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H.B. 231 Enrolled
This act modifies the Health Code. The act creates the Detection of Public Health
Emergencies Act. The act requires health care providers to report to the Department of
Health when the health care provider suspects that an individual has been exposed to or
harbors an illness or condition resulting from bioterrorism, an epidemic or pandemic
disease, or other highly fatal infectious agent. The act authorizes a health care provider to
report certain emergency illnesses and health conditions. The act specifies the manner and
content of reports. The act authorizes the Department of Health to investigate reports of
suspected bioterrorism or highly fatal, infectious disease. The act provides for limited
sharing of information as necessary to abate a public health emergency. The act provides for
enforcement. The Detection of Public Health Emergencies Act sunsets on July 1, 2004.
This act affects sections of Utah Code Annotated 1953 as follows:
AMENDS:
63-55-226, as last amended by Chapter 3, Laws of Utah 2001
ENACTS:
26-23b-101, Utah Code Annotated 1953
26-23b-102, Utah Code Annotated 1953
26-23b-103, Utah Code Annotated 1953
26-23b-104, Utah Code Annotated 1953
26-23b-105, Utah Code Annotated 1953
26-23b-106, Utah Code Annotated 1953
26-23b-107, Utah Code Annotated 1953
26-23b-108, Utah Code Annotated 1953
26-23b-109, Utah Code Annotated 1953
26-23b-110, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 26-23b-101 is enacted to read:
26-23b-101. Title.
This chapter is known as the "Detection of Public Health Emergencies Act."
Section 2. Section 26-23b-102 is enacted to read:
26-23b-102. Definitions.
As used in this chapter:
(1) "Bioterrorism" means:
(a) the intentional use of any microorganism, virus, infectious substance, or biological
product to cause death, disease, or other biological malfunction in a human, an animal, a plant, or
another living organism in order to influence, intimidate, or coerce the conduct of government or a
civilian population; and
(b) includes anthrax, botulism, small pox, plague, tularemia, and viral hemorrhagic fevers.
(2) "Department" means the Department of Health created in Section 26-1-4 and a local
health department as defined in Section 26A-1-102 .
(3) "Diagnostic information" means a clinical facility's record of individuals who present for
treatment, including the reason for the visit, chief complaint, presenting diagnosis, final diagnosis,
and any pertinent lab results.
(4) "Epidemic or pandemic disease":
(a) means the occurrence in a community or region of cases of an illness clearly in excess
of normal expectancy; and
(b) includes diseases designated by the Department of Health which have the potential to
cause serious illness or death.
(5) "Health care provider" shall have the meaning provided for in Section 78-14-3 .
(6) "Public health emergency" means an occurrence or imminent credible threat of an illness
or health condition, caused by bioterrorism, epidemic or pandemic disease, or novel and highly fatal
infectious agent or biological toxin, that poses a substantial risk of a significant number of human
fatalities or incidents of permanent or long-term disability. Such illness or health condition includes
an illness or health condition resulting from a natural disaster.
(7) "Reportable emergency illness and health condition" includes the diseases, conditions,
or syndromes designated by the Utah Department of Health.
Section 3. Section 26-23b-103 is enacted to read:
26-23b-103. Mandatory reporting requirements -- Contents of reports -- Penalties.
(1) (a) A health care provider shall report to the department any case of any person who the
provider knows has a confirmed case of, or who the provider believes in his professional judgment
is sufficiently likely to harbor any illness or health condition that may be caused by:
(i) bioterrorism;
(ii) epidemic or pandemic disease; or
(iii) novel and highly fatal infectious agents or biological toxins which might pose a
substantial risk of a significant number of human fatalities or incidences of permanent or long-term
disability.
(b) A health care provider shall immediately submit the report required by Subsection (1)(a)
within 24 hours of concluding that a report is required under Subsection (1)(a).
(2) (a) A report required by this section shall be submitted electronically, verbally, or in
writing to the department or appropriate local health department.
(b) A report submitted pursuant to Subsection (1) shall include, if known:
(i) diagnostic information on the specific illness or health condition that is the subject of the
report, and, if transmitted electronically, diagnostic codes assigned to the visit;
(ii) the patient's name, date of birth, sex, race, occupation, and current home and work
address and phone number;
(iii) the name, address, and phone number of the health care provider; and
(iv) the name, address, and phone number of the reporting individual.
(3) The department may impose a sanction against a health care provider for failure to make
a report required by this section only if the department can show by clear and convincing evidence
that a health care provider willfully failed to file a report.
Section 4. Section 26-23b-104 is enacted to read:
26-23b-104. Authorization to report.
(1) A health care provider is authorized to report to the department any case of a reportable
emergency illness or health condition in any person when:
(a) the health care provider knows of a confirmed case; or
(b) the health care provider believes, based on his professional judgment that a person likely
harbors a reportable emergency illness or health condition.
(2) A report pursuant to this section shall include, if known:
(a) the name of the facility submitting the report;
(b) a patient identifier that allows linkage with the patient's record for follow-up
investigation if needed;
(c) the date and time of visit;
(d) the patient's age and sex;
(e) the zip code of the patient's residence;
(f) the reportable illness or condition detected or suspected;
(g) diagnostic information and, if available, diagnostic codes assigned to the visit; and
(h) whether the patient was admitted to the hospital.
(3) (a) If the department determines that a public health emergency exists, the department
may, with the concurrence of the governor and the executive director or in the absence of the
executive director, his designee, issue a public health emergency order and mandate reporting under
this section for a limited reasonable period of time, as necessary to respond to the public health
emergency.
(b) The department may not mandate reporting under this subsection for more than 90 days.
If more than 90 days is needed to abate the public health emergency declared under Subsection
(3)(a), the department must obtain the concurrence of the governor to extend the period of time
beyond 90 days.
(4) (a) Unless the provisions of Subsection (3) apply, a health care provider is not subject
to penalties for failing to submit a report under this section.
(b) If the provisions of Subsection (3) apply, a health care provider is subject to the penalties
of Subsection 26-23-103 (3) for failure to make a report under this section.
Section 5. Section 26-23b-105 is enacted to read:
26-23b-105. Pharmacy reporting requirements.
(1) Notwithstanding the provisions of Subsection 26-23b-103 (1)(a), a pharmacist shall report
unusual drug-related events as described in Subsection (2).
(2) Unusual drug-related events that require a report include:
(a) an unusual increase in the number of prescriptions filled for antimicrobials;
(b) any prescription that treats a disease that has bioterrorism potential if that prescription
is unusual or in excess of the expected frequency; and
(c) an unusual increase in the number of requests for information about or sales of
over-the-counter pharmaceuticals to treat conditions which may suggest the presence of one of the
illnesses or conditions described in Section 26-23b-103 or 26-23b-104 and which are designated by
department rule.
(3) (a) A pharmacist shall submit the report required by this section within 24 hours after the
pharmacist suspects, in his professional judgement, that an unusual drug-related event has occurred.
(b) If a pharmacy is part of a health care facility subject to the reporting requirements of this
chapter, the pharmacist in charge shall make the report under this section on behalf of the health care
facility.
(4) (a) The report required by this section shall be submitted in accordance with Subsection
26-23b-103 (2)(a).
(b) A report shall include the name and location of the reporting pharmacist, the name and
type of pharmaceuticals that are the subject of the unusual increase in use, and if known, the
suspected illness or health condition that is the subject of the report.
(5) A pharmacist is subject to the penalties under Subsection 26-23b-103 (3) for failing to
make a report required by this section.
Section 6. Section 26-23b-106 is enacted to read:
26-23b-106. Medical laboratory reporting requirements.
(1) (a) Notwithstanding the provisions of Subsection 26-23b-103 (1), the director of a
medical laboratory located in this state is responsible for reporting results of a laboratory test that
confirm a condition or illness described in Subsection 26-23b-103 (1) within 24 hours after obtaining
the results of the test. This reporting requirement also applies to results obtained on specimens sent
to an out-of-state laboratory for analysis.
(2) The director of a medical laboratory located outside this state that receives a specimen
obtained inside this state is responsible for reporting the results of any test that confirm a condition
or illness described in Subsection 26-23b-103 (1), within 24 hours of obtaining the results, provided
that the laboratory that performs the test has agreed to the reporting requirements of this state.
(3) If a medical laboratory is part of a health care facility subject to the reporting
requirements of this chapter, the director of the medical laboratory shall make the report required by
this section on behalf of the health care facility.
(4) The report required by this section shall be submitted in accordance with Subsection
26-23b-103 (2).
(5) The director of a medical laboratory is subject to the penalties of Subsection
26-23b-103 (3) for failing to make a report required by this section.
Section 7. Section 26-23b-107 is enacted to read:
26-23b-107. Exemptions from liability.
(1) A health care provider may not be discharged, suspended, disciplined, or harassed for
making a report pursuant to this chapter.
(2) A health care provider may not incur any civil or criminal liability as a result of making
any report under this chapter so long as the report is made in good faith.
Section 8. Section 26-23b-108 is enacted to read:
26-23b-108. Investigation of suspected bioterrorism and diseases.
(1) The department shall:
(a) ascertain the existence of cases of an illness or condition caused by the factors described
in Subsections 26-23b-103 (1) and 26-23b-104 (1);
(b) investigate all such cases for sources of infection or exposure;
(c) ensure that any cases, suspected cases, and exposed persons are subject to proper control
measures; and
(d) define the distribution of the suspected illness or health condition.
(2) (a) Acting on information received from the reports required by this chapter, or other
reliable information, the department shall identify all individuals thought to have been exposed to
an illness or condition described in Subsection 26-23b-103 (1).
(b) The department may request information from a health care provider concerning an
individual's identifying information as described in Subsection 26-23b-103 (2)(b) when:
(i) the department is investigating a potential illness or condition described in Subsection
26-23b-103 (1) and the health care provider has not submitted a report to the department with the
information requested; or
(ii) the department has received a report from a pharmacist under Section 26-23b-105 , a
medical laboratory under Section 26-23b-106 , or another health care provider under Subsection
26-23b-104 (1) and the department believes that further investigation is necessary to protect the
public health.
(c) A health care provider shall submit the information requested under this section to the
department within 24 hours after receiving a request from the department.
(3) The department shall counsel and interview identified individuals as appropriate to:
(a) assist in the positive identification of other cases and exposed individuals;
(b) develop information relating to the source and spread of the illness or condition; and
(c) obtain the names, addresses, phone numbers, or other identifying information of any
other person from whom the illness or health condition may have been contracted and to whom the
illness or condition may have spread.
(4) The department shall, for examination purposes, close, evacuate, or decontaminate any
facility when the department reasonably believes that such facility or material may endanger the
public health due to a condition or illness described in Subsection 26-23b-103 (1).
(5) The department will destroy personally identifying health information about an
individual collected by the department as a result of a report under this chapter upon the earlier of:
(a) the department's determination that the information is no longer necessary to carry out
an investigation under this chapter; or
(b) 180 days after the information is collected.
Section 9. Section 26-23b-109 is enacted to read:
26-23b-109. Enforcement.
The department may enforce the provisions of this chapter in accordance with existing
enforcement laws and regulations.
Section 10. Section 26-23b-110 is enacted to read:
26-23b-110. Information sharing with public safety authorities.
(1) For purposes of this section, "public safety authority" means a local, state, or federal law
enforcement authority including the division of emergency services homeland security, emergency
medical services personnel, and firefighters.
(2) Notwithstanding the provisions of Title 63, Chapter 2, Government Records Access and
Management Act:
(a) whenever a public safety authority suspects a case of a reportable illness or condition
under the provisions of this chapter, it shall immediately notify the department;
(b) whenever the department learns of a case of a reportable illness or condition under this
chapter that it reasonably believes has the potential to be caused by one of the factors listed in
Subsection 26-23b-103 (1), it shall immediately notify the appropriate public safety authority; and
(c) sharing of information reportable under the provisions of this chapter between persons
authorized by this chapter shall be limited to information necessary for the treatment, control,
investigation, and prevention of a public health emergency.
(3) Except to the extent inconsistent with this chapter, Sections 26-6-27 and 26-6-28 apply
to this chapter.
Section 11. Section 63-55-226 is amended to read:
63-55-226. Repeal dates, Title 26.
(1) Title 26, Chapter 1, Department of Health Organization, is repealed July 1, 2006.
(2) Title 26, Chapter 4, Utah Medical Examiner Act, is repealed July 1, 2010.
(3) Title 26, Chapter 9f, Utah Telehealth Commission, is repealed July 1, 2002.
(4) Title 26, Chapter 10, Family Health Services, is repealed July 1, 2010.
(5) Title 26, Chapter 18, Medical Assistance Act, is repealed July 1, 2004.
(6) Title 26, Chapter 23b, Detection of Public Health Emergencies Act, is repealed July 1,
2004.
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