Response considerations for handling ultra-low temperature vaccines

Some vaccines pending approval need to be transported at low or ultra-low temperatures, around -109 degrees Fahrenheit. These vaccines will be transported and stored with dry ice, which presents several potential response concerns in the event of an accident or other related incident.

To understand the key response considerations around dry ice, the International Association of Fire Chiefs (IAFC) released a White Paper on Dry Ice (Carbon Dioxide Response.  The information for the fire service and EMS personnel on scene management, personnel safety, storage information, health hazards and patient management.

The IAFC encourages fire chiefs to review information related to dry ice safety. Take a moment to review this important information and ensure your personnel are ready for any potential emergencies. The following is link to the document that the International Association of Fire Chiefs (IAFC) has developed and put out for review and consideration.

Bradley York Quoted in Independent Agent Magazine

“Public entities should plan for an evolving landscape in terms of higher rates, shrinking capacity and potentially increased liabilities,” says Bradley York, president of OneBeacon Government Risks. “We are truly in a new environment.”

Public Entities: Planning for an Evolving Landscape

As social inflation, pressure on pricing, capacity and the coronavirus pandemic turn up the heat on the public entity insurance market, many of the existing troubling trends, such as cyber liability, the growth of technology and the waning economy continue to leave insurance professionals scratching their heads when trying to find solutions for clients.

“Public entities should plan for an evolving landscape in terms of higher rates, shrinking capacity and potentially increased liabilities,” says Bradley York, president of OneBeacon Government Risks. “We are truly in a new environment.”

During the coronavirus pandemic, cybercrime skyrocketed. A month into the pandemic, the FBI reported that it was receiving between 3,000 and 4,000 cybersecurity complaints each day, a major jump from prior to the pandemic when about 1,000 complaints were received daily.

To read the story in its entirety, visit Independent Agent.

Considerations for a Fireworks Show Amid COVID-19

Amid the COVID-19 pandemic, many cities across the country have canceled or postponed their 4th of July celebrations including the traditional fireworks display. But with so many activities and events cancelled in 2020, some cities have decided maintaining their fireworks show is a tradition too important to forego. Working through the logistics of keeping spectators safe and socially distanced, however, is a new challenge. Some cities are promoting drive-in events with parking lot recommendations for good viewing while others are hosting neighborhood-based events which allow the community to remain in their own backyard.

Although attendance at this year’s fireworks celebrations will be different from past years, one thing remains a constant for a public entity – the liability that comes with hosting a fireworks display. The following are considerations for planning and contracting with a vendor for a fireworks show. All government entities should develop controls that will fit their specific needs.

Guidelines and procedures by which fireworks may be safely displayed and/or discharged upon an entity’s property. These polices should comply with applicable federal, state, and local laws, rules and regulations as well.

Establish who within your entity will have the authority to oversee and control the use of fireworks displays.

The polices that your government entity develops should comply with all local, state, and federal laws and state that local, state, or federal government shall have the sole authority to suspend or terminate fireworks shows/displays any time upon their own discretion and/or upon the advice of the operator, the producer of the event.

The fireworks company/operator shall supply the fireworks, tools and equipment for shipping and receiving, on-site storage, and the necessary number of qualified personnel needed to set up, fire the display and thoroughly clear the entire area of fireworks debris at the conclusion of the event.

The operators shall be licensed and approved in accordance with any and all applicable state, federal, county, parish, or municipal laws.

The sponsor of the event or the contractor shall furnish a certificate of liability insurance in the amount of at least $1,000,000 naming the government entity as an additional insured. They shall provide a hold harmless agreement in favor of the government entity. This is to satisfy claims for damages to property or personal injuries arising out of any act or omission on the part of such person, firm or corporation or any agent or employee thereof with an occurrence.

Jail is No Place to Get Sick

Throughout the United States, there over 3,200 local and county jails housing more than 700,000 inmates. Providing adequate medical care to the inmate population is challenging to say the least which has led to many states contracting out their jail healthcare to private companies. Unfortunately many of the leading jail healthcare vendors have been on the receiving end of hundreds of lawsuits, some with multi-million dollar judgments.

Increased exposure to liability and significant medical costs indicate a current healthcare crisis in jails yet public entities remain challenged with controlling costs without jeopardizing the quality of medical services. Taking a proactive approach to establishing strong management and oversight of jail healthcare is necessary to reduce complaints, claims, and overall liability to your public entity.

Jail Inmates Have Complicated Healthcare Needs

Caring for the pre-existing conditions of jail inmates is a major contributor to the high cost of jail healthcare. Jail inmates tend to have high rates of chronic illness, substance abuse, and mental health conditions. According to data published by the journal American Family Physician, 26.3 percent of jail inmates presented with hypertension, 63.3 percent with drug dependence or abuse, and 44.3 percent with a history of mental health issues. It’s common for inmates to have multiple pre-existing conditions when they arrive at the jail. It is important to accurately identify, acknowledge and treat these issues. Some courts say that jails need to go so far as to treat the inmate’s conditions regardless of whether the inmate sought prior treatment or not. Once again, your legal council’s advice here is necessary.

Budget Decisions Can Impact Liability and Service Quality

A recent study conducted by The Pew Charitable Trusts provided several insights into the jail healthcare crisis. Decisions made for budgetary reasons can increase exposure to liability and have a tremendous impact on the quality of medical care. One example that can have various negative outcomes is the common practice of not budgeting to staff a jail with healthcare personnel around the clock.

Since jails book new inmates at all hours, some inmates are not screened by trained medical personnel when they arrive. It’s easy for correctional staff, who usually do not have medical training, to miss that a new inmate needs medical treatment or has symptoms of a communicable disease. If the inmate or someone the inmate comes in contact with experiences a negative health outcome due to the delayed medical screening, a claim or even a lawsuit could result.

Not having medical care on-site has resulted in unnecessary expenses. When correctional staff cannot reach medical staff for advice about an inmate’s condition, their next step is to have the inmate taken to the hospital for an expensive emergency room visit.

Improper Management of Private Providers Can Aggravate the Crisis

Many public entities have a contract with a private company that provides jail healthcare. It’s important that public entities involve the entity’s legal counsel in the creation of these contracts. Otherwise, the public entity may later find it disagrees with the private provider’s interpretation of the company’s responsibilities.

It’s also critical to ensure Request For Proposals (RFPs) are detailed enough for contractors to create adequate proposals. Although such diligence may seem obvious, the aforementioned Pew Charitable Trusts study found critical omissions in the RFPs related to jail healthcare. A sample of their findings follows:

  • Many RFPs did not include any utilization data.
  • 70 of the 81 RFPs they reviewed did not request medication-assisted treatment, an evidence-based protocol for treating substance abuse.
  • Most RFPs didn’t include performance requirements.

When contracts have performance requirements, failure to meet them can have serious consequences for the health of inmates as well as legal action against the public entity. Also, it’s important to acknowledge contracts with performance requirements that carry financial incentives or penalties are meaningless if the public entity does not assign anyone to monitor the third-party provider’s performance.

Public sentiment toward the healthcare system in jails may never change; however, public entities can certainly work to develop stronger partnerships with medical providers helping to support continued care for their inmate population.

ADA Compliance? It Goes for your Public Entity Website & Mobile App Too

Title III of the Americans with Disabilities Act (ADA) prohibits discrimination in “places of public accommodation” which historically has included restaurants, theaters, retail stores and more. However, a recent ruling by the 9th Circuit Court of Appeals in San Francisco held in its decision that the ADA applies also to a company’s website and mobile app.

An increasing number of website lawsuits—2,285 in 2018—is cause for action. Within a public entity, poor online accessibility can make it hard for the disabled to apply for benefits, renew library books, register to vote, etc. An accessible website also benefits other users, as it encourages simple designs that work well on all devices and makes it easier for people to find the information they need. The Web Content Accessibility Guidelines give us some hints as to the likely coming legislation that websites will be required follow. You can find a simpler format here.

Being fully compliant is time consuming but there are few easy (and important) changes you can start to make now:

  1. Provide alternative text for all pictures. Infographics should have a full caption. Proper alt text is invisible to sighted visitors but picked up by screen readers. Show full captions beneath the image.
  2. Ensure all links in text stand out from the normal text by using at least two markups.
  3. Keep a consistent layout through the site.
  4. Provide proper captioning of any videos on the site. If you use YouTube, they have an easy way to add closed captions. Text transcripts are also vital, although they can take a little longer to input.
  5. Remove any automatic video or audio (besides affecting accessibility, this can annoy regular users).
  6. Provide a search function on the homepage.
  7. No pop-ups unless they are there to assist users. Pop-ups can mess with screen readers.
  8. Do not use color alone to convey meaning.
  9. Use proper nested headings within the text.

The Section 508 Standards are what Federal agencies use, and there is a useful guide here. Section 508 provides tutorials and recommendations for products that can help with accessibility. One of the most important things you can do is be consistent through your site and avoid frequent changes. Similar pages should look and feel the same. This also makes for a clean website your users will appreciate. Don’t rely on automatic checkers, which find only a small number of the problems. Instead, have manual tests, which should include:

  1.  Navigating the website using a screen reader.
  2. Navigating the website without using a mouse.
  3. Checking for alternatives to all content, such as alt text for pictures, transcripts for videos, etc.

If users don’t find your site accessible, they are likely to complain. If you are lucky, they will only complain to you. If you receive an accessibility complaint, it’s best to address it as soon as possible considering the high expense of a potential lawsuit. A website audit can help find problems, but it will not fix them. And the ADA is a strict liability law, which means you won’t be able to use any arguments other than compliance. The only way to get out of an ADA lawsuit is to fix the problem immediately.


More than 4 million disabled persons have never used the Internet due to either accessibility frustrations or lack of trying. Either way, ensuring your public entity website meets ADA standards is good business practice and will benefit people in the communities you serve.