SUMMARY

• Jurisdiction, Venue, and Relevant Civil Actions (Chapter 1.00)
• Emergency and Emergency Management (Chapter 2.00)
• Health Agencies and Boards (Chapter 3.00)
• Communicable Disease Tracking (Chapter 4.00)
• Communicable Disease Control (Chapter 5.00)
• Courtroom Procedure (Chapter 7.00)

Jurisdiction, Venue, and Relevant Civil Actions (Chapter 1.00)

The U.S. Constitution (1.11)

• Federal government's public health powers limited to those that fall within its jurisdiction (defense, interstate commerce, tax powers).

• Responsibility for safeguarding public health in other areas falls largely to the states.

• Federal government has responsibility for public health in some discrete geographic areas such as military bases.

• Pursuant to its itemized powers, federal government may exercise some public health functions such as those granted to the U.S. Department of Health and Human Services or those related to public health emergencies precipitated by acts of war or terrorism.

States as Primary Actors (1.12)

• The state's public health authority comes from its police powers.

• The Washington Constitution established the State Board of Health with powers set forth by the legislature.

• The Washington Constitution gives local governments power to make and enforce police, sanitary and other regulations not in conflict with general laws.

Jurisdiction Over Public Health Matters (1.21)

• Superior courts have original jurisdiction.

• The Court of Appeals and the Supreme Court have appellate jurisdiction.

Venue for Public Health Matters (1.22)

• Proper venue is in the superior court of the county at issue or Thurston County Superior Court.

• Venue may be changed as provided in statute and court rule.

Petitions for Writs of Habeas Corpus (1.30.A)

• Governed by chapter 7.36 RCW.

• May be granted by the Supreme Court, Court of Appeals, or Superior Court.

• Any person "restrained of his liberty under any pretense whatever, may prosecute a writ of habeas corpus."

• Writ must be signed, verified and contain information set out in statute.

• Writ requires officer restraining individual to produce the individual without delay at the time and place directed by the judge.

• To prevail, habeas petitioner must show actual prejudice resulting from constitutional error.

Personal Restraint Petitions (1.30.B)

• Governed by chapter 10.73 RCW and RAP 16.3 to 16.15, 16.24 to 16.27.

• Court of Appeals and Supreme Court have concurrent jurisdiction. Cases filed in Superior Court should be transferred to the Court of Appeals for lack of Superior Court jurisdiction.

• Mandatory elements for petition set out in RAP 16.7.

• If responding party is the government, petitioner need not name a specific agency or individual.

• To prevail, petitioner must show either (1) actual or substantial prejudice arising from constitutional error, or (2) nonconstitutional error that inherently results in a "complete miscarriage of justice."

Statutory Writs of Mandamus and Prohibition (1.40)

• Writ of mandamus compels the performance of an act.

• Writ of prohibition arrests the proceedings of any tribunal, corporation, board, or person.

Applicability of King County Rules of Court to Public Health Cases (1.50)

• As a general rule, public health cases are conducted in same manner as other proceedings.

Emergency and Emergency Management (Chapter 2.00)

Emergency Defined (2.20)

• "Emergency" defined in RCW 38.52.010(6)(a).

State Organization (2.31)

• State Military Department shall administer emergency management program of the state.

• Adjutant General is the Director of the Military Department and is responsible to Governor for carrying out program for emergency management.

Authority of the Governor (2.32)

• Governor may find existence of emergency pursuant to RCW 43.06.010(12).

• Emergency powers only effective within area described in Governor's proclamation.

• Procedural requirements for proclamation set out in RCW 43.06.210.

• Governor issues proclamation to terminate state of emergency and must do so when order has been restored in the area affected.

• After proclaiming state of emergency, Governor may issue orders as provided in RCW 43.06.220.

• In the event of a disaster beyond local control, the Governor may assume control over all or any part of emergency functions of the state.

• Governor authorized to:
  • Make, amend, and rescind necessary orders, rules and regulations
  • Enter into mutual aid agreements
  • Coordinate mutual aid interlocal arrangements
  • Delegate administrative authority
  • Cooperate with federal officials and officers and agencies from other states

• Duty of every organization for emergency management to enforce Governor's orders.

• Criminal sanctions as provided in chapter 43.06 RCW apply during an emergency.

• In case of removal, resignation, death, or disability of the Governor, duties devolve upon the following, in order: Lieutenant Governor, Secretary of State, Treasurer, Auditor, Attorney General, Superintendent of Public Instruction, Commissioner of Public Lands.

• Case law involving actions by the Governor during an emergency:
  • Clear intent by the Legislature to delegate requisite police power to the Governor in times of emergency
  • Governor has discretion to determine both the start and end of an emergency

Local Organization (2.41)

• Each local organization for emergency management shall: (1) perform emergency management functions within its jurisdiction, and (2) conduct such functions outside as may be required.

• Emergency management director shall have direct responsibility for the local organization, subject to direction and control of the executive officer.

Local Authority (2.42)

• May exercise statutory emergency management powers in light of the exigencies of an extreme emergency situation without regard to procedures and formalities.

• Will have the power to enter into contracts and incur obligations necessary to combat disaster, protect health and safety of persons and property, and provide emergency assistance.

• Directed to use existing services, equipment, supplies, and facilities. Officers and personnel required to cooperate notwithstanding other provisions of law.

• Services and equipment may be commandeered by Governor, executive, and emergency management director after proclamation by Governor of emergency.

King County Code Provisions (2.50)

• The Office of Emergency Management is responsible for planning and providing effective direction, control and coordinated response to emergencies.

• Office of Emergency Management Duty Officer telephone number:
  206-296-3830.

• Emergency defined in K.C.C. 12.52.030 and 12.53.010A.

• Executive may proclaim an emergency as provided in K.C.C. 12.52.030.A.

• Upon proclamation of emergency, Executive may make orders that include:
  • Recalling employees from vacation or retirement and authorizing overtime
  • Waiving certain procurement and contracting requirements
  • Imposing a curfew
  • Requiring businesses to close
  • Closing public places
  • Other such orders as are imminently necessary for the protection of life and property

• Executive orders must be filed with the clerk of the council and are in effect until terminated by the Executive or as provided in K.C.C. 4.16.050 for orders waiving procurement requirements.

• Emergency purchasing authorized by K.C.C. 4.16.050.A for:
  • Lease or purchase of tangible personal property or services
  • Contracts for public works
  • Selection and award of professional or technical services consultant contracts

• Waivers must be filed with the clerk of the council and expire as provided in K.C.C. 4.16.050.

• Reasonably necessary expenditures to respond to emergency will not result in contracts or purchases being null and void, notwithstanding the lack of an appropriation.

• Continuity of King County Government

  • Vacancy in office of county executive filled by temporary interim successor.

  • Council may conduct business during an emergency at a location other than the usual meeting place and may conduct business with a reduced number of councilmembers.

  • Other elected officials are authorized and directed to designate temporary interim successors to the office in the event of a vacancy during an emergency.

• Criminal sanctions apply for failure or refusal to obey an executive order during an emergency.

Seattle Municipal Code Provisions (2.60)

• Mayor may declare an emergency as provided in SMC 10.02.010.A.

• Mayor's proclamation of emergency must be filed with the clerk of the council and may be modified or rejected by resolution of the city council.

• Proclamation of emergency must be delivered to the Governor and to all news media within the city.

• Emergency ceases to exist upon proclamation by Mayor or by resolution passed by not less than 2/3 of the city council.

• Upon proclamation of emergency, Mayor may make orders that include:
  • Imposing a curfew
  • Closing businesses
  • Closing public places
  • Directing the use of all public and private health, medical, and convalescent facilities and equipment to provide emergency health and medical care for injured persons
  • Other such orders as are imminently necessary for the protection of life and property

• Mayor's orders must be filed with the clerk of the council.

• Upon proclamation of emergency, Mayor may enter into contracts and incur obligations.

• Criminal sanctions apply for failure or refusal to obey a mayoral order during an emergency.

Health Agencies and Boards (Chapter 3.00)

Washington State Board of Health (3.20)

• Powers and Duties Related to Communicable Disease Control
  • Rulemaking
  • Enforcement of State Board of Health Rules

Washington State Department of Health (3.30)

• Powers and Duties Related to Communicable Disease Control
  • Enforcement of laws and rules
  • Investigation of outbreaks of disease
  • Investigation of conditions that threaten public health

Local Health Boards, Departments, and Officers (3.40)

• Structure

  • Local Board of Health
    Membership
    Jurisdiction coextensive with county boundaries

  • Local Health Departments
    County or district
    Combined city-county health department

  • Local Health Officer

• Powers and Duties Related to Communicable Disease Control

  • Local Boards of Health
    Rulemaking for the public health
    Enforcement of state public health statutes and rules
    Supervision of health and sanitary measures
    Provide for control and prevention of contagious disease

  • Local Health Officers
    Enforce state and local laws, including filing of civil actions
    Maintain health and sanitation supervision
    Control and prevent spread of contagious disease
    Investigate diseases and institute control measures
    Control disease at schools and day care centers, including shut down, in certain circumstances, and after appropriate notification
    Report and track communicable diseases
    Implement isolation and quarantine

  • Case law involving authority of local board of health and health officers
    Law and actions are to be liberally construed
    Local regulations may not conflict with state or federal law

Violations and Penalties (3.50)

• Misdemeanor for person to violate rule or order of local health officer or local or State Board of health.

• Public officers and employees can be fined for failing to enforce rules adopted by State Board of Health.

• Members of local boards of health can be fined for failing to enforce rules adopted by State Board of Health for the control of dangerous infectious disease.

• Local health officer who refuses or neglects to enforce the provisions of chapters 70.05 or 70.24 RCW, or rules of State Board of Health can be removed.

Health Districts (3.60)

• Establishment
  • Is all the territory consisting of one or more counties.
  • If two or more counties, created by the county commissioners.
  • If one county, created by county legislative authority.

• District Boards of Health
  • At least five members for districts of two counties, and seven members for districts of more than two counties
  • County commissioners provide for membership on the boards
  • If health district is one county, county legislative authority specifies membership.

Relationship Between State and Local Health Departments (3.70)

• State Board of Health rules to be enforced by local boards of health and local health officers

• Secretary of Health can enforce state public health laws and regulations in local matters when an emergency exists or the local board of health has failed to act with sufficient promptness, or no local board of health has been established.

• Secretary of Health can exercise authority of local health officer when needed due to an emergency, the local health officer has failed to act, or pursuant to agreement.

King County Code Provisions (3.80)

• Seattle-King County Department of Public Health
  • Combined city-county health department, established pursuant to chapters 70.05 and 70.08 RCW.
  • King County Code establishes duties of the Department.
  • Public Health Duty Officer telephone number: 206-296-4606.

• King County Board of Health
  • King County Code establishes the membership.

Communicable Disease Tracking (Chapter 4.00)

Communicable Disease Reporting and Investigation (4.20)

• Reportable Diseases

  • State regulations identify notifiable conditions and time in which they must be reported.

  • Diseases of suspected bioterrorism origin are to be reported immediately. Examples: Anthrax and smallpox.

  • Other rare diseases of public health significance are to be reported immediately.

  • Unexplained critical illness or death is to be reported immediately.

  • Local health officer can require notification of additional conditions of public health importance.

  • Outbreaks or suspected outbreaks are reportable, even if the disease is not identified as a notifiable condition.

• Persons and entities having a duty to report: health care providers; laboratories; health care facilities.

• Records and specimens containing or accompanied by patient identifying information are confidential. Local health officers and State Department of Health to maintain confidentiality. (Permissible disclosures discussed at § 4.32.)

• Other persons and entities with responsibilities related to reporting: veterinarians (to State Department of Health and to State Department of Agriculture); food service establishments; child day care facilities; schools.

• Federal regulations identify select agents and toxins that must be reported to the Centers for Disease Control or the U.S. Department of Agriculture (unless entity is registered to possess, use, or transfer select agents)

Communicable Disease Investigation (4.22)

• Duties of local health officer
  • Review and determine appropriate action.
  • Conduct investigations and institute control measures.
  • Notify state Department of Health of notifiable condition upon completion of case investigation.

• Authority of local health officer
  • Carry out additional steps to verify diagnosis reported by health care provider.
  • Require person suspected of having reportable disease to be examined.
  • Investigate case or suspected case of reportable disease, if necessary.
  • Require notification of additional conditions of public health importance.

• Duties of state Department of Health related to investigation.
  • Provide consultation and technical assistance to local health departments when requested.
  • Conduct investigations and institute control measures.

Confidentiality (4.30)

• Federal and State Law Protecting Health Care Information

  • Federal: HIPAA ( 45 CFR pts. 160, 164). General Rule: Covered entity (health plan, health care clearinghouse, and health care providers who transmit certain transactions electronically) may not use or disclose protected health care information except as permitted by HIPAA. If a covered entity is a public health authority, it may use protected health information for certain public health activities. Preempts less stringent state laws.

  • State: HCIA ( chapter 70.02 RCW). General rule: Health care providers and health care facilities may not disclose health care information without a patient’s written authorization, except as authorized by RCW 70.02.050. State and local agencies obtaining information pursuant to RCW 70.02.050 are to establish record acquisition, retention, and security policies consistent with HCIA.

• Disclosures Related to Communicable Disease Control

  • Disclosures permitted by HIPAA
    Disclosures otherwise authorized by law.
    Disclosures for public health activities.
    Disclosures to avert a threat to health and safety.

  • Disclosures permitted by HCIA
    To federal, state, or local public health authorities to the extent required by law.
    To federal, state, or local public health authorities when needed to protect the public health.
    To avoid or minimize an imminent danger.

  • Disclosures by local and state health departments
    Local and state Health Department not to disclose report information identifying an individual case or suspected case except to:

    Employees or other officials needing to know for administering public health laws and regulations in chapter 246-101 WAC;

    Health care providers and others for the purpose of collecting additional information about a case or suspected case, as required for disease control.

• Public Records Act

  • PRA provides that HCIA applies to inspection and copying of health care information of patients.

  • PRA permits third parties affected by requests to be notified.

Communicable Disease Control (Chapter 5.00)

Social Distancing Measures (5.20)

• Intended to decrease spread of disease of decreasing opportunities for close contact among individuals. Examples:
  • Closing schools and large child care centers.
  • Limiting social interaction at various facilities.
  • Closing churches, theaters, and other places where crowds gather.
  • Suspending large gatherings, such as sports events and concerts.
  • Suspending non-essential government activity.

• Implementation may be voluntary or compulsory.

• Authorities:
  • Heads of political subdivisions in response to emergency. (See § 2.42.)
  • Local health officer to prevent spread of disease. (See § 3.42.B.)
  • Governor in response to an emergency. (See § 2.32.B.)

Isolation and Quarantine (5.30; 5.31)

• Form of social distancing

• Under rules adopted by State Board of Health, local health officer has authority to implement isolation and quarantine. Applies to person or group of persons.

• Local health officer can initiate emergency detention by issuing emergency detention order or by petitioning the superior court ex parte.

• Local health officer may initiate emergency detention when (s)he:

  • Has made reasonable efforts to gain voluntary compliance with requests for medical examination, testing, treatment, counseling, vaccination, decontamination of persons or animals, isolation, quarantine, and inspection and closure of facilities, or has determined that seeking voluntary compliance would create a risk of serious harm; and

  • Has reason to believe that the person or group of persons is, or is suspected to be, infected with, exposed to, or contaminated with a communicable disease or chemical, biological, or radiological agent that could spread to or contaminate others if remedial action is not taken; and

  • Has reason to believe that the person or group of persons would pose a serious and imminent risk to the health and safety of others if not detained for purposes of isolation or quarantine.

  Local Health Officer Emergency Detention Order

• Local health officer shall issue written emergency detention order as soon as reasonably possible and always within twelve hours of detention, with copies to persons, by posting in some cases.

• An order issued by a local health officer shall constitute the duly authorized application of lawful rules adopted by the State Board of Health and must be enforced by all police officers, sheriffs, constables, and all other officers and employees of any political subdivisions within the jurisdiction of the health department in accordance with RCW 43.20.050.

• No explicit authority for arrest by law enforcement, though see RCW 10.31.100(1).

  Court proceedings for emergency detention (see Isolation and Quarantine Checklist on page 17)

• The local health officer may petition the superior court ex parte for an order authorizing involuntary detention of a person or group of persons for up to ten (10) days.

• The court shall issue the order if there is a reasonable basis to find that isolation or quarantine is necessary to prevent a serious and imminent risk to the health and safety of others.

  Court proceedings for continued detention (see Isolation and Quarantine Checklist on page 18)

• The local health officer may petition the superior court for an order authorizing continued detention of a person or group of persons for up to thirty (30) days.

• The court shall grant the petition if it finds that there is clear, cogent, and convincing evidence that isolation or quarantine is necessary to prevent a serious and imminent risk to the health and safety of others.

  Court proceedings for an additional period of continued detention (see Isolation and Quarantine Checklist on page 18)

• Prior to the expiration of a court order for continued detention, the local health officer may petition the superior court for an order to continue isolation or quarantine for up to an additional thirty (30) days.

• Isolation or quarantine may be continued when the court finds that there is a reasonable basis to require continued isolation or quarantine to prevent a serious and imminent risk to the health and safety of others.

  Statutes and rules that supersede

• The provisions of WAC 246-100-040 shall be superseded by state statutes and rules, and state and federal emergency declarations that contain procedures for detention, examination, counseling, testing, treatment, vaccination, isolation, or quarantine for:

  • Specified health emergencies; or

  • Specified communicable diseases, including, but not limited to, tuberculosis and HIV.

  Right to representation

• A person or group of persons isolated or quarantined has a right to be represented by counsel.

  • If a person or group requests counsel and cannot afford counsel, the court shall appoint counsel consistent with the provisions of chapter 10.101 RCW.

  • The local health officer must provide adequate means of communication between persons or groups and their counsel.

  Relief from isolation or quarantine

• A person or group of persons detained by order of the local health officer may apply to the court for an order to show cause why the individual or group should not be released. The court shall rule on the application to show cause within forty-eight (48) hours of its filing. If the court grants the application, the court shall schedule a hearing on the order to show cause as soon as practicable. The issuance of an order to show cause shall not stay or enjoin an isolation or quarantine order.

• A person or group isolated or quarantined may request a hearing for remedies regarding breaches to the conditions required by WAC 246-100-045. A request for a hearing shall not stay or enjoin an isolation or quarantine order. Upon receipt of a request alleging extraordinary circumstances justifying the immediate granting of relief, the court shall fix a date for a hearing as soon as practicable. Upon receipt of a request, the court shall fix a date for a hearing within five (5) days from receipt of the request. In extraordinary circumstances and for good cause shown, the local health authority may move the court to extend the time for a hearing.

  Infection control and consolidation of hearings

• Any hearings for relief involving a petitioner or petitioners judged to be contagious will be conducted in a manner that utilizes appropriate infection control and minimizes the risk of disease transmission.

  Consular notification

• Article 36(1)(b) of the Vienna Convention on Consular Relations provides that a non-U.S. citizen who is arrested or detained must be informed that consular officials may be notified about the detention. In addition, some bilateral consular agreements require notification.

  Isolation and quarantine conditions and principles (5.32)

• The local health officer must adhere to conditions and principles described in WAC 246-100-045 when isolating or quarantining a person or group.

Federal Authority to Control Communicable Disease (5.34)

• Federal government has authority to control spread of communicable disease from foreign countries into the U.S. and from one state or possession into another state or possession.

• Authorities include isolation and quarantine for diseases listed in Executive Orders of the President

Animal Health (5.40)

• The Washington Department of Agriculture has authority to prevent the spread of diseases affecting animals.

• Veterinarians are required to report certain diseases.

• The Director of Agriculture may order animal quarantine, hold, treatment, and destruction.

• The Secretary of Health may take action if an emergency arises out of an outbreak of diseases communicable to humans caused by pet animals.

• The Secretary of the U.S. Department of Agriculture and the Director of the Centers for Disease Control have certain authorities related to importation of animals, movement in interstate commerce, and risk of interstate spread of disease.

Courtroom Procedure (Chapter 7.00)

Appearance other than in person (7.11)

• Telephonic or videoconference

• Requirements in local criminal rules for analogy: observation, presence of counsel, security, interpreters, contemporaneous document transmission, and public access.

Relocation of Court (7.21)

• Conduct of hearings without a clerk

• Conduct of hearings within or without the county

• Relocation of the Court by agreement of the Court and Council

Additional Judicial Personnel (7.31)

• Judges from other courts of the state

• Visiting superior court judges from other counties

• Pro tempore judges

• Commissioners

• Appointment of other officers

Consolidation of Cases (7.32)

• Criteria for consolidation of isolation and quarantine cases at WAC 246-100-065

Emergency Court Closure (7.40)

• Emergency court closure governed by GR 21

Presiding Judge in Superior Court District and Limited Jurisdiction Court District (7.50)

• Provisions for presiding judge in each superior court district and each limited jurisdiction court district contained in GR 29