DO NOT TAKE THE SWINE FLU SHOT, MORE INFO COMING



WEST TX(August 31, 2009)

If you live in Iowa :


The Iowa Department of Public Health (Department) has determined that you have had contact with a person with Novel Influenza A H1N1. Novel Influenza A H1N1 is a disease which is spread from person to person and is associated fever (greater than 100.0 F), cough, sore throat, rhinorrhea (runny nose), nasal congestion, body aches, headache, chills and fatigue. Novel Influenza A H1N1 presents a risk of serious harm to public health and if it spreads in the community severe public health consequences may result.


The Department has determined that it is necessary to quarantine your movement to a specific facility to prevent further spread of this disease. The Department has determined that quarantine in your home and other less restrictive alternatives are not acceptable because [insert the reason home quarantine is not acceptable, the person violated a previously issued home quarantine order, the person does not have an appropriate home setting conducive to home quarantine, etc.] The Department is therefore ordering you to comply with the following provisions during the entire period of quarantine:

1. Terms of confinement. You are ordered to remain at the quarantine facility, _____________________ [insert name and address of facility], from ___________ to ____________ [insert dates of quarantine].

2. Requirements during confinement. During the period of quarantine:

a. You must not leave the quarantine facility at any time unless you have received prior written authorization from the Department to do so.

b. You must not come into contact with anyone except the following persons:

(i) other persons who are also under similar quarantine order at the quarantine facility;
(ii) authorized healthcare providers and other staff at the quarantine facility;
(iii) authorized Department staff or other persons acting on behalf of the Department; and
(iv) such other persons as are authorized by the Department.

c. Your daily needs, including food, shelter, and medical care, will be provided for you during the period of quarantine at the quarantine facility. You should bring clothing, toiletries, and other personal items with you to the quarantine facility. You will have limited access to a telephone at the quarantine facility. You may bring your cell phone with you should you desire to have greater access to a means of communication.

d. You should inform your employer that you are under quarantine order and are not authorized to physically come to the work place, although you may work from the facility via electronic or other means if appropriate. You should be aware that Iowa law prohibits an employer from firing, demoting, or otherwise discriminating against an employee due to the compliance of an employee with a quarantine order issued by the Department. (Iowa Code section 139A.13A).




4. Legal authority. This order is issued pursuant to the legal authority contained at Iowa Code chapters 135, 139A and 641 Iowa Administrative Code chapter 1, a copy of which is labeled Attachment B and is attached to this order for your review. The Department shall comply with the principles for quarantine contained in subrule 1.9(3) of this attachment when issuing and implementing this order.

5. Ensuring compliance. In order to ensure that you strictly comply with this Quarantine Order the Department or persons authorized by the Department may regularly inspect the quarantine facility.

6. Violations of order. If you fail to comply with this Quarantine Order you may be ordered to be quarantined in a more restrictive facility. In addition, failure to comply with this order is a simple misdemeanor for which you may be arrested, fined, and imprisoned.

If you live in Florida: FL Quarantine Of Facility Order Apr 09 252

Department Of Health
__________ County Health Department

QUARANTINE OF FACILITY ORDER
(Hospital/Medical/Security/Parts Thereof)

By authority of Chapters 381 and 252, Florida Statutes
and Chapter 64D-3, Florida Administrative Code

_____ CHD Order #____________.


Due to an outbreak and/or the high volume of ______________ cases which is a communicable disease or unsafe condition, you, _____________(name)_______________, as the administrator, authorized representative, or person in charge of the ________________________ facility are hereby notified by the _______ County Health Department (CHD) that ___________________ of your facility is placed under a QUARANTINE. This order is in force from the date below until (date) or until QUARANTINE is released by the undersigned authority. No person shall be allowed to enter or leave your facility without the written approval of the undersigned.

While this QUARANTINE is in effect, you shall comply with all orders of the _______ County Health Department.


Other Requirements/Orders:




Reasons For Above:






DONE and ORDERED by the ________ County Health Director/Administrator this ____

day of ___________, 20___.

By order of:

___________________________
________ County Health Department

_________Area Code & Phone Number
(for quarantine review requests, contact person)

DUTY TO COMPLY: This action is taken under the police power authority of the health department and your cooperation is required by law. Violation of any term of this Order or failure to comply during the life of this Order with the above-stated directives, including any attempt by a person to enter, exit or behave in a manner prohibited by the Order, is a CRIME.

RIGHT TO REVIEW. Upon request to the CHD, this Quarantine Order will be reviewed on an expedited basis. Review can be initiated by a phone call to the telephone number of the official whose name appears on this Order.

RIGHT TO CHALLENGE: This Quarantine Order may be challenged, such as through petition for writ of habeas corpus, Ch. 79, F.S., following the procedures set out in Rule 1.630, Florida Rules of Civil Procedure (extraordinary remedies) or by Petition For Administrative Review, sec. 120.569 et seq., F.S.

If you have concerns or questions regarding this Quarantine Order that you wish to discuss with your attorney please do so by telephone. Do not go to your attorney

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