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Legislation #: 971620 Introduction Date: 11/20/1997
Type: Ordinance Effective Date: 12/22/1997
Sponsor: None
Title: Amending Chapter 34, Health and Sanitation, Code of Ordinances, by repealing Sections 34-51 through 34-72 and Sections 34-101 through 34-105, Sections 34-107 through 34-111 and Section 34-401, and enacting in lieu thereof new Sections 34-51 through 34-71 and Section 34-111, to be known as communicable diseases and other health conditions, and Section 34-401.

Legislation History
DateMinutesDescription
12/11/1997

Waive Charter Requirements City Council

12/1/1997

Waive Charter Requirements City Council

11/24/1997

Prepare to Introduce

11/24/1997

Referred Neighborhood Development Committee

12/1/1997

Do Pass

12/1/1997

Assigned to Third Read Calendar

12/11/1997

Passed


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ORDINANCE NO. 971620

 

Amending Chapter 34, Health and Sanitation, Code of Ordinances, by repealing Sections 34-51 through 34-72 and Sections 34-101 through 34-105, Sections 34-107 through 34-111 and Section 34-401, and enacting in lieu thereof new Sections 34-51 through 34-71 and Section 34-111, to be known as communicable diseases and other health conditions, and Section 34-401.

 

BE IT ORDAINED BY THE COUNCIL OF KANSAS CITY:

 

Section 1. That Chapter 34, Health and Sanitation, Code of Ordinances of the City of Kansas City, Missouri, is hereby amended by repealing Sections 34-51 through 34-72 and Sections 34-101 through 34-105, Sections 34-107 through 34-111 and Section 34-401, and enacting in lieu thereof Sections 34-51 through 34-71 and Section 34-111, to be known as communicable diseases and other health conditions, and Section 34-401, said sections 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 speciality, 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 aimed 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) 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.

 

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

 

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

 

(z) 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.

 

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

 

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

 

(cc) Physicians 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.

 

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

 

(ee) 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.

 

(ff) Reportable disease/health condition - Any disease or condition which must be reported to the Director of Health under the provisions of this Article.

 

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

 

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

 

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

 

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

 

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

 

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

 

(mm) 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.

 

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

 

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

 

Sec. 34-52. Supervision of schools and child care facilities.

 

The Director shall control and supervise all public and private schools and child care facilities within the city and all persons thereof, as may be necessary to prevent the introduction or spread of communicable diseases. The Director shall cause the implementation of appropriate control, containment or eradication measures, including exclusion of persons from such schools or child care facilities, until in the opinion of the Director, the disease is controlled or eradicated.

 

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

 

(a) The following diseases must be reported to the Director: animal bites, anthrax, botulism, brucellosis, campylobacter, chancroid, chlamydia, cholera, cryptosporidiosis, diphtheria, ehrlichiosis, encephalitis (arthropod-borne), Escherichia coli 015:H7, food poisoning (suspected or confirmed; infectious or toxic), giardiasis, gonorrhea (all manifestations including ophthalmia and pelvic inflammatory disease), Haemophilus influenza (invasive disease and meningitis), hantavirus, hemolytic uremic syndrome (post-diarrheal), hepatitis A, hepatitis B (including surface antigen positive pregnant women), hepatitis C, hepatitis D, hepatitis E, hepatitis non-A non-B, human immunodeficiency virus (HIV asymptomatic or symptomatic, AIDS, and T-helper (CD4+) lymphocyte count on any person with HIV infection), influenza, Kawasaki disease, 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, plague, poliomyelitis, psittacosis, rabies (animal and human), Reyes syndrome, Rocky Mountain spotted fever, rubella, salmonellosis (including typhoid fever), shigellosis, streptococcal Group A invasive disease, syphilis (all stages including congenital syndrome), tetanus, toxic shock syndrome, trichinosis, tularemia, vibrio, and yersinia; those diseases designated by the United States Public Health Service as being of international concern; those declared reportable in the regulations of the Missouri Department of Health; others declared reportable by the Director of Health; and the occurrence of epidemics or outbreaks of any illness or disease or condition which may be of public health concern.

 

(b) 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 that may be available. The report shall be made and received by the Director within two (2) days of diagnosis in writing or 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, lead poisoning (blood lead level equal to or greater than ten micrograms per deciliter (> 10 mg/dl) in persons under age eighteen or equal to or greater than twenty-five micrograms per deciliter (> 25 mg/dl) in persons age eighteen or older, methemoglobinemia, occupational lung diseases (including silicosis, asbestosis, byssinosis, farmer's lung and toxic organic dust syndrome), other heavy metal poisoning (including mercury, arsenic and cadmium), pesticide poisoning, and respiratory diseases triggered by environmental factors (including environmentally or occupationally induced asthma and bronchitis).

 

(b) Unless otherwise specified, the report shall include the name, 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 that may be available. The report shall be made to and received by the Director within seven (7) 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 or animal 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.

 

(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, 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) Persons infected with or suspected of being infected with venereal diseases shall be isolated or quarantined in a hospital or the isolation unit of the municipal correction institute, if deemed necessary.

 

(5) 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.

 

(6) 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.

 

(7) 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.

 

(8) 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.

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

 

Sec. 34-58 - 34-66. Reserved.

 

Sec. 34-67. Immunization of children attending school or child care facilities.

 

No child shall be permitted to attend any private or public school of any district operating within the city limits, totally or partially, or in any child care facility with an enrollment of ten (10) or more children, unless properly immunized, or exempted from immunization according to the current recommendations of the United States Public Health Service and the Missouri Department of Health, and as set forth by the Director. Parents and guardians shall cause their children and wards to be properly immunized or exempted. Every school and child care facility must maintain a current immunization record on each child that includes types of immunizations received and dates administered. Every school and child care facility shall file an annual immunization status report on all children with the Director. The principal or administrator is responsible for insuring attendees are properly immunized or exempted for their age or grade status in accordance with the following levels: an immunization level of at least ninety-eight percent (98%) of school attendees or ninety-five percent (95%) of child care facility attendees.

 

Sec. 34-68. Disease investigation.

 

The Director shall investigate, to the extent necessary and practical, each reported communicable disease or disease condition, or other unusual or epidemic illness as deemed necessary for the public health, to verify diagnosis, identify additional cases and persons at risk, and determine the probable source of infection or intoxication, and when appropriate, to institute appropriate control, containment, eradication, or remediation measures. In such investigations, the Director is hereby vested with full powers of inspection, examination, isolation, quarantine, and disinfection of all persons, animals, places and things.

 

(1) Every physician, physicians assistant, advanced practice nurse, coroner or medical examiner who practices within the city or the administrator of any institution within the city, shall cooperate fully with the Director in the discharge of any investigation. It shall be unlawful for any such person to fail to or refuse to so cooperate with the Director.

 

(2) Pertinent information from the medical record of each person under investigation for a reportable disease or condition shall be furnished to the Director upon demand. Consent of the person afflicted with a reportable disease or condition shall not be required unless information other than that pertaining to the disease or condition being investigated is requested. Information obtained from the medical records shall remain confidential.

 

(3) It shall be unlawful for any physician, administrator, or other person to secrete any patient or client with a reportable disease or condition, or mislead the Director so as to prevent the control of the disease.

 

Sec. 34-69 - 34-70. Reserved.

 

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 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: arthropod-borne encephalitis, brucellosis, campylobacter, Escherichia coli O157:H7, leptospirosis, salmonella, psittacosis, and rabies. The report shall be made to and received by the Director within two (2) days of diagnosis in writing or 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).

 

Sec. 34-72 - 34-105. Reserved.

 

Sec. 34-107 - 34-110. Reserved.

 

Sec. 34-111. Penalty for violation of article II.

 

Whenever in any section of this article II the doing of any act is required or is prohibited or is declared to be unlawful or an ordinance violation, any person who shall be convicted of a violation of any such provision of this codification or of any such ordinance shall, for each offense, be fined not less than $100.00 and not more than $500.00, or be punished by imprisonment in the municipal correctional institution, not to exceed six months, or be punished by both fine and imprisonment.

 

Sec. 34-401. Purpose of article.

 

Lead poisoning in humans is a reportable condition as established in section 34-54. The purpose of this article is to prevent lead poisoning resulting from the internal consumption of lead-bearing substances into the human body by means of, without limitation thereon, ingestion, inhalation and absorption, which internal consumption is hereby declared to constitute a serious hazard to the health, safety and welfare of the inhabitants of this city.

 

______________________________________________________

 

Approved as to form and legality:

 

 

_________________________________

Assistant City Attorney