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Legislation #: 010104 Introduction Date: 1/18/2001
Type: Ordinance Effective Date: 2/11/2001
Sponsor: None
Title: Amending Chapter 34, Code of Ordinances, by repealing Sections 34-51, Definitions, 34-53, Report of certain diseases and events required, 34-54, Report of certain conditions required, 34-55, Confidentiality of information and report, 34-56, Persons required to report diseases and conditions, 34-57, Quarantine and isolation, and 34-71, Powers of the director of health regarding animal diseases, and enacting in lieu thereof seven new sections of like number and subject matter.

Legislation History
DateMinutesDescription
2/1/2001

Waive Charter Requirements City Council

1/25/2001

Waive Charter Requirements City Council

1/18/2001

Prepare to Introduce

1/18/2001

Referred Neighborhood Development Committee

1/24/2001

Do Pass as a Committee Substitute

1/25/2001

Assigned to Third Read Calendar

2/1/2001

Passed as Substituted


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COMMITTEE SUBSTITUTE FOR ORDINANCE NO. 010104

 

Amending Chapter 34, Code of Ordinances, by repealing Sections 34-51, Definitions, 34-53, Report of certain diseases and events required, 34-54, Report of certain conditions required, 34-55, Confidentiality of information and report, 34-56, Persons required to report diseases and conditions, 34-57, Quarantine and isolation, and 34-71, Powers of the director of health regarding animal diseases, and enacting in lieu thereof seven new sections of like number and subject matter.

 

BE IT ORDAINED BY THE COUNCIL OF KANSAS CITY:

 

Section 1. That Chapter 34, Code of Ordinances of the City of Kansas City, Missouri, is hereby amended by repealing Sections 34-51, Definitions, 34-53, Report of certain diseases required, 34-54, Report of certain conditions required, 34-55, Confidentiality of information and report, 34-56, Persons required to report diseases and conditions, 34-57, Quarantine and isolation, and 34-71, Powers of the director of health regarding animal diseases, and enacting in lieu thereof seven new sections of like number and subject matter, to read as follows:

 

Sec. 34_51. Definitions.

 

(a) Administrator. The person in charge of an institution including but not limited to the chief executive officer, chairperson of the board, president, clinician in charge, or any equivalent position, or the authorized designee of any such person.

 

(b) Advanced practice nurse. A nurse who has education beyond the basic nursing education and is certified by a nationally recognized professional organization as having a nursing specialty, or who meets the criteria for advanced practice nurses established by the state board of nursing.

 

(c) Agent. A factor, such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or relative absence is essential for the occurrence of a disease.

 

(d) Blood donating center. An entity that recruits blood donors and processes and distributes blood.

 

(e) Carrier. A person or animal that harbors a specific infectious agent in the absence of discernible clinical disease and serves as a potential source of infection.

 

(f) Case. A person or animal identified as having the particular disease, health disorder, or condition under investigation.

 

(g) Child care facility. Any house or other place conducted or maintained by any person who advertises or holds himself out as providing care for children, regardless of the number of children, unless otherwise specified in this article. The term "child care facility" also includes all preschools and nursery schools and other such entities. It does not include persons who provide child care services/day care on a short_term non_regular temporary basis.

 


(h) Communicable disease. An illness caused by an infectious agent or its toxic products that arises through transmission of that agent or its products from an infected person, animal, or reservoir of infection to a susceptible person or animal, either directly or indirectly through an intermediate plant or animal or person, vector, or the inanimate environment.

 

(i) Contagious. See definition of "Communicable disease."

 

(j) Containment. Localized eradication of a communicable disease.

 

(k) Control. Operations or programs armed at eliminating or reducing the incidence and/or prevalence of communicable diseases.

 

(l) Director. The Director of Health for the City of Kansas City, Missouri or the designee.

 

(m) Disease. A state of physiological or psychological dysfunction.

 

(n) Disease condition. Any health problem listed as reportable under section 34_54.

 

(o) Environment. All that is external to the person or animal.

 

(p) Eradication. Termination of transmission of infection by extermination of the agent through surveillance and containment.

 

(q) Exposure. The absorption, ingestion or inhalation of chemical, radiological or other agents by a person or animal that results in biochemical, physiological or histological changes.

 

(r) Health department. The Health Department of the City of Kansas City, Missouri.

 

(s) Immunization. The treatment which renders a person less susceptible to the pathologic effects of a disease or provides a measure of protection against the disease.

 

(t) Incubation period. The time interval between invasion by an infectious agent and the appearance of the first sign or symptom of the disease in question.

 

(u) Infection. The entry and development or multiplication of an infectious agent in the body of a person or animal.

 

(v) Infectious. See the definition of "Communicable disease."

 

(w) Institution. Any public or private hospital, nursing home, clinic, mental health facility, or home health agency, or medical or professional corporation, association or person.

 

(x) Isolate. Recovery or the demonstration of a microorganism by prevailing laboratory techniques.

 

(y) Isolation. Separation, for the period of communicability, of infected persons or animals from others in such places and under such conditions as to prevent or limit the direct or indirect transmission of the infectious agent from those infected to those who are susceptible or who may spread the agent to others.

 

(z) Medical record. A file of information relating to transaction(s) in personal health care. In addition to facts about a patient's illness, the medical record may contain other information of importance to the health disease or condition under investigation.

 

(aa) Period of communicability. The period of time during which an etiologic agent may be transferred, directly or indirectly, from an infected person or animal to another person or animal.

 

(bb) Person. Any human, individual, partnership, corporation, association, institution, city, county, other political subdivision authority, state agency or institution or federal agency or institution.

 

(cc) Physician. Professional person qualified by education and authorized by law to practice medicine.

 

(dd) Physician's assistant. Professional person qualified by education and authorized by law to engage in the examination or treatment of patients while under the supervision, control and responsibility of a licensed physician.

 

(ee) Plasma center. An entity that recruits blood donors and processes and distributes plasma for the manufacture of pharmaceutical products.

 

(ff) Quarantine. Restriction of the activities of persons or animals who have been exposed to a case of communicable disease during its period of communicability to prevent disease transmission during the incubation period if infection should occur. Quarantine may be absolute or modified with regards to limitation of freedom of movement.

 

(gg) Reportable disease/health condition. Any disease or condition which must be reported to the director of health under the provisions of this article.

 

(hh) Reservoir of infection. The natural habitat of the infectious agent.

 

(ii) School. A public or private organization that provides instruction to persons from kindergarten through twelfth grade.

 

(jj) Source of infection. The person, animal, object or substance from which an infectious agent is transmitted.

(kk) Surveillance. The continuing scrutiny of all aspects of occurrence and spread of a disease that are pertinent to effective control.

 

(ll) Syndrome. A symptom complex in which the symptoms and/or signs coexist more frequently than would be expected by chance.

 

(mm) Threat to others. A carrier who is likely to place others at risk of infection through behavior, proximity, or other circumstances.

 

(nn) Transmission of infection. Any mechanism by which an infectious agent is spread from a source or reservoir of infection to another person or animal.

 

(oo) Vector. An insect or any living carrier that transports an infectious agent from an infected person or his waste to a susceptible person or his food or immediate surroundings.

 

(pp) Veterinarian. Professional person qualified by education and authorized by law to practice veterinary medicine.

 

(qq) Zoonotic diseases. Communicable diseases transmissible from an animal to a person.

 

Sec. 34-53. Report of certain diseases and events required.

 

(a) Upon laboratory or clinical confirmation the following diseases must be reported to the director: animal bites, blastomycosis, campylobacter, chancroid, chlamydia, Creutzfeldt-Jacob disease, cryptosporidiosis, Cyclospora infection, diphtheria, ehrlichiosis, Escherichia coli 015:H7, food poisoning (suspected or confirmed; infectious or toxic), gonorrhea (all manifestations including ophthalmia and pelvic inflammatory disease), Haemophilus influenzae (invasive disease and meningitis), hantavirus, hepatitis A, hepatitis B (including surface antigen positive pregnant women), hepatitis C, hepatitis D, hepatitis E, human immunodeficiency virus (HIV asymptomatic or symptomatic, AIDS, detection of HIV nuclei acid, HIV viral culture, or other test indicating HIV infection, T-helper (CD4+) lymphocyte count on any person with HIV infection, and viral load measurement including non-detectable results), influenza, legionellosis, leptospirosis, listeria, Lyme disease, malaria, measles, meningitis (aseptic), meningococcal disease (invasive and meningitis), mumps, mycobacterial infections (active disease and infection, tuberculosis and mycobacteria other than tuberculosis including leprosy, pulmonary and non-pulmonary, and positive Mantoux skin tests), nosocomial disease (outbreaks only), pertussis, poliomyelitis, psittacosis, rabies, Rocky Mountain spotted fever, rubella, salmonellosis (including typhoid fever), shigellosis, Staphylococcus aureus (vancomycin resistant only), streptococcal Group A invasive disease, Streptococcus pneumoniae drug resistant disease, syphilis (all stages including congenital syndrome), tetanus, trichinosis, varicella infection (only deaths), vibrio, and yersinia; and others declared reportable by the director of health; and the occurrence of epidemics or outbreaks of any illness or disease which may be of public health concern.

 

(b) Upon suspicion of or confirmation the following diseases must be reported to the director: acute adult respiratory distress syndrome (ARDS) in an unusual number of patients under 50 years of age (without a contributing medical history), anthrax, botulism, brucellosis, cholera, encephalitis (arthropod-borne), food poisoning (infectious or toxic) with multiple cases or resulting in hospitalization, glanders, hemorrhagic fevers, plague, Q fever, ricin poisoning, smallpox, staphylococcal enterotoxin B, and T-2 mycotoxins, and tularemia and others declared reportable by the director of health; and the occurrence of epidemics or outbreaks of any illness or disease which may be of public health concern.

 

(c) Unless otherwise specified, the report shall include the name, time and date of diagnosis, date of birth, sex, race, address or location, telephone number, name of the attending physician, name of the disease, condition or finding diagnosed or suspected, date of onset, name and address of treating facility (if any), any appropriate laboratory results and other such facts and information which may be available. For diseases listed in (a) the report shall be made and received by the director within two days of diagnosis in writing or by telephone, facsimile communication or other rapid communication. For diseases listed in (b) the report shall be made and received by the director within four hours of suspicion or confirmation by telephone, facsimile communication or other rapid communication.

 

Sec. 34-54 Report of certain conditions required.

 

(a) The following disease conditions must be reported to the director: acute chemical poisoning, carbon monoxide poisoning, hyperthermia, hypothermia, any blood lead level in persons <72 months of age, methemoglobinemia, occupational lung diseases, heavy metal poisoning, pesticide poisoning, and respiratory diseases triggered by environmental factors (including environmentally or occupationally induced asthma and bronchitis).

 

(b) Unless otherwise specified, the report notification shall include the name, date of diagnosis, date of birth, sex, race, address or location, telephone number, name of the physician, disease, condition or finding diagnosed or suspected, date of onset, name and address of treating facility (if any), any appropriate laboratory results and other such facts and information that may be available. The report shall be made to the director within seven days of diagnosis in writing or by telephone, facsimile communication or other rapid communication.

 

Sec. 34_55. Confidentiality of information and reports.

 

(a) The health department is authorized to receive information from patient medical records for official purposes or functions.

 

(b) The health department shall maintain the confidentiality of all medical record information abstracted by or reported to the department. The department may only release medical record information in a statistical aggregate form that precludes and prevents the identification of patient, physician, or medical facility, except that all medical record information may be shared with other public health authorities and co_investigators if such person abides by the same confidentiality restrictions required of the department.

(c) All information, records and reports concerning persons or animals with communicable diseases or with reportable disease conditions shall be confidential and shall be inaccessible to the public.

 

(d) It shall be unlawful for any person to intentionally disseminate a false report or rumor concerning the existence of a communicable disease in any person, animal, or location within the city.

 

Sec. 34-56. Persons required to report diseases and conditions.

 

(a) The following persons are required to file with the director of health the reports required in sections 34-53 and 34-54:

 

(1) Duly licensed physicians;

 

(2) Physicians assistants;


 

(3) Advanced practice nurses;

 

(4) Every nurse, superintendent, or principal of a public or private school;

 

(5) Every owner or any person in charge of a child care facility;

 

(6) Administrator of each institution. The reports filed by such administrator shall not be considered the divulging of confidential information, and does not relieve the responsible physician or other person of the duty to report the same case.

 

(b) Any person in charge of a plasma center or blood donating center shall report when blood extracted from a person tests positive for the human immunodeficiency virus or hepatitis viruses by prevailing laboratory techniques.

 

(c) Any person in charge of a clinical laboratory shall report when a laboratory examination of any specimen derived from the human body yields microscopical, cultural, chemical, immunological, serological, or other evidence suggestive of those communicable diseases or disease conditions deemed reportable. This reporting requirement also applies to laboratory specimens sent to another laboratory for analysis or evaluation. Isolates of the following specimens must be submitted to the Missouri Department of Health Laboratory for epidemiological or confirmation purposes:

 

(1) anthrax

(2) cholera

 

(3) diphtheria

(4) Escherichia coli 0157:H7

 

(5) Haemophilus influenzae from invasive disease

 

(6) malaria

 

(7) measles

 

(8) tuberculosis

 

(9) Neisseria meningitis from invasive disease

 

(10) pertussis

 

(11) plague

 

(12) salmonella, all species

 

(13) shigella, all species

 

(14) Staphylococcus aureus, vancomycin resistant strains only.

 

Submission of specimens does not relieve the person in charge of a clinical laboratory from the reporting requirement.

 

(d) It shall be unlawful for any person to fail to make a report required in this article within the applicable reporting time.

 

Sec. 34_57. Quarantine and isolation.

 

The director of health is authorized to use isolation and/or quarantine measures for the control, containment or eradication of communicable diseases or disease vectors. These measures may be used on persons, animals, public or private property, or areas of land.

 

(1) Persons who have been exposed to communicable diseases deemed reportable in section 34_53, or who are carriers of infections, or where there is sufficient evidence to cause the director to believe that they may be carriers of infection and represent a health threat to others, may be placed under isolation or quarantine restrictions. These restrictions may include removal to another public or private location, as may be deemed necessary until the nature of the disease has been determined or the communicability of the disease has ceased.

 

(2) No physician, administrator or any other person may remove a person from isolation or quarantine or modify the restrictions of the isolation or quarantine without prior written authorization from the director.

 

(3) Persons infected with or suspected of being infected with tuberculosis shall be isolated or quarantined at a hospital, if deemed necessary.

 

(4) The removal or transportation within or from the city, of persons subject to isolation or quarantine shall be done in compliance with the conditions, procedures and requirements established by the director for that person.

 

(5) When isolation or quarantine restrictions apply to any public or private property, or area of land, the director shall placard the public or private property, or area of land with conspicuous letters stating the name of the disease. The director is authorized to cause such public or private property, or area of land to be vacated by all persons and to prohibit unauthorized persons from entering in or out, except under such rules and regulations as he may prescribe. The isolation or quarantine restrictions shall continue and remain in effect until the director shall order them removed.

 

(6) The director may prohibit the removal or other distribution of any food or property from any public or private property, or area of land under isolation or quarantine, and, if applicable, may direct the method of disinfection or destruction of such food or property.

 

(7) It shall be unlawful for any person to refuse to allow the director to place a placard on his property or property under his control or to endeavor to prevent the placing of the placard or to take down or remove such placard.

 

(8) It shall be unlawful for any person to violate any of the provisions of this section.

 

Sec. 34-71. Powers of the director of health regarding animal diseases.

 

The director shall be empowered to issue regulations for the control of animal diseases and conditions declared dangerous or potentially dangerous to the health of the public, and to cause any animal to be examined for the presence of suspected diseases or conditions by prevailing accepted procedures. Neither the city nor its employees shall be liable for any expenses incurred in such an examination of an animal or for any damages if the animal is required to be destroyed for any reason.

 

(1) Zoonotic diseases of animals declared by the director to be dangerous or potentially dangerous to the public health shall be reported to the director by any veterinarian who practices veterinary medicine within the city.

 

(2) The following diseases must be reported to the director: anthrax, arthropod-borne encephalitis, botulism, brucellosis, glanders, plague, Q-fever, psittacosis, rabies and others declared reportable by the director of health; and the occurrence of epidemics or outbreaks of any illness or disease which may be of public health concern. The report shall be made to and received by the director within four hours of suspicion or diagnosis by telephone, facsimile communication or other rapid communication.

 

(3) It shall be unlawful for any veterinarian to fail to make any reports required in section 34-71(2).

 

________________________________________________________

 

Approved as to form and legality:

 

 

 

___________________________________

Assistant City Attorney