYS DOH Office of Health Systems Management; Guthrie S. Birkhead, M.D., M.P.H., Director, NYS DOH Center for Community Health; and Thomas R. Frieden, M.D., M.P.H., Commissioner, NYC DOHMH discuss smallpox preparedness plans and the role of hospitals in preparing for and managing suspect smallpox cases with GNYHA's Executive Committee on January 9.
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