VIRGINIA DEPARTMENT OF HEALTH (VDH) SUMMARY OF MANDATES REQUIRED BY FEDERAL LAW, STATE LAW, CONTRACT OR INTERAGENCY AGREEMENT Revised for Virginia Beach Department of Public Health March 2017 Note: The majority of Public Health Laws in the State of Virginia are found in Title 32 in the State Legislative Information System. Specific chapters of the law are referenced in the table below. 1. OVERARCHING AGENCY MISSION, CONTEXT AND STRUCTURE Mandated Service or Authority (and Obligating Description of Mandate or Authorizing Text Activity Instrument, if any): Establishment of the §§ 32.1-2, 32.1-16 There shall be a State Board of Health and a State Department of State Board of Health Health in the executive department responsible to the Secretary of and the State Health and Human Resources. Department of Health Purpose of the Board §32.1-2 The General Assembly finds that the protection, improvement and and Department preservation of the public health and of the environment are essential to the general welfare of the citizens of the Commonwealth. For this reason, the State Board of Health and the State Health Commissioner, assisted by the State Department of Health, shall administer and provide a comprehensive program of preventive, curative, restorative and environmental health services, educate the citizenry in health and environmental matters, develop and implement health resource plans, collect and preserve vital records and health statistics, assist in research, and abate hazards and nuisances to the health and to the environment, both emergency and otherwise, thereby improving the quality of life in the Commonwealth. Development of §32.1-11 The Board may formulate a program of environmental health, Programs laboratory services, and preventive, curative and restorative medical care services, including home and clinic health services. Necessity for adopting §§32.1-12, 32.1-12.1, The Board may make, adopt, promulgate and enforce such regulations regulations 32.1-13 and provide for reasonable variances there from as may be necessary to carry out its mission, as set forth in law. The Board shall promulgate regulations to carry out the law regarding human research to be conducted or authorized by the Department or related facilities; the Board may make separate orders and regulations to meet any emergency to suppress nuisances dangerous to the public health. Existence of local §32.1-30 Each county and city shall establish and maintain a local department of health departments health which shall be headed by a local health director, who shall be a physician licensed to practice medicine in this Commonwealth. Independent local §32.1-32 The governing body of any county or city which does not enter into a health departments contract with the Board for the operation of the local health department shall appoint the local health director and may appoint a local board of health to establish policies and to advise the local health department. Each local health director and local board of health appointed by a governing body shall enforce all health laws of this Commonwealth and regulations of the State Board of Health. Providing direct §32.1-11 (B) Persons deemed to be medically indigent shall receive the medical care medical care services services of the Department without charge; the Board of Health may prescribe charges to be paid for such services by persons who are not indigent and a scale of charges based on ability to pay. Board shall Page 1 Revised for VBDPH March, 2017 review periodically the program and the charges adopted. Operation of local §32.1-31 The Commissioner shall appoint the health director for the local health health departments department or district health director who shall be deemed to be the under contract with local health director of each county and city in the district, whenever a Board contract is entered into between a county or city and the Board. Each health director shall perform such duties as may be prescribed in the contract or contracts and, with the approval of the Commissioner, any other health-related duties prescribed by local ordinances. 2. COMMUNICABLE DISEASE SERVICES AND PREVENTION Surveillance and §§32.1-35, 32.1-39 The Board shall promulgate a list of diseases which shall be reported. investigation of The Board shall provide for the surveillance of and investigation into diseases all preventable diseases and epidemics in this Commonwealth and into the means for the prevention of such diseases and epidemics. Surveillance and investigation may include contact tracing in accordance with the regulations of the Board. When any outbreak or unusual occurrence of a preventable disease shall be identified through reports required pursuant to Article 1 (§ 32.1-35 et seq.) of Title 32.1 of the Code, the Commissioner or his designee shall investigate the disease in cooperation with the local health director or directors in the area of the disease. If in the judgment of the Commissioner the resources of the locality are insufficient to provide for adequate investigation, he may assume direct responsibility and exclusive control of the investigation, applying such resources as he may have at his disposal. The Board may issue emergency regulations and orders to accomplish the investigation. Emergency rules and § 32.1-42 The Board of Health may promulgate regulations and orders to meet regulations any emergency or to prevent a potential emergency caused by a disease dangerous to public health, including, but not limited to, procedures specifically responding to any disease listed pursuant to § 32.1-35 that is determined to be caused by an agent or substance used as a weapon or any communicable disease of public health threat that is involved in an order of quarantine or an order of isolation pursuant to Article 3.02 (§ 32.1-48.05 et seq.) of this chapter. Authority of State § 32.1-43 The State Health Commissioner shall have the authority to require Health Commissioner quarantine, isolation, immunization, decontamination, or treatment of to require quarantine, any individual or group of individuals when he determines any such etc. measure to be necessary to control the spread of any disease of public health importance and the authority to issue orders of isolation pursuant to Article 3.01 (§ 32.1-48.01 et seq.) of this chapter and orders of quarantine and orders of isolation under exceptional circumstances involving any communicable disease of public health threat pursuant to Article 3.02 (§ 32.1-48.05 et seq.) of this chapter. Providing childhood §32.1-46 Local health departments must provide immunizations required for immunizations school attendance without charge. (Sections 22.1-271.1 and 22.1-271.2 of the Code require documentary proof of immunization in order for a child to enter school.) §63.2-603 Recipients of Aid to Families with Dependent Children (AFDC) must provide verification of receipt of immunizations for all children not enrolled in school or licensed day care; local health departments are required to provide assistance to AFDC recipients in obtaining verification from immunization providers. §32.1-46 Local health departments must provide immunizations to a child to provide documentary proof to the child or his parent or guardian of all immunizations administered. Local health departments are also required to evaluate any immunization record which does not contain Page 2 Revised for VBDPH March, 2017 the month/day/year of administration to determine that such student is adequately immunized. Sexually transmitted §32.1-57 et seq. Local health departments may require a person suspected of being disease (STD) infected with an STD to be examined, tested and treated; if any such screening, diagnosis, person refuses, the local health director may apply to circuit court for treatment, & an order compelling submission to such care; if the local health director surveillance requires such a person to receive treatment, no fee shall be charged. Advising courts in §32.1-45.2 The Commissioner shall advise a court that is considering issuance of instances where public an order requiring blood testing in an instance where a public safety safety employees may employee may have been exposed to a blood-borne pathogen and the be exposed to blood- person whose body fluids are involved refuses to be tested. borne pathogens Tuberculosis (TB) §32.1-49 et seq. TB shall be included in the list of reportable diseases required by control screening, §32.1-35 of the Code. Local health directors may request a person diagnosis, treatment, suspected of having TB to be examined immediately tested and treated; and surveillance the Board may build hospitals for the treatment of TB and the Commissioner may charge patients for care. Tuberculosis treatment §32.1-50.1 Each physician practicing in the Commonwealth or facility who plan assumes responsibility for the treatment of a person for active TB shall develop, maintain and update as indicted an individualized written plan of treatment tailored to the person's medical and personal needs and identifying the method for effective treatment and prevention of transmission. Written treatment plan shall upon request be submitted by the provider to the local health director and shall be subject to approval by the local health director. The Commissioner shall have the authority to settle disagreements between the written plan submitted and standards of care established by the local health director. HIV/AIDS §§32.1-36, 32.1-36.1, Physicians must report persons with HIV and AIDS to the local health surveillance, 32.1-39 department, which will investigate; the patient’s identity shall remain investigation, and confidential, and disclosed only as authorized.. The Board may Seroprevalence Survey conduct counseling and contact tracing and issue emergency orders to accomplish the investigation. Submission of Public Health Service Act, The Centers for Disease Control and Prevention (CDC) provides morbidity data and §§ 3101 (A), 311, 317 (K) funding to conduct surveillance activities.