- Introduced -

SB 712 - This act creates the "Missouri State Emergency Health Powers Act" within a new Chapter 38.

Definitions are provided for related terms, including "bioterrorism", "health care facility", and "public health emergency" (Section 38.100).

Health care providers, coroners and medical examiners must report all cases of suspicious health conditions that may be potential causes of a public health emergency. Pharmacists must report unusual increases in prescriptions for certain medications. Veterinarians or others caring for animals must report suspicious health conditions in animals. A report must be made within twenty-four hours to the Department of Health and Senior Services or a designated public health authority (Section 38.103).

The public health authority must review and investigate all suspicious health conditions and identify exposed individuals. Any order given by the public health authority will be immediately enforced by the public safety authority (Section 38.106).

Notification procedures are outlined for public health and public safety authorities upon the occurrence of suspicious events or conditions. Information sharing is restricted (Section 38.109).

The Governor is required to declare a state of public health emergency upon the occurrence of suspicious health conditions and events that pose a substantial risk of significant fatalities or disabilities. The Governor shall consult with the public health authority, but may act without consultation if necessary (Section 38.112). The emergency shall be declared by an executive order giving details of the emergency (Section 38.115).

Declaration of an emergency will activate disaster response and recovery plans. The deployment and use of forces, supplies, etc. is authorized. The Governor may suspend state business, utilize state resources, mobilize militia, and provide and seek aid. The public health authority will have responsibility for coordinating the response. After declaration, special identification must be issued for public health personnel to indicate their authority to exercise emergency powers during such time (Section 38.118). During an emergency, the public health authority may request assistance from the public safety authority who may, in turn, request assistance from the militia (Section 38.121).

The Governor must terminate the state of emergency upon finding that the incidents no longer pose a substantial risk to the public. An emergency will automatically terminate 30 days after declaration unless renewed by the Governor. The General Assembly may terminate an emergency 60 days after declaration upon finding a substantial risk no longer exists (Section 38.124).

Sections 38.127 - 38.136 give the public health authority certain powers during an emergency to:

- Close or decontaminate dangerous facilities or materials;

- Use facilities, materials, roads, or public areas;

- Safely dispose of infectious waste;

- Safely dispose of corpses.

The public health authority is allowed to purchase and distribute medications and other supplies as necessary to control an emergency, without additional legislative authorization. The public health authority may regulate the use of such products and may give preference to individuals directly involved with the emergency. If other states are affected, this section may not be construed to allow the hoarding of medications or supplies (Section 38.139).

The state must compensate the owner of any facilities or materials that are used by the public health authority during an emergency. Compensation will not be paid if the facility or materials endanger public health (Section 38.142). Prior to the destruction of dangerous property, if possible, the public health authority must institute civil proceedings for the property to be destroyed (Section 38.145).

During an emergency, the public health authority must use all available means to prevent and control the transmission of infectious diseases (Section 38.148). The public health authority will have emergency powers to compel a physical examination of a person, require any physician to perform the exam, and immediately enforce such orders (Section 38.151).

It is the state's public policy to preserve the dignity of isolated or quarantined individuals during an emergency. Adequate necessities shall be provided. Certain emergency powers over such individuals will apply and their failure to follow the authority's provisions will constitute a misdemeanor. No person may enter quarantined premises without permission. Before quarantine, the public health authority must obtain an ex parte order, unless the person poses an immediate threat to public health. Quarantined individuals have the right to a court hearing to contest the order, but may not stay the order of quarantine. After 30 days, continuing quarantine may also be contested and remedies may be sought for treatment during quarantine (Section 38.154).

The public health authority will have emergency powers to compel the vaccination and treatment of a person. Individuals refusing will be guilty of a misdemeanor and may be quarantined if they pose a public health risk (Section 38.157).

During an emergency, the public health authority may collect specimens and perform tests on any person or animal. Chain of custody procedures must be used. Any person or agency authorized to collect specimens or perform tests must provide support in future criminal investigations, if necessary (Section 38.160).

Access to health information of patients will be limited to those with a legitimate need. The public health authority will not disclose information without the patient's informed consent, with certain exceptions (Section 38.163).

The public health authority will have emergency powers to license health personnel, including out-of-state emergency health care providers, and appoint emergency coroners and medical examiners. The authority may terminate a temporary license at any time, but licensure may not continue past the expiration of the emergency. No liability will result from medical care or treatment performed by out-of-state providers during the emergency, unless there is evidence of reckless disregard (Section 38.166).

The public health authority is responsible for notifying the public of the emergency and instructing them on further action (Section 38.169). During and after an emergency, the public health authority must provide information about mental health support and treatment (Section 38.172).

The Governor shall appoint a public health emergency planning commission (Section 38.175). Within six months of appointment, the Commission must deliver a plan to the Governor for responding to an emergency. Provisions are specified (Section 38.178).

The public health authority is authorized to make rules (Section 38.181).

The Governor may transfer funds as necessary to deal with the emergency, if certain conditions are met. All monies must be repaid. Expenses must be approved by the Governor and may not exceed an amount determined by the General Assembly each fiscal year (Section 38.184).

No liability will exist against certain entities and persons for complying with these sections (Section 38.187). Compensation will be paid to persons only if private property is lawfully taken by a public health authority during an emergency. Actions may be brought against the state. Compensation will be calculated in the same manner as for the taking of property through non-emergency eminent domain (Section 38.190). A severability and preemption clause are provided (Sections 38.193 and 38.196).

These sections do not restrict anyone from complying with federal law. These sections will apply in the event of a conflict with other state or local laws (Section 38.199).

Ninety days after the enactment of these sections and every year thereafter, the Governor must make a report to the General Assembly including a specific description of the implementation of the law (Section 38.202).

This act contains an emergency clause.

ERIN MOTLEY