State Isolation and Quarantine Measures A Survey of State Laws Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Methodology Steps for legal analysis of state Q&I statutes – Summary of state Q&I laws published by the Health Policy Tracking Service – Examination of procedures mandated by state code and due process protections afforded under state statute in the event of an outbreak requiring Q&I – Examination of state regulations – Research of surveillance powers, privacy protections, and preparedness requirements under state law Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Methodology (cont.) Key dimensions for analysis – Who has the authority to implement quarantine and isolation measures – Whether the state health department has the authority to perform surveillance – What individual rights are explicitly protected by the laws – Whether state law requires or allows preparedness planning Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Results States Authority to Isolate/Implement a Quarantine Authority to Perform Surveillance/Repor ting Safeguarding Rights Preparedness GovernorState PHALocal PHANotice Due Process/Right to a Hearing Confidentiality & Privacy Religious Protections AK X XXXX AL X X X X AR X X X AZ XX CA XXX CO XX CT X X X DC X (Mayor) XX X DE X XXXX X FL X GA X HA XX XX IA X ID XX X IL XX X IN X KS XX KT X LA X MA XX MD X XXXX X ME XX MI XX MN X XX Figure 1. Overall Summary Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Results (cont.) States Authority to Isolate/Implement a Quarantine Authority to Perform Surveillance/ Reporting Safeguarding Rights Preparedness Governor State PHA Local PHANotice Due Process/Right to a Hearing Confidentiality & Privacy Religious Protections MO XX MS X MT XX XX NC XX X ND XX XXX NE XXX X NH X XXXX NJ XX X NM XX XX NV XX XX NY X OH X OK X OR X PA XX XX RI XX SC X XXXX SD X TN X TX X UT XXXXXX X VA X X VT X WA X X WV XX WI XX WY X XX Total Figure 1. Overall Summary Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Results (cont.) Figure 2. Procedures for Implementing Isolation and Quarantine Measures States Procedure for isolation and quarantine measures Emergency Declaration Required Investigation Required Prior Court ApprovalConsent Required Written Notice Required Notice Not Required for temp isolation AK X (unless consent) X AL AR XX AZ XX CA CO CT X DC X DE X X X FL X X GA X HA X X X IA ID X IL X (unless consent or serious danger) X (unless court order or serious danger) X Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Results (cont.) States Procedure for isolation and quarantine measures Emergency Declaration Required Investigation Required Prior Court ApprovalConsent Required Written Notice Required Notice Not Required for temp isolation IN KS KT LA X MAX MD X MEX MI MN X X MO X MS MT X NC X ND XX NE X NH X X NJ X (TB Program) NMX X X NV X NY OH X OK X OR X PA X X Figure 2. Procedures for Implementing Isolation and Quarantine Measures Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Results (cont.) States Procedure for isolation and quarantine measures Emergency Declaration Required Investigation Required Prior Court ApprovalConsent Required Written Notice Required Notice Not Required for temp isolation RI X SC X X (unless temporary) XX SD TN TX UT X (unless consent) X (unless court order) X VA VT WA X X WV WI X WY Total Figure 2. Procedures for Implementing Isolation and Quarantine Measures Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Key Comparisons Between Surveys State law survey did not include regulations State law survey did not include job protection category State law survey did not include memoranda of understanding (MOUs) Most results reasonably similar Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Key Differences Between Surveys Due process for individuals – Legal survey 18, state survey 21 Due process for groups – Legal survey 7, state survey 17 Preparedness – Legal survey 5, state survey 0 Local health officer’s authority for quarantine/isolation – Legal survey 21, state survey 27 Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Key Differences Between Surveys (cont.) Governor’s general legal authority – Legal survey 7, state survey all – Legal survey can’t be correct Governor’s authority for emergency declarations – Legal survey 7, state survey all – Legal survey can’t be correct Specific gubernatorial authority for quarantine/isolation – Legal survey 7, state survey 9 Expert Panel on Isolation and Quarantine University of Michigan School of Public Health

Deficiencies in Legal Authority Due process concerns – Group due process – Specificity of procedures (hearing, counsel, appeal) – Comments raise questions about state survey results – Implementation issues Need for MOUs to resolve concurrent jurisdiction Mandated training considerations Income replacement needs Expert Panel on Isolation and Quarantine University of Michigan School of Public Health