Authority And Actions Under The Public Health Code To .

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Authority and Actions Underthe Public Health Code to Preventand Control the Spread of DiseasePresented by:Denise Chrysler, DirectorOffice of Legal AffairsMichigan Department of Community HealthProtection of the public’s health“The public health and general welfare ofthe people of the state are hereby declaredto be matters of primary public concern.The legislature shall pass suitable laws forthe protection and promotion of the publichealth.”Const 1963, art 4, § 511

Michigan Department ofCommunity Health“Pursuant to section 51 of article 4 of the stateconstitution of 1963, the department [ofcommunity health] shall continually anddiligently endeavor to prevent disease, prolonglife, and promote the public health throughorganized programs, including prevention andcontrol of diseases ”MCL 333.2221(1)Michigan Public Health Code“ shall be liberally construed for theprotection of the health, safety, andwelfare of the people of this state.”MCL 333.1111(2)2

Powers of Director of MichiganDepartment of Community HealthIf the Director determines that conditionsanywhere in this state constitute a menaceto the public health, she is authorized totake full charge of the administration ofapplicable state and local health laws,rules, regulations, and ordinancesMCL 333.2251(3)Director’s PowersImminent Danger Order“Upon a determination that an imminentdanger to the health or lives of individualsexists in this state, the director immediatelyshall inform the individuals affected by theimminent danger and issue an order . . . .The order shall incorporate the director'sfindings and require immediate actionnecessary to avoid, correct, or remove theimminent danger.”MCL 333.2251(1)3

Powers of Local Health Officer The Director of the Department ofCommunity Health has statewide jurisdiction. Under Part 24 of the Public Health Code, localhealth officers have most of the powersgranted to the Director to respond to publichealth emergencies within the area served bythe local health department For example, MCL 333.2451 authorizes localhealth officers to issue imminent dangerorders within the local health department’sjurisdictionDirector’s PowersEmergency Order to Control Epidemic“If the director [or local health officer]determines that control of an epidemic isnecessary to protect the public health, thedirector, by emergency order, may prohibit thegathering of people for any purpose and mayestablish procedures to be followed during theepidemic to insure continuation of essentialpublic health services and enforcement ofhealth laws.”MCL 333.2253; MCL 333.24534

Violation ofDirector’s Orders A person who violates a rule or order of thedepartment is guilty of a misdemeanorpunishable by imprisonment for not morethan 6 months, or a fine of not more than 200, or both. MCL 333.2261 An individual may be arrested if violationoccurs in the presence of a police officer, orthe police officer has reasonable cause tobelieve individual has violated a rule or order.MCL 764.15(1)Director’s PowersWarning Notice Against Carrier of Disease Allows director or local health officer who determines“that an individual is a carrier and is a health threat toothers” to issue a warning notice requiring person tocooperate in preventing or controlling transmission ofdisease.Must inform the individual that if he or she fails tocomply with the warning notice, the health departmentshall seek a court orderMust also inform the individual that, except in anemergency, the individual will have a right to a hearingbefore the court issues its orderMCL 333.52035

Director’s PowersPetition Court for Order Against Carrier“If a department representative or a localhealth officer knows or has reasonablegrounds to believe that an individual hasfailed or refused to comply with a warningnotice issued under section 5203, thedepartment or local health department maypetition the circuit court for the county ofIngham or for the county served by the localhealth department for an order ”MCL 333.5205(1)Director’s PowersEmergency Action Against Carrier“To protect the public health in an emergency, upon thefiling of an affidavit by a department representative or alocal health officer, the circuit court may order thedepartment representative, local health officer, or a peaceofficer to take an individual whom the court hasreasonable cause to believe is a carrier and is a healththreat to others into custody and transport the individualto an appropriate emergency care or treatment facility forobservation, examination, testing, diagnosis, or treatmentand, if determined necessary by the court, temporarydetention.”MCL 333.5207(1)6

Department’s PowersInspection or Investigation State and local health departments areauthorized to inspect or investigate:– A suspected outbreak or exposure– Any matter, thing, premises, place, person,record, vehicle, incident, or eventMCL 333.2221(2)(d), MCL 333.2241(1), MCL333.2433(2)(c), MCL 333.2446Department’s PowersInspection or InvestigationState and local health investigators are to beprovided with medical and epidemiologicalinformation pertaining to individuals who have,are suspected of having, or may have beenexposed to a disease or condition of public healthsignificanceCommunicable Disease Rules, R 325.174(2)7

Department’s PowersInspection or Investigation“[The communicable disease rule] whichrequires that personal medical information of anindividual with a disease shall be provided to aninvestigator of the Michigan Department of[Community] Health or a local healthdepartment, is within the statutory authoritygranted to the Department of [Community]Health by the Public Health Code to makeinvestigations of reported cases of diseases.”Op Atty Gen 1986, No 6376, p 336Department’s Responsibilitiesto protect private health information“Medical and epidemiological information whichidentifies an individual and which is gathered inconnection with an investigation is confidentialand is not open to public inspection without theindividual's consent or the consent of theindividual's guardian, unless public inspectionis necessary to protect the public health asdetermined by a local health officer or thedirector.”Communicable Disease Rules, R 325.181(2)8

Director’s PowersMaintain Court ActionsTo compel compliance with ImminentDanger Order To compel compliance with EmergencyOrder to Control Epidemic To obtain warrant to inspect or investigateand to seize property To obtain an injunction Director’s PowersMaintain court action to obtain warrant toinspect or investigate and to seize property Application for warrant may be filed by State orLocal Health DepartmentIssued by Magistrate based on facts stated inaffidavitMay authorize property to be seizedMay direct law enforcement to assist healthdepartment in inspection or investigationMCL 333.2241-2247, MCL 333.24469

Director’s PowersMaintain Court Action for Injunction State Health Director or Local Health Directormay maintain actionMay seek court order to restrain, prevent, orcorrect:– A violation of a law, rule or order that healthdepartment has duty to enforce– An activity or condition that health departmentbelieves adversely affects the public healthMCL 333. 2265, MCL 333.2465Director’s PowersQuarantine, Isolation, & ImmunizationPolice PowerThe power of government to imposerestrictions on private rights for the sake ofthe public welfare, order, and security Subject to constitutional limitations,especially to the requirement of dueprocess and right to equal protection 10

Director’s PowersQuarantine, Isolation, & ImmunizationCompagnie Francaise De Navigation AVapeur, 186 US 380 (1902) Jacobson v Massachusetts, 197 US 11(1904) Rock v Carney, 216 Mich 280 (1921) QuarantineCampagnie Francaise de Navigation aVapeur v Louisiana State Board of Health,186 US 380 (1902)Quarantine held to be: Legitimate exercise of police power No violation of Commerce Clause11

ImmunizationJacobson v Massachusetts, 197 US 11 (1905) Involved mandatory vaccinations, not quarantine.Based on earlier quarantine decisions, validexercise of state’s police power.Expressly recognized power of localadministrative agencies to develop and implementhealth regulations.Jacobson v Massachusetts“ The liberty secured by the Constitution of theUnited States to every person within itsjurisdiction does not import an absolute rightto each person to be, at all times and in allcircumstances, wholly freed from restraint.There are manifold restraints to which everyperson is necessarily subject for the commongood”12

Quarantine & IsolationRock v Carney, 216 Mich 280 (1921): Plaintiff quarantined by local authorities for 12weeks. Lower court upheld exercise of policepower.Supreme Court reversed, but recognized:“That the power exists in the boards of healthacting through their respective health officers toquarantine persons infected with these diseaseseither in their homes or in detention hospitals,such detention to continue so long as the diseasesare in their infectious state . . .”Quarantine & IsolationRock v Carney, continued“When sufficient reasonable cause exists tobelieve that a person is afflicted with aquarantinable disease, there is no doubt of theright of the health authorities to examine intothe case . . . remembering that the persons soaffected are to be treated as patients, and notas criminals.”13

Thank you for your attention.Denise Chrysler(517) 373-2109Chryslerd@michigan.gov14

Michigan Department of Community Health Protection of the public’s health “The public health and general welfare of the people of the state are hereby declared to be matters of primary public concern. The legislature shall pass suitable laws for the protection and promotion of the public health.” Const 1963, art 4, §51

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