Report Title:

Emergency Health Powers Act

Description:

Provides broad powers to the department of health to respond to a public health emergency.

HOUSE OF REPRESENTATIVES

H.B. NO.

516

TWENTY-THIRD LEGISLATURE, 2005

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to emergency health powers.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"Chapter

EMERGENCY HEALTH POWERS ACT

§   -1 Purpose. The purposes of this chapter are:

(1) To require the development of a comprehensive plan to provide for a coordinated appropriate response in the event of a public health emergency;

(2) To harmonize the public health laws of this State in order to clarify existing authority and provide sufficient authority for the taking of appropriate protective measures, during emergency and certain nonemergency periods;

(3) To provide state and county officials with the ability to prevent, detect, manage, and contain emergency health threats without unduly interfering with civil rights and liberties;

(4) To facilitate the early detection of a public health emergency, and allow for immediate investigation of the emergency by granting access to individuals' health information under specified and limited circumstances;

(5) To clarify the authority of state and county officials to provide care, treatment, and vaccination to persons who are ill or who have been exposed to dangerous diseases or conditions, or who have been otherwise affected by an event, including mental health, crisis counseling, and substance abuse services, and to separate affected individuals from the population at large to interrupt disease transmission;

(6) To ensure that the needs of infected or exposed persons are addressed to the fullest extent possible, given the primary goal of controlling serious health threats; and

(7) To grant state officials the authority to use and appropriate property as necessary for the care, treatment, and housing of patients, and to destroy contaminated materials or facilities.

§   -2 Definitions. For the purposes of this chapter, unless the context clearly requires otherwise:

"Department" means the department of health.

"Director" means the director of health.

"Disease or condition dangerous to the public health" does not include acquired immune deficiency syndrome or the human immunodeficiency virus.

"Health care facility":

(1) Means any non-federal institution, building, or agency, or portion thereof, whether public or private, that is used, operated, or designed to provide health services, medical treatment, or nursing, rehabilitative, or preventive care to any person or persons. This includes ambulatory surgical facilities, health maintenance organizations, home health agencies, hospices, hospitals, infirmaries, intermediate care facilities, kidney treatment centers, long-term care facilities, medical assistance facilities, mental health centers, outpatient facilities, public health centers, rehabilitation facilities, residential treatments facilities, skilled nursing facilities, and adult residential care homes and adult day-care centers.

(2) Includes the following related property when used for or in connection with the foregoing: laboratories; research facilities; pharmacies; laundry facilities; health personnel training and lodging facilities; patient, guest, and health personnel, and food service facilities; and offices and office buildings for persons engaged in health care professions or services.

"Health care provider" means any person or entity who provides health care services including health plans, health maintenance organizations, hospitals, hospital and medical service associations, medical clinics and offices, special care facilities, medical laboratories, physicians, pharmacists, dentists, physician assistants, nurse practitioners, registered and other nurses, paramedics, emergency medical or laboratory technicians, and ambulance and emergency medical workers. For purposes of reporting, "health care provider" shall also include out-of-state medical laboratories; provided that those laboratories have agreed to the reporting requirements of this State.

"Isolation" means separation, for the period of communicability, of infected individuals or animals from other individuals or animals in places and under conditions that will prevent the direct or indirect transmission of an infectious agent to susceptible people or to other individuals or animals who may spread the agent to others.

"Public health authority" means the department of health, unless otherwise specifically ordered in the declaration of a state of public health emergency.

"Public safety authority" means the department of public safety, unless otherwise specifically ordered in the declaration of a state of public health emergency.

"Public health emergency" means an actual or imminent threat of injury, illness, or health condition that:

(1) Is caused or is reasonably suspected to be caused by any of the following:

(A) Bioterrorism;

(B) Terrorism;

(C) The appearance of a novel or previously controlled or eradicated infectious agent or biological toxin;

(D) Chemical attack or accidental release; and

(E) Nuclear attack or accident; and

(2) Poses a high probability of any of the following harms:

(A) A large number of deaths in the affected population;

(B) A large number of serious or long-term disabilities in the affected population; or

(C) Widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of people in the affected population.

"Quarantine" means the physical separation and confinement of an individual or groups of individuals, who are or may have been exposed to a contagious or possibly contagious disease and who do not show signs or symptoms of a contagious disease, from non-quarantined individuals, to prevent or limit the transmission of the disease to non-quarantined individuals. "Quarantine" also includes restricting the freedom of movement of healthy individuals or domestic animals who have been exposed to a communicable disease for a period of time relating to the usual incubation period of the disease, in order to prevent contact with those not so exposed.

§   -3 Reporting. (a) A health care provider, coroner, or medical examiner shall report all cases of persons who harbor any injury, illness, or health condition that is or may be a potential cause of a public health emergency. Reportable injuries, illnesses, and health conditions include the diseases caused by the biological agents listed in 42 C.F.R. Section 72, appendix A, and any injuries, illnesses, or health conditions identified by the public health authority. A health care provider, coroner, or medical examiner may report cases of persons who are reasonably believed to harbor any injury, illness, or health condition caused or reasonably suspected to be caused by a public health emergency. Test results subject to this section shall be reported by the laboratory that performs the test, but an in-state laboratory that sends specimens to an out-of-state laboratory shall also be responsible for reporting results.

(b) In addition to the foregoing requirements for health care providers, a pharmacist or drugstore shall report any unusual or increased prescription rates or purchases, unusual types of prescriptions, or unusual trends in pharmacy visits or purchases that are caused or reasonably suspected to be caused by a public health emergency. Prescription-related events that require a report include:

(1) An unusual increase in the number of prescriptions or over-the-counter pharmaceuticals to treat conditions identified by the public health authority through rules;

(2) An unusual increase in the number of prescriptions for antibiotics; and

(3) Any prescription that treats a disease that is relatively uncommon and may be associated with a public health emergency.

(c) Every veterinarian, livestock owner, veterinary diagnostic laboratory director, or other person having the care of animals shall report animals having or suspected of having any disease caused or reasonably suspected to be caused by a public health emergency. The report shall be made electronically or in writing within twenty-four hours of the person's treatment of the suspected animal to the public health authority or other agency as identified by rule, and shall include as much of the following information as is available:

(1) The location of the suspected animal;

(2) The name and address of any known owner; and

(3) The name and address of the reporting individual.

The public health authority may require that certain injuries, illnesses, and health conditions shall be reported immediately.

§   -4 Declaration of public health emergency. (a) A state of public health emergency shall be declared by the governor upon the occurrence of a public health emergency.

Prior to a declaration of a state of public health emergency, the governor shall consult with the public safety authority and the director and may consult with any public health, public safety, and other experts as needed. Nothing in the duty or discretion of the governor to consult with the public safety authority, the director, or other experts shall be construed to limit the governor's authority to act without a consultation when the situation calls for prompt and timely action.

(b) The state of public health emergency shall be declared by an executive order that specifies:

(1) The nature of the public health emergency;

(2) The counties or geographic areas subject to the declaration;

(3) The conditions that brought about the public health emergency;

(4) Duration of the state of the public health emergency, if less than ninety days; and

(5) The primary authority responding to the emergency.

A copy of the executive order shall be filed with the federal Department of Homeland Security.

(c) During a state of public health emergency, the governor may:

(1) Suspend the provisions of any regulatory statute prescribing procedures for conducting state business, or the orders or rules of any state agency, if strict compliance with the same would prevent, hinder, or delay necessary action (including emergency purchases) by the public health authority to respond to the public health emergency, or increase the health threat to the population;

(2) Utilize all available resources of the state and county governments, as reasonably necessary to respond to the public health emergency;

(3) Transfer the direction, personnel, or functions of state departments and agencies to perform or facilitate response and recovery programs regarding the public health emergency;

(4) Provide aid to and seek aid from other states in accordance with any interstate emergency compact made with this State;

(5) Seek aid from the federal government in accordance with the federal programs or requirements; and

(6) Mobilize all or any part of the organized militia into service of the State. An order directing the organized militia to report for active duty shall state the purpose for which it is mobilized and the objectives to be accomplished.

(d) After the declaration of a state of public health emergency, special identification for all public health personnel working during the emergency shall be issued as soon as possible. The identification shall indicate the authority of the bearer to exercise public health functions and emergency powers during the state of public health emergency. Public health personnel shall wear the identification in plain view.

(e) Anyone aggrieved by this section may appeal to a single justice of the supreme court.

§   -5 Maintenance of public health and prevention of disease. (a) Upon declaration by the governor that a public health emergency exists, the director, during a period of emergency, may act and incur any liabilities that the director may consider necessary to assure the maintenance of public health and the prevention of disease. The director may establish procedures to be followed during an emergency to ensure the continuation of essential public health services and the enforcement of the same. The director may authorize expenditures that the director considers necessary to respond to the public health emergency, including expenditures for mental health, crisis counseling, and substance abuse services needed due to the public health emergency, and expenditures to reimburse other state agencies that incur liabilities in responding to the public health emergency. The aggregate amount of all expenses incurred pursuant to this section shall not exceed $              for any fiscal year without legislative appropriation.

(b) Upon declaring a public health emergency, the governor may authorize the deployment and use of any forces and the use or distribution of any supplies, equipment, materials, and facilities assembled, stockpiled, or available.

(c) During a declared public health emergency, any person who renders assistance or advice during the emergency shall be protected from liability to the extent provided by law.

(d) During a declared public health emergency, any person owning or controlling real estate or other premises who voluntarily and without compensation grants a license or privilege, or otherwise permits the designation or use of the whole or any part or parts of the real estate or premises for the purpose of assisting in responding to the emergency, shall not be civilly liable for causing the death of, or injury to, any person on or about the real estate or premises under the license, privilege, or other permission, or for causing loss of, or damage to, the property of the person, except in the event of wilful, wanton, or reckless misconduct.

(e) The immunities provided in subsection (d) shall not apply to any person whose act or omission caused in whole or in part the public health emergency or who would otherwise be liable therefor.

(f) The declaration of public health emergency shall automatically terminate after ninety days or when so declared by the governor, unless renewed by the governor. Each renewal shall terminate after ninety days unless renewed for an additional ninety days, or unless sooner terminated by order of the supreme court.

(g) Upon the termination of the declaration of public health emergency, all powers granted to and exercised by the director under this section shall terminate.

§   -6 Additional power to protect public health. (a) The director shall have and may exercise, or may direct or authorize other state or county government agencies to exercise, authority relative to any one or more of the following if necessary to protect the public health during a declared public health emergency:

(1) To require the owner or occupier of premises to permit entry into and investigation of the premises;

(2) To close, direct, and compel the evacuation of, or to decontaminate, cause to be decontaminated any building or facility, and to allow the reopening of the building or facility when the danger has ended;

(3) To decontaminate, cause to be decontaminated, or destroy any material;

(4) To restrict or prohibit assemblages of persons;

(5) To require a health care facility to provide services or the use of its facility, or to transfer the management and supervision of the health care facility to the department;

(6) To control ingress to and egress from any stricken or threatened public area, and the movement of persons and materials within the area;

(7) To adopt and enforce measures to provide for the safe disposal of infectious waste and human remains; provided that religious, cultural, family, and individual beliefs of the deceased person shall be followed to the extent possible when disposing of human remains, whenever that may be done without endangering the public health;

(8) To procure, store, or distribute any antitoxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies located within the State as may be necessary to respond to the public health emergency, with the right to take immediate possession thereof;

(9) To require in-state health care providers to assist in the performance of vaccination, treatment, examination, or testing of any individual as a condition of licensure, authorization, or the ability to continue to function as a health care provider in the State;

(10) To waive licensing requirements for health care professionals as necessary;

(11) To allow for the dispensing of controlled substances as necessary for the prevention or treatment of illness;

(12) To authorize the county medical examiners to appoint and prescribe the duties of any emergency assistant medical examiners that may be required for the proper performance of their duties;

(13) To collect specimens and perform tests on any animal, living or deceased;

(14) To isolate or quarantine individuals or groups when those individuals or groups pose a substantial risk of transmitting a dangerous disease or condition to others; and

(15) To care for any emerging mental health or crisis counseling needs that individuals may exhibit, with the consent of the individuals.

An order of the director, or designee, given to effectuate the purposes of this subsection shall be immediately enforceable by any law enforcement official of the state or county governments having the power to arrest and serve criminal process.

(b) The director shall have and may exercise, or may direct or authorize other state or county government agencies to exercise, the authority to:

(1) Vaccinate or provide precautionary prophylaxis to individuals as protection against communicable disease and to prevent the spread of communicable or possibly communicable disease; provided that any vaccine to be administered must not be such as is reasonably likely to lead to serious harm to the affected individual; and

(2) Treat individuals exposed to or infected with disease; provided that treatment must not be such as is reasonably likely to lead to serious harm to the affected individual.

An individual who is unable or unwilling to submit to vaccination or treatment shall not be required to submit to the procedures but may be isolated or quarantined if the refusal poses a substantial risk to public health or results in uncertainty as to whether that person has been exposed to or is infected with a disease or condition that poses a substantial risk to public health.

(c) During a state of public health emergency, the director may request assistance in enforcing orders pursuant to this chapter from the public safety authority. The public safety authority may request assistance from the Hawaii national guard or any component thereof, or other military force organized under the laws of this State, in enforcing the orders of the public health authority.

(d) All state and county agencies engaged in responding to the public health emergency shall consult and cooperate in:

(1) Exercising of their powers over routes of transportation and over materials and facilities including but not limited to communication devices, carriers, public utilities, fuels, food, clothing, and shelter; and

(2) Informing the people of the State about how to protect themselves during the emergency and its aftermath and what actions are being taken to control the emergency. For the benefit of people of the State who lack sufficient skills in English to understand the information, reasonable efforts shall be made to provide the information in the primary languages of those people as well as in English; and reasonable efforts shall be made to provide the information in a manner accessible to individuals with disabilities.

(e) All state and county agencies engaged in responding to the public health emergency may share and disclose information to the extent necessary for the treatment, control, and investigation of the emergency.

§   -7 Public health emergency fund. (a) There is created in the treasury the public health emergency fund. The fund shall accept deposits from appropriations, transfers from other funds, gifts, grants, or contributions for the purposes of the fund. The moneys in the fund shall be expended without further appropriation to pay liabilities incurred by the department in meeting a declared public health emergency and its aftermath. In addition, the department may expend moneys in the fund to reimburse other state agencies that have incurred liabilities in responding to the declared public health emergency.

(b) Whenever the governor has declared a public health emergency, the governor may direct the comptroller to transfer up to $          from the general fund to the public health emergency fund; provided, that:

(1) The governor first determines that no appropriation or other authorization for expenditure is available or sufficient to meet the emergency; and

(2) The governor immediately transmits a written determination to the chairpersons of the house committee on finance and the senate committee on ways and means and further identifies the emergency, the need for and amount of the transfer, and the expected purposes of expenditures from the fund.

(c) Upon the termination of the public health emergency, and upon the comptroller's determination in consultation with the director that all liabilities incurred as described in subsection (a) have been satisfied, the comptroller shall retransfer to the general fund the full amount transferred therefrom under subsection (b), less the total of expenditures from the fund on account of the public health emergency; provided that no retransfer shall reduce the balance in the fund to a sum less than when the public health emergency was declared. The comptroller shall immediately transmit to the chairpersons of the house committee on finance and the senate committee on ways and means a report listing the expenditures made from the fund during the emergency, specifying the amounts transferring from and being retransferred to the general fund, and explaining the calculation of the retransfer amounts.

(d) Within ninety days of the termination of the public health emergency, the auditor shall conduct and complete a review of all expenditures made from the fund during the emergency, and all remaining liabilities expected to be paid from the fund, and shall transmit findings to the chairpersons of the house committee on finance and the senate committee on ways and means, and the comptroller.

§   -8 Compensation. (a) The State shall pay just compensation to the owner of any facilities or materials that are permanently taken or permanently appropriated by a public health authority during a public health emergency. The State shall not pay just compensation to the owner of any facilities or materials that the public health authority closes, evacuates, decontaminates, or destroys when there is reasonable cause to believe that the facilities or materials endanger the public health during a public health emergency.

(b) During a public health emergency, when the public health authority deems it necessary in the interest of public health to require a resident wage earner to be isolated or quarantined or to otherwise interfere with pursuing employment, the resident shall be deemed eligible to receive unemployment benefits.

(c) Compensation for property shall be made only if private property is lawfully taken or appropriated by a public health authority for its temporary or permanent use during a state of public health emergency declared by the governor pursuant to this chapter.

(d) Any action against the State with regard to the payment of compensation shall be brought in the courts of this State in accordance with law or any rule for use during a state of public health emergency.

(e) The amount of compensation shall be calculated in the same manner as compensation due for taking of property pursuant to nonemergency eminent domain procedures, except that the amount of compensation calculated for items obtained under section    -9 shall be limited to the costs incurred to produce the item.

§   -9 Destruction of property. To the extent practicable and consistent with the protection of public health, prior to the destruction of any property under this chapter, the public health authority shall institute appropriate civil proceedings against the property to be destroyed in accordance with law or any rule for use during a state of public health emergency. Any property acquired by the public health authority through the proceedings, after entry of the decree, shall be destroyed. Any person aggrieved shall receive compensation.

§   -10 Purchase, production, and distribution of pharmaceutical or medical supplies. The department may purchase, produce, and distribute antitoxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical or medical supplies in the interest of preparing for or controlling diseases dangerous to the public health.

Whenever the director determines that there is a shortage or threatened shortage of any antitoxin, serum, vaccine, or other analogous product, the department may purchase, produce, and distribute the product under any conditions and restrictions that it may prescribe. While a shortage exists, as determined by the director, the director may establish by written order or orders, rules and priorities for the distribution and use of any such product within the State.

§   -11 Responsibilities of health care providers and others to report. (a) The department shall have the power to specify, and shall from time to time specify, the responsibilities of health care providers, medical examiners, and others to report to the department diseases, injuries, health conditions, and threats to health specified by the department. The department shall have the power to specify, and shall from time to time specify, the responsibilities of county health officials to report illnesses or health conditions to the department. The department may specify the responsibilities of pharmacists to report to the department unusual or increased prescription rates, unusual types of prescriptions, or unusual trends in pharmacy visits that may indicate a threat to public health.

(b) The boards of medical examiners, nursing, and pharmacy shall keep a record of all reports received under this section, containing the name and location of every person reported, the person's disease, injury, or health condition, the name of the person reporting the case, the date of the report, and other information required by the department. These records shall be kept in the manner or upon forms prescribed by the department. If a report concerns a student in or an employee of a public school, the department shall notify the school health authorities. County health officials shall appoint a person who shall have the responsibility to make reports to the department as provided in subsection (a).

(c) This subsection governs the confidentiality of information in the possession of the department, county health officials, or any other governmental agency. Information that relates to an individual's past, present, or future physical or mental health, condition, treatment, service, products purchased, or provisions of care, that reveals the identity of the individual, or where there is a reasonable basis to believe that the information could be utilized to reveal the identity of that individual, either alone or with other information that is, or should reasonably be known to be, available to predictable recipients of the information, shall not be considered a public record. This information shall be kept confidential except when necessary for disease investigation, control, treatment, and prevention purposes. Only those individuals who have a specific need to review the information to carry out the responsibilities of their employment shall be entitled to have access to the information.

(d) Whenever the department or a county health official learns of a case of a reportable disease or health condition, an unusual cluster, or a suspicious event, that it reasonably believes may have been caused by a criminal act or that may result in a public health emergency, it shall immediately notify the appropriate public safety authorities. Sharing of information shall be restricted to that necessary for treatment and control of illness, investigation of the incident, and prevention of a public health emergency.

(e) No person making a report under this section shall be liable in any civil or criminal action by reason of the report if it was made in good faith.

(f) Any health care provider or other person who neglects or refuses to file a report required by this section shall be subject to a fine of not more than $1,000. The health care provider shall be subject to suspension or revocation of license or certification if the neglect or refusal to file a report is gross, wanton, or wilful misconduct and poses a serious risk to the public health.

§   -12 Investigation. (a) If a disease or condition dangerous to the public health exists or is likely to exist in any place within the State, the department shall make an investigation of it and of the means of preventing its spread, and shall consult with county authorities. The department shall have concurrent powers with the respective county health official.

(b) The department may obtain, upon request, medical records and other information that the department considers necessary to carry out its responsibilities to investigate, monitor, prevent, and control diseases or conditions dangerous to the public health.

§   -13 Assistance of law enforcement authorities. Law enforcement authorities, at the request of the director or the director's designee, shall assist appropriate medical personnel in the transportation of any person to the designated treatment center.

§   -14 Issuance of or order. (a) Whenever the director, or a county health official determines that there is reasonable cause to believe that a disease or condition dangerous to the public health exists or may exist or that there is an immediate risk of an outbreak of such a disease or condition, that the disease or condition presents a substantial risk to public health, and that certain measures are necessary to decrease or eliminate the risk to public health, the director or county health official may issue an order, which shall be in writing, and shall state the reasons for the order. The order may also require the:

(1) Owner or occupier of premises to permit entry into and investigation of the premises;

(2) Owner or occupier of premises to close the premises or a specific part of the premises, and allow reopening of the premises when the danger has ended;

(3) Placing of placards on premises to give notice of an order requiring the closing of the premises;

(4) Cleaning or disinfection, or both, of the premises or the item specified in the order; and

(5) Destruction of the matter or item specified in the order.

The order shall be delivered personally to the person to whom it is directed, but if personal delivery is not possible, the order shall be delivered in a manner that is reasonably calculated to notify the person of the order. If a person does not comply with the order, and if the noncompliance poses a substantial risk to public health, the director or county health official may notify the police department of the county where the person is present, and the police shall enforce the order. If a person does not comply with the order within the time specified in the order, but the noncompliance does not pose a substantial risk to public health, the director or county health official may apply to a court of competent jurisdiction for an order requiring the person to comply with the order within the time specified and to do whatever else the court considers appropriate in the circumstances to protect the public health. The law enforcement authorities of the county where the person is present shall enforce the court order. Any person who knowingly violates an order issued under this subsection may be subject to a civil fine of not more than $1,000 per violation. Each day that the violation continues shall be deemed a separate violation. Any fine collected for a violation pursuant to this section shall be credited to the general fund. The director or county health official may recover expenses incurred in enforcing the order from the person to whom the order was directed.

(b) The director or county health official may exercise the following powers:

(1) Vaccinate or provide precautionary prophylaxis to individuals as protection against communicable disease and to prevent the spread of communicable or possibly communicable disease; provided that any vaccine to be administered must not be such as is reasonably likely to lead to serious harm to the affected individual; and

(2) Treat individuals exposed to or infected with disease; provided that treatment must not be such as is reasonably likely to lead to serious harm to the affected individual. An individual who is unable or unwilling to submit to vaccination or treatment shall not be required to submit to the procedures but may be isolated or quarantined if refusal poses a substantial risk to public health or results in uncertainty as to whether the person has been exposed to or is infected with a disease or condition that poses a substantial risk to public health.

§   -15 Safe disposal of human remains. (a) The department may adopt and enforce measures to provide for the safe disposal of human remains as may be reasonable and necessary to respond to the public health emergency. These measures may include:

(1) Embalming, burial, cremation, interment, disinterment, transportation, and disposal of human remains;

(2) Taking possession or control of any human remains;

(3) Ordering the disposal of any human remains of a person who has died of a contagious disease through burial or cremation within twenty-four hours after death. Religious, cultural, family, and individual beliefs of the deceased person or the person's family shall be considered when disposing of any human remains;

(4) Compelling any business or facility authorized to embalm, bury, cremate, inter, disinter, transport, and dispose of human remains under the laws of this State to accept any human remains or provide the use of its business or facility if the actions are reasonable and necessary to respond to the public health emergency as a condition of licensure, authorization, or the ability to continue to doing business in the State. The use of the business or facility may include transferring the management and supervision of the business or facility to the public health authority or other authority as the public health authority determines, for a limited or unlimited period of time, but shall not exceed the termination of the declaration of the state of public health emergency; or

(5) Procuring, by eminent domain or otherwise, any business or facility authorized to embalm, bury, cremate, inter, disinter, transport, and dispose of human remains under the laws of this State as may be reasonable and necessary to respond to the public health emergency, with the right to take immediate possession thereof.

(b) Every human remains prior to disposal shall be clearly labeled with all available information to identify the decedent and the circumstances of death. Any human remains of a deceased person with a contagious disease shall have an external, clearly visible tag indicating that the human remains is infected and, if known, the contagious disease.

(c) Every person in charge of the disposal of human remains shall maintain an electronic or written record of each human remain and all available information to identify the decedent and the circumstances of death and disposal. If human remains cannot be identified, prior to disposal a qualified person, to the extent possible, shall take fingerprints and one or more photographs of the corpse, and collect a DNA specimen. All information gathered under this subsection shall be promptly forwarded to the public health authority.

(d) Nothing in this section shall relieve third party payers from meeting their contractual or other legal obligations, including the coverage of medical expenses.

(e) Any person aggrieved by this section may appeal to a single justice of the supreme court.

§   -16 Power of director of health or county health official. (a) The director or any county health official may:

(1) Decontaminate or cause to be decontaminated any individual; provided that decontamination measures shall be by the least restrictive means necessary to protect the public health and shall be such as are not reasonably likely to lead to serious harm to the affected individual; and

(2) Perform physical examinations, tests, and specimen collection necessary to diagnose a disease or condition and ascertain whether an individual presents a risk to public health.

If an individual is unable or unwilling to submit to decontamination or procedures necessary for diagnosis, the decontamination or diagnosis procedures may proceed only pursuant to an order of the court. During the time necessary to obtain the court order, the individual may be isolated or quarantined if refusal to submit to decontamination or diagnosis procedures poses a substantial risk to public health or results in uncertainty as to whether the person has been exposed to or is infected with a disease or condition that poses a substantial risk to public health.

(b) When the director or a county health official reasonably believes that a person may have been exposed to a disease or condition that poses a threat to the public health, the person may be detained for as long as may be reasonably necessary for the director or county health official to convey information to the person regarding the disease or condition and to obtain contact information, including the person's residence and employment addresses, date of birth, and telephone numbers.

(c) If a person detained under subsection (b) refuses to provide the information requested, the person may be isolated or quarantined if refusal poses a substantial risk to public health or results in uncertainty as to whether the person has been exposed to or is infected with a disease or condition that poses a substantial risk to public health.

(d) This section shall not affect the authority of the director or a county health official to take action under any other law or rule.

§   -17 Isolation and quarantine. (a) Whenever the director or a county health official determines that an individual or group of individuals has or may have a disease or condition dangerous to the public health or is or may be infected with an agent of the disease or condition, which disease or condition is transmissible between people and poses a substantial risk to public health, the director or county health official may order the individual or group to be isolated or quarantined. An order for isolation or quarantine may include any individual who is unwilling or unable to undergo vaccination, precautionary prophylaxis, medical treatment, decontamination, medical examinations, tests, or specimen collection and whose refusal of one or more of these measures poses a substantial risk to public health or results in uncertainty as to whether the person has been exposed to or is infected with a disease or condition that poses a substantial risk to public health. A quarantine or isolation order shall be delivered personally, but if personal delivery is not possible, the order shall be delivered in a manner that is reasonably calculated to notify the affected individual or group of the order. In the case of a group, this may include delivery through the mass media and posting the order in a place where members of the group are reasonably likely to see it.

(b) Isolation and quarantine orders must utilize the least restrictive means necessary to prevent a substantial risk to public health, and may include:

(1) Restricting a person from being present in certain places including school or work;

(2) Confinement to private homes;

(3) Confinement to other private or public premises; or

(4) Quarantine of an area.

(c) An order for isolation or quarantine shall be immediately enforceable by any law enforcement official of the State or the counties having the power to arrest and serve criminal process.

(d) Orders for isolation or quarantine that restrict an individual from being present in a place or places are subject to the following requirements:

(1) The order shall be in writing and shall state the specific restrictions that are applicable;

(2) The individual subject to the order may request that the order be rescinded by contacting a designated health official at a telephone number stated on the order; and

(3) An order that has not expired shall be rescinded when the individual poses no substantial risk of transmitting to others a disease or condition dangerous to the public health.

(e) Orders for home isolation or quarantine are subject to the following requirements:

(1) The order shall be in writing and shall require an individual to remain at home or at premises of the individual's choice that are acceptable to the director or county health official, under conditions and for a period of time that will prevent transmission of the disease or condition;

(2) The individual subject to the order may request that the order be rescinded by contacting a designated health official at a telephone number stated on the order;

(3) An order for home isolation or quarantine which has not expired shall be rescinded when the individual poses no substantial risk of transmitting to others a disease or condition dangerous to the public health; and

(4) If an individual violates an order for home isolation or quarantine, the director or county health official may apply to a judge of a court of competent jurisdiction who may order the individual to be taken into custody and detained in a place specified by the judge. The place of detention shall not include a jail, prison, or other correctional facility.

(f) Orders for isolation or quarantine in a place other than an individual's home or premises of the individual's choice are subject to the following requirements:

(1) The director or a county health official may order an individual or group detained in a medical facility, premises, or other appropriate facility designated by the director or county health official, except that the place of detention shall not include a jail, prison, or other correctional facility. The order shall be in writing and shall include:

(A) The reason for the detention;

(B) The legal authority for the order;

(C) An individualized assessment of the individual's or group's circumstances or behavior constituting the basis for issuance of the order;

(D) The less restrictive alternatives that were attempted and were unsuccessful or the less restrictive alternatives that were considered and rejected, with reasons for the rejection; and

(E) The procedure by which the individual or group may request release from detention;

(2) The individual or group detained may request release from detention by contacting a designated health official at a telephone number stated on the order;

(3) Whether or not the individual or group requests release from detention, the director or county health official must obtain an order from a court of competent jurisdiction authorizing the detention within ten days following the commencement of detention. The court shall issue the order if it finds by a fair preponderance of the evidence that detention is the least restrictive means to prevent a substantial risk to public health;

(4) The court shall appoint counsel at government expense to represent an individual or group who is isolated or quarantined under this subsection and who is not otherwise represented by counsel. Adequate means of communication between individuals or groups and their counsel shall be provided;

(5) Isolation or quarantine in a place other than an individual's home or premises of the individual's choice shall be subject to the following provisions:

(A) Isolated individuals shall be confined separately from quarantined individuals;

(B) The health status of isolated and quarantined individuals shall be monitored regularly to determine if they require continued isolation or quarantine;

(C) If a quarantined individual subsequently acquires or is reasonably believed to have acquired a disease or condition dangerous to the public health, that person shall promptly be removed to isolation;

(D) Isolated and quarantined individuals shall be immediately released when they pose no substantial risk of transmitting to others a disease or condition dangerous to the public health;

(E) The needs of individuals isolated and quarantined shall be addressed in a systematic and competent fashion, including providing adequate food, clothing, shelter, means of communication with those in isolation or quarantine and outside these settings, medication, competent medical care, and crisis counseling or other mental health services when needed;

(F) Premises used for isolation and quarantine shall be maintained in a safe and hygienic manner and shall be designed to minimize the likelihood of further transmission of infection or other harms to individuals isolated and quarantined;

(G) To the extent possible, cultural and religious beliefs and existing disabilities should be considered in addressing the needs of individuals, and in establishing and maintaining isolation and quarantine premises; and

(H) The director or county health official may authorize physicians, health care workers, mental health workers, and others access to individuals in isolation or quarantine as necessary to meet the needs of isolated or quarantined individuals. No individual other than an authorized individual shall enter isolation or quarantine premises. Any individual entering isolation or quarantine premises with or without authorization may be isolated or quarantined.

(g) Orders for quarantine of an area are subject to the following requirements:

(1) The director or a county health official may order the quarantine of an area coextensive with an area that poses a substantial risk to public health;

(2) The director or county health official shall use all reasonable means of communication to inform individuals in the quarantine area of the director's or county health official's orders and instructions during the period of area quarantine. At a minimum, the communication shall include posting notices in places where people in and approaching the area are reasonably likely to see them, and publishing a notice in a newspaper of general circulation in the area at least once each week during the area quarantine period, which notices shall state the orders and instructions in force with a brief explanation of their meaning and effect;

(3) The director or county health official shall terminate an area quarantine when the area no longer poses a substantial risk to public health;

(4) Any individual in the area subject to an order of area quarantine may request that the order be rescinded by contacting a designated health official at a telephone number stated on the order; and

(5) If an individual violates an order of area quarantine, the director or county health official may apply to a judge of a court of competent jurisdiction, who may order the individual to be taken into custody and detained in a place specified by the judge. The place of detention shall not include a jail, prison, or other correctional facility.

(h) In any proceedings brought under this section:

(1) If the parties cannot personally appear before the court, proceedings may be conducted by their authorized representatives and may be held by any means that allows all parties to participate fully;

(2) A health care provider's sworn affidavit attesting to the medical examination, treatment, or evaluation of an individual for the purposes of a hearing under this section shall be prima facie evidence of the facts stated therein and the affiant need not appear except at the discretion of the court; and

(3) To promote the fair and efficient operation of justice, and giving due regard to the rights of the affected individuals, the protection of the public's health, the exigency of the circumstances, and the availability of necessary witnesses and evidence, the court may order the consolidation of individual claims into groups of claims.

(i) Any person who knowingly violates an order for isolation or quarantine may be subject to a civil fine of not more than $1,000 per violation. Each day that the violation continues shall be deemed a separate violation.

(j) When the director or a county health official requires a resident wage earner to be isolated or quarantined or otherwise interferes with the resident wage earner's employment for the protection of public health, that person shall be deemed eligible to receive unemployment benefits to the extent permitted by law.

It shall be a violation for an employer to discharge or reduce any benefits of an employee because the employee is subject to an order of isolation or quarantine.

(k) This section does not affect the authority of the department to isolate or quarantine individuals with active tuberculosis.

§   -18 Control of houses. If necessary, the director or a county health official may take control of houses or buildings for the purpose of isolation or quarantine or for the safekeeping of articles dangerous to the public health, and may make orders to effectuate this section. The director or county health official may secure any infected clothing, furnishings, or other articles dangerous to the public health and may disinfect or dispose of them in a manner that will protect the public health.

§   -19 No professional liability. (a) Any public employee, in response to a public health emergency declared under this chapter, and all persons acting within the scope of rendering assistance or advice during the emergency and at the request or order of a public employee, representative, or agent of a public employer, shall be a public employee of the public employer making the request or order. The immunities provided in this section shall not apply to any person whose act or omission caused in whole or in part the public health emergency or who would otherwise be liable therefor.

(b) No dentist, physician, mental health counselor, nurse, occupational therapist, optician, optometrist, pharmacist, psychologist, or social worker licensed under chapter 448, 453, 453D, 457, 457G, 458, 459, 460, 461, 465, or 467E who, in good faith, as a volunteer and without fee, renders emergency care or treatment, other than in the ordinary course of the person's practice, shall be liable in a suit for damages as a result of acts or omissions, nor shall the person be liable to a hospital for its expenses if, under the emergency conditions, the person orders an individual hospitalized or causes the individual's admission into a hospital.

§   -20 Governor's declaration of supply emergency. (a) The governor may declare that a supply emergency exists, after conferring with the attorney general, the director of commerce and consumer affairs, and the director of business, economic development, and tourism, as a result of a natural disaster, military act, civil disorder, terrorist act, bioterrorist act or other extraordinary circumstance. The governor shall support the declaration of a supply emergency by making written findings regarding the market disruption, the products or services that are in short supply, and that the products or services are essential to the health, safety, or welfare of the people. The written declaration shall be filed with the house and senate clerks, the attorney general, the department of commerce and consumer affairs, and the department of business, economic development, and tourism. The supply emergency shall automatically terminate ninety days after its declaration but may be renewed by the governor under the same standards and procedures set forth in this subsection.

(b) By a majority vote, the supreme court may terminate a declaration of a supply emergency upon finding that the market disruption has ended, the products or services are no longer in short supply, and that the products or services are not essential to the health, safety, or welfare of the people.

(c) The attorney general, in consultation with the department of commerce and consumer affairs and the department of business, economic development, and tourism, and upon the declaration by the governor that a supply emergency exists, shall take appropriate action to ensure that no person shall sell a product or service at a price that unreasonably exceeds the price charged before the emergency. The attorney general shall adopt, in accordance with chapter 91, rules governing exceptions for the additional costs incurred in connection with the acquisition, production, distribution, or sale of an energy resource, and rules regarding violations of this section.

§   -21 Rules. The department of health shall adopt rules in accordance with chapter 91 to implement this chapter."

SECTION 2. The board of pharmacy and a representative from the National Association of Chain Drug Stores, in conjunction with the department of health, shall study the feasibility of a statewide pharmacy and drugstore electronic communication network to comply with section     -3 in Section 1 of this Act, and that may also be used to track epidemic or pandemic disease. The department of health shall report its findings to the legislature prior to the convening of the regular session of       .

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:

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