Legal Toolkit for Public Health Professionals

Thanks to NACCHO for their contribution in helping to create this resource.

A Primer on Public Health Law

Public health officials have broad authority to ensure a safe and orderly community. State laws tend to be broad and do not set forth, in detail, specific criteria on how or when public health officials can or should issue orders. There is very limited guidance on the how long an order should be in place, the process for issuing orders and for the legal enforcement of orders. Nor is there guidance on legal recourse or the implementation of orders or the legal process should health officials face non compliant citizens.

Wisconsin state laws give local health officers great latitude in keeping the public healthy. With this latitude comes a loss of freedom and privacy. Justification for this loss of freedom and privacy stems from the notion that people’s actions can have a devastating effect on the overall health and well-being of a community and that quick action is vital if public health officials hope to contain the spread of communicable diseases. It is also understood that personal freedom is not an absolute right.

About this Toolkit

The most commonly referenced containment measures applied on an individual level are isolation and quarantine. However, public health containment measures are much broader than simply isolation and quarantine, and include measures that can be applied at both the individual and the community level. Community containment measures that can be employed in an outbreak include suspending school, public transportation and public gatherings, as well as limiting travel. This toolkit provides templates and guidelines for public health orders as well as the supporting legal documents to enforce those orders should that become necessary.

Hypothetical scenarios were created to guide the development of templates for each of the containment measures listed above. These scenarios have been provided with each set of templates as it may illuminate the assumptions that drove the creation of the documents. Most of the scenarios refer to the containment of influenza like illness. In light of the current H1N1 pandemic this most likely situation in which the documents will be used.

Using this Toolkit

We suggest you take a moment to read through the sections above first, and then browse the templates and guidelines below associated with the containment measure or measures you are interested in learning more about. The guidance documents offer suggestions for using the templates. It begins with guidelines for using the templates regardless of the containment measure being employed. Subsequent sections of the guidance document offers more detailed information pertinent to specific containment measures, and list legal documents in the general order they might be used. We hope you find our templates and guidance documents helpful. Please feel free to provide feedback so we can make this toolkit as user friendly as possible by clicking here.

Disclaimer

IMPORTANT: Click here to read a one-page disclaimer regarding the documents provided below.

Basic Guidelines for All Containment Measures

Minimize the duration of the public health order as much as possible.

Strongly encourage voluntary compliance.

When serving orders:

- Have someone from the district attorney’s office or local law enforcement accompany the public health worker serving the public health order.
- Have an interpreter accompany the public health worker serving the order if necessary.
- Provide PPE and fit testing for public health worker, representative from the district attorney’s office, law enforcement, and interpreter if necessary.

Identify “trigger points” for implementation of containment measures and the serving of public health orders appropriate for local circumstances.

Determine what constitutes non-compliance “triggering” activation of the legal process compelling compliance.

Community education and public messaging are critical in ensuring the effectiveness of containment measures.

Have orders translated into the languages most commonly spoken in the local community. However, do not do this without the input of local representatives. In our community we have found that one of the major ethnic groups does not need documents translated into their language instead suggesting translation of just a few key words. Very few of their community members can read in their native language. Those who cannot read in English rely on community members who do for their information.