Rules of divisions under this department “umbrella” include Substance Abuse[643], Professional Licensure[645], Dental Examiners[650], Medical Examiners[653], Nursing Board[655] and Pharmacy Examiners[657]
1.4(135,139A) Reporting and investigation
1.7(139A) Treatment of infant eyes
1.9(135,139A) Quarantine and isolation
1.11(141A) Contagious or infectious disease notification at time of death
1.12(135,137,139A) Quarantine and isolation—model rule for local boards
1.13(135,139A) Area quarantine
VIRAL HEPATITIS
PROGRAM—VACCINATIONS
AND TESTING
2.3(135) Exposure risks for hepatitis C virus
2.4(135) Information for public distribution
2.5(135) Hepatitis vaccination and testing program
HEPATITIS C AWARENESS PROGRAM—VETERANS
2.12(135) Awareness information
2.13(135) Resources for hepatitis follow–up and treatment
CHAPTER 3
EARLY HEARING DETECTION
AND INTERVENTION
3.3(80GA,ch102) Goal and outcomes
3.4(80GA,ch102) Screening the hearing of all newborns
3.5(80GA,ch102) Procedures required of birthing hospitals
3.6(80GA,ch102) Procedures required of birth centers
3.8(80GA,ch102) Reporting hearing screening results and information to the department
3.9(80GA,ch102) Conducting and reporting diagnostic audiologic assessments to the department
3.10(80GA,ch102) Sharing of information and confidentiality
3.11(80GA,ch102) Reporting requirements for AEAs
3.12(80GA,ch102) Procedure to accommodate parental objection
3.13(80GA,ch102) Civil/criminal liability
CHAPTER 4
CENTER FOR CONGENITAL
AND INHERITED DISORDERS
4.3(136A) Iowa neonatal metabolic screening program (INMSP)
4.4(136A) Expanded maternal serum alpha–fetoprotein screening program
4.5(136A) Regional genetic consultation service (RGCS)
4.6(136A) Neuromuscular and other related genetic disease program (NMP)
4.7(136A) Iowa registry for congenital and inherited disorders
5.1(135) Reporting of maternal deaths
5.2(135) Ascertainment of maternal deaths
5.3(135) Reviewing of maternal deaths
CHAPTER 6
VENEREAL DISEASE PROPHYLACTICS
6.2(135) Application for permit
6.3(135) Permit number and decal to be displayed
7.4(139A) Required immunizations
7.6(139A) Proof of immunization
7.7(139A) Provisional enrollment
7.8(139A) Records and reporting
7.9(139A) Providing immunization services
7.11(22) Iowa’s immunization registry
7.12(22) Release of immunization information
CHAPTER 8
SEXUAL ASSAULT EXAMINATION
AND REIMBURSEMENT
Transferred to 61—Justice Department 8/8/90; see 61—9.82, 9.83
CHAPTER 9
OUTPATIENT DIABETES EDUCATION PROGRAMS
9.4(135) Application procedures for American Diabetes Association recognized program
9.5(135) Renewal procedures for American Diabetes Association recognized programs
9.6(135) Application procedures for programs not recognized by the American Diabetes Association
9.8(135) Program staff for programs not recognized by the American Diabetes Association
CHAPTER 11
ACQUIRED IMMUNE
DEFICIENCY SYNDROME (AIDS)
CERTIFICATION OF LABORATORIES
FOR HIV TESTING
11.18(141) Responsibilities of the department
11.19(141) Initial application and certification requirements
11.21(141) Renewal of laboratory certification
11.22(141) Reinstatement of certification
11.23(141) Application fees and inspection costs
11.24(141) Requirements for laboratory personnel
11.25(141) Laboratory procedures and procedure manual requirements
11.26(141) Notification of certain changes during a certification period
11.27(141) Testing methodologies and confirmation of positive test results
11.28(141) Record maintenance and documentation of the testing process
11.29(141) Reporting of test results to the department
11.30(141) Complaints or noncompliance
11.31(141) Adverse actions and the appeal process
TRAINING PROGRAMS
DIRECT
NOTIFICATION OF AN IDENTIFIABLE
THIRD PARTY
EMERGENCY CARE PROVIDERS EXPOSED
TO CONTAGIOUS OR INFECTIOUS DISEASES
11.47(139B,141) General provisions
11.48(139B,141) Contagious or infectious diseases, not including HIV—hospitals
11.49(139B,141) Contagious
or infectious diseases, not including HIV—health care
providers
11.50(139B,141) HIV infection—hospitals
11.51(139B,141) HIV infection—health care providers
11.53(139B,141) Confidentiality
hiv–related test for convicted or alleged sexual–assault offenders and the victims
11.72(709B) HIV test—convicted or alleged sexual assault offender
11.73(709B) Medical examination costs
11.74(709B) Testing,
reporting, and
counseling—penalties
hiv home collection
11.82(126) HIV home testing kit
11.83(126) HIV home collection kit
AIDS DRUG ASSISTANCE PROGRAM (ADAP)
11.86(141A) Eligibility requirements
11.87(141A) Enrollment process
11.88(141A) Distribution requirements
CHAPTER 12
APPROVAL OF CONFIRMATORY
LABORATORIES FOR PRIVATE SECTOR DRUG–FREE WORKPLACE TESTING
12.4(730) Application procedures and requirements
12.6(730) Quality assurance program and procedure manual requirements
12.7(730) Analytical quality control
12.8(730) Sample security and confidentiality of test results
12.9(730) Confirmatory testing
12.10(730) Documentation of the confirmatory testing process
12.11(730) Reporting of confirmed positive test results to the medical review officer
12.12(730) Reporting requirements to department
12.13(730) Approval, renewal, and inspection fees
12.16(730) Changes during approval periods
12.18(730) Denial, suspension, modification or revocation of approval
12.19(730) Restoration of approval
CHAPTER 14
RESIDENTIAL WATER TREATMENT
14.5(714) Approval of third–party testing agencies
14.6(714) Labeling and manufacturer’s performance data sheet
14.7(714) Consumer information pamphlet
CHAPTER 15
SWIMMING POOLS AND SPAS
15.3(135I) Definitions and abbreviations
swimming pools
15.4(135I) Swimming pool operations
15.5(135I) Construction and reconstruction
administration
15.11(135I) Swimming pool/spa operator qualifications
15.14(135I) Application
denial or partial
denial—appeal
SPAS
15.52(135I) Construction and reconstruction
CHAPTER 20
COMMUNITY WATER FLUORIDATION GRANT PROGRAM
20.4(135) Review and rating of applications
20.6(135) Implementation procedures
CHAPTER 21
CENTRAL REGISTRY FOR BRAIN
AND SPINAL CORD INJURIES
21.4(135) Who reports and under what circumstances
21.5(135) Method and frequency of reporting
CHAPTER 22
PRACTICE OF TATTOOING
22.4(135) Sanitation and infection control
22.7(135) Application for permit—fees
22.9(135) Adverse actions and the appeal process
CHAPTER 24
PRIVATE WELL TESTING, RECONSTRUCTION, AND PLUGGING—GRANTS TO COUNTIES
24.5(135) Eligible grant costs
24.6(135) Ineligible grant costs
24.7(135) Performance requirements
24.8(135) Contents of grant application
24.9(135) Grant application submission
24.10(135) Multicounty grant applications
24.12(135) Record keeping and retention
24.14(135) Termination or forfeiture of grant funds
CHAPTER 25
STATE PLUMBING CODE
25.4(135) Amendments to the Uniform Plumbing Code
25.5(135) Backflow prevention with containment
CHAPTER 26
BACKFLOW PREVENTION ASSEMBLY TESTER REGISTRATION
26.3(135K) Registration required
26.4(135K) Backflow prevention assembly tester training
26.6(135K) Standards of conduct
26.8(135K) Denial, suspension or revocation
CHAPTER 38
GENERAL PROVISIONS FOR
RADIATION MACHINES AND
RADIOACTIVE MATERIALS
38.3(136C) Exemptions from the regulatory requirements
38.4(136C) General regulatory requirements
38.9(136C) Administrative enforcement actions
38.10(136C) Deliberate misconduct
39.4(136C) Requirements for licensing of radioactive materials
39.5(136C) Transportation of radioactive material
CHAPTER 40
STANDARDS FOR PROTECTION AGAINST RADIATION
GENERAL PROVISIONS
RADIATION PROTECTION PROGRAMS
40.10(136C) Radiation protection programs
OCCUPATIONAL DOSE LIMITS
40.15(136C) Occupational dose limits for adults
40.16(136C) Compliance with requirements for summation of external and internal doses
40.17(136C) Determination of external dose from airborne radioactive material
40.18(136C) Determination of internal exposure
40.19(136C) Determination of prior occupational dose
40.20(136C) Planned special exposures
40.21(136C) Occupational dose limits for minors
40.22(136C) Dose equivalent to an embryo/fetus
RADIATION DOSE LIMITS FOR
INDIVIDUAL
MEMBERS OF THE PUBLIC
40.26(136C) Dose limits for individual members of the public
40.27(136C) Compliance with dose limits for individual members of the public
radiological criteria for
license termination
40.28(136C) Radiological criteria for license termination
40.29(136C) Radiological criteria for unrestricted use
40.30(136C) Criteria for license termination under restricted conditions
40.31(136C) Alternate criteria for license termination
TESTING FOR LEAKAGE OR CONTAMINATION OF SEALED SOURCES
40.32(136C) Testing for leakage or contamination of sealed sources
SURVEYS AND MONITORING
40.36(136C) Surveys
and monitoring—
general
40.37(136C) Conditions requiring individual monitoring of external and internal occupational dose
CONTROL OF EXPOSURE FROM EXTERNAL SOURCES IN RESTRICTED AREAS
40.42(136C) Control of access to high radiation areas
40.43(136C) Control of access to very high radiation areas
40.44(136C) Control of access to very high radiation areas—irradiators
RESPIRATORY PROTECTION AND
CONTROLS
TO RESTRICT INTERNAL EXPOSURE IN RESTRICTED AREAS
40.48(136C) Use of process or other engineering controls
40.49(136C) Use of other controls
40.50(136C) Use of individual respiratory protection equipment
STORAGE AND CONTROL OF LICENSED
OR
REGISTERED SOURCES OF RADIATION
40.54(136C) Security and control of licensed radioactive material in quantities of concern
40.55(136C) Security and control of licensed or registered sources of radiation
PRECAUTIONARY PROCEDURES
40.61(136C) Posting requirements
40.62(136C) Exceptions to posting requirements
40.63(136C) Labeling containers and radiation machines
40.64(136C) Exemptions to labeling requirements
40.65(136C) Procedures for receiving and opening packages
WASTE DISPOSAL
40.70(136C) General requirements
40.71(136C) Method for obtaining approval of proposed disposal procedures
40.72(136C) Disposal by release into sanitary sewerage
40.73(136C) Treatment or disposal by incineration
40.74(136C) Disposal of specific wastes
40.75(136C) Transfer for disposal and manifests
40.76(136C) Compliance with environmental and health protection regulations
RECORDS
40.80(136C) General provisions
40.81(136C) Records of radiation protection programs
40.82(136C) Records of surveys
40.83(136C) Records of tests for leakage or contamination of sealed sources
40.84(136C) Records of prior occupational dose
40.85(136C) Records of planned special exposures
40.86(136C) Records of individual monitoring results
40.87(136C) Records of dose to individual members of the public
40.88(136C) Records of waste disposal
40.89(136C) Records of testing entry control devices for very high radiation areas
REPORTS
40.95(136C) Reports of stolen, lost, or missing licensed or registered sources of radiation
40.96(136C) Notification of incidents
40.98(136C) Reports of planned special exposures
40.99(136C) Reports of transactions involving nationally tracked sources
40.100(136C) Reports of individual monitoring
40.101(136C) Notifications and reports to individuals
40.102(136C) Reports of leaking or contaminated sealed sources
ADDITIONAL REQUIREMENTS
40.105(136C) Vacating premises
NOTICES, INSTRUCTIONS, AND REPORTS
TO
WORKERS; INSPECTIONS
40.110(136C) Posting of notices to workers
40.111(136C) Instructions to workers
40.112(136C) Notifications and reports to individuals
40.113(136C) Presence of representatives of licensees or registrants and workers during inspection
40.114(136C) Consultation with workers during inspections
40.115(136C) Requests by workers for inspections
40.116(136C) Inspections not warranted—informal review
40.117(136C) Employee protection
41.1(136C) X–rays in the healing arts
41.2(136C) Use of radionuclides in the healing arts
41.3(136C) Therapeutic use of radiation machines
41.6(136C) X–ray machines used for screening and diagnostic mammography
41.7(136C) X–ray machines used for stereotactically guided breast biopsy
42.2(136C) General requirements
42.3(136C) Specific requirements for diagnostic radiographers
42.4(136C) Specific requirements for nuclear medicine technologists
42.5(136C) Specific requirements for radiation therapists
42.6(136C) Specific eligibility requirements for radiologist assistant
42.7(136C) Specific requirements for podiatric radiographers
CHAPTER 43
MINIMUM REQUIREMENTS FOR RADON TESTING AND ANALYSIS
43.4(136B) Application for certification
43.5(136B) Revocation of certification
43.6(136B) Reporting requirements
43.7(136B) Training and continuing education programs
43.11(136B) Persons exempted from certification
CHAPTER 44
MINIMUM REQUIREMENTS FOR RADON MITIGATION
44.4(136B) Application for credentialing
44.5(136B) Revocation of credentialing
44.6(136B) Additional record–keeping requirements
44.7(136B) Continuing education
CHAPTER 45
RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS
45.1(136C) General requirements for industrial radiography operations
45.2(136C) Radiation safety requirements for the use of radiation machines in industrial radiography
45.4(136C) Radiation safety requirements for the use of particle accelerators for nonhuman use
45.5(136C) Radiation safety requirements for analytical X–ray equipment
CHAPTER 46
MINIMUM REQUIREMENTS FOR
TANNING FACILITIES
46.5(136D) Construction and operation of tanning facilities
46.6(136D) Inspections, violations and injunctions
CHAPTER 55
ADVISORY COUNCIL ON HEAD INJURIES
55.5(135) Duties of the council
55.6(135) Conflict of interest
CHAPTER 56
BRAIN INJURY SERVICES PROGRAM
56.3(135) Waiver–eligible component
56.4(135) Cost–share component
56.6(135) Service providers and reimbursement
56.7(135) Available services/service plan
CHAPTER 68
CONTROL OF LEAD–BASED
PAINT HAZARDS
68.3(135) Elevated blood lead (EBL) inspections required
68.4(135) Refusal of admittance
68.5(135) Lead hazard reduction required
68.6(135) Retaliation prohibited
CHAPTER 69
RENOVATION, REMODELING, AND
REPAINTING—LEAD HAZARD
NOTIFICATION PROCESS
69.3(135) Notification required
69.4(135) Notification required in multifamily housing
69.5(135) Emergency renovation, remodeling, and repainting
69.6(135) Certification of attempted delivery
69.8(135) Record–keeping requirements
69.9(135) Compliance inspections
CHAPTER 70
LEAD–BASED PAINT ACTIVITIES
70.4(135) Course approval and standards
70.5(135) Certification, interim certification, and recertification
70.9(135) Compliance inspections
CHAPTER 72
CHILDHOOD LEAD POISONING PREVENTION PROGRAM
CHAPTER 73
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS,
AND CHILDREN (WIC)
73.2(135) Adoption by reference
73.3(135) Availability of rules
73.4(135) Certain rules exempted from public participation
73.6(135) Staffing of contract agencies
73.7(135) Certification of participants
73.12(135) Appeals and fair hearings—local agencies and vendors
73.13(135) Right to appeal—participant
73.14(135) State monitoring of contract agencies
73.22(135) Caseload management
73.23(135) Grant application procedures for contract agencies
CHAPTER 74
FAMILY PLANNING SERVICES
74.2(135) Adoption by reference
74.5(135) Grant application procedures for contract agencies
74.6(135) Funding levels for contract agencies
74.11(135) Denial, suspension, revocation, or reduction of contracts with contract agencies
74.12(135) Right to appeal—contract agency
CHAPTER 75
STATEWIDE OBSTETRICAL AND
NEWBORN INDIGENT PATIENT
CARE PROGRAM
75.4(255A) Eligibility criteria
75.5(255A) Application procedures
75.6(255A) Reimbursement of providers
75.7(255A) Reassignment of county quotas
75.8(255A) Appeals and fair hearings
CHAPTER 76
MATERNAL AND CHILD
HEALTH PROGRAM
76.2(135) Adoption by reference
76.6(135) Client eligibility criteria
76.7(135) Client application procedures for MCH services
76.8(135) Right to appeal—client
76.9(135) Grant application procedures for community–based contract agencies
76.10(135) Funding
levels for community–
based contract agencies
76.11(135) Contract agency performance
76.16(135) Denial, suspension, revocation or reduction of contracts with contract agencies
76.17(135) Right to appeal—contract agency
CHAPTER 77
LOCAL BOARDS OF HEALTH
77.1(137) Purpose of local boards of health
77.3(137) Roles and responsibilities of local boards of health
77.4(137) Organization of local boards of health
77.5(137) Operating procedures of local boards of health
77.6(137) Expenses of board of health members
CHAPTER 78
DISTRICT HEALTH DEPARTMENTS
78.1(137) Minimum standards for district health departments
78.2(137) Preparation of district health department plan
78.3(137) Approval of district health departments
78.4(137) Additions to district health departments
78.5(137) Withdrawal from district health departments
CHAPTER 80
LOCAL PUBLIC HEALTH SERVICES
80.3(135) Local public health services state grant
80.4(135) Billing services to the local public health services state grant
80.7(135) Local board of health services
80.8(135) Local public health services
80.9(135) Public health nursing services
80.10(135) Home care aide services
CHAPTER 81
GENERAL RULES FOR MIGRATORY
LABOR CAMPS
81.5(138) Central dining facilities
CHAPTER 82
OFFICE OF MULTICULTURAL HEALTH
82.3(135) Responsibilities of the office of multicultural health
CHAPTER 84
STATE SUBSTITUTE MEDICAL
DECISION–MAKING BOARD
84.2(135) Composition of board
84.8(135) Review of local boards
CHAPTER 85
LOCAL SUBSTITUTE MEDICAL
DECISION–MAKING BOARDS
85.3(135) Appointment of local boards
85.4(135) Filing an application
85.5(135) Notification of patient and review of application
85.6(135) Panel appointment and procedures
85.7(135) Panel determination of need for surrogate decision making
85.8(135) Panel determination regarding proposed medical care decision
85.10(135) Procedure when there is no local board
85.11(135) Records and reports
CHAPTER 86
PLACES WHERE DEAD HUMAN BODIES ARE PREPARED FOR BURIAL
OR ENTOMBMENT
86.6(156) Crematorium chambers
CHAPTER 87
HEALTHY FAMILIES IOWA (HFI)
87.3(135) Applicant eligibility
87.4(135) Participant eligibility
87.5(135) Program requirements
87.6(135) Contractor assurance
87.7(135) Applicant appeal process
87.8(135) Participant right to appeal
CHAPTER 88
VOLUNTEER HEALTH CARE
PROVIDER PROGRAM
88.3(135) Eligibility for defense and indemnification coverage
88.4(135) Sponsor program eligibility
88.5(135) Covered health care services
88.6(135) Defense and indemnification
88.8(135) Reporting requirements and duties
88.9(135) Revocation of eligibility and registration
88.10(135) Procedure for revocation of eligibility and registration
88.11(135) Effect of suspension or revocation
88.12(135) Registration denied
88.13(135) Board notice of disciplinary action
88.14(135) Effect of eligibility certification
88.15(135) Reporting by volunteer health care provider and program
DECISION–MAKING ASSISTANCE PROGRAM
NOTIFICATION PROCESS
89.21(135L) Notification of parent prior to the performance of abortion on a pregnant minor
89.22(135L) Exceptions to notification of parent
89.23(135L) Physician compliance
89.26(135L) Fraudulent practice
CHAPTER 90
IOWA CHILD DEATH REVIEW TEAM
90.7(135) Expenses of team members
90.8(135) Team responsibilities
90.10(135) Confidentiality and disclosure of information
90.11(135) Immunity and liability
CHAPTER 91
IOWA DOMESTIC ABUSE DEATH
REVIEW TEAM
91.7(77GA,ch1221) Expenses of team members
91.8(77GA,ch1221) Team responsibilities
91.10(77GA,ch1221) Confidentiality and disclosure of information
91.11(77GA,ch1221) Immunity and liability
CHAPTER 92
IOWA FATALITY REVIEW COMMITTEE
92.4(135) Formation of the committee
92.5(135) Committee protocol for review
92.7(135) Consultation with county attorney
92.9(135) Confidentiality and disclosure of information
92.10(135) Immunity and liability
CHAPTER 93
ABUSE EDUCATION REVIEW PANEL
93.5(135) Standards for approval of curricula
93.6(135) Process for application review and approval
CHAPTER 94
CHILD PROTECTION CENTER
GRANT PROGRAM
94.5(135) Eligibility and criteria
CHAPTER 95
CERTIFICATE OF BIRTH—
REGISTRATION FEE
95.1(144) Birth certificates—when filing fee required
95.5(144) Responsibilities of institutions
96.5(144) Additional statistical data
96.6(144) General public accessibility
96.7(144) Direct tangible interest accessibility
96.8(144) County custodians’ responsibility for maintenance of confidentiality
98.1(144) Forms
property of Iowa
department of public health
98.2(144) Preparation of certificates
CHAPTER 99
DELAYED BIRTH, DEATH AND
MARRIAGE REGISTRATION
99.1(144) Foundling registration
99.2(144) Birth registration—five days to one year
99.3(144) Delayed birth registration—after one year
99.4(144) Who may file delayed certificate
99.5(144) Delayed certificate to be signed
99.6(144) Facts to be established for delayed registration of birth
99.7(144) Documentary evidence
99.8(144) Abstraction and certification by state registrar
99.10(144) Cancellation after one year
99.11(144) Duties of county registrar
99.12(144) Delayed registration of death records
99.13(144) Delayed registration of marriage records
CHAPTER 100
ESTABLISHMENT OF NEW
CERTIFICATES OF BIRTH
100.1(144) Certificates, forms
100.3(144) Certificate following adoption
100.4(144) Certificate following legitimation
100.5(144) Certificate following determination of paternity
100.6(144) Minimum information required
100.7(144) Original certificate to be sealed
CHAPTER 101
DEATH CERTIFICATION, AUTOPSY
AND DISINTERMENT
101.1(144) Report of autopsy findings
101.2(144) Attending physician not available
101.3(144) Hospital or institution may assist in preparation of certificate
101.4(135) Removal of dead body or fetus
101.5(144) Burial–transit permit
101.6(135) Transportation and disposition of dead body or fetus
101.7(135,144) Disinterment permits
CHAPTER 102
CORRECTION AND AMENDMENT
OF VITAL RECORDS
102.1(144) Application to amend records
102.2(144) Correction of minor errors within first year
102.3(144) Amendments or major corrections
102.4(144) Correction of same item more than once
102.5(144) Methods of amending certificates
102.6(144) Amendment of birth certificate by paternity affidavit
102.7(144) Change of given names within first year
102.8(144) Addition of given names until seventh birthday
102.9(144) Addition of given name after seventh birthday
102.10(144) Legal change of name
CHAPTER 103
CONFIDENTIALITY OF RECORDS
CHAPTER 104
COPIES OF VITAL RECORDS
104.1(144) Certified copies and verifications
104.2(144) Cancellation of fraudulent records
CHAPTER 105
DECLARATION OF PATERNITY
REGISTRY
105.2(144) Registry established
105.3(144) Information to be provided
105.6(144) Access to registry information
CHAPTER 106
REPORTING OF TERMINATION
OF PREGNANCY
106.2(144) Report of termination of pregnancy
106.3(144) Confidentiality of released information
106.4(144) Confidentiality of reports submitted
106.6(144) Unlawful acts—punishment
CHAPTER 107
MUTUAL CONSENT VOLUNTARY ADOPTION REGISTRY
107.5(78GA,HF497) Notification
CHAPTER 109
PRESCRIPTION DRUG DONATION REPOSITORY PROGRAM
109.3(135M) Eligibility criteria for program participation by medical facilities and pharmacies
109.4(135M) Standards and procedures for accepting donated prescription drugs and supplies
109.6(135M) Standards and procedures for dispensing donated prescription drugs and supplies
109.7(135M) Eligibility criteria for individuals to receive donated prescription drugs and supplies
109.8(135M) Forms and record keeping
109.10(135M) List of drugs and supplies program will accept
109.11(135M) Exemption from disciplinary action, civil liability and criminal prosecution
CHAPTER 110
CENTER FOR RURAL HEALTH
AND PRIMARY CARE
110.3(135) Responsibilities of the center
110.4(135) Advisory committee to the center for rural health and primary care
PRIMECARRE COMMUNITY GRANT PROGRAM
PRIMECARRE PRIMARY CARE PROVIDER
COMMUNITY SCHOLARSHIP PROGRAM
PRIMECARRE PRIMARY CARE PROVIDER
LOAN REPAYMENT PROGRAM
CHAPTER 112
BIOLOGICAL AGENT RISK ASSESSMENT
112.3(135) Biosecurity council established
112.4(135) Biological agent risk assessment
112.5(135) Requests for biological agent information
CHAPTER 113
PUBLIC HEALTH RESPONSE TEAMS
113.4(135) Public health response team members
113.5(135) Disaster medical assistance team
113.6(135) Environmental health response team
113.7(135) Legal and other protections
113.8(135) Reporting requirements and duties
CHAPTER 121
STANDARD FOR IMPACT RESISTANCE AND METHOD OF TESTING
121.1(135) Standard for impact–resistant lenses
121.2(135) Method of testing lenses
CHAPTER 124
INTERAGENCY COORDINATING COUNCIL FOR THE STATE MEDICAL EXAMINER
CHAPTER 125
ADVISORY COUNCIL FOR THE STATE MEDICAL EXAMINER
CHAPTER 126
STATE MEDICAL EXAMINER
126.1(144,331,691) Definitions
126.3(691) Fees for autopsies and related services and reimbursement for related expenses
126.4(691) Fees for tissue recovery
CHAPTER 127
COUNTY MEDICAL EXAMINERS
127.1(144,331,691) Definitions
127.2(331,691) Duties of medical examiners—jurisdiction over deaths which affect the public interest
127.5(144,331,691) Death certificates—deaths affecting the public interest
127.7(331,691) County medical examiner investigators
127.8(331,691) Deputy county medical examiners
127.9(331,691) Failure to comply with rules
127.10(331,691,22) Confidentiality
127.11(331,691,670) Indemnification
CHAPTER 128
DOGS FOR SCIENTIFIC RESEARCH
128.2(145B) Investigation and authorization of applicant
128.3(145B) Expiration of authorization
128.4(145B) Minimum requirements for animal care
128.5(145B) Investigation of noncompliance
CHAPTER 130
EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL
130.8(147A) Expenses of advisory council members
CHAPTER 131
EMERGENCY MEDICAL SERVICES PROVIDER EDUCATION/
TRAINING/CERTIFICATION
131.2(147A) Emergency medical care providers—requirements for enrollment in training programs
131.3(147A) Emergency medical care providers—EMS provider authority
131.5(147A) Training programs—standards, application, inspection and approval
131.6(147A) Continuing education providers—approval, record keeping and inspection
131.9(147A) Reinstatement of certification
131.10(147A) Certification denial
131.11(147A) Emergency adjudicative proceedings
131.12(147A) Complaints, investigations and appeals
CHAPTER 132
EMERGENCY MEDICAL SERVICES—
SERVICE PROGRAM AUTHORIZATION
132.2(147A) Authority of emergency medical care provider
132.8(147A) Service program levels of care and staffing standards
132.9(147A) Service program—off–line medical direction
132.14(147A) Temporary variances
132.15(147A) Transport options for fully authorized paramedic service programs
CHAPTER 133
WHITE FLASHING LIGHT AUTHORIZATION
133.4(321) Approval, denial, probation, suspension and revocation of authorization
133.5(321) Appeal of denial, probation, or revocation of authorization
CHAPTER 134
TRAUMA CARE FACILITY CATEGORIZATION AND VERIFICATION
134.2(147A) Trauma care facility categorization and verification
CHAPTER 135
TRAUMA TRIAGE AND TRANSFER PROTOCOLS
135.2(147A) Trauma triage and transfer protocols
135.3(147A) Offenses and penalties
136.3(147A) Offenses and penalties
CHAPTER 137
TRAUMA EDUCATION AND TRAINING
137.2(147A) Initial trauma education for Iowa’s trauma system
137.3(147A) Continuing trauma education for Iowa’s trauma system
137.4(147A) Offenses and penalties
CHAPTER 138
TRAUMA SYSTEM EVALUATION QUALITY IMPROVEMENT COMMITTEE
138.2(147A) System evaluation quality improvement committee (SEQIC)
CHAPTER 139
IOWA LAW ENFORCEMENT
EMERGENCY CARE PROVIDER
139.2(147A) Authority of Iowa law enforcement emergency care provider
139.5(147A) Iowa law enforcement training programs
139.6(147A) Law enforcement AED service program authorization
CHAPTER 140
EMERGENCY MEDICAL SERVICES SYSTEM DEVELOPMENT GRANTS FUND
140.3(135) County EMS associations
140.4(135) County EMS system development grants
CHAPTER 141
LOVE OUR KIDS GRANT
141.3(321) Funding limitations
141.5(321) Application process
141.6(321) Application
denial or partial
denial—appeal
CHAPTER 142
OUT–OF–HOSPITAL DO–NOT–RESUSCITATE ORDERS
142.3(144A,147A) Responsibilities of the department
142.4(144A,147A) EMS providers
142.5(144A) Guidelines for non–EMS health care providers, patients, and organizations
142.6(144A) Revocation of the out–of–hospital do–not–resuscitate order
142.8(144A) Transfer of patients
142.9(144A) Application to existing orders
CHAPTER 143
AUTOMATED EXTERNAL DEFIBRILLATOR GRANT PROGRAM
143.3(135) Application process
143.4(135) Early defibrillation program
CHAPTER 150
IOWA REGIONALIZED SYSTEM OF PERINATAL HEALTH CARE
Purpose and scope
Definitions
Perinatal guidelines advisory committee
Categorization and selection of level of care designation
Recommendation by the statewide perinatal care program
Level I hospitals
Level II hospitals
Level II regional centers
Level II regional neonatology centers
Level III centers
Grant or denial of certificate of verification; and offenses and penalties
Prohibited acts
Construction of rules
CHAPTER 151
TOBACCO USE PREVENTION
AND CONTROL COMMUNITY PARTNERSHIP INITIATIVE
151.2(142A) Community partnership areas
151.3(142A) Community partnerships
151.4(142A) Application requirements for community partnerships
151.5(142A) Performance indicators
151.6(142A) Application deadline
151.7(142A) Distribution of funding
CHAPTER 152
TOBACCO USE PREVENTION AND CONTROL FUNDING PROCESS
152.1(78GA,HF2565) Scope and purpose
CHAPTER 155
LICENSURE STANDARDS FOR SUBSTANCE ABUSE TREATMENT PROGRAMS
155.5(125) Application procedures
155.7(125) Inspection of licensees
155.9(125) Corrective action plan
155.10(125) Grounds for denial of initial license
155.11(125) Suspension, revocation, or refusal to renew a license
155.12(125) Contested case hearing
155.13(125) Rehearing application
155.15(125) Reissuance or reinstatement
155.16(125) Complaints and investigations
155.21(125) General standards for all substance abuse treatment programs
155.22(125) Inpatient, residential, and halfway house safety
155.23(125) Specific standards for inpatient, residential, and halfway house service
155.25(125) Specific standards for assessment and evaluation programs
155.35(125) Specific standards for opioid treatment programs
CHAPTER 156
LICENSURE STANDARDS FOR SUBSTANCE ABUSE TREATMENT PROGRAMS IN CORRECTIONAL
FACILITIES
156.3(125) General standards for all correctional substance abuse treatment programs
157.2(125) Screening, evaluation, treatment, and drinking drivers course
157.3(125) Screening, evaluation, treatment, and drinking drivers course completion
157.4(125) Cost of evaluation and treatment
CHAPTER 158
REGIONS FOR SUBSTANCE ABUSE PREVENTION AND TREATMENT
158.1(125) Service areas established
158.2(125) Request for a change in service areas
158.4(125) Notification of affected parties
158.7(125) Change during term of contract
158.8(125) State board of health review
158.9(125) State board of health decision
CHAPTER 162
LICENSURE STANDARDS FOR PROBLEM GAMBLING TREATMENT PROGRAMS
162.5(135) Application procedures
162.7(135) Inspection of licensees
162.9(135) Corrective action plans
162.10(135) On–site inspection for initial licensure
162.11(135) Denial, suspension, revocation, or refusal to renew a license
162.12(135) Contested case hearings
162.13(135) Rehearing application
162.15(135) Reissuance or reinstatement
162.16(135) Complaints and investigations
162.19(135) Exemptions to rule 641—162.20(135)
162.20(135) General standards for all problem gambling treatment programs
CHAPTER 170
DESCRIPTION OF ORGANIZATION
170.2(17A) State board of health
170.3(17A) Director of public health
170.4(17A,135) Administrative divisions of the department
170.7(17A) Submission of materials
170.8(17A) Request for information
CHAPTER 171
PETITIONS FOR RULE MAKING
171.1(17A) Petition for rule making
171.4(17A) Department consideration
CHAPTER 172
DECLARATORY ORDERS
172.1(17A) Petition for declaratory order
172.6(17A) Service and filing of petitions and other papers
172.9(17A) Refusal to issue order
172.10(17A) Contents of declaratory order—effective date
172.12(17A) Effect of a declaratory order
173.1(17A) Scope and applicability
173.4(17A) Requests for contested case proceeding
173.7(17A) Waiver of procedures
173.8(17A) Telephone proceedings
173.10(17A) Consolidation—severance
173.12(17A) Service and filing of pleadings and other papers
173.16(17A) Prehearing conference
173.20(17A) Hearing procedures
173.23(17A) Ex parte communication
173.25(17A) Interlocutory appeals
173.27(17A) Appeals and review
173.28(17A) Applications for rehearing
173.29(17A) Stays of department actions
173.30(17A) No factual dispute contested cases
173.31(17A) Emergency adjudicative proceedings
CHAPTER 174
AGENCY PROCEDURE FOR
RULE MAKING
(Uniform Rules)
174.3(17A) Public rule–making docket
174.4(17A) Notice of proposed rule making
174.5(17A) Public participation
174.6(17A) Regulatory flexibility analysis
174.11(17A) Concise statement of reasons
174.13(17A) Agency rule–making record
CHAPTER 175
FAIR INFORMATION PRACTICES AND PUBLIC RECORDS
(175.1 to 175.8 Uniform Rules)
175.3(17A,22) Requests for access to records
175.7(17A,22) Consent to disclosure by the subject of a confidential record
175.8(17A,22) Notice to suppliers of information
175.9(17A,22) Disclosures without the consent of the subject
175.11(17A,22) Consensual disclosure of confidential records
175.12(17A,22) Release to subject
175.13(17A,22) Availability of records
175.14(17A,22) Personally identifiable information
175.15(17A,22) Other groups of records
175.16(17A,22) Data processing systems
CHAPTER 176
CRITERIA FOR AWARDS OR GRANTS
176.5(135,17A) Review process (competitive applications only)
176.7(135,17A) Public notice of available funds
177.2(76GA,ch1212) Definitions
177.3(76GA,ch1212) Description of data to be submitted
177.4(76GA,ch1212) Department studies
177.6(76GA,ch1212) Patient confidentiality
177.7(76GA,ch1212) Department contracting
177.8(76GA,ch1212) Address and specification for data submissions
CHAPTER 178
VARIANCES AND WAIVERS OF PUBLIC HEALTH ADMINISTRATIVE RULES
178.2(17A,135) Sample petition for waiver
CHAPTER 191
ADVISORY BODIES OF
THE DEPARTMENT
191.7(135) Expenses of advisory body members
CHAPTER 192
CHILD SUPPORT NONCOMPLIANCE
192.1(252J) Issuance or renewal of a license—denial
192.2(252J) Suspension or revocation of a license
192.3(17A,22,252J) Sharing of information
CHAPTER 193
IMPAIRED PRACTITIONER
REVIEW COMMITTEE
193.1(272C) Impaired practitioner review committee
CHAPTER 195
STUDENT LOAN DEFAULT/NONCOMPLIANCE WITH AGREEMENT FOR PAYMENT OF OBLIGATION
195.1(261) General definitions
195.2(261) Issuance or renewal of a license—denial
195.3(261) Suspension or revocation of a license
195.4(17A,22,261) Sharing of information
CHAPTER 201
ORGANIZED DELIVERY SYSTEMS
LICENSURE AND REGULATION
201.1(135,75GA,ch158) Purpose and scope
201.2(135,75GA,ch 158) Definitions
201.3(135,75GA,ch158) Application
201.4(135,75GA,ch158) Governing body
201.5(135,75GA,ch158) Service
area/
geographic access
201.6(135,75GA,ch158,78GA,ch41)
Provider network and contracts; treatment and services
201.7(135,75GA,ch158) Complaints
201.8(135,75GA,ch158) Accountability
201.9(135,75GA,ch158) Reporting
201.10(135,75GA,ch158) Evaluation
201.11(135,75GA,ch158) Annual report
201.12(135,75GA,ch158) Finance
and
solvency
201.13(135,75GA,ch158) Investment
201.14(135,75GA,ch158) Rating practices
201.16(135,75GA,ch158) Change in organizational documents or control
201.18(135,78GA,ch41) External review
ANTITRUST
201.20(135,75GA,ch158) Purpose
201.21(135,75GA,ch158) Definitions
201.23(135,75GA,ch158) Application
201.24(135,75GA,ch158) Notice and comment
201.25(135,75GA,ch158) Procedure for review of applications
201.26(135,75GA,ch158) Criteria for decision
201.27(135,75GA,ch158) Decision
201.29(135,75GA,ch158) Supervision after approval
201.30(135,75GA,ch158) Revocation
CHAPTER 202
CERTIFICATE OF NEED PROGRAM
202.4(135) Submission of application
202.5(135) Organizational procedures
202.6(135) Public hearing on application
202.8(135) Extension of review time
202.9(135) Rehearing of certificate of need decision
202.10(135) Status reports to affected persons
202.12(135) Project progress reports
202.13(135) Request for extension of certificate
202.14(135) Application changes after approval
CHAPTER 203
STANDARDS FOR CERTIFICATE OF
NEED REVIEW
203.1(135) Acute care bed need
203.2(135) Cardiac
catheterization and
cardiovascular surgery
standards
203.3(135) Radiation
therapy or
radiotherapy standards
203.4(135) Computerized
tomography
standards
203.6(135) Bed need formula for mentally retarded
203.7(135) End–stage renal disease standards
203.8(135) Financial
and economic
feasibility
203.9(135) Obstetrical services and neonatal intensive care unit standards
203.10(135) Designated
pediatric units
standards
203.11(135) Designated inpatient substance abuse treatment unit standards
203.12(135) Magnetic
resonance imaging
services standards
203.13(135) Positron emission tomography services standards
CHAPTER 204
UNIFORM REPORTING REQUIREMENTS
204.1(135) Reporting requirements
204.2(135) Initial reporting period
chapter 1
NOTIFICATION AND SURVEILLANCE OF REPORTABLE COMMUNICABLE
AND INFECTIOUS DISEASES, POISONINGS AND CONDITIONS
[Prior to 7/29/87, Health Department[470]]
641—1.1(139A) Definitions. For the purpose of these rules, the following definitions shall apply:
“Acute hearing loss and tinnitus” means any sudden deafness, hearing loss, or tinnitus due to exposure to noise in the work setting. (International Classification of Diseases, Tenth Edition, (ICD–10) codes H83.3, H90.2, H90.3, H91.2, H93.1, and H93.2)
“Acute or chronic respiratory conditions due to fumes, vapors or dusts” means acute chemical bronchitis, any acute, subacute, or chronic respiratory condition due to inhalation of a chemical fume or vapor, or pneumoconioses not specifically listed elsewhere in these rules. (ICD–10 codes J63.0–J64, J66, and J68.0–J68.9) “Acute or chronic respiratory conditions due to fumes, vapors or dusts” excludes those respiratory conditions related to tobacco smoke exposure.
“Agriculturally related injury” means any injury to a farmer, farm worker, farm family member, or other individual which occurred on a farm, or in the course of handling, producing, processing, transporting or warehousing farm commodities.
“Area quarantine” means prohibiting ingress and egress to and from a building or buildings, structure or structures, or other definable physical location, or portion thereof, to prevent or contain the spread of a suspected or confirmed quarantinable disease or to prevent or contain exposure to a suspected or known chemical, biological, radioactive, or other hazardous or toxic agent.
“Carpal tunnel or related neuropathy” means carpal tunnel syndrome, other lesions of the median nerve, ulnar nerve or radial nerve, causalgia or other related neuropathy of the upper limb. (ICD–10 codes G56.0–G56.9)
“Clinical laboratory” means any laboratory performing analyses on specimens taken from the body of a person in order to assess that person’s health status.
“Communicable disease” means any disease spread from person to person or animal to person.
“Contagious or infectious disease” means any contagious or infectious disease which is transmitted by a bloodborne route or by skin–to–skin contact.
“Health care facility” means a health care facility as defined in Iowa Code section 135C.1, an ambulatory surgical center, or a clinic.
“Health care provider” means a person licensed to practice medicine and surgery, osteopathic medicine and surgery, osteopathy, chiropractic, podiatry, nursing, dentistry, optometry, or licensed as a physician assistant, dental hygienist, or acupuncturist.
“Investigation” means an inquiry conducted to determine the specific source, mode of transmission, and cause of a disease or suspected disease occurrence and to determine the specific incidence, prevalence, and extent of the disease in the affected population. “Investigation” may also include the application of scientific methods and analysis to institute appropriate control measures.
“Isolation” means the separation of persons or animals presumably or actually infected with a communicable disease, or that are disease carriers, for the usual period of communicability of that disease. Isolation shall be in such places, marked by placards if necessary, and under such conditions to prevent the direct or indirect conveyance of the infectious agent or contagion to susceptible individuals.
“Local board of health” means a county, city, or district board of health.
“Occupationally related asthma, bronchitis or respiratory hypersensitivity reaction” means any extrinsic asthma or acute chemical pneumonitis due to exposure to toxic agents in the workplace. (ICD–10 codes J67.0–J67.9)
“Poison control or poison information center” means any organization or program which has as one of its primary objectives the provision of toxicologic and pharmacologic information and referral services to the public and to health care providers (other than pharmacists) in response to inquiries about actual or potential poisonings.
“Public health disaster” means an incident as defined in Iowa Code Supplement section 135.140.
“Quarantinable disease” means any communicable disease which presents a risk of serious harm to public health and which may require isolation or quarantine to prevent its spread. “Quarantinable disease” includes but is not limited to cholera; diphtheria; infectious tuberculosis; plague; smallpox; yellow fever; viral hemorrhagic fevers, including Lassa, Marburg, Ebola, Crimean–Congo, South American, and others not yet isolated or named; and severe acute respiratory syndrome (SARS).
“Quarantine” means the limitation of freedom of movement of persons or animals that have been exposed to a communicable disease, within specified limits marked by placards, for a period of time equal to the longest usual incubation period of the disease. The limitation of movement shall be in such manner as to prevent the spread of a communicable disease.
“Raynaud’s phenomenon” means ischemia of fingers, toes, ears or nose including “vibration white finger” caused by exposure to heat, cold, vibration or other physical agents in the work setting. (ICD–10 code I73.0)
“Reportable cancers” means those cancers included in the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program.
“Severe skin disorder” means those dermatoses, burns, and other severe skin disorders which result in death or which require hospitalization or other multiple courses of medical therapy.
“Sexually transmitted disease or infection” means a disease or infection that is primarily transmitted through sexual practices.
“Suspected” or “suspected case” means an individual that presents with clinical signs or symptoms indicative of a reportable or quarantinable disease.
“Toxic agent” means any noxious substance in solid, liquid or gaseous form capable of producing illness in humans including, but not limited to, pesticides, heavy metals, organic and inorganic dusts and organic solvents. Airborne toxic agents may be in the form of dusts, fumes, vapors, mists, gases or smoke.
“Toxic hepatitis” means any acute or subacute necrosis of the liver or other unspecified chemical hepatitis caused by exposure to nonmedicinal toxic agents other than ethyl alcohol including, but not limited to, carbon tetrachloride, chloroform, tetrachloroethane, trichloroethylene, phosphorus, TNT, chloronapthalenes, methylenedianilines, ethylene dibromide, and organic solvents. (ICD–10 codes K71.0–K71.9)
641—1.2(139A) Authority. The director of public health is the principal officer of the state to administer disease reporting and control procedures. The State Health Registry of Iowa, administered by the Department of Epidemiology of the College of Public Health at the University of Iowa, is a public health authority for purposes of collecting cancer data in accordance with this chapter.
641—1.3(139A) Reportable diseases. Reportable diseases are those diseases or conditions listed in subrules 1.3(1) and 1.3(2). The director of public health may also designate any disease, condition or syndrome temporarily reportable for the purpose of a special investigation. Each case of a reportable disease is required to be reported to the Iowa Department of Public Health, Lucas State Office Building, 321 E. 12th Street, Des Moines, Iowa 50319–0075, by the physician or other health practitioner attending any person having a reportable disease and by laboratories performing tests identifying reportable diseases.
1.3(1) List of reportable diseases or conditions.
a. Specific communicable diseases.
(1) Common diseases:
†Acquired immune deficiency syndrome (AIDS) and AIDS–defining conditions
#Aeromonas
Campylobacteriosis
†Chlamydia
Cryptosporidiosis
Encephalitis, arboviral
~Enterococcus invasive disease
#Enterohemorrhagic Escherichia coli (non–O157:H7)
~Escherichia coli O157:H7 related diseases (includes HUS)
Giardiasis
†Gonorrhea
~Group A Streptococcus invasive disease
~*Haemophilus influenza type B invasive disease
Hepatitis, types A, †B, C, D, and E
†Human immunodeficiency virus (HIV) infection, including HIV–exposed newborn infant (i.e.,
newborn infant whose mother is infected with HIV)
Legionellosis
Lyme disease
*Measles (rubeola)
~*Meningococcal invasive disease
~Methicillin–resistant Staphylococcus aureus invasive disease
#Norwalk–like virus
Pertussis
Rabies (animal and *human)
~Salmonellosis (including Typhoid fever)
~Shigellosis
**Staphylococcus aureus invasive disease
~Streptococcus pneumoniae invasive disease
†Syphilis
Tuberculosis
#Yersinia
(2) Rare diseases:
Anthrax
*Botulism
Brucellosis
*Cholera
Cyclospora
*Diphtheria
Hansen’s disease (Leprosy)
Hantavirus syndromes
~Listeria monocytogenes invasive disease
Malaria
Mumps
*Plague
*Poliomyelitis
Psittacosis
Rocky Mountain spotted fever
Rubella (including congenital)
Tetanus
Toxic shock syndrome
Trichinosis
*Yellow fever
~*Vancomycin–resistant Staphylococcus aureus
*Outbreaks of any kind, unusual syndromes, or uncommon diseases
*Diseases or syndromes of any kind caused by a biological agent or toxin when the provider reasonably believes or suspects that the agent or toxin may be a result of a deliberate act such as terrorism. Examples of these agents include *ricin, *tularemia and *smallpox.
b. Specific noncommunicable diseases.
Acute or chronic respiratory conditions due to fumes or vapors or dusts
Asbestosis
Birth defect or genetic disease***
Cancer***
Carbon monoxide poisoning
Coal workers pneumoconiosis
Heavy metal poisoning
Hepatitis, toxic
Hypersensitivity pneumonitis (including farmers lung and toxic organic dust syndrome)
Methemoglobinemia
Pesticide poisoning (including pesticide–related contact dermatitis)
Silicosis
Silo fillers disease
*Diseases or syndromes of any kind caused by a chemical or radiological agent when the provider reasonably believes or suspects that the agent or toxin may be a result of a deliberate act such as terrorism. Examples of these agents include *mustard gas and *sarin gas.
c. Specific occupationally related conditions.
Acute hearing loss and tinnitus
Carpal tunnel and related neuropathyà
Asthma, bronchitis or respiratory hypersensitivity reactions
Raynaud’s phenomenonà
Severe skin disorder
d. Agriculturally related injuries (work– or non–work–related).
e. Heavy metal poisonings.
(1) Lead poisoning. All analytical values for blood lead analysis shall be reported to the department. Analytical values less than 10 micrograms per deciliter (mg/dL) may be reported as less than 10 micrograms per deciliter (mg/dL) rather than as the actual value. In addition to the analytical value, the following information shall be reported to the department: the date of sample collection, whether the sample is a capillary or venous blood sample, the date of birth and the address of the patient, the name and address of the patient’s physician, analytical method used for the analysis, lower quantitation limit of the analytical method, and the quality assurance/quality control values associated with the analysis.
(2) Mercury poisonings.
1. Blood mercury values equal to or greater than 2.8 mcg/dL.
2. Urine mercury values equal to or greater than 20 mcg/L.
(3) Arsenic poisonings.
1. Blood arsenic values equal to or greater than .07 mcg/mL.
2. Urine arsenic values equal to or greater than 100 mcg/L.
3. Twenty–four hour urinary arsenic excretion values equal to or greater than .02 mg/day.
(4) Cadmium poisonings.
1. Blood cadmium values equal to or greater than 5 mcg/L.
2. Urine cadmium values equal to or greater than 10 mcg/L.
(5) Physicians and other health care practitioners are exempted from the requirements of 1.3(1)“e” if the laboratory performing the analysis provides the report containing the required information to the department.
f. Pesticide poisonings.
(1) Organophosphate and carbamate cholinesterase inhibiting pesticides. In using a given analytic method to measure cholinesterase inhibition, measurement techniques often vary among laboratories. For this reason, when a depressed cholinesterase value is found, in addition to reporting the items specified in rule 641—1.3(139A), each laboratory shall provide to the Iowa department of public health evidence of the rational bases upon which the laboratory identified the reported value as depressed. For example, for nonautomated analytic methods, a laboratory may judge that a cholinesterase value is depressed on the basis of the value falling below two standard deviations from the mean value for tests completed by that laboratory on the general unexposed population. For automated methods, such as automated spectrophotometry, for which there are built–in quality control procedures and appropriate literature for determining normality, the laboratory should judge a value as depressed on the basis of such appropriate literature. In all instances, clinical laboratories shall report any test finding which shows a 25 percent depression in red blood cell, plasma or whole blood cholinesterase from preexposure levels.
(2) Other pesticide poisonings. Any herbicide, organochlorine insecticide or metabolite thereof in a clinical specimen taken from a person with a history of overexposure to such pesticides within the 48 hours previous to collection of the specimen. If a laboratory has no information regarding the exposure history of a person, a report of a positive test finding for a herbicide, organochlorine insecticide or metabolite thereof is not required, but is encouraged to be reported if the levels found are consistent with overexposure.
g. Nitrate poisonings. Blood analyses showing greater than 5 percent of total hemoglobin present as methemoglobin.
h. Toxic hepatitis. In cases where a laboratory has been made aware of a prolonged or possible overexposure to carbon tetrachloride, tetrachloroethane, trichloroethylene, phosphorus, TNT, chloronapthalenes, methylenedianilines, cresol or ethylene dibromide and any abnormal liver tissue biopsy findings which would be attributable to such exposure. If a laboratory has no information on the exposure history of a person, but that person’s liver biopsy findings are consistent with exposure to these chemicals, then a laboratory is encouraged, but not required, to report such findings.
i. Noncommunicable respiratory illnesses. Any biopsy of lung tissue indicating prolonged exposure or overexposure to asbestos, silica, silicates, aluminum, graphite, bauxite, beryllium, cotton dust or other textile material, or coal dust.
j. Carbon monoxide (CO) poisoning.
(1) Blood carbon monoxide level equal to or greater than 10 percent carboxyhemoglobin or its equivalent with a breath analyzer test, or
(2) A clinical diagnosis of CO poisoning regardless of any test results.
1.3(2) Other reportable diseases. Physicians are required to report any other disease or condition which is unusual in incidence, occurs in unusual numbers or circumstances, or appears to be of public health concern (such as epidemic diarrhea of the newborn in nurseries or a food poisoning episode) including outbreaks of suspected environmental or occupational illness.
641—1.4(135,139A) Reporting and investigation.
1.4(1) Reporting by telephone.
a. Quarantinable diseases. A health care provider and a public, private, or hospital clinical laboratory shall immediately report any confirmed or suspected case of quarantinable disease by telephone to the department’s disease notification hotline at 1–800–362–2736. The report shall include all information required by Iowa Code section 139A.3 and the following:
(1) The stage of the disease process.
(2) Clinical status.
(3) Any treatment provided for the disease.
(4) All household and other known contacts.
(5) Whether household and other known contacts have been examined and the results of such examinations.
b. Other diseases that carry serious consequences or spread rapidly. A health care provider and a public, private, or hospital clinical laboratory shall immediately report any confirmed or suspected case of a common source epidemic or disease outbreak of unusual numbers by telephone to the department’s disease notification hotline at 1–800–362–2736.
1.4(2) Reporting of other reportable diseases. Cases of other reportable diseases and conditions not included in 1.4(1) shall be reported to the department at least weekly by mail, telephone, facsimile, or other secure electronic means. If the department determines that reporting by mail hinders the application of organized control measures to protect the public health, the department may require that the disease or condition be reported by telephone.
1.4(3) Investigation of reportable diseases. A health care provider and a public, private, or hospital clinical laboratory shall assist in a disease investigation conducted by the department, a local board, or local department. A health care provider and a public, private, or hospital clinical laboratory shall provide the department, local board, or local department with all information necessary to conduct the investigation, including but not limited to medical records; exposure histories; medical histories; contact information; and test results necessary to the investigation, including positive, pending, and negative test results.
1.4(4) Each occurrence of a reportable cancer that is diagnosed or treated in an Iowa resident or occurs in a nonresident who is diagnosed or treated in an Iowa facility shall be reported to the State Health Registry of Iowa, administered by the Department of Epidemiology of the College of Public Health at the University of Iowa, by mail, telephone or electronic means.
1.4(5) Issuance of investigatory subpoenas.
a. The department may upon the written request of a local board of health, the state epidemiologist or designee, or the deputy state epidemiologist or designee, subpoena records, reports, or any other evidence necessary to conduct a disease investigation. The subpoena shall be signed by the division director of the division of acute disease prevention and emergency response or the division director’s designee following review and approval of the written request for subpoena.
b. A written request for a subpoena shall contain the following:
(1) The name and address of the person, facility, or entity to which the subpoena will be directed;
(2) A specific description of the records, reports, or other evidence requested; and
(3) An explanation of why the documents sought to be subpoenaed are necessary for the department to conduct the disease investigation.
c. Each subpoena shall contain:
(1) The name and address of the person, facility, or entity to which the subpoena is directed;
(2) A description of the records, reports, or other evidence requested;
(3) The date, time, and location for production, inspection, or copying;
(4) The time within which a motion to quash or modify the subpoena must be filed;
(5) The signature, address, and telephone number of the division director;
(6) The date of issuance; and
(7) A return of service.
d. Process to challenge a subpoena.
(1) Any person who is aggrieved or adversely affected by compliance with the subpoena and who desires to challenge the subpoena must, within five days after service of the subpoena, or before the time specified for compliance if such time is less than five days, file with the department a motion to quash or modify the subpoena. The motion shall describe the reasons why the subpoena should be quashed or modified, and may be accompanied by legal briefs or factual affidavits.
(2) Upon receipt of a timely motion to quash or modify a subpoena, the department may request an administrative law judge to issue a decision. Oral argument may be scheduled at the discretion of the administrative law judge. The administrative law judge may quash or modify the subpoena, deny the motion, or issue an appropriate protective order.
(3) A person aggrieved by a ruling of an administrative law judge who desires to challenge that ruling must appeal the ruling to the department by serving on the department director, either in person or by certified mail, a notice of appeal within ten days after the service of the decision of the administrative law judge. The department director’s decision is final for purposes of judicial review.
e. Subpoenas issued under this subrule and requests, motions, and pleadings related to the issuance of subpoenas are confidential pursuant to Iowa Code sections 139A.3 and 22.7.
641—1.5(139A) Reporting forms.
1.5(1) Cases of reportable diseases, poisonings and conditions shall be submitted in a format specified by the department.
1.5(2) Sexually transmitted disease/infection should be reported to the department on a sexually transmitted disease/infection form which is provided to health care providers and laboratories. Since these reports are confidential, they shall be transmitted in sealed envelopes or other secure fashion.
1.5(3) Occupational nurses may submit cases of occupationally related reportable diseases or conditions on report forms provided by the department, or may submit copies of either of the following forms:
a. Occupational Safety and Health Act Form No. 101, “Supplementary Record of Occupational Injuries and Illnesses,” or
b. State of Iowa Form No. L–1WC–1, “Employers Work Injury Report, Employers First Report of Injury.”
Copies of report forms listed in paragraph “a” or “b” will suffice only if the employer of the occupational nurse has already submitted the original reports to the Iowa industrial commissioner.
1.5(4) Reportable cancers shall be reported on the forms developed and distributed by the State Health Registry of Iowa. Data from the report forms will be supplemented with information obtained from records from hospitals, radiation treatment centers, outpatient surgical centers, oncology clinics, pathology laboratories, and physician offices through an abstracting process developed by the State Health Registry of Iowa. Tissue samples may also be submitted under the authority of this rule. The content of the reports shall include, but not be limited to, follow–up data and demographic, diagnostic, treatment, and other medical information.
641—1.6(139A) Who should report.
1.6(1) Health care providers are required by law to report all cases of reportable diseases attended by them.
1.6(2) Hospitals and other health care facilities are required to report cases of reportable diseases.
1.6(3) School nurses are to report suspected cases of reportable diseases occurring among the children supervised.
1.6(4) School officials, through the principal or superintendent as appropriate, are required to report when there is no school nurse.
1.6(5) Laboratories are required to report cases of reportable diseases and results obtained in the examination of all specimens which yield evidence of or are reactive for sexually transmitted diseases.
1.6(6) Poison control and poison information centers are required to report inquiries about cases of reportable diseases received by them.
1.6(7) Medical examiners are required to report their investigatory finding of any death which was caused by or otherwise involved a reportable disease.
1.6(8) Occupational nurses are required to report cases of reportable diseases, if occupationally related.
1.6(9) Occurrences of reportable cancers shall be reported by registrars employed by the State Health Registry of Iowa, registrars employed by health care facilities, and health care providers involved in the diagnosis, care, or treatment of individuals with a reportable cancer.
641—1.7(139A) Treatment of infant eyes. The Iowa department of public health approves 1 percent silver nitrate solution in single–dose ampules or single–use tubes of an ophthalmic ointment containing 1 percent tetracycline or 0.5 percent erythromycin in each conjunctival sac as an ophthalmia prophylactic for newborn infants’ eyes. Prophylaxis should be given after birth, but in no instance delayed for more than one hour after delivery. Once applied, none of the above agents used for prophylaxis shall be flushed from the eyes following installation.
This rule is intended to implement Iowa Code section 139A.38.
641—1.8(139A) Isolation. Isolation and quarantine should be consistent with guidelines provided by the Centers for Disease Control and Prevention, Atlanta, Georgia. (Garner JS, Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996; 17:53–80, and Am J Infect Control 1996; 24:24–52.)
641—1.9(135,139A) Quarantine and isolation.
1.9(1) Examination, testing and treatment of quarantinable diseases.
a. A health care provider who attends an individual with a suspected or active quarantinable disease shall make all reasonable efforts in accordance with guidance from a local health department or the department to examine or cause all household and other known contacts of the individual to be examined by a physician. The physician shall promptly report to the department the results of such examination. If the individual refuses or is unable to undergo examination, the health care provider shall promptly report such information to the department.
b. When required by the department, all contacts not examined by a physician, including all adult and minor contacts, shall submit to a diagnostic test or tests. If any suspicious abnormality is found, steps satisfactory to the department shall be taken to refer the individual promptly to a physician or appropriate medical facility for further evaluation and, if necessary, treatment. The referring health care provider or facility shall notify the receiving health care provider or facility of the suspicious abnormality. When requested by the department, a physician shall report the results of the examination of a contact to the case or suspected case or incident.
c. Upon order of the department or local board of health, an individual with a suspected or active quarantinable disease shall not attend the workplace or school and shall not be present at other public places until the individual receives the approval of the department or a local board of health to engage in such activity. Upon order of the department or local board of health, employers, schools and other public places shall exclude an individual with a suspected or active quarantinable disease. An individual may also be excluded from other premises or facilities if the department or a local board of health determines the premises or facilities cannot be maintained in a manner adequate to protect others against the spread of the disease.
1.9(2) General provisions.
a. Voluntary confinement. Prior to instituting mandatory isolation or quarantine pursuant to this rule, the department or a local board of health may request that an individual or group of individuals voluntarily confine themselves to a private home or other facility.
b. Quarantine and isolation. The department and local boards of health are authorized to impose and enforce quarantine and isolation restrictions. Quarantine and isolation shall rarely be imposed by the department or by local boards of health. If a quarantinable disease occurs in Iowa, individuals with a suspected or active quarantinable disease and contacts to the case may be quarantined or isolated as the particular situation requires. Any quarantine or isolation imposed by the department or a local board of health shall be established and enforced in accordance with this rule.
1.9(3) Conditions and principles. The department and local boards of health shall adhere to all of the following conditions and principles when isolating or quarantining individuals or a group of individuals:
a. The isolation or quarantine shall be by the least restrictive means necessary to prevent the spread of a communicable or possibly communicable disease to others and may include, but not be limited to, confinement to private homes, other private premises, or public premises.
b. Isolated individuals shall be confined separately from quarantined individuals.
c. The health status of isolated or quarantined individuals shall be monitored regularly to determine if the individuals require further or continued isolation or quarantine.
d. If a quarantined individual subsequently becomes infected or is reasonably believed to have become infected with a communicable or possibly communicable disease, the individual shall be promptly removed to isolation.
e. Isolated or quarantined individuals shall be immediately released when the department or local board of health determines that the individuals pose no substantial risk of transmitting a communicable or possibly communicable disease.
f. The needs of isolated or quarantined individuals shall be addressed in a systematic and competent fashion including, but not limited to, providing adequate food; clothing; shelter; means of communicating with those in and outside of isolation or quarantine; medication; and competent medical care.
g. The premises used for isolation or quarantine shall be maintained in a safe and hygienic manner and shall be designed to minimize the likelihood of further transmission of infection or other harm to isolated or quarantined individuals.
h. To the extent possible, cultural and religious beliefs shall be considered in addressing the needs of individuals in isolation or quarantine premises and in establishing and maintaining the premises.
1.9(4) Isolation or quarantine premises.
a. Sites of isolation or quarantine shall be prominently placarded with isolation or quarantine signs prescribed and furnished by the department and posted on all sides of the building wherever access is possible.
b. An individual subject to isolation or quarantine shall obey the rules and orders of the department or the local board of health and shall not go beyond the isolation or quarantine premises.
c. The department or a local board of health may authorize physicians, health care workers, or others access to individuals in isolation or quarantine as necessary to meet the needs of isolated or quarantined individuals.
d. No individual, other than an individual authorized by the department or a local board of health, shall enter isolation or quarantine premises. If the department has requested the assistance of law enforcement in enforcing the isolation or quarantine, the department shall provide law enforcement personnel with a list of individuals authorized to enter the isolation or quarantine premises.
e. Any individual entering an isolation or quarantine premises with or without authorization of the department or a local board of health may be isolated or quarantined pursuant to this rule.
1.9(5) Isolation and quarantine by local boards of health.
a. A local board of health may:
(1) Isolate individuals who are presumably or actually infected with a quarantinable disease;
(2) Quarantine individuals who have been exposed to a quarantinable disease;
(3) Establish and maintain places of isolation and quarantine; and
(4) Adopt emergency rules and issue orders as necessary to establish, maintain, and enforce isolation or quarantine.
b. Isolation and quarantine undertaken by a local board of health shall be accomplished according to the rules and regulations of the local board of health so long as such rules are not inconsistent with this chapter.
1.9(6) Isolation and quarantine by the Iowa department of public health.
a. Authority.
(1) The department, through the director, the department’s medical director, or the director’s or medical director’s designee, may:
1. Isolate individuals or groups of individuals who are presumably or actually infected with a quarantinable disease; and
2. Quarantine individuals or groups of individuals who have been exposed to a quarantinable disease, including individuals who are unable or unwilling to undergo examination, testing, vaccination, or treatment, pursuant to 2003 Iowa Acts, chapter 33.
(2) The department may:
1. Establish and maintain places of isolation and quarantine; and
2. Adopt emergency rules and issue orders as necessary to establish, maintain, and enforce isolation or quarantine.
(3) Isolation and quarantine undertaken by the department, including isolation and quarantine undertaken by the department in the event of a public health disaster, shall be established pursuant to paragraph 1.9(6)“b” or “c.”
b. Temporary isolation and quarantine without notice. The department may temporarily isolate or quarantine an individual or groups of individuals through an oral order, without notice, only if delay in imposing the isolation or quarantine would significantly jeopardize the department’s ability to prevent or limit the transmission of a communicable or possibly communicable disease to others. If the department imposes temporary isolation or quarantine of an individual or groups of individuals through an oral order, the department shall issue a written order as soon as is reasonably possible and in all cases within 24 hours of issuance of the oral order if continued isolation or quarantine is necessary to prevent or limit the transmission of a communicable or possibly communicable disease.
c. Written order. The department may isolate or quarantine an individual or groups of individuals through a written order issued pursuant to this rule.
(1) The written order shall include all of the following:
1. The identity of the individual, individuals, or groups of individuals subject to isolation or quarantine.
2. The premises subject to isolation or quarantine.
3. The date and time at which isolation or quarantine commences.
4. The suspected communicable disease.
5. A description of the less restrictive alternatives that were attempted and were unsuccessful, or the less restrictive alternatives that were considered and rejected, and the reasons such alternatives were rejected.
6. A statement of compliance with the conditions and principles for isolation and quarantinespecified in subrule 1.9(3).
7. The legal authority under which the order is requested.
8. The medical basis upon which isolation or quarantine is justified.
9. A statement advising the individual, individuals, or groups of individuals of the right to appeal the written order pursuant to subrule 1.9(7) and the rights of individuals and groups of individuals subject to quarantine and isolation as listed in subrule 1.9(8).
10. A copy of this chapter and the relevant definitions of this rule.
(2) A copy of the written order shall be provided to the individual to be isolated or quarantined within 24 hours of issuance of the order in accordance with any applicable process authorized by the Iowa Rules of Civil Procedure. If the order applies to a group or groups of individuals and it is impractical to provide individual copies, the order may be posted in a conspicuous place in the isolation or quarantine premises.
1.9(7) Appeal from order imposing isolation or quarantine.
a. Contested case. The subject of a department order imposing isolation or quarantine may appeal a written order and has the right to a contested case hearing regarding such appeal. The subject of a department order imposing isolation or quarantine may appeal the order by submitting a written appeal within ten days of receipt of the written order. The appeal shall be addressed to the Department of Public Health, Division of Epidemiology, Emergency Medical Services, and Disaster Operations, Lucas State Office Building, Des Moines, Iowa 50319–0075. Unless stayed by order of the director or a district court, the written order for quarantine or isolation shall remain in force and effect until the appeal is finally determined and disposed of upon its merits.
b. Presiding officer. The presiding officer in a contested case shall be the director or the director’s designee. The director or the director’s designee may be assisted by an administrative law judge in conducting the contested case hearing. The decision of the director or the director’s designee shall be the department’s final decision and is subject to judicial review in accordance with the provisions of Iowa Code chapter 17A.
c. Proceeding. The contested case hearing shall be conducted in accordance with the provisions contained at 641—Chapter 173. The hearing shall be held as soon as is practicable, and in no case later than ten days from the date of receipt of the appeal. The hearing may be held by telephonic or other electronic means if necessary to prevent additional exposure to the communicable or possibly communicable disease. In extraordinary circumstances and for good cause shown, the department may apply to continue the hearing date for up to ten additional days on a petition filed pursuant to this rule. The presiding officer may use discretion in granting a continuance giving due regard to the rights of the affected individuals, the protection of the public’s health, and the availability of necessary witnesses and evidence.
d. Judicial review. The aggrieved party to the final decision of the department may petition for judicial review of that action pursuant to Iowa Code chapter 17A. Petitions for judicial review shall be filed within 30 days after the decision becomes final.
e. Immediate judicial review of department order. The department acknowledges that in certain circumstances the subject or subjects of a department order may desire immediate judicial review of a department order in lieu of proceeding with the contested case process. The department recognizes that the procedural step of pursuing exhaustion of administrative remedies may be inadequate for purposes of Iowa Code section 17A.19, and the department may consent to immediate jurisdiction of the district court when requested by the subject or subjects of a department order and justice so requires. Unless stayed by order of the director or a district court, the written order for quarantine or isolation shall remain in force and effect until the judicial review is finally determined and disposed of upon its merits.
1.9(8) Rights of individuals and groups of individuals subject to isolation or quarantine. Any individual or group of individuals subject to isolation or quarantine shall have the following rights:
a. The right to be represented by legal counsel.
b. The right to be provided with prior notice of the date, time, and location of any hearing.
c. The right to participate in any hearing. The hearing may be held by telephonic or other electronic means if necessary to prevent additional exposure to the communicable or possibly communicable disease.
d. The right to respond and present evidence and argument on the individual’s own behalf in any hearing.
e. The right to cross–examine witnesses who testify against the individual.
f. The right to view and copy all records in the possession of the department which relate to the subject of the written order.
1.9(9) Consolidation of claims. In any proceeding brought pursuant to this rule, to promote the fair and efficient operation of justice and having given due regard to the rights of the affected individuals, the protection of the public’s health, and the availability of necessary witnesses and evidence, the department or a court may order the consolidation of individual claims into group claims, if all of the following conditions exist:
a. The number of individuals involved or to be affected is so large that individual participation is impractical.
b. There are questions of law or fact common to the individual claims or rights to be determined.
c. The group claims or rights to be determined are typical of the affected individuals’ claims or rights.
d. The entire group will be adequately represented in the consolidation.
1.9(10) Implementation and enforcement of isolation and quarantine.
a. Jurisdictional issues. The department has primary jurisdiction to isolate or quarantine individuals or groups of individuals if the communicable disease outbreak has affected more than one county or has multicounty, statewide, or interstate public health implications. When imposing isolation or quarantine, the department shall coordinate with the local health department as appropriate. If isolation or quarantine is imposed by the department, a local board of health or local health department may not alter, amend, modify, or rescind the isolation or quarantine order.
b. Assistance of local boards of health and local health departments. If isolation or quarantine is imposed by the department, the local boards of health and the local health departments in the affected areas shall assist in the implementation of the isolation or quarantine order.
c. Assistance of law enforcement. Pursuant to Iowa Code section 135.35, all peace officers of the state shall enforce and execute a lawful department order for isolation or quarantine within their respective jurisdictions. The department shall take all reasonable measures to minimize the risk of exposure to peace officers and others assisting with enforcement of an isolation or quarantine order.
d. Penalty. Pursuant to Iowa Code section 135.38, any individual who knowingly violates a lawful department order for isolation or quarantine, whether written or oral, shall be guilty of a simple misdemeanor. The court–ordered sentence may include a fine of up to $500 and imprisonment not to exceed 30 days.
e. Enforcement action. The department may file a civil action in Polk County district court to enforce a department order for isolation or quarantine. Such action shall be filed in accordance with Iowa Rules of Civil Procedure.
641—1.10(139A) Disinfection. Disinfection should be consistent with guidelines provided by the Centers for Disease Control and Prevention, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia. (Garner JS, Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996; 17:53–80, and Am J Infect Control 1996; 24:24–52.)
641—1.11(141A) Contagious or infectious disease notification at time of death. The purpose of this rule is to establish contagious or infectious disease notification requirements for the information of any person handling a dead body.
1.11(1) A health care provider attending a person prior to the person’s death shall, at the time of death, place with the body a written notice which specifies or signifies either “known contagious or infectious disease” or “suspected contagious or infectious disease.”
1.11(2) The health facility in which the health care provider is working shall be responsible for establishing written procedures and implementing the specific internal practices necessary to satisfy this notification requirement.
641—1.12(135,137,139A) Quarantine and isolation—model rule for local boards.
1.12(1) Applicability. The provisions of rule 1.12(135,137,139A) are applicable in jurisdictions in which a local board has adopted this rule by reference in accordance with Iowa Code section 137.6. This rule shall not be construed to require a local board to adopt this model rule.
1.12(2) Definitions.
“Board” means [insert the name of the city, county, or district board of health].
“Department” means the Iowa department of public health.
“Isolation” means the separation of persons or animals presumably or actually infected with a communicable disease, or that are disease carriers, for the usual period of communicability of that disease. Isolation shall be in such places, marked by placards if necessary, and under such conditions to prevent the direct or indirect conveyance of the infectious agent or contagion to susceptible individuals.
“Quarantinable disease” means any communicable disease which presents a risk of serious harm to public health and which may require isolation or quarantine to prevent its spread. “Quarantinable disease” includes but is not limited to cholera; diphtheria; infectious tuberculosis; plague; smallpox; yellow fever; viral hemorrhagic fevers, including Lassa, Marburg, Ebola, Crimean–Congo, South American, and others not yet isolated or named; and severe acute respiratory syndrome (SARS).
“Quarantine” means the limitation of freedom of movement of persons or animals that have been exposed to a communicable disease, within specified limits marked by placards, for a period of time equal to the longest usual incubation period of the disease. The limitation of movement shall be in such manner as to prevent the spread of a communicable disease.
1.12(3) General provisions.
a. Voluntary confinement. Prior to instituting mandatory isolation or quarantine pursuant to this rule, the board may request that an individual or group of individuals voluntarily confine themselves to a private home or other facility.
b. Quarantine and isolation. The board is authorized to impose and enforce quarantine and isolation restrictions. Quarantine and isolation shall rarely be imposed by the board. If a quarantinable disease occurs in Iowa, individuals with a suspected or active quarantinable disease and contacts to the case may be quarantined or isolated as the particular situation requires. Any quarantine or isolation imposed by the board shall be established and enforced in accordance with this rule.
c. The local board of health shall notify, consult and work cooperatively with the Iowa department of agriculture and land stewardship and the state veterinarian office on issues relating to isolation and quarantine of animals.
1.12(4) Conditions and principles. The board shall adhere to all of the following conditions and principles when isolating or quarantining individuals or a group of individuals:
a. The isolation or quarantine shall be by the least restrictive means necessary to prevent the spread of a communicable or possibly communicable disease to others and may include, but is not limited to, confinement to private homes, other private premises, or public premises.
b. Isolated individuals shall be confined separately from quarantined individuals.
c. The health status of isolated or quarantined individuals shall be monitored regularly to determine if the individuals require further or continued isolation or quarantine.
d. If a quarantined individual subsequently becomes infected or is reasonably believed to have become infected with a communicable or possibly communicable disease, the individual shall be promptly removed to isolation.
e. Isolated or quarantined individuals shall be immediately released when the board determines that the individuals pose no substantial risk of transmitting a communicable or possibly communicable disease.
f. The needs of isolated or quarantined individuals shall be addressed in a systematic and competent fashion including, but not limited to, providing adequate food; clothing; shelter; means of communicating with those in and outside of isolation or quarantine; medication; and competent medical care.
g. The premises used for isolation or quarantine shall be maintained in a safe and hygienic manner and shall be designed to minimize the likelihood of further transmission of infection or other harm to isolated or quarantined individuals.
h. To the extent possible, cultural and religious beliefs shall be considered in addressing the needs of individuals in isolation and quarantine premises and in establishing and maintaining the premises.
1.12(5) Isolation or quarantine premises.
a. Sites of isolation or quarantine shall be prominently placarded with isolation or quarantine signs prescribed and furnished by the department and posted on all sides of the building wherever access is possible.
b. An individual subject to isolation or quarantine shall obey the rules and orders of the board and shall not go beyond the isolation or quarantine premises.
c. The department or the board may authorize physicians, health care workers, or others access to individuals in isolation or quarantine as necessary to meet the needs of isolated or quarantined individuals.
d. No individual, other than an individual authorized by the department or the board, shall enter isolation or quarantine premises. If the department has requested the assistance of law enforcement in enforcing the isolation or quarantine, the department shall provide law enforcement personnel with a list of individuals authorized to enter the isolation or quarantine premises.
e. Any individual entering an isolation or quarantine premises with or without authorization of the department or the board may be isolated or quarantined pursuant to this rule.
1.12(6) Isolation and quarantine.
a. Authority. The board may:
(1) Isolate individuals who are presumably or actually infected with a quarantinable disease;
(2) Quarantine individuals who have been exposed to a quarantinable disease;
(3) Establish and maintain places of isolation and quarantine; and
(4) Adopt emergency rules and issue orders as necessary to establish, maintain, and enforce isolation or quarantine.
b. Isolation and quarantine undertaken by the board shall be accomplished in accordance with this rule.
c. Temporary isolation and quarantine without notice. The board may temporarily isolate or quarantine an individual or groups of individuals through an oral order, without notice, only if delay in imposing the isolation or quarantine would significantly jeopardize the board’s ability to prevent or limit the transmission of a communicable or possibly communicable disease to others. If the board imposes temporary isolation or quarantine of an individual or groups of individuals through an oral order, the board shall issue a written order as soon as is reasonably possible and in all cases within 24 hours of issuance of the oral order if continued isolation or quarantine is necessary to prevent or limit the transmission of a communicable or possibly communicable disease.
d. Written order. The board may isolate or quarantine an individual or groups of individuals through a written order issued pursuant to this rule.
(1) The written order shall include all of the following:
1. The identity of the individual, individuals, or groups of individuals subject to isolation or quarantine.
2. The premises subject to isolation or quarantine.
3. The date and time at which isolation or quarantine commences.
4. The suspected communicable disease.
5. A description of the less restrictive alternatives that were attempted and were unsuccessful, or the less restrictive alternatives that were considered and rejected, and the reasons such alternatives were rejected.
6. A statement of compliance with the conditions and principles for isolation and quarantinespecified in subrule 1.12(4).
7. The legal authority under which the order is requested.
8. The medical basis upon which isolation or quarantine is justified.
9. A statement advising the individual, individuals, or groups of individuals of the right to appeal the written order pursuant to subrule 1.12(7) and the rights of individuals and groups of individuals subject to quarantine and isolation as listed in subrule 1.12(8).
10. A copy of this rule and the relevant definitions.
(2) A copy of the written order shall be provided to the individual to be isolated or quarantined within 24 hours of issuance of the order in accordance with any applicable process authorized by the Iowa Rules of Civil Procedure. If the order applies to a group or groups of individuals and it is impractical to provide individual copies, the order may be posted in a conspicuous place in the isolation or quarantine premises.
1.12(7) Appeal from order imposing isolation or quarantine.
a. Appeal. The subject of a board order imposing isolation or quarantine may appeal a written order by submitting a written appeal within ten days of receipt of the written order. The appeal shall be addressed to [insert name of board and board address]. Unless stayed by order of the board or a district court, the written order for quarantine or isolation shall remain in force and effect until the appeal is finally determined and disposed of upon its merits.
b. Proceeding. The appeal proceeding shall be conducted in accordance with this rule [or insert specific board rule governing appeal proceedings]. The proceeding shall be held as soon as is practicable, and in no case later than ten days from the date of receipt of the appeal. The hearing may be held by telephonic or other electronic means if necessary to prevent additional exposure to the communicable or possibly communicable disease. In extraordinary circumstances and for good cause shown, the board may continue the proceeding date for up to ten days, giving due regard to the rights of the affected individuals, the protection of the public’s health, and the availability of necessary witnesses and evidence. At the appeal proceeding, the subject of the appeal shall have the right to introduce evidence on all issues relevant to the order. The board, by majority vote, may modify, withdraw, or order compliance with the order under appeal.
c. Judicial review. The aggrieved party to the final decision of the board may petition for judicial review of that action by filing an action in the appropriate district court. Petitions for judicial review shall be filed within 30 days after the decision becomes final.
d. Immediate judicial review of board order. The board acknowledges that in certain circumstances the subject or subjects of a board order may desire immediate judicial review of a board order in lieu of proceeding with the board’s appeal process. The board may consent to immediate jurisdiction of the district court when requested by the subject or subjects of a board order and justice so requires. Unless stayed by order of the board or a district court, the written order for quarantine or isolation shall remain in force and effect until the judicial review is finally determined and disposed of upon its merits.
1.12(8) Rights of individuals and groups of individuals subject to isolation or quarantine. Any individual or group of individuals subject to isolation or quarantine shall have the following rights:
a. The right to be represented by legal counsel.
b. The right to be provided with prior notice of the date, time, and location of any hearing.
c. The right to participate in any hearing. The hearing may be held by telephonic or other electronic means if necessary to prevent additional exposure to the communicable or possibly communicable disease.
d. The right to respond and present evidence and argument on the individual’s own behalf in any hearing.
e. The right to cross–examine witnesses who testify against the individual.
f. The right to view and copy all records in the possession of the board which relate to the subject of the written order.
1.12(9) Consolidation of claims. In any proceeding brought pursuant to this rule, to promote the fair and efficient operation of justice and having given due regard to the rights of the affected individuals, the protection of the public’s health, and the availability of necessary witnesses and evidence, the board or a court may order the consolidation of individual claims into group claims, if all of the following conditions exist:
a. The number of individuals involved or to be affected is large enough that consolidation would be the best use of resources.
b. There are questions of law or fact common to the individual claims or rights to be determined.
c. The group claims or rights to be determined are typical of the affected individuals’ claims or rights.
d. The entire group will be adequately represented in the consolidation.
1.12(10) Implementation and enforcement of isolation and quarantine.
a. Jurisdictional issues. The department has primary jurisdiction to isolate or quarantine individuals or groups of individuals if the communicable disease outbreak has affected more than one county or has multicounty, statewide, or interstate public health implications. If isolation or quarantine is imposed by the department, the board may not alter, amend, modify, or rescind the isolation or quarantine order.
b. Assistance of local boards of health and local health departments. If isolation or quarantine is imposed by the department, the local boards of health and the local health departments in the affected areas shall assist in the implementation of the isolation or quarantine order.
c. Penalty. Pursuant to Iowa Code sections 137.21 and 139A.25(1), any individual who violates a lawful board order for isolation or quarantine, whether written or oral, shall be guilty of a simple misdemeanor. The court–ordered sentence may include a fine of up to $500 and imprisonment not to exceed 30 days.
d. Enforcement action. The board, through the office of the county attorney, may file a civil action in the appropriate district court to enforce a board order for isolation or quarantine. Such action shall be filed in accordance with Iowa Rules of Civil Procedure.
641—1.13(135,139A) Area quarantine.
1.13(1) General provisions. The department and local boards of health are authorized to impose and enforce area quarantine in accordance with this rule. Area quarantine shall rarely be imposed by the department or by local boards of health.
1.13(2) Conditions and principles. The department and local boards of health shall adhere to all of the following conditions and principles when imposing and enforcing area quarantine:
a. Area quarantine shall be imposed by the least restrictive means necessary to prevent or contain the spread of a suspected or confirmed quarantinable disease or suspected or known hazardous or toxic agent.
b. Area quarantine shall be immediately terminated when the department or a local board of health determines that no substantial risk of exposure to a quarantinable disease or hazardous or toxic agent continues to exist.
c. The geographical boundaries of an area quarantine shall be established by risk assessment procedures including medical and scientific analysis of the quarantinable disease or hazardous or toxic agent, the location of the affected area, the risk of spread or contamination, and other relevant information.
1.13(3) Area quarantine sites.
a. Sites of area quarantine shall be prominently identified to restrict ingress and egress to and from the area, to the extent practicable. The department or a local board of health may placard or otherwise identify the site, or may request the assistance of law enforcement in identifying the site.
b. No individual, other than an individual authorized by the department or a local board of health, shall enter a building, structure, or other physical location subject to area quarantine. The department or a local board of health may authorize public health officials, environmental specialists, health care providers, or others access to an area quarantine site as necessary to conduct public health investigations, to decontaminate the site, or for other public health purposes. Notwithstanding any provision in this chapter to the contrary, law enforcement, fire service, and emergency medical service providers may enter an area quarantine site to provide emergency response services or to conduct emergency law enforcement investigations or other emergency activities without authorization by the department or a local board of health. If the department has requested the assistance of law enforcement in enforcing the area quarantine, the department shall provide law enforcement personnel with a list of individuals authorized to enter the area quarantine site.
c. An individual authorized to enter an area quarantine site may be required to wear personal protective equipment as appropriate.
d. No individual, other than an individual authorized by the department or a local board of health, shall remove any item or object from a building, structure, or other physical location subject to area quarantine.
e. An individual entering an area quarantine site without authorization of the department or a local board of health may be isolated or quarantined pursuant to rule 1.9(135,139A) and may be found guilty of a simple misdemeanor.
1.13(4) Area quarantine by local boards of health or the department of public health.
a. Authority.
(1) The department, through the director, the department’s medical director, or the director or medical director’s designee, may impose area quarantine through oral or written order. Prior to imposing area quarantine, the department shall attempt to notify the local board or boards of health in the affected geographic area. If attempts to notify the local boards of health are initially unsuccessful, the department shall continue to make regular notification attempts until successful.
(2) A local board of health may impose area quarantine through oral or written order. Prior to imposing area quarantine, a local board of health shall attempt to notify the department by contacting the director, medical director, or department duty officer by telephone. If attempts to notify the department are initially unsuccessful, the local board of health shall continue to make regular notification attempts until successful.
b. Temporary area quarantine without notice. The department or a local board of health may temporarily impose area quarantine through an oral order, without notice, only if delay in imposing area quarantine would significantly jeopardize the department’s or local board’s ability to prevent or contain the spread of a suspected or confirmed quarantinable disease or to prevent or contain exposure to a suspected or known hazardous or toxic agent. If the department or local board imposes temporary area quarantine through an oral order, a written order shall be issued as soon as is reasonably possible and in all cases within 24 hours of issuance of the oral order if continued area quarantine is necessary.
c. Written order. The department or local board may impose area quarantine through a written order issued pursuant to this rule.
(1) The written order shall include all of the following:
1. The building or buildings, structure or structures, or other definable physical location, or portion thereof, subject to area quarantine.
2. The date and time at which area quarantine commences and the date and time at which the area quarantine shall be terminated, if known.
3. The suspected or confirmed quarantinable disease or the chemical, biological, radioactive, or other hazardous or toxic agent.
4. A statement of compliance with the conditions and principles for area quarantine specified in subrule 1.13(2).
5. The legal authority under which the order is imposed.
6. The medical or scientific basis upon which area quarantine is justified.
7. A statement advising the owner or owners of the building or buildings, structure or structures, or other definable physical location subject to area quarantine of the right to appeal the written order pursuant to subrule 1.13(5) and the rights of owners of sites subject to area quarantine pursuant to subrule 1.13(6).
8. A copy of 641—Chapter 1 and the relevant provisions of this rule.
(2) A copy of the written order shall be provided to the owner or owners of the building or buildings, structure or structures, or other definable physical location subject to area quarantine within 24 hours of issuance of the order in accordance with any applicable process authorized by the Iowa Rules of Civil Procedure; or, if the order applies to a group of owners and it is impractical to provide individual notice to each owner, the written order shall be posted in a conspicuous place at the site of area quarantine.
1.13(5) Appeal from order imposing area quarantine.
a. Contested case. The subject of a department order imposing area quarantine may appeal a written order and has the right to a contested case hearing regarding such appeal. The subject of a department order imposing area quarantine may appeal the order by submitting a written appeal within 10 days of receipt or other notice of the written order. The appeal shall be addressed to the Department of Public Health, Division of Acute Disease Prevention and Emergency Response, Lucas State Office Building, Des Moines, Iowa 50319–0075. Unless stayed by order of the director or a district court, the written order for area quarantine shall remain in force and effect until the appeal is finally determined and disposed of upon its merits.
b. Presiding officer. The presiding officer in a contested case shall be the director or the director’s designee. The director or the director’s designee may be assisted by an administrative law judge in conducting the contested case hearing. The decision of the director or the director’s designee shall be the agency’s final decision and is subject to judicial review in accordance with the provisions of Iowa Code chapter 17A.
c. Proceeding. The contested case hearing shall be conducted in accordance with the provisions contained at 641—Chapter 173. The hearing shall be held as soon as is practicable, and in no case later than 10 days from the date of receipt of the appeal. In extraordinary circumstances and for good cause shown, the department may apply to continue the hearing date on a petition filed pursuant to this paragraph for up to 10 days, which continuance the presiding officer may grant in its discretion giving due regard to the rights of the affected individuals, the protection of the public’s health, and the availability of necessary witnesses and evidence.
d. Judicial review. The aggrieved party to the final decision of the department may petition for judicial review of that action pursuant to Iowa Code chapter 17A. Petitions for judicial review shall be filed within 30 days after the decision becomes final.
e. Immediate judicial review of department order. The department acknowledges that in certain circumstances the subject or subjects of a department order may desire immediate judicial review of a department order in lieu of proceeding with the contested case process. The department recognizes that the procedural step of pursuing exhaustion of administrative remedies may be inadequate for purposes of Iowa Code section 17A.19, and the department may consent to immediate jurisdiction of the district court when requested by the subject or subjects of a department order and justice so requires. Unless stayed by order of the director or a district court, the written order for area quarantine shall remain in force and effect until the judicial review is finally determined and disposed of upon its merits.
1.13(6) Rights of owners of sites subject to area quarantine. An owner of a building, structure, or other physical location subject to area quarantine shall have the following rights:
a. The right to be represented by legal counsel.
b. The right to be provided with prior notice of the date, time, and location of any hearing.
c. The right to participate in any hearing.
d. The right to respond and present evidence and argument on the owner’s own behalf in any hearing.
e. The right to cross–examine witnesses who testify against the individual.
f. The right to view and copy all records in the possession of the department which relate to the subject of the written order.
1.13(7) Consolidation of claims. In any proceeding brought pursuant to this rule, to promote the fair and efficient operation of justice and having given due regard to the rights of the affected individuals, the protection of the public’s health, and the availability of necessary witnesses and evidence, the department or a court may order the consolidation of individual claims into group claims, if all of the following conditions exist:
a. The number of individuals involved or who may be affected is so large that individual participation is impractical.
b. There are questions of law or fact common to the individual claims or rights to be determined.
c. The group claims or rights to be determined are typical of the affected individuals’ claims or rights.
d. The entire group will be adequately represented in the consolidation.
1.13(8) Implementation and enforcement of area quarantine.
a. Jurisdictional issues. The department has primary jurisdiction to impose area quarantine if the quarantinable disease or hazardous or toxic agent has affected more than one county and implicates multicounty or statewide public health concerns. If area quarantine is imposed by the department, a local board of health or local health department may not alter, amend, modify, or rescind the area quarantine order.
b. Assistance of local boards of health and local health departments. If area quarantine is imposed by the department, the local boards of health and the local health departments in the affected areas shall assist in the implementation of the area quarantine.
c. Assistance of law enforcement. Pursuant to Iowa Code section 135.35, all peace officers of the state shall enforce and execute a lawful department order for area quarantine within their respective jurisdictions. The department shall take all reasonable measures to minimize the risk of individual exposure of peace officers and others assisting with enforcement of an area quarantine order.
d. Emergency response, investigation, and decontamination—authority of other agencies. Emergency response, investigation, and decontamination activities in and around an area quarantine site shall be conducted by law enforcement, fire service, emergency medical service providers, or other appropriate federal, state, or local officials in accordance with federal and state law and accepted procedures and protocols for emergency response, investigation, and decontamination. This rule shall not be construed to limit the authority of law enforcement, fire service, emergency medical service providers, or other federal, state, or local officials to conduct emergency response, investigation, or decontamination activities to the extent authorized by federal and state law and accepted procedures and protocols.
e. Penalty. Pursuant to Iowa Code section 135.38, any individual who knowingly violates a lawful department order for area quarantine, whether written or oral, shall be guilty of a simple misdemeanor. The court–ordered sentence may include a fine of up to $500 and imprisonment not to exceed 30 days.
f. Enforcement action. The department may file a civil action in Polk County District Court to enforce a department order for area quarantine. Such action shall be filed in accordance with Iowa Rules of Civil Procedure.
These rules are intended to implement Iowa Code Supplement sections 135.140, 135.144, and 139A.2 and Iowa Code sections 135.11(4), 139A.3, 139A.4, 139A.5, 139A.9, 139A.21, 139A.31, 141A.1, 141A.2 and 141A.5.
[Filed November 20, 1970; amended August 31, 1971]
[Filed emergency 8/15/77—published 9/7/77, effective 8/15/77]
[Filed 11/10/77, Notice 10/5/77—published 11/30/77, effective 1/4/78]
[Filed 4/3/81, Notice 2/18/81—published 4/29/81, effective 6/5/81]
[Filed 2/12/82, Notice 10/28/81—published 3/3/82, effective 4/7/82]
[Filed 11/18/83, Notice 8/31/83—published 12/7/83, effective 1/13/84]
[Filed 8/14/85, Notice 4/24/85—published 9/11/85, effective 10/16/85]
[Filed emergency 7/10/87—published 7/29/87, effective 7/10/87]
[Filed 11/17/88, Notice 6/1/88—published 12/14/88, effective 1/18/89]
[Filed 5/10/89, Notice 4/5/89—published 5/31/89, effective 7/5/89]
[Filed 11/9/89, Notice 10/4/89—published 11/29/89, effective 1/3/90]
[Filed 9/24/90, Notice 8/8/90—published 10/17/90, effective 11/21/90]
[Filed 7/17/92, Notice 4/1/92—published 8/5/92, effective 9/9/92]
[Filed 11/6/92, Notice 9/16/92—published 11/25/92, effective 1/1/93]
[Filed 7/16/93, Notice 4/28/93—published 8/4/93, effective 9/8/93]
[Filed emergency 1/11/96 after Notice 11/8/95—published 1/31/96, effective 1/12/96]
[Filed 3/15/96, Notice 1/31/96—published 4/10/96, effective 5/15/96]
[Filed 7/10/98, Notice 5/6/98—published 7/29/98, effective 9/2/98]
[Filed 11/10/98, Notice 9/23/98—published 12/2/98, effective 1/6/99]
[Filed 5/10/01, Notice 4/4/01—published 5/30/01, effective 7/4/01]
[Filed emergency 9/14/01—published 10/3/01, effective 9/14/01]
[Filed 11/19/01, Notice 10/3/01—published 12/12/01, effective 1/16/02]à
[Filed 1/16/04, Notice 12/10/03—published 2/4/04, effective 3/10/04]
[Filed 1/13/05, Notice 11/24/04—published 2/2/05, effective 3/9/05]
[Filed 5/12/05, Notice 3/30/05—published 6/8/05, effective 7/13/05]
[Filed 1/10/07, Notice 11/22/06—published 1/31/07, effective 3/7/07]
[Filed 11/14/07, Notice 10/10/07—published 12/5/07,
effective 1/9/08]
VIRAL HEPATITIS PROGRAM—VACCINATIONS AND TESTING
641—2.1(135) Definitions. For the purpose of these rules, the following definitions shall apply:
“Contracted agencies” means local health departments, clinics, and community–based organizations that are funded by the department to provide HCV testing and vaccination services.
“Department” means the Iowa department of public health.
“HCV” means the hepatitis C virus as defined by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.
“Viral hepatitis” means inflammation of the liver caused by one of several viruses: hepatitis A, B, C (formerly non–A, non–B), D and E.
641—2.2(135) Purpose. The purpose of the viral hepatitis program shall be to distribute information, offer HCV testing, and offer hepatitis A and B vaccinations to the citizens of this state who are at an increased risk of viral hepatitis exposure.
641—2.3(135) Exposure risks for hepatitis C virus. The following individuals are at increased risk of exposure to HCV as outlined by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.
2.3(1) The following individuals are at high risk of infection:
a. Injection drug users (IDUs);
b. Recipients of clotting factors made before 1987; and
c. Hemodialysis patients.
2.3(2) The following individuals are at intermediate risk of infection:
a. Recipients of blood or solid organs before 1992;
b. Persons with undiagnosed liver problems; and
c. Infants born to HCV–infected mothers.
2.3(3) The following individuals are at low risk of infection:
a. Health care/public safety workers;
b. Persons having sex with multiple partners; and
c. Persons having sex with an HCV–infected steady partner.
641—2.4(135) Information for public distribution. The department shall make available educational materials to the public on hepatitis C infection, how to avoid transmitting the virus, and where to seek counseling and testing services. The information shall be available on the department’s Web site at http://www.idph.state.ia.us/adper/hepatitis.asp and by mail to HIV/AIDS Hepatitis Program, Lucas State Office Building, 321 East 12th Street, Des Moines, Iowa 50319.
641—2.5(135) Hepatitis vaccination and testing program.
2.5(1) When sufficient state and federal funds are available, the department will establish a vaccination and testing program. The program shall offer HCV testing and hepatitis A and B vaccinations through local health departments, clinics, and community–based organizations to high–risk individuals as defined in 2.5(2) and 2.5(3). Contracted agencies offering testing and vaccination services shall be required to provide integrated HIV, viral hepatitis, and sexually transmitted disease education; pretest and posttest counseling; and referral services.
2.5(2) Contracted agencies shall offer HCV testing to the following high–risk individuals:
a. Persons who have ever injected drugs;
b. Injection drug users who share needles or other equipment;
c. Persons who receive blood, blood products, or organ transplants prior to 1992; and
d. Persons ever on long–term hemodialysis.
2.5(3) Contracted agencies shall offer hepatitis A and B vaccinations to the following high–risk individuals:
a. Injection and noninjection drug users;
b. Men who have sex with men;
c. Persons with a diagnosis of a recently acquired sexually transmitted disease (STD);
d. HIV– or HCV–infected persons; and
e. Sexual partners of persons infected with HIV, hepatitis A (HAV), or hepatitis B (HBV).
2.5(4) Contracted agencies shall provide individuals presenting for counseling, testing, and referral services and testing positive for hepatitis C educational brochures explaining their potential risk of exposure.
2.5(5) Contracted agencies shall provide individuals testing positive for HCV a referral list of health care providers to aid in seeking additional follow–up testing and other hepatitis–related services.
HEPATITIS C AWARENESS PROGRAM—VETERANS
641—2.9(135) Definitions. For the purpose of these rules, the following definitions shall apply:
“Department” means the Iowa department of public health.
“HCV” means the hepatitis C virus as defined by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.
“Veteran” means an individual meeting the definition contained in Iowa Code section 35.1.
641—2.10(135) Purpose. The purpose of the hepatitis C awareness program shall be to distribute information to veterans regarding the higher incidence of hepatitis C exposure and infection among veterans, the dangers presented by the disease, and contact information and referrals.
641—2.11(135) Awareness materials. The department shall provide hepatitis awareness materials to veterans through various educational media.
641—2.12(135) Awareness information. Information distributed by the department shall contain the following statements:
2.12(1) HCV infection rates for veterans are estimated to be at least three times higher than the general population.
2.12(2) Vietnam veterans experience a higher HCV infection rate than other veteran groups.
2.12(3) Exposure to blood during combat and combat–related medical services poses a risk for HCV infection.
2.12(4) Many veterans currently infected with HCV may have been exposed prior to the development of screening tests.
2.12(5) Symptoms and liver complications associated with chronic hepatitis infection may not appear for decades after initial infection.
641—2.13(135) Resources for hepatitis follow-up and treatment. The department shall provide hepatitis resource information to veterans regarding medical follow–up and treatment options.
These rules are intended to implement Iowa Code sections 135.19 and 135.20.
[Filed 11/14/07, Notice 10/10/07—published 12/5/07, effective 1/9/08]
chapter 3
early hearing detection and intervention
641—3.1(80GA,ch102) Definitions. For the purposes of this chapter, the following definitions will apply:
“Area education agency” or “AEA” means an intermediate educational unit created by Iowa Code chapter 273.
“Audiologist” means a person licensed pursuant to Iowa Code chapter 147 or certified by the Iowa board of educational examiners pursuant to 282—15.3(272) or a person appropriately licensed in the state where the person practices.
“Birth center” means “birth center” as defined in Iowa Code section 135.61.
“Birthing hospital” means a private or public hospital licensed pursuant to Iowa Code chapter 135B that has a licensed obstetric unit or is licensed to provide obstetric services.
“Department” means the Iowa department of public health.
“Diagnostic audiologic assessment” means physiologic or behavioral procedures completed by an audiologist to evaluate and diagnose hearing loss.
“Discharge” means a release from a hospital to the parent or legal guardian of the child.
“Early ACCESS” means Iowa’s Individuals with Disabilities Education Act (IDEA), Part C, program for infants and toddlers. It is a statewide, comprehensive, interagency system of integrated early intervention services that supports eligible children and their families as defined in 281—Chapter 120.
“Guardian” means a person who is not the parent of a minor child, but who has legal authority to make decisions regarding life or program issues for the child. A guardian may be a court or a juvenile court. “Guardian” does not mean conservator, as defined in Iowa Code section 633.3, although a person who is appointed to be a guardian may also be appointed to be a conservator.
“Hearing loss” means a permanent unilateral or bilateral hearing loss of greater than 30 dB HL in the frequency region important for speech recognition (500–4000 Hz).
“Hearing screening” means a physiological measurement of hearing of a newborn or infant with a “pass” or “refer” result. Screening is used to determine the newborn’s or infant’s need for further testing and must be performed bilaterally, when applicable.
“Initial screening” means a newborn hearing screening performed during the birth admission for an infant born in a birthing hospital, or the first newborn hearing screening performed on a newborn born in a facility other than a hospital.
“Newborn hearing screening” means a physiological test to separate those newborns with normal hearing from those newborns who may have hearing thresholds of greater than 30 dB HL in either ear in the frequency region important for speech recognition (500–4000 Hz).
“Normal hearing” means hearing thresholds in both ears of 30 dB HL or less in the frequency region important for speech recognition (500–4000 Hz).