Bioterrorism, Communicable Diseases, and the Courts

1
Bioterrorism, Communicable Diseases, andthe
Courts

• Conference of Superior
• Court Judges
• June 20, 2003

2
House Bill 1508

• Communicable Disease Outbreaks
• N.C. Gen. Stat. 130A-145
• Suspected Terrorist Attacks (STA)
• N.C. Gen. Stat. 130A-475
• Nuclear, Biological, or Chemical (NBC)

3
Communicable Disease

• N.C. Gen. Stat. 130A-2 an illness due to an
  infectious agent transmitted from an infected
  person or animal through an intermediary.
• Communicable condition being infected without
  symptoms

4
Communicable DiseasesN.C. Gen. Stat. 130A-145

• Both State Health Director (SHD) and
• Local Health Directors (LHDs) have
• authority in outbreak situations to
• issue Orders.
• Isolation and Quarantine Orders

5
Communicable DiseasesN.C. Gen. Stat. 130A-145

• SHD/LHDs have quarantine/isolation authority when
  
• The public health is actually endangered
• All other reasonable means have been exhausted
• No less restrictive alternative exists

6
Communicable DiseasesN.C. Gen. Stat. 130A-145

• Isolation Order ( 130A-2) limits freedom of
  movement or action of person or animal who
  actually has disease or condition
• Freedom of movement stay at home, cant go
  certain places.
• Freedom of action restricts behavior, but not
  where you can go.

7
Communicable DiseasesN.C. Gen. Stat. 130A-145

• Quarantine Order ( 130A-2)
• limits freedom of movement/action of
  person/animal that has been/is reasonably
  suspected to have been exposed to communicable
  disease or condition
• limits access to areas that may be contaminated
  with an infectious agent

8
Communicable DiseasesN.C. Gen. Stat. 130A-145

• Quarantine Order (continued)
• limit freedom of movement/action of people who
  are not immunized (does not apply to animals)
• - 130A-157 there is a religious exemption
  to immunization laws, but not to SHD/LHD Order

9
Communicable Diseases N.C. Gen. Stat. 130A-145

• A person who is substantially affected by Order
  may petition to Superior Court for review of the
  Order.
• Can be filed either where limitations are
  imposed, or in Wake County
• Hearing within 72 hours (no weekends)
• Chapter 7A court-appointed lawyer

10
Communicable DiseasesN.C. Gen. Stat. 130A-145

• Burden on substantially affected person to show
  by a preponderance that limitations are not
  reasonably necessary to prevent or limit the
  conveyance of a communicable disease to others
• If burden is met, then court shall reduce the
  limitations.

11
Communicable Diseases N.C. Gen. Stat. 130A-145

• SHD/LHD Communicable Disease Orders
• Initial Order only valid for ten days (unless
  Order limits freedom of action)
• To extend the Order petition Superior Court
  (where limitations are/Wake) prior to expiration
  of the Order

12
Communicable Diseases N.C. Gen. Stat. 130A-145

• Extension Burden on SHD/LHD to show by a
  preponderance that extension is reasonably
  necessary to prevent or limit conveyance of
  disease or condition to others
• Extension period for up to 30 days SHD/LHD can
  file subsequent petitions.

13
Communicable DiseasesN.C. Gen. Stat. 130A-145

• Judicial modification of SHD/LHDs Orders
• Judge MUST make specific findings about the
  reasonable necessity (or lack thereof) of the
  limitations to prevent or limit conveyance of
  communicable disease or condition to modify
  Order.

14
Suspected Terrorist AttacksN.C. Gen. Stat.
130A-475

• ONLY SHD (not LHD) may enter STA Orders.
• SHD has STA authority when -
• Public health threat may exist
• All other reasonable means have been exhausted
• No less restrictive alternative exists

15
Suspected Terrorist AttacksN.C. Gen. Stat.
130A-475

• Definition of public health threat
• A situation that is likely to cause an immediate
  risk to human life, an immediate risk of serious
  physical injury or illness, or an immediate risk
  of serious adverse health effects.

16
Suspected Terrorist AttacksN.C. Gen. Stat.
130A-475

• SHD has STA authority to -
• Require testing
• Test real/personal property
• Evacuate/close property
• - ten day limit then Superior Court
• Limit movement/action
• Limit access to places

17
Suspected Terrorist AttacksN.C. Gen. Stat.
130A-475

• Many of the Communicable Disease provisions also
  apply to STA Orders.
• STA Orders are valid for ten days.
• Substantially affected person may petition
  (where limitations are/Wake) for review. Hearing
  within 72 hours (no weekends).

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Suspected Terrorist AttacksN.C. Gen. Stat.
130A-475

• Chapter 7A court-appointed lawyer
• Substantially affected person must show
  limitations are not reasonably necessary on
  review (preponderance)
• SHD petitions Superior Court for (30 day)
  extensions for extension, SHD must show that
  limitations are reasonably necessary
  (preponderance)

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Suspected Terrorist AttacksN.C. Gen. Stat.
130A-475

• Judge shall reduce limitations if the
  substantially affected person meets burden on
  review of the STA Order.
• Review of STA Order Judge may apply such
  conditions to the limitation as the court deems
  reasonable and necessary. Make findings to
  support modifications anyway.

20
Violations of Communicable Disease / STA Orders

• N.C. Gen. Stat. 130A-25
• Violation of a quarantine / isolation / STA Order
  is a Class 1 misdemeanor.

21
Violations of Communicable Disease / STA Orders

• Section 15A-401 Defendant charged may be
  detained until first appearance before a judicial
  official.
• Law enforcement may detain defendant in an area
  designated by SHD or LHDs until first appearance.
  

22
Violations of Communicable Disease / STA Orders

• First appearance N.C. Gen. Stat. 15A-534.5
  SHD/LHDs must show by clear and convincing
  evidence that defendant poses a threat to health
  and safety of others for defendant to be
  detained.

23
Violations of Communicable Disease / STA Orders

• Once SHD/LHD meets burden, defendant shall be
  denied pretrial release and shall be confined in
  facility/area designated by judicial official
  (with input from SHD/LHD).
• Then pretrial confinement until defendant is no
  longer a threat burden switches to Defendant
  (preponderance)

24
Violations of Communicable Disease / STA Orders

• Section 130A-25 maximum two year sentence for
  violation (exempted from Structured Sentencing.)
  
• Defendant shall serve sentence in a confinement
  facility in consultation with SHD.

25
Violations of Communicable Disease / STA Orders

• Section 130A-25(c) Defendant not to be released
  early (e.g., parole) until judge determines that
  release will not create a danger to the public
  health. Burden here appears to be on Defendant
  (preponderance).

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Notes

• SARS in North Carolina
• HIPAA