ARIZONA STATE SENATE
Phoenix, Arizona
FINAL
REVISED
board of dental examiners;
fees.
(NOW: enhanced surveillance advisory;
bioterrorism)
Authorizes the Governor to
issue enhanced surveillance advisories, allowing the Department of Health
Services (DHS) and local health authorities to respond to public health
emergencies by using enhanced reporting, isolation and quarantine measures.
In the wake of the September
11, 2001 attack on the World Trade Center and the Pentagon, the Centers for
Disease Control and Prevention (CDC) have initiated several programs to prepare
for biological and chemical terrorism. The CDC’s Center for Law and Public
Health at Georgetown University and Johns Hopkins University drafted a model
emergency health powers act for states to use as a guideline for procedures in
the event of a bioterrorist incident.
Congress has also made federal monies available through a state
bioterrorism preparedness and response block grant program to enable states and
localities to prepare for and respond to biological threats and attacks.
According to statute, during
a state of emergency, the Governor has complete authority over all agencies of
state government and all police power in the State (A.R.S. § 26-303). Additionally, statute authorizes the
Director of DHS to define and prescribe emergency measures for detecting,
reporting, preventing and controlling communicable or infectious diseases if
there is a threat to the public’s health and welfare (A.R.S § 36-136). Although DHS has prescribed communicable
diseases and their control measures and what providers are required to report,
statute lacks a comprehensive plan to coordinate the response effort during a
public health emergency.
As well, DHS prescribes
which communicable or infectious diseases need isolation. In recent years, due to immunizations and
safeguards, isolation and quarantine have not been frequently used. Further, statute establishes due process rights
for persons who are isolated and quarantined for tuberculosis, but not for
other infectious diseases (A.R.S. § 36-711).
H.B. 2044 authorizes the
Governor to issue enhanced surveillance advisories and creates additional
powers and responsibilities for DHS and local health authorities. DHS and local health authorities will
experience some costs if an enhanced surveillance advisory is declared.
1. Authorizes the Governor, in consultation with the Director of DHS, to issue an enhanced surveillance advisory.
2. Specifies terms of an enhanced surveillance advisory.
3. Requires DHS to notify local health authorities before the Governor issues an enhanced surveillance advisory.
4. Requires DHS and local health authorities to provide the enhanced surveillance advisory to persons and entities who are required to report.
5. Clarifies this article does not alter DHS or local health authority's ability to monitor community health or implement control measures for early detection of communicable and preventative diseases permitted by law.
6. Requires DHS and local health authorities to discuss issues and resources with health care providers before issuing an enhanced surveillance advisory or, if impractical, within 72 hours after issuance.
7. Requires DHS and local health authorities to make arrangements for sharing resources to assist persons or institutions affected by the implementation of the advisory.
8. Authorizes the enhanced surveillance advisory to be revised or terminated by DHS or it automatically terminates after 60 days unless renewed by the Governor.
9. Authorizes DHS to assist persons and institutions affected in seeking reimbursement for cost incurred as a result of implementing the advisory.
10. Requires a health care provider or medical examiner to report to a local health authority all cases of illness, health conditions or clinical syndromes that may be associated with bioterrorism or specified in the enhanced surveillance advisory.
11. Requires a veterinarian or a wildlife professional to report to DHS or a local health authority any case of animal illness or death due to a disease or other health condition designated in the enhanced surveillance advisory.
12. Requires a pharmacist who identifies any unusual increase in drugs used to treat health conditions identified in the enhanced surveillance advisory to report this information to a local health authority.
13. Specifies contents of the reports from health care providers, veterinarians and pharmacists and requires reports to be submitted within 24 hours after identifying the reportable circumstance.
14. Classifies failure to report as an act of unprofessional conduct.
15. Requires DHS and local health authorities to maintain certain information as confidential.
16. Authorizes DHS and local health authorities to access confidential patient information during an enhanced surveillance advisory.
17. Requires DHS and local health authorities to interview any person to develop information relating to the source and spread of an illness or health condition.
18. Requires a public safety authority to immediately notify DHS or a local health authority of a suspicious disease event or a threatened bioterrorism act.
19. Requires DHS or a local health authority to notify the appropriate public safety authority or tribal health authorities of a reportable illness or suspicious disease event.
20. Limits, between public safety and local health authorities, the sharing of information to information necessary to effect the enhanced surveillance advisory. Prohibits medical records from being released to public safety authorities.
21. Classifies information that might identify a person’s family as confidential.
22. Requires the State Laboratory to coordinate specimen testing during an enhanced surveillance advisory.
23. Authorizes DHS to designate alternative or secondary laboratories to assist it in testing specimens at the State’s expense.
24. Requires DHS to determine the criteria for laboratories to conduct testing associated with bioterrorism or other health conditions specified in the enhanced surveillance advisory.
25. Requires, on request of DHS or a local health authority, a public safety authority to transport clinical or environmental samples to the State Laboratory or other labs.
26. Requires DHS to coordinate all public health emergency responses.
27. Specifies DHS has primary jurisdiction, authority and responsibility for public health emergency responses.
28. Authorizes DHS and professional licensing boards to establish a process for a temporary waiver of professional licensure requirements and health care institution licensure requirements to address the state of emergency or state of war emergency.
29. Prescribes the Governor’s authority to issue public health orders during a state of emergency or state of war emergency.
30. Requires law enforcement officials and the National Guard to enforce orders issued by the Governor.
31. Allows DHS, on the Governor's direction, to assist persons and institutions affected by the state of emergency or state of war emergency in seeking reimbursement of cost incurred as a result of providing services related to implementation of isolation and quarantine.
32. Requires DHS, a county health department or a public health services district to investigate if there is cause to believe that a highly contagious and fatal disease exists.
33. Eliminates the responsibility of DHS to define isolation or quarantine procedures in rule.
34. Authorizes the isolation and quarantine of individuals who are exposed to a disease that normal containment measures are impracticable.
35. Allows DHS or the local health authority to exercise powers over persons to establish and maintain places of isolation and quarantine and require isolation or quarantine of any person by the least restrictive means necessary to protect the public health.
36. Requires DHS, a county health department or a public health services district to ensure the isolated and quarantined premises are maintained in hygienic manners, are designed to minimize further transmission of disease or other harm and have means for affected persons to communicate with those in and outside the setting.
37. Requires necessities and medical care to be made available to persons who are isolated and quarantined.
38. Requires persons subject to isolation or quarantine to comply with rules and orders, not leave the isolation or quarantine premises and not come in contact with any persons not subject to isolation or quarantine except for authorized persons.
39. Prohibits a person from entering the isolation or quarantine premises unless authorized.
40. Allows DHS or the local health authority to place a person in isolation or quarantine for unauthorized entry.
41. Requires DHS or the local health authority to terminate isolation or quarantine when it is no longer necessary.
42. Allows the isolation or quarantine of a person through a written directive without first obtaining a written order from a court if there is an immediate threat to the public health.
43. Requires, within ten days of issuing a written directive or when a delay of isolation or quarantine does not pose an immediate threat, DHS or the local health authority to file a petition for a court order authorizing the initial or continued isolation or quarantine.
44. Requires the petition to be accompanied by an affidavit attesting to the facts asserted in the petition.
45. Requires notice to a person identified in the petition to be notified within 24 hours.
46. Requires a hearing on the petition within five days after filing the petition.
47. Allows, for good cause, DHS or the local health authority to apply to continue the petition hearing date for up to ten days.
48. Requires the court to grant the petition if isolation or quarantine is necessary to protect the public’s health.
49. Limits an order authorizing isolation or quarantine to 30 days.
50. Allows an order to be continued for an additional 30 days.
51. Allows a person who is isolated or quarantined to apply to the court to show cause why the person should not be released. Requires the court to rule on the application within 48 hours and, if the court grants the application, the court must schedule a hearing within 24 hours.
52. Allows a person who is isolated or quarantined to request a hearing regarding treatment and the conditions of the isolation or quarantine.
53. Requires, after receiving a request for a hearing, the court to set a date within ten days.
54. Allows, if the court finds the isolation or quarantine does not comply with requirements, the court to make remedies to the circumstances of the state of emergency or state of war emergency and the rights of the individual.
55. Requires a record of the proceeding.
56. Requires the court, at the State’s expense, to appoint counsel.
57. Exempts acquired immune deficiency or other infections caused by the human immunodeficiency virus from the enhanced surveillance advisory and isolation and quarantine requirements.
58. Preserves a persons right to refuse treatment if sanitary or preventative measures and quarantine laws are followed.
59. Prescribes definitions.
60. Exempts DHS from the rule making requirements and requires DHS to hold at least one public hearing before it adopts rules.
61. Specifies the reporting of medical information is not prevented by physician patient privilege. Requires DHS and local health authorities to maintain the confidentiality of medical information and personal identifiers.
62. Prescribes immunity for state, political subdivisions, officers, agents, employees and a person or health care provider undertaking any activity required in the article.
63. Provides for a general effective date.
Amendments Adopted by Committee
· Adopted the strike everything amendment.
Amendments Adopted by Conference Committee
1. Specifies the diseases for which the Governor may mandate treatment and isolate and quarantine persons.
2. Makes a clarifying change.
Senate Action House Action
HEA 4/16/02 DPA/SE 7-0-1-0 Final Read 5/16/02 45-10-5-0
3rd Read 4/25/02 29-0-1-0
Final Read 5/16/02 29-0-1-0
Signed by Governor 5/23/02
Chapter 303
Prepared by Senate Staff
May 29, 2002