Topic: Local Government Role and Relations with Health Authorities

Public Health Act Guidance Note DRAFT November 3, 2014

Reporting of Infections, Exposures and Health Hazards

Note: This guidance note is to provide general orientation to the Public Health Act (PHA) and related legislation for public health officials who are responsible for implementing the PHA and others affected by the PHA. This guidance note is not legal advice and individuals should consult with their legal counsel in determining whether or to what extent the PHA may apply to a particular circumstance. If there is a conflict between the guidance note and the PHA, its regulations or related legislation, this guidance note is superseded by the latter authorities to the extent of any conflict.

Purpose: To provide guidance to those required to report and receive such reports about infectious diseases, exposures and health hazards.

Background: Requiring the reporting of infectious diseases, exposures, and health hazards is important to support monitoring issues of public health concern, and to trigger public health interventions to prevent disease or other adverse consequences. The PHA outlines the purposes for collection, use and disclosure; provides the authority to require reporting while protecting privacy and confidentiality; and contains provision for information gathering and reporting in emergencies.

Subject Legislation:  PHA sections 1, 9-14, 91-95  Public Health Act Transition Regulation (PHATR) sections 2, 3, and 15 (attached).  Health Act Communicable Disease Regulation (CD Regulation) sections 1-6, Schedules A and B.

Issues, Guidance, Questions and Answers:

1. Reporting infections or exposure  The PHA continues the previous requirements that health professionals, laboratory directors, and hospital administrators report infectious diseases to MHOs, as identified in the scheduled lists of reportable communicable diseases, and that MHOs report this information to the PHO.  Information required to be reported is outlined in the PHA, as well as in the CD Regulation  Others may be prescribed by regulation to report, but no such prescriptions have been made.

2. Privacy and Confidentiality  The Freedom of Information and Protection of Privacy Act for public bodies or the Personal Information Protection Act for organizations continue to apply in concert with PHA and regulations.

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 The PHA does not “over ride” these statutes except where specifically indicated or potentially in emergency situations.  The purposes for collection, use, and disclosure of information are found in PHA s. 9.  Section 91 and CD Regulation s. 6.1-6.3 contain additional confidentiality, use, and disclosure provisions.

3. Reporting health hazards  Health hazards must be prescribed by regulation to be reportable.  The PHATR s. 15 prescribes that toxic spills must be reported to the medical health officer.

4. Reporting for other public health purposes  While PHA s. 12 anticipates that other public health issues may be prescribed as reportable, no such regulations have been developed.

5. Mandatory sampling and reporting  Medical health officers may require that tests be done and reports made to assist in their public health functions under PHA s. 13

6. Requesting and disclosing information  PHA s. 14 allows for the development of regulations to further support public health information collection, use, and disclosure according to the purposes outlined in s. 9.  No such regulations have been developed.

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Legislation excerpts:

Public Health Act Transition Regulation Excerpts

Health Act regulations apply 2 A regulation made under the Health Act continues to apply for the purposes of the Act, subject to any modifications, express or implied, made to it by the Act or this regulation.

PART 2 – DISEASE

Infectious agents 3 (1) For the purposes of applying the Health Act Communicable Disease Regulation, B.C. Reg. 4/83, to the Act, (a) except in section 18 of the regulation “communicable disease” and “infectious agent” have the same meaning as in the Act, (b) all provisions of that regulation also apply to the communicable diseases (i) chancroid, (ii) granuloma inguinale, and (iii) lymphogranuloma venereum as if those communicable diseases had been prescribed as reportable communicable diseases under Schedule A of that regulation, and (c) all provisions of that regulation apply to the organisms (i) Haemophilus ducreyi, and (ii) Klebsiella granulomatis as if those organisms had been prescribed as reportable communicable diseases under Schedule B of that regulation. (2) The following are prescribed as infectious agents for the purposes of all sections of the Act, except section 17, that refer to an infectious agent or an infected person: (a) a reportable communicable disease within the meaning of the Health Act Communicable Disease Regulation, B.C. Reg. 4/83; (b) a communicable disease listed in subsection (1) (b) or (c).

Reporting of toxic spills 15 In addition to satisfying the requirements of the Environmental Management Act, a person who causes or permits the discharge into the land, water or air of a substance that is a health hazard must (a) promptly notify a medical health officer in writing of the matters set out in section 11 of the Act, as well as the time, duration and quantity of the discharge of the substance, and (b) take immediate action to prevent and cease the discharge.