During an outbreak of disease, the Texas government or one of its local subdivisions may take certain actions to contain the disease. These actions are called “control measures” and may include quarantine, isolation, decontamination, and detention.
A quarantine order may require a person or group of people to remain at home or in another location, or within a certain geographic area, for a certain duration of time.
These powers stem from the Communicable Disease Prevention and Control Act (ch. 81 of the Health and Safety Code), the Local Public Health Reorganization Act (ch. 121), other laws, and rules in the Texas Administrative Code.
Control orders issued by state or local health authorities during an epidemic may limit civil liberties — such as freedom of movement — in exceptional ways. However, government powers during such a crisis are not absolute.
Activation of Control Measures
The declaration of a public health disaster by the state governor acts as a trigger that immediately grants emergency powers to the State Health Commissioner and public health authorities in their jurisdictions.
Such a state of disaster lasts 30 days and may be renewed one time for an additional 30 days. The governor may terminate a declaration of a public health disaster at any time.
On March 13, 2020, the Texas governor declared a public health disaster over the COVID-19 coronavirus outbreak. “The things we are doing are without precedent at least within living memory,” said State Health Commissioner Dr. John Hellerstedt.
Control Measures for Individuals
During a public health disaster, if a person is suspected of having a communicable disease, public health authorities “may order the individual… to implement control measures that are reasonable and necessary to prevent the introduction, transmission, and spread of the disease in this state” (Health and Safety Code sec. 81.083).
The Texas Administrative Code elaborates: “A health authority may declare a house, building, apartment, room, or place within the health authority’s jurisdiction to be a place of quarantine… No person shall leave or enter the place during the period of quarantine except with specific permission of the health authority” (TAC title 25 ch. 97).
Such an order must be given in writing, and it may only be given if there is “reasonable cause” of suspicion that a person is infected.
In practice, compliance with such orders during an epidemic is generally self-policed. State Health Commissioner John Hellerstadt said at a legislative hearing March 10 that persons who contract COVID-19 will be told to isolate at home for the duration of their illness, unless they get too sick, in which case they may be admitted to a hospital.
However, health authorities do have the power to order a person to be quarantined at a particular hospital or other facility, where entry and exit may be restricted.
Health authorities also have a right of entry to visit a person who is quarantined or isolated. Refusing entry in that circumstance is a Class A misdemeanor. But health authorities cannot enter private residences for health inspections if there isn’t a quarantined person living there.
Area Quarantines
The state health commissioner or a local health authority may impose an area quarantine affecting an entire population: “In establishing quarantine or isolation, the health authority shall designate and define the limits of the areas in which the persons are quarantined or isolated” (TAC title 25 ch. 97).
The law says they must do this “by the least restrictive means necessary to protect the public health” (Health and Safety Code sec. 508.003). In order to enable local health authorities to act quickly, the law allows a local health authority to declare such a quarantine after consulting directly with the state health department, without approval from the local governing body, such as a city council or commissioners court.
The health authority also must publish weekly notices in a newspaper with the details of the orders or instructions in force. However, there is no legal requirement to notify each affected resident individually. Failure or refusal to comply with orders issued under a quarantine is a third-degree felony, punishable by two to ten years in prison and/or a $10,000 fine.
Law enforcement officers “may use reasonable force” to secure a quarantine area and prevent people from entering or leaving, except as directed by state or local health authorities.
Compulsory Testing
State law gives health authorities the power to require testing of persons suspected of exposing others to certain diseases (sec. 81.050). If a person refuses to take such a test, then the health authority can seek a court order requiring the test.
In practice, it seems unlikely that state health authorities will seek to compel persons to submit to testing if they do not want to and also agree to a voluntary period of isolation.
Can the State Compel Certain Treatments?
Technically, yes, a state or local health authority can order a person to be treated or immunized. However, the law makes it rather difficult to enforce such an order. Additionally, it’s important to note that in the case of the COVID-19 outbreak, there is no vaccine and there are no anti-viral drugs approved for use to treat the disease. (Editor’s note: this article was written early in the COVID-19 pandemic, before vaccines and treatments were available).
State Health Commissioner John Hellerstedt pointed out at a legislative hearing March 10 that the treatment plan for someone who tests positive for COVID-19 is “all supportive.” He noted, “There are no anti-viral drugs that exist to knock out the virus.”
Even if immunizations or treatments were available, compulsory treatment would likely not be a viable option politically. State health authorities fall under the oversight of elected officials, including the Texas Legislature, where lawmakers generally in recent years have been accommodative of concerns by persons opposed to immunizations.
Update, November 2020: Following development of a COVID-19 vaccine, state health officials announced that vaccination would be voluntary.
This article is part of Texapedia, the Encyclopedia of Texas Government. Information in this online encyclopedia is drawn from credible sources, including state laws, agency publications, reference books, historical works, the Texas Constitution, and a variety of well-known news sources.
