SPONSOR: |
Rep. Maier & Sen. Blevins |
& Rep. Spence; Reps. Buckworth, Ewing, Hudson, Ulbrich, Valihura, Keeley; Sens. Adams, McDowell, Henry, Marshall, McBride, Sokola, Vaughn, Amick, Sorenson, Cloutier, Connor, Simpson, Still, Winslow |
HOUSE SUBSTITUTE NO. 1 FOR HOUSE BILL NO. 377 AS AMENDED BY HOUSE AMENDMENT NOS. 2,3,4, 5 & 7 AND SENATE AMENDMENT NOS. 1 & 2 |
AN ACT TO AMEND TITLES 16 AND 20 OF THE DELAWARE CODE RELATING TO EMERGENCIES AND PUBLIC HEALTH.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE :
WHEREAS, the national Centers for Disease Control has recommended that all states review their statutory schemes to ensure that those schemes provide specific procedures and authority in the event of a bioterrorism attack or other emergency involving communicable disease; and
WHEREAS, Delaware statute provides the government with broad authority in the event of a declared emergency, but does not provide sufficient specific procedures and authority for the government to use in the event of a bioterrorism attack or other emergency involving communicable disease; and
WHEREAS, model legislation has been proposed by legal and medical authorities to ensure that state governments are able to properly react to bioterrorism attacks; and
WHEREAS, the following legislation is based in part upon that model legislation, with alterations made to reflect existing Delaware law and situations unique to Delaware; and
WHEREAS, this legislation seeks to specify, not expand, emergency authority and procedures.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:
Section 1. This Act may be cited as the "Delaware Emergency Health Powers Act".
Section 2. Add new subparagraph (8) to Title 16, Section 122 of the Delaware Code, which shall read as follows:
"(8) The powers and duties of the Department are subject to the powers and duties granted other entities in Title 20 of the Delaware Code. Provisions of Title 20 of the Delaware Code which conflict with provisions of this Section shall take precedence over this Section.".
Section 3. Delete Title 16, Section 129 of the Delaware Code, and replace it with the following:
"§ 129. Threatened epidemics; appointment of officers to enforce regulations and orders.
With the exception of circumstances encompassed by Title 20 of the Delaware Code, when any contagious or infectious disease shall become or threaten to become epidemic, and the local authorities shall neglect or refuse to enforce efficient measures for its prevention, the Secretary or the Secretary’s designee may appoint a medical officer and such assistants as the Department or Division may require, and authorize such medical officer to enforce such orders or regulations as the Secretary deems necessary. Provisions of Title 20 of the Delaware Code which conflict with provisions of this Section shall take precedence over this Section.".
Section 4. Amend §3115(a), Title 20 of the Delaware Code by adding the following between the second and third sentences of subsection (a):
"No state of emergency can continue for more than 30 days without being renewed by the Governor."
Section 5. Delete Title 16, Section 130 of the Delaware Code, and replace it with the following:
"§130. Reporting of Potential or Existing Public Health Emergencies.
(1) an unusual increase in the number of prescriptions to treat fever, respiratory, or gastrointestinal complaints;
Section 6. Delete Title 16, Section 503 of the Delaware Code, and replace it with the following:
"§ 503. Unreported contagious disease.
When complaint is made or there is a reasonable belief of the existence of an infectious or contagious disease in a building or facility which has not been reported as required by § 502 of this Title, the Secretary of Health and Social Services or his or her designee shall inspect or cause the relevant building or facility to be inspected and, on discovering that such disease exists, shall immediately make a report as described in Section 130 of this Title.".
Section 7. Delete Title 16, Section 504 of the Delaware Code, and replace it with the following:
" § 504. Notifiable Diseases.
The Division of Public Health may by regulation declare any disease to be a notifiable disease, as that term is used in Section 130(b) of this Title.".
Section 8. Add a new subsection to Title 16, Section 505 of the Delaware Code, to read as follows:
"(c) The powers and duties of the Division under this Section are subject to the powers and duties granted other entities in Title 20 of the Delaware Code. Provisions of Title 20 of the Delaware Code which conflict with provisions of this Section shall take precedence over this Section.".
Section 9. Delete Title 16, Section 506 of the Delaware Code, and replace it with the following:
"§ 506. Due Process Rights of Quarantined Individuals.
The Division of Public Health shall afford persons who are quarantined pursuant to Section 505 of this Title the same due process rights as those afforded to persons who are quarantined pursuant to 20 Del. C. § 3138.".
Section 10. Delete Title 16, Section 508 of the Delaware Code, and replace it with the following:
"§ 508. Tracking of Potential or Existing Public Health Emergencies.
The Division of Public Health shall ascertain the existence of cases of an illness or health condition which may be potential causes of a public health emergency; shall investigate all such cases for sources of infection and shall ensure that they are subject to proper control measures; and shall define the distribution of the illness or health condition. To fulfill these duties, the Division of Public Health perform the following:
(a) Acting on information developed in accordance with Section 130 of this Title, or other reliable information, the Division shall identify all individuals thought to have been exposed to an illness or health condition which may be potential causes of a public health emergency.
(b) The Division shall counsel and interview such individuals as appropriate to assist in the positive identification of exposed individuals and develop information relating to the source and spread of the illness or health condition. Such information includes the name and address (including city and county) of any person from whom the illness or health condition may have been contracted and to whom the illness or health condition may have spread.
(c) The Division may close, evacuate, or decontaminate any facility or decontaminate or destroy any material when the Division reasonably believes that it is more likely than not that such facility or material may seriously endanger the public health. However, to the extent practicable and consistent with the protection of public health, prior to the destruction of any material pursuant to this subsection, the Division shall institute appropriate civil proceedings against the material to be destroyed in accordance with the existing laws and rules of the Superior Court or any rules that may be developed by the Superior Court. Additionally, a person whose property is destroyed pursuant to this subsection is entitled to seek compensation pursuant to the procedures and restrictions of 20 Del. C. §3148.
Section 11. Add a new Section 532 to Title 16 of the Delaware Code, to read as follows:
"§ 532. Health Emergencies.
The provisions of this subchapter are subject to the provisions of Title 20 of the Delaware Code. Provisions of Title 20 of the Delaware Code which conflict with provisions of this subchapter shall take precedence over this subchapter.".
Section 12. Add a new Subchapter III to Title 16, Chapter 12 of the Delaware Code, to read as follows:
"Subchapter III: Confidentiality of Personal Health Information.
§ 1230. Definitions.
As used in this Subchapter, the following terms shall have the following meanings:
§ 1231. Use of Protected Health Information.
§ 1232. Disclosure of Protected Health Information.
Section 13. Add a new subchapter to Title 20, Chapter 31 of the Delaware Code, to read as follows:
"Subchapter V. Public Health Emergencies.
§ 3131. Findings.
The State of Delaware finds as follows:
§ 3132. Definitions.
The following terms shall have the indicated meanings when used in this subchapter.
(a) ‘Bioterrorism’ is the intentional use of any microorganism, virus, infectious substance, or biological product that may be engineered as a result of biotechnology, or any naturally occurring or bioengineered component of any such microorganism, virus, infectious substance, or biological product, to cause death, disease, or other biological malfunction in a human, an animal, a plant, or another living organism in order to influence the conduct of government or to intimidate or coerce a civilian population.
(b) ‘Chain of custody’ means the methodology of tracking specimens for the purpose of maintaining control and accountability from initial collection to final disposition of the specimens and providing for accountability at each stage of collecting, handling, testing, storing, and transporting the specimens and reporting test results.
(c) ‘Contagious disease’ is an infectious disease that can be transmitted from person to person, animal to person, or insect to person.
(e) ‘Health care provider’ means any person or entity who provides health care services including, but not limited to, hospitals, medical clinics and offices, special care facilities, medical laboratories, physicians, pharmacists, dentists, physician assistants, nurse practitioners, registered and other nurses, paramedics, emergency medical or laboratory technicians, and ambulance and emergency medical workers.
(f) ‘Infectious disease’ is a disease caused by a living organism or other pathogen, including a fungus, bacillus, parasite, protozoan, or virus. An infectious disease may, or may not, be transmissible from person to person, animal to person, or insect to person.
(g) ‘Infectious waste’ means:
(i) ‘biological waste’ which includes blood and blood products, excretions, exudates, secretions, suctioning and other body fluids, and waste materials saturated with blood or body fluids;
(ii) ‘cultures and stocks,’ which includes etiologic agents and associated biologicals, including specimen cultures and dishes and devices used to transfer, inoculate, and mix cultures, wastes from production of biologicals and serums, and discarded live and attenuated vaccines;
(iii) ‘pathological waste,’ which includes biopsy materials and all human tissues, anatomical parts that emanate from surgery, obstetrical procedures, autopsy and laboratory procedures and animal carcasses exposed to pathogens in research and the bedding and other waste from such animals, but does not include teeth or formaldehyde or other preservative agents; and
(iv) ‘sharps,’ which includes needles, IV tubing with needles attached, scalpel blades, lancets, breakable glass tubes, and syringes that have been removed from their original sterile containers.
(h) ‘Isolation’ is the physical separation and confinement of an individual or groups of individuals who are infected or reasonably believed to be infected with a contagious or possibly contagious disease from non-isolated individuals, to prevent or limit the transmission of the disease to non-isolated individuals.
(i) ‘Mental health support personnel’ includes, but is not limited to, psychiatrists, psychologists, social workers, and volunteer crisis counseling groups.
(j) ‘Protected health information’ means any information, whether oral, written, electronic, visual, pictorial, physical, or any other form, that relates to an individual’s past, present, or future physical or mental health status, condition, treatment, service, products purchased, or provision of care, and that reveals the identity of the individual whose health care is the subject of the information, or where there is a reasonable basis to believe such information could be utilized (either alone or with other information that is, or should reasonably be known to be, available to predictable recipients of such information) to reveal the identity of that individual.
(k) ‘Public health authority’ means the Secretary of Health and Social Services or such person as he/she may designate with the Governor’s consent.
(i) is believed to be caused by any of the following:
and
(ii) poses a high probability of any of the following harms:
§ 3134. Control of Health Care Supplies.
The public health authority may purchase and distribute anti-toxins, serums, vaccines, immunizing agents, antibiotics, and other pharmaceutical agents or medical supplies that it deems advisable in the interest of preparing for or controlling a public health emergency, without any additional legislative authorization.
§ 3135. Destruction of Property.
To the extent practicable and consistent with the protection of public health, prior to the destruction of any property under this Subchapter, the public safety authority or public health authority shall institute appropriate civil proceedings against the property to be destroyed in accordance with the existing laws and rules of the Superior Court or any such rules that may be developed by the Superior Court for use during a state of emergency. Any property acquired by the public safety authority or public health authority through such proceedings shall, after entry of the decree, be disposed of by destruction as the Court may direct.
§ 3137. Medical Examination and Testing During Public Health Emergency.
During a State of Emergency, the following rules shall apply:
§ 3138. Isolation and Quarantine During Public Health Emergency.
The following isolation and quarantine procedures shall be in effect during a state of emergency:
(i) the number of individuals involved or to be affected is so large as to render individual participation impractical;
§ 3139. Vaccination and Treatment During Public Health Emergency.
During a State of Emergency, the public safety authority may exercise, for such period as the state of emergency exists, the following emergency powers:
§ 3140. Collection of Laboratory Specimens; Performance of Tests During Public Health Emergency.
During a State of Emergency, the public health authority may, for such period as the state of emergency exists, collect specimens and perform tests on any person or animal, living or deceased, and acquire any previously collected specimens or test results that are reasonable and necessary for emergency response.
(a) All specimens shall be clearly marked.
§ 3141. Confidentiality of Medical Information.
Protected health information gathered during a emergency shall be subject to the provisions of Title 16, Chapter 12, Subchapter III of the Delaware Code.
§ 3142. Licensing and Appointment of Health Personnel During Public Health Emergency.
During a State of Emergency, the public health authority may exercise, for such period as the state of emergency exists, the following emergency powers regarding licensing of health personnel:
(1) The appointment of out-of-state emergency health care providers pursuant to this Section may be for a limited or unlimited time, but shall not exceed the termination of the state of emergency. The public health authority may terminate the out-of-state appointments at any time or for any reason provided that any such termination will not jeopardize the health, safety, and welfare of the people of this State.
(2) The public health authority may waive any or all licensing requirements, permits, or fees required by the State code and applicable orders, rules, or regulations for health care providers from other jurisdictions to practice in this State, so long as health care providers from other jurisdictions possess the licensing, permit, or fee requirement for health care providers in their jurisdictions.
(3) Any out-of-state emergency health care provider appointed pursuant to this Section shall be considered a public employee under 10 Del. C. §§ 4001-4002;
(c) To authorize the medical examiner to appoint and prescribe the duties of such emergency assistant medical examiners as may be required for the proper performance of the duties of the office.
(3) Any emergency assistant medical examiner appointed pursuant to this Section shall be considered a public employee under 10 Del. C. §§ 4001-4002.
§ 3143. Public Health Emergency Planning Commission.
The Public Health Emergency Planning Commission (‘the Commission’) shall consist of the following voting members, or a member's designee:
The Secretary of Health and Social Services or his or her designee shall serve as the Chair of the Commission. The Governor shall also appoint representatives of affected constituencies, including the medical community, local health departments and governments, local police, fire, and emergency medical service agencies, community health centers, and volunteer organizations as ex officio members of the Commission.
§ 3144. Public Health Emergency Plan.
(a) The Commission shall, within three months of the enactment of this legislation into law, deliver to the Governor a plan for responding to a public health emergency, that includes provisions for the following:
(1) A means of notifying and communicating with the population during a state of public health emergency in compliance with this subchapter, including a plan that ensures that 90% of the population is covered by a Health Alert Network;
(2) Centralized coordination of resources, manpower, and services, including coordination of responses by State, local, and federal agencies;
(3) The location, procurement, storage, transportation, maintenance, and distribution of essential materials, including medical supplies, drugs, vaccines, food, shelter, and beds, including a plan (with identified personnel to be trained) to receive and distribute critical stockpile items and manage a mass distribution of vaccine and/or antibiotics on a twenty-four hours a day, seven days a week basis;
(4) The continued, effective operation of the judicial system including, if deemed necessary, the identification and training of personnel to serve as emergency judges regarding matters of isolation and quarantine as described in this subchapter;
(5) The method of evacuating populations, and housing and feeding the evacuated populations;
(6) The identification and training of health care providers to diagnose and treat persons with infectious diseases, including a review of statutes, regulations, and ordinances that provide for credentialing, licensure, and delegation of authority for executing emergency public health measures;
(7) Guidelines for the vaccination of persons, in compliance with the provisions of this subchapter;
(8) Guidelines for the treatment of persons who have been exposed to or who are infected with diseases or health conditions caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins, that pose a substantial risk of a significant number of fatalities or incidents of permanent or long-term disability. The guidelines should cover, but not be limited to, the following diseases: anthrax, botulism, smallpox, plague, tularemia, and viral hemorrhagic fevers;
(9) Guidelines for the safe disposal of human remains, in compliance with the provisions of this subchapter;
(10) Guidelines for the safe disposal of infectious waste, in compliance with the provisions of this subchapter;
(11) Guidelines for the safe and effective management of persons isolated, quarantined, vaccinated, or treated during a state of public health emergency;
(12) Tracking the source and outcomes of infected persons, including a plan to receive and evaluate urgent disease reports from all parts of the State on a twenty-four hour a day, seven days a week basis;
(13) Ensuring that each county and city within the State identifies the following:
(i) sites where persons can be isolated or quarantined, with such sites complying with the provisions of this subchapter regarding the least restrictive means for isolation and quarantine, and the requirements for the safety, health and maintenance of personal dignity of those isolated or quarantined;
(ii) sites where medical supplies, food, and other essentials can be distributed to the population;
(iii) sites where emergency workers can be housed and fed;
(iv) routes and means of transportation of people and materials;
§ 3145. Rules and Regulations.
The public health authority and Department of Public Safety are authorized to promulgate and implement such rules and regulations as are reasonable and necessary to implement and effectuate the provisions of this Subchapter. The public health authority and public safety authority shall have the power to enforce the provisions of this Subchapter through the imposition of fines and penalties, the issuance of orders, and such other remedies as are provided by law, but nothing in this Subchapter shall be construed to limit specific enforcement powers enumerated in this Subchapter. However, rules and regulations promulgated and implemented under this subchapter and enforcement of the provisions of this subchapter must be in accord with the due process rights guaranteed by the 1897 Constitution of the State of Delaware, as amended, and the Constitution of the United States of America.
§ 3147. Liability.
§ 3148. Compensation.
§ 3149. Saving clause.
This Subchapter does not explicitly preempt other State laws or regulations that preserve to a greater degree the powers of the Governor or public health authority, provided such laws or regulations are consistent, and do not otherwise restrict or interfere, with the operation or enforcement of the provisions of this Subchapter. The powers assigned to the Governor, public safety authority, and public health authority by this Subchapter supplement and do not derogate the Governor’s powers under Subchapters III and IV of this Title.
§ 3150. Conflicting laws.
Section 14. Severability.
The provisions of this Act are severable. If any provision of this Act or its application to any person or circumstances is held invalid in a federal or State Court having jurisdiction, the invalidity will not affect other provisions or applications of this Act that can be given effect without the invalid provision or application.
Section 15. The provisions of this Act shall take effect upon signature of the Governor.