1. PUBLIC HEALTH REMEDIES

2. How do you get people to comply with public health laws? Usually seek voluntary compliance first— educate, persuade. If that doesn’t work, NC law provides several public health remedies – that is, legal means for enforcing the public health laws.

3. Categories of Remedies Criminal –Misdemeanor –Infraction Civil –Injunction –Public health nuisance –Imminent hazard –Embargo Administrative –Permit actions –Penalties

4. Misdemeanor – GS 130A-25 Any violation of a public health statute, state regulation, or local rule may be prosecuted as a misdemeanor. –Except smoking laws Special sentencing rules for communicable disease law violations: –May be sentenced for up to two years –May be released earlier if judge determines person is no longer a danger to public health

5. Misdemeanor – The Process Decide whether criminal charge is the remedy you want to pursue Initiate charge (usually before magistrate) –Bring a copy of relevant laws and rules –Bring person(s) who can testify to violation and/or relevant documents –If judicial official finds probable cause, will issue criminal summons or arrest warrant

6. Misdemeanor – The Process (cont.) Prepare for trial in district court –Make copies of relevant statutes and rules –Assemble relevant documents –Identify appropriate person(s) to testify –Communicate with prosecutor

7. Example – CD law violator Mr. Jones has tuberculosis and is receiving directly observed therapy. After he misses a few appointments, the health director issues an isolation order directing him to comply with treatment. The week after the order is issued, Mr. Jones keeps his DOT appointments. But then he misses more appointments.

8. Example – CD law violator Can Mr. Jones be charged with a crime? –Yes. Violation of any public health statute or rule is a misdemeanor. –By failing to keep his DOT appointments, Mr. Jones has violated the law requiring all persons to comply with communicable disease control measures. –The isolation order is evidence that Mr. Jones knows he has TB and is required to comply with DOT.

9. Example – CD law violator What to take to the magistrate’s office: –Applicable statutes and rules –Copy of isolation order, to show Mr. Jones was told he had TB and was required to comply with DOT –Evidence that he missed DOT appointments--someone who can testify and/or documentation

10. Civil –Injunction –Public health nuisance –Imminent hazard –Embargo

11. Injunctions – GS 130A-18 An injunction may be used to enforce any state public health statute, state regulation, or local board of health rule If the person violates an injunction, she may be held in contempt of court Must be handled in superior court

12. Injunctions – The Process Contact an attorney Provide copies of the relevant laws –GS 130A-18 (highlight “superior court”) –Specific laws violated Complaint Temporary Restraining Order Preliminary Injunction Permanent Injunction

13. Example – Straight-piped waste An EH specialist discovers a homeowner is straight-piping wastewater into a local stream. The owner is an 85 year-old woman who bought the house two years earlier. –What are the options? –Are some options more desirable than others?

14. Authority to abate public health nuisances and imminent hazards Public health nuisance GS 130A-19 Health director may order abatement If no compliance, go to court Undefined Imminent hazard GS 130A-20 Health director may order abatement If no compliance, may take action to abate Defined in GS 130A-2

15. Is [something unpleasant] a(n) … Public health nuisance? No statutory definition No cases defining it “Public nuisance” is “an unreasonable interference with rights common to the general public.” Key terms: health, public, unreasonable Imminent hazard? If no immediate action is taken, is likely to cause: –An immediate threat to human life, –An immediate threat of serious physical injury, –An immediate threat of serious adverse health effects, or –A serious risk of irreparable damage to the environment.