Excerpted from the Ohio Department of Health Limitations of Movement and Infection Control Practices Version 2.

0 Revised January 2009 http://www.odh.ohio.gov/PDF/IDCM/sect5.pdf Found on Ohio Department of Health web page: http://www.odh.ohio.gov/healthResources/infectiousDiseaseManual.aspx

SECTION IV
Legal
(page 51) I. Authority All governmental acts must arise from and be supported by legal authority. States, localities and tribes have primary responsibility for all public health matters that occur within their borders. This responsibility extends to isolation and quarantine. While state government is a government of general jurisdiction (the federal government is one of limited jurisdiction), the authority of state government is not unlimited. An official act may be authorized by law, but the act cannot violate an individual right without a compelling state interest. When considering quarantine or isolation, it is important for the government official to carefully weigh the situation to ensure the data indicating a need for quarantine or isolation are clear and convincing.1 The state official needs to ensure the quarantine or isolation utilizes the least restrictive means of achieving the public good. Similarly, the government official needs to ensure the quarantine or isolation order is sustainable and logistically supportable. To this end, the government official should be familiar with the appropriate scope of authority and fully engage the appropriate legal counsel early in the process. II. Federal Constitutional Provisions United States Constitution, Amendment I - Right of Assembly. http://caselaw.lp.findlaw.com/data/constitution/amendment01/ United States Constitution, Amendment IV - Right Against Unreasonable Searches and Seizures. http://en.wikipedia.org/wiki/Fourth_Amendment_to_the_United_States_Constitution
The United States Supreme Court has long held that a state is permitted to involuntarily quarantine (limit the movement of) a person with a communicable disease. Compagnie Francaise de Navigation a Vapeur v. Louisiana Bd. of Health, 186 U.S. 380 (1902). However, the Supreme Court has also indicated that the Due Process Clause of the 14th Amendment to the United States Constitution requires at least a clear and convincing standard of evidence when the state chooses to limit the movement of or confine an individual (for other than a criminal act) in order to protect the health and safety of the individual or others. Addington v. Texas, 441 U.S. 418 (1979). To this end, the treatability of or recoverability from the illness is not a factor in determining the appropriateness of the limitation of movement or confinement order. Kansas v. Hendricks, 521 U.S. 346 (1997).
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United States Constitution, Amendment XIV - No State shall make or enforce any laws which shall abridge the privileges and immunities of citizens of the United States. http://www.law.cornell.edu/constitution/constitution.amendmentxiv.html United States Constitution, Amendment XIV - No State shall deprive any person of life, liberty, or property, without due process of law. http://www.law.cornell.edu/constitution/constitution.amendmentxiv.html United States Constitution, Amendment XIV - No State shall deny to any person within its jurisdiction the equal protection of the laws. http://www.law.cornell.edu/constitution/constitution.amendmentxiv.html

III. Federal Authority Under the authority of Section 361 of the Public Health Service Act (42 USC 264), the Health and Human Services (HHS) Secretary may make and enforce regulations as necessary to prevent the introduction, transmission or spread of communicable diseases from foreign countries into the United States of from one state or possession into another. The CDC (under authority delegated by the HHS Secretary) Director may isolate and quarantine persons who have been exposed to or are infected with certain specified communicable diseases and are arriving in the United States from a foreign country or traveling from one state or possession into another. CFR Title 42, Chapter 1, Part 70 - Interstate Control of Communicable Disease. http://www.access.gpo.gov/nara/cfr/waisidx_03/42cfr70_03.html CFR Title 42, Chapter 1, Part 71 - Foreign Quarantine. http://www.access.gpo.gov/nara/cfr/waisidx_03/42cfr71_03.html IV. International New International Health Regulations (IHR) were recently adopted by the World Health Assembly requiring all members to report cases of human infections that are caused by a new subtype. When the World Health Organization (WHO) has determined that a particular event constitutes a public health emergency, the IHR will require WHO to make a real-time response to the emergency. The Director General of WHO then makes recommendations for implementation measures to the affected member states. Subsequently the recommendations are made public and based on evidence the recommended measures can be modified or ended. (HHS Pandemic Influenza Plan) V. State Constitutional Provisions: http://www.constitution.org/cons/usohcons.txt Ohio Constitution, Article I, Section 1 - Inalienable Rights recognized. Ohio Constitution, Article I, Section 2 - Equal Protection and Benefit. Ohio Constitution, Article I, Section 3 - Rights of Assembly and Petition. Ohio Constitution, Article I, Section 8 - Right of Habeas Corpus shall not be suspended. Ohio Constitution, Article I, Section 14 - Right Against Unreasonable Searches and Seizures. Ohio Constitution, Article I, Section 16 - All courts shall be open and everyone shall have an opportunity for redress of injuries in the due course of law. Ohio Constitution, Article I, Section 18 - Only the General Assembly may suspend laws.

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Ohio Constitution, Article I, Section 19 - The State may not exercise Eminent Domain without due process of law or just compensation. Ohio Constitution, Article II, Section 42 - The General Assembly has the power and duty to pass such laws as may be necessary and proper for insuring the continuity of governmental operations in periods of emergency resulting from disasters caused by enemy attack. VI. State Authority ORC 3701.13i - ODH has ultimate authority in matters of quarantine. ORC 3701.56ii - Provides for law enforcement and public health officials to enforce isolation and quarantine orders. ORC 3701.14iii - General powers of the Director. ORC 3701.81iv- Requiring persons to limit spread and inform the health authorities of known contagions. ORC 5923.21 - Governor may call-up Ohio National Guard (ONG) to enforce the laws of Ohio. ORC 5923.27 - ONG called up by Governor is considered a law enforcement officer. ORC 5923.27 - Arrest and detention by ONG is for purposes of escorting to civil authorities. VII. Local Authority ORC 3707.04v - Authority to promulgate quarantine regulations ORC 3707.05vi - Local health department (LHD) may not close highway without ODH permission and in compliance with regulations. ORC 3707.08vii - Isolation of persons exposed to communicable diseases; placarding of premises. ORC 3707.09viii - Establishment of quarantine guard. ORC 3707.16ix - Attendance at gatherings by quarantined persons prohibited. ORC 3707.17x - Quarantine in place other than that of legal settlement. ORC 3707.21xi - Isolation of affected persons in institutions. ORC 3707.23xii - Examination of common carriers by board of health during quarantine. ORC 3709.20xiii & 3709.21xiv LHD and Boards of Health may make such orders as necessary to protect public health. Ohio Attorney General Opinion 926 (1949) - A LHD may impose a quarantine if reasonable. VIII. State of Ohio Attorney General Memorandum 2-15-06 a. Summary: Isolation and quarantine orders may be issued by either local departments of health, or by the Ohio Department of Health. These orders may include restrictions on individuals, places, transportation, and gatherings. A local board of health of a city or general health district may employ persons sworn as quarantine guards with police powers, who may enforce all orders of the board. Separately, local and state law enforcement officers must enforce the terms of an order of isolation or quarantine, but are not under the command or supervision of the health authorities. Local and state officers may also enforce criminal statutes against persons violating isolation or quarantine orders, and may transport these persons to isolation within jails, prisons or other secure facilities, or in hospitals or other health facilities, as necessary. b. Analysis:
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i.

ii.

iii. iv.

Scope: This analysis is focused on the interaction between law enforcement officers, and orders of quarantine and isolation entered by health agencies. It does not detail the standards and procedures preceding issuance of such orders, or the enforcement, modification, or abolishment of such orders, other than as these affect law enforcement officers. The Ohio Department of Health has independent authority to declare, enforce, modify, relax or abolish quarantine and isolation for the purpose of preserving life and health. Although the statute anticipates that duties including isolation and quarantine will be carried out in cooperation with the health commissioner of a general or city health district, the department may make and enforce orders in local matters when an emergency exists, or when the local board has neglected to act quickly enough. LHDs have authority to declare, enforce, modify, relax or abolish quarantine and isolation for the purpose of preserving the life and health of people of the community or the state The governor may declare a state of emergency, at the request of the Director of the Department of Health. The Governor may also order the Ohio State Highway Patrol to enforce the criminal law within an area threatened by riot, civil disorder, or insurrection, upon the request of the sheriff or mayor.

Resource Documents
The following resources were used in preparation for this guide. Please reference these documents: http://www.cdc.gov/ncidod/dhqp/gl_isolation_ptII.html http://www.bt.cdc.gov/agent/smallpox/response-plan/index.asp Draft Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. 2004 HICPAC http://www.premierinc.com/all/safety/resources/guidelines/downloads/2004-draftisoguideline.pdf Scheckler, W.E., Brimhall, D., Buck, A.S., Farr, B.M., Friedman, C., Garibaldi, R.A., Gross, P.A., Harris, J., Hierholzer, W.J., Martone, W.J., McDonald, L.L., Solomon, S.L. 1998. Requirements for Infrastructure and Essential Activities of Infection Control and Epidemiology in Hospitals: A Consensus Panel report. AJIC: American Journal of Infection Control. 26: 4760. Friedman, C., Barnette, M., Buck, A.S., Ham, R., Harris, J., Hoffman, P., Johnson, D., Manian, F., Nicolle, L., Pearson, M.L., Perl, T.M., Solomon, S.L. 1999. Requirements for Infrastructure and Essential Activities of Infection Control and Epidemiology in Out-of-Hospital Settings: A

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Consensus Panel report. AJIC: American Journal of Infection Control. 27: 418 - 430. Simone, Patricia M., Division of Global Migration and Quarantine, National Center for Infectious Diseases, Centers for Disease Control and Prevention, December, 2003. Guidelines for Environmental Infection Control in Health-Care Facilities http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm Institute for Bioethics, Health Policy and Law, University of Louisville School of Medicine. Quarantine and Isolation: Lessons Learned from SARS. A Report to the Centers for Disease Control and Prevention, November 1003. APIC/CDC Bioterrorism Template Bioterrorism Readiness Plan: A Template for Healthcare Facilities. Available at http://www.apic.org/ or http://www.cdc.gov/ Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/ Jennings, Jan., Wideman, Joan. APIC Handbook of Infection Control, Third Edition 2002 APIC brochure Hand Hygiene for Healthcare Workers Interim Guidance for Managing Patients with Suspected Viral Hemorrhagic Fever in U.S. Hospitals, May 19, 2005, CDC Fact Sheet on Isolation and Quarantine: Severe Acute Respiratory Syndrome. Available at: http://www.cdc.gov/ncidod/sars/isolationquarantine.htm Department of Health and Human Services; Centers for Disease Control and Prevention: http://www.cdc.gov/ncidod/sars/guidance/d/word/d.doc Supplement D: Community Containment Measures, Including Non-hospital Isolation and Quarantine. January 8, 2005 California Department of Health Services Severe Acute Respiratory Syndrome Infection Control Recommendations Home Settings, June 3, 2003. Seattle & King County Public Health http://www.kingcounty.gov/healthservices/health/communicable/sars/discharge.aspx Department of Health and Human Services; http://www.hhs.gov/pandemicflu/plan/; November 2005 Draft Model Operational Guidelines for Disease Exposure Control, Center for Strategic and International Studies Homeland Security Program, November 2, 2005 http://www.csis.org/hs/ Guideline for hand hygiene in health care settings-recommendations of the health care infection control practices advisory committee and the HICPAC/SHEA/APIC/IDSA hand hygiene task force-MMWR October 25, 2002/Vol.51/No. RR-16. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm
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Gostin, L. Public Health Law in a New Century, Part II: Public Health Powers and Limits. JAMA. June 14, 2000, Vol. 283, No. 22, pp. 2895-3030 Centers for Disease Control and Prevention: Questions and Answers on Legal Authorities for Isolation and Quarantine, May 3, 2005. http://www.cdc.gov/ncidod/sars/quarantineqa.htm Centers for Disease Control and Prevention: Fact Sheet on Legal Authorities for Isolation/Quarantine, May 3, 2005. http://www.cdc.gov/ncidod/sars/factsheetlegal.htm American Bar Association, State and Local Government Law Section. Draft Checklist for State and Local Government Attorneys to Prepare for Possible Disasters. Compiled by the Task Force on Emergency Management and Homeland Security, March 2003. Schwartz, Kurt. Police Powers during Public Emergencies U.S. Dept. of Labor, OSHA Bloodborne Pathogens Standard, http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=100 051 Ohio EPA Infectious Wastes, http://www.epa.state.oh.us/dsiwm/document/currentrule/3745-2701_current.pdf

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APPENDIX C (page 61)

Executive Order 13295: Revised List of Quarantinable Communicable Diseases (April 4, 2003) Download PDF version formatted for print (54 KB/1 page) By the authority vested in me as President by the Constitution and the laws of the United States of America, including section 361(b) of the Public Health Service Act (42 U.S.C. 264(b)), it is hereby ordered as follows: Section 1. Based upon the recommendation of the Secretary of Health and Human Services (the "Secretary"), in consultation with the Surgeon General, and for the purpose of specifying certain communicable diseases for regulations providing for the apprehension, detention, or conditional release of individuals to prevent the introduction, transmission, or spread of suspected communicable diseases, the following communicable diseases are hereby specified pursuant to section 361(b) of the Public Health Service Act: (a) Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; and Viral Hemorrhagic Fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named). (b) Severe Acute Respiratory Syndrome (SARS), which is a disease associated with fever and signs and symptoms of pneumonia or other respiratory illness, is transmitted from person-toperson predominantly by the aerosolized or droplet route, and, if spread in the population, would have severe public health consequences. Sec. 2. The Secretary, in the Secretary's discretion, shall determine whether a particular condition constitutes a communicable disease of the type specified in section 1 of this order. Sec. 3. The functions of the President under sections 362 and 364(a) of the Public Health Service Act (42 U.S.C. 265 and 267(a)) are assigned to the Secretary. Sec. 4. This order is not intended to, and does not, create any right or benefit enforceable at law or equity by any party against the United States, its departments, agencies, entities, officers, employees or agents, or any other person. Sec. 5. Executive Order 12452 of December 22, 1983, is hereby revoked. GEORGE W. BUSH

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Ohio Revised Code:

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3701.13 Department of health - powers. The department of health shall have supervision of all matters relating to the preservation of the life and health of the people and have ultimate authority in matters of quarantine and isolation, which it may declare and enforce, when neither exists, and modify, relax, or abolish, when either has been established. The department may approve methods of immunization against the diseases specified in section 3313.671 of the Revised Code for the purpose of carrying out the provisions of that section and take such actions as are necessary to encourage vaccination against those diseases. The department may make special or standing orders or rules for preventing the use of fluoroscopes for nonmedical purposes which emit doses of radiation likely to be harmful to any person, for preventing the spread of contagious or infectious diseases, for governing the receipt and conveyance of remains of deceased persons, and for such other sanitary matters as are best controlled by a general rule. Whenever possible, the department shall work in cooperation with the health commissioner of a general or city health district. It may make and enforce orders in local matters when an emergency exists, or when the board of health of a general or city health district has neglected or refused to act with sufficient promptness or efficiency, or when such board has not been established as provided by sections 3709.02, 3709.03, 3709.05, 3709.06, 3709.11, 3709.12, and 3709.14 of the Revised Code. In such cases the necessary expense incurred shall be paid by the general health district or city for which the services are rendered. The department may make evaluative studies of the nutritional status of Ohio residents, and of the food and nutrition-related programs operating within the state. Every agency of the state, at the request of the department, shall provide information and otherwise assist in the execution of such studies. Effective Date: 02-12-2004; 05-06-2005

3701.56 Enforcement of rules and regulations. Boards of health of a general or city health district, health authorities and officials, officers of state institutions, police officers, sheriffs, constables, and other officers and employees of the state or any county, city, or township, shall enforce quarantine and isolation orders, and the rules the department of health adopts. Effective Date: 02-12-2004 3701.14 Special duties of director of health. (A) The director of health shall investigate or make inquiry as to the cause of disease or illness, including contagious, infectious, epidemic, pandemic, or endemic conditions, and take prompt action to control and suppress it. The reports of births and deaths, the sanitary conditions and effects of localities and employments, the personal and business habits of the people that affect their health, and the relation of the diseases of man and beast, shall be subjects of study by the director. The director may make and execute orders necessary to protect the people against diseases of lower animals, and shall collect and preserve information in respect to such matters and kindred subjects as may be useful in the discharge of the directors duties, and for dissemination among the people. When called upon by the state or local governments, or the board of health of a general or city health district, the director shall promptly investigate and report upon the water supply, sewerage, disposal of excreta of any locality, and the heating, plumbing, and ventilation of a public building. (B) Information obtained during an investigation or inquiry that the director currently is conducting pursuant to division (A) of this section and that is not yet complete is confidential during the course of that investigation or inquiry and shall not be released except pursuant to division (D) or (J) of this section or under one of the following conditions: (1) The confidential information is released pursuant to a search warrant or subpoena issued by or at the request of a grand jury or prosecutor, as defined in section 2935.01 of the Revised Code.
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(2) The director has entered into a written agreement to share or exchange the information with a person or government entity, and that agreement requires the person or entity to comply with the confidentiality requirements established under this section. (3) The information is contained in a preliminary report released by the director pursuant to division (G)(1) of this section. (C) Division (B) of this section applies during any investigation or inquiry the director makes pursuant to division (A) of this section, notwithstanding any other provision of the Revised Code that establishes the manner of maintaining confidentiality or the release of information, except that the confidentiality and release of protected health information under section 3701.17 of the Revised Code is governed by that section. (D) Nothing in this section bars the release of information that is in summary, statistical, or aggregate form and that does not identify a person. Information that is in summary, statistical, or aggregate form and that does not identify a person is a public record under section 149.43 of the Revised Code. (E) Nothing in this section authorizes the director to conduct an independent criminal investigation without the consent of each local law enforcement agency with jurisdiction to conduct the criminal investigation. (F) Except for information released pursuant to division (G) or (J) of this section, any disclosure pursuant to this section shall be in writing and accompanied by a written statement that includes the following or substantially similar language: This information has been disclosed to you from confidential records protected from disclosure by state law. If this information has been released to you in other than a summary, statistical, or aggregate form, you shall make no further disclosure of this information without the specific, written, and informed release of the person to whom it pertains, or as otherwise permitted by state law. A general authorization for the release of medical or other information is not sufficient for the release of information pursuant to this section. (G)(1) If an investigation or inquiry the director currently is conducting pursuant to division (A) of this section is not completed within six months after the date of commencement, the director shall prepare and release a report containing preliminary findings. Every six months thereafter, the director shall prepare and release a supplementary preliminary report until such time as the investigation or inquiry is completed. (2) Upon completion of an investigation or inquiry conducted pursuant to division (A) of this section, the director shall prepare and release a final report containing the directors findings. (H) No report prepared by the director pursuant to this section shall contain protected health information, as defined in section 3701.17 of the Revised Code. (I) The director shall adopt, in accordance with Chapter 119. of the Revised Code, rules establishing the manner in which the reports prepared by the director pursuant to this section are to be released. (J) The director shall release information obtained during an investigation or inquiry that the director currently is conducting pursuant to division (A) of this section and that is not yet complete, if the director determines the release of the information is necessary, based on an evaluation of relevant information, to avert or mitigate a clear threat to an individual or to the public health. Information released pursuant to this division shall be limited to the release of the information to those persons necessary to control, prevent, or mitigate disease or illness. Effective Date: 02-12-2004
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3701.81 Exposing others to contagion. (A) No person, knowing or having reasonable cause to believe that he is suffering from a dangerous, contagious disease, shall knowingly fail to take reasonable measures to prevent exposing himself to other persons, except when seeking medical aid.

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(B) No person, having charge or care of a person whom he knows or has reasonable cause to believe is suffering from a dangerous, contagious disease, shall recklessly fail to take reasonable measures to protect others from exposure to the contagion, and to inform health authorities of the existence of the contagion. (C) No person, having charge of a public conveyance or place of public accommodation, amusement, resort, or trade, and knowing or having reasonable cause to believe that persons using such conveyance or place have been or are being exposed to a dangerous, contagious disease, shall negligently fail to take reasonable measures to protect the public from exposure to the contagion, and to inform health authorities of the existence of the contagion. Effective Date: 01-01-1974 3707.04 Quarantine regulations. In time of epidemic or threatened epidemic, or when a dangerous communicable disease is unusually prevalent, the board of health of a city or general health district, after a personal investigation by its members or executive officer to establish the facts in the case, and not otherwise, may impose a quarantine on vessels, railroads, or other public or private vehicles conveying persons, baggage, or freight, or used for such purpose. The board may make and enforce such rules and regulations as are wise and necessary for the protection of the health of the people of the community or state, but the running of any train or car on any steam or electric railroad, or of steamboats, vessels, or other public conveyances shall not be prohibited. A true copy of such quarantine rules and regulations shall be immediately furnished by such board to the department of health, and thereafter no change shall be made except by the order of the department or the board to meet a new and sudden emergency. Effective Date: 10-01-1953
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3707.05 Board must secure approval of department of health in certain cases. The board of health of a city or general health district shall not close public highways or prohibit travel thereon, interfere with public officers not afflicted with or directly exposed to a contagious or infectious disease, in the discharge of their official duties, or establish a quarantine of one municipal corporation or township against another municipal corporation or township, as such, without permission first obtained from the department of health and under regulations established by the department. Effective Date: 10-01-1953 3707.08 Isolation of persons exposed to communicable disease - placarding of premises. When a person known to have been exposed to a communicable disease declared quarantinable by the board of health of a city or general health district or the department of health is reported within its jurisdiction, the board shall at once restrict such person to his place of residence or other suitable place, prohibit entrance to or exit from such place without the boards written permission in such manner as to prevent effective contact with individuals not so exposed, and enforce such restrictive measures as are prescribed by the department. When a person has, or is suspected of having, a communicable disease for which isolation is required by the board or the department, the board shall at once cause such person to be separated from susceptible persons in such places and under such circumstances as will prevent the conveyance of the infectious agents to susceptible persons, prohibit entrance to or exit from such places without the boards written permission, and enforce such restrictive measures as are prescribed by the department. When persons have, or are exposed to, a communicable disease for which placarding of premises is required by the board or the department the board shall at once place in a conspicuous position on the premises where such a person is isolated or quarantined a placard having printed on it, in large letters, the name of the disease. No person shall remove, mar, deface, or destroy such placard, which shall remain in place until after the persons restricted have been released from isolation or quarantine.

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Physicians attending a person affected with a communicable disease shall use such precautionary measures to prevent its spread as are required by the board or the department. No person isolated or quarantined by a board shall leave the premises to which he has been restricted without the written permission of such board until released from isolation or quarantine by it in accordance with the rules and regulations of the department. Effective Date: 10-01-1953 3707.09 Board may employ quarantine guards. The board of health of a city or general health district may employ as many persons as are necessary to execute its orders and properly guard any house or place containing any person affected with or exposed to a communicable disease declared quarantinable by the board or the department of health. The persons employed shall be sworn in as quarantine guards, shall have police powers, and may use all necessary means to enforce sections 3707.01 to 3707.53, inclusive, of the Revised Code, for the prevention of contagious or infectious disease, or the orders of any board made in pursuance thereof. Effective Date: 10-01-1953
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3707.16 Attendance at gatherings by quarantined person prohibited. No person isolated or quarantined for a communicable disease declared by the board of health of a city or general health district or the department of health to require isolation or quarantine shall attend any public, private, or parochial school or college, Sunday school, church, or any other public gathering, until released from isolation or quarantine by the board. All school principals, Sunday school superintendents, or other persons in charge of such schools or other gatherings shall exclude any such person until he presents a written permit of the board to attend. Effective Date: 10-01-1953

3707.17 Quarantine in place other than that of legal settlement. When a person with a contagious disease, quarantined in a county by a city or general health district, has a legal settlement in a municipal corporation or township within the same county but other than that in which quarantined, or has a legal settlement in another county of the state, and such person is unable to pay the expenses of the service provided under section 3707.14 of the Revised Code, the city or general health district rendering such service shall notify in writing the proper officials of the municipal corporation or township of legal settlement or the board of county commissioners of the county of legal settlement if such legal settlement is in another county that such services are being rendered. Such notice shall be sent within three days if the fact of nonresidence is disclosed upon the beginning of such service or admission to a hospital or other institution of quarantine, or within three days after the discovery of such fact if it is not so disclosed. Within twenty days after the discharge of such quarantined person, the health commissioner of the city or general health district shall send a notice of such discharge and a sworn statement of the expenses, either actual or at the established rate of the hospital or other institution of quarantine, to the proper officials of the municipal corporation or township of legal settlement or the board of county commissioners of the county of legal settlement if such legal settlement is in another county. Thereupon the municipal corporation or township of legal settlement or county of legal settlement if such legal settlement is in another county shall be liable to the city or general health district rendering such service, and shall pay for it within thirty days after date of the sworn statement of expenses. If the notice of the rendering of such service, required to be sent by the health commissioner, is not sent within three days after the disclosure by the person quarantined or the discovery of such nonresidence, the municipal corporation or township of legal settlement or the county of legal settlement if such legal settlement is in another county shall be liable only after receipt of such notice. This section does not prevent the removal of such quarantined person by the municipal corporation, township, or county of legal settlement, at its expense, but such removal shall not relieve the municipal

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corporation, township, or county of legal settlement for the expenses previously incurred by the city or general health district in which such person has been quarantined. Any such person who does not, upon discharge, pay the expenses of such quarantine shall be deemed indigent insofar as the city or general health district is concerned. The municipal corporation, township, or county of legal settlement is hereby subrogated to all the rights of the city or general health district in which such service was rendered. Effective Date: 10-01-1953
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3707.21 Disease in public institution - temporary building. When cholera, yellow fever, diphtheria, scarlet fever, or other dangerous, contagious, or infectious disease appears in any state, county, or municipal benevolent or correctional institution, the superintendent or manager of the institution shall at once isolate the persons so affected and enforce sections 3707.01 to 3707.53 of the Revised Code, for the prevention of contagious diseases, and the rules and orders of the department of health to that effect. The trustees or managers of any benevolent or correctional institution may erect any necessary temporary building for the reception of the affected persons or for the detention of persons exposed to the listed diseases and may remove the persons to, and confine them in, the building. Effective Date: 10-06-1994 3707.23 Examination of common carriers by board during quarantine. When a quarantine is declared, all railroads, steamboats, or other common carriers, and the owners, consignees, or assignees of any railroad, steamboat, or other vehicle used for the transportation of passengers, baggage, or freight, shall submit to any rules or regulations imposed and any examination required by a board of health of a city or general health district or health commissioner. They shall submit to any examination required by the health authorities respecting any circumstances or event touching the health of the crew, operatives, or passengers and the sanitary condition of the baggage and freight. Effective Date: 10-01-1953 3709.20 Orders and regulations of board of city health district - hearing referees or examiners. (A) The board of health of a city health district may make such orders and regulations as are necessary for its own government, for the public health, the prevention or restriction of disease, and the prevention, abatement, or suppression of nuisances. Orders and regulations not for the government of the board, but intended for the general public, shall be adopted, advertised, recorded, and certified as are ordinances of municipal corporations and the record thereof shall be given in all courts the same effect as is given such ordinances. In cases of emergency caused by epidemics of contagious or infectious diseases, or conditions or events endangering the public health, the board may declare such orders and regulations to be emergency measures, and such orders and regulations shall become effective immediately without such advertising, recording, and certifying. (B) In any hearing conducted by the board of health of a city health district, general health district, or combined health district, the board may appoint a referee or examiner to conduct the hearing. In a hearing conducted by a board of health of a city health district, a combined health district, or a general health district at least one member of the board shall be present. The referee or examiner appointed to conduct the hearing shall have the same powers and authority in conducting the hearing as is granted to the board. The referee or examiner shall have been admitted to the practice of law in the state and be possessed of such additional qualifications as the board may require. The referee or examiner shall submit to the board a written report setting forth his findings of fact and conclusions of law and a recommendation of the action to be taken by the board. A copy of such written report and recommendation of the referee or examiner shall, within five days of the date of filing thereof, be served upon the party or his attorney or other representative of record, by certified mail. The party may, within ten days of receipt of the copy of the written report or recommendation, file with the board

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written objections to the report and recommendation, which objections shall be considered by the board before approving, modifying, or disapproving the recommendation. The board may grant extensions of time to the party within which to file such objections. No recommendation of the referee or examiner shall be approved, modified, or disapproved by the board until ten days after the service of the report and recommendation as provided in this section. The board may order additional testimony to be taken or permit the introduction of further documentary evidence. No recommendation shall be final until approved by a quorum of the entire board as indicated by an order on its record of proceedings. Effective Date: 08-06-1976
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3709.21 Orders and regulations of board of general health district. The board of health of a general health district may make such orders and regulations as are necessary for its own government, for the public health, the prevention or restriction of disease, and the prevention, abatement, or suppression of nuisances. Such board may require that no human, animal, or household wastes from sanitary installations within the district be discharged into a storm sewer, open ditch, or watercourse without a permit therefore having been secured from the board under such terms as the board requires. All orders and regulations not for the government of the board, but intended for the general public, shall be adopted, recorded, and certified as are ordinances of municipal corporations and the record thereof shall be given in all courts the same effect as is given such ordinances, but the advertisements of such orders and regulations shall be by publication in one newspaper published and of general circulation within the district. Publication shall be made once a week for two consecutive weeks and such orders and regulations shall take effect and be in force ten days from the date of the first publication. In cases of emergency caused by epidemics of contagious or infectious diseases, or conditions or events endangering the public health, the board may declare such orders and regulations to be emergency measures, and such orders and regulations shall become effective immediately without such advertising, recording, and certifying. Effective Date: 10-01-1953

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