Download LEGAL PROCEDURES FOR DEALING WITH INFECTIOUS DISEASE

Minnesota’s Emergency
Health Powers
Emergency Readiness Rounds
March 7, 2007
Jan Malcolm
CEO, Courage Center
Former Commissioner, MN Dept of Health
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Individual
Rights
Public
Health
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Statutory health powers added
in 2002 and updated in 2005
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Isolation and
quarantine
Commissioner of
Health/Court authority
Applies to individuals or
small groups
New or re-emerging
infectious disease
Legal process/procedures;
defense counsel, hearings,
etc.
Added to Chapter 144
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Emergency
Management Act
In 2002 created public
health emergency – added
measures for disease
control
In 2005 included public
health emergencies under
all-hazards
Volunteer liability and
workers compensation
Added to Chapter 12
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Emergency Declaration
by the Governor
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Redirect state staffing to priority activities
Close or alter school attendance
Close or restrict businesses with public
gatherings (movie theaters, offices)
Commandeer private resources as needed
(compensation provisions)
Authorize use of volunteers (liability and
workers compensation same as employees)
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Emergency Declaration (cont.)
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Authorize or direct resources of one political
subdivision to assist another
Enter into contracts quickly
Adopt rules or modify existing rules quickly
Limit types of burials and funeral practices;
oversee disposition of bodies
Issue executive order to provide liability
protection for any responder in a region
when health care resources are exceeded
(off-site hospital)
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Use of Isolation and Quarantine
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Old public health measures that have
not been used on a large scale in the
U.S. for more than 50 years
Re-emerged due to bioterrorism
preparedness and worldwide outbreak
of Severe Acute Respiratory Syndrome
(SARS) in 2002-2003
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Chicago
1918-1919
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Minnesota Authority to Compel
Isolation or Quarantine
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Isolation – for a person who is infected or
sick
Quarantine – for a person who is exposed
or believed to be exposed to the infectious
disease
Commissioner of Health has authority to
issue temporary hold or to seek court
order
Commissioner may delegate to local public
health board authority to seek court orders
– Statute does not allow Commissioner to
delegate temporary hold authority to local
public health
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Requirements for Care of
Persons in Isolation or
Quarantine
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I/Q must use least restrictive means
necessary to achieve the goal of limited
contact with others and may include
“confinement to private homes or other
private or public premises”
Health status must be regularly monitored
to determine if person(s) require continued
I/Q
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Requirements for Care
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Needs of person(s) in I/Q must be
addressed in a “systematic and
competent fashion” including:
– adequate food, clothing, and shelter
– means of external communication
– medication and competent medical
care
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I/Q in the Context of Other Community
Containment Measures
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I/Q are community-level measures to control
disease spread
Other potential community-level measures
include:
– closure of mass transit
– group assembly restrictions
– cancellation of public events
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Example: closure of state fair in 1946 due to
polio epidemic
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Other Key Concepts
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Liability protections
Licensing of professionals from other
states
Mass dispensing
Roles of multiple levels of government
(local, state, federal)
Multiple departments and perspectives
(public health vs. military or criminal)
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Special Consideration for
Vulnerable Populations
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Large numbers (12% elderly, 12% nonelderly “disabled”)
Tremendous diversity of issues and needs
among “disabilities”
Narrower “margin of health”, critical
importance of primary and secondary
prevention
Capacity to deliver appropriate care in a
mass emergency?
Impact on scarce resources?
Vital importance of inclusion in planning
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