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Cleveland Ordinances, Ohio Laws, and Federal Laws Related to or that
May Be Related to Communicable Disease Outbreaks and
Quarantine/Isolation Issues (I#20480)
_________________________________________________________________
INTRODUCTION
This overview focuses primarily on the authority, duties, and responsibilities of
government to respond to public health emergencies or threatened emergencies
involving influenza/communicable disease outbreaks, epidemics, or pandemics,
and to declare and enforce quarantine or isolation.
In Ohio, the boards of health of a general or city health district have primary
responsibility for public health emergencies within their jurisdiction, including
isolation and quarantine. This authority is subject to oversight or intervention by
the State through its Department of Health (ODH). ODH has “ultimate” authority
in matters of quarantine and isolation, but is required to work in cooperation
with the health commissioner of the general or city health district.1 The federal
government has various laws that authorize it to act in a public health
emergency as appropriate and consistent with state and local authorities.
CITY OF CLEVELAND – CHARTER AND ORDINANCES

Charter, Chapter 23, §114
City may enforce all laws and ordinances related to health, and
shall perform and may exercise all powers provided by general law, relative to
public health, to be performed and exercised by municipalities by health officers.
CCO §141.02 Duties of Commissioner of Health
Shall administer Health Code and see that all ordinances and rules
of the City and all applicable State laws affecting the public health are properly
enforced. “He shall maintain and supervise a laboratory to assist in the diagnosis
of communicable diseases and in fixing the period of quarantine…”

CCO §141.12 Subdivision of Communicable Diseases
Establishes subdivision of communicable diseases administered by
a chief subject to direction of Commissioner of Health. The subdivision’s function
is to prevent the transmission of communicable diseases, perform disinfections,
establish and maintain quarantine, and perform such other duties deemed
necessary for the prevention and control of epidemics.


1
R.C. 3701.13
CCO §203.01 Investigations; Remedial Measures
Permits Commissioner of Environmental Health or any other
authorized City officer/employee to investigate and take measures necessary to
abate nuisance.
CCO §203.02 Notice to Abate; Exception
When nuisance affects or endangers the public health,
Commissioner of Environmental Health or authorized officer/employee shall give
notice to property owner or person in charge to abate the nuisance. If no
owner/person is charge can be found within a reasonable time or immediate
abatement is needed, the Commissioner need not wait to abate the nuisance.

STATE OF OHIO LAWS2
A. GENERAL
 RC §301.24 County health department or agency.
Provides authority to create a county health department by charter.
In accordance with the county charter, the county health department shall
exercise all powers and perform all duties vested in or imposed upon authorities
of city or general health districts.

RC §307.61 Institutions subject to inspection of
commissioners or board of health.
Each public or private hospital, reformatory home, house of
detention, private asylum, and correctional institution shall be open at all times
to inspection by board of county commissioners or the board of health of the
general health district or the city health district in which the institiution is
located.
RC §715.37 Health; contagious diseases; hospitals.
Provides that any municipal corporation may “[s]ecure the
inhabitants of the municipal corporation from the evils of contagious, malignant,
and infectious diseases…”


RC §3313.67 Immunization of pupils to prevent spread of
diseases….
The board of education of a city, exempted village, or local school
district may make and enforce rules to secure immunization of, and to prevent
spread of, communicable diseases among pupils. The board of health, municipal
corporation, or township, upon application by the board of education, must
2
Only parts of the Revised Code Sections deemed pertinent are set forth in summary.
2
provide, at public expense, immunizations to pupils not so provided by parents or
guardians.
RC §3313.68 Employment of medical personnel….
Boards of education shall cooperate with boards of health in the
prevention and control of epidemics.


RC 3313.74 Certain institutions…not permitted near
schools.
Prohibits establishment of any institution to house or care for
persons suffering from communicable disease, as defined by the director of
health, within 2000 feet of any public, private, or parochial school.
RC §3701.03 General duties of director of health.3
The director of public health may designate employees of ODH,
and, during a public health emergency, others persons to administer the health
and sanitation laws and rules of the ODH on the director’s behalf. This section
cannot be used to authorize any action that prevents the fulfillment of duties or
impairs the exercise of authority established by law for any other person or
entity.

RC §3701.07 …Reporting of information….
The public health council may establish rules requiring hospitals
and dispensaries to report, among other specified information, any other
information that the council considers relevant to the safety of patients served by
the institution.


RC §3701.072 Preparedness and capacity of trauma center
to respond to disasters, mass casualties, and bioterrorism.
Public health council may require trauma centers to report on their
preparedness and capacity to respond to disasters, mass casualties, and
bioterrorism.
RC §3701.13 Powers of department.
ODH shall have supervision of all matters relating to preservation of
the life and health and has ultimate authority in matters of quarantine and
isolation, which it may declare and enforce, and modify, relax, or abolish when
established. It may make special or standing orders or rules for preventing the
spread of contagious or infectious diseases. Whenever possible, the department
shall work in cooperation with the health commissioner (or his/her equivalent) in
a general or city health district. It may make and enforce orders in local matters

Unless otherwise noted, “director of health”, as used throughout this memorandum, refers to the Director
of the Ohio Department of Public Health (ODH).
3
3
when an emergency exists, or when the board of health of a general or city
health district neglects or refuses to act with sufficient promptness or efficiency.
RC §3701.14 Special duties of director of health.
The director of ODH shall investigate causes of disease or illness
including contagious, infectious, epidemic, pandemic, or endemic conditions, and
take prompt action to control and suppress it. The director may make and
execute orders necessary to protect people against diseases of lower animals.
Information collected during an investigation, generally, is confidential except
when director determines that release is necessary to avert or mitigate clear
threat to individual or to the public health. In this event, release is restricted to
person needing to know and only to extent necessary.


RC §3701.146 Powers and duties regarding tuberculosis;
public health council standards.4
The director shall maintain registries of hospitals and other
healthcare providers the director shall refer persons to who contact ODH
regarding possible exposure to TB; engage in TB surveillance activities and
maintain a registry to record incidences of TB in the state; and, may appoint
physicians to act as consultants to advise physicians and other health care
practitioners participating in TB control activities. The public health council shall
establish standards regarding TB screenings, examinations, treatment,
preventing infection of others by infected individuals, lab testing, etc. The rules
shall apply to county or district tuberculosis control units, physicians that
examine and treat individuals for TB, and labs performing TB testing.

RC §3701.16 Purchasing, storing, and distribution of items
needed for public health emergencies.
The director of health may purchase, store, and distribute
antitoxins, serums, vaccines, immunizing agents, antibiotics, and other
pharmaceutical agents or medical supplies to prepare for or respond to a public
health emergency.

RC §3701.201 Reporting of events that might be caused by
bioterrorism or certain other causes.
The public health council is to adopt rules requiring certain healthrelated entities to report events that may be caused by bioterrorism, epidemic or
pandemic disease, or established or novel infectious agents or biological or
chemical toxins posing a risk of human fatality or disability.

4
RC §3701.352 Violation of rule or order prohibited.
See below additional pertinent law specific to tuberculosis and the role of the county.
4
No person shall violate any rule that the public health council,
director of health, or ODH adopts or any order the director or ODH issues under
RC Chapter 3701 to prevent a threat to the public caused by a pandemic,
epidemic, or bioterrorism event.
RC §3701.56 Enforcement of rules and regulations.
The boards of health of a general or city health district, police
officers, sheriffs, and others shall enforce the quarantine and isolation orders,
and the rules adopted by ODH.


RC §3701.57 Prosecutions and proceedings; injunctive or
other relief.
Authorizes the director of health, the board of health of a general
or city health district, or any person charged with enforcing the rules of the ODH
(under Chapter 3701), to petition the court of common pleas in which the
offense is alleged to be occurring. The court may grant injunctive or other
appropriate relief as the equities of the case require.
RC §3701.81 Spreading contagion.
A person who knows or has reasonable cause to know he/she is
suffering from a dangerous, contagious disease, shall take reasonable measures
to prevent exposing him/herself to others. A person having charge of or care of
a person known or reasonably known by him/her to have a dangerous,
contagious disease, shall take reasonable measures to protect others from
exposure and to inform health authorities. A person in charge of a public
conveyance or place of accommodation, amusement, resort, or trade, who
knows or has reasonable cause to believe that a person using the conveyance or
place has been or is being exposed to a dangerous, contagious disease, shall
take reasonable measures to protect the public and to inform health authorities.

RC §3707.01 Powers of board; abatement of nuisances.
The board of health of a City or general health district shall abate
and remove all nuisances within its jurisdiction.


RC §3707.02 Proceedings when order of board is
neglected or disregarded.
Authorizes the board of health of a general health district to
prosecute a refusal to obey an abatement of a nuisance.

RC §3707.021 Injunction.
5
Authorizes the board of health of a general health district to seek an
injunction in the court of common pleas when its order to abate a nuisance is not
complied with.

RC §3707.03 Correction of nuisance or unsanitary.
conditions on school property.
The board of health of a city or general health district may remove
or correct all conditions detrimental to health or well-being found upon school
property by serving an order upon the board of education for the abatement of
the nuisance or condition.
RC §3707.04 Quarantine regulations.
In times of epidemic, threatened epidemic, or when a dangerous
communicable disease is unusually prevalent, the board of health of a city, after
a personal investigation, may impose quarantine on vessels, railroads, or other
public or private vehicles.


RC §3707.05 Board must secure approval of department of
health in certain cases.
City board of health shall not close or prohibit travel on public
highways, interfere with the official duties of public officers not afflicted or
directly exposed to a contagious or infectious disease, or establish a quarantine
of one municipal corporation or township against another municipal corporation
or township without the permission of the department of health.

RC §3707.07 Complaint concerning prevalence of disease;
inspection by health commissioner.
Upon a complaint or a reasonable belief that an infectious or
contagious disease exists in a house or other locality, the city board of
health/general health district shall have the site inspected by its health
commissioner. If the disease exists, the board may send the person(s) diseased
to a hospital or other place provided for such person(s), may restrain the
person(s) exposed from interaction with others, and prohibit ingress/egress
to/from the premises.

RC §3707.08 Isolation of persons exposed to
communicable disease; placarding of premises.
When a person known to be exposed to a communicable disease
declared quarantinable by the city board of health or department of health is
reported, the board shall restrict the person to his place of residence or other
suitable place, prohibit entrance to or exit from the place without the board’s
permission, and enforce any restrictive measures prescribed by the department.
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When the person is required by the board or department of health
to be isolated, the board shall at once separate the person from others in the
premises.
The board shall place a placard in a prominent place at the
premises identifying the name of the disease.
No person isolated or quarantined by a board shall leave the
premises without the written permission of the board.
RC §3707.09 Board may employ quarantine guards.
The board of health of a city/general health district may employ
persons to execute its orders and properly guard any house or place containing a
quarantined person.


RC §3707.14 Maintenance of persons confined in
quarantined house.
The board of health of a city/general health district shall provide
necessities of life for persons confined in a house due to quarantine for
contagious diseases. Person quarantined responsible for cost, unless unable to
pay, and, when not, the municipal corporation responsible for cost.

RC §3707.16 Attendance at gatherings by quarantined
person prohibited.
No person isolated of quarantined for a communicable disease shall
attend any public, private, or parochial school or college, Sunday school, church,
or any other public gathering until released from isolation or quarantine by the
board.

RC §3707.21 Contagious disease in public institution;
temporary building.
When cholera, yellow fever, diphtheria, scarlet fever, or other
dangerous, contagious, or infectious disease appears in a municipal correctional
facility, the manager of the facility shall at once isolate the persons affected.

RC §3707.22 Removal of affected or exposed persons from
public institution to hospital.
Trustees/managers of correctional institution may remove persons
affected with or exposed to diseases mentioned in RC §3707.21 to a hospital or
other place upon an order from the court that imposed the sentence.

RC §3707.26 Board shall inspect schools and may close
them.
During an epidemic or threatened epidemic, or when a dangerous
communicable disease is unusually prevalent, the board may close any school
and prohibit public gatherings for as long as necessary.
7

RC §3707.30 Care and control of hospital; removal of
persons to hospital.
When a person suffering from a dangerous contagious disease is
found in a hotel, lodging-house, boardinghouse, tenement house, or other public
place in the municipal corporation, the board, if it deems it necessary for the
protection of the public health, may remove the person to a hospital.
RC §3707.31 Establishment of quarantine hospital.
A municipal corporation may establish a quarantine hospital within
or without its limits. When great emergency exists, the board of health of a
city/general health district may seize, occupy, and temporarily use for a
quarantine hospital a suitable vacant house or building within its jurisdiction.


RC §3707.32 Erection of temporary buildings by board;
destruction of property.
The board of health of a city/general health district may erect
temporary wooden buildings or field hospital necessary for the isolation or
protection of persons or freight thought to be infected, and may employ nurses,
physicians, and laborers to operate them, and sufficient police to guard them.
The board may disinfect, renovate, or destroy bedding, clothing, or other
property when deemed necessary or a reasonable precaution against the spread
of contagious or infectious diseases.

RC §3707.34 Authority of health commissioner regarding
quarantine and isolation provisions.
The health commissioner of a general or city health district may act
on behalf of the board in administering RC sections 3707.04 to 3707.32
regarding quarantine and isolation if the commissioner acts pursuant to a policy
the board adopts as described in this section. Each board of health shall adopt a
policy specifying the actions a health commissioner may take pursuant to this
section.
B. STATE LAWS SPECIFIC TO TUBERCULOSIS
For many years, control of tuberculosis was largely left up to local health
boards/departments under Ohio law. In 2000, the Ohio General Assembly
repealed many antiquated tuberculosis control laws and enacted laws that
identify the county of the district to be served or a “tuberculosis control
unit” designated by the county board of commissioners as the entity responsible
for tuberculosis control. These laws are contained in Ohio Revised Code Sections
339.71 to 339.89.
Under these laws, each county must designate a county tuberculosis (TB) control
unit or enter into an agreement with other counties for a jointly designated TB
8
control unit. The county can elect to designate, among others, a board (or
department) of health of a City or health district as its TB control unit or a
hospital under contract with the county.5 The TB control unit must accept its
designation and fulfill its duties under State law.6
Tuberculosis treatment responsibilities of the TB control unit are limited to cases
of “active tuberculosis.”7 Active TB is defined8 as TB, regardless of
communicability status that has been demonstrated by clinical, bacteriological, or
radiographic evidence, to be present in a person who has not completed the
appropriate treatment. It can include pulmonary and extra pulmonary TB. The
TB control unit is required to treat all active cases regardless of ability to pay.
The county is the payer of last resort.9
Physicians are required to report confirmed cases of TB to the county or TB
control unit. Administrators of hospitals, clinics or other facilities, and labs
performing TB tests, must also report to the county or TB control unit confirmed
or suspected TB in individuals. Any person suspecting an individual has TB may
report it to the TB control unit.10 The county/TB control unit must notify the
Ohio Department of Health (ODH) of all reports of suspected of confirmed cases
of TB.11 When the county/TB control unit receives a report, it must investigate
within three working days.12 All information gathered must be kept confidential
by the county/TB control unit and the ODH except to the extent necessary to
control TB.13
An individual with active TB is required to complete a TB treatment regimen and
to follow the county/TB control unit’s directions regarding protecting against
spread of the disease, including submitting to hospitalization.14 The TB control
unit may issue an order compelling a person with TB to comply.15 If the person
does not comply with the order, the county/TB control unit may apply to the
probate court for an injunction prohibiting the person from violating the unit’s
order. If there is an immediate danger to the public health, the TB control unit
may request that the injunction be issued without an opportunity for the person
with TB to have a prior hearing or upon an expedited hearing with the individual
present.16 If the person with TB does not comply with the court’s injunction, the
5
R.C. 339.72(A).
R.C. 339.72(B).
7
R.C. 339.73.
8
R.C. 339.71
9
R.C. 339.73
10
R.C. 339.78.
11
R.C. 339.79.
12
R.C. 339.80.
13
R.C. 339.81.
14
R.C. 339.82.
15
R.C. 339.83; R.C. 339.84.
16
R.C. 339.85.
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9
county/TB control unit may ask the probate court to grant an order permitting
the unit to detain the person in a hospital for examination or treatment for TB.17
If a person with suspected or active TB poses a substantial danger to the health
of others, the TB control unit can issue an emergency order directing law
enforcement to bring the person to a hospital or other place for examination and
treatment. The unit can hold the person for a period of three days before it
must obtain an order of the probate court to continue the confinement.18 A
person cannot be required to undergo testing, medical treatment, or detention in
a hospital or other treatment place, if the person relies exclusively on spiritual
treatment through prayer in accordance with a recognized, religious method of
healing. But, the person may be quarantined or otherwise isolated in the home
or other place approved by the tuberculosis control unit.19
C. OHIO ADMINISTRATIVE CODE (OAC)
Definitions That May Be Pertinent
These are from OAC 3701-3-0120, and pertain to as used in OAC 3701-3, but,
can also be applied to other Ohio Revised Code Sections unless a specific
definition in the Code preempts it.
"Board of health" means the board of health of the city or general health
district, or the authority having the duties of a board of health in any city as
authorized by RC §3709.05.
"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 a
microorganism, virus, infectious substance, or biological product, to cause death,
disease, or other biological malfunction in a human, animal, plant, or other living
organism, as a means of influencing the conduct of government or intimidating
or coercing a population.
"Endemic" means the constant presence of a disease or infectious agent
within a given geographic area.
"Epidemic" or "outbreak" means the occurrence of cases of disease in
numbers greater than expected in a particular population or for a particular
period of time.
"Health care provider" includes, but is not limited to, hospitals, medical
clinics and offices, special care facilities, medical laboratories, physicians,
dentists, physician assistants, registered and licensed practical nurses,
17
R.C. 339.86.
R.C. 339.87.
19
R.C. 339.89
20
There are other definitions in OAC 3701-03-01 not listed here.
18
10
emergency medical service organization personnel, and ambulance service
personnel.
"Health district" means a city or general health district as created by
Chapter 3709 of the Revised Code.
"Incidence" means the number of new cases of a disease occurring during
a specified interval of time in a defined population.
"Infected individual" means a person whose body harbors a specific
microorganism capable of producing disease, whether or not the person is
experiencing signs or symptoms of the disease.
"Isolation" means the separation of an infected individual from others
during the period of disease communicability in such a way that prevents, as far
as possible, the direct or indirect conveyance of an infectious agent to those who
are susceptible to infection or who may spread the agent to others.
"Pandemic" means an epidemic disease that is occurring throughout a very
wide area, usually several countries or continents, and usually affecting a large
proportion of the population.
"Period of communicability" means the interval during which an infected
individual or animal is shedding the specific microorganism of a communicable
disease in such a manner that those who are susceptible could acquire the
infection.
"Quarantine" means the restriction of the movements or activities of a well
individual or animal that has been exposed to a communicable disease during
the period of communicability of that disease and in such a manner that
transmission of the disease may have occurred. The duration of the quarantine
ordered shall be equivalent to the usual incubation period of the disease to which
the susceptible person or animal was exposed.
"Sensitive occupation" means direct food handling, direct patient care, the
handling of food or provision of direct care to children in a child care center, or
any other occupation which provides significant opportunity for an infected
individual to transmit infectious disease agents.
"Surveillance" means, in the public health service, the systematic
collection, analysis, interpretation, and dissemination, of health data on an ongoing basis, to gain knowledge of the pattern of disease occurrence and
potential in a community in order to control and prevent disease in the
community.
"Susceptible person" means a person that, when exposed to an infectious
microorganism, may not possess sufficient resistance to prevent contracting the
infection or disease.
11
FEDERAL LAWS21
 Public Health Service (PHS) Act (42 USC 264) Section 361
- Authorizes the director of the U.S. Department of Health and Human Services
(HHS) to make and enforce regulations to prevent the introduction, transmission,
or spread of communicable diseases from foreign countries into the U.S. or from
one state or possession into another.
 PHS Act, 42 CFR 71.32(a); 42 CFR 70.6 – HHS Secretary can
delegate authority to the CDC director to isolate and quarantine persons exposed
to or infected with certain specified communicable diseases and who are coming
into the U.S. from a foreign country or traveling from one state or possession
into another.
o Executive Order 13295 of 4/4/03 lists the communicable
diseases for which a person may be subject to federal quarantine. The order
was amended by Executive Order 13375 of 4/5/05 to add influenza that is
causing or has the potential to cause a pandemic.
 PHS Act (42 USC 242) Section 311 – HHS may cooperate with
and aid state and local authorities in the enforcement of quarantine and other
health regulations. Authorizes the Secretary to make available resources to help
control epidemics and deal with other public health emergencies.
 PHS Act (42 USC 247d) Section 319(a) – Authorizes the HHS
Secretary to declare a public health emergency and “take such action as may be
appropriate to respond” to that emergency consistent with existing authorities.
May include making grants, providing award for expenses, entering into
contracts, conducting and supporting investigation into cause, treatment, or
prevention of disease/disorder causing the emergency.
 PHS Act, Section 2102 – HHS has broad authority to coordinate
vaccine development, distribution, and use activities.
 Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 USC 5121 et seq.) – authorizes the Federal Emergency
Management Agency (FEMA), Department of Homeland Security, to coordinate
the response of federal agencies to a Presidential declaration of a major disaster
or emergency. HHS has the lead for health and medical services.
 National Emergencies Act (50 USC 1601 et seq.) – Authorizes
the President to declare an emergency.
21
This overview of Federal Law that may apply is taken from Appendix E of the current HHS Pandemic
Influenza Plan that can be obtained from HHS’ website.
12
 42 USC §97 – HHS may request that Customs, Coast Guard, and
military officers aid in the execution of quarantines imposed by states.
13