Chapter 19

10 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 1 CHAPTER 19 EMERGENCY HEALTH POWERS SOURCE: This entire Chapter was enacted by P.L. 26-173:2 (Jan. 5, 2003) unless separately noted. Article 1. Title, Findings, Purposes and Definitio ns. Article 2. Planning for a Public Health Emergency. Article 3. Measures to Detect and Track Public Hea lth Emergencies. Article 4. Declaring a State of Public Health Emer gency. Article 5. Special Powers during a State of Public Health Emergency: Management of Property. Article 6. Special Powers during a State of Public Health Emergency: Protection of Persons. Article 7. Public Information Regarding Public Hea lth Emergency. Article 8. Miscellaneous. ARTICLE 1 TITLE , FINDINGS , PURPOSES AND DEFINITIONS . § 19101. Short Title. § 19102. Legislative Findings. § 19103. Purposes. § 19104. Definitions. § 19101. Short Title. This Chapter may be cited as the 'Islan Guåhan Emer gency Health Powers Act.' § 19102. Legislative Findings. [The Guam Legislature] finds that: (a) the government must do more to protect the heal th, safety and general well being of its citizens; (b) new and emerging dangers, including emergent an d resurgent infectious

islature] finds that: (a) the government must do more to protect the heal th, safety and general well being of its citizens; (b) new and emerging dangers, including emergent an d resurgent infectious diseases and incidents of civi lian mass casualties, pose serious and immediate threats; COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 2 (c) a renewed focus on the prevention, detection, management and containment of public health emergen cies is needed; (d) emergency health threats, including those cause d by bioterrorism, may require the exercise of extraordi nary government powers and functions; (e) the government of Guam must have the ability to respond, rapidly and effectively, to potential or a ctual public health emergencies; (f) the exercise of emergency health powers must promote the common good; (g) emergency health powers must be grounded in a thorough scientific understanding of public health threats and disease transmission; (h) guided by principles of justice and anti- discrimination, it is the duty of the government of Guam to act with fairness and tolerance towards individuals and groups; (i) the rights of People to liberty, bodily integri ty and

ustice and anti- discrimination, it is the duty of the government of Guam to act with fairness and tolerance towards individuals and groups; (i) the rights of People to liberty, bodily integri ty and privacy must be respected to the fullest extent pos sible, consistent with maintaining and preserving the publ ic =s health and security; and (j) this Chapter is necessary to protect the health and safety of the citizens of Guam. § 19103. Purposes. The purposes of this Chapter are: (a) to require the development of a comprehensive p lan to provide for a coordinated, appropriate response in the event of a public health emergency; (b) to authorize the reporting and collection of da ta and records, the management of property, the protection of persons, and access to communications; (c) to facilitate the early detection of a health e mergency, and allow for immediate investigation of such an em ergency COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 3 by granting access to individuals = health information under specified circumstances; (d) to grant the government of Guam and local offic ials the authority to use and appropriate property as ne cessary for the care,

s to individuals = health information under specified circumstances; (d) to grant the government of Guam and local offic ials the authority to use and appropriate property as ne cessary for the care, treatment, vaccination and housing of pat ients, and to destroy contaminated facilities or materials; (e) to grant the government of Guam and local offic ials the authority to provide care, treatment and vaccin ation to persons who are ill, or who have been exposed to co ntagious diseases, and to separate affected individuals from the population at large to interrupt disease transmissi on; (f) to ensure that the needs of infected or exposed persons are properly addressed to the fullest exten t possible, given the primary goal of controlling serious healt h threats, and (g) to provide the government of Guam and local officials with the ability to prevent, detect, mana ge and contain emergency health threats without unduly int erfering with civil rights and liberties. § 19104. Definitions. (a) 'Bioterrorism' is the intentional use of any mi cro- organism, virus, infectious substance or biological product that may be engineered as a result of biotechnology, or any naturally occurring or

(a) 'Bioterrorism' is the intentional use of any mi cro- organism, virus, infectious substance or biological product that may be engineered as a result of biotechnology, or any naturally occurring or bioengineered component of any such microorganism, virus, infectious substance or biolo gical product, to cause death, disease or other biological malfunc tion in a human, an animal, a plant or another living organism in or der to influence the conduct of government or to intimidate or coerc e a civilian population. (b) 'Chain of Custody' is the methodology of tracki ng specimens for the purpose of maintaining control an d accountability from initial collection to final dis position of the specimens, and providing for accountability at each stage of collecting, handling, testing, storing and transpor ting the specimens and reporting test results. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 4 (c) 'Contagious Disease' is an infectious disease t hat can be transmitted from person to person. (d) 'Health Care Facility' means any non-Federal in stitution, building, or agency, or portion thereof, whether pu blic or private (for-profit or nonprofit) that is used,

itted from person to person. (d) 'Health Care Facility' means any non-Federal in stitution, building, or agency, or portion thereof, whether pu blic or private (for-profit or nonprofit) that is used, operated or designed to provide health services, medical treatment or nursi ng, rehabilitative, or preventive care to any person or persons. This includes, but is not limited to: ambulatory surgic al facilities, home health agencies, hospices, hospitals, infirmar ies, intermediate care facilities, kidney treatment cent ers, long term care facilities, medical assistance facilities, men tal health centers, outpatient facilities, public health centers, rehab ilitation facilities, residential treatments facilities, skilled nursing facilities, and adult day-care centers. This also includes, but is not li mited to, the following related property when used for, or in con nection with, the foregoing: laboratories; research facilities; p harmacies; laundry facilities; health personnel training and l odging facilities; patient, guest and health personnel food service fa cilities; and offices and office buildings for persons engaged in health care professions or services.

personnel training and l odging facilities; patient, guest and health personnel food service fa cilities; and offices and office buildings for persons engaged in health care professions or services. (e) 'Health Care Provider' is any person or entity who provides health care services, including, but not l imited to, hospitals, medical clinics and offices, special car e facilities, medical laboratories, physicians, pharmacists, dent ists, physician assistants, nurse practitioners, registered and oth er nurses, paramedics, emergency medical or laboratory technic ians, and ambulance and emergency medical workers. (f) 'Infectious Disease' is a disease caused by a l iving organism or other pathogen, including a fungus, bac teria, parasite, protozoan or virus. An infectious disease may, or m ay not, be transmissible from person to person, animal to pers on, or insect to person. (g) 'Infectious Waste' is: (i) 'biological waste,' which includes blood and bl ood products, excretions, exudates, secretions, suction ing and other body fluids, and waste materials saturated wi th blood or body fluids; COL9/7/202110 GCA HEALTH AND SAFETY CH.

ludes blood and bl ood products, excretions, exudates, secretions, suction ing and other body fluids, and waste materials saturated wi th blood or body fluids; COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 5 (ii) 'cultures and stocks,' which includes etiologi c agents and associated biologicals, including specim en cultures and dishes and devices used to transfer, i noculate and mix cultures, wastes from production of biologi cals and serums, and discarded live and attenuated vaccines; (iii) 'pathological waste,' which includes biopsy materials and all human tissues, anatomical parts t hat emanate from surgery, obstetrical procedures, necro psy or autopsy and laboratory procedures, and animal carca sses exposed to pathogens in research and the bedding an d other waste from such animals, but does not include teeth or formaldehyde, or other preservative agents; and (iv) 'sharps,' which includes needles, I.V . tubing with needles attached, scalpel blades, lancets, breakabl e glass tubes, and syringes that have been removed from the ir original sterile containers. (h) 'Isolation' is the physical separation and conf inement of an individual or groups of individuals

akabl e glass tubes, and syringes that have been removed from the ir original sterile containers. (h) 'Isolation' is the physical separation and conf inement of an individual or groups of individuals who are infe cted or reasonably believed to be infected with a contagiou s or possibly contagious disease from non-isolated individuals, t o prevent or limit the transmission of the disease to non-isolat ed individuals. (i) 'Mental Health Support Personnel' includes, but is not limited to, psychiatrists, psychologists, social wo rkers and volunteer crisis counseling groups. (j) 'Organized Militia' includes the Department of Military Affairs and the Guam National Guard or any other mi litary force organized under the laws of Guam or through empower ment of the Organic Act of Guam. (k) 'Protected health information' is any informati on, whether oral, written, electronic, visual or any ot her form, that relates to an individual =s past, present, or future physical or mental health status, condition, treatment, service, produ cts purchased, or provision of care, and that reveals the identity of the individual whose health care is the subject of the information , or where there is a

us, condition, treatment, service, produ cts purchased, or provision of care, and that reveals the identity of the individual whose health care is the subject of the information , or where there is a reasonable basis to believe such information c ould be utilized, either alone or with other information that is, or should reasonably COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 6 be known to be, available to predictable recipients of such information, to reveal the identity of that individ ual. (l) 'Public health authority' is the Department of Public Health and Social Services; or any local government agency that acts principally to protect or preserve the public =s health; or any person directly authorized to act on behalf of the Department of Public Health and Social Services or local public h ealth agency. The determination of the >Public health authority = shall be determined by I Maga =låhen Guåhan, based upon the circumstances of the public health emergency. The >public health authority = shall be appointed by I Maga =låhen Guåhan by an Executive Order declaring a public health emergency .

han, based upon the circumstances of the public health emergency. The >public health authority = shall be appointed by I Maga =låhen Guåhan by an Executive Order declaring a public health emergency . (m) A 'public health emergency' is an occurrence or imminent threat of an illness or health condition t hat: (1) is believed to be caused by any of the followin g: (i) bioterrorism; (ii) the appearance of a novel or previously controlled or eradicated infectious agent or biolog ical toxin; (iii) a natural disaster relative to an act of God caused by a typhoon, earthquake, tsunami, flood or intra-terrestrial collision; (iv) a chemical attack or accidental release; or(v) a nuclear attack or accident; and (2) poses a high probability of any of the followin g harms: (i) a large number of deaths in the affected population; (ii) a large number of serious or long-term disabilities in the affected population; or (iii) widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of people in the affected population. COL9/7/202110 GCA HEALTH AND SAFETY CH.

pread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of people in the affected population. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 7 (n) 'Public safety authority' means the Guam Police Department; or any local government agency that act s principally to protect or preserve the public safety, or any pe rson directly authorized to act on behalf of the Guam Police Depa rtment or local agency. (o) 'Quarantine' is the physical separation and con finement of an individual or groups of individuals who are, or may have been, exposed to a contagious, or possibly contagio us, disease, and who do not show signs or symptoms of a contagio us disease, from non-quarantined individuals, to prevent or lim it the transmission of the disease to non-quarantined indi viduals. (p) 'Specimens' include, but are not limited to, bl ood, sputum, urine, stool, other bodily fluids, wastes, tissues and cultures necessary to perform required tests. (q) 'Tests' include, but are not limited to, any di agnostic or investigative analyses necessary to prevent the spr ead of disease or protect the public =s health, safety

y to perform required tests. (q) 'Tests' include, but are not limited to, any di agnostic or investigative analyses necessary to prevent the spr ead of disease or protect the public =s health, safety and welfare. (r) 'Superior Court of Guam' is the court designate d by the Public Health Emergency Plan under Article 2 of thi s Chapter when a public health emergency has been declared. ---------- ARTICLE 2 PLANNING FOR A PUBLIC HEALTH EMERGENCY § 19201. Public Health Emergency Planning Commissi on. § 19202. Public Health Emergency Plan. § 19201. Public Health Emergency Planning Commissio n. I Maga’låhen Guåhan [The Governor] shall appoint a Public Health Emergency Planning Commission ('Commi ssion'), consisting of the government of Guam directors, or their designees, of agencies I Maga =låhen Guåhan [The Governor deems relevant to public health emergency preparedn ess, a representative group of Senators from I Liheslaturan Guahån [the Legislature], members of the Judiciary, and any oth er persons chosen by I Maga =låhen Guahån the Governor]. I Maga =låhen COL9/7/202110 GCA HEALTH AND SAFETY CH.

tors from I Liheslaturan Guahån [the Legislature], members of the Judiciary, and any oth er persons chosen by I Maga =låhen Guahån the Governor]. I Maga =låhen COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 8 Guahån [The Governor] shall also designate the chair of t he Commission. § 19202. Public Health Emergency Plan. (a) Content. The Commission shall, within six (6) m onths of its appointment, deliver to I Maga =låhen Guåhan [The Governor] a plan for responding to a public health emergency, that includes provisions or guidelines on the following: (1) notifying and communicating with the population during a state of public health emergency in compli ance with this Chapter; (2) central coordination of resources, manpower and services, including coordination of responses by th e government of Guam, military and Federal agencies; (3) the location, procurement, storage, transportat ion, maintenance, and distribution of essential material s, including but not limited to medical supplies, drug s, vaccines, food, shelter, clothing and beds; (4) compliance with the reporting requirements in § 19301; (5) the continued, effective operation of the Judic ial System

ited to medical supplies, drug s, vaccines, food, shelter, clothing and beds; (4) compliance with the reporting requirements in § 19301; (5) the continued, effective operation of the Judic ial System including, if deemed necessary, the identifi cation and training of personnel to serve as emergency judges regarding matters of isolation and quarantine as described in this Chapter; (6) the method of evacuating populations, and housi ng and feeding the evacuated populations; (7) the identification and training of health care providers to diagnose and treat persons with infect ious diseases; (8) the vaccination of persons, in compliance with the provisions of this Chapter; (9) the treatment of persons who have been exposed to or who are infected with diseases or health conditi ons that may be the cause of a public health emergency; COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 9 (10) the safe disposal of infectious wastes and hum an remains in compliance with the provisions of this C hapter; (11) the safe and effective control of persons isol ated, quarantined, vaccinated, tested or treated during a state of public health emergency; (12) tracking the source and

ovisions of this C hapter; (11) the safe and effective control of persons isol ated, quarantined, vaccinated, tested or treated during a state of public health emergency; (12) tracking the source and outcomes of infected persons; (13) ensuring that each municipality within Guam identifies the following: (i) sites where persons can be isolated or quarantined in compliance with the conditions and principles for isolation or quarantine of this Chap ter; (ii) sites where medical supplies, food, and other essentials can be distributed to the population; (iii) sites where public health and emergency workers can be housed and fed; and (iv) routes and means of transportation of people and materials; (14) cultural norms, values, religious principles a nd traditions that may be relevant; and (15) other measures necessary to carry out the purp oses of this Chapter. (b) Distribution. The Commission shall distribute t his plan to those who will be responsible for its implementatio n, health care providers, other interested persons, and the public , and seek their review and comments. (c) Review. The Commission shall annually review it s plan for responding to a public health emergency.

care providers, other interested persons, and the public , and seek their review and comments. (c) Review. The Commission shall annually review it s plan for responding to a public health emergency. ---------- ARTICLE 3 MEASURES TO DETECT AND TRACK PUBLIC HEALTH EMERGENCIES § 19301. Reporting. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 10 § 19302. Tracking. § 19303. Information Sharing. § 19301. Reporting. § 19301. Reporting. (a) Illness or Health Condition. A health care prov ider, coroner, or medical examiner shall report all cases of persons who harbor any illness or health condition that may be potential causes of a public health emergency. Reportable illnesses and health conditions include, but are not limited to, the dis eases caused by the biological agents listed in 42 C.F.R. § 72, App . A (2000), and any illnesses or health conditions identified by th e public health authority. (b) Pharmacists. In addition to the foregoing requi rements for health care providers, a pharmacist shall report an y unusual or increased prescription rates, unusual types of pres criptions, or unusual trends in pharmacy visits that may be poten tial causes of a public

care providers, a pharmacist shall report an y unusual or increased prescription rates, unusual types of pres criptions, or unusual trends in pharmacy visits that may be poten tial causes of a public health emergency. Prescription-related eve nts that require a report include, but are not limited to: (1) an unusual increase in the number of prescripti ons or over-the-counter pharmaceuticals to treat condition s that the public health authority identifies through regulati ons; (2) an unusual increase in the number of prescripti ons for antibiotics; and (3) any prescription that treats a disease that is relatively uncommon or may be associated with bioterrorism. (c) Manner of Reporting. Suspicion of a Class 1 dis ease as specified by the Director of Public Health and Soci al Services shall be reported within twenty-four (24) hours of diagnosis to the public health authority. The report shall include a s much of the following information as is available: the specifi c illness or health condition that is the subject of the report; the pa tient =s name, date of birth, sex, race, occupation, and current home a nd work addresses (including village) and phone numbers; th e name and

alth condition that is the subject of the report; the pa tient =s name, date of birth, sex, race, occupation, and current home a nd work addresses (including village) and phone numbers; th e name and address of the health care provider, coroner, or me dical examiner and of the reporting individual, if different; and any other information needed to locate the patient for follow -up. For cases COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 11 related to animal or insect bites, the suspected lo cating information of the biting animal or insect, and the name and address of any known owner, shall be reported. (d) Animal Diseases. Every veterinarian, livestock owner, veterinary diagnostic laboratory director, kennels businesses or other person having the care of animals shall repor t animals having or suspected of having any diseases that may be potential causes of a public health emergency. The report sha ll be reported within twenty-four (24) hours of diagnosis to the p ublic health authority to the public health authority and shall include as much of the following information as is available: the specific illness or health condition that is the subject of the

the p ublic health authority to the public health authority and shall include as much of the following information as is available: the specific illness or health condition that is the subject of the report; the suspected locating information of the animal; the name and ad dress of any known owner and phone numbers; and the name, addres s and phone number of the reporting individual. (e) Laboratories. For the purposes of this Section, the definition of 'health care provider' shall include any on-Guam and off-Guam military United States Department of D efense operated or off-Guam medical laboratories; provided , that such laboratories have agreed to the reporting requireme nts of Guam. Results must be reported by the laboratory that per forms the test, but an on-Guam laboratory that sends specimens to a n off-Guam laboratory is also responsible for reporting result s. (f) Enforcement. Failure of a health care provider or veterinarian to report any illness or health condit ion identified by the Director of the Department of Public Health and Social Services as a Class 1 disease in the manner and wit hin the time period specified in this Section shall be reported to the authority or

d by the Director of the Department of Public Health and Social Services as a Class 1 disease in the manner and wit hin the time period specified in this Section shall be reported to the authority or agency responsible for licensing that health ca re provider. The licensing authority shall, at its next regular meet ing, hold a hearing to determine what action, if any, should be taken w ith regard to this report. The penalty for failure to comply with the provisions of this Article may include suspension of license t o practice a healing art for up to thirty (30) days for a first offense, and suspension or revocation of license for a second or subsequent offense. The action taken by the licensing authorit y in any such case shall be reported to the Director of the Depar tment of Public Health and Social Services, published in a paper of public record COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 12 and posted in an appropriate location at the Guam M emorial Hospital and at a conspicuous location at the site of practice of the health care provider. The public health authority m ay also enforce the provisions of this Section in accordance with a ny other laws of

l and at a conspicuous location at the site of practice of the health care provider. The public health authority m ay also enforce the provisions of this Section in accordance with a ny other laws of Guam, Federal laws applicable to Guam and any ot her rules and regulations. (g) Freedom from Liability. No person, health care provider, or health care practice and establishment furnishin g any information, data or report in fulfillment of the p rovisions of this Article shall, by reason of such furnishing, be dee med to have violated any confidential relationship, or be held liable in damages, or be held to answer for willful betrayal of a professional confidence within the meaning and intent of relevan t sections of the Government Code of Guam or the laws of the Unit ed States. § 19302. Tracking. The public health authority shall ascertain the exi stence of cases of an illness or health condition that may be potential causes of a public health emergency; investigate all such cases for sources of infection and to ensure that they are subject to proper control measures; and define the distribution of the illnes s or health condition.

health emergency; investigate all such cases for sources of infection and to ensure that they are subject to proper control measures; and define the distribution of the illnes s or health condition. To fulfill these duties, the public heal th authority shall identify exposed individuals as follows: (a) Identification of Individuals. Acting on inform ation developed in accordance with § 19301 of this Chapte r, or other reliable information, the public health autho rity shall identify all individuals thought to have been expos ed to an illness or health condition that may be a potential cause of a public health emergency. (b) Interviewing of Individuals. The public health authority shall counsel and interview such individu als where needed to assist in the positive identification of exposed individuals and develop information relating to the source and spread of the illness or health condition. Such information includes the name and address, includin g municipality, of any person from whom the illness o r health COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 13 condition may have been contracted and to whom the illness or health condition may have spread.

from whom the illness o r health COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 13 condition may have been contracted and to whom the illness or health condition may have spread. (c) Examination of Facilities or Materials. The pub lic health authority shall, for examination purposes, c lose, evacuate or decontaminate any facility, or decontam inate or destroy any material when the authority reasonably suspects that such facility or material may endanger the pub lic health. (d) Enforcement. The public health authority may enforce the provisions of this Section in accordanc e with existing enforcement rules and regulations. An orde r of the public health authority given to effectuate the pur poses of this Section shall be enforceable immediately by the pub lic safety authority. § 19303. Information Sharing. (a) Whenever the public safety authority or other government of Guam agency learns of a case of a rep ortable illness or health condition, an unusual cluster, or a suspicious event that may be the cause of a public health emer gency, it shall immediately notify the public health authority.

e of a rep ortable illness or health condition, an unusual cluster, or a suspicious event that may be the cause of a public health emer gency, it shall immediately notify the public health authority. (b) Whenever the public health authority learns of a case of a reportable illness or health condition, an unusual cluster, or a suspicious event that it reasonably believes has th e potential to be caused by bioterrorism, it shall immediately notify the public safety authority, Civil Defense, the Guam Memorial Hospital Authority, the Department of Customs and Quarantine and Federal health and public safety authorities. (c) Sharing of information on reportable illnesses, health conditions, unusual clusters or suspicious events b etween public health and safety authorities shall be restricted t o the information necessary for the treatment, control, investigation and prevention of a public health emergency. ---------- ARTICLE 4 DECLARING A STATE OF PUBLIC HEALTH EMERGENCY § 19401. Declaration. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 14 § 19402. Content of Declaration. § 19403. Effect of Declaration § 19404. Enforcement. § 19405. Termination of Declaration.

ation. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 14 § 19402. Content of Declaration. § 19403. Effect of Declaration § 19404. Enforcement. § 19405. Termination of Declaration. § 19401. Declaration. A state of public health emergency may be declared by I Maga =låhen Guåhan [The Governor] upon the occurrence of a ‘public health emergency,’ as defined in § 19104(m) . Prior to such a declaration, I Maga =låhen Guåhan [The Governor] shall consult with the public health authority and may consult wi th any additional public health or other experts as needed . I Maga =låhen Guåhan [The Governor] may act to declare a public health emergency without consulting with the public health authority or other experts when the situation calls for prompt a nd timely action. § 19402. Content of Declaration. A state of public health emergency shall be declare d by an executive order that specifies: (a) the nature of the public health emergency; (b) the geographic area(s) applicable to the declar ation; (c) the conditions that have brought about the publ ic health emergency; (d) the duration of the state of the public health emergency, if less than thirty (30) days; and (e) the

to the declar ation; (c) the conditions that have brought about the publ ic health emergency; (d) the duration of the state of the public health emergency, if less than thirty (30) days; and (e) the primary public health authority responding to the emergency. § 19403. Effect of Declaration. The declaration of a state of public health emergen cy shall activate the disaster response and recovery aspects of the government of Guam. Such declaration authorizes the deployment and use of any forces to which the plans apply and the use or distribution of any supplies, equipment, and materi als and facilities assembled, stockpiled or available pursu ant to this Chapter. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 15 (a) Emergency Powers. During a state of public heal th emergency, I Maga =låhen Guåhan [The Governor] may: (1) through an executive order suspend, the provisions of any regulatory statute prescribing procedures for conducting local business, or the or ders, rules and regulations of any government of Guam agency, to the extent that strict compliance with t he same would prevent, hinder or delay necessary actio n (including emergency purchases) by the

rs, rules and regulations of any government of Guam agency, to the extent that strict compliance with t he same would prevent, hinder or delay necessary actio n (including emergency purchases) by the public healt h authority to respond to the public health emergency , or increase the health threat to the population; (2) utilize all available resources of the governme nt of Guam, as reasonably necessary to respond to the public health emergency; (3) transfer the direction, personnel or functions of the government of Guam departments and agencies in order to perform or facilitate response and recover y programs regarding the public health emergency; (4) mobilize all or any part of the organized milit ia into service; an executive order directing the orga nized militia to report for active duty shall state the p urpose for which it is mobilized and the objectives to be accomplished; (5) provide aid to and seek aid from the Federal Government in accordance with any emergency compact made with the government of Guam; and (6) seek aid from the Federal Government in accordance with Federal programs or requirements. (b) Coordination.

vernment in accordance with any emergency compact made with the government of Guam; and (6) seek aid from the Federal Government in accordance with Federal programs or requirements. (b) Coordination. The public health authority shall coordinate all matters pertaining to the public hea lth emergency response of Guam. The public health autho rity shall have primary jurisdiction, responsibility and authority for: (1) planning and executing public health emergency assessment, mitigation, preparedness response and recovery for Guam; COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 16 (2) coordinating public health emergency response between Federal and local authorities; (3) collaborating with relevant Federal government authorities, elected officials of other states, pri vate organizations or companies; (4) coordinating recovery operations and mitigation initiatives subsequent to public health emergencies; and (5) organizing public information activities regarding public health emergency response operatio ns. (c) Identification. After the declaration of a stat e of public health emergency, special identification for all public health personnel working during the

blic health emergency response operatio ns. (c) Identification. After the declaration of a stat e of public health emergency, special identification for all public health personnel working during the emergency shall be issued as soon as possible. The identification shal l indicate the authority of the bearer to exercise public heal th functions and emergency powers during the state of public hea lth emergency. Public health personnel shall wear the identification in plain view. § 19404. Enforcement. During a state of public health emergency, the publ ic health authority may request assistance in enforcing order s pursuant to this Chapter from the public safety authority. The public safety authority may request assistance from the organized militia in enforcing the orders of the public health authority . § 19405. Termination of Declaration. (a) Executive Order. I Maga =låhen Guåhan [The Governor] shall terminate the declaration of a state of publi c health emergency by executive order upon finding that the occurrence of an illness or health condition that caused the emer gency no longer poses a high probability of a large number of death s in the affected population, a large number

pon finding that the occurrence of an illness or health condition that caused the emer gency no longer poses a high probability of a large number of death s in the affected population, a large number of incidents of serious permanent or long-term disability in the affected population, or a significant risk of substantial future harm to a large number of peo ple in the affected population. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 17 (b) Automatic Termination. Notwithstanding any othe r provision of this Chapter, the declaration of a sta te of public health emergency shall be terminated automatically after t hirty (30) days, unless renewed by I Maga =låhen Guåhan [The Governor] under the same standards and procedures set forth in this Article. Any such renewal shall also be terminated automatically after thirty (30) days, unless renewed by the I Maga =låhen Guåhan [The Governor] under the same standards and procedures set forth in this Article. (c) [The Guam Legislature] . By a majority vote, [T he Guam Legislature] may terminate the declaration of a st ate of public health emergency at any time from the date of origi nal declaration upon finding that the

egislature] . By a majority vote, [T he Guam Legislature] may terminate the declaration of a st ate of public health emergency at any time from the date of origi nal declaration upon finding that the occurrence of an illness or h ealth condition that caused the emergency does not or no longer pos es a high probability of a large number of deaths in the affe cted population, a large number of incidents of serious permanent or long-term disability in the affected population or a signific ant risk of substantial future harm to a large number of people in the affected population. Such a termination by [The Guam Legisla ture] shall override any renewal by I Maga =låhen Guåhan [The Governor] . (d) Content of Termination Order. All orders or leg islative actions terminating the declaration of a state of p ublic health emergency shall indicate the nature of the emergenc y, the area(s) that was threatened and the conditions that make po ssible the termination of the declaration. ---------- ARTICLE 5 SPECIAL POWERS DURING A STATE OF PUBLIC HEALTH EMERGENCY : MANAGEMENT OF PROPERTY § 19501. Emergency Measures Concerning Facilities and Materials. § 19502.

on of the declaration. ---------- ARTICLE 5 SPECIAL POWERS DURING A STATE OF PUBLIC HEALTH EMERGENCY : MANAGEMENT OF PROPERTY § 19501. Emergency Measures Concerning Facilities and Materials. § 19502. Access to and Control of Facilities and P roperty - Generally. § 19503. Safe Disposal of Infectious Waste. § 19504. Safe Disposal of Human Remains. § 19505. Control of Health Care Supplies. § 19506. Compensation. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 18 § 19507. Destruction of Property. § 19501. Emergency Measures Concerning Facilities a nd Materials. The public health authority may exercise, for such period as the state of public health emergency exists, the fo llowing powers over facilities or materials: (a) Facilities. To close, direct and compel the eva cuation of, or to decontaminate or cause to be decontaminat ed any facility of which there is reasonable cause to beli eve that it may endanger the public health. (b) Materials. To decontaminate, or cause to be decontaminated, or destroy any material of which th ere is reasonable cause to believe that it may endanger th e public health. § 19502.

public health. (b) Materials. To decontaminate, or cause to be decontaminated, or destroy any material of which th ere is reasonable cause to believe that it may endanger th e public health. § 19502. Access to and Control of Facilities and Pr operty - Generally. The public health authority may exercise, for such period as the state of public health emergency exists, the fo llowing powers concerning facilities, materials, roads or public a reas: (a) Use of Materials and Facilities. To procure, by condemnation or otherwise, construct, lease, transp ort, store, maintain, renovate, or distribute materials and fac ilities as may be reasonable and necessary to respond to the p ublic health emergency, with the right to take immediate possession thereof. Such materials and facilities i nclude, but are not limited to, communication devices, carriers , real estate, fuels, food and clothing. (b) Use of Health Care Facilities. To require a hea lth care facility to provide services or the use of its facility if such services or use are reasonable and necessary t o respond to the public health emergency as a condition of li censure, authorization or the ability to continue doing busi ness on

its facility if such services or use are reasonable and necessary t o respond to the public health emergency as a condition of li censure, authorization or the ability to continue doing busi ness on Guam as a health care facility. The use of the heal th care facility may include transferring the management an d supervision of the health care facility to the publ ic health authority for a limited or unlimited period of time , but shall COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 19 not exceed the termination of the declaration of a state of public health emergency. (c) Control of Materials. To inspect, control, rest rict, and regulate by rationing and using quotas, prohibition s on shipments, allocation, or other means, the use, sal e, dispensing, distribution or transportation of food, fuel, clothing and other commodities, as may be reasonabl e and necessary to respond to the public health emergency . (d) Control of Roads and Public Areas. (1) To prescribe routes, modes of transportation, and destinations in connection with evacuation of persons or the provision of emergency services.

emergency . (d) Control of Roads and Public Areas. (1) To prescribe routes, modes of transportation, and destinations in connection with evacuation of persons or the provision of emergency services. (2) To control or limit ingress and egress to and from any stricken or threatened public area, the movement of persons within the area, and the occupa ncy of premises therein, if such action is reasonable a nd necessary to respond to the public health emergency . § 19503. Safe Disposal of Infectious Waste. The public health authority may exercise, for such period as the state of public health emergency exists, the fo llowing powers regarding the safe disposal of infectious waste. (a) Adopt Measures. To adopt and enforce measures t o provide for the safe disposal of infectious waste a s may be reasonable and necessary to respond to the public h ealth emergency. Such measures may include, but are not l imited to, the collection, storage, handling, destruction, treatment, transportation and disposal of infectious waste. (b) Control of Facilities. To require any business or facility authorized to collect, store, handle, dest roy, treat, transport and dispose of infectious waste under the

disposal of infectious waste. (b) Control of Facilities. To require any business or facility authorized to collect, store, handle, dest roy, treat, transport and dispose of infectious waste under the laws of Guam, and any landfill business or other such prope rty, to accept infectious waste, or provide services or the use of the business, facility, or property if such action is r easonable and necessary to respond to the public health emergency as a condition of licensure, authorization or the abilit y to continue doing business on Guam as such a business or facili ty. The COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 20 use of the business, facility or property may inclu de transferring the management and supervision of such business, facility or property to the public health authority for a limited or unlimited period of time, but shall no t exceed the termination of the declaration of a state of public health emergency. (c) Use of Facilities. To procure, by condemnation or otherwise, any business or facility authorized to c ollect, store, handle, destroy, treat, transport and dispos e of infectious waste under the laws of Guam, and any la ndfill business or

emnation or otherwise, any business or facility authorized to c ollect, store, handle, destroy, treat, transport and dispos e of infectious waste under the laws of Guam, and any la ndfill business or other such property as may be reasonabl e and necessary to respond to the public health emergency , with the right to take immediate possession thereof. (d) Identification. All bags, boxes or other contai ners for infectious waste shall be clearly identified as con taining infectious waste, and if known, the type of infecti ous waste. § 19504. Safe Disposal of Human Remains. The public health authority may exercise, for such period as the state of public health emergency exists, the fo llowing powers regarding the safe disposal of human remains. (a) Adopt Measures. To adopt and enforce measures t o provide for the safe disposal of human remains as m ay be reasonable and necessary to respond to the public h ealth emergency. Such measures may include, but are not l imited to, the embalming, burial, cremation, interment, disinterment, transportation and disposal of human remains. (b) Possession. To take possession or control of an y human remains. (c) Disposal.

imited to, the embalming, burial, cremation, interment, disinterment, transportation and disposal of human remains. (b) Possession. To take possession or control of an y human remains. (c) Disposal. To order the disposal of any human remains of a person who has died of a contagious di sease through burial or cremation within twenty-four (24) hours after death. To the extent possible, religious, cul tural, family and individual beliefs of the deceased person or th at person =s family shall be considered when disposing of any hu man remains. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 21 (d) Control of Facilities. To require any business or facility authorized to embalm, bury, cremate, inter , disinter, transport and dispose of human remains under the la ws of Guam to accept any human remains or provide the use of its business or facility if such actions are reasonable and necessary to respond to the public health emergency as a condition of licensure, authorization or the abilit y to continue doing business on Guam as such a business or facili ty. The use of the business or facility may include transfe rring the management and supervision of such business or

on or the abilit y to continue doing business on Guam as such a business or facili ty. The use of the business or facility may include transfe rring the management and supervision of such business or faci lity to the public health authority for a limited or unlimi ted period of time, but shall not exceed the termination of th e declaration of a state of public health emergency. (e) Use of Facilities. To procure, by condemnation or otherwise, any business or facility authorized to e mbalm, bury, cremate, inter, disinter, transport and dispo se of human remains under the laws of Guam as may be reasonable and necessary to respond to the public health emergency , with the right to take immediate possession thereof. (f) Labeling. Every human remains prior to disposal shall be clearly labeled with all available informa tion to identify the decedent and the circumstances of deat h. Any human remains of a deceased person with a contagiou s disease shall have an external, clearly visible tag indicating that the human remains is infected and, if known, t he contagious disease. (g) Identification.

s of a deceased person with a contagiou s disease shall have an external, clearly visible tag indicating that the human remains is infected and, if known, t he contagious disease. (g) Identification. Every person in charge of dispo sing of any human remains shall maintain a written or el ectronic record of each human remains and all available info rmation to identify the decedent and the circumstances of d eath and disposal. If human remains cannot be identified pri or to disposal, a qualified person shall, to the extent p ossible, take fingerprints and photographs of the human remains, obtain identifying dental information, and collect a DNA s pecimen. All information gathered under this Paragraph shall be promptly forwarded to the public health authority. § 19505. Control of Health Care Supplies. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 22 (a) Procurement. The public health authority may pu rchase and distribute anti-toxins, serums, vaccines, immun izing agents, antibiotics and other pharmaceutical agents or medi cal supplies that it deems advisable in the interest of preparin g for, or controlling, a public health emergency, without any additional

g agents, antibiotics and other pharmaceutical agents or medi cal supplies that it deems advisable in the interest of preparin g for, or controlling, a public health emergency, without any additional legislative authorization. (b) Rationing. If a state of public health emergenc y results in a Guam-wide or threatened shortage of any product, §19505(a), under (a), whether or not such product has been pur chased by the public health authority, the public health authorit y may control, restrict, and regulate by rationing and using quota s, prohibitions on shipments, allocation, or other means, the use, sale, dispensing, distribution, or transportation of the relevant pro duct necessary to protect the public health, safety and welfare of th e People of Guam. (c) Priority. In making rationing or other supply a nd distribution decisions, the public health authority may give preference to health care providers, disaster respo nse personnel and mortuary staff. (d) Distribution. During a state of public health e mergency, the public health authority may procure, store or d istribute any anti-toxins, serums, vaccines, immunizing agents, a ntibiotics and other pharmaceutical agents or medical

f public health e mergency, the public health authority may procure, store or d istribute any anti-toxins, serums, vaccines, immunizing agents, a ntibiotics and other pharmaceutical agents or medical supplies loc ated within Guam as may be reasonable and necessary to respond to the public health emergency, with the right to take immediate possession thereof. § 19506. Compensation. The government of Guam shall pay just compensation to the owner of any facilities or materials that are lawfu lly taken or appropriated by a public health authority for its t emporary or permanent use under this Article according to the p rocedures and standards set forth in § 19805 of this Chapter. Com pensation shall not be provided for facilities or materials that ar e closed, evacuated, decontaminated or destroyed when there i s reasonable cause to believe that they may endanger the public health pursuant to § 19501. § 19507. Destruction of Property. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 23 To the extent practicable consistent with the prote ction of public health, prior to the destruction of any prop erty under this Article, the public health authority shall institut e

HEALTH POWERS 23 To the extent practicable consistent with the prote ction of public health, prior to the destruction of any prop erty under this Article, the public health authority shall institut e appropriate civil proceedings against the property to be destroyed in accordance with the existing laws and rules of the courts of G uam, or any such rules that may be developed by the courts for use d uring a state of public health emergency. Any property acquired by t he public health authority through such proceedings shall, af ter entry of the decree, be disposed of by destruction as the court may direct. ---------- ARTICLE 6 SPECIAL POWERS DURING A STATE OF PUBLIC HEALTH EMERGENCY : PROTECTION OF PERSONS § 19601. Protection of Persons. § 19602. Medical Examination and Testing. § 19603. Vaccination and Treatment. § 19604. Isolation and Quarantine. § 19605. Procedures for Isolation and Quarantine § 19606. Collection of Laboratory Specimens; Perfo rmance of Tests. § 19607. Access to and Disclosure of Protected Hea lth Information. § 19608. Licensing and Appointment of Health Perso nnel. § 19601. Protection of Persons.

boratory Specimens; Perfo rmance of Tests. § 19607. Access to and Disclosure of Protected Hea lth Information. § 19608. Licensing and Appointment of Health Perso nnel. § 19601. Protection of Persons. During a state of public health emergency, the publ ic health authority shall use every available means to preven t the transmission of infectious disease and to ensure th at all cases of contagious disease are subject to proper control an d treatment. § 19602. Medical Examination and Testing. During a state of public health emergency, the publ ic health authority may perform physical examinations and/or tests as necessary for the diagnosis or treatment of individ uals. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 24 (a) Medical examinations or tests may be performed by any qualified person authorized to do so by the pub lic health authority. (b) Medical examinations or tests must not be such as are reasonably likely to lead to serious harm to th e affected individual. (c) The public health authority may isolate or quarantine, pursuant to §19604, any person whose re fusal of medical examination or testing results in uncertain ty regarding whether that person has

l. (c) The public health authority may isolate or quarantine, pursuant to §19604, any person whose re fusal of medical examination or testing results in uncertain ty regarding whether that person has been exposed to o r is infected with a contagious or possibly contagious d isease, or otherwise poses a danger to public health. § 19603. Vaccination and Treatment. During a state of public health emergency, the publ ic health authority may exercise the following emergency powe rs over persons as necessary to address the public health e mergency. (a) Vaccination. To vaccinate persons as protection against infectious disease and to prevent the sprea d of contagious or possibly contagious disease. (1) Vaccination may be performed by any qualified person authorized to do so by the public health aut hority. (2) A vaccine to be administered must not be such as is reasonably likely to lead to serious harm to the affected individual. (3) To prevent the spread of contagious or possibly contagious disease the public health authority may isolate or quarantine, pursuant to ' 19604, persons who are unable or unwilling for reasons of health, reli gion or conscience to undergo vaccination pursuant

disease the public health authority may isolate or quarantine, pursuant to ' 19604, persons who are unable or unwilling for reasons of health, reli gion or conscience to undergo vaccination pursuant to this Section. (b) Treatment. To treat persons exposed to or infec ted with disease. (1) Treatment may be administered by any qualified person authorized to do so by the public health authority. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 25 (2) Treatment must not be such as is reasonably likely to lead to serious harm to the affected indi vidual. (3) To prevent the spread of contagious or possibly contagious disease the public health authority may isolate or quarantine, pursuant to §19604, persons who are unable or unwilling for reasons of health, reli gion or conscience to undergo treatment pursuant to this Section. § 19604. Isolation and Quarantine. (a) Authorization. During the public health emergen cy, the public health authority may isolate, consistent wit h the definition of ‘isolation’ in §19103(h), or quarantine, consist ent with the definition of >quarantine = in §19103(o), an individual or groups of individuals.

thority may isolate, consistent wit h the definition of ‘isolation’ in §19103(h), or quarantine, consist ent with the definition of >quarantine = in §19103(o), an individual or groups of individuals. This includes individuals or groups wh o have not been vaccinated, treated, tested, or examined pursu ant to §§ 19602 and 19603. The public health authority may also est ablish and maintain places of isolation and quarantine, and se t rules and make orders. Failure to obey these rules, orders or prov isions shall constitute a misdemeanor. (b) Conditions and Principles. The public health au thority shall adhere to the following conditions and princi ples when isolating or quarantining individuals or groups of individuals: (1) Isolation and quarantine must be by the least restrictive means necessary to prevent the spread o f a contagious or possibly contagious disease to others , and may include, but are not limited to, confinement to pri vate homes or other private and public premises. (2) Isolated individuals must be confined separatel y from quarantined individuals. (3) The health status of isolated and quarantined individuals must be monitored regularly to determin e if they require

Isolated individuals must be confined separatel y from quarantined individuals. (3) The health status of isolated and quarantined individuals must be monitored regularly to determin e if they require isolation or quarantine. (4) If a quarantined individual subsequently become s infected, or is reasonably believed to have become infected with a contagious or possibly contagious disease, t hat person must promptly be removed to isolation. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 26 (5) Isolated and quarantined individuals must be immediately released when they pose no substantial risk of transmitting a contagious or possibly contagious di sease to others. (6) The needs of persons isolated and quarantined s hall be addressed in a systematic and competent fashion, including, but not limited to, providing adequate f ood, clothing, shelter, means of communication with thos e in isolation or quarantine and outside these settings, medication and competent medical care. (7) Premises used for isolation and quarantine sha ll be maintained in a safe and hygienic manner, and be de signed to minimize the likelihood of further transmission of infection or other harms to

. (7) Premises used for isolation and quarantine sha ll be maintained in a safe and hygienic manner, and be de signed to minimize the likelihood of further transmission of infection or other harms to persons isolated and qu arantined. (8) To the extent possible, cultural and religious beliefs should be considered in addressing the needs of ind ividuals, and establishing and maintaining isolation and quar antine premises. (c) Cooperation. Persons subject to isolation or qu arantine shall obey the public health authority’s rules and orders; and shall not go beyond the isolation or quarantine premises. Failure to obey these provisions shall constitute a misdemeanor. (d) Entry into Isolation or Quarantine Premises. (1) Authorized Entry. The public health authority m ay authorize physicians, health care workers or others access to individuals in isolation or quarantine as necessary to meet the needs of isolated or quarantined individuals. (2) Unauthorized Entry. No person, other than a per son authorized by the public health authority, shall en ter isolation or quarantine premises. Failure to obey this provis ion shall constitute a misdemeanor. (3) Potential Isolation or Quarantine.

er son authorized by the public health authority, shall en ter isolation or quarantine premises. Failure to obey this provis ion shall constitute a misdemeanor. (3) Potential Isolation or Quarantine. Any person entering an isolation or quarantine premises with o r without authorization of the public health authority may be isolated or quarantined pursuant to §19604(a). COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 27 § 19605. Procedures for Isolation and Quarantine. During a public health emergency, the isolation and quarantine of an individual or groups of individual s shall be undertaken in accordance with the following procedu res. (a) Temporary Isolation and Quarantine Without Noti ce. (1) Authorization. The public health authority may temporarily isolate or quarantine an individual, or groups of individuals, through a written directive if delay in imposing the isolation or quarantine would significantly jeopardize the public health authorit y’s ability to prevent or limit the transmission of a contagious or possibly contagious disease to others . (2) Content of Directive.

rantine would significantly jeopardize the public health authorit y’s ability to prevent or limit the transmission of a contagious or possibly contagious disease to others . (2) Content of Directive. The written directive sha ll specify the following: (i) the identity of the individual(s) or groups of individuals subject to isolation or quarantine; (ii) the premises subject to isolation or quarantine; (iii) the date and time at which isolation or quarantine commences; (iv) the suspected contagious disease if known; and (v) a copy of Article 6 and relevant definitions of this Chapter. (3) Copies. A copy of the written directive shall b e given to the individual to be isolated or quarantin ed or, if the order applies to a group of individuals and it is impractical to provide individual copies, it may be posted in a conspicuous place in the isolation or quarantine premises. (4) Petition for Continued Isolation or Quarantine. Within ten (10) days after issuing the written dire ctive, the public health authority shall file a petition p ursuant to §19605(b) for a court order authorizing the cont inued COL9/7/202110 GCA HEALTH AND SAFETY CH.

ays after issuing the written dire ctive, the public health authority shall file a petition p ursuant to §19605(b) for a court order authorizing the cont inued COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 28 isolation or quarantine of the isolated or quaranti ned individual or groups of individuals. (b) Isolation or Quarantine With Notice. (1) Authorization. The public health authority may make a written petition to the Superior Court of Gu am for an order authorizing the isolation or quarantin e of an individual or groups of individuals. (2) Content of Petition. A petition under Subsectio n (b)(1) shall specify the following: (i) the identity of the individual(s) or groups of individuals subject to isolation or quarantine; (ii) the premises subject to isolation or quarantine; (iii) the date and time at which isolation or quarantine commences; (iv) the suspected contagious disease if known; (v) a statement of compliance with the conditions and principles for isolation and quarantine of §19604(b); and (vi) a statement of the basis upon which isolation or quarantine is justified in compliance with this Article.

liance with the conditions and principles for isolation and quarantine of §19604(b); and (vi) a statement of the basis upon which isolation or quarantine is justified in compliance with this Article. The petition shall be accompanie d by the sworn affidavit of the public health authori ty attesting to the facts asserted in the petition, together with any further information that may be relevant and material to the court =s consideration. (3) Notice. Notice to the individuals or groups of individuals identified in the petition shall be accomplished within twenty-four (24) hours in accordance with the rules of civil procedure. (4) Hearing. A hearing must be held on any petition filed pursuant to this Subsection within five (5) d ays of filing of the petition. In extraordinary circumstan ces and for good cause shown, the public health authority m ay COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 29 apply to continue the hearing date on a petition fi led pursuant to this Section for up to ten (10) days, w hich continuance the court may grant in its discretion g iving due regard to the rights of the affected individual s, the protection of the public =s health, the

is Section for up to ten (10) days, w hich continuance the court may grant in its discretion g iving due regard to the rights of the affected individual s, the protection of the public =s health, the severity of the emergency and the availability of necessary witness es and evidence. (5) Order. The court shall grant the petition if, b y a preponderance of the evidence, isolation or quarant ine is shown to be reasonably necessary to prevent or l imit the transmission of a contagious or possibly contag ious disease to others. (i) An order authorizing isolation or quarantine may do so for a period not to exceed thirty (30) days. (ii) The order shall: (aa) identify the isolated or quarantined individuals, or groups of individuals, by name or shared or similar characteristics or circumstances; (bb) specify factual findings warranting isolation or quarantine pursuant to this Chapter; (cc) include any conditions necessary to ensure that isolation or quarantine is carried out within the stated purposes and restrictions of this Chapter; and (dd) served on affected individuals or groups of individuals in accordance with the rules of civil procedure. (6) Continuances.

ed out within the stated purposes and restrictions of this Chapter; and (dd) served on affected individuals or groups of individuals in accordance with the rules of civil procedure. (6) Continuances. Prior to the expiration of an order issued pursuant to §19605(b)(5), the public h ealth authority may move to continue isolation or quarant ine for additional periods not to exceed thirty (30) da ys each. The court shall consider the motion in accord ance with standards set forth in §19605(b)(5). COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 30 (c) Relief from Isolation and Quarantine. (1) Releases. An individual or group of individuals isolated or quarantined pursuant to this Chapter ma y apply to the Superior Court of Guam for an order to show cause why the individual or group of individua ls should be released. The Court shall rule upon the application to show cause within forty-eight (48) h ours of its filing. If the court grants the application, the Court shall schedule a hearing on the order to show cause within twenty-four (24) hours from issuance of the order to show cause.

t (48) h ours of its filing. If the court grants the application, the Court shall schedule a hearing on the order to show cause within twenty-four (24) hours from issuance of the order to show cause. The issuance of an order to show cau se shall not stay or enjoin an isolation or quarantine order. (2) Remedies for Breach of Conditions. An individual or groups of individuals isolated or quarantined pursuant to this Chapter may request a hearing in the Superior Court of Guam for remedies regarding breaches to the conditions of isolation o r quarantine. A request for a hearing shall not stay or enjoin an isolation or quarantine order. (i) Upon receipt of a request under this Subsection alleging extraordinary circumstances justifying the immediate granting of relief, the Court shall fix a date for hearing on the matters alleged not more than twenty-four (24) hours from receipt of the request. (ii) Otherwise, upon receipt of a request under this Subsection, the Court shall fix a date for hearing on the matters alleged within five (5) days from receipt of the request. (3) Extensions. In any proceedings brought for relief under this Subsection, in extraordinary circumstances and for good

aring on the matters alleged within five (5) days from receipt of the request. (3) Extensions. In any proceedings brought for relief under this Subsection, in extraordinary circumstances and for good cause shown the public health authority may move the Court to extend the t ime for a hearing, which extension the Court in its dis cretion may grant giving due regard to the rights of the af fected individuals, the protection of the public =s health, the COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 31 severity of the emergency and the availability of necessary witnesses and evidence. (d) Proceedings. A record of the proceedings pursuant to this Section shall be made and retained . In the event that, given a state of public health emergenc y, parties cannot personally appear before the Court, proceedi ngs may be conducted by their authorized representatives an d be held via any means that allows all parties to fully part icipate. (e) Court to Appoint Counsel and Consolidate Claims . (1) Appointment. The Court shall appoint counsel at the expense of the government of Guam to represe nt individuals or groups of individuals who are, or wh o are about to be isolated

olidate Claims . (1) Appointment. The Court shall appoint counsel at the expense of the government of Guam to represe nt individuals or groups of individuals who are, or wh o are about to be isolated or quarantined pursuant to the provisions of this Chapter, and who are not otherwi se represented by counsel. Appointments shall be made in accordance with the procedures to be specified in t he Public Health Emergency Plan and shall last through out the duration of the isolation or quarantine of the individual or groups of individuals. The public hea lth authority must provide adequate means of communication between such individuals or groups an d their counsel. (2) Consolidation. In any proceedings brought pursuant to this Section, to promote the fair and e fficient operation of justice and having given due regard to the rights of the affected individuals, the protection of the public =s health, the severity of the emergency and the availability of necessary witnesses and evidence, t he Court may order the consolidation of individual cla ims into group or claims where: (i) the number of individuals involved or to be affected is so large as to render individual participation

ce, t he Court may order the consolidation of individual cla ims into group or claims where: (i) the number of individuals involved or to be affected is so large as to render individual participation impractical; (ii) there are questions of law or fact common to the individual claims or rights to be determined ; COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 32 (iii) the group claims or rights to be determined are typical of the affected individuals = claims or rights; and (iv) the entire group will be adequately represented in the consolidation. 2021 NOTE: This provision was declared 'inorganic and void' by the Supreme Court of Guam in its ruling in a certified question case presented by Governor of Guam Lourdes Leon Guerrero. See In re: Request of Lourdes A. Leon Guerrero, I Maga’hågan Guåhan, Rela tive to the Power of the Executive Branch to Establish, Maintain, and Operate Quarantine Facilities in Guam and to Promulgate Quarantine and Sanitation Regulations for the Protection of Guam Against the Importation and Spread of Disease , 2021 Guam 6 ¶ 2 (July 2, 2021).

perate Quarantine Facilities in Guam and to Promulgate Quarantine and Sanitation Regulations for the Protection of Guam Against the Importation and Spread of Disease , 2021 Guam 6 ¶ 2 (July 2, 2021). The Supreme Cour t determined that 'Section 19605 intrudes too far int o the Governor’s power to operation quarantine stations and regulate quara ntine by dictating substantive quarantine decisions . . . [and] theref ore prevents the Governor from accomplishing her Organic Act responsibilities over quarantine.' 2021 Guam 6 ¶ 50. § 19606. Collection of Laboratory Specimens; Perfor mance of Tests. The public health authority may, for such period as the state of public health emergency exists, collect specimen s and perform tests on living persons as provided in §19602, and also upon deceased persons and any animal (living or deceased ), and acquire any previously collected specimens or test results that are reasonable and necessary to respond to the public h ealth emergency. (a) Marking. All specimens shall be clearly marked. (b) Contamination. Specimen collection, handling, storage and transport to the testing site shall be performed in a manner that will reasonably preclude specimen

ll specimens shall be clearly marked. (b) Contamination. Specimen collection, handling, storage and transport to the testing site shall be performed in a manner that will reasonably preclude specimen contamination or adulteration, and provide for the safe collection, storage, handling and transport of such specimen. (c) Chain of Custody. Any person authorized to coll ect specimens or perform tests shall use chain of custo dy procedures to ensure proper record keeping, handlin g, labeling and identification of specimens to be test ed. This requirement applies to all specimens, including spe cimens collected using on-site testing kits. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 33 (d) Criminal Investigation. Recognizing that, durin g a state of public health emergency, any specimen coll ected or test performed may be evidence in a criminal invest igation, any business, facility or agency authorized to coll ect specimens or perform tests shall provide such suppo rt as is reasonable and necessary to aid in a relevant crimi nal investigation. § 19607. Access to and Disclosure of Protected Heal th Information. (a) Access.

perform tests shall provide such suppo rt as is reasonable and necessary to aid in a relevant crimi nal investigation. § 19607. Access to and Disclosure of Protected Heal th Information. (a) Access. Access to protected health information of persons who have participated in medical testing, treatment , vaccination, isolation, or quarantine programs or efforts by the public health authority during a public health emergency shall be limited to those persons having a legitimate need to acquire o r use the information to: (1) provide treatment to the individual who is the subject of the health information; (2) conduct epidemiologic research; or (3) investigate the causes of transmission. (b) Disclosure. Protected health information held b y the public health authority shall not be disclosed to o thers without individual written, specific informed consent, exce pt for disclosures made: (1) directly to the individual; (2) to the individual =s immediate family members or personal representative; (3) to appropriate Federal agencies or authorities pursuant to Federal law; (4) pursuant to a court order to avert a clear dang er to an individual or to the public health; or (5) to identify a

tive; (3) to appropriate Federal agencies or authorities pursuant to Federal law; (4) pursuant to a court order to avert a clear dang er to an individual or to the public health; or (5) to identify a deceased individual or determine the manner or cause of death. § 19608. Licensing and Appointment of Health Person nel. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 34 The public health authority may exercise, for such period as the state of public health emergency exists, the fo llowing emergency powers regarding licensing and appointmen t of health personnel. (a) Health Care Providers. To require on-Guam healt h care providers to assist in the performance of vacc ination, treatment, examination or testing of any individual as a condition of licensure, authorization or the abilit y to continue to function as a health care provider on Guam. (b) Health Care Providers from Other Jurisdictions. To appoint and prescribe the duties of such out-of-off -Guam emergency health care providers as may be reasonabl e and necessary to respond to the public health emergency . (1) The appointment of off-Guam emergency health care providers may be for a limited or unlim ited

ealth care providers as may be reasonabl e and necessary to respond to the public health emergency . (1) The appointment of off-Guam emergency health care providers may be for a limited or unlim ited time, but shall not exceed the termination of the declaration of a state of public health emergency. The public health authority may terminate the off-Guam appointments at any time or for any reason; provide d, that any such termination will not jeopardize the h ealth, safety and welfare of the People of Guam. (2) The public health authority may waive any or all licensing requirements, permits or fees require d by the Government Code of Guam and applicable orders, rules or regulations for health care providers from other jurisdictions to practice on Guam. (3) Any off-Guam emergency health care provider appointed pursuant to this Section shall not be hel d liable for any civil damages as a result of medical care or treatment related to the response to the public health emergency, unless such damages result from providin g, or failing to provide, medical care or treatment un der circumstances demonstrating a reckless disregard fo r the consequences so as to affect the life or health of

ch damages result from providin g, or failing to provide, medical care or treatment un der circumstances demonstrating a reckless disregard fo r the consequences so as to affect the life or health of the patient. (c) Personnel to Perform Duties of Medical Examiner or Coroner.To authorize the medical examiner or corone r to COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 35 appoint and prescribe the duties of such emergency assistant medical examiners or coroners as may be required fo r the proper performance of the duties of the office. (1) The appointment of emergency assistant medical examiners or coroners may be for a limited or unlimited time, but shall not exceed the terminatio n of the declaration of a state of public health emergen cy. The medical examiner or coroner may terminate such emergency appointments at any time or for any reaso n; provided, that any such termination will not impede the performance of the duties of the office. (2) The medical examiner or coroner may waive licensing requirements, permits, or fees required b y Guam code and applicable orders, rules or regulatio ns for the performance of these duties.

office. (2) The medical examiner or coroner may waive licensing requirements, permits, or fees required b y Guam code and applicable orders, rules or regulatio ns for the performance of these duties. (3) Any emergency assistant medical examiner or coroner appointed pursuant to this Section and acti ng without malice and within the scope of the prescrib ed duties shall be immune from civil liability in the performance of such duties. ---------- ARTICLE 7 PUBLIC INFORMATION REGARDING PUBLIC HEALTH EMERGENCY § 19701. Dissemination of Information § 19702. Access to Mental Health Support Personnel. § 19701. Dissemination of Information. The public health authority shall inform the People of Guam when a state of public health emergency has been de clared or terminated, how to protect themselves during a stat e of public health emergency, and what actions are being taken to control the emergency. (a) Means of Dissemination. The public health autho rity shall provide information by all available and reas onable COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 36 means calculated to bring the information promptly to the attention of the general public. (b) Languages.

ailable and reas onable COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 36 means calculated to bring the information promptly to the attention of the general public. (b) Languages. If the public health authority has r eason to believe there are large numbers of people on Gua m who lack sufficient skills in English to understand the information, the public health authority shall make reasonable efforts to provide the information in th e primary languages of those people as well as in English. (c) Accessibility. The provision of information sha ll be made in a manner accessible to individuals with dis abilities. § 19702. Access to Mental Health Support Personnel. During and after the declaration of a state of publ ic health emergency, the public health authority shall provid e information about and referrals to mental health support person nel to address psychological responses to the public health emerge ncy. ---------- ARTICLE 8 MISCELLANEOUS § 19801. Titles. § 19803. Financing and Expenses. § 19803. Financing and Expenses. § 19804. Liability. § 19805. Compensation. § 19806. Severability. § 19807. Savings Clause. § 19808. Conflicting Laws. § 19809.

itles. § 19803. Financing and Expenses. § 19803. Financing and Expenses. § 19804. Liability. § 19805. Compensation. § 19806. Severability. § 19807. Savings Clause. § 19808. Conflicting Laws. § 19809. Effective Date. § 19801. Titles. For the purposes of this Chapter, titles and subtit les of Articles, Sections, and Subsections are instructive , but not binding. §19802. Rules and Regulations. The public health au thority and other affected agencies are authorized to promulgat e and implement such rules and regulations as are reasona ble and necessary to implement and effectuate the provision s of this Chapter. The public health authority and other affe cted agencies COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 37 shall have the power to enforce the provisions of t his Chapter through the imposition of fines and penalties, the issuance of orders, and such other remedies as are provided by law, but nothing in this Section shall be construed to limit specifi c enforcement powers enumerated in this Chapter. § 19803. Financing and Expenses. (a) Transfer of Funds. I Maga =låhen Guahån [The Governor] may transfer from the General Fund up to One Hundre d Thousand

forcement powers enumerated in this Chapter. § 19803. Financing and Expenses. (a) Transfer of Funds. I Maga =låhen Guahån [The Governor] may transfer from the General Fund up to One Hundre d Thousand Dollars ($100,000.00) monthly as an emergency appro priation upon the declaration of a public health emergency, and upon notification to the United States Centers for Disea se Control ('CDC'), to address, mitigate or abate any catastro phic disease control situations relating to the spread or outbre ak of communicable diseases, or for any biological threat s to mankind. I Maga =ahen Guåhan [The Governor] is allowed to utilize this emergency appropriation up to three (3) consecutive months per emergency notification to the CDC, and at such time shall be subject to I Liheslaturan Guåhan =s appropriation. Notice of any transfer shall be delivered to the Speaker and to t he Committee of Ways and Means of [The Guam Legislature] by I Maga =lahen Guåhan [The Governor] within ten (10) days after such t ransfer. (b) Conditions. A transfer of funds by I Maga =lahen Guåhan [The Governor] under the provisions of this Sectio n may be made only when one (1) or more of the following conditio ns

ter such t ransfer. (b) Conditions. A transfer of funds by I Maga =lahen Guåhan [The Governor] under the provisions of this Sectio n may be made only when one (1) or more of the following conditio ns exist: (1) no appropriation or other authorization is avai lable to meet the public health emergency; (2) an appropriation is insufficient to meet the pu blic health emergency; or (3) Federal monies available for such a public heal th emergency require the use of local or other public monies. (c) Expenses. All expenses incurred by the governme nt of Guam during a state of public health emergency shal l be subject to the following limitations: (1) no expense shall be incurred against the monies authorized under this Section, without the general approval of I Maga =lahen Guåhan [The Governor] ; and COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 38 (2) the aggregate amount of all expenses incurred pursuant to this Section shall not exceed Six Hundr ed Thousand Dollars ($600,000.00) for any fiscal year. Any amounts in excess is subject to [The Guam Legislatu re =s] appropriation § 19804. Liability. (a) Immunity.

ection shall not exceed Six Hundr ed Thousand Dollars ($600,000.00) for any fiscal year. Any amounts in excess is subject to [The Guam Legislatu re =s] appropriation § 19804. Liability. (a) Immunity. Neither the government of Guam, nor, except in cases of gross negligence or willful misconduct, I Maga =lahen Guåhan [The Governor] , the public health authority or an y other government or local official referenced in this Cha pter, is liable for the death of or any injury to persons, or damag e to property, as a result of complying with or attempting to comply with this Chapter, or any rule or regulations promulgated pur suant to this Chapter during a state of public health emergency. (b) Private Liability. (1) During a state of public health emergency, any person owning or controlling real estate or other p remises who voluntarily and without compensation grants a l icense or privilege, or otherwise permits the designation or use of the whole or any part or parts of such real estate or premises for the purpose of sheltering persons, together wit h that person =s successors in interest, if any, shall not be civi lly liable for negligently causing the death of, or inj ury to, any

or premises for the purpose of sheltering persons, together wit h that person =s successors in interest, if any, shall not be civi lly liable for negligently causing the death of, or inj ury to, any person on or about such real estate or premises und er such license, privilege or other permission, or for negl igently causing loss of, or damage to, the property of such person. (2) During a state of public health emergency, any private person, firm or corporation and employees a nd agents of such person, firm or corporation in the performa nce of a contract with, and under the direction of, the gove rnment of Guam or its political subdivisions under the provis ions of this Chapter shall not be civilly liable for causing the death of, or injury to, any person or damage to any property, ex cept in the event of gross negligence or willful misconduct. (3) During a state of public health emergency, any private person, firm or corporation, and employees and agents of such person, firm or corporation, who ren ders COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 39 assistance or advice at the request of the governme nt of Guam or its political subdivisions under the

corporation, who ren ders COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 39 assistance or advice at the request of the governme nt of Guam or its political subdivisions under the provis ions of this Chapter shall not be civilly liable for causing the death of, or injury to, any person or damage to any property, ex cept in the event of gross negligence or willful misconduct. (4) The immunities provided in this Subsection shal l not apply to any private person, firm, or corporation o r employees and agents of such person, firm, or corpo ration whose act or omission caused in whole or in part th e public health emergency, and who would otherwise be liable therefor. § 19805. Compensation. (a) Taking. Compensation for property shall be made only if private property is lawfully taken or appropriated by a public health authority for its temporary or permanent use during a state of public health emergency declared by I Maga =lahen Guåhan [The Governor] pursuant to this Chapter. (b) Actions. Any action against the government of G uam with regard to the payment of compensation shall be brou ght in the courts of Guam in accordance with existing court la ws and rules, or

apter. (b) Actions. Any action against the government of G uam with regard to the payment of compensation shall be brou ght in the courts of Guam in accordance with existing court la ws and rules, or any such rules that may be developed by the cour ts for use during a state of public health emergency. (c) Amount. The amount of compensation shall be cal culated in the same manner as compensation due for taking o f property pursuant to non-emergency eminent domain procedures , as provided in Chapter 15 of Title 21 of the Guam Code Annotated, except that the amount of compensation calculated f or items obtained under § 19505 shall be limited to the cost s incurred to produce the item. § 19806. Severability. The provisions of this Chapter are severable. If an y provision of this Chapter or its application to any person or circumstances is held invalid in a Federal or local court having jur isdiction, the invalidity will not affect other provisions or appl ications of this Chapter that can be given effect without the invali d provision or application. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 40 § 19807. Savings Clause.

or appl ications of this Chapter that can be given effect without the invali d provision or application. COL9/7/202110 GCA HEALTH AND SAFETY CH. 19 EMERGENCY HEALTH POWERS 40 § 19807. Savings Clause. This Chapter does not explicitly preempt other laws or regulations that preserve to a greater degree the p owers of I Maga =lahen Guåhan [The Governor] or public health authority; provided, such laws or regulations are consistent, and do not otherwise restrict or interfere, with the operation or enforcement of the provisions of this Chapter. § 19808. Conflicting Laws. (a) Federal Supremacy. This Chapter does not restri ct any person from complying with Federal law or regulatio ns. (b) Prior Conflicting Acts. In the event of a confl ict between this Chapter and other local laws or regulations co ncerning public health powers, the provisions of this Chapter apply . § 19809. Effective Date. The provisions of this Chapter shall take effect up on signature of I Maga =lahen Guåhan [The Governor]. ---------- COL9/7/2021 COL9/7/2021