Has the state or any
city or county issued a “shelter-in-place” order?
Yes, Dallas County
became the first entity to issue such an order
yesterday. The City of Waco followed suit today, and
it appears that other cities will be doing so shortly. The governor has
thus far chosen not to do so. He did take action related to cancelling
elective surgeries to free up hospital beds. With regard to further local
shelter-in-place orders, “Local officials have the authority to implement more
strict standards than I as governor have implemented in the state of Texas,”
Abbott said. “If they choose to do so I would applaud them for doing so,
but at this time it is not the appropriate approach to mandate that same strict
standard across every area of the state...”
If a city decides to
issue a shelter-in-place order, should certain businesses and activities be
exempt from the order?
The Dallas County order or City of Waco order could
serve as a template for other local orders. It appears to follow what other
states and localities have done with regard to exemptions. For example,
certain “critical infrastructure”
is typically exempted. In addition, the Texas construction industry,
including the Texas Association of Homebuilders and other associations, has
issued an open letter to elected
officials asking that their work be allowed to continue. (The Dallas
County order contains their suggested language.) Finally, the Federal
Aviation administration has issued guidance to airports related to attempted airport closures.
What is a “public
health authority” under Texas law?
In Texas, a public
health authority is called a “local health authority.” A local health authority
(LHA) is a competent and reputable physician licensed to practice medicine in
Texas who is appointed by a municipality or county to administer state and
local laws relating to public health within the appointing authority’s
applicable jurisdiction. Tex. Health & Safety Code §§ 121.002; 121.022.
Cities that have established local health departments, a public health
district, or that receive grants from Department of State Health Services
(DSHS) for essential public services are required to appoint an LHA. Id.
§§ 121.028(b); 121.033; 121.041. In a city that has a local health
department, the local health department director serves as the city’s LHA,
provided that the director is a physician. Id. § 121.033(d). If the local
health department director is not a physician, he or she is required to appoint
a physician as the LHA, subject to approval by the DSHS and city council. Id. A
city that does not have a local health department may appoint an LHA. Id.
An LHA has supervisory
authority and control over the administration of communicable disease control
measures within his or her jurisdiction unless specifically preempted by the
state. Id. § 81.082. The LHA is also authorized to perform each duty that
is necessary to implement and enforce a law to protect the public health or
prescribed by DSHS, including the right of entry to real property and a right
of access to an individual that is in isolation or quarantine. Id.
§§ 121.024; 81.065. The LHA’s responsibilities also include, among others:
(1) establishing, maintaining, and enforcing quarantine in the LHA’s
jurisdiction; (2) aiding DSHS with local quarantine, inspection, disease
prevention and suppression, birth and death statistics, and general sanitation
within the LHA’s jurisdiction; (3) reporting the presence of contagious,
infectious, and dangerous epidemic diseases in the city; (4) reporting to the
DSHS on any subject on which it is proper for a report to DSHS to be made; and
(5) aiding DSHS in enforcing proper rules, requirements, ordinances, sanitation
laws, quarantine rules, and vital statistics collection. Id. § 121.024.
Does Texas law allow
for disclosure of protected health information to local health authorities or
Yes. The Texas
Communicable Disease Prevention and Control Act (Health & Safety Code
Chapter 81) allows for disclosure of information linking a person who is
exposed to a person with a communicable disease as well as required disclosure
of monitored individuals to first responders. Information related to a person
with a communicable disease can be released generally for statistical purposes
so long as the release protects the identify of the any person. Id. §
81.046(c)(1). Medical or epidemiological information, including information
linking a person who is exposed to a person with a communicable disease, may be
1. for statistical purposes if released in a
manner that prevents the identification of any person;
2. with the consent of each person identified in
3. to medical personnel treating the individual,
appropriate state agencies in this state or another state, a health authority
or local health department in this state or another state, or federal, county,
or district courts to comply with this chapter and related rules relating to
the control and treatment of communicable diseases and health conditions or
under another state or federal law that expressly authorizes the disclosure of
4. to appropriate federal agencies, such as the
Centers for Disease Control and Prevention, but, except as provided under Subsection
(c-3), the information must be limited to the name, address, sex, race, and
occupation of the patient, the date of disease onset, the probable source of
infection, and other requested information relating to the case or suspected
case of a communicable disease or health condition;
5. to medical personnel to the extent necessary
in a medical emergency to protect the health or life of the person identified
in the information;
6. to a designated infection control officer;
7. to governmental entities that provide first
responders who may respond to a situation involving a potential communicable
disease of concern and need the information to properly respond to the
8. to a local health department or health
authority for a designated monitoring period based on the potential risk for
developing symptoms of a communicable disease of concern.
81.046(c)(1)-(8). Only the minimum necessary information may be released
to first responders and local health departments or LHAs for a designated
monitoring period, as determined by an LHA, local health department,
governmental entity, or DSHS. Id. § 81.046(c-2).
Does the Health
Insurance Portability and Accountability Act (HIPAA) allow protected health
information to be disclosed to a local health authority without the
provides that health plans, health care clearinghouses, and health care
providers may use or disclose protected health information without the written
authorization of the individual or the opportunity for the individual to agree
or object to:
(i) A public health
authority that is authorized by law to collect or receive such information for
the purpose of preventing or controlling disease, injury, or disability,
including, but not limited to, the reporting of disease, injury, vital events
such as birth or death, and the conduct of public health surveillance, public
health investigations, and public health interventions; or, at the direction of
a public health authority, to an official of a foreign government agency that
is acting in collaboration with a public health authority.
. . .
(iv) A person who may
have been exposed to a communicable disease or may otherwise be at risk of
contracting or spreading a disease or condition, if the covered entity or
public health authority is authorized by law to notify such person as necessary
in the conduct of a public health intervention or investigation
45 C.F.R. §
164.512(b)(i), (iv). See this U.S. Department of Health and Human Services
bulletin as well.
authority means an agency or authority of the United States, a State, a
territory, a political subdivision of a State or territory, or an Indian tribe,
or a person or entity acting under a grant of authority from or contract with
such public agency, including the employees or agents of such public agency or
its contractors or persons or entities to whom it has granted authority, that
is responsible for public health matters as part of its official mandate. 45
C.F.R. § 164.501.
What can a city
official say publicly about local cases of COVID-19?
A city official can
say how many cases exist in the city so long as they do not identify any
individuals. Tex. Health & Safety Code § 81.046(c)(1). A city should not
disclose any additional information to the public about the cases to avoid
disclosing protected health information. In addition to local resources a city
may have, the Department of State Health Services has a web page with cases in
each Texas county.
Must a LHA disclose
information about COVID-19 to first responders?
Yes. A local health
department or health authority shall provide to first responders the physical
address of a person who is being monitored by the local department or authority
for a communicable disease for the duration of the disease’s incubation period.
Id. § 81.046(c-1). The local health department, health authority, or other
governmental entity, as applicable, shall remove the person’s physical address
from any computer-aided dispatch system after the monitoring period expires.
Reports, records, and
information relating to cases or suspected cases of diseases or health
conditions may be released to the extent necessary during a public health
disaster, including an outbreak of a communicable disease, to law enforcement
personnel and first responders solely for the purpose of protecting the health
or life of a first responder or the person identified in the report, record, or
information. Id. § 81.046(f). Only the minimum necessary information may be
released under this subsection, as determined by the health authority, the
local health department, or the department. Id.
Who is considered a
first responder for the purposes of the Texas Communicable Disease Prevention
and Control Act?
First responders are
defined as public safety employees or volunteers whose duties include
responding rapidly to an emergency. Examples of first responders include peace
officers, fire protection personnel, certified firefighters or members of an
organized volunteer firefighting unit, and individuals certified as emergency
medical services personnel by DSHS. Tex. Gov’t Code § 421.095(1).
received under the Texas Communicable Disease Prevention and Control Act
considered public information under the Public Information Act?
No. Reports, records,
and information relating to cases or suspected cases of diseases or health
conditions are not public information under Chapter 552 of the Government Code.
Tex. Health & Safety Code § 81.046(b). This also includes investigations by
local health authorities into suspected cases of diseases. Open Records Decision No. 577
(1990) (concluding that any information acquired or created during
an investigation under Chapter 81 of the Health and Safety Code is confidential
and may not be released unless an exception set out in the statute applies);
Op. Tex. Att’y Gen. No. OR2009-10186 (2009) (concluding information gathered or
created by the city’s health department pursuant to the provisions of chapter
81 were not subject to disclosure under the Public Information Act).
Has TCEQ extended the
deadlines for occupational licenses renewal?
Yes. In response
to the disaster declaration issued by the governor, TCEQ is extending the expiration dates of all
occupational licenses expiring in March and April of 2020 by 30
days. These occupational licenses include the following:
Assembly Tester (BPAT)
Technician and Inspector
Storage Tank (LPST) Corrective Action Specialist and Project Manager
-Municipal Solid Waste
Facilities (OSSFs), including Septic Tanks
-Smoke School: Visible
Tank Contractors and On-Site Supervisors
Has TCEQ extended the
deadlines for the continuing education requirements for renewal of occupational
No. TCEQ is
encouraging anyone with continuing education requirements to seek online training opportunities
Has TCEQ canceled
occupational license exams?
Yes. In the
interest of safety, paper exams have been cancelled through May 2020. In
addition, computer-based testing (CBT) is not currently available. Therefore,
TCEQ is extending the validity of new applications until testing is available.
If you have an approved application on file, you will not be required to reapply
and pay the application fee again.
For other questions or
concerns, please email email@example.com.
Can hotels in our city
be used to quarantine or treat COVID-19 patients?
The Texas Hotel and
Lodging Association (THLA)has reached out to TML to offer some member hotels to
cities for that purpose. THLA recommends the following:
1. Each city should work with its national CDC
contact and the city’s local health authorities to determine the potential
worst case need for separate living accommodation units (e.g.; separate hotel
rooms) for quarantined individuals, recovering individuals, other at-risk
populations, and for medical and emergency providers.
2. THLA can provide a list of hotels that are
willing to work with their local government entity to lease their facilities
for that purpose. THLA already has a list of over 600 hotels statewide
that are willing to enter into such a lease agreement and can expand that list
3. THLA has a sample lease document that has been
used for this purpose in other states that we have adapted for Texas and we can
provide to your city legal department. The leases can be edited and
adjusted to meet the particular needs of the community and the hotel.
4. Each city should determine NOW the specific
duties that it would contract for in such accommodation lease scenarios, and
with what entities for items such as food service, staffing, maintenance,
etc. A city will not want to have to figure out these items in the height
of the health crisis.
5. Lodging industry leaders are ready to work
with each city’s leadership on developing working protocols in advance on all
of these items.
6. If done successfully, each city will already
have an option contract for all of the potential quarantine and recovery space
that it may need in the worst case scenario. This will help get the community
through this crisis and keep hospitals and medical workers safer and focused on
treating the most critical care patients.
According to THLA, “we
are ready to provide this partnership and want to do everything we can to
ensure readiness and the optimal resources for this health crisis. Please
contact us as soon as possible to ensure and formalize this resource.” THLA
can be reached at 512-474-2996.
Where can I find
archived issues of the TML Coronavirus Updates?
Coronavirus Updates are archived chronologically here and by subject here.