TB Control and the Law

Public health officials in California are re-examining their duties and responsibilities for tuberculosis (TB) control in light of two recent cases regarding the civil detention of a non-compliant TB patient in a county jail. The first case cost the county $1.2 million in settlement funds, and the second resulted in an appeals court decision ordering the county to cease using jail as a civil detention site for persistently nonadherent TB patients. These cases highlight the need for public health professionals to understand the statutory and constitutional limitations on their ability to manage TB patients who are resistant to public health mandates. Public Health Law & Policy has responded to this need by providing a set of reference materials for health officers, their staff, and their attorneys.

Materials

Model Civil Detention Order
This packet contains a model Civil Order of Detention for Tuberculosis, along with several related forms. It is essential to read the Introduction and Overview and to consult with legal counsel before using the forms. Form fields marked with a blue underline may be completed online and then printed for signature.

Model Forms Related to Civil Detention

Legal Analysis

California Tuberculosis Control Law
This 26-page paper summarizes the legal underpinnings of communicable disease control, describes California’s statutory scheme for TB control, and points out some areas of uncertainty relating to the TB control statute.

Memo on Procedural Due Process Requirements for Recipients of TB-Control-Related Home Isolation and Work Exclusion Orders
This memo discusses the due process rights of patients in the context of TB home isolation and work exclusion orders. It provides practical suggestions for giving appropriate deference to individual rights without compromising the fundamental commitment to stop the spread of communicable disease.

FAQs
The first two FAQ sheets provide clear and concise answers to questions that often arise around civil and criminal commitment. The third fact sheet provides a point-by-point comparison of the main steps involved in civil versus criminal detention processes.

Frequently Asked Questions on Civil Commitment

Frequently Asked Questions on Criminal Commitment

Frequently Asked Questions on the Comparison Between Civil and Criminal Commitment

Types of Health Orders
This one-page document enumerates the various types of health orders that the TB control statute allows health officers to issue.

Types of Health Orders Related to TB Control

Checklists
These one-page checklists are designed to make it easy for health officers and their staff to ensure that they are following the statutory requirements when they issue health orders and when they civilly detain persistently nonadherent TB patients.

Checklist on the Required Contents of Health Orders

Checklist on the Legal Rights of Civil Detainees

Flow Charts
These first three of these one-page flow charts depict the stepwise procedures that govern civil detention, release from civil detention, and criminal detention. The final flow chart provides a visual comparison of the differences between the civil and criminal detention procedures.

Flow Chart on Civil Detention

Flow Chart on Procedures for Release

Flow Chart on Criminal Detention

Flow Chart on Comparison of Civil and Criminal Detention

Case Study
This three-page paper describes the facts behind the Fresno litigation involving the civil detention of a Laotian immigrant in the county jail. It concludes with a few questions that invite the reader to apply statutory and constitutional principles to the facts at hand.

Souvannarath Case Study