September 19, 2009
OKLAHOMA PANDEMIC PLANNING POLICY
This is the bottom line at least insofar as outlined in Public Documentation.
The Health Commissioner seems to have ultimate authority on matters of treatment, isolation, quarantine, examination and release.
AxXiom
Oklahoma’s 2008 Catastrophic Health Emergency (CHE) Plan
www.ok.gov/health/documents/2008%20CHE%20Plan%20final.pdf
Recommended Actions from the Catastrophic Health Emergency Task Force 2008
Pg 50 copy/paste
ISOLATION/QUARANTINE
Issue #1: Law enforcement officials protect the peace and public safety based on rules and a
force continuum. However, the enforcement of isolation or quarantine orders during a
declared catastrophic health emergency lacks clarity. The Oklahoma Department of Public
Safety plans to request an Attorney General’s opinion on this issue before the 2005
Legislative Session commences.
Recommendation: Support statutory and/or regulatory changes that are requested by the
Oklahoma Department of Public Safety or the Oklahoma State Department of Health,
pursuant to the Attorney General’s opinion.
Outcome: Initially an Attorney General’s opinion was requested, but it was suggested the
issue be brought forth for each catastrophic health emergency because a more informed
decision could be made on an event-by-event basis. No singular event decision would be carried over to other catastrophic health emergencies.
To help define this issue, circumstances under which the Commissioner of Health may issue
orders of isolation and quarantine under the current authority provided pursuant to Title 63
O.S. §1-106 were clarified to apply to any communicable disease constituting a biologic
public health threat in a revision to Oklahoma Administrative Code 310: Chapter 521. The
new subchapter seven better outlines the procedures the Oklahoma State Department of
Health undertakes when implementing isolation and quarantine, including ordering of
treatment, determining suitable locations, providing for administrative hearings, monitoring
health status, and determining cessation of quarantine or isolation.
Recommended Actions from the Catastrophic Health Emergency Task Force 2008
Title 310 – Oklahoma State Department of Health
Find here
http://www.oar.state.ok.us/oar/codedoc02.nsf/All/6F1A5E874D5C9783862575F40010FE5C?OpenDocument
Chapter 521 – Control and Treatment of Communicable Disease
Subchapter 7 – Isolation or Quarantine
3
10:521-
310:521-7-1. Examination
The Commissioner may issue an order for the examination of any individual upon the suspicion or confirmation that said individual has a communicable disease. Such examination may include a clinical examination, a specific diagnostic test or tests, or a specific laboratory test or tests. The purpose of such examination(s) and/or test(s) is to determine the presence of the suspected infectious organism or the presence of indicators of the suspected infectious organism, and to determine the contagious state of the individual to the extent possible.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
310:521-7-2. Treatment
The Commissioner may issue an order for the treatment of any individual
suspected or confirmed to have a communicable disease. The Commissioner may also order the treatment of any individual or individuals exposed to certain infectious agents. Such treatment plans will be according to procedures developed within the Department.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
310:521-
310:521-7-3. Isolation or quarantine
-
Isolation.
The Commissioner may issue an order for the isolation of any individual or group of individuals upon determination:
(1) That such individual or individuals who are reasonably known or suspected to have a communicable disease constituting a biologic public health threat and who remain within the transmission period for said disease; and
(2) That isolation is the necessary means to control the spread of the agent and the disease constituting a biologic public health threat.
(b) Quarantine. The Commissioner may issue an order for the quarantine of any individual or group of individuals upon determination:
(1) That such individual or individuals who are reasonably known or suspected to have been exposed to a communicable disease constituting a biologic public health threat and who remain within the incubation period for said disease; and
(2) That quarantine is the necessary means to contain the communicable disease constituting a biologic public health threat to which an individual or individuals have been or may have been exposed.
(c) Affected area. The Commissioner may issue an order for the quarantine of a facility, complex, or campus including but not limited to an apartment complex, dormitory, health care facility, hotel, correctional facility, or the individuals therein.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
310:521-7-4. Means of isolation or quarantine
The Department
shall recommend to the Commissioner the appropriate means of isolation or quarantine, which shall generally be the least restrictive means that effectively protects unexposed and susceptible individuals. The place of isolation selected shall meet such infection control standards that it effectively complies with nationally accepted guidelines for the prevention of transmission of the infectious agent. The place of quarantine selected shall allow the most freedom of movement and communication with family members and other contacts without allowing transmission of the suspected infectious agent to others.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
310:521-7-5. Delivery of orders
A representative of the Department shall deliver orders of examination, treatment, quarantine, or isolation, or shall ensure the delivery of the order by an appropriate party, to the affected individual or individuals in person to the extent practicable.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
310:521-7-6. Administrative hearings and court enforcement
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Any person who is subject to an order of the Commissioner for isolation or quarantine and who contests such an order
may request an individual proceeding or hearing. In order to uphold a quarantine order the Department must prove by a preponderance of the evidence that the Respondent was, or was suspected of having been, exposed to an infectious disease constituting a biologic public health threat. In order to uphold an isolation order the Department must prove by a preponderance of the evidence that the Respondent has, or is suspected of having, an infectious disease constituting a biologic public health threat. If requested, an individual proceeding pursuant to this subsection shall be convened as quickly as reasonably possible, which may be held telephonically or by other electronic means. A Respondent may request a hearing verbally or in writing. If the request for hearing is verbal, it shall be the duty of the hearing officer to take a statement for the record of the Respondent’s reason for contesting the Commissioner’s order. If the Commissioner’s order is upheld at the conclusion of the hearing, the Respondent may appeal the administrative decision pursuant to Section 318 of Title 75 of the Oklahoma Statutes.
(b) Upon finding that there is probable cause to believe that any individual or individuals who are subject to an order of examination, treatment, isolation, or quarantine has failed to or refuse to comply with such order, the Commissioner may request an emergency order from the district court to enforce the Commissioner’s order. If granted, the emergency order shall require the individual or individuals to be taken immediately into custody by law enforcement officials for the purpose of examination or treatment or to be detained for the duration of the order of isolation or quarantine or until the Commissioner determines that the risk of transmission of a biologic public health threat is no longer present.
(c) Subsections a or b of this section may be suspended in the event of a declaration of emergency by the Governor pursuant to Oklahoma law or upon written directive of the Commissioner of Health to employ a constitutionally-sufficient alternative process due to exigent circumstances during such emergency. Such suspension of subsections a and b shall only exist for the duration of the emergency.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
310:521-7-7. Health status monitoring
A representative of the Department shall monitor the health status of those under quarantine or isolation according to means dictated through procedure of the Department. Such means may include use of appropriate data collection forms, use of appropriate medical tests and or procedures, regular telephone calls, visits by local health personnel or other pre-determined providers, self-reports, reports of caregivers or healthcare providers, or by other means. If an individual or individuals under quarantine develop symptoms compatible with a disease constituting a biologic public health threat, then such individual or individuals may be further ordered into isolation.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
310:521-7-8. Essential needs
A representative of the Department shall conduct an assessment to determine the essential needs of those isolated or quarantined as required by procedure of the Department.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
310:521-7-9. Release from isolation or quarantine
The Commissioner will determine when an individual or individuals are determined to no longer be at risk of developing disease and becoming infectious or to no longer pose a risk of transmission of the infectious agent constituting a biologic public health threat to other individuals. The individuals under the order of quarantine or isolation shall be so notified by the Commissioner and shall be released from quarantine or isolation immediately upon notification.
[Source: Added at 25 Ok Reg 1148, eff 5-25-08]
Here is a letter written in 2002 that takes issue with the Model States Emergency Health Powers Act. The MSEPHA is the template from which these measures have been adopted by the states.
June 10, 2002
The Model State Emergency Health Powers Act: An Assault on Civil Liberties in the Name of Homeland Security
by Sue Blevins
Heritage Lecture #748
A number of people have asked me what health freedom could possibly have to do with homeland security. Let me assure you that there is a major connection. It’s called the Model State Emergency Health Powers Act. Those who have heard of it are far outnumbered by those who have not. And, as proposed, the Model State Emergency Health Powers Act will impact our individual freedoms and civil liberties for years to come.
A HIDDEN AGENDA
In response to the tragedy of September 11, the U.S. Department of Health and Human Services announced its support for model legislation. The goal was to provide federal funds to states to encourage the enactment of legislation to prevent and detect bioterrorist attacks. Drafted for the Centers for Disease Control by academicians from the Center for Law and the Public’s Health at Georgetown and Johns Hopkins Universities, the so-called Model State Emergency Health Powers Act was released on October 23, 2001.
It is noteworthy that a key attorney who assisted in drafting this proposal was also very involved in Hillary Clinton’s health care task force nearly a decade ago. It is also significant that two articles related to this proposal were published or prepared well before the Trade Center attacks. In January 1999, in a Columbia Law Review article, a plan was presented for changing public health laws. A similar plan appeared in an American Journal of Public Health article, published coincidentally in September 2001, but accepted for publication in March 2001.
It appears that this model legislation–formulated long before the terrorism of last fall–actually represents the promotion and expansion of a long-standing agenda. As these proposals come before the individual states, our elected officials should be aware of this history and examine carefully all proposals submitted to them.
Although this model legislation was recommended as a means to help states protect citizens against bioterrorist attacks and deal with national defense issues, the draft bill goes much, much further. It calls for giving state public health officials broad, new police powers–all in the name of controlling epidemics of infectious diseases during public health emergencies.
Furthermore, with an equally broad stroke, this model legislation defines “infectious disease” as “a disease caused by a living organism.” As drafted, the October 23, 2001, proposal stresses that “an infectious disease may or may not be transmissible from person to person, animal to person or insect to person.” Thus, any disease caused by a living organism could be classified as an infectious disease creating or invoking a public health emergency.
It is these broad definitions–painted with an overly broad brush in equally broad language–that our state officials and our state-based think tanks must be alerted to, aware of, and involved in examining as similar bills advance on state legislative agendas.
Key to all of this is what may or may not be considered or defined as a “public health emergency.”
A THREAT TO FUNDAMENTAL RIGHTS
Under this legislative proposal, once a public health emergency is declared, governors and state public health authorities would be granted greatly expanded police powers. While a few other actions are enumerated, I want to bring to your attention 10 main powers conveyed into the hands of only a very few individuals by this model plan.
Under the Model State Emergency Health Powers Act, upon the declaration of a “public health emergency,” governors and public health officials would be empowered to:
- Force individuals suspected of harboring an “infectious disease” to undergo medical examinations.
- Track and share an individual’s personal health information, including genetic information.
- Force persons to be vaccinated, treated, or quarantined for infectious diseases.
- Mandate that all health care providers report all cases of persons who harbor any illness or health condition that may be caused by an epidemic or an infectious agent and might pose a “substantial risk” to a “significant number of people or cause a long-term disability.” (Note: Neither “substantial risk” nor “significant number” are defined in the draft.)
- Force pharmacists to report any unusual or any increased prescription rates that may be caused by epidemic diseases.
- Preempt existing state laws, rules and regulations, including those relating to privacy, medical licensure, and–this is key–property rights.
- Control public and private property during a public health emergency, including pharmaceutical manufacturing plants, nursing homes, other health care facilities, and communications devices.
- Mobilize all or any part of the “organized militia into service to the state to help enforce the state’s orders.”
- Ration firearms, explosives, food, fuel and alcoholic beverages, among other commodities.
- Impose fines and penalties to enforce their orders.
As you can imagine, citizens across the country–at least the ones who were informed about it–were quite concerned about this model legislation. The American Legislative Exchange Council and other groups immediately began tracking the issue and reporting on how such legislation could affect citizens’ individual freedoms and property rights. As Time magazine recently reported, gun activists were some of the strongest and most influential opponents.
Consequently, a revised model bill was released on December 21, 2001. Both models–which the states are using in formulating legislation–are on line at http://www.publichealthlaw.net. I encourage you to read them.
In an attempt to make the October draft appear less authoritarian, several words were changed in the December draft. For example, the revised language calls for “protecting” persons rather than “controlling” persons during a public health emergency. It says that the state would “manage” private property rather than “control” private property during a public health emergency. And it removes any direct mention of rationing firearms or alcoholic beverages but still retains the right to ration “other commodities,” which clearly could be interpreted to include guns and alcoholic beverages–or many other items for that matter.
The revised model bill also contained two major changes. For those who may have been concerned initially about the new police powers granted, the revised text actually broadens them to include local governments as well as state officials. Furthermore, the revised language incorporates powers over medical licensing laws. Thus, health care facilities, doctors, and other providers will have to abide by added licensure requirements during a public health emergency to maintain or guarantee their right to practice medicine or run a health care business.
A DENIAL OF CONSCIENCE
How this medical licensure clause would affect doctors’ freedom of conscience–and medical freedom for us all–must be scrutinized.
The state of Maryland’s draft bill–one of the worst in the country, in my opinion–includes this language: “If the health care practitioner fails to comply with an order, regulation or directive, the secretary may request the appropriate licensing board to take disciplinary action against the health care practitioner.” It goes on to authorize the imposition of fines of up to $10,000 for each offense.
What does this mean in practicality?
First, it means that a doctor, who might be opposed to abortion, would be forced by law during a public health emergency to administer a vaccine derived from fetal tissue. This legislation lays the groundwork for such a provision, and it clearly and absolutely infringes on doctors’ and other health care providers’ freedom of conscience.
Second, it means each of us as individuals is affected. Patients would not be able to refuse these treatments. Whether state exemptions–those granted for religious or philosophical reasons regarding selected vaccines or types of treatments–would remain in effect or not remains unclear. This legislation fails to clarify that such exemptions will not be overridden.
RECENT STATE ACTIVITY
According to the American Legislative Exchange Council, 24 states have actually introduced versions of the Model State Emergency Health Powers Act. On their Web site–www.alec.org–a color-coded map, showing the status of this legislation in all 50 states, is maintained. According to their data, three states–New Mexico, South Dakota, and Utah–have passed legislation. Four states–Idaho, Washington, Wisconsin, and Wyoming–have either inactivated or defeated this legislation.1
Clearly this legislation is being considered by a significant number of states across the country. It is our duty in the public policy community to help educate, inform, and alert both our state officials and state-based think tank leaders to the challenge to our freedoms and liberties this extreme model legislation will have for years to come.
I truly hope our national leaders will reconsider the coercive provisions of this Model State Emergency Health Powers Act. We can and must find a better way to defend citizens against bioterrorism while protecting our precious individual freedoms–the very freedoms that this current war on terror is being waged to defend.
As a gentleman reminded me recently, “You can’t defend freedom by eliminating it.” I believe–and believe it should be evident to you–that this model plan, if enacted throughout the states, would indeed do just that: eliminate our freedom to choose our medical care and health treatment and potentially eliminate a broader range of our basic civil liberties.
Sue Blevins is President of the Institute for Health Freedom. Her remarks were delivered at the 25th Annual Resource Bank Meeting in Philadelphia, Pennsylvania.
1. Since these remarks were delivered, additional states have acted on this legislation. The ALEC Web site should be consulted for the most current status report.
For more of the MSEPHA go to;
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