National Guidelines for the Management of People with HIV Who Place Others at Risk

Level Four: Detention and/or Isolation

Page last updated: April 2008

Level

Likely Pathway

Services to consider

Decision, decision maker and action

Four: detention and/or isolation

Detention and / or isolation under a Detention Order and / or an Isolation Order.

At Level Four, specific powers that may be exercised include:

to order a person to be subject to isolation;
to order a person to be subject to detention.
Issuance of a Detention Order and / or an Isolation Order following advice from HIV Advisory Panel to Chief Health Officer or equivalent.

OR

Urgent referral of case to Chief Health Officer or equivalent by the Chair of HIV Advisory Panel.
Detention in secure premises.

Isolation in an appropriate facility.

Full range of counselling, treatment and support services as required.

Medical / psychological examination at intervals as specified by administrative or judicial body to ensure wellbeing of individual and that Order remains relevant.
Decision is making a Detention Order and / or an Isolation Order.

Made by Chief Health Officer or equivalent considering advice including from Chair of HIV Advisory Panel following Panel deliberations.

Mandatory review by administrative review mechanism or similar and access to avenue of appeal.

Communication of Order and its requirements to client together with offer of support and advocacy services.

Consider options for management under Mental Health Act, Guardianship Act, etc.

Regular review by Panel and advice to Chief Health Officer or equivalent regarding continuation or otherwise of Order, and maintenance, discharge or escalation under Guidelines at not greater than four monthly intervals.
  1. Detention and / or isolation for the purposes of managing HIV public health risk are expected to be rare occurrences, as public health legislation and these Guidelines provide for a flexible range of responses, with detention and isolation considered to be strategies of last resort.
  2. State and Territory Departments’ of Health should ensure that adequate provision is made for a secure environment where persons to whom a Detention Order or Isolation Order applies may be secured. It is not expected that such a facility would be identified and remain unused; rather that a suitable facility could be made available at short notice if required. In addition, arrangements for the staffing of such secure environments on an ad hoc basis should be considered.
  3. Where the client to whom the Detention Order or Isolation Order applies is already detained under a custodial sentence, consideration should be given to the unique circumstances of implementing the Order, including:
  • that client confidentiality, legal and safety issues be considered; and
  • that segregation measures may require negotiation with State and Territory Departments of Corrective Services and / or Juvenile Justice or equivalent.
  1. Written reports of follow up of clients managed under the Guidelines at Level 2 or above must be considered by the Panel at each of its regular meetings (every four months, or more frequently). This will require liaison with the providers of secure detention services as appropriate.