Subchapter A. GENERAL PROVISIONS


Sec.


27.1.    Definitions.
27.2.    Specific identified reportable diseases, infections and conditions.
27.3.    Reporting outbreaks and unusual diseases, infections and conditions.
27.4.    Reporting cases.
27.5.    [Reserved].
27.5a.    Confidentiality of case reports.
27.6.    Disciplinary consequences for violating reporting responsibilities.
27.7.    Cooperation between clinical laboratories and persons who order laboratory tests.
27.8.    Criminal penalties for violating the act or this chapter.

§ 27.1. Definitions.

 The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

   ACIP—The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, United States Department of Health and Human Services.

   AIDS (Acquired Immune Deficiency Syndrome)—As defined by the CDC case definition published in the CDC Morbidity and Mortality Weekly Report (MMWR). (The Department will publish in the Pennsylvania Bulletin a reference to a CDC update of the case definition within 30 days of its publication in the MMWR).

   Act—The Disease Prevention and Control Law of 1955 (35 P. S. § §  521.1—521.21).

   Anonymous HIV Testing—HIV testing performed at a State-designated HIV testing site for an individual who chooses not to provide his name in giving consent for the testing.

   Board—The Advisory Health Board of the Department.

   CDC—Centers for Disease Control and Prevention.

   Caregiver—The entity or individual responsible for the safe and healthful care or education of a child in a child care group setting.

   Carrier—A person who, without any apparent symptoms of a communicable disease, harbors a specific infectious agent and may serve as a source of infection.

   Case—A person or animal that is determined to have or suspected of having a disease, infection or condition.

   Case report form—The form designated by the Department for reporting a case or a carrier.

   Central office—Department headquarters located in Harrisburg.

   Child—A person under 18 years of age.

   Child care group setting—The premises in which care is provided at any one time to four or more children, unrelated to the operator.

   Clinical laboratory—A laboratory for which a permit has been issued to operate as a clinical laboratory under the Clinical Laboratory Act (35 P. S. § §  2151—2165).

   Communicable disease—An illness which is capable of being spread to a susceptible host through the direct or indirect transmission of an infectious agent or its toxic product by an infected person, animal or arthropod, or through the inanimate environment.

   Communicable period—The time during which an etiologic agent may be transferred directly or indirectly from an infected person to another person, or from an infected animal to a person.

   Confidential HIV testing—HIV testing performed for an individual who, in giving his consent for the testing, provides his name and other personal or demographic identifiers.

   Contact—A person or animal known to have had an association with an infected person or animal which presented an opportunity for acquiring the infection.

   County morbidity reporting area—A county so designated by the Board wherein initial reports for communicable and noncommunicable diseases are to be reported to the State health center of the Department.

   Department—The Department of Health of the Commonwealth.

   District office—One of the district headquarters of the Department located within this Commonwealth.

   FDA—Food and Drug Administration.

   HIV services—The range of services, including prevention, counseling, testing, treatment, case management, support and referral services, which are provided to persons infected with or affected by HIV or AIDS, and are intended to alleviate physical and psychosocial problems created by these diseases and conditions.

   Health care facility—

     (i)   A chronic disease, or other type of hospital, a home health care agency, a hospice, a long-term care nursing facility, a cancer treatment center using radiation therapy on an ambulatory basis, an ambulatory surgical facility, a birth center, and an inpatient drug and alcohol treatment facility, regardless of whether the health care facility is operated for profit, nonprofit or by an agency of the Commonwealth or local government.

     (ii)   The term does not include:

       (A)   An office used primarily for the private practice of a health care practitioner.

       (B)   A facility providing treatment solely on the basis of prayer or spiritual means in accordance with the tenets of any church or religious denomination.

       (C)   A facility conducted by a religious organization for the purpose of providing health care services exclusively to clergy or other persons in a religious profession who are members of a religious denomination.

   Health care practitioner—An individual who is authorized to practice some component of the healing arts by a license, permit, certificate or registration issued by a Commonwealth licensing agency or board.

   Health care provider—An individual, a trust or estate, a partnership, a corporation (including associations, joint stock companies and insurance companies), the Commonwealth, or a political subdivision, or instrumentality (including a municipal corporation or authority) thereof, that operates a health care facility.

   Household contact—A person living in the same residence as a case, including a spouse, child, parent, relation or other person, whether or not related to the case.

   Infectious agent—Any organism, such as a virus, bacterium, fungus or parasite, that is capable of being communicated by invasion and multiplication in body tissues and capable of causing disease.

   Isolation—The separation for the communicable period of an infected person or animal from other persons or animals, in such a manner as to prevent the direct or indirect transmission of the infectious agent from infected persons or animals to other persons or animals who are susceptible or who may spread the disease to others.

   LMRO—Local morbidity reporting office—A district office of the Department or a local health department.

   Local health authority—A county or municipal department of health, or board of health of a municipality that does not have a department of health. The term includes a sanitary board.

   Local health department—Each county department of health under the Local Health Administration Law (16 P. S. § §  12001—12028), and each department of health in a municipality approved for a Commonwealth grant to provide local health services under section 25 of the Local Health Administration Law (16 P. S. §  12025).

   Local health officer—The person appointed by a local health authority to head the daily administration of duties imposed upon or permitted of local health authorities by State laws and regulations.

   Medical record—An account compiled by physicians and other health professionals including a patient’s medical history; present illness; findings on physical examination; details of treatment; reports of diagnostic tests; findings and conclusions from special examinations; findings and diagnoses of consultants; diagnoses of the responsible physician; notes on treatment, including medication, surgical operations, radiation, and physical therapy; and progress notes by physicians, nurses and other health professionals.

   Modified quarantine—A selected, partial limitation of freedom of movement determined on the basis of differences in susceptibility or danger of disease transmission which is designated to meet particular situations. The term includes the exclusion of children from school and the prohibition, or the restriction, of those exposed to a communicable disease from engaging in particular activities.

   Monitoring of contacts—The close supervision of persons and animals exposed to a communicable disease without restricting their movement.

   Municipality—A city, borough, incorporated town or township.

   Operator—The legal entity that operates a child care group setting or a person designated by the legal entity to serve as the primary staff person at a child care group setting.

   Outbreak—An unusual increase in the number of cases of a disease, infection or condition, whether reportable or not as a single case, above the number of cases that a person required to report would expect to see in a particular geographic area or among a subset of persons (defined by a specific demographic or other features).

   Perinatal exposure of a newborn to HIV—The potential perinatal transmission of HIV to a newborn indicated by a positive HIV test result for the pregnant woman or mother of a newborn.

   Physician—An individual licensed to practice medicine or osteopathic medicine within this Commonwealth.

   Placarding—The posting on a home or other building of a sign or notice warning of the presence of communicable disease within the structure and the danger of infection therefrom.

   Quarantine

     (i)   The limitation of freedom of movement of a person or an animal that has been exposed to a communicable disease, for a period of time equal to the longest usual incubation period of the disease, or until judged noninfectious by a physician, in a manner designed to prevent the direct or indirect transmission of the infectious agent from the infected person or animal to other persons or animals.

     (ii)   The term does not exclude the movement of a person or animal from one location to another when approved by the Department or a local health authority under §  27.67 (relating to the movement of persons and animals subject to isolation or quarantine by action of a local health authority or the Department).

   Reportable disease, infection, or condition—A disease, infection, or condition, made reportable by §  27.2 (relating to specific identified reportable diseases, infections and conditions).

   SHC—State Health Center—The official headquarters of the Department in a county, other than a district office.

   Secretary—The Secretary of the Department.

   Segregation—The separation for special control or observation of one or more persons or animals from other persons or animals to facilitate the control of a communicable disease.

   Sexually transmitted disease—A disease which, except when transmitted perinatally, is transmitted almost exclusively through sexual contact.

   State-designated anonymous HIV testing site—An HIV testing site supported by the Department either through direct funding or payment for testing, which provides anonymous and confidential testing and which agrees to adhere to the CDC’s counseling and testing standards and guidelines issued by the Department.

   Surveillance of disease—The continuing scrutiny of all aspects of occurrence and spread of disease that are pertinent to effective control.

   Volunteer—A person who provides services to a school or child care group setting without receiving remuneration.

Authority

   The provisions of this §  27.1 amended under section 16(b) of the Disease Prevention and Control Law of 1955 (35 P. S. §  521.16(b)); sections 2102(g), 2106(a) and 2111(b) of The Administrative Code of 1929 (71 P. S. § §  532(g), 536(a) and 541(b)); and section 803 of the Health Care Facilities Act (35 P. S. §  448.803).

Source

   The provisions of this §  27.1 amended January 25, 2002, effective January 26, 2002, 32 Pa.B. 491; amended July 19, 2002, effective July 20, 2002, 32 Pa.B. 3597. Immediately preceding text appears at serial pages (287126) to (287128) and (288381).

Cross References

   This section cited in 28 Pa. Code §  23.82 (relating to definitions).

§ 27.2. Specific identified reportable diseases, infections and conditions.

 The diseases, infections and conditions in Subchapter B (relating to the reporting of diseases, infections and conditions) are reportable to the Department or the appropriate local health authority by the persons or entities in the manner and within the time frames set out in this chapter.

Authority

   The provisions of this §  27.2 amended under sections 4 and 16 of the Disease Prevention and Control Law of 1955 (35 P. S. § §  521.4 and 521.16); and sections 2102(g) and 2111(b) of The Administrative Code of 1929 (71 P. S. § §  532 (g) and 541(b)).

Source

   The provisions of this §  27.2 amended November 26, 1982, effective November 27, 1982, 12 Pa.B. 4057; amended January 16, 1987, effective January 17, 1987, 17 Pa.B. 250; amended August 2, 1991, effective October 2, 1991, 21 Pa.B. 3416; amended January 25, 2002, effective January 26, 2002, 32 Pa.B. 491. Immediately preceding text appears at serial pages (243655) to (243656) and (256555).

Cross References

   This section cited in 6 Pa. Code §  11.3 (relating to definitions); 28 Pa. Code §  5.52 (relating to contents of records); 28 Pa. Code §  27.1 (relating to definitions); 28 Pa. Code §  567.3 (relating to policies and procedures); 55 Pa. Code §  2380.17 (relating to reporting of unusual incidents); 55 Pa. Code §  2380.111 (relating to individual physical examination); 55 Pa. Code §  2380.113 (relating to staff physical examination); 55 Pa. Code §  2380.114 (relating to communicable diseases); 55 Pa. Code §  2600.16 (relating to reportable incidents and conditions); 55 Pa. Code §  2800.16 (relating to reportable incidents and conditions); 55 Pa. Code §  3800.16 (relating to reportable incidents); 55 Pa. Code §  6400.18 (relating to reporting of unusual incidents); 55 Pa. Code §  6400.152 (relating to communicable diseases); 55 Pa. Code §  6500.20 (relating to reporting of unusual incidents); and 55 Pa. Code §  6500.126 (relating to communicable diseases).

§ 27.3. Reporting outbreaks and unusual diseases, infections and conditions.

 (a)  A person required to report under this chapter shall report an outbreak within 24 hours, and in accordance with §  27.4 (relating to reporting cases).

 (b)  A person required to report under this chapter who suspects a public health emergency, shall report an unusual occurrence of a disease, infection or condition not listed as reportable in Subchapter B (relating to reporting of diseases, infections and conditions) or defined as an outbreak, within 24 hours, and in accordance with §  27.4.

 (c)  Any unusual or group expression of illness which the Department designates as a public health emergency shall be reported within 24 hours, and in accordance with §  27.4.

Source

   The provisions of this §  27.3 amended January 25, 2002, effective January 26, 2002, 32 Pa.B. 491. Immediately preceding text appears at serial page (256555).

Cross References

   This section cited in 28 Pa. Code §  5.52 (relating to contents of records); and 28 Pa. Code §  27.35 (relating to reporting cases of diseases in animals).

§ 27.4. Reporting cases.

 (a)  Except for reporting by a clinical laboratory, a case is to be reported to the LMRO serving the area in which a case is diagnosed or identified unless another provision of this chapter directs that a particular type of case is to be reported elsewhere. A clinical laboratory shall make reports to the appropriate office of the Department.

 (b)  Upon the Department’s implementation of its electronic disease surveillance system for certain types of case reports, persons who make those reports shall do so electronically using an application and reporting format provided by the Department. At least 6 months in advance of requiring a type of case report to be reported electronically, the Department will publish a notice in the Pennsylvania Bulletin announcing when electronic reporting is to begin.

 (c)  This section does not prohibit a reporter from making an initial report of a case to the Department or an LMRO by telephone. The reporter will be instructed on how to make a complete case report at the time of the telephone call.

 (d)  Department offices to which this chapter requires specified case reports to be filed are as follows:

   (1)  Cancer Registry, Division of Health Statistics, Bureau of Health Statistics and Research.

   (2)  Division of Infectious Disease Epidemiology, Bureau of Epidemiology.

   (3)  HIV/AIDS Epidemiology Section, Division of Infectious Disease Epidemiology, Bureau of Epidemiology.

   (4)  Division of Newborn Disease Prevention and Identification, Bureau of Family Health.

 (e)  A case shall be reported using the appropriate case report format. Information solicited by the case report form shall be provided by the reporter, irrespective of whether the report is made by submitting the form directly in hard copy or by telecommunication or electronic submission. An appropriate case report form or format may be procured from the office to which the type of case is reportable.

Authority

   The provisions of this §  27.4 issued under sections 2101—2111 of The Administrative Code of 1929 (71 P. S. § §  531—561); amended under section 16 of the Disease Prevention and Control Law of 1955 (35 P. S. §  521.16); sections 3 and 5 of the Newborn Child Testing Act (35 P. S. § §  623 and 625); section 16(a) of the Disease Prevention and Control Law of 1955 (35 P. S. §  521.16(a)); and sections 2102(g) and 2111(b) of The Administrative Code of 1929 (71 P. S. § §  532(g) and 541(b)).

Source

   The provisions of this §  27.4 amended October 24, 1980, effective October 25, 1980, 10 Pa.B. 4212; amended August 19, 1988, effective August 20, 1988, 18 Pa.B. 3697; amended January 25, 2002, effective January 26, 2002, 32 Pa.B. 491; amended May 17, 2002, effective May 18, 2002, 32 Pa.B. 2435. Immediately preceding text appears at serial pages (287130) to (287131).

Cross References

   This section cited in 28 Pa. Code §  5.52 (relating to contents of records); 28 Pa. Code §  27.3 (relating to reporting outbreaks and unusual diseases, infections and conditions); 28 Pa. Code §  27.21a (relating to reporting of cases by health care practitioners and health care facilities); 28 Pa. Code §  27.24a (relating to reporting of cases by veterinarians); 28 Pa. Code §  27.30 (relating to reporting cases of certain diseases in the newborn child); and 28 Pa. Code §  27.35 (relating to reporting cases of disease in animals).

§ 27.5. [Reserved].


Source

   The provisions of this §  27.5 adopted November 26, 1982, effective November 27, 1982, 12 Pa.B. 4057; reserved January 25, 2002, effective January 26, 2002, 32 Pa.B. 491. Immediately preceding text appears at serial page (256556).

§ 27.5a. Confidentiality of case reports.

 Case reports submitted to the Department or to an LMRO are confidential. Neither the reports, nor any information contained in them which identifies or is perceived by the Department or the LMRO as capable of being used to identify a person named in a report, will be disclosed to any person who is not an authorized employe or agent of the Department or the LMRO, and who has a legitimate purpose to access case information, except for any of the following reasons:

   (1)  When disclosure is necessary to carry out a purpose of the act, as determined by the Department or LMRO, and disclosure would not violate another act or regulation.

   (2)  When disclosure is made for a research purpose for which access to the information has been granted by the Department or an LMRO. Access shall be granted only when disclosure would not violate another act or regulation. The research shall be subject to strict supervision by the LMRO to ensure that the use of information disclosed is limited to the specific research purpose and will not involve the further disclosure of information which identifies or is perceived as being able to be used to identify a person named in a report.

Source

   The provisions of this §  27.5a adopted January 25, 2002, effective January 26, 2002, 32 Pa.B. 491.

§ 27.6. Disciplinary consequences for violating reporting responsibilities.

 (a)  Failure of a clinical laboratory to comply with the reporting provisions of this chapter may result in restrictions being placed upon or revocation of the laboratory’s permit to operate as a clinical laboratory, as provided for in the Clinical Laboratory Act (35 P. S. § §  2151—2165) unless failure to report is due to circumstances beyond the control of the clinical laboratory.

 (b)  Failure of a Department licensed health care facility to comply with the reporting provisions of this chapter may result in restrictions being placed upon or revocation of the health care facility’s license, as provided for in the Health Care Facilities Act (35 P. S. § §  448.101—448.904b).

 (c)  Failure of a health care practitioner to comply with the reporting provisions of this chapter may result in referral of that matter to the appropriate licensure board for disciplinary action.

 (d)  Failure of a child care group setting to comply with the reporting provisions of this chapter may result in referral of that matter to the appropriate licensing agency for appropriate action.

Source

   The provisions of this §  27.6 adopted January 25, 2002, effective January 26, 2002, 32 Pa.B. 491.

§ 27.7. Cooperation between clinical laboratories and persons who order laboratory tests.

 To facilitate the reporting of cases by clinical laboratories, the following is required:

   (1)  When a clinical laboratory is requested to conduct a test which, depending upon the results, would impose a reporting duty upon the clinical laboratory, the clinical laboratory shall provide to the person who orders the testing, a form that solicits all information which is required for completion of the applicable case report form.

   (2)  A person who orders testing subject to paragraph (1) shall, at the time of ordering the test, provide the clinical laboratory with the information solicited by the form which that person either possesses or may readily obtain.

Source

   The provisions of this §  27.7 adopted January 25, 2002, effective January 26, 2002, 32 Pa.B. 491.

§ 27.8. Criminal penalties for violating the act or this chapter.

 (a)  A person who violates any provision of the act or this chapter shall, for each offense, upon conviction thereof in a summary proceeding before a district justice in the county wherein the offense was committed, be sentenced to pay a fine of not less than $25 and not more than $300, together with costs, and in default of payment of the fine and costs, shall be imprisoned in the county jail for a period not to exceed 30 days.

 (b)  A person afflicted with communicable tuberculosis, ordered to be quarantined or isolated in an institution, who leaves without consent of the medical director of the institution, is guilty of a misdemeanor, and upon conviction thereof, shall be sentenced to pay a fine of not less than $100 nor more than $500, or undergo imprisonment for not less than 30 days nor more than 6 months, or both.

 (c)  Prosecutions may be instituted by the Department, by a local health authority, or by any person having knowledge of a violation of the act or this chapter.

Source

   The provisions of this §  27.8 adopted January 25, 2002, effective January 26, 2002, 32 Pa.B. 491.



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