1. Legal Issues in H1N1 Response Jill Moore UNC School of Government

2. Control measures In NC, all persons must comply with communicable disease control measures established by the Commission for Public Health. G.S. 130A-144(f).

3. Control measures Who decides what the control measures will be in North Carolina? –The NC Commission for Public Health. Where does the Commission publish control measures? –In the NC Administrative Code. Where in the Administrative Code can you find the specific H1N1 control measures?

4. 10A N.C.A.C. 41A.0201(a) If the Commission has not adopted specific control measures for a particular communicable disease, then the required control measures for North Carolinians will be the measures published by the CDC in its guidance documents.

5. Evolving control measures Example 1: School closure –In late April, CDC guidance called for schools to be closed if students or staff members became infected with H1N1. –Guidance changed early in the outbreak. At present, not closing schools as a communicable disease control measure.

6. Evolving control measures Example 2: Isolation period –In the last week of June 2009, CDC guidance said people with known or suspected H1N1 should isolate themselves at home for 7 days or until 24 hours after symptoms resolved, whichever was later. –Right now, guidance calls for isolating until 24 hours after fever resolves without the use of fever-reducing medicines.

7. Finding H1N1 control measures www.cdc.gov/h1n1/guidance http://flu.nc.gov/epi/gcdc/H1N1flu.html

9. Local official legal authority: Some examples Local officialAuthority Local health directorOrder isolation or quarantine Order compliance with other control measures Local elected officialsOrder actions authorized by local emergency management ordinances: closures, cancellation of gatherings, etc. Local school officialsClose schools for either disease control reasons or operational reasons

10. How to contact me Jill Moore UNC School of Government 919.966.4442 moore@sog.unc.edu moore@sog.unc.edu