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How Should Government Respond

to a Health Crisis?

A Classroom Activity and Explanatory Performance Task

Grade 8 Civics

Written by:

Diane Kemp

Lake Forest School District

Acknowledgements: Ms. Denise Weiner, Private Consultant in collaboration with the University of Delaware’s Professional Development Center for Educators

“This document may contain copyrighted material whose use has not been specifically authorized by the copyright owner. This document is made available in an effort to advance the understanding of performance tasks in general and as practice of student application. The authors believe that this constitutes a 'fair use' of the copyrighted material as provided for in section 107 of the U.S. Copyright Law. If you wish to use this copyrighted material for purposes of your own that go beyond 'fair use,' you must obtain permission from the copyright owner.”

Classroom Activity

Resources Needed:

• Sort Cards (Appendix 1)

• Federalism Student Table (Appendix 2)

• Glue

Learning Goals

• Students will analyze the functions of federal, state, and local government.

• Students will examine the reasons for the different organizational structures of each government.

• Students will understand key terms:

o Ebola: a deadly virus that causes terrifying symptoms

o Center for Disease Control and Prevention (CDC): a United States agency that promotes health by preventing and controlling disease

o Federalism: the division of power between the national, state, and local governments.

Classroom Activity

Facilitator says: “What is the Ebola virus?” [Facilitator must elicit student Reponses and generate a small group/class discussion about Ebola.]

Facilitator says: “The Ebola virus is a virus that can be spread through direct contact with body fluids of a person who is sick or by objects such as needles or medical equipment that are contaminated with the virus.

It is not spread through normal, everyday contact, air, water, or food grown.

The virus can be spread to others after symptoms begin and symptoms can appear from 2 to 21 days after exposure.

Symptoms include: fever, headache, diarrhea, vomiting, abdominal (stomach) pain, unexplained bleeding, and muscle pain.

Many Americans are fearful that a family member will be infected.

As an American citizen, if you contract the virus, you have the right to return to America to be treated. With the current outbreak in Africa, there are American medical professionals in Africa contracting the virus and returning to America for treatment. This has caused a scare because people think that the virus is being brought into America and will be passed on to American citizens.

The Center for Disease Control (CDC) is a federally funded governmental agency that assists states and local governments when there is a disease outbreak. News reports have focused on the CDC because Americans feel that the Federal government is not approaching the Ebola problem adequately.

Federalism is the division of power between the national, state, and local governments. Under Federalism, each branch of government is assigned specific powers. We are going to review some of those powers and which government would you turn to if you have a problem.

I am going to give you a set of cards. Your task is to put the cards into the appropriate column on the Federalism student table. Place it in the National column if it is a national government’s power, in the State column if it is a state government’s power, and in the Local column if it is a local government’s power.

[Give a set of cards to each student and have them sort their cards. Allow the students adequate time to place the cards in the appropriate columns.]

Facilitator says: “Let’s check and see if you were able to sort the cards correctly.” [Use the table below to review if the students categorized the cards correctly.]

|National |State |Local |

|Makes laws for the nation |Makes laws for the state |Makes laws for counties, cities, and towns|

|Prints and coins money |Establish schools |Trash Schedule |

|Runs the armed forces and provides |Repair Roads in Delaware |Provides roads, parks, hospitals |

|national defense | | |

|Deals with other nations |Issues drivers licenses |Provides law enforcement, fire protection |

|Meets in Washington, D.C. |Meets in the State Capitol |Meets at City Hall |

Facilitator says: Now that you have each of the powers in the appropriate column, glue them to your paper. While gluing, read each power as you place it in the correct column.

Facilitator says: Now that you have categorized the jobs of each of the governments, what are the reasons that power belongs to that particular government?”

[Allow student answers but ensure that the students are able to identify the reasons given on the chart below]

Facilitator says: Let’s write the reasons next to the power on our table.

|National |State |Local |

|Makes laws for the nation |Makes laws for the state |Makes laws for counties, cities, and towns|

|Scope – the problem affects all citizens |Scope – the problem affects those citizens|Scope – the problem affects those citizens|

|in the country |in the state |in the town or county |

|Prints and coins money |Establish schools |Trash Schedule |

|Scope and authority – affects all citizens|Proximity – states can identify the types |Burden – less important problems are |

|and the National Gov. has the power over |of schools they need for their specific |better handled by those with less |

|our nation’s economic needs. |state |responsibilities |

|Runs the armed forces and provides |Repair roads in Delaware |Provides roads, parks, hospitals |

|national defense |Scope, Proximity, - affects citizens in |Scope, Proximity – affects citizens in the|

|Scope, Resources, and Authority – affects |the state, and states can identify which |state, states can identify which roads, |

|all citizens, the National Gov. has the |roads need repaired, |parks, and hospitals are needed |

|resources and the power to protect its | | |

|citizens and defend the nation | | |

|Deals with other nations |Issues drivers licenses |Provides law enforcement, fire protection |

|Scope, Resources, and Authority– affects |Authority and Proximity – states have the |Scope and Proximity – affects all citizens|

|all citizens, the National Gov. has the |power over drivers in their state and are |in their area and local governments can |

|resources and the power to deal with other|able to identify needs within the state |identify areas of need |

|nations | | |

|Meets in Washington, D.C. |Meets in the State Capitol |Meets at City Hall |

Facilitator says: The work completed today, will be used to complete a Performance Task on Federalism. You will be reading some articles about Ebola and identifying which level of government is best suited to handle the Ebola problem.

Appendix 1: Sort Cards

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|Makes laws for the nation |Makes laws for the state |Makes laws for counties, cities, and towns |

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|Prints and Coins Money |Establish Schools |Trash Schedule |

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|Runs the armed forces and provides nation |Repair roads in Delaware |Provides roads, parks, hospitals |

|defense | | |

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|Deals with other nations |Issues drivers licenses |Provides law enforcement, fire protection |

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|Meets in Washington, D. C. |Meets in the State Capitol |Meets at City Hall |

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Appendix 2

Federalism Student Table

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|National Government |State Government |Local Government |

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Performance Task:

One of the major issues debated during the writing of the Constitution was how much power the Federal government should have versus the state government. Federalism was created to address the needs of both governments while avoiding tyranny. With the emergence of the Ebola virus there is a fear it will spread and put your family at risk. You are motivated to make a difference on this issue. However, you need to determine, which level of government will address this epidemic.

After you have reviewed these sources, you will answer some questions about them. Briefly scan the sources and the three questions that follow. Then, go back and read the sources carefully so you will have the information you will need to answer the questions and complete your research. You may use scratch paper to take notes on the information you find in the sources.

In Part 2, you will write an explanatory article on a topic related to the sources.

Directions for Beginning:

You will now examine several sources. You can re-examine any of the sources as often as you like.

Research Questions:

After examining the research sources, use the remaining time in Part 1 to answer three questions about them. Your answers to these questions will be scored. Also, your answers will help you think about the research sources you have read and viewed, which should help you write your explanatory article.

You may refer back to your scratch paper to look at your notes when you think it would be helpful. Answer the questions in the spaces below the items.

Your written notes on scratch paper will be available to you in Part 1 and Part 2 of the performance task.

Part 1: Sources for Performance Task

Source #1

Who's in charge of stopping Ebola in the U.S.?

By Michael Martinez, CNN

October 3, 2014

(CNN) -- Ebola has come to the United States -- first in the form of sick Americans brought home for treatment, now with one confirmed case in Dallas and others being monitored -- and public concern over that reality includes a pointed question: Who's in charge of stopping Ebola before it can spread?

A series of events has unfolded since a visiting Liberian citizen in Texas became the first-ever Ebola case diagnosed in the United States this week: 50 more people in Dallas are being monitored for the disease. Officials struggle to clean a contaminated apartment there. And a patient in Washington, D.C., who recently visited Nigeria was hospitalized Friday and was being monitored for health issues that could be associated with Ebola.

So, who's in charge of the battle against Ebola?

It's a partnership between the federal Centers for Disease Control and Prevention, and state and local governments where an Ebola case occurs, said CDC Director Tom Frieden. But local officials ultimately are in charge of each case, he said.

"We work very closely with state and local governments, and when there's an episode in a state or local government, they are in charge, and we support them in every way," Frieden told CNN on Friday.

"They assign an incident manager. They establish an emergency operations system.

They outline every aspect and we work very closely ... There's a great collaboration," Frieden added.

In the Ebola case in Dallas, authorities at the state, county and city levels

are working with the CDC.

Specifically, it's Dallas County that's in charge, said Dallas County Judge Clay Jenkins, also director of the county's Homeland Security and Emergency Management.

The county has "set up an Incident Management Center and is acting as the lead agency for the Ebola investigation and containment," said the county judge, who is vested with broad judicial and administrative powers under the Texas Constitution.

Has there been criticism?

Yes, largely from Republicans. Even before the first case on U.S. soil, U.S. Sen. Rob Portman, R-Ohio, urged President Barack Obama, a Democrat, to appoint one federal official to lead the U.S. strategy to address the worldwide Ebola outbreak, especially in Africa.

"Unfortunately, the lack of a central coordinator to facilitate cooperation between all of the U.S. efforts at home and abroad appears to have led to a delay in an effective U.S.

government response and an absence of financial and operational accountability," Portman wrote to Obama last month.

This week, another Republican, Sen. Jerry Moran of Kansas, urged Obama to appoint to an "Ebola czar" to address the outbreak in Africa, Moran told BuzzFeed News. Moran, however, didn't make any reference to the ongoing Texas situation. "There is no person to go to, to tell us how all this is going to be funded," Moran said of the U.S. response to the Ebola outbreak in Africa. "I don't think there is a person in charge," he added. "And I don't think there is a plan internationally to bring the folks together to combat this."

For its part, the United Nations has set up the first-ever U.N. emergency health mission, the Mission for Ebola Emergency Response, to deal with the "the unprecedented outbreak" of Ebola, the agency said.

What does Obama say about a U.S. Ebola czar?

Obama doesn't want one. The White House said the structure of the federal response is "sufficient," with particular officials leading the way on both domestic and international fronts.

"On the question of why we have not tapped an 'Ebola czar,' we are cognizant that doing so would create another layer of bureaucracy," a senior administration official said. "To be sure, our response needs to be as nimble and as bureaucratically lean as possible in order to bring the overseas epidemic under control," the official said. "We feel the current structure we have in place is sufficient."

On Friday, Lisa Monaco, Obama's homeland security and counterterrorism adviser, said the U.S. government has been "enhancing our domestic preparedness to respond" to cases like Texas. "The United States has the most capable health care infrastructure and the best doctors in the world, bar none," Monaco said. "The United States is prepared to deal with this crisis, both at home and in the region. Every Ebola outbreak over the past 40 years has been stopped."

CDC Director Frieden applauded the U.S. domestic response and cited how Texas has successfully established an incident management system. "That's been done in Texas. They've done exactly what we've recommended. They have an incident manager in place. We're supporting that person. The state of Texas is supporting that person, and I'm confident we'll break the chain of transmission there," Frieden said.

Source # 2

America's Ebola Command: Just Who's In Charge Here?

by Maggie Fox NBC news

October 17, 2014

Ebola spreads in the United States, first killing a patient who went days without treatment because of a hospital error and then infecting at least two of his nurses. A Cleveland wedding store closes because one infected nurse shopped there.

Members of Congress call for travel from West Africa to be banned. The heads of the Centers for Disease Control and Prevention, Customs and Border Patrol, and the National Institutes of Health are called on the carpet.

And Americans, jumpy and nervous, are asking: Who’s in charge of America’s Ebola response?

"There has to be some kind of czar," Arizona Sen. John McCain said on CNN this week. "I'd like to know who's in charge, among other things."

U.S. Sen. John Cornyn, a Texas Republican, called on the administration to "designate an experienced, proven leader to coordinate a national response involving local, state and federal agencies to contain Ebola in the United States, including considering temporary restrictions on travel from impacted West African nations.”

And President Barack Obama did get the message, canceling a fundraising trip and holding a high-level meeting on Ebola at the White House. On Friday, a senior administration official said Obama would appoint Ron Klain, Vice President Joe Biden's former chief of staff, to head up efforts to address the threat.

But the public health system is designed specifically so that no one single person or agency is in charge.

“The current administration is, essentially, playing out the playbook that was developed over a period of time,” says Mike Leavitt, a former Utah governor who was Health and Human Services secretary from 2005 to 2009.

Tommy Thompson, a former Wisconsin governor who headed HHS before Leavitt, helped set up the current disaster response system after 9/11 and the anthrax attacks that followed. It’s not a top-down system, Thompson told NBC News.

“It was never set up that way,” Thompson said. “It was always set up that public health is really a joint effort. The states have got to be involved.”

In fact, public health preparedness starts at the state and local level, Thompson said. “You have to do it in conjunction with the states,” he said.

“If you have a quarantine, it requires the involvement of the city. It cannot be done from the top down.”

States wouldn’t stand for it any other way, said an HHS spokesman. “We can’t just come in and take over a state,” he said.

“We can’t be everywhere. Everyone has to do their part,” CDC director Dr. Thomas Frieden told a hearing Thursday of the House Oversight Committee.

Leavitt and Thompson, both Republicans, could be critical of a Democratic administration’s response to the crisis. But they aren’t.

“Anything is going to seem inadequate,” Leavitt said.

“The thing that is unique about a disease emergency is that, in its full manifestation, it happens everywhere at once,” Leavitt added. “It is one thing to have a case in Dallas. But if it begins to spread beyond that and we lose the battle of containment, then you are fighting a war on every front and it requires that state and local governments step to the front.”

Many critics are blaming CDC. But few understand the agency doesn’t have much authority and must be invited by states or cities to intervene. “We have no regulatory authority, so we make guidelines and then facilities follow those guidelines,” said Abbigail Tumpey, a CDC spokeswoman.

Dr. Irwin Redlener, a disaster preparedness expert at Columbia University’s school of public health, says it’s unfair for critics to blame the CDC. “The problem is not so much at the CDC level. It is really at the local level,” Redlener told NBC News.

One problem is that it’s hard to keep up an effort year after year. There have been bumps in interest in public health — after the 2001 anthrax attacks, after the SARS pandemic in 2003 and when H1N1 swine flu hit in 2009. But budget cuts have hit hard and public health has lost 50,000 jobs since 2006, Redlener said.

“I have been looking at the appropriations process, which has allowed this erosion of funding,” he said.

“People are berating the president for not having an Ebola czar, and we do need some organized federal structure. But this plays at the local level.”

In 2003 and 2004, Congress appropriated $500 million a year to help get hospitals ready for a health emergency such as a pandemic. That’s been cut by more than half, Redlener said.

“That’s the money that is used to train hospital personnel for them to be ready for all kind of threats,” he said. “The ability to stop the epidemic has been scorched by these gradual but continuing funding cutbacks.”

Source # 3

States, cities examine best practices for stopping spread of Ebola in US

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Editors' Picks

By Harry Bruinius, Christian Science Monitor

October 6, 2014

New York — As a fifth American diagnosed with the Ebola virus returned to the United States from Africa on Monday, health officials around the country began to reexamine their protocols for treating the disease and locating those who may have been exposed to the virus abroad. 

Cameras closely followed the jet carrying Ashoka Mukpo, an American freelance journalist who was diagnosed with Ebola while on the job in Liberia last week, as it made its way to the Nebraska Medical Center in Omaha, which is specially equipped to quarantine and treat infectious diseases.

The Nebraska center, which is the largest of four biocontainment units in the US, treated the American missionary doctor Richard Sacra last month after the Massachusetts native contracted Ebola while on a humanitarian mission to Liberia. 

But after a Texas hospital initially bungled the diagnosis of Liberian-born Thomas Eric Duncan, who recently returned from a visit to his home country, health officials in a number of states have been reexamining procedures for treatment and prevention.  

Texas Gov. Rick Perry (R) said on Monday that his state would set up an infectious disease task force after the mistakes made at the Dallas hospital, where Mr. Duncan is being treated. 

“Over the past several days, we have learned a lot about the unique challenges of situations like this, and it's important that we continue to adapt our responses to these realities,” Governor Perry told a news conference at the State Capitol.

In New York, officials have been trying to locate anyone who may have unknowingly been exposed to Ebola. Operators for the 911 emergency system are asking all who call to report Ebola-like symptoms whether they have traveled to West Africa in the past few weeks. City officials also have begun to reach out to the West African community, encouraging city residents to go to the hospital if they are experiencing symptoms of the virus that the World Health Organization has said has been responsible for more than 3,400 deaths in Africa.

Health officials in south Florida, another well-traveled area with a diverse population from around the globe, also responded to the Duncan case by assuring citizens that the region has been ramping up preparations for Ebola cases, should they be found in Florida.

But more and more, public officials are turning their attention to the nation’s ports of entry. On Sunday, New York Sen. Charles Schumer (D) called for the Transportation Security Administration to screen passengers from Ebola-afflicted countries when entering the US and to have passengers fill out health surveys before being admitted into the country.

On Monday, a high-ranking government health official said that, in fact, an additional layer of screening is being considered.

"The discussion that is under way right now, and all options are going to be looked at, is what kind of screening do you do on the entry end, namely, when people come in here right now," Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN. "And that's something that's on the table now, and the discussion is, is that extra added layer of screening going to be worth the resources that are put into doing it? That hasn't been decided right now." 

Senator Schumer also wrote a letter to Customs and Border Commissioner Gil Kerlikowske and Centers for Disease Control and Prevention Director Tom Frieden, urging them to work with the Department of Homeland Security to create a database, available to local hospitals nationwide, of passengers flying to and from West Africa.

“This database would allow hospitals to confirm whether patients exhibiting symptoms have been to one of the source countries and would ensure that physicians have the most truthful information of a patient’s travel itinerary,” Schumer wrote.

On Friday, Louisiana Gov. Bobby Jindal (R), a likely 2016 presidential aspirant, called for the Obama administration to impose a complete travel ban on flights from those countries with Ebola outbreaks.

“President Obama said it was ‘unlikely’ that Ebola would reach the U.S,” the Louisiana Republican said in statement. “Well, it has, and we need to protect our people. But the Obama administration keeps saying they won’t shut down flights. They instead say we should listen to ‘the experts.’ In fact, they said it would be counterproductive to stop these flights. That statement defies logic.”

But administration officials spoke out against such a travel ban.

"When you close off a country, you create such stress and fear and amplify the problem,” said Dr. Fauci on "Fox News Sunday." “I think any health-care person will agree with me that that's not a good idea to completely block off the country.”

Part 1: Research Questions

1. What is the Ebola problem?

________________________________________________________________________________________________________________________________________________________________

2. Place a check (√) identifying the level of government responsible for handling the Ebola problem.

|Source |National Government |State Government |Local Government |

|Source # 1: | | | |

|Who’s in charge of stopping Ebola in| | | |

|the U.S.? | | | |

|Source # 2: | | | |

|America’s Ebola Command: Just Who’s| | | |

|in Charge Here? | | | |

|Source # 3: | | | |

|States, cities examine best | | | |

|practices for stopping spread of | | | |

|Ebola in US | | | |

3. Why is a particular level of government responsible for the Ebola problem? Provide two pieces of evidence, one piece of evidence from each of two different sources, and explain how each piece of evidence supports your answer. Identify the source of each piece of evidence by title or number.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Part 2: Federalism: Who Should I Turn To? Explanatory Writing Task

You will now review your notes and sources, and plan, draft, revise and edit your writing. You may use your notes and refer to the sources. Now read your assignment and the information about how your writing will be scored; then begin your work.

Your Assignment

Using your knowledge of the structure and functions of the American federal system, determine which level of government is responsible for addressing the Ebola problem and explain why that level of government should address the problem. Clearly organize your information by providing arguments, clear reasons, and citing two pieces of relevant evidence to support your argument.

Article Scoring:

Your explanatory writing will be scored using the following:

1. Organization/purpose: How well did you state your thesis/controlling idea, and maintain your thesis/controlling idea with a logical progression of ideas from beginning to end? How well did you narrow your thesis/controlling idea so you can develop and elaborate the conclusion? How well did you consistently use a variety of transitions? How effective was your introduction and your conclusion.

2. Evidence/elaboration: How well did you integrate relevant and specific information from the sources? How well did you elaborate your ideas? How well did you clearly state ideas using precise language that is appropriate for your audience and purpose?

3. Conventions: How well did you follow the rules of grammar, usage, punctuation, capitalization and spelling?

Now begin work on your article. Manage your time carefully so that you can

1. Plan your multi-paragraph article

2. Write your multi-paragraph article

3. Revise and edit the final draft of your multi-paragraph article

Dictionaries and Thesauri are available to you.

For Part 2, you are being asked to write a multi-paragraph explanatory article, so please be as thorough as possible. Write your response in the space provided.

Remember to check your notes and your pre-writing/planning as you write and then revise and edit your explanatory article.

Scoring Rubrics (Teacher Use Only)

Part 1: Research Questions

|Item # |Grade |

|2 |Response is an identification and an adequate evidence-based justification of which source provides the most accurate |

| |information about the Ebola problem. |

|1 |Response is an identification and a limited/partial evidence based justification of which source provides the most |

| |accurate information about the Ebola problem. |

|0 |Response is an explanation that is insufficient, incorrect or irrelevant. Just identifying the source is |

| |insufficient. |

|Item # |Grade |Claim |Target |

|Source # 1: | | | |

|Who’s in charge of stopping Ebola in | | |√ |

|the U.S.? | | | |

|Source # 2: | | | |

|America’s Ebola Command: Just Who’s in| |√ |√ |

|Charge Here? | | | |

|Source # 3: | | | |

|States, cities examine best practices | |√ |√ |

|for stopping spread of Ebola in US | | | |

|Item # |Grade |

|2 |Response is an identification and an adequate evidence-based justification of which source provides the most accurate |

| |information about the Ebola problem supported by two details from the identified source. |

|1 |Response is an identification and a limited/partial evidence based justification of which source provides the most |

| |accurate information about the Ebola problem |

|0 |Response is an explanation that is insufficient, incorrect or irrelevant. Just identifying the source is |

| |insufficient. |

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