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2009 H1N1 Flu Legal Preparedness

The outbreak of A/H1N1 "swine flu" in the United States and countries around the world has triggered public health emergency legal responses in many jurisdictions. Please visit this page regularly for current information about legal actions and other relevant legal information as it becomes available.

The Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO), funded by CDC's Office of Public Health Preparedness and Response, have completed assessments of legal and other policy barriers, encountered by public health officials responding to the influenza A(H1N1) epidemic. The final reports include findings about the extent to which policies inhibited response and about specific federal, state, and local policies that could be addressed to improve the public health response to future events. The reports also suggest promising practices and opportunities for additional federal, state, and local collaboration to improve or address policies that influence public health response.  The ASTHO report is posted at and the NACCHO report is posted at


Declarations of Emergency or Related Actions

American Samoa
Office of the Governor, American Samoa, Proclamation: Public Health Emergency, (May 1, 2009).
Governor Togiola T.A. Tulafono has declared a public health emergency in American Samoa in response to concerns that cases of H1N1 have been confirmed in countries with direct travel routes to the region.
(posted 5/07/09)

Governor Arnold Schwarzenegger, State of Emergency – Swine Flu, (April 28, 2009).
Pursuant to his powers under the California Constitution and California Emergency Services Act (Cal. Government Code §§ 8448(b), 8625), the Governor has issued a proclamation in response to identified H1N1 Influenza cases in California.
(posted 4/29/09)

Department of Health, Declaration of Public Health Emergency Supplemental Order #01, (May 5, 2009).
The Florida Surgeon General has suspended Chapters 120 and 287, Florida Statutes, to the extent needed to procure any and all supplies of the antivirals Tamiflu and Relenza needed to cope with this emergency.
(posted 5/05/09)

Department of Health, Declaration of Public Health Emergency Supplemental Order #02, (May 5, 2009).
The Florida Surgeon General has suspended wholesale distribution permit requirements under Chapter 499 Part 1, Florida Statutes, to allow the wholesale distribution of Tamiflu and Relenza.
(posted 5/05/09)

Department of Health, Declaration of Public Health Emergency, (May 1, 2009).
The State Surgeon General has declared a public health emergency in response to confirmed cases of H1N1 influenza in two counties.
(posted 5/4/09)

Governor Pat Quinn, Proclamation of Public Health Emergency, (October 14, 2009).

The Governor has declared a public health emergency in response to confirmed cases of H1N1 influenza in the state, pursuant to his authority under Illinois Emergency Management Agency Act, 20 ILCS 3305/7 §7.
(posted 10/30/09)

Governor John E. Baldacci, Proclamation of a Civil Emergency Due to a Highly Infectious Agent, (April 29, 2009). Renewed, (September 30, 2009).
Pursuant to his authority under 37-B M.R.S.A. §§ 741, 742, 824, the Governor has issued a proclamation of civil emergency in response to identified cases of H1N1 influenza in Maine.
(posted 5/1/09)

Governor Martin O’Malley, Declaration of Emergency: Influenza Response and Mitigation, Exec. Order No. 01.01.2009.05, (May 1, 2009).
The Governor has declared an emergency as a result of the possibility of a pandemic in the state and surrounding jurisdictions, pursuant to his authority under MD. Code Ann. Pub. Safety § 14-3A-02.

Governor Martin O’Malley, Declaration of Emergency – Emergency Medical Services Staffing, (November 6, 2009).
The Governor has declared a state of emergency and has authorized Emergency Medical Technician-Paramedics and Cardiac Rescue Technicians to administer 2009 H1N1 Influenza Vaccine.r> (posted 11/20/09)

Governor Dave Heineman, Proclamation, (April 30, 2009).
The Governor of Nebraska declared a state of emergency after one confirmed case in the state.
(posted 5/4/09)

New York
Governor David A. Paterson, Governor Paterson Activates Health Emergency Preparedness Plan; Puts State on ‘High Alert’ for Swine Flu, (April 26, 2009).
After eight confirmed cases of H1N1 Influenza in New York City, Governor Paterson activated the state’s emergency preparedness plan.
(posted 4/29/09)

New York Governor David A. Paterson, Governor Paterson Issues Executive Order To Assist Local Governments With Statewide H1N1 Vaccination Campaign, (October 29, 2009).
The Governor has declared an emergency in response to requests for assistance from local governments.
(posted 10/30/09)

Governor Ted Strickland, Proclamation of Emergency: Authorizing State Agencies and Personnel to Assist with the Receipt, Transportation and Storage of Medicine and Supplies Associated with the Swine Flu Virus, (Issued on April 28, 2009 - Terminated in June 2009).
Following the identification of a patient with H1N1 influenza in Ohio, Gov. Strickland declared a state of emergency and authorized the Ohio National Guard to assist with SNS supplies.
(posted 5/05/09)

Governor Ted Strickland, Emergency Proclamation Regarding the H1N1 Vaccine, (October 9, 2009).
The Governor has issued an emergency proclamation authorizing EMTs-Intermediate and EMTs-Paramedic to perform immunizations under physician medical direction and authorizing registered Ohio Citizen Corps/Ohio Medical Reserve Corps volunteers to assist with the receipt, distribution, and administration of the H1N1 influenza vaccine.
(posted 10/30/09)

Governor Rick Perry, Governor Perry Issues Disaster Proclamation for Swine Influenza, (April 29, 2009).
In response to confirmed cases of H1N1 Influenza in certain Texas jurisdictions, the Governor has announced that a public health emergency exists and has declared a state of disaster.
(posted 04/29/09)

Governor Timothy Kaine, Governor Kaine Announces Precautions to Prepare Virginia to Respond to H1N1 Virus Outbreak, (April 27, 2009).
Prior to the confirmation of H1N1 cases in the state, Virginia Health Commissioner Karen Remley declared a public health emergency.
(posted May 4, 2009)

Governor Jim Doyle, Executive Order #280, Relating to a Proclamation Declaring a Public Health Emergency, (April 30, 2009).
Pursuant to his authority under Wis. Stat. §§ 166.03(1)(b) and 321.39(1)(a), the Governor has issued a proclamation of civil emergency in response in Wisconsin.
(posted 5/01/09)

Isolation/Quarantine Procedures & Draft Orders

The Florida Department of Health has released the following draft orders suitable for use during the current outbreak:
Voluntary Home Quarantine Agreement
Quarantine to Residence Order
Quarantine to Residence Order
Quarantine to Facility Order
Quarantine Detention Order
Quarantine of Facility Order
Building Quarantine Closure Order
Area Quarantine Closure Order

Procedures for Isolation and Quarantine,105 Mass. Code Regs. 300.210 (2008).

North Carolina
The North Carolina Department of Health and Human Services has released the following draft isolation order:
Isolation Order: Swine Influenza A(H1N1) Infection

Procedures for Isolation and Quarantine, Wash. Admin. Code § 246-100-040.

Washington Department of Health (DOH), templates for isolation and quarantine orders.

Mass Vaccination - Legal Authority to Vaccinate

To assist in mass administration of H1N1 vaccine, states are evaluating their laws to determine individuals who are authorized to administer H1N1 vaccines. If necessary, states are amending legal provisions to extend legal authority to administer HlNl vaccine to persons who would not otherwise be permitted to administer vaccine. Three states provide examples:

    Massachusetts emergency regulation passed recently by the Public Health Council (to be effective upon filing with the Secretary of State) authorizing the Commissioner of Public Health to issue an order designating the persons who may administer H1N1 vaccine and the conditions under which the vaccine may be administered. To access the regulation, 105 CMR 700.003(H), please click here.

    Michigan statute authorizing physicians to delegate administration of vaccine to appropriately trained individuals. To access the statute, MCL 333.16215, please click here.

    Recently-amended Minnesota statute extending the authority of the Commissioner of Health to respond to requests of local officials by expanding the categories of persons authorized to administer vaccine. To access Minnesota Statutes section 144.4197 (2008) as amended by Minnesota Laws 2009, chapter 41, section 5, please click here.

School Closure

Department of State Health Services, All Schools in Schertz District to Close, (April 26, 2009).
The Department announced that all 14 schools and two district facilities in this school district were to be closed immediately after the discovery of suspected H1N1 Influenza in that jurisdiction.
(posted 4/29/09)

Insurance Coverage

Insurance Commissioner, Health Insurance Emergency Planning & Procedures (Emergency Rule), (June 16, 2009).
The State Bureau of Insurance issued an emergency preparedness rule "To ensure that all health insurance companies... are adequately prepared to deal with public health emergencies."
Draft Antiviral Shortage Order


The following draft order was provided by the Iowa Department of Public Health:
Antiviral Shortage Order


International Legal Actions

For more information about international legal actions, please visit the Public Health Law and Policy Program, at Arizona State University Sandra Day O'Connor College of Law.

World Health Organization (WHO), Statement by WHO Director-General Dr. Margaret Chan, (April 25, 2009).
The Director-General has determined that the outbreak of H1N1 Influenza constitutes a public health emergency of international concern, pursuant to the International Health Regulations.
(posted 4/29/09)

Department of Health and Ageing, Australia Strengthens Border Surveillance for Swine Flu, (April 27, 2009).
The Commonwealth Chief Medical Officer, Professor Jim Bishop, has authorized the strengthening of border surveillance at airports, including requiring the captains of all planes arriving from the Americas to report to the Australian Quarantine Inspection Service.
(posted 4/29/09)

Public Health Agency of Canada, Government of Canada Provides Update on Prevention Measures Being Taken Regarding Human Swine Influenza, (April 28, 2009).
This News Release details actions taken by the Canadian government, including activating the Government’s emergency Operations Centre.
(posted 4/29/09)

Costa Rica
Presidente de la República Óscar Arias, Decretan Emergencia Sanitaria Nacional por Epidemia Humana de Fiebre Porcina, (April 28, 2009) (in Spanish).
The President of the Republic of Costa Rica has declared a public health emergency.
(posted 5/01/09)

Presidente Felipe de Jesús Calderón Hinojosa, Decreto por el que se Ordenan Diversas Acciones en Materia de Salubridad General, para Prevenir, Controlar y Combatir la Existencia y Transmisión del Virus de Influenza Estacional Epidémica, (April 25, 2009) (in Spanish)..
The President of Mexico has instructed the Ministry of Health to take action to control and combat H1N1 Influenza, including isolation of those identified as carrying the virus, and inspection of passengers.
(posted 4/29/09)

Secretario de Salud, José Ángel Córdova Villalobos, Suspensión de Clases en el Distrito Federal y el Estado de México por Influenza, (April 24, 2009)) (in Spanish).
The Mexican Minister of Health has authorized the closure of schools in these jurisdictions.
(posted 4/29/09)

Court Opinons

Service Employees International Union, Local 121RN, et al. v. Los Robles Regional Medical Center, et al.
United States District Court for the Northern District of California, San Jose Division
C 09-5065 JF (RS)
Filed November 17, 2009
Opinion by Judge Fogel
Injunctive relief from hospital’s implementation of mandatory H1N1 and seasonal flu vaccination policy for healthcare workers denied
(Posted 12/22/2009)

Secondary Sources

David Fidler, The Swine Flu Outbreak and International Law, 13 ASIL Insights (April 27, 2009).


U.S. Senate Committee on Homeland Security and Governmental Affairs held a hearing entitled “Swine Flu: Coordinating the Federal Response,” at 10:00 a.m. ET, on April 29, 2009, at the Dirksen Senate Office Building. A video archive of the hearing, featuring DHS Secretary Janet Napolitano and CDC Interim Deputy Director for Science and Public Health Program, Rear Admiral Anne Schuchat, is available at

Disclaimer: Please note that this information is not legal advice. Any questions regarding the application of specific laws should be directed to your official legal counsel.

Pandemic Influenza Legal Preparedness Tools



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