REPORT TITLE:
Epidemiologic Investigations


DESCRIPTION:
Expands the department of health's ability to investigate
significant causes of illness which threaten the public health.
Protects the confidentiality of information received by the
department.  Appropriates funds to conduct soil testing for
Village Park and West Loch Fairways.  (HB1138 SD2)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        1138
                                                        H.D. 1
HOUSE OF REPRESENTATIVES                H.B. NO.           S.D. 2
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                   A  BILL  FOR  AN  ACT

RELATING TO EPIDEMIOLOGIC INVESTIGATIONS.



BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1                              PART I
 
 2      SECTION 1.  The purpose of this part is to allow the
 
 3 department of health to update its ability to investigate
 
 4 significant causes of illness which threaten the public health
 
 5 and safety, while protecting the confidentiality of information
 
 6 and shielding the providers of information from liability.
 
 7      SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended
 
 8 by adding a new section to be appropriately designated and to
 
 9 read as follows:
 
10      "§321-    Epidemiologic investigations.  (a)  The department
 
11 may conduct investigations to determine the nature and extent of
 
12 diseases and injuries deemed by the department to threaten the
 
13 public health and safety.
 
14      (b)  Every person, health care provider, and medical
 
15 facility shall provide the patient's name, the name of a minor
 
16 patient's parent or guardian, address, telephone number, age,
 
17 sex, race or ethnicity, clinical signs and symptoms, laboratory
 
18 test results, diagnostic interview data, treatment provided, and
 
19 the disposition of the patient when requested by an authorized
 

 
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 1 representative of the director for the purpose of conducting such
 
 2 an investigation.  The authorized representative may only view
 
 3 the limited portion of the patient's medical record which is
 
 4 directly relevant in time and scope to the subject of the
 
 5 investigation.
 
 6      (c)  No person, health care provider, or medical facility
 
 7 that provides information requested by an authorized
 
 8 representative of the director for the purpose of conducting an
 
 9 investigation under this section shall be held civilly or
 
10 criminally liable for providing that information to the
 
11 department.
 
12      (d)  All information provided to the department under this
 
13 section shall be kept strictly confidential, except as the
 
14 director determines is necessary to protect the public health and
 
15 safety.  Access to confidential records shall be restricted to
 
16 those individuals specifically authorized to participate in any
 
17 given investigation.  However, epidemiologic and statistical
 
18 information with no individual identifying information may be
 
19 released to the public.  The identities of individuals whose
 
20 medical records are investigated shall be disclosed only to those
 
21 persons authorized by the director or the director's
 
22 representative to conduct a specific investigation under this
 
23 section or determined by the director to be necessary to protect
 

 
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 1 the health and safety of the public."
 
 2      SECTION 3.  Section 321-1, Hawaii Revised Statutes, is
 
 3 amended to read as follows:
 
 4      "§321-1  General powers and duties of the department.(a)
 
 5 The department of health shall have general charge, oversight,
 
 6 and care of the health and lives of the people of the State.
 
 7      (b)  The department may conduct epidemiologic investigations
 
 8 of diseases and injuries that threaten or are deemed by the
 
 9 department to threaten the public health and safety.
 
10      [(b)] (c)  The department shall have authority in matters of
 
11 quarantine and other health matters and may declare and enforce
 
12 quarantine when none exists and modify or release quarantine when
 
13 it is established.
 
14      [(c)] (d)  When it is determined that there is imminent
 
15 danger of epidemic or serious outbreak of communicable disease,
 
16 the department may refuse, modify, or limit attendance at any
 
17 school in the State.
 
18      [(d)] (e)  When in the judgment of the director, there is
 
19 deemed to be a potential health hazard, the department, through
 
20 the director, may take precautionary measures to protect the
 
21 public through the imposition of an embargo or the detention of
 
22 products regulated by the department, or the removal of products
 
23 regulated by the department from the market, or the declaration
 

 
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 1 of quarantine; provided that the director must find evidence of a
 
 2 health hazard within seventy-two hours of the action taken or
 
 3 rescind the action.  The director shall make public the findings.
 
 4      [(e)] (f)  All county health authorities, sheriffs, police
 
 5 officers, and all other officers and employees of the State, and
 
 6 every county thereof, shall enforce the rules of the department.
 
 7 All such powers in health matters as have been or may be
 
 8 conferred upon any county shall be concurrent with those of the
 
 9 department.
 
10      [(f)] (g)  The department may establish charges and collect
 
11 fees for any of its services; provided that the department shall
 
12 not refuse to provide services to any person due to the person's
 
13 inability to pay the fee for the service.  The department,
 
14 through the director, shall make an annual report to the
 
15 governor, showing in detail all its expenditures and
 
16 transactions, and such other information regarding the public
 
17 health as the department may deem of special interest.
 
18      [(g)] (h)  The department, during the prevalence of any
 
19 severe pestilence or epidemic, shall publish a weekly report of
 
20 the public health.
 
21      [(h)] (i)  The department shall establish and administer
 
22 programs, and adopt rules as deemed necessary, for the prevention
 
23 of domestic and sexual violence and the protection and treatment
 

 
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 1 of victims of domestic and sexual violence."
 
 2                              PART II
 
 3      SECTION 4.  The purpose of this part is to appropriate funds
 
 4 for the department of health to conduct soil sample surveys as
 
 5 part of an epidemiologic investigation into the causes of a
 
 6 disturbing and as yet unexplained pattern of physical and
 
 7 learning disabilities of children in the Village Park and West
 
 8 Loch Fairways communities.
 
 9      The legislature finds that, as the population of the State
 
10 grows, housing developments and residential areas are being
 
11 constructed on former agricultural lands or on locations formerly
 
12 used by the military.  This situation is certain to increase as
 
13 agriculture declines and additional lands become available for
 
14 residential development.  Environmental health hazards in the
 
15 soil as residue from pesticides can remain undetected until
 
16 significant clusters of disease or illness are identified.
 
17 Secret underground military facilities, such as tunnels or
 
18 bunkers, in which were stored arms or chemicals, are also capable
 
19 of causing environmental health hazards.
 
20      The legislature finds that significant clusters of illness
 
21 or disease are not readily identifiable until some commonality
 
22 occurs, such as proximate neighbors comparing notes or children
 
23 of the same age level entering a single neighborhood school being
 

 
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 1 enrolled in special education classes.
 
 2      The legislature further finds that when a significant
 
 3 cluster or increase of illness or disease occurs in a school and
 
 4 is identified by the faculty, it should be the responsibility of
 
 5 the principal and faculty to report their suspicions to the
 
 6 department of health.  The department of health, working in
 
 7 cooperation with the department of education, should be
 
 8 responsible for the related health services.
 
 9      Of particular concern to the legislature is the Village Park
 
10 and West Loch Fairways communities.  Village Park is a
 
11 subdivision of approximately 2,000 families, and West Loch
 
12 Fairways is a subdivision of approximately 720 families, who
 
13 share a common health phenomenon.  Many of the Village Park and
 
14 West Loch Fairway families and children have varying degrees of
 
15 disabilities and illnesses that are more than coincidence.  One
 
16 out of ten children has some physical or learning disability, or
 
17 both, that requires special needs education.  Physical
 
18 disabilities include Downs Syndrome, trisomy 8 and trisomy 18,
 
19 spina bifida, heart abnormalities, leukemia, and respiratory
 
20 ailments.  Learning disabilities include mental retardation,
 
21 hearing, emotional, visual, speech and language, attention
 
22 deficit disorder, hyperactivity, oppositional defiant disorder,
 
23 multiple handicaps, and autism.
 

 
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 1      The purpose of this part is to appropriate funds to the
 
 2 department of health to conduct soil testing for Village Park and
 
 3 West Loch Fairways as part of an epidemiologic investigation to
 
 4 determine if physical and learning disabilities of children are
 
 5 caused by the soil.
 
 6      SECTION 5.  There is appropriated out of the environmental
 
 7 response revolving fund under section 128D-2, Hawaii Revised
 
 8 Statutes, the sum of $1, or so much thereof as may be necessary,
 
 9 for fiscal year 1999-2000, for the department of health to
 
10 conduct soil testing at Village Park and West Loch Fairways to
 
11 determine if the soil is a cause of the illnesses, and the
 
12 physical and learning disabilities of children and families
 
13 living in Village Park and West Loch Fairways.  The testing shall
 
14 be completed by December 15, 1999.
 
15      SECTION 6.  The sum appropriated shall be expended by the
 
16 department of health.
 
17      SECTION 7.  The department of health, with the assistance of
 
18 the department of agriculture, Citizens for a Safe Environment,
 
19 and Life of the Land, shall report its findings and
 
20 recommendations to the legislature no later than twenty days
 
21 prior to the convening of the regular session of 2000.
 
22                             PART III
 
23      SECTION 8.  Statutory material to be repealed is bracketed.
 

 
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                                     H.B. NO.           S.D. 2
                                                        
                                                        

 
 1 New statutory material is underscored.
 
 2      SECTION 9.  This Act shall take effect upon its approval;
 
 3 provided that section 5 shall take effect on July 1, 1999.