(1)
Applicability. The
provisions of rule
641-1.12
(135,137,139A) are applicable in jurisdictions in which a local board has
adopted this rule by reference in accordance with Iowa Code section 137.6. This
rule shall not be construed to require a local board to adopt this model
rule.
(2)
Definitions.
"Board" means [insert the name of the city,
county, or district board of health].
"Department" means the Iowa department of
public health.
"Isolation " means the separation of persons
or animals presumably or actually infected with a communicable disease, or that
are disease carriers, for the usual period of communicability of that disease.
Isolation shall be in such places, marked by placards if necessary, and under
such conditions to prevent the direct or indirect conveyance of the infectious
agent or contagion to susceptible individuals.
"Quarantinable disease" means any communicable
disease which presents a risk of serious harm to public health and which may
require isolation or quarantine to prevent its spread. "Quarantinable disease"
includes but is not limited to cholera; diphtheria; infectious tuberculosis;
plague; smallpox; yellow fever; viral hemorrhagic fevers, including Lassa,
Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or
named; novel influenza; and severe acute respiratory syndrome (SARS).
"Quarantine" means the limitation of freedom
of movement of persons or animals that have been exposed to a communicable
disease, within specified limits marked by placards, for a period of time equal
to the longest usual incubation period of the disease. The limitation of
movement shall be in such manner as to prevent the spread of a communicable
disease.
(3)
General provisions.
a.
Voluntary confinement. Prior to instituting mandatory isolation or quarantine
pursuant to this rule, the board may request that an individual or group of
individuals voluntarily confine themselves to a private home or other
facility.
b. Quarantine and
isolation. The board is authorized to impose and enforce quarantine and
isolation restrictions. Quarantine and isolation shall rarely be imposed by the
board. If a quarantinable disease occurs in Iowa, individuals with a suspected
or active quarantinable disease and contacts to the case may be quarantined or
isolated as the particular situation requires. Any quarantine or isolation
imposed by the board shall be established and enforced in accordance with this
rule.
c. The local board of health
shall notify, consult and work cooperatively with the Iowa department of
agriculture and land stewardship and the state veterinarian office on issues
relating to isolation and quarantine of animals.
(4)
Conditions and
principles. The board shall adhere to all of the following conditions
and principles when isolating or quarantining individuals or a group of
individuals:
a. The isolation or quarantine
shall be by the least restrictive means necessary to prevent the spread of a
communicable or possibly communicable disease to others and may include, but is
not limited to, confinement to private homes, other private premises, or public
premises.
b. Isolated individuals
shall be confined separately from quarantined individuals.
c. The health status of isolated or
quarantined individuals shall be monitored regularly to determine if the
individuals require further or continued isolation or quarantine.
d. If a quarantined individual subsequently
becomes infected or is reasonably believed to have become infected with a
communicable or possibly communicable disease, the individual shall be promptly
removed to isolation.
e. Isolated
or quarantined individuals shall be immediately released when the board
determines that the individuals pose no substantial risk of transmitting a
communicable or possibly communicable disease.
f. The needs of isolated or quarantined
individuals shall be addressed in a systematic and competent fashion including,
but not limited to, providing adequate food; clothing; shelter; means of
communicating with those in and outside of isolation or quarantine; medication;
and competent medical care.
g. The
premises used for isolation or quarantine shall be maintained in a safe and
hygienic manner and shall be designed to minimize the likelihood of further
transmission of infection or other harm to isolated or quarantined
individuals.
h. To the extent
possible, cultural and religious beliefs shall be considered in addressing the
needs of individuals in isolation and quarantine premises and in establishing
and maintaining the premises.
(5)
Isolation and quarantine
premises.
a. If deemed appropriate
by the department, sites of isolation or quarantine shall be prominently
placarded with isolation or quarantine signs prescribed and furnished by the
department and posted on all sides of the building wherever access is
possible.
b. An individual subject
to isolation or quarantine shall obey the rules and orders of the board and
shall not go beyond the isolation or quarantine premises unless expressly
authorized to do so by the order.
c. The department or the board may authorize
physicians, health care workers, or others access to individuals in isolation
or quarantine as necessary to meet the needs of isolated or quarantined
individuals.
d. No individual,
other than an individual authorized by the department or the board, shall enter
an isolation or quarantine premises. If the department has requested the
assistance of law enforcement in enforcing the isolation or quarantine, the
department shall provide law enforcement personnel with a list of individuals
authorized to enter the isolation or quarantine premises.
e. Any individual entering an isolation or
quarantine premises with or without authorization of the department or the
board may be isolated or quarantined pursuant to this rule.
(6)
Isolation
and quarantine.
a. Authority. The
board may:
(1) Isolate individuals who are
presumably or actually infected with a quarantinable disease;
(2) Quarantine individuals who have been
exposed to a quarantinable disease;
(3) Establish and maintain places of
isolation and quarantine; and
(4)
Adopt emergency rules and issue orders as necessary to establish, maintain, and
enforce isolation or quarantine.
b. Isolation and quarantine undertaken by the
board shall be accomplished in accordance with this rule.
c. Temporary isolation and quarantine without
notice. The board may temporarily isolate or quarantine an individual or groups
of individuals through an oral order, without notice, only if delay in imposing
the isolation or quarantine would significantly jeopardize the board's ability
to prevent or limit the transmission of a communicable or possibly communicable
disease to others. If the board imposes temporary isolation or quarantine of an
individual or groups of individuals through an oral order, the board shall
issue a written order as soon as is reasonably possible and in all cases within
24 hours of issuance of the oral order if continued isolation or quarantine is
necessary to prevent or limit the transmission of a communicable or possibly
communicable disease.
d. Written
order. The board may isolate or quarantine an individual or groups of
individuals through a written order issued pursuant to this rule.
(1) The written order shall include all of
the following:
1. The identity of the
individual, individuals, or groups of individuals subject to isolation or
quarantine.
2. The premises subject
to isolation or quarantine.
3. The
date and time at which isolation or quarantine commences.
4. The suspected communicable
disease.
5. A description of the
less restrictive alternatives that were attempted and were unsuccessful, or the
less restrictive alternatives that were considered and rejected, and the
reasons such alternatives were rejected.
6. A statement of compliance with the
conditions and principles for isolation and quarantine specified in subrule
1.12(4).
7. The legal authority
under which the order is imposed.
8. The medical basis upon which isolation or
quarantine is justified.
9. A
statement advising the individual, individuals, or groups of individuals of the
right to appeal the written order pursuant to subrule 1.12(7) and the rights of
individuals and groups of individuals subject to quarantine and isolation as
listed in subrule 1.12(8).
10. A
copy of this rule and the relevant definitions.
(2) A copy of the written order shall be
provided to the individual to be isolated or quarantined within 24 hours of
issuance of the order in accordance with any applicable process authorized by
the Iowa Rules of Civil Procedure. If the order applies to a group or groups of
individuals and it is impractical to provide individual copies, the order may
be posted in a conspicuous place in the isolation or quarantine premises.
(7)
Appeal from order imposing isolation or quarantine.
a.
Appeal. The subject of a
board order imposing isolation or quarantine may appeal a written order by
submitting a written appeal within ten days of receipt of the written order.
The appeal shall be addressed to [insert name of board and board address].
Unless stayed by order of the board or a district court, the written order for
quarantine or isolation shall remain in force and effect until the appeal is
finally determined and disposed of upon its merits.
b.
Proceeding. The appeal
proceeding shall be conducted in accordance with this rule [or insert specific
board rule governing appeal proceedings]. The proceeding shall be held as soon
as is practicable, and in no case later than ten days from the date of receipt
of the appeal. The hearing may be held by telephonic or other electronic means
if necessary to prevent additional exposure to the communicable or possibly
communicable disease. In extraordinary circumstances and for good cause shown,
the board may continue the proceeding date for up to ten days, giving due
regard to the rights of the affected individuals, the protection of the
public's health, and the availability of necessary witnesses and evidence. At
the appeal proceeding, the subject of the appeal shall have the right to
introduce evidence on all issues relevant to the order. The board, by majority
vote, may modify, withdraw, or order compliance with the order under
appeal.
c.
Judicial
review. The aggrieved party to the final decision of the board may
petition for judicial review of that action by filing an action in the
appropriate district court. Petitions for judicial review shall be filed within
30 days after the decision becomes final.
d.
Immediate judicial review of
board order. The board acknowledges that in certain circumstances the
subject or subjects of a board order may desire immediate judicial review of a
board order in lieu of proceeding with the board's appeal process. The board
may consent to immediate jurisdiction of the district court when requested by
the subject or subjects of a board order and justice so requires. Unless stayed
by order of the board or a district court, the written order for quarantine or
isolation shall remain in force and effect until the judicial review is finally
determined and disposed of upon its merits.
(8)
Rights of individuals and groups
of individuals subject to isolation or quarantine. Any individual or
group of individuals subject to isolation or quarantine shall have the
following rights:
a. The right to be
represented by legal counsel.
b.
The right to be provided with prior notice of the date, time, and location of
any hearing.
c. The right to
participate in any hearing. The hearing may be held by telephonic or other
electronic means if necessary to prevent additional exposure to the
communicable or possibly communicable disease.
d. The right to respond and present evidence
and argument on the individual's own behalf in any hearing.
e. The right to cross-examine witnesses who
testify against the individual.
f.
The right to view and copy all records in the possession of the board which
relate to the subject of the written order.
(9)
Consolidation of claims.
In any proceeding brought pursuant to this rule, to promote the fair and
efficient operation of justice and having given due regard to the rights of the
affected individuals, the protection of the public's health, and the
availability of necessary witnesses and evidence, the board or a court may
order the consolidation of individual claims into group claims, if all of the
following conditions exist:
a. The number of
individuals involved or to be affected is large enough that consolidation would
be the best use of resources.
b.
There are questions of law or fact common to the individual claims or rights to
be determined.
c. The group claims
or rights to be determined are typical of the affected individuals' claims or
rights.
d. The entire group will be
adequately represented in the consolidation.
(10)
Implementation and enforcement
of isolation and quarantine.
a.
Jurisdictional issues. The department has primary jurisdiction
to isolate or quarantine individuals or groups of individuals if the
communicable disease outbreak has affected more than one county or has
multicounty, statewide, or interstate public health implications. If isolation
or quarantine is imposed by the department, the board may not alter, amend,
modify, or rescind the isolation or quarantine order.
b.
Assistance of local boards of
health and local health departments. If isolation or quarantine is
imposed by the department, the local boards of health and the local health
departments in the affected areas shall assist in the implementation of the
isolation or quarantine order.
c.
Penalty. Pursuant to Iowa Code sections 137.21 and
139A.25(1),
any individual who violates a lawful board order for isolation or quarantine,
whether written or oral, shall be guilty of a simple misdemeanor. The
court-ordered sentence may include a fine of up to $500 and imprisonment not to
exceed 30 days.
d.
Enforcement action. The board, through the office of the
county attorney, may file a civil action in the appropriate district court to
enforce a board order for isolation or quarantine. Such action shall be filed
in accordance with the Iowa Rules of Civil Procedure.