Order and Procedure for Isolation, Quarantine and Closure

Section 690.1330  Order and Procedure for Isolation, Quarantine and Closure a) The Department or certified local health department may order a person or group of persons to be quarantined or isolated or may order a place to be closed and made off limits to the public on an immediate basis without prior consent or court order if, in the reasonable judgment of the Department or certified local health department, immediate action is required to protect the public from a dangerously contagious or infectious disease .  (Section 2(c) of the Act) The determination that immediate action is required shall be based on the following: 1)         The Department or the certified local health department has reason to believe that a person or group of persons is, or is suspected to be, infected with, exposed to, or contaminated with a dangerously contagious or infectious disease that could spread to or contaminate others if remedial action is not taken; and 2)         The Department or the certified local health department has reason to believe that the person or group of persons would pose a serious and imminent risk to the health and safety of others if not detained for isolation; and 3)         The Department or the certified local health department has first made efforts, which shall be documented, to obtain voluntary compliance with requests for medical examination, testing, treatment, counseling, vaccination, decontamination of persons or animals, isolation, and inspection and closure of facilities, or has determined that seeking voluntary compliance would create a risk of serious harm. b) All police officers, sheriffs and all other officers and employees of the State or any locality shall enforce the rules and regulations so adopted and orders issued by the Department or the certified local health department.  (Section 2(a) of the Act)  The Department or certified local health department may request the assistance of police officers, sheriffs, and all other officers and employees of any political subdivision within the jurisdiction of the Department or certified local health department to immediately enforce an order given to effectuate the purposes of this Subpart. c)         If the Department or certified local health department orders the immediate isolation or quarantine of a person or group of persons: 1)         The immediate isolation or quarantine order shall be for a period not to exceed the period of incubation and communicability, as determined by the Department or certified local health department, for the dangerously contagious or infectious disease. 2)         The Department or certified local health department shall issue a written isolation or quarantine order within 24 hours after the commencement of isolation or quarantine pursuant to a verbal order, which shall specify the following: A)        The identity of all persons or groups subject to quarantine or isolation, if known; B)        The premises subject to quarantine, isolation or closure; C) Notice of the right to counsel; D) Notice that if the person or owner is indigent, the court will appoint counsel for that person or owner; E) Notice of the reason for the order for isolation, quarantine or closure , including the suspected dangerously contagious or infectious disease, if known; F) Notice of whether the order is an immediate order, and if so, the time frame for the Department or certified local health department to seek consent or to file a petition requesting a court order; G) Notice of the anticipated duration of the isolation, quarantine, or closure , including the dates and times at which isolation, quarantine, or closure commences and ends (Section 2(c) of the Act); H)        A statement of the measures taken by the Department or the certified local health department to seek voluntary compliance or the basis on which the Department or the certified local health department determined that seeking voluntary compliance would create a risk of serious harm; I)         A statement regarding the medical basis on which isolation, quarantine, or closure is justified, e.g., clinical manifestations; physical examination; laboratory tests, diagnostic tests or other medical tests; epidemiologic information; or other evidence of exposure or infection available to the Department or certified local health department at the time; J)         A statement that such persons may refuse examination, medical monitoring, medical treatment, prophylaxis, or vaccination, but remain subject to isolation or quarantine; and K)        A statement that, at any time while the isolation, quarantine or closure order is in effect, persons under isolation, quarantine, or closure may request a hearing to review the isolation, quarantine or closure order as set forth in Section 690.1345 of this Subpart. d)         Verbal Orders. 1)         The Department or certified local health department may issue a verbal order of isolation, quarantine, or closure without prior notice to the person or group of persons if the delay in imposing a written order of isolation, quarantine, or closure would jeopardize the Department's or certified local health department's ability to prevent or limit: A)        The transmission of a dangerously contagious or infectious disease that poses a threat to the public; or B)        The transmission of an infectious agent or possibly infectious agent that poses a threat to the public health; 2)         A verbal order of isolation, quarantine, or closure issued under this Subpart: A)        Is valid for 24 hours and shall be followed up with a written order; B)        May be verbally communicated by a first responder to the person or group of persons subject to isolation, quarantine, or closure; and C)        May be enforced by the first responder until a written order is issued. e) In the event of an immediate order issued without prior consent or court order, the Department or certified local health department shall, as soon as practical, within 48 hours after issuing the order, obtain the consent of the person or owner or file a petition requesting a court order authorizing the isolation, quarantine or closure.  When exigent circumstances exist that cause the court system to be unavailable or that make it impossible to obtain consent or file a petition within 48 hours after issuance of an immediate order, the Department or certified local health department must obtain consent or file a petition requesting a court order as soon as reasonably possible. (Section 2(c) of the Act) 1)         The petition for a court order authorizing involuntary isolation or quarantine of a person or group of persons or the closure of premises shall specify the following: A)        The identity of all persons or groups subject to isolation or quarantine, if known; B)        The premises subject to isolation, quarantine or closure; C)        The reason for the order for isolation, quarantine or closure, including the suspected dangerously contagious or infectious disease if known; D)        The date and time at which isolation, quarantine or closure will commence; E)        The anticipated duration of isolation, quarantine, or closure based on the suspected dangerously contagious or infectious disease, if known; F)         The measures taken by the Department or the certified local health department to seek voluntary compliance or the basis on which the Department or the certified local health department determined that seeking voluntary compliance would create a risk of serious harm; G)        The medical basis on which isolation, quarantine or closure is justified, e.g., clinical manifestations; physical examination; laboratory tests, diagnostic tests or other medical tests; epidemiologic information; or other evidence of exposure or infection available to the Department or certified local health department at the time. 2)         The petition shall be accompanied by the declaration of the Department or the certified local health department attesting to the facts asserted in the petition, together with any further information that may be relevant and material to the court's consideration. f)         Upon filing a petition requesting a court order authorizing the isolation, quarantine or closure, or a petition requesting continued isolation, quarantine, or closure, the Department or certified local health department shall serve a notice of the hearing upon the person or persons who are being quarantined or isolated or upon the owner of the property that is being closed at least 24 hours before the hearing.  If it is impractical to provide individual notice to large groups who are isolated or quarantined, a copy of the notice shall be posted in a designated location.  The notice shall contain the following information: 1)         The time, date and place of the hearing; 2)         The grounds and underlying facts upon which continued isolation, quarantine or closure is sought; 3)         The person's right to appear at the hearing; and 4)         The person's right to counsel, including the right, if the person is indigent, to be represented by counsel designated by the court. g) To obtain a court order, the Department or certified local health department , by clear and convincing evidence, must prove that the public's health and welfare are significantly endangered by a person or group of persons that has, that is suspected of having, that has been exposed to, or that is reasonably believed to have been exposed to a dangerously contagious or infectious disease, including non-compliant tuberculosis patients or that the public's health and welfare have been significantly endangered by a place where there is a significant amount of activity likely to spread a dangerously contagious or infectious disease.  The Department or certified local health department must also prove that all other reasonable means of correcting the problem have been exhausted and no less restrictive alternative exists.  For purposes of this subsection, in determining whether no less restrictive alternative exists, the court shall consider evidence showing that, under the circumstances presented by the case in which an order is sought, quarantine or isolation is the measure provided for in a rule of the Department or in guidelines issued by the Centers for Disease Control and Prevention or the World Health Organization. (Section 2(c) of the Act) 1)         Isolation, quarantine, or closure authorized as a result of a court order shall be for a period not to exceed 30 days from the date of issuance of the court order. 2)         The Department or certified local health department may petition the court to continue the isolation, quarantine, or closure beyond the initial 30 days. 3)         The Department or the certified local health department may petition the court to provide interpreters. 4)         Prior to the expiration of a court order for continued isolation, quarantine, or closure, the Department or certified local health department may petition the court to continue isolation, quarantine, or closure, provided that: A)        The Department or certified local health department provides the court with a reasonable basis to require continued isolation, quarantine, or closure to prevent a serious and imminent threat to the health and safety of others. B)        The request for a continued order shall be for a period not to exceed 30 days.