Public Health Law News

Director of the Southeastern Regional Center of the Network for Public Health Law; Senior Fellow at the North Carolina Institute for Public Health at the University of North Carolina Gillings School of Global Public Health

JD, University of North Carolina at Chapel Hill School of Law; BA, history and mathematics, University of North Carolina at Chapel Hill

Public Health Law News (PHLN): Please describe your education and career path.

Matthews: I graduated from law school at the University of North Carolina (UNC), and at the time, my wife was going to graduate school to get her master’s degree in public health. So, I had that ticking away in the back of my mind. After law school, I did some other things but came back to public health and was working with the Office of the General Counsel for Health and Human Services in Washington, DC, when the job with CDC opened. I took the job as chief general counsel for CDC in 1979, and it was the professional opportunity of my life. I never looked back, and I have no regrets. When I started at CDC, it was me and one administrative assistant. When I left in 2004, 25 years later, we had about 30 people working in the Office of the General Counsel for CDC, and the Public Health Law Program (PHLP) was well underway.

PHLN: How did you become interested in public health law?

Matthews: When I was at UNC, in my last year of law school I took a health law course at the UNC School of Government. That’s where I became “infected”; that was the original germ that contaminated my career. Also, my wife was a public health nurse and taught at nursing schools and was in the field. I was very interested and had been hoping to crack into the public health law field when the job came open at CDC. So, I applied and the rest is history.

PHLN: You were CDC’s chief legal counsel from 1979 to 2004. Can you describe some of the most significant public health changes and challenges you observed during your tenure?

Matthews: I feel like the Forrest Gump of public health law. I was there for most of it by great fortune. My career began with the AIDS epidemic. I was in the room in June 1981 when the first four AIDS cases were reported to the CDC director at his Wednesday afternoon staff meeting. Then, toward the end of my tenure at CDC, I was in my office on September 11, 2001, planning the first Public Health Law Conference, when my son called me from New York and told me to turn on the TV because planes had hit the World Trade Center.

So, those were the two big events that bookended my CDC career—the AIDS epidemic and all that was associated with it for about 15 years—and the emergency preparedness and public health law issues associated with first the terrorist attacks of September 11, 2001 and the subsequent anthrax attacks through the US mail, which precipitated PHLP’s creation.

AIDS was the defining issue for the career of a whole cohort of CDC leaders in the 1980s, many of whom were around from 1998–2001 and helped us develop and launch PHLP.

Within and around those two big public health events and catalysts, I worked on a variety of other issues and, with the generosity of CDC offering resources and full-time staff, I also worked to build the Department of Health and Human Services Office of the General Counsel at CDC.

PHLN: What is the Network for Public Health Law (“the Network”) and how does it advance public health?

Matthews: The Robert Wood Johnson Foundation (RWJF) created the Network seven years ago. It comprises a national coordinating center and five regional offices. I direct the southeastern regional office, which is based at UNC Chapel Hill.

The Network’s job is to build the field of public health law through three main functions: 1) provide technical assistance to practitioners in the field, be they state or local health departments or non-profits; 2) offer training, communication, and education about public health law (we offer many webinars, conference trainings, and professional development opportunities); and 3) build and serve as a connector in the field by offering opportunities to engage and network with the many public health law “nodes” and also by hosting the Public Health Law Conference.

PHLN: What are your day-to-day responsibilities as the director of the Network’s southeastern regional center?

	Gene Matthews and Corey Davis at North Carolina local health directors’ training in Chapel Hill, April 2016.

Gene Matthews and Corey Davis at North Carolina local health directors’ training in Chapel Hill, April 2016.

Matthews: I supervise a staff of four attorneys and some law interns. Our first job is to address technical assistance requests from states in our region. We maintain expertise in specific topic areas that are unique to us, and we provide support to other regions as well.

Our inventory of expertise includes public health issues around prescription drug and opioids, for example. The attorney in charge of that, Corey Davis, has collaborated with CDC and the former director of the White House Office of National Drug Control Policy, Michael Botticelli, to create a robust library of information and materials about opioid-related public health law.

We also have lawyers working with the National Health Law Program who are on the cutting edge of the health law reform. Most recently they’ve been working on the proposed changes to the Patient Protection and Affordable Care Act.

PHLN: What projects have you been working on recently?

Matthews: I’ve been working with other colleagues to craft richer messages for public health to reach broader audiences. This is at the center of the advocacy piece in the Five Essential Public Health Law Services.

I’ve also spent a good deal of time building relationships between local public health departments and their area hospitals for community health needs assessments and stakeholder-building with community coalitions. We are now looking at how GIS mapping of social determinants of health at the census track area is a powerful tool for local coalition building of hospitals and health departments within local health communities. In my opinion, community coalition building is the heart of public health.

Every day is different, and every day is fresh. I think it’s neat to see how you can connect the dots. It’s a creative and exciting area of work.

PHLN: You’ve been a national leader in public health law for most of your career. During your time in the field, how has public health law changed?

Matthews: Public health law has changed significantly. I spoke about this at the opening plenary at the most recent Public Health Law Conference in September 2016. I’ve lived through much of the four areas of the modern public health law renaissance, which is an ongoing journey that we’re on.

In the first phase, from 1950 to about 2000 or 2001, legal expertise existed in isolated nodes within academia, state and large city health departments, and in non-profits. We weren’t a field, and we were all operating independently without a shared consciousness that we were working in the same area. Then, in phase two, CDC leaders in the late 1990s started looking into whether we should be doing something to build the field of public health law.

We began asking how we could build it into another recognized tool to help public health practice. The leaders for this were both inside and outside of CDC—people like Larry Gostin at Georgetown University College of Law, CDC’s Office of the General Counsel, along with Rick Goodman and Tony Moulton, who also worked at CDC. We received a lot of support from CDC leaders, including CDC Director Jeff Koplan, CDC Deputy Director Martha Katz, the director of the CDC Public Health Practice Office, Dr. Ed Baker, and, then head of CDC’s Chronic Disease Center, Jim Marks.

PHLP was launched in about 2000 or 2001, very nearly coinciding with time of the September 11, 2001, terrorist attacks on the World Trade Center and the anthrax attacks. Suddenly everyone was interested in public health law, specifically issues like quarantine and isolation. The preparedness funding streams went out to states, and we used that money to help build this field. At the same time, academic centers and non-governmental organizations began to expand, publishing and sharing their public health law research. Building on this momentum and the need for a public health law network, CDC hosted the first Public Health Law Conference in 2002, and it was like the reunion of the lost tribe. It was great.

In the third phase of the renaissance, philanthropic organizations, specifically RWJF, began funding a whole new suite of public health law initiatives around 2007. This was in great part because Jim Marks had left CDC and was a vice president at RWJF. He knew about public health law from his time at CDC and was a firm supporter. He instigated a whole cluster of new public health law initiatives, including funding a public health law research program at Temple University, supporting and working on getting a legal “Domain 6” included in the Public Health Accreditation Program, and standing up the Network for Public Health Law in 2010. So, in this era of the renaissance CDC and private foundations were really collaborating.

In this current fourth phase, we’re moving into a new territory. We’re looking at new research tools like legal epidemiology, LawAtlas, and a systems approach to public health law. We’re also looking at a transdisciplinary, multi-sector advocacy approach to the Five Essential Health Law Services, etc. A lot of these changes are based on technology. As lawyers, we all work differently from what we used to—and we collaborate more easily. Searching law effortlessly from your desk is something that wasn’t available 25 years ago. Making partnerships virtually wasn’t how you connected people back then.

PHLN: In what direction(s) do you see public health law evolving?

Matthews: Public health law evolves as public health evolves. We’re moving into new areas. The field of public health and the public health system understand that public health law is an essential part of public health practice; lawyers used to be considered as technicians, like human resources or information technology professionals—we weren’t part of the leadership thinking. But we’re at the table now, and it’s clear that when you want to change law and policy to implement an intervention, you need legal skills, lawyers, advocates, communications specialists, and scientists to make it work.

In the next four years we anticipate less emphasis on the big, federal, overarching funding streams and more emphasis on funding streams to local governments emphasizing more granular, locally driven type of initiatives. With that local focus, we’ll still need to provide public health law support because most local jurisdictions can’t afford dedicated legal support for public health. So, that’s going to be a challenge.

As changes are made to large federal infrastructure systems that have been in place since the 1960s, we’re also going to have to figure out how to continue supporting public health with modified or fewer resources.

PHLN: What advice do you have for students and young professionals interested in public health law?

Matthews: You have to figure out what your passion is and what drives you. Then whatever your passion is, do that. To me it’s public health law. You won’t make the same amount of money in public health law as you might in a silk stocking private law firm, but the amount of satisfaction is immense. So it’s been a thrill to have had this ride.

PHLN: What’s your favorite part of your job?

Matthews: Now, and in my 25 years at CDC, the best part is being able to engage people on something really meaningful. If you give me the Meyers-Briggs test, I test out as an introvert. But I can stand up and do a plenary in front of 500 people because it’s something I’m passionate for, it’s something that I know and love. It’s meaningful and thrilling to talk to people and engage with people about their real problems. Working with all these public health giants from the small pox era was a thrill in 1979. I loved it. And I’m thrilled to do it now with the Network for public health law.

PHLN: What would you be doing if you weren’t working in public health law?

Matthews: If I weren’t working in public health law, I’d be spoiling my grandchildren even more; the thrill of my day is picking up my grand girls in the afternoon and spoiling them rotten.

PHLN: Have you read any good books lately?

Matthews: Hillbilly Elegy by J.D. Vance

PHLN: If you could travel anywhere in the world, where would you go and what would you do?

Matthews: I’d go back to the Amalfi Coast or return to Micronesia to see the atolls.

PHLN: Do you have any hobbies?

Matthews: I enjoy swimming, reading, and keeping in touch with my colleagues.

[Editor’s note: For additional reading please check out Matthews G, Burris S, Ledford SL, Baker EL, Advocacy for Leaders: Crafting Richer Stories for Public Health. Journal of Public Health Management and Practice May‒June 2016;22(3):311–5 and Public Health Law Year in ReviewLooking Back and Ahead. Public Health Law Conference. October 16, 2014.]

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