Ala. Admin. Code r. 420-4-1 420-4-1-.04

Current through Register Vol. 42, No. 11, August 30, 2024

Section 420-4-1-.04 - Reporting

(1) Responsibility for Reporting. Each physician, dentist, nurse, medical examiner, hospital administrator, nursing home administrator, laboratory director, school principal, and child care center/Head Start director shall be responsible to report cases or suspected cases of notifiable diseases and health conditions. Reports by laboratories as outlined in 420-4-1-.04(3) shall not substitute for reports by persons responsible for reporting cases or suspected cases of notifiable diseases and health conditions. Said report shall contain such data as may be required by the rules of the State Board of Health. Said report shall be in the manner designated in Rule 420-4-1-.04(3) -(7).

(2) Reports by Pharmacists. Pharmacists shall report to the State Health Officer or designee in the manner designated in Rule 420-4-1-.04(4) -(7) the dispensing of:

(a) Any anti-tuberculosis medication.

(b) Any antiretroviral (ARV) medication to an infant < 18 months of age.

(3) Reports by Laboratories. Laboratories shall report laboratory test results to the Department by electronic means as specified by the Department within the designated time required by disease category for the corresponding disease/condition not to exceed 24 hours. All reportable laboratory test results for laboratories are listed in Appendix II. In addition to the minimum data elements outlined in 420-4-1-.04(7), laboratories shall report test method, specimen source, specimen collection date, and reference ranges. All HIV viral loads and CD4 counts shall be reported by laboratories regardless of the result.

(4) Report of Immediate, Extremely Urgent Diseases. Diseases designated as immediate, extremely urgent shall be reported to the State Health Officer or the County Health Officer within 4 hours of presumptive diagnosis or laboratory test result by telephone.

If reported to the County Health Officer, the County Health Officer shall report to the State Health Officer or designee at the state public health office within the same 4 hours.

(5) Report of Immediate, Urgent Diseases. Diseases designated as immediate, urgent shall be reported to the State Health Officer or the County Health Officer within 24 hours of presumptive diagnosis or laboratory test result by electronic means as specified by the Department or by telephone. If reported to the County Health Officer, the County Health Officer shall report to the State Health Officer or designee at the state public health office within the same 24 hours.

(6) Report of Standard Notification Diseases. Diseases and health conditions designated as standard notification diseases shall require notification by electronic means as specified by the Department, in writing, or by telephone to either the County Health Officer or the State Health Officer within 3 days of diagnosis. If reported to the County Health Officer, the County Health Officer shall report to the State Health Officer or designee at the state public health office within the same time frame.

(7) Minimum information to be reported. Reports shall include, at a minimum: the name of the disease or health condition; the name, date of birth, sex, ethnicity, race, address, and phone number(s) of the person having said disease or health condition; the date of onset, date of laboratory result, and/or date of diagnosis of said disease or health condition; and name, phone number, and the facility affiliated with the reporter.

(8) Reporting of Birth Defects. Each healthcare facility, healthcare provider, or physician who diagnoses the birth defect shall be responsible to report diagnoses of the designated birth defects made prenatally, at delivery, and up to 12 months of age to the Department as the State Health Officer considers necessary and appropriate for the prevention and early detection of birth defects to facilitate health surveillance of the incidence and prevalence of birth defects in Alabama. In addition to the minimum data elements outlined in 420-4-1-.04(7), for birth defects, the following shall also be reported:

(a) Mother's individual identifiable health information and demographics.

(b) Identification/diagnosis associated with the following conditions:

* Anencephalus

* Anotia/microtia

* Atrioventricular septal defect

* Cleft lip and/or palate

* Common truncus arteriosus

* Gastroschisis

* Hypoplastic left heart syndrome

* Limb deficiencies

* Spina bifida

* Tetralogy of Fallot

* Total anomalous pulmonary venous connection

* Transposition of great arteries

* Trisomy 21 (Down syndrome)

(c) Other information as necessary to identify the patient and ensure accuracy and completeness.

(9) Supplemental Case Report Information. The State Health Officer may require additional information concerning any of the notifiable diseases or health conditions in order to properly investigate and control said disease or health condition. For this purpose, the State Health Officer may designate supplemental forms for various notifiable diseases for collecting the required information. Physicians, hospitals, nurses, and others as required by law shall, in addition to the basic information required on the initial report, provide such information as required on the supplemental report for those diseases so designated. Such case report information is confidential and shall not be subject to public inspection or admission into evidence in any court except via proceedings brought under this chapter to compel the examination, testing, commitment or quarantine of any person, or upon the written consent of the patient, provided that other persons are not so identified.

(10) Epidemiologic Study Information. The State Health Officer, or his or her designee, may require additional investigation of confirmed or suspected a) outbreaks or any kind, (b) cases of notifiable diseases and conditions, (c) exposures to notifiable diseases or conditions, (d) cases of diseases of potential public health importance, or e) exposures to environmental hazards, by collecting information from the individuals suspected of being part of the outbreak, from individuals with the suspected or confirmed notifiable disease or condition, from close contacts, from others who may have the disease or condition based on symptoms, exposure or other factors, from controls, and from others with information relevant to the investigation. For this purpose, the State Health Officer, or his or her designee, may design questionnaire instruments that permit the recordings of information such as, but not limited to, personal identifiers, medical facts such as symptoms and laboratory test results, and exposure histories. Such questionnaires may be voluntarily completed by persons identified by Department staff conducting the investigation. In addition to such questionnaires, all working documents, including, but not limited to, written notes and computer records, and documents and records relating to the investigation and received from outside parties, including, but not limited to, medical records and laboratory records, are confidential and shall not be subject to the inspection, subpoena, or admission into evidence in any court, except via proceedings brought under this chapter by the Department to compel the examination, testing, commitment, or quarantine of any person. A record generated by the Department dealing with the symptoms, condition, or other information concerning only one individual or entity is releasable upon the written consent of the individual or entity, or if the individual is a minor, his or her parent or legal guardian. Any individual providing information to the Department as part of the investigation shall be immune from any civil or criminal liability. Nothing in this paragraph is meant to supersede other rules in this chapter.

Ala. Admin. Code r. 420-4-1 420-4-1-.04

Filed September 1, 1982. Emergency repeal and adoption of new rule filed September 23, 1987. Repealed and new rule: Filed November 19, 1987. Amended: Filed January 20, 1999; effective February 24, 1999. Amended: Filed January 15, 2002; effective February 19, 2002. Repealed and New Rule: Filed May 26, 2011; effective June 30, 2011.

Amended by Alabama Administrative Monthly Volume XXXIII, Issue No. 03, December 31, 2014, eff. 12/30/2014.

Adopted by Alabama Administrative Monthly Volume XLII, Issue No. 05, February 29, 2024, eff. 4/14/2024.

Author: Donald E. Williamson, M.D., Charles Woernle, M.D., M.P.H., Sherri L. Davidson, M.P.H., P. Brian Hale, J.D.

Statutory Authority:Code of Ala. 1975, §§22-2-2(6); 22-11A-1, et seq.; 22-21-28