Current through Register Vol. 47, No. 6, September 18, 2024
Isolation and quarantine should be consistent with guidelines
provided by the Centers for Disease Control and Prevention.
(1)
General provisions.
a.
Voluntary confinement.
Prior to instituting mandatory isolation or quarantine pursuant to this rule,
the department or a local board of health may request that an individual or
group of individuals voluntarily confine themselves to a private home or other
facility.
b.
Quarantine and
isolation. The department and local boards of health are authorized to
impose and enforce quarantine and isolation restrictions. Quarantine and
isolation shall rarely be imposed by the department or by local boards of
health. If a quarantinable disease occurs in Iowa, individuals with a suspected
or active quarantinable disease and contacts to the case may be quarantined or
isolated as the particular situation requires. Any quarantine or isolation
imposed by the department or a local board of health shall be established and
enforced in accordance with this rule.
(2)
Issuance of isolation or
quarantine orders. The department or the local board of health may
isolate or quarantine an individual or groups of individuals, and area
quarantine in the rarest of instances, through a written order issued pursuant
to this rule. The isolation or quarantine of an individual or group, whether
during a declared state of emergency or not, shall be conducted as follows:
a. A written administrative order to isolate
or quarantine an individual or group of individuals shall be issued when
voluntary measures are deemed impracticable or ineffective. Orders shall become
effective immediately upon issuance.
b. Orders for isolation and quarantine may
include, without limitation, confinement in a residence or other private or
public premises including medical and nonmedical facilities; conditions on
travel or behavior; and exclusion of individuals or groups from certain places,
including but not limited to school, workplace, public conveyances, and other
places where members of the public may congregate; or a requirement that a
person self-monitor specified health conditions (e.g., body temperature) and
report the findings.
c.
Administrative orders to isolate or quarantine an individual or a group of
individuals may be issued orally if delay in imposing the isolation or
quarantine would pose a serious imminent danger to the public health. If an
oral order is issued, a written order shall be issued as soon as is reasonably
possible, but in no event later than 24 hours following the issuance of the
oral order.
d. A copy of the
written order shall be provided to the individual to be isolated or quarantined
or, if that is not possible, by any means reasonably calculated to provide
actual notice. If the order applies to a group of individuals and it is
impractical to provide individual copies, the order shall be posted in a
conspicuous place in the isolation or quarantine premises.
e. The order of isolation or quarantine shall
include the following:
(1) Full name and
address of person or description of the group subject to the order.
(2) The clinical grounds for believing that
the individual or group is infected with, or may have been exposed to, a
communicable disease.
(3) The
location where the individual or group will be confined during the period of
isolation or quarantine.
(4) The
exact date and time when the period of isolation or quarantine will expire. If
it is not possible to fix an exact date, the order should specify the
conditions or circumstances under which the individual or group would no longer
pose a threat to the public health and confinement would end (e.g., the
disappearance or absence of specified clinical symptoms).
(5) The conditions under which the individual
or group will be isolated or quarantined.
(6) Notice of right to challenge the
isolation or quarantine.
f. When individuals or groups are isolated or
quarantined, whether through an administrative order or through voluntary
compliance, the department or county board of health shall determine what
method and place of isolation or quarantine is appropriate based upon the
suitability of an individual's home or other designated facility and the
services available.
g. To the
greatest extent that it is possible to do so without jeopardizing the integrity
of the isolation or quarantine, the authority issuing the isolation or
quarantine order shall preserve and facilitate the ability of isolated and
quarantined individuals to communicate with the outside world and, in
particular, to exchange confidential communications with legal and medical
advisors of their choice.
h. A
person diagnosed with or clinically suspected of having infectious tuberculosis
shall complete voluntary treatment until, in the opinion of the health care
provider or the state public health medical director and epidemiologist, the
person's tuberculosis is cured or such person is no longer a threat to public
health. If such person refuses to complete the course of voluntary treatment,
the department or local board of health may issue an order compelling mandatory
treatment. Such order shall include the identity of the person subject to the
mandatory treatment order, a description of the treatment ordered, the medical
basis upon which the treatment is ordered, and a description of the potential
medical and legal consequences of violating such order. A person who violates a
mandatory treatment order may be subject to the penalties provided in Iowa Code
section 135.38 or
137.117 and may be placed under
mandatory quarantine or isolation in accordance with the provisions of this
chapter.
(3)
Appeal from department order imposing isolation or quarantine.
a. Individuals have the right to appeal an
order imposing isolation or quarantine. Appeal procedures for department orders
are as laid forth in 441-Chapter 7.
b. A request for a hearing shall not stay an
isolation or quarantine order unless by order of the issuing department or
board, or by a district court.
(4)
Appeal from a local board of
health order imposing isolation or quarantine.
a.
Appeal. The subject of a
board order imposing isolation or quarantine may appeal a written order by
submitting a written appeal within ten days of receipt of the written order.
The appeal shall be addressed to the issuing board. Unless stayed by order of
the board or a district court, the written order for quarantine or isolation
shall remain in force and effect until the appeal is finally determined and
disposed of upon its merits.
b.
Proceeding. The appeal proceeding shall be conducted in
accordance with this rule and specific local board of health rules governing
appeal proceedings. The proceeding shall be held as soon as is practicable and
in no case later than ten days from the date of receipt of the appeal. The
hearing may be held by telephonic or other electronic means if necessary to
prevent additional exposure to the communicable or possibly communicable
disease. In extraordinary circumstances and for good cause shown, the board may
continue the proceeding date for up to ten days, giving due regard to the
rights of the affected individuals, the protection of the public's health, and
the availability of necessary witnesses and evidence. At the appeal proceeding,
the subject of the appeal shall have the right to introduce evidence on all
issues relevant to the order. The board, by majority vote, may modify,
withdraw, or order compliance with the order under appeal.
c.
Judicial review. The
aggrieved party to the final decision of the board may petition for judicial
review of that action by filing an action in the appropriate district court.
Petitions for judicial review shall be filed within 30 days after the decision
becomes final.
d.
Immediate
judicial review of board order. The board acknowledges that in certain
circumstances the subject or subjects of a board order may desire immediate
judicial review of a board order in lieu of proceeding with the board's appeal
process. The board may consent to immediate jurisdiction of the district court
when requested by the subject or subjects of a board order and justice so
requires. Unless stayed by order of the board or a district court, the written
order for quarantine or isolation shall remain in force and effect until the
judicial review is finally determined and disposed of upon its
merits.
(5)
Implementation and enforcement of isolation and quarantine.
a.
Jurisdictional issues.
The department has primary jurisdiction to isolate or quarantine individuals or
groups of individuals if the communicable disease outbreak has affected more
than one county or has multicounty, statewide, or interstate public health
implications. When imposing isolation or quarantine, the department will
coordinate with the local health department as appropriate. If isolation or
quarantine is imposed by the department, a local board of health or local
health department may not alter, amend, modify, or rescind the isolation or
quarantine order.
b.
Assistance of local boards of health and local health
departments. If isolation or quarantine is imposed by the department,
the local boards of health and the local health departments in the affected
areas will assist in the implementation of the isolation or quarantine
order.
c.
Assistance of law
enforcement. Pursuant to Iowa Code chapter 135, all peace officers of
the state will enforce and execute a lawful department order for isolation or
quarantine within their respective jurisdictions. The department will take all
reasonable measures to minimize the risk of exposure to peace officers and
others assisting with enforcement of an isolation or quarantine
order.
d.
Penalty.
Violation of a lawful isolation or quarantine order will be subject to
penalties pursuant to Iowa Code chapter 135.
e.
Enforcement action. The
department may file a civil action in the Polk County district court or in the
district court for the county in which the individual resides or is located to
enforce a department order for isolation or quarantine. Such action will be
filed in accordance with the Iowa Rules of Civil Procedure.
(6)
Control of isolation and
quarantine premises.
a. The
department or local board of health may authorize physicians, health care
workers, or others access to individuals in isolation or quarantine as
necessary to meet the needs of isolated or quarantined individuals.
b. No person shall enter isolation or
quarantine premises unless authorized to do so by the department or local board
of health.
c. Any person entering
isolation or quarantine premises may be required to wear personal protective
equipment or receive vaccination or any other preventative care as
appropriate.
d. Any person entering
isolation or quarantine premises, with or without authorization, may be subject
to an order of quarantine as deemed medically necessary.