An Introduction to Public An Introduction to Public Health Law in TexasHealth Law in Texas
Anne KimbolAnne Kimbol
University of Houston Health Law and Policy University of Houston Health Law and Policy InstituteInstitute
What is Public Health Law?What is Public Health Law?
Intersection between public health Intersection between public health professionals and government/regulationprofessionals and government/regulation
Largely deals with authority and the Largely deals with authority and the balance between the need to protect the balance between the need to protect the public health and individuals’ rightspublic health and individuals’ rights
Authority in Texas - FederalAuthority in Texas - Federal
Police powers v. Commerce Clause.Police powers v. Commerce Clause.
President – communicable disease President – communicable disease definitiondefinition
Secretary of HHS/CDC – regulations Secretary of HHS/CDC – regulations relating to communicable diseases and relating to communicable diseases and help stateshelp states
Authority in Texas - GovernorAuthority in Texas - Governor
Texas Disaster ActTexas Disaster Act
EvacuationsEvacuations
Emergency management planEmergency management plan
Authority in Texas - DSHSAuthority in Texas - DSHS
Implementation of communicable disease Implementation of communicable disease control measurescontrol measures
Declare public health disasterDeclare public health disaster
Define reportable diseasesDefine reportable diseases
Help/preempt local authoritiesHelp/preempt local authorities
Investigate casesInvestigate cases
Authority in Texas - LocalAuthority in Texas - Local
Local health authority is in charge of Local health authority is in charge of control measures locally and most control measures locally and most communication between locals and DSHScommunication between locals and DSHS
Authority generally overlaps with DSHS Authority generally overlaps with DSHS but with area limitationsbut with area limitations
For certain actions, LHA must consult For certain actions, LHA must consult DSHSDSHS
Authority in Texas - CourtsAuthority in Texas - Courts
Courts largely play a role of ensuring Courts largely play a role of ensuring adequate balance between public safety adequate balance between public safety and individual rightsand individual rights
Mostly get involved when a party refuses Mostly get involved when a party refuses to comply with an order from the LHA or to comply with an order from the LHA or DSHSDSHS
Reportable Diseases - Who?Reportable Diseases - Who?
DentistsDentistsVetsVetsLocal school authoritiesLocal school authoritiesPerson in charge of clinical or hospital lab, blood bank, mobile unit, Person in charge of clinical or hospital lab, blood bank, mobile unit, or other facility performing labsor other facility performing labsRNRNAdministrator or director of nursing home, personal care home, Administrator or director of nursing home, personal care home, maternity home, adult respite care center, adult day-care center, maternity home, adult respite care center, adult day-care center, home health agency, institution of higher ed, public or private camp, home health agency, institution of higher ed, public or private camp, home, or institution, correctional institutionhome, or institution, correctional institutionOwner or manager of restaurant, dairy, other good handling or Owner or manager of restaurant, dairy, other good handling or processing placeprocessing placeEMTEMTPeace officerPeace officerFirefighterFirefighter
Reportable Disease – What And Reportable Disease – What And When?When?
Defined by DSHSDefined by DSHS
http://www.dshs.state.http://www.dshs.state.tx.us/idcu/investigatiotx.us/idcu/investigation/conditions/n/conditions/
Additional organismsAdditional organisms
Information to be Information to be reportedreported
Reportable Diseases - AnimalsReportable Diseases - AnimalsMultiple species diseasesMultiple species diseases
Akabane - Akabane virusAkabane - Akabane virus Anthrax** - Bacillus anthracisAnthrax** - Bacillus anthracis Aujeszky’s disease - Pseudorabies virus, herpesvirus suisAujeszky’s disease - Pseudorabies virus, herpesvirus suis Leishmaniasis** - Leishmania infantum and L donavaniLeishmaniasis** - Leishmania infantum and L donavani Foot and mouth disease - Aphthovirus, types A,O,C, SAT, AsiaFoot and mouth disease - Aphthovirus, types A,O,C, SAT, Asia Heartworm - Cowdria ruminantiumHeartworm - Cowdria ruminantium African Trypanosomosis (Nagana) - Trypanosoma brucei, T. vivax,African Trypanosomosis (Nagana) - Trypanosoma brucei, T. vivax, T. bruceiT. brucei Rinderpest - MorbillivirusRinderpest - Morbillivirus Rift Valley fever - Bunya virusRift Valley fever - Bunya virus Vesicular stomatitis - Rhabdovirus; 2 serotypes; New Jersey and IndianaVesicular stomatitis - Rhabdovirus; 2 serotypes; New Jersey and Indiana Screwworm - Cochliomyia hominivoraxScrewworm - Cochliomyia hominivorax
Cattle diseases (including Exotic Bovidae)Cattle diseases (including Exotic Bovidae) Bovine babesiosis - Bovine babesiosis - B. bovis, B. divergensB. bovis, B. divergens, Babesia microti, Babesia microti Bovine brucellosis - Brucella abortusBovine brucellosis - Brucella abortus Bovine ephemeral fever - RhabdovirusBovine ephemeral fever - Rhabdovirus Bovine tuberculosis - Mycobacterium bovisBovine tuberculosis - Mycobacterium bovis East coast fever (Theileriosis) - Theileria parvaEast coast fever (Theileriosis) - Theileria parva Malignant catarrhal fever (wildebeest associated) – Alcelaphine herpesvirus (AHV 1)Malignant catarrhal fever (wildebeest associated) – Alcelaphine herpesvirus (AHV 1) Contagious bovine pleuropneumonia - Mycoplasma mycoidesContagious bovine pleuropneumonia - Mycoplasma mycoides Lumpy skin disease - Neethling poxvirusLumpy skin disease - Neethling poxvirus Bovine spongiform encephalopathy -Bovine spongiform encephalopathy - Scabies - Sarcoptes scabiei, Psoroptes bovis, Chorioptes bovisScabies - Sarcoptes scabiei, Psoroptes bovis, Chorioptes bovis
Reportable Diseases - AnimalsReportable Diseases - AnimalsCervidaeCervidae
Brucellosis - Brucella abortus, Brucella suis (biotype 4)Brucellosis - Brucella abortus, Brucella suis (biotype 4) Chronic Wasting Disease -Chronic Wasting Disease - Tuberculosis - Mycobacterium bovisTuberculosis - Mycobacterium bovis
Sheep and goat diseasesSheep and goat diseases Caprine and ovine brucellosis (not B. ovis infection) - Brucella melitensisCaprine and ovine brucellosis (not B. ovis infection) - Brucella melitensis Contagious caprine pleuropneumonia - Mycoplasma capri (biotype 78)Contagious caprine pleuropneumonia - Mycoplasma capri (biotype 78) Louping ill - FlavovirusLouping ill - Flavovirus Nairobi sheep disease - BunyaviridaeNairobi sheep disease - Bunyaviridae Peste des petits ruminants - Morbillivirus, Paramyxoviridae familyPeste des petits ruminants - Morbillivirus, Paramyxoviridae family Sheep pox and goat pox - CapripoxvirusSheep pox and goat pox - Capripoxvirus ScrapieScrapie Scabies - Sarcoptes scabieiScabies - Sarcoptes scabiei
Equine diseasesEquine diseases African horse sickness - OrbivirusAfrican horse sickness - Orbivirus Contagious equine metritis - Tayorella equigenitalisContagious equine metritis - Tayorella equigenitalis Dourine - Trypanosoma equiperdumDourine - Trypanosoma equiperdum Epizootic lymphangitis - Histoplasma farciminosumEpizootic lymphangitis - Histoplasma farciminosum Equine encephalomyelitis (Eastern and Western)** - AlphavirusEquine encephalomyelitis (Eastern and Western)** - Alphavirus Equine infectious anemia - LentivirusEquine infectious anemia - Lentivirus Equine morbillivirus pneumonia - MorbillivirusEquine morbillivirus pneumonia - Morbillivirus Equine piroplasmosis - Babesia equi, B. caballiEquine piroplasmosis - Babesia equi, B. caballi Glanders - Pseudomonas malleiGlanders - Pseudomonas mallei Japanese encephalitis - FlavovirusJapanese encephalitis - Flavovirus Surra - Trypanosoma evansiSurra - Trypanosoma evansi Venezuelan equine encephalomyelitis** - Alphavirus; Togaviridae familyVenezuelan equine encephalomyelitis** - Alphavirus; Togaviridae family Equine Viral Arteritis (EVA)* ***Equine Viral Arteritis (EVA)* *** Equine Herpes Virus-1 (EHV-1)*Equine Herpes Virus-1 (EHV-1)*
Reportable Diseases - AnimalsReportable Diseases - AnimalsSwine diseasesSwine diseases
African swine fever - PoxvirusAfrican swine fever - Poxvirus Classical swine fever (hog cholera) - TogovirusClassical swine fever (hog cholera) - Togovirus Pseudorabies - Herpesvirus suisPseudorabies - Herpesvirus suis Porcine brucellosis - Brucella suisPorcine brucellosis - Brucella suis Swine vesicular disease - PicornavirusSwine vesicular disease - Picornavirus Vesicular Exanthema - CalicivirusVesicular Exanthema - Calicivirus
Poultry diseasesPoultry diseases Avian influenza - OrthomyxoviruseAvian influenza - Orthomyxoviruse Avian infectious laryngotracheitis - Orthomyxovirus, herpesvirusAvian infectious laryngotracheitis - Orthomyxovirus, herpesvirus Avian tuberculosis - Mycobacterium avium serovars 1,2Avian tuberculosis - Mycobacterium avium serovars 1,2 Duck virus hepatitis - PicornavirusDuck virus hepatitis - Picornavirus Duck virus enteritis - HerpesvirusDuck virus enteritis - Herpesvirus Fowl typhoid - Salmonella gallinarumFowl typhoid - Salmonella gallinarum Highly pathogenic avian influenza (fowl plague) - Orthomyxovirus (type H5 or H7)Highly pathogenic avian influenza (fowl plague) - Orthomyxovirus (type H5 or H7) Infectious encephalomyelitis - ArbovirusInfectious encephalomyelitis - Arbovirus Ornithosis (psitticosis) - Chlamydia psittaciOrnithosis (psitticosis) - Chlamydia psittaci Pullorum disease - Salmonella pullorumPullorum disease - Salmonella pullorum Newcastle disease (VVND) - Paramyxovirus-1 (PMV-1)Newcastle disease (VVND) - Paramyxovirus-1 (PMV-1) Paramyxovirus infections (other than Newcastle disease) - PMV-2 to PMV-9Paramyxovirus infections (other than Newcastle disease) - PMV-2 to PMV-9
Rabbit diseasesRabbit diseases Myxomatosis - Myxomatosis virusMyxomatosis - Myxomatosis virus Viral haemorrhagic disease of rabbits - Calciviral diseaseViral haemorrhagic disease of rabbits - Calciviral disease
*These diseases will only be reportable through the last day of the 81st Texas Legislative Session unless *These diseases will only be reportable through the last day of the 81st Texas Legislative Session unless continued in effect by act of the legislature.continued in effect by act of the legislature.**These diseases are also reportable to the Department of State Health Services (DSHS)**These diseases are also reportable to the Department of State Health Services (DSHS)***This disease has reporting standards in Chapter 49, §49.4 of this title (relating to Equine Viral Arteritis (EVA): ***This disease has reporting standards in Chapter 49, §49.4 of this title (relating to Equine Viral Arteritis (EVA): Reporting and Handling for Breeding of Infected Equine).Reporting and Handling for Breeding of Infected Equine).
Reportable Diseases – Where?Reportable Diseases – Where?
To DSHS or Local Health AuthorityTo DSHS or Local Health Authority
Local Health Authority must report to Local Health Authority must report to DSHSDSHS
Texas Animal Health CommissionTexas Animal Health Commission
Reportable Diseases – Why?Reportable Diseases – Why?
TrackingTracking
Class B MisdemeanorClass B Misdemeanor
Liability protection for good faith reportingLiability protection for good faith reporting
Protection of those handling dead bodiesProtection of those handling dead bodies
Communicable Diseases - SchoolsCommunicable Diseases - Schools
LHA may close school if needed to protect public healthLHA may close school if needed to protect public healthExclusionary conditionsExclusionary conditions
AmebiasisAmebiasis CampylobacteriosisCampylobacteriosis Chickenpox AmebiasisChickenpox Amebiasis Common cold Common cold Conjunctivitis, bacterial and/or viral Conjunctivitis, bacterial and/or viral Fever Fever Fifth disease Fifth disease Gastroenteritis Gastroenteritis Giardiasis Giardiasis Head lice Head lice Hepatitis A Hepatitis A Impetigo Impetigo Infections mononucleosis Infections mononucleosis Influenza Influenza Measles Measles Meningitis bacterial Meningitis bacterial Mumps Mumps Whopping coughWhopping cough RingwormRingworm Rubella Rubella Salmonellosis Salmonellosis Scabies Scabies Shigellosis Shigellosis Streptococcal sore throat and scarlet fever Streptococcal sore throat and scarlet fever – – until antibiotic treatment has begun and physician certificate or health permit is obtaineduntil antibiotic treatment has begun and physician certificate or health permit is obtained
Quarantine and Isolation - TermsQuarantine and Isolation - Terms
QuarantineQuarantine Not defined in Texas H&S CodeNot defined in Texas H&S Code PH definition – Separation and restriction of PH definition – Separation and restriction of
movement of individuals who are not yet ill but have movement of individuals who are not yet ill but have been exposed to a communicable diseasebeen exposed to a communicable disease
IsolationIsolation Also not defined in lawAlso not defined in law Separation of individuals ill with a communicable Separation of individuals ill with a communicable
diseasedisease
Terms are often used interchangeably in lawTerms are often used interchangeably in law
Quarantine and Isolation - PropertyQuarantine and Isolation - PropertyQuarantine of Property
(Texas Health & Safety Code §§ 81.063-065, 067-068, 084, 087-088)
Suspect property is infected or contaminated
Provide notice to owner and quarantine property
Take samples for testing; offer
similar samples to the owner
Determine appropriate control
measures
Release quarantine if no contamination or
infection found
Release quarantine when
safe
If no appropriate control measures exist, require owner to destroy
property. If land, require secure fencing and sealing off of all structures
Class B misdemeanor to knowingly remove, conceal, or dispose of
property under investigation
Class A misdemeanor to refuse entry or
inspection
Failure to comply is a Class B
misdemeanor
Q&I – Property - DSHSQ&I – Property - DSHS
Right of entryRight of entry
SamplesSamples
Impose control measuresImpose control measures QuarantineQuarantine Restrict accessRestrict access DestructionDestruction
Q&I – Property – LHA Q&I – Property – LHA
Same as DSHS within regionSame as DSHS within region
Q&I – Property – CourtsQ&I – Property – Courts
PenaltiesPenalties
EnforcementEnforcement
Quarantine and Isolation - CarriersQuarantine and Isolation - CarriersActions Involving Carrier or Private Conveyances
(Texas Health & Safety Code §§ 81.086, 089)
Vehicle or craft in Texas
Reasonable cause to believe it traveled through or from an area infected or contaminated by a communicable
disease
Determine control measures and issue related order – order vehicle stopped
and obtain information on the passengers and cargo
Owner may be ordered to pay costs of any technically feasible control
measures
Release
Knowingly transporting infected or contaminated people or property is a
Class A misdemeanor; if intent to cause harm or defraud then felony of
the third degree
Q&I – Carriers - DSHSQ&I – Carriers - DSHS
Order the vehicle stoppedOrder the vehicle stopped
Get information on people aboardGet information on people aboard
Impose control measuresImpose control measures
Q&I – Carriers – LHA Q&I – Carriers – LHA
Same as DSHSSame as DSHS
Q&I – Carriers - CourtsQ&I – Carriers - Courts
PenaltiesPenalties
EnforcementEnforcement
Quarantine and Isolation - AreasQuarantine and Isolation - AreasArea Quarantines
(Texas Health & Safety Code § 81.085)
Issue area quarantine order upon reasonable cause to believe persons or
property contaminated (if HA, must consult with DSHS and give notice to
impacted governing bodies)
If needed, cooperative agreements with neighboring states
Publish notice in newspaper of general circulation each week
Use other reasonable means to communicate with persons in the area of the quarantine and needed actions
If needed, request disclosure of individuals’ immunization records and
take any appropriate action
If needed, commissioner’s court of affected county or governing body of municipality or hospital district may
suspend admission of patients seeking elective treatment; does not impact responsibilities to indigent residents
Termination by DSHS (HA may only terminate with DSHS consent)
Failure to comply with area quarantine and related orders is a felony of the third
degree
Q&I – Areas – DSHS Q&I – Areas – DSHS
QuarantineQuarantine
InvestigationsInvestigations
Work with neighboring statesWork with neighboring states
Publish noticePublish notice
Obtain immunization recordsObtain immunization records
Q&I – Areas – LHA Q&I – Areas – LHA
Quarantine after Quarantine after DSHS consultDSHS consult
Written noticeWritten notice Governing bodyGoverning body PublicPublic
Designate facilitiesDesignate facilities
Q&I – Area – CourtsQ&I – Area – Courts
PenaltiesPenalties
EnforcementEnforcement
Suspend admission of patients seeking Suspend admission of patients seeking elective treatmentelective treatment
Quarantine and Isolation - PeopleQuarantine and Isolation - PeopleDiagnosis and Reporting
Implementation of control measures by health authority or department by means of written orders . (Delivery and non-compliance with HA or DSHS order not required during disaster.)
Violation of orders
Seek court-ordered treatment (Person may make religious objection unless there is a proclaimed disaster , public health emergency, or area quarantine; in which case seek only protective custody)
Motion for order for temporary protective custody ; must allege:1. Application for an order for protective custody and an application for a court order for management of a person with a commun icable disease will be filed the next business day ; and 2. There is probable cause to find a substantial risk of serious harm without the order .
Order for temporary protective custody 1. Terminates by 4 p.m. the following business day. Termination delayed to allow court to rule if applications for an order for protective
custody and for a court order for management of a person with a communicable disease have been filed .2. Order is issued based on representations in the court filings and not an adversary hearing .
Person remains free pending order for protective custody and /or court for management if TPC order not granted .
Application for court order for management of person with a communicable disease ; must contain:1. Person’s name and address; 2. Person’s county of residence;
3. Person is infected with communicable disease ; 4. Copy of written order; 5. Medical evaluation
Motion for Order for Protective Custody; must allege:1. Person meets all criteria for commitment ; and
2. Person presents immediate threat to the public health .
Quarantine Process – Individual (Texas Health & Safety Code §§ 81.066, 082-083, 151-199)
Compliance with Orders
Criminal Penalty – Class B Misdemeanor
Apprehension and detention under court order
Probable cause hearing within 72 hours of detention (delay allowed if location of person or court is in a
public health disaster).
Appointment of attorney
Order for continued detention (requires finding of risk of serious harm to self or
others).
Order for release
Appointment of attorney within 24 hours of application
Hearing within 14 days (cannot be held within first 3 days if person or attorney objects; good faith continuances allowed but hearing must be held within 30 days)
Notice to appropriate parties
Disclosure of information/document to person’s attorney
Recommendation of treatment and designation of facility by health authority or department (eligible facilities designated by Commissioner of Health )
Hearing on application
Order for extended
management (90 days – 1
year)
Order for temporary
management (1-90 days)
Court-ordered outpatient services
Motion for modification orderCompliance with
order
Motion deniedOrder for temporary detention pending
modification
Modification of order for outpatient treatment
AppealPerson released Compliance with order, including transportation to facility and acknowledgement of delivery
Modification upheld
Appeal or rehearing
Designation of facility
Release
Quarantine and Isolation - PeopleQuarantine and Isolation - PeopleDiagnosis and Reporting
Implementation of control measures by health authority or department by means of written orders. (Delivery and non-compliance with HA or DSHS order not required during disaster.)
Violation of orders
Seek court-ordered treatment; statements in application should be based on group actions (Person may make religious objection unless there is a proclaimed disaster, public health emergency, or area quarantine; in which
case seek only protective custody)
Motion for order for temporary protective custody; must allege:1. Application for an order for protective custody and an application for a court order for management of a group with a communi cable disease will be filed the next business day; and 2. There is probable cause to find a substantial risk of serious harm without the order.
Order for temporary protective custody 1. Terminates by 4 p.m. the following business day. Termination delayed to allow court to rule if applications for an order for protective
custody and for a court order for management of a group with a communicable disease have been filed.2. Order is issued based on representations in the court filings and not an adversary hearing.
Group remains free pending order for protective custody and/or court for management if TPC order not granted.
Application for court order for management of group with a communicable disease; must contain:1. Description and location of group; 2. Narrative on how group was exposed or infected; 3. Estimate on number in group; 4. Names, addresses, and counties of residence if known (if not known statement of how sought and why unknown); 5. Statement that the members failed to comply with control measure orders; and 6. Medical evaluation of group – may be based on individual evaluation if doctor believes it to be representative of the
group.
Motion for Order for Protective Custody; must allege:1. Group meets all criteria for commitment; and
2. Group presents immediate threat to the public health.
Quarantine Process – Group of 5 or more (Texas Health & Safety Code §§ 81.066, 082-083, 151-199)
Compliance with Orders
Criminal Penalty – Class B Misdemeanor
Apprehension and detention under court order
Probable cause hearing within 72 hours of detention (delay allowed if location of group or court is in a
public health disaster).
Appointment of attorney
Order for continued detention (requires finding of risk of serious harm to selves
or others).
Order for release
Appointment of attorney within 24 hours of application; one for group is fine unless anyone requests an individual attorney
Hearing within 14 days (cannot be held within first 3 days if group or attorney objects; good faith continuances allowed but hearing must be held within 30 days)
Notice to appropriate parties
Disclosure of information/document to group’s attorney(s)
Recommendation of treatment and designation of facility by health authority or department (eligible facilities designated by Commissioner of Health)
Hearing on application
Order for extended
management (90 days – 1
year)
Order for temporary
management (1-90 days)
Court-ordered outpatient services
Motion for modification orderCompliance with
order
Motion deniedOrder for temporary detention pending
modification
Modification of order for outpatient treatment
AppealGroup released Compliance with order, including transportation to facility and acknowledgement of delivery
Modification upheld
Appeal or rehearing
Designation of facility
Release
Q&I – People – DSHSQ&I – People – DSHS
Preempt LHAPreempt LHA
Return other states’ residentsReturn other states’ residents
Impose control measuresImpose control measures IndividualsIndividuals GroupsGroups
Q&I – People – LHAQ&I – People – LHA
Same as DSHSSame as DSHS
Q&I – People – CourtsQ&I – People – Courts
PenaltiesPenalties
Different types/levels/procedures for Different types/levels/procedures for enforcementenforcement Order for Management of Person with a Order for Management of Person with a
Communicable DiseaseCommunicable DiseaseTemporaryTemporary
ExtendedExtended Protective Custody OrdersProtective Custody Orders
Q&I – People – Courts – PCO Q&I – People – Courts – PCO
Motion for Order for temporary protective Motion for Order for temporary protective custodycustody
Order for TPCOrder for TPC
Motion for Order for Protective CustodyMotion for Order for Protective Custody
AttorneyAttorney
Probable Cause hearingProbable Cause hearing
Court order – continued detention or Court order – continued detention or releaserelease
Q&I – People – Courts – OMPCD Q&I – People – Courts – OMPCD
ApplicationApplicationAppointment of attorneyAppointment of attorneyTimingTimingNoticeNoticeRecommendationsRecommendationsHearingHearingCourt decision – release, outpatient, Court decision – release, outpatient, temporary, extended temporary, extended
Q&I – People – ModificationsQ&I – People – Modifications
CauseCause
NoticeNotice
HearingHearing
DetentionDetention
CounselCounsel
Court decisionCourt decision
Q&I – People – Renewal Q&I – People – Renewal
For extended management orderFor extended management order
ApplicationApplication
AffidavitAffidavit
AttorneyAttorney
HearingHearing
Q&I – People – Rehearings Q&I – People – Rehearings
RehearingRehearing
AppealAppeal
ExaminationExamination
TimingTiming
Q&I – People – Treatment Q&I – People – Treatment
FacilityFacility
Temporary PassesTemporary Passes
Release/dischargeRelease/discharge
Q&I – People – Groups Q&I – People – Groups
Any statement or determination regarding the Any statement or determination regarding the conduct of a member of the group must apply to the conduct of a member of the group must apply to the majority of its members; majority of its members; Any finding or statement regarding compliance must Any finding or statement regarding compliance must apply to all members of the group; apply to all members of the group; Any notice being sent to the group must also be Any notice being sent to the group must also be published in the local newspaper of general published in the local newspaper of general circulation, state that the group is appointed one circulation, state that the group is appointed one attorney but any individual member may request an attorney but any individual member may request an individual attorney, and include instructions for individual attorney, and include instructions for people who suspect they may be part of the group to people who suspect they may be part of the group to contact DSHS or the LHA.contact DSHS or the LHA.
RabiesRabies
A reportable condition in humans and animalsA reportable condition in humans and animals
For animalsFor animals Report within one working day of diagnosis for animalReport within one working day of diagnosis for animal Report to regional zoonosis control office of Zoonosis Report to regional zoonosis control office of Zoonosis
Control Division in AustinControl Division in Austin
For humans – report immediately to LHA or For humans – report immediately to LHA or DSHS regional director (considered public health DSHS regional director (considered public health emergency)emergency)
Rabies – DSHS Rabies – DSHS
H&S Code Chapter 826H&S Code Chapter 826
Set minimum standardsSet minimum standards
Provide vaccine or serumProvide vaccine or serum
Adopt control measure rulesAdopt control measure rules
Hold hearingsHold hearings
Regulate facilitiesRegulate facilities
Override localsOverride locals
Rabies – Local/ProfessionalsRabies – Local/Professionals
Local rabies control authorityLocal rabies control authority
Animal licensingAnimal licensing
Quarantine and other control measuresQuarantine and other control measures
Liability protection for veterinariansLiability protection for veterinarians
Exemptions for police dogsExemptions for police dogs
Penalties for facilitiesPenalties for facilities
Rabies biologicalsRabies biologicals
Rabies – Individuals Rabies – Individuals
Vaccinate cats and dogsVaccinate cats and dogs Penalties for failurePenalties for failure
Reporting of suspected rabies and/or Reporting of suspected rabies and/or possible transmission to humanspossible transmission to humans
Rabies – Area QuarantinesRabies – Area Quarantines
Area quarantine if rabies exists in an areaArea quarantine if rabies exists in an area
Borders and rules adoptedBorders and rules adopted
Restraint provisionsRestraint provisions
Penalty for failure to complyPenalty for failure to comply
Contact Information; OtherContact Information; Other
UH Health Law and Policy Institute will be UH Health Law and Policy Institute will be releasing a bench book for judges on releasing a bench book for judges on isolation and quarantine issues. Will isolation and quarantine issues. Will include charts shown here as well as include charts shown here as well as sample forms and simplified language sample forms and simplified language summarizing the key statutes.summarizing the key statutes.
Anne Kimbol, [email protected], Anne Kimbol, [email protected], 713-743-2198713-743-2198
Further Contacts/InformationFurther Contacts/Information
FEDERALFEDERAL Centers for Disease Control and Prevention (Centers for Disease Control and Prevention (800) CDC-INFO800) CDC-INFO Federal Emergency Management Agency Federal Emergency Management Agency (800) 621-FEMA(800) 621-FEMA National Institutes of Health (National Institutes of Health (301) 496-4000301) 496-4000 Office of the Surgeon General (301) 443-4000Office of the Surgeon General (301) 443-4000 Public Health Service Commissioned Corps (240) 453-6000Public Health Service Commissioned Corps (240) 453-6000
STATESTATE Commissioner of Health (888) 963-7111Commissioner of Health (888) 963-7111 Governor’s Office (800) 843-5789Governor’s Office (800) 843-5789 Office of General Counsel, TDSHS (512) 458-7236Office of General Counsel, TDSHS (512) 458-7236 Office of Public Health Practice, TDSHS (512) 458-7700Office of Public Health Practice, TDSHS (512) 458-7700 Center for Public Health Preparedness and Response, TDSHS Center for Public Health Preparedness and Response, TDSHS
(512) 458-7219(512) 458-7219
Further Contacts/InformationFurther Contacts/InformationSUGGESTED LOCAL CONTACTSSUGGESTED LOCAL CONTACTS
County Commissioners’ Court County Commissioners’ Court County and/or municipal departments of healthCounty and/or municipal departments of health City CouncilCity Council City Attorney’s OfficeCity Attorney’s Office Local office of public health preparednessLocal office of public health preparedness County Attorney County Attorney County Appraisal District County Appraisal District
Information Available on the InternetInformation Available on the Internet Centers for Disease Control and Prevention http://www.cdc.gov/Centers for Disease Control and Prevention http://www.cdc.gov/ Federal Emergency Management Agency http://www.fema.gov/Federal Emergency Management Agency http://www.fema.gov/ National Institutes of Health http://www.nih.gov/National Institutes of Health http://www.nih.gov/ Governor’s Office http:///www.governor.state.tx.usGovernor’s Office http:///www.governor.state.tx.us Texas Department of State Health Services http://www.dshs.state.tx.usTexas Department of State Health Services http://www.dshs.state.tx.us Communicable Disease Control Measures in Texas, DSHS Report Communicable Disease Control Measures in Texas, DSHS Report
http://www.dshs.state.tx.us/comprep/ogc/cdmanual.pdfhttp://www.dshs.state.tx.us/comprep/ogc/cdmanual.pdf Avian Flu Pandemic Litigation Forms, Office of the Attorney General Avian Flu Pandemic Litigation Forms, Office of the Attorney General
http://www.oag.state.tx.us/notice/emergency /birdflu/index_forms.phphttp://www.oag.state.tx.us/notice/emergency /birdflu/index_forms.php
