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--------------------------------------------------------------------- ¦ REFERENCE TITLE: surveillance advisories; public health emergencies ¦ --------------------------------------------------------------------- ¦ ¦ ¦ ¦ ¦ ¦ ¦ State of Arizona ¦ ¦ Senate ¦ ¦ Forty-fifth Legislature ¦ ¦ Second Regular Session ¦ ¦ 2002 ¦ ¦ ¦ --------------------------------------------------------------------- ¦ SB 1400 ¦ --------------------------------------------------------------------- ¦ Introduced by ¦ ¦ Senators Gerard, Guenther ¦ ---------------------------------------------------------------------
AN ACT
AMENDING SECTIONS 36-136 AND 36-624, ARIZONA REVISED STATUTES; AMENDING TITLE 36, CHAPTER 6, ARIZONA REVISED STATUTES, BY ADDING ARTICLE 9; RELATING TO ENHANCED SURVEILLANCE ADVISORIES AND PUBLIC HEALTH EMERGENCIES.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 36-136, Arizona Revised Statutes, is amended to read:
36-136. Powers and duties of director; compensation of personnel
A. The director shall:
1. Be the executive officer of the department of health services and the state registrar of vital statistics but shall not receive compensation for services as registrar.
2. Perform all duties necessary to carry out the functions and responsibilities of the department.
3. Prescribe the organization of the department. The director shall appoint or remove such personnel considered necessary for the efficient work of the department and shall prescribe the duties of all personnel. The director may abolish any office or position in the department that the director believes is unnecessary.
4. Administer and enforce the laws relating to health and sanitation and the rules of the department.
5. Provide for the examination of any premises if the director has reasonable cause to believe that on the premises there exists a violation of any health law or rule of the state.
6. Exercise general supervision over all matters relating to sanitation and health throughout the state. When in the opinion of the director it is necessary or advisable, a sanitary survey of the whole or of any part of the state shall be made. The director may enter, examine and survey any source and means of water supply, sewage disposal plant, sewerage system, prison, public or private place of detention, asylum, hospital, school, public building, private institution, factory, workshop, tenement, public washroom, public rest room, public toilet and toilet facility, public eating room and restaurant, dairy, milk plant or food manufacturing or processing plant, and any premises in which the director has reason to believe there exists a violation of any health law or rule of the state that the director has the duty to administer.
7. Prepare sanitary and public health rules.
8. Perform other duties prescribed by law.
B. If the director has reasonable cause to believe that there exists a violation
of any health law or rule of the state, the director may inspect any person
or property in transportation through the state, and
of any car, boat, train, trailer,
airplane or other vehicle in which such person or property is transported,
and may enforce detention or disinfection as reasonably necessary for the
public health if there exists a violation of any health law or rule.
C. The director may deputize, in writing, any qualified officer or employee in the department to do or perform on the director's behalf any act the director is by law empowered to do or charged with the responsibility of doing.
D. The director may delegate to a local health department or public health services district any functions, powers or duties that the director believes can be competently, efficiently and properly performed by the health department or public health services district if:
1. The director or superintendent of the local health agency or public health services district is willing to accept the delegation and agrees to perform or exercise the functions, powers and duties conferred in accordance with the standards of performance established by the director.
2. Monies appropriated or otherwise made available to the department for distribution to or division among counties or public health services districts for local health work may be allocated or reallocated in a manner designed to assure the accomplishment of recognized local public health activities and delegated functions, powers and duties in accordance with applicable standards of performance. Whenever in the director's opinion there is cause, the director may terminate all or a part of any such delegation and may reallocate all or a part of any funds that may have been conditioned on the further performance of the functions, powers or duties conferred.
E. The compensation of all personnel shall be as determined pursuant to section 38-611.
F. The director may make and amend rules necessary for the proper administration and enforcement of the laws relating to the public health.
G. Notwithstanding subsection H, paragraph 1 of this section, the director may define and prescribe emergency measures for detecting, reporting, preventing and controlling communicable or infectious diseases or conditions if the director has reasonable cause to believe that a serious threat to public health and welfare exists. Emergency measures are effective for no longer than eighteen months.
H. The director shall, by rule:
1. Define and prescribe reasonably necessary measures for detecting, reporting,
preventing and controlling communicable and preventable diseases. The rules
shall declare certain diseases reportable.
and shall further establish minimum periods of isolation
or quarantine and procedures and measures to institute isolation or quarantine,
including the right to a hearing. The rules shall allow the director to institute
isolation or quarantine before the completion of a hearing if the director
determines that clear and convincing evidence exists that a person poses
a substantial danger to another person or the community.
The rules shall prescribe measures reasonably required to prevent the occurrence
of, or to seek early detection and alleviation of, disability, insofar as
possible, from communicable or preventable diseases. The rules shall include
reasonably necessary measures to control animal diseases transmittable to
humans.
2. Define and prescribe reasonably necessary measures, in addition to those prescribed by law, regarding the preparation, embalming, cremation, interment, disinterment and transportation of dead human bodies and the conduct of funerals, relating to and restricted to communicable diseases and regarding the removal, transportation, cremation, interment or disinterment of any dead human body.
3. Define and prescribe reasonably necessary procedures not inconsistent with law in regard to the use and accessibility of vital records, delayed birth registration and the completion, change and amendment of vital records.
4. Except as relating to the beneficial use of wildlife meat by public institutions and charitable organizations pursuant to title 17, prescribe reasonably necessary measures to assure that all food, including meat and meat products sold at the retail level, or drink, other than milk and milk products, sold or distributed for human consumption is free from unwholesome, poisonous or other foreign substances and filth, insects or disease-causing organisms. The rules shall prescribe reasonably necessary measures governing the production, processing, labeling, storing, handling, serving and transportation of such food and drink. The rules shall prescribe minimum standards for the sanitary facilities and conditions that shall be maintained in any plant, other than a meat packing plant, slaughterhouse or wholesale meat processing plant, and in any warehouse, restaurant or other premises and in any truck or other vehicle in which food or drink is produced, processed, stored, handled, served or transported. The rules shall provide for the inspection and licensing of premises and vehicles so used, and for abatement as public nuisances of any premises or vehicles that do not comply with the rules and minimum standards.
5. Prescribe reasonably necessary measures to assure that all meat and meat products for human consumption handled at the retail level are delivered in a manner and from sources approved by the Arizona department of agriculture and are free from unwholesome, poisonous or other foreign substances and filth, insects or disease-causing organisms. The rules shall prescribe standards for sanitary facilities to be used in identity, storage, handling and sale of all meat and meat products sold at the retail level.
6. Prescribe reasonably necessary measures regarding production, processing, labeling, handling, serving and transportation of bottled water to assure that all bottled drinking water distributed for human consumption is free from unwholesome, poisonous, deleterious or other foreign substances and filth or disease-causing organisms. The rules shall prescribe minimum standards for the sanitary facilities and conditions that shall be maintained at any source of water, bottling plant and truck or vehicle in which bottled water is produced, processed, stored or transported and shall provide for inspection and certification of bottled drinking water sources, plants, processes and transportation and for abatement as a public nuisance of any water supply, label, premises, equipment, process or vehicle that does not comply with the minimum standards. The rules shall prescribe minimum standards for bacteriological, physical and chemical quality for bottled water and for the submission of samples at intervals prescribed in the standards.
7. Define and prescribe reasonably necessary measures governing ice production,
handling, storing and distribution to assure that all ice sold or distributed
for human consumption or for the preservation or storage of food for human
consumption is free from unwholesome, poisonous, deleterious or other foreign
substances and filth or disease-causing organisms. The rules shall prescribe
minimum standards for the sanitary facilities and conditions and the quality
of ice that shall be maintained at any ice plant, storage and truck or vehicle
in which ice is produced, stored, handled or
transported, and shall provide for
inspection and licensing of the premises and vehicles, and for abatement
as public nuisances of ice, premises, equipment, processes or vehicles that
do not comply with the minimum standards.
8. Define and prescribe reasonably necessary measures concerning sewage and excreta disposal, garbage and trash collection, storage and disposal, and water supply for recreational and summer camps, campgrounds, motels, tourist courts, trailer coach parks and hotels. The rules shall prescribe minimum standards for preparation of food in community kitchens, adequacy of excreta disposal, garbage and trash collection, storage and disposal and water supply for recreational and summer camps, campgrounds, motels, tourist courts, trailer coach parks and hotels and shall provide for inspection of such premises and for abatement as public nuisances of any premises or facilities that do not comply with the rules.
9. Define and prescribe reasonably necessary measures concerning the sewage and excreta disposal, garbage and trash collection, storage and disposal, water supply and food preparation of all public schools. The rules shall prescribe minimum standards for sanitary conditions that shall be maintained in any public school and shall provide for inspection of such premises and facilities and for abatement as public nuisances of any premises that do not comply with the minimum standards.
10. Prescribe reasonably necessary measures to prevent pollution of water used in public or semipublic swimming pools and bathing places and to prevent deleterious health conditions at such places. The rules shall prescribe minimum standards for sanitary conditions that shall be maintained at any public or semipublic swimming pool or bathing place and shall provide for inspection of such premises and for abatement as public nuisances of any premises and facilities that do not comply with the minimum standards. The rules shall be developed in cooperation with the director of the department of environmental quality and shall be consistent with the rules adopted by the director of the department of environmental quality pursuant to section 49-104, subsection B, paragraph 12.
11. Prescribe reasonably necessary measures to keep confidential information relating to diagnostic findings and treatment of patients, as well as information relating to contacts, suspects and associates of communicable disease patients. In no event shall such confidential information be made available for political or commercial purposes.
12. Prescribe reasonably necessary measures regarding human immunodeficiency virus testing as a means to control the transmission of that virus, including the designation of anonymous test sites as dictated by current epidemiologic and scientific evidence.
I. The rules adopted under the authority conferred by this section shall be observed throughout the state and shall be enforced by each local board of health or public health services district, but this section does not limit the right of any local board of health or county board of supervisors to adopt ordinances and rules as authorized by law within its jurisdiction, provided that the ordinances and rules do not conflict with state law and are equal to or more restrictive than the rules of the director.
J. The powers and duties prescribed by this section do not apply in instances in which regulatory powers and duties relating to public health are vested by the legislature in any other state board, commission, agency or instrumentality, except that with regard to the regulation of meat and meat products, the department of health services and the Arizona department of agriculture within the area delegated to each shall adopt rules that are not in conflict.
K. The director, in establishing fees authorized by this section, shall comply with title 41, chapter 6. The department shall not set a fee at more than the department's cost of providing the service for which the fee is charged. State agencies are exempt from all fees imposed pursuant to this section.
L. After consultation with the state superintendent of public instruction, the director shall prescribe the criteria the department shall use in deciding whether or not to notify a local school district that a pupil in the district has tested positive for the human immunodeficiency virus antibody. The director shall prescribe the procedure by which the department shall notify a school district if, pursuant to these criteria, the department determines that notification is warranted in a particular situation. This procedure shall include a requirement that before notification the department shall determine to its satisfaction that the district has an appropriate policy relating to nondiscrimination of the infected pupil and confidentiality of test results and that proper educational counseling has been or will be provided to staff and pupils.
Sec. 2. Section 36-624, Arizona Revised Statutes, is amended to read:
36-624. Quarantine and sanitary measures to prevent contagion
When a local board of health or local health department is apprised that
infectious or contagious disease exists within its jurisdiction, it shall
immediately make an investigation. If the investigation discloses that the
disease does exist, the board or department may adopt quarantine and sanitary
measures consistent with department rules adopted
pursuant to section 36-136, subsection H, paragraph 1
SECTIONS 36-788 AND 36-789 to prevent the spread
of the disease. The local board or health department shall immediately notify
the department of health services of the existence and nature of the
disease, and measures taken concerning
it.
Sec. 3. Title 36, chapter 6, Arizona Revised Statutes, is amended by adding article 9, to read:
ARTICLE 9. ENHANCED SURVEILLANCE ADVISORIES AND
PUBLIC HEALTH EMERGENCIES
36-781. Definitions
IN THIS ARTICLE, UNLESS THE CONTEXT OTHERWISE REQUIRES:
1. "BIOTERRORISM" MEANS THE INTENTIONAL USE OF ANY MICROORGANISM, VIRUS, INFECTIOUS SUBSTANCE OR BIOLOGICAL PRODUCT THAT MAY BE ENGINEERED AS A RESULT OF BIOTECHNOLOGY OR ANY NATURALLY OCCURRING OR BIOENGINEERED COMPONENT OF ANY MICROORGANISM, VIRUS, INFECTIOUS SUBSTANCE OR BIOLOGICAL PRODUCT, TO CAUSE OR ATTEMPT TO CAUSE DEATH, DISEASE OR OTHER BIOLOGICAL MALFUNCTION IN ANY LIVING ORGANISM.
2. "DIRECTOR" MEANS THE DIRECTOR OF THE DEPARTMENT OF HEALTH SERVICES.
3. "HEALTHCARE PROVIDER" HAS THE SAME MEANING PRESCRIBED IN SECTION 12-2291.
4. "LOCAL HEALTH AUTHORITY" MEANS A COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT OR ANY PERSON AUTHORIZED TO ACT ON BEHALF OF THE COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT.
5. "PUBLIC SAFETY AUTHORITY" MEANS THE DEPARTMENT OF PUBLIC SAFETY, A LOCAL LAW ENFORCEMENT AGENCY OR A PERSON AUTHORIZED TO ACT ON BEHALF OF THE DEPARTMENT OF PUBLIC SAFETY OR LOCAL LAW ENFORCEMENT AGENCY
36-782. Enhanced surveillance advisory
A. THE GOVERNOR, IN CONSULTATION WITH THE DIRECTOR, MAY ISSUE AN ENHANCED SURVEILLANCE ADVISORY IF THE GOVERNOR HAS REASONABLE CAUSE TO BELIEVE THAT AN ILLNESS OR HEALTH CONDITION CAUSED BY BIOTERRORISM, EPIDEMIC OR PANDEMIC DISEASE OR A HIGHLY FATAL AND HIGHLY INFECTIOUS AGENT OR BIOLOGICAL TOXIN HAS OR MAY OCCUR OR THAT THERE IS A PUBLIC EVENT THAT COULD REASONABLY BE THE OBJECT OF A BIOTERRORISM EVENT. THE ILLNESS OR HEALTH CONDITION MAY NOT INCLUDE ACQUIRED IMMUNE DEFICIENCY SYNDROME OR ANY OTHER INFECTION CAUSED BY THE HUMAN IMMUNODEFICIENCY VIRUS.
B. AS DETERMINED BY THE GOVERNOR, THE ENHANCED SURVEILLANCE ADVISORY SHALL DIRECT THE FOLLOWING IN ACCORDANCE WITH THIS ARTICLE:
1. THOSE PERSONS AND ENTITIES REQUIRED TO REPORT.
2. THE CLINICAL SYNDROMES, ANY ILLNESS OR HEALTH CONDITION THAT MAY BE ASSOCIATED WITH BIOTERRORISM OR A SPECIFIC ILLNESS OR HEALTH CONDITION TO BE REPORTED.
3. PATIENT TRACKING.
4. INFORMATION SHARING.
5. SPECIMEN TESTING COORDINATION.
C. THE DIRECTOR SHALL NOTIFY LOCAL HEALTH AUTHORITIES BEFORE THE GOVERNOR ISSUES AN ENHANCED SURVEILLANCE ADVISORY. THE DEPARTMENT AND LOCAL HEALTH AUTHORITIES SHALL PROVIDE THE ENHANCED SURVEILLANCE ADVISORY TO THOSE PERSONS AND ENTITIES REQUIRED BY THE ADVISORY TO REPORT PURSUANT TO THIS ARTICLE BY USING ANY AVAILABLE MEANS OF COMMUNICATION.
D. AN ENHANCED SURVEILLANCE ADVISORY MAY BE REVISED OR TERMINATED AT ANY TIME BY THE DIRECTOR AND AUTOMATICALLY TERMINATES AFTER SIXTY DAYS, UNLESS RENEWED BY THE GOVERNOR.
36-783. Increased reporting during enhanced surveillance advisory
A. A HEALTHCARE PROVIDER OR MEDICAL EXAMINER SHALL REPORT TO THE LOCAL HEALTH AUTHORITY ALL CASES OF PERSONS WHO HARBOR ANY ILLNESS, HEALTH CONDITION OR CLINICAL SYNDROME THAT MAY BE ASSOCIATED WITH BIOTERRORISM OR ANY ILLNESS, HEALTH CONDITION OR CLINICAL SYNDROME SPECIFIED IN THE ENHANCED SURVEILLANCE ADVISORY. THE REPORT SHALL PROVIDE ADDITIONAL INFORMATION DESIGNATED IN THE ENHANCED SURVEILLANCE ADVISORY.
B. THE STATE VETERINARIAN, A VETERINARIAN, A VETERINARY LABORATORIAN OR A WILDLIFE PROFESSIONAL SHALL REPORT ANY CASE OF ANIMAL ILLNESS OR DEATH DUE TO THE DISEASE OR OTHER HEALTH CONDITION DESIGNATED IN THE ENHANCED SURVEILLANCE ADVISORY TO THE DEPARTMENT OR LOCAL HEALTH AUTHORITY. THE REPORT SHALL INCLUDE THE SPECIES AND NUMBER OF AFFECTED ANIMALS AND THE NAME AND ADDRESS OF THE REPORTING VETERINARIAN, LABORATORIAN OR WILDLIFE PROFESSIONAL.
C. A PHARMACIST WHO IDENTIFIES ANY UNUSUAL INCREASE IN PRESCRIPTIONS FOR ANTIBIOTICS OR ANY UNUSUAL INCREASE IN PRESCRIPTIONS OR SALES OF OVER-THE-COUNTER PHARMACEUTICALS TO TREAT THE DISEASE OR CLINICAL SYNDROMES IDENTIFIED IN THE ENHANCED SURVEILLANCE ADVISORY SHALL REPORT THIS INFORMATION TO THE LOCAL HEALTH AUTHORITY. THE REPORT SHALL INCLUDE THE TYPE OF PHARMACEUTICAL AND THE NAME AND ADDRESS OF THE PHARMACEUTICAL PROVIDER.
D. THE REPORTS MUST BE IN WRITING OR BY ANY METHOD DIRECTED BY THE DEPARTMENT OR LOCAL PUBLIC HEALTH AUTHORITY AND MUST BE SUBMITTED WITHIN TWENTY-FOUR HOURS AFTER IDENTIFYING THE REPORTABLE CIRCUMSTANCE. ALL PERSONS REQUIRED TO REPORT UNDER THIS SECTION MUST COOPERATE WITH THE DEPARTMENT AND LOCAL HEALTH AUTHORITY IN EFFECTING THE ENHANCED SURVEILLANCE ADVISORY. FAILURE TO REPORT PURSUANT TO THIS SECTION IS AN ACT OF UNPROFESSIONAL CONDUCT.
E. A PERSON REPORTING OR PROVIDING INFORMATION TO THE DEPARTMENT OR LOCAL HEALTH AUTHORITY AS REQUIRED BY THIS SECTION IS IMMUNE FROM CIVIL OR CRIMINAL LIABILITY IF THE PERSON ACTED IN GOOD FAITH AND WITHOUT MALICE.
F. THE DEPARTMENT AND LOCAL PUBLIC HEALTH AUTHORITY SHALL MAINTAIN AS CONFIDENTIAL:
1. ANY INFORMATION OR A PARTICULAR PART OF INFORMATION PROVIDED UNDER THIS SECTION THAT, IF MADE PUBLIC, WOULD DIVULGE THE TRADE SECRETS OF A PERSON OR BUSINESS.
2. OTHER INFORMATION LIKELY TO CAUSE SUBSTANTIAL HARM TO THE PERSON'S OR BUSINESS' COMPETITIVE POSITION.
G. THE LOCAL HEALTH AUTHORITY SHALL IMMEDIATELY NOTIFY THE DEPARTMENT OF ANY REPORTS RECEIVED DURING THE PERIOD OF AN ENHANCED SURVEILLANCE ADVISORY.
36-784. Patient tracking during enhanced surveillance advisory
A. DURING AN ENHANCED SURVEILLANCE ADVISORY, TO IDENTIFY, DIAGNOSE, TREAT AND TRACK PERSONS WHO MAY HAVE BEEN EXPOSED TO AN ILLNESS OR HEALTH CONDITION CAUSED BY BIOTERRORISM, PANDEMIC INFLUENZA OR A HIGHLY FATAL OR HIGHLY INFECTIOUS AGENT OR BIOLOGICAL TOXIN, THE DEPARTMENT AND LOCAL HEALTH AUTHORITY MAY ACCESS CONFIDENTIAL PATIENT INFORMATION, INCLUDING MEDICAL RECORDS, WHEREVER AND BY WHOMEVER HELD AND WHETHER OR NOT PATIENT IDENTITY IS KNOWN.
B. THE DEPARTMENT OR LOCAL HEALTH AUTHORITY SHALL COUNSEL AND INTERVIEW ANY PERSON AS NECESSARY TO ASSIST IT IN THE POSITIVE IDENTIFICATION OF EXPOSED PERSONS AND TO DEVELOP INFORMATION RELATING TO THE SOURCE AND SPREAD OF THE ILLNESS OR HEALTH CONDITION. THIS INFORMATION MUST INCLUDE THE NAMES AND ADDRESSES OF ANY PERSONS FROM WHOM THE ILLNESS OR HEALTH CONDITION MAY HAVE BEEN CONTRACTED AND TO WHOM THE ILLNESS OR HEALTH CONDITION MAY HAVE SPREAD.
C. ANY MEDICAL INFORMATION OR OTHER INFORMATION FROM WHICH A PERSON OR A PERSON'S FAMILY MIGHT BE IDENTIFIED THAT IS RECEIVED BY THE DEPARTMENT OR LOCAL HEALTH AUTHORITY IN THE COURSE OF AN ENHANCED SURVEILLANCE ADVISORY IS CONFIDENTIAL AND IS NOT AVAILABLE TO THE PUBLIC.
36-785. Information sharing during an enhanced surveillance advisory
A. DURING AN ENHANCED SURVEILLANCE ADVISORY, WHENEVER A PUBLIC SAFETY AUTHORITY LEARNS OF A SUSPICIOUS DISEASE EVENT OR A THREATENED BIOTERRORISM ACT, IT SHALL IMMEDIATELY NOTIFY THE DEPARTMENT OR THE LOCAL HEALTH AUTHORITY, AND THE AGENCY THAT RECEIVES THIS INFORMATION MUST IMMEDIATELY NOTIFY THE OTHER AGENCY.
B. WHEN THE DEPARTMENT OR THE LOCAL HEALTH AUTHORITY IDENTIFIES A REPORTABLE ILLNESS OR HEALTH CONDITION, UNUSUAL DISEASE CLUSTER OR SUSPICIOUS DISEASE EVENT THAT IT REASONABLY BELIEVES MAY BE CAUSED BY BIOTERRORISM, THE DEPARTMENT OR LOCAL HEALTH AUTHORITY MUST IMMEDIATELY NOTIFY THE APPROPRIATE PUBLIC SAFETY AUTHORITY AND, IF APPROPRIATE, TRIBAL HEALTH AUTHORITIES.
C. SHARING OF INFORMATION ON REPORTABLE ILLNESSES, HEALTH CONDITIONS, UNUSUAL DISEASE CLUSTERS OR SUSPICIOUS DISEASE EVENTS BETWEEN PUBLIC SAFETY AND LOCAL HEALTH AUTHORITIES IS LIMITED TO THE INFORMATION NECESSARY TO EFFECT THE ENHANCED SURVEILLANCE ADVISORY. INFORMATION FROM WHICH A PERSON OR A PERSON'S FAMILY MIGHT BE IDENTIFIED THAT IS RECEIVED BY THE DEPARTMENT, LOCAL HEALTH AUTHORITY OR PUBLIC SAFETY AUTHORITY IN THE COURSE OF AN ENHANCED SURVEILLANCE ADVISORY IS CONFIDENTIAL AND NOT AVAILABLE TO THE PUBLIC.
36-786. Laboratory testing during an enhanced surveillance advisory
A. THE STATE LABORATORY SHALL COORDINATE SPECIMEN TESTING DURING AN ENHANCED SURVEILLANCE ADVISORY. IF NECESSARY AND AT STATE EXPENSE, THE DEPARTMENT MAY DESIGNATE ALTERNATIVE OR SECONDARY LABORATORIES TO ASSIST IT IN TESTING SPECIMENS.
B. THE DEPARTMENT SHALL DETERMINE THE CRITERIA NECESSARY FOR PRIVATE OR PUBLIC LABORATORIES TO CONDUCT CLINICAL OR ENVIRONMENTAL TESTING ASSOCIATED WITH BIOTERRORISM OR ANY ILLNESS OR HEALTH CONDITION SUBJECT TO THE ENHANCED SURVEILLANCE ADVISORY.
C. DURING AN ENHANCED SURVEILLANCE ADVISORY, A PUBLIC SAFETY AUTHORITY, IF REQUESTED BY THE DEPARTMENT OR LOCAL HEALTH AUTHORITY, SHALL COORDINATE AND PROVIDE TRANSPORTATION OF CLINICAL OR ENVIRONMENTAL SAMPLES TO THE STATE LABORATORY OR OTHER TESTING LABORATORY DESIGNATED BY THE DEPARTMENT.
36-787. Public health authority during state of emergency
A. DURING A STATE OF EMERGENCY DECLARED BY THE GOVERNOR IN WHICH THERE IS AN OCCURRENCE OR IMMINENT THREAT OF AN ILLNESS OR HEALTH CONDITION CAUSED BY BIOTERRORISM, AN EPIDEMIC OR PANDEMIC DISEASE OR A HIGHLY FATAL INFECTIOUS AGENT OR BIOLOGICAL TOXIN AND THAT POSES A SUBSTANTIAL RISK OF A SIGNIFICANT NUMBER OF HUMAN FATALITIES OR INCIDENTS OF PERMANENT OR LONG-TERM DISABILITY, THE DEPARTMENT SHALL COORDINATE ALL MATTERS PERTAINING TO THE PUBLIC HEALTH EMERGENCY RESPONSE OF THE STATE. THE DEPARTMENT HAS PRIMARY JURISDICTION, RESPONSIBILITY AND AUTHORITY FOR:
1. PLANNING AND EXECUTING PUBLIC HEALTH EMERGENCY ASSESSMENT, MITIGATION, PREPAREDNESS RESPONSE AND RECOVERY FOR THIS STATE.
2. COORDINATING PUBLIC HEALTH EMERGENCY RESPONSE AMONG STATE, LOCAL AND TRIBAL AUTHORITIES.
3. COLLABORATING WITH RELEVANT FEDERAL GOVERNMENT AUTHORITIES, ELECTED OFFICIALS OF OTHER STATES, PRIVATE ORGANIZATIONS AND PRIVATE SECTOR COMPANIES.
4. COORDINATING RECOVERY OPERATIONS AND MITIGATION INITIATIVES SUBSEQUENT TO PUBLIC HEALTH EMERGENCIES.
5. ORGANIZING PUBLIC INFORMATION ACTIVITIES REGARDING STATE PUBLIC HEALTH EMERGENCY RESPONSE OPERATIONS.
B. IN ADDITION TO THE AUTHORITY PROVIDED IN SUBSECTION A, DURING A STATE OF EMERGENCY, THE GOVERNOR, IN CONSULTATION WITH THE DIRECTOR OF THE DEPARTMENT OF HEALTH SERVICES, MAY ISSUE ORDERS THAT:
1. MANDATE MEDICAL EXAMINATIONS FOR EXPOSED PERSONS.
2. RATION MEDICINE AND VACCINES.
3. MANDATE TREATMENT OR VACCINATION OF PERSONS WHO ARE DIAGNOSED WITH ILLNESS RESULTING FROM EXPOSURE OR WHO ARE REASONABLY BELIEVED TO HAVE BEEN EXPOSED OR WHO MAY REASONABLY BE EXPECTED TO BE EXPOSED.
4. PROVIDE FOR TRANSPORTATION.
5. ISOLATE AND QUARANTINE PERSONS.
6. PROVIDE FOR PROCUREMENT OF MEDICINES AND VACCINES.
C. LAW ENFORCEMENT OFFICIALS OF THIS STATE AND THE NATIONAL GUARD SHALL ENFORCE ORDERS ISSUED BY THE GOVERNOR UNDER THIS SECTION.
D. THIS SECTION DOES NOT APPLY TO PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME OR OTHER INFECTION CAUSED BY THE HUMAN IMMMODEFICIENCY VIRUS.
36-788. Isolation and quarantine during a state of emergency
A. DURING A STATE OF EMERGENCY AS DECLARED PURSUANT TO SECTION 36-787, THE DEPARTMENT, A COUNTY HEALTH DEPARTMENT OR A PUBLIC HEALTH SERVICES DISTRICT MUST INITIATE AN INVESTIGATION IF THAT AGENCY HAS REASONABLE CAUSE TO BELIEVE THAT A HIGHLY CONTAGIOUS AND FATAL DISEASE EXISTS WITHIN ITS JURISDICTION. IF THE NATURE OF THE DISEASE REQUIRES AND NORMAL CONTROL MEASURES ARE IMPRACTICAL OR INEFFECTIVE, PERSONS WHO HAVE CONTRACTED THE DISEASE OR WHO HAVE BEEN EXPOSED TO THE DISEASE MAY BE SUBJECT TO ISOLATION AND QUARANTINE. DISEASES FOR WHICH ISOLATION AND QUARANTINE MAY BE ORDERED DO NOT INCLUDE ACQUIRED IMMUNE DEFICIENCY SYNDROME OR OTHER INFECTION CAUSED BY THE HUMAN IMMMODEFICIENCY VIRUS.
B. THE DEPARTMENT, COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT MAY EXERCISE, DURING THE STATE OF EMERGENCY DECLARED BY THE GOVERNOR, THE FOLLOWING POWERS OVER PERSONS:
1. TO ESTABLISH AND MAINTAIN PLACES OF ISOLATION AND QUARANTINE, WHICH MAY INCLUDE THE RESIDENCE OF THE PERSON QUARANTINED.
2. TO REQUIRE ISOLATION OR QUARANTINE OF ANY PERSON BY THE LEAST RESTRICTIVE MEANS NECESSARY TO PROTECT THE PUBLIC HEALTH. THE PUBLIC HEALTH AUTHORITY SHALL USE ALL REASONABLE MEANS TO PREVENT THE TRANSMISSION OF DISEASE AMONG THE ISOLATED OR QUARANTINED PERSONS.
C. THE DEPARTMENT, A COUNTY HEALTH DEPARTMENT OR A PUBLIC HEALTH SERVICES DISTRICT SHALL ENSURE, TO THE EXTENT POSSIBLE, THAT THE PREMISES IN WHICH PERSONS ARE ISOLATED OR QUARANTINED ARE MAINTAINED IN SAFE AND HYGIENIC MANNERS AND DESIGNED TO MINIMIZE THE LIKELIHOOD OF FURTHER TRANSMISSION OF DISEASE OR OTHER HARM TO PERSONS SUBJECT TO ISOLATION OR QUARANTINE. ADEQUATE FOOD, CLOTHING, MEDICATION AND OTHER NECESSITIES AND COMPETENT MEDICAL CARE SHALL BE MADE AVAILABLE.
D. A PERSON SUBJECT TO ISOLATION OR QUARANTINE SHALL COMPLY WITH THE DEPARTMENT'S, COUNTY HEALTH DEPARTMENT'S OR PUBLIC HEALTH SERVICES DISTRICT'S RULES AND ORDERS, SHALL NOT GO BEYOND THE ISOLATION OR QUARANTINE PREMISES AND SHALL NOT COME IN CONTACT WITH ANY PERSON NOT SUBJECT TO ISOLATION OR QUARANTINE OTHER THAN A PHYSICIAN OR OTHER HEALTH CARE PROVIDER, PUBLIC HEALTH AUTHORITY OR PERSON AUTHORIZED TO ENTER AN ISOLATION OR QUARANTINE PREMISES BY THE PUBLIC HEALTH AUTHORITY.
E. OTHER THAN A PERSON AUTHORIZED BY THE DEPARTMENT, A COUNTY HEALTH DEPARTMENT OR A PUBLIC HEALTH SERVICES DISTRICT, A PERSON SHALL NOT ENTER AN ISOLATION OR QUARANTINE PREMISES. IF, BY REASON OF AN UNAUTHORIZED ENTRY INTO AN ISOLATION OR QUARANTINE PREMISES, THE PERSON POSES A DANGER TO PUBLIC HEALTH, THE DEPARTMENT, COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT MAY PLACE THE PERSON IN ISOLATION OR QUARANTINE PURSUANT TO THIS SECTION OR SECTION 36-789.
F. THE DEPARTMENT, COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT MUST TERMINATE ISOLATION OR QUARANTINE OF A PERSON IF IT DETERMINES THAT THE ISOLATION OR QUARANTINE IS NO LONGER NECESSARY TO PROTECT THE PUBLIC HEALTH.
36-789. Due process for isolation and quarantine during a state of emergency
A. THE DEPARTMENT, A COUNTY HEALTH DEPARTMENT OR A PUBLIC HEALTH SERVICES DISTRICT MAY ISOLATE OR QUARANTINE A PERSON OR GROUP OF PERSONS THROUGH A WRITTEN DIRECTIVE WITHOUT FIRST OBTAINING A WRITTEN ORDER FROM THE COURT IF ANY DELAY IN THE ISOLATION OR QUARANTINE OF THE PERSON WOULD POSE AN IMMEDIATE THREAT TO THE PUBLIC HEALTH. THE DIRECTIVE SHALL:
1. SPECIFY THE IDENTITY OF THE PERSON OR PERSONS SUBJECT TO ISOLATION OR QUARANTINE, THE PREMISES SUBJECT TO ISOLATION OR QUARANTINE, THE DATE AND TIME AT WHICH ISOLATION OR QUARANTINE COMMENCES, THE SUSPECTED HIGHLY CONTAGIOUS AND FATAL DISEASE, IF KNOWN, AND THAT A STATE OF EMERGENCY HAS BEEN DECLARED BY THE GOVERNOR.
2. BE GIVEN TO THE PERSON OR PERSONS TO BE ISOLATED OR QUARANTINED. IF THE DIRECTIVE APPLIES TO GROUPS OF PERSONS AND IT IS IMPRACTICAL TO PROVIDE INDIVIDUAL COPIES, IT MAY BE POSTED IN A CONSPICUOUS PLACE IN THE ISOLATION OR QUARANTINE PREMISES.
B. WITHIN TEN DAYS AFTER ISSUING THE WRITTEN DIRECTIVE, OR WHEN ANY DELAY IN THE ISOLATION OR QUARANTINE OF A PERSON WILL NOT POSE AN IMMEDIATE THREAT TO THE PUBLIC HEALTH, THE DEPARTMENT, COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT SHALL FILE A PETITION FOR A COURT ORDER AUTHORIZING THE INITIAL OR CONTINUED ISOLATION OR QUARANTINE OF A PERSON OR GROUP OF PERSONS. THE PETITION SHALL SPECIFY THE FOLLOWING:
1. THE IDENTITY OF THE PERSON OR GROUP OF PERSONS SUBJECT TO ISOLATION OR QUARANTINE.
2. THE PREMISES SUBJECT TO ISOLATION OR QUARANTINE.
3. THE DATE AND TIME AT WHICH ISOLATION OR QUARANTINE COMMENCES.
4. THE SUSPECTED CONTAGIOUS DISEASE, IF KNOWN.
5. A STATEMENT OF COMPLIANCE WITH THE CONDITIONS AND PRINCIPLES FOR ISOLATION AND QUARANTINE.
6. A STATEMENT OF THE BASIS ON WHICH ISOLATION OR QUARANTINE IS JUSTIFIED PURSUANT TO THIS ARTICLE.
C. THE PETITION MUST BE ACCOMPANIED BY THE SWORN AFFIDAVIT OF THE DEPARTMENT, COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT ATTESTING TO THE FACTS ASSERTED IN THE PETITION, TOGETHER WITH ANY FURTHER INFORMATION THAT MAY BE RELEVANT AND MATERIAL TO THE COURT'S CONSIDERATION.
D. NOTICE TO A PERSON OR GROUP OF PERSONS IDENTIFIED IN A PETITION FILED PURSUANT TO SUBSECTION B OF THIS SECTION MUST BE COMPLETED WITHIN TWENTY-FOUR HOURS AND IN ACCORDANCE WITH THE RULES OF CIVIL PROCEDURE.
E. A HEARING MUST BE HELD ON A PETITION FILED PURSUANT TO THIS SECTION WITHIN FIVE DAYS AFTER FILING OF THE PETITION. IN EXTRAORDINARY CIRCUMSTANCES AND FOR GOOD CAUSE SHOWN, THE DEPARTMENT, COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT MAY APPLY TO CONTINUE THE HEARING DATE ON A PETITION FOR NOT MORE THAN TEN DAYS. IF THE COURT GRANTS A CONTINUANCE IT MUST GIVE DUE REGARD TO THE RIGHTS OF THE AFFECTED PERSONS, THE PROTECTION OF THE PUBLIC'S HEALTH, THE SEVERITY OF THE EMERGENCY AND THE AVAILABILITY OF NECESSARY WITNESSES AND EVIDENCE.
F. THE COURT SHALL GRANT THE PETITION IF, BY A PREPONDERANCE OF THE EVIDENCE, ISOLATION OR QUARANTINE IS SHOWN TO BE REASONABLY NECESSARY TO PROTECT THE PUBLIC HEALTH.
G. AN ORDER AUTHORIZING ISOLATION OR QUARANTINE MAY DO SO FOR A PERIOD NOT TO EXCEED THIRTY DAYS. THE ORDER MUST:
1. IDENTIFY THE ISOLATED OR QUARANTINED PERSONS OR GROUPS OF PERSONS BY NAME OR SHARED OR SIMILAR CHARACTERISTICS OR CIRCUMSTANCES.
2. SPECIFY FACTUAL FINDINGS WARRANTING ISOLATION OR QUARANTINE PURSUANT TO THIS ARTICLE, INCLUDE ANY CONDITIONS NECESSARY TO ENSURE THAT ISOLATION OR QUARANTINE IS CARRIED OUT WITHIN THE STATED PURPOSES AND RESTRICTIONS OF THIS ARTICLE.
3. BE SERVED ON AFFECTED PERSONS OR GROUPS OF PERSONS IN ACCORDANCE WITH THE RULES OF CIVIL PROCEDURE.
H. BEFORE AN ISOLATION OR QUARANTINE ORDER EXPIRES, THE DEPARTMENT, COUNTY HEALTH DEPARTMENT OR PUBLIC HEALTH SERVICES DISTRICT MAY MOVE TO CONTINUE THE ISOLATION OR QUARANTINE FOR ADDITIONAL PERIOD NOT TO EXCEED THIRTY DAYS. THE COURT SHALL GRANT THE MOTION IF, BY A PREPONDERANCE OF THE EVIDENCE, ISOLATION OR QUARANTINE IS SHOWN TO BE REASONABLY NECESSARY TO PROTECT THE PUBLIC HEALTH.
I. A PERSON OR GROUP OF PERSONS ISOLATED OR QUARANTINED PURSUANT TO THIS ARTICLE MAY APPLY TO THE COURT FOR AN ORDER TO SHOW CAUSE WHY THE PERSON OR GROUP OF PERSONS SHOULD NOT BE RELEASED. THE COURT MUST RULE ON THE APPLICATION TO SHOW CAUSE WITHIN FORTY-EIGHT HOURS AFTER IT IS FILED. IF THE COURT GRANTS THE APPLICATION, THE COURT MUST SCHEDULE A HEARING ON THE ORDER TO SHOW CAUSE WITHIN TWENTY-FOUR HOURS AFTER IT ISSUES THE ORDER TO SHOW CAUSE. THE ISSUANCE OF AN ORDER TO SHOW CAUSE DOES NOT STAY OR ENJOIN AN ISOLATION OR QUARANTINE ORDER.
J. A PERSON ISOLATED OR QUARANTINED PURSUANT TO THIS ARTICLE MAY REQUEST A COURT HEARING REGARDING THE PERSON'S TREATMENT AND THE CONDITIONS OF THE QUARANTINE OR ISOLATION.
K. ON RECEIVING A REQUEST FOR A HEARING PURSUANT TO THIS SECTION, THE COURT MUST FIX A DATE FOR A HEARING. THE HEARING MUST TAKE PLACE WITHIN TEN DAYS AFTER THE COURT RECEIVES THE REQUEST. THE REQUEST FOR A HEARING DOES NOT ALTER THE ORDER OF ISOLATION OR QUARANTINE. IF THE COURT FINDS THAT THE ISOLATION OR QUARANTINE OF THE PERSON OR GROUP OF PERSONS DOES NOT COMPLY WITH THE REQUIREMENTS OF THIS SECTION OR SECTION 36-788, THE COURT MAY FASHION REMEDIES APPROPRIATE TO THE CIRCUMSTANCES OF THE STATE OF EMERGENCY AND IN KEEPING WITH THE PROVISIONS OF THIS ARTICLE.
L. A RECORD OF THE PROCEEDINGS PURSUANT TO THIS SECTION SHALL BE MADE AND RETAINED. IF, BECAUSE OF A STATE OF PUBLIC HEALTH EMERGENCY, PARTIES CANNOT PERSONALLY APPEAR BEFORE THE COURT, THE PROCEEDINGS MAY BE CONDUCTED BY THE AUTHORIZED REPRESENTATIVES OF THE PARTIES AND HELD BY ANY MEANS THAT ALLOWS ALL PARTIES TO FULLY PARTICIPATE.
M. THE COURT SHALL APPOINT COUNSEL AT STATE EXPENSE TO REPRESENT PERSONS OR GROUPS OF PERSONS WHO ARE OR WHO ARE ABOUT TO BE ISOLATED OR QUARANTINED PURSUANT TO THIS ARTICLE AND WHO ARE NOT OTHERWISE REPRESENTED BY COUNSEL. REPRESENTATION BY APPOINTED COUNSEL CONTINUES THROUGHOUT THE DURATION OF THE ISOLATION OR QUARANTINE OF THE PERSON OR GROUP OF PERSONS. THE PUBLIC HEALTH AUTHORITY MUST PROVIDE ADEQUATE MEANS OF COMMUNICATION BETWEEN THE ISOLATED OR QUARANTINED PERSONS AND THEIR COUNSEL.
N. IN ANY PROCEEDINGS BROUGHT PURSUANT TO THIS SECTION, TO PROMOTE THE FAIR AND EFFICIENT OPERATION OF JUSTICE AND HAVING GIVEN DUE REGARD TO THE RIGHTS OF THE AFFECTED PERSONS, THE PROTECTION OF THE PUBLIC'S HEALTH, THE SEVERITY OF THE EMERGENCY AND THE AVAILABILITY OF NECESSARY WITNESSES AND EVIDENCE, THE COURT MAY ORDER THE CONSOLIDATION OF INDIVIDUAL CLAIMS INTO GROUPS OF CLAIMS IF:
1. THE NUMBER OF PERSONS INVOLVED OR TO BE AFFECTED IS SO LARGE AS TO RENDER INDIVIDUAL PARTICIPATION IMPRACTICAL.
2. THERE ARE QUESTIONS OF LAW OR FACT COMMON TO THE INDIVIDUAL CLAIMS OR RIGHTS TO BE DETERMINED.
3. THE GROUP CLAIMS OR RIGHTS TO BE DETERMINED ARE TYPICAL OF THE AFFECTED PERSON'S CLAIMS OR RIGHTS.
4. THE ENTIRE GROUP WILL BE ADEQUATELY REPRESENTED IN THE CONSOLIDATION.
36-790. Immunities
THE IMMUNITIES PRESCRIBED IN SECTION 26-314 ARE APPLICABLE TO SECTIONS 36-787, 36-788 AND 36-789.
Sec. 4. Exemption from rule making
A. For the purposes of this act, the department of health services is exempt from the rule making requirements of title 41, chapter 6, Arizona Revised Statutes.
B. The department shall hold at least one public hearing before it adopts a rule pursuant to this act.