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Codification of & Public Health Part 2 • United States (USC) • Code of Federal Regulations (CFR)

PHC 6102 Principles of Health Policy and Management

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Codification of Laws & Regulations The U.S. Constitution • The Constitution of the United States of America has • United States Constitution been in operation since 1789. – Superior to the USC or CFR – The supreme – Smallest document • United States Code (USC) – The framework for the organization of the United States government – Superior to the CFR / Subordinate to the Constitution – Much larger (far more detailed) than the Constitution / – The framework for the relationship of the federal Smaller than the CFR government with the states and citizens of the • Code of Federal Regulations (CFR) United States. – Subordinate to the USC and the Constitution – Largest document (and most detailed)`

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The U.S. Constitution Public Health in the Constitutional Design • Relative size of the Constitution: – The Constitution is a small document – roughly 22 • No inquiry is more important to public health pages long (8½” x 11” sheets with normal law than understanding the role of government pagination). in the constitutional design.

• The U.S. Constitution is the starting point for any analysis concerning the distribution of governmental powers.

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1 The Constitution of the United States Constitution (Cond.) - The (Article I)

• Comprised of Seven articles (Article I – VII) • Article I: The Legislature “Power of the Purse” – Article I The Legislative Branch – Article I is comprised of ten sections – Article II The Branch – Sections 1-6- address the make-up and operations of the – Article III The Judicial Branch House & Senate, elections, rules, compensation, etc. – Article IV The States – Section 7 - Revenue Bills, Legislative Process, Presidential Veto – Article V Amendment – Section 8 – The powers of Congress – Article VI Debts, Supremacy, Oaths – Section 9 – The limitations of Congress – Article VII Ratification – Section 10 – Powers prohibited of States (what the states – Amendments (there are 27 Amendments) cannot do)

Useful Link: http://www.usconstitution.net/const.pdf

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Constitution (Cond.) - The Executive & Judicial Branches (Articles II & III) The Constitution’s Functions

• The Executive Branch (Article II) • Public health and individual rights may – Section 1 – The President directly conflict. – Section 2 – Civilian Power over the , Cabinet, Pardon Power, and Appointments – Section 3 – State of the Union, Convening Congress • Resolving the tension between population-based – Section 4 – Disqualification regulations and individual rights requires a trade-off.

• The Judicial Branch (Article III) • Thus, although the Constitution grants extensive – Section 1 – Judicial Powers powers to governments, it also limits that power by – Section 2 – by , Original , Jury – Section 3 – Treason protecting individual rights and freedoms.

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The Constitution’s Functions Continued The Constitution’s Functions • The Constitution acts as both a fountain • (1) it allocates power among the federal and a levee; government and the states (federalism) – it originates the flow of power—to preserve the public health—and it curbs that • (2) it divides power among the three branches power—to protect individual freedoms. of government () • Levee – power curbing mechanism found in the Bill of Rights. • The Bill of Rights is the collective name for the • (3) it limits government power (to protect first ten amendments to the United States individual liberties) Constitution.

Source: E. Chemerinsky, : Principles and Policies (: Aspen Law & Business, 1997), 1–6. 11 12

2 The Constitution’s Functions Continued United States Code (USC) Bill of Rights: • A compilation and codification of the general and • Freedom of religion, press, expression permanent laws of the United States. • Right to bear arms. – • No quartering of soldiers. The Constitution is a small document which cannot begin to cover many potential legal and • No unreasonable search and seizure. regulatory situations. • Trial and punishment, compensation for takings • Right to speedy trial, confrontation of witnesses. • The Constitution is roughly 22 pages long • Trial by jury in civil cases (a very small document) • No cruel and unusual punishment. • The USC contains 51 titles and is over • Construction of Constitution. 200,000 pages (a very large document) • Powers of the states and people

Source: J. Areen et al., Law, Science and Medicine, 2d ed. (New York: Foundation Press, 1996), 520. 13 14

United States Code (USC) Code of Federal Regulations (CFR) • The Code of Federal Regulations (CFR) is the Title 1 General Provisions Title 38 Veterans Benefits codification of the general and permanent rules and Title 2 The Congress Title 39 Postal Service regulations (sometimes called or Title 3 The President Title 42 The Public Health and Welfare administrative regulation) Title 6 Domestic Security Title 43 Public Lands Title 13 Census Title 50 War and National Title 20 Education • Promulgates rules and detailed instructions and Title 21 Food and Drugs guidelines regarding fiscal and programmatic Title 24 Hospitals and Asylums operations of the federal government agencies Title 26 Title 29 Labor Title 31 Money and Finance

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The Code of Federal Regulations (CFR) The Code of Federal Regulations (CFR) • Administrative law exists because the U.S. Congress grants broad authority to executive • The CFR is divided into 50 titles that represent branch (federal) agencies to interpret the broad areas subject to Federal regulation. in the U.S. Code which the agencies are entrusted with enforcing.

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3 Code of Federal Regulations (CFR) Codification of Laws & Regulations

Title 1: General Provisions Title 30: Mineral Resources • United States Constitution Title 2: Grants and Agreements Title 31: Money and Finance: Treasury – Smallest document Title 3: The President Title 32: National Defense Title 11: Federal Elections Title 34: Education – Supreme Law Title 12: Banks and Banking Title 40: Protection of Environment – Takes Precedence over the USC or CFR Title 20: Employees' Benefits Title 42: Public Health Title 21: Food and Drugs Title 44: Emergency Management and • United States Code (USC) Title 24: Housing and Urban Assistance – Much larger than the Constitution Development Title 45: Public Welfare – Takes Precedence over the CFR Title 26: Internal Revenue Title 50: Wildlife and Fisheries Title 28: Judicial Administration • Code of Federal Regulations (CFR) Title 29: Labor – Largest document (most detailed document)

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Codification of Laws & Regulations This concludes our • An old crotchety law professor once said that discussion on Public Health federal law is comprised of: Law Part 2. – About 3-5% from the U.S. Constitution – About 17-20% from the U.S. Code (USC) Please make sure that you also watched Public Health – About 75-80% from the Code of Federal Regulations (CFR) Law Part 1.

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Sources Questions

• Areen, J. et al., Law, Science and Medicine, 2d ed. (New York: Foundation • What document represents the supreme law of the Press, 1996), 520. • Constitution of the United States of America United States? • Gostin, L.O., Public , in Principles for Population-Based • Rank the Constitution, USC, and CFR in order of Management, 2nd Edition, Edited by L.F. Novick, C.B. Morrow, and G.P. importance? Mays, Jones and Bartlett Publishers, Boston, 2008. • http://www.law.cornell.edu/uscode/text • Rank the Constitution, USC, and CFR in order of • http://www.archives.gov/federal-register/cfr/ document size? • http://uscode.house.gov/ • How is the Constitution like a fountain and a levee? • http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.html • Williams, S. J. & Torrens, P.R., Introduction to Health Services, 7th • What is the Constitution a framework for? Edition, Delmar-Cengage, NY, 2008.

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