Leadership Trailblazer Spotlight: Donna Levin, Act for Public Health Project Director, Network for Public Health Law

October 28, 2022 | ASTHO Staff

The legal landscape of public health authority has changed considerably over the past several years. What should current legislators know as they shape future policies?

It would be wonderful if legislators could learn more about what public health is and what public health departments do. This should include how closely the very important work of these agencies is tied to the authority given to them, and how the health and health equity of their jurisdictions—state, county, municipal and community—is impacted by daily public health and emergency authority.

Legislators should also understand the critical need for continuous, sustained funding—not just for the problem/disease “du jour,” or for a public health intervention that works and consequently is not adequately funded going forward (e.g., childhood vaccines).

Recently, in response to public health measures taken to address COVID-19, more than half of U.S. states have passed legislation that will undermine public health now and in the future. A greater understanding by legislatures of the consequences, both intended and unintended, of this kind of legislation on the health of their constituents is critically needed.

For the past two years, a working group of the Network for Public Health Law and other public health law partners have joined together in the Act for Public Health (A4PH) initiative that provides resources, technical assistance, and training to increase understanding of public health and public health authority, and to help push back against attempts to block public health officials’ ability to do their job.

Why should people consider a career in public health law? What makes it different than other forms of health-related legal practice, and why is it such an important specialty?

Because it is an immediate way to be part of the solution, and because it is incredibly interesting, challenging and, YES, fun!

Public health issues are so numerous and include harm reduction, injuries/opioid overdose, maternal and child health, environmental health, chronic and infectious disease, food safety, public health emergency preparation and response, and so much more. And since it is always changing you will never be bored!

You can count on learning more all the time, and you will be working with other lawyers and disciplines—medicine, epidemiology, behavioral scientists—all of whom have an incredibly aligned sense of mission and purpose. You will be part of a fantastic team of peers!

During your time with the Massachusetts Department of Health, what was one of the most interesting legal issues you dealt with?

Two important issues stand out for me. First, in 1997, Massachusetts was one of the first states to expand newborn screening (NBS) when the technology advanced to screen for additional disorders. This effort involved standing up a NBS Advisory Committee that included parents, physicians, researchers, ethicists, and others to pave the way for the expanded program by solving a myriad of legal, ethical, and logistical problems.

Second, following the 9/11 attacks, I helped establish and worked with an expert advisory committee to create a process and standards for allocating scarce resources during a public health emergency.  As a result of that work, I was invited to the then Institute of Medicine’s Committee on Guidance for Establishing Standards of Care for Use in Disaster Situations and worked with others on a Letter Report published in 2009 and a Six Volume Framework for Catastrophic Disaster Response published in 2012. These reports remained relevant as we entered the recent pandemic during which several states invoked crisis standards of care.

You just retired as the longest-serving executive director of the Network for Public Health Law. What are you most proud of, and why is the Network an important partner in the field?

I am so proud of the work the Network does so it is hard to choose. We develop great resources and train and educate public health lawyers and practitioners about their authority and how to use it—we bring them together at conferences and provide legal technical assistance.

I was the General Counsel of the well-funded, well-regarded Office of General Counsel for the Massachusetts Department of Health before coming to the Network. But not all state, and especially county and local health, departments have dedicated lawyers. So, I am exceptionally proud of the no-cost, real time technical assistance we have been able to provide to our colleagues on the front lines for more than 10 years.

Public health has a rich history of women in leadership. Are there any figures who inspire you most?

Dr. Deborah Prothrow-Stith was one of the Massachusetts Department of Public Health Commissioners I worked with as General Counsel. She stands out for me as an inspiration for her dedication to the field and for working on youth violence long before anyone understood that to be a public health issue.

I also am currently following the work of Judy Monroe, former CDC Deputy Directory and former Director of CDC’s Office of State, Tribal, Local and Territorial Support. She also served as Indiana’s State Health Commissioner following a career in medicine. Currently, Dr. Monroe is the very effective CEO of the CDC Foundation, which funds projects that protect and enhance the public’s health.

Dr. Monroe recently co- chaired the Indiana’s Governor appointed Commission on Public Health—formed to study sider the state’s public health system. This circles back neatly to the earlier first question on what legislators need to know about public health authority. The Commission has issued a report based on a look at the response to the pandemic and what is needed going forward. I very much admire that critically needed work.

And as I retire and exit the field, I am very impressed with and thankful for all the younger women I have had the pleasure to work with and those who are joining the public health law workforce—they are committed, energized, and terrific. Fabulous!