PART 1. DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 97. COMMUNICABLE DISEASES
SUBCHAPTER A. CONTROL OF COMMUNICABLE DISEASES
The Executive Commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Texas Department of State Health Services (DSHS), proposes amendments to §97.3, concerning What Condition to Report and What Isolates to Report or Submit; §97.4, concerning When and How to Report a Condition or Isolate; and §97.6, concerning Reporting and Other Duties of Local Health Authorities and Regional Directors.
BACKGROUND AND PURPOSE
The purpose of the proposal is to implement Senate Bill (S.B.) 969, 87th Regular Session, 2021, Kolkhorst, and to add melioidosis and Cronobacter spp. in infants as notifiable conditions in Texas.
SECTION-BY-SECTION SUMMARY
The proposed amendment to §97.3 updates the public website link available for reviewing the summary list of notifiable conditions, adds Cronobacter spp. in infants and melioidosis as notifiable conditions in Texas, and corrects punctuation.
The proposed amendment to §97.4 updates the immediately notifiable conditions by adding melioidosis; removes faxing as an option for reporting immediately notifiable conditions; and identifies the preferred reporting option as electronic data transmission but allows persons to report via telephone or fax for all other notifiable conditions not listed in paragraphs (1) - (4) of this subsection. Additionally, this amendment removes mail or courier as reporting options and corrects punctuation. DSHS will allow a transition period and will continue to accept HIV reporting via mail while 25 TAC §97.134 is amended.
The proposed amendment to §97.6 lists the preferred reporting option as electronic data transmission but allows persons to report via telephone or fax; removes mail or courier as reporting options; and requires any notifiable conditions reported via telephone be followed up with an electronic data transmission through an approved electronic means within 24 hours of the original notification.
FISCAL NOTE
Christy Havel Burton, DSHS Chief Financial Officer, has determined that for each year of the first five years that the rules will be in effect, enforcing or administering the rules does not have foreseeable implications relating to costs or revenues of state or local governments.
GOVERNMENT GROWTH IMPACT STATEMENT
DSHS has determined during the first five years the rules will be in effect:
(1) the proposed rules will not create or eliminate a government program;
(2) implementation of the proposed rules will not affect the number of DSHS employee positions;
(3) implementation of the proposed rules will result in no assumed change in future legislative appropriations;
(4) the proposed rules will not affect fees paid to DSHS;
(5) the proposed rules will not create a new regulation;
(6) the proposed rules will expand existing regulation(s);
(7) the proposed rules will not change the number of individuals subject to the rule(s); and
(8) the proposed rules will not affect the state's economy.
SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS
Christy Havel Burton has also determined there will be no adverse economic effect on small businesses, micro-businesses, or rural communities. The rules do not impose any additional costs on small businesses, micro-businesses, or rural communities that are required to comply with the rules. Small or micro-businesses and rural communities with IT infrastructure or resource limitations will have the opportunity to continue to report notifiable conditions via telephone or fax.
LOCAL EMPLOYMENT IMPACT
The proposed rules will not affect a local economy.
COSTS TO REGULATED PERSONS
Texas Government Code §2001.0045 does not apply to these rules because the rules are necessary to protect the health, safety, and welfare of the residents of Texas, do not impose a cost on regulated persons, and are necessary to implement legislation that does not specifically state that §2001.0045 applies to the rule.
PUBLIC BENEFIT AND COSTS
Dr. Varun Shetty, Associate Commissioner, has determined for the first five years the rules are in effect, the public benefit will be improved ability of public health entities to plan and implement response and mitigation measures, enhance public surveillance and timely reporting, and increase the availability of public health data in Texas. Additionally, making melioidosis and Cronobacter spp. in infants reportable will increase information about these rare but potentially fatal diseases.
Christy Havel Burton, Chief Financial Officer, has also determined for the first five years the rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules because alternative reporting options for notifiable conditions are available to those experiencing IT infrastructure or resource limitations.
TAKINGS IMPACT ASSESSMENT
DSHS has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.
PUBLIC COMMENT
Written comments on the proposal may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 701 West 51st Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.
To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 24R052" in the subject line.
STATUTORY AUTHORITY
These amendments are authorized by Texas Government Code §531.0055, and Texas Health and Safety Code §1001.075, which authorize the Executive Commissioner of HHSC to adopt rules for the operation and provision of services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001; and Texas Health and Safety Code Chapter 81 (Communicable Disease Prevention and Control Act), which authorizes the Executive Commissioner of HHSC to identify reportable diseases and prescribe the form and method for reporting.
The amendments implement Texas Government Code Chapter 531 and Texas Health and Safety Code Chapters 81 and 1001.
§97.3.What Condition to Report and What Isolates to Report or Submit.
(a) Humans.
(1) Identification of notifiable conditions.
(A) A summary list of notifiable conditions and reporting
time frames is published on the Department of State Health Services
web site at https://www.dshs.texas.gov/idcu/investigation/conditions/.
[http://www.dshs.state.tx.us/idcu/investigation/conditions/.]
Copies are filed in the Emerging and Acute Infectious Disease Unit [Branch], Department of State Health Services, 1100 West 49th
Street, Austin, Texas 78756.
(B) Repetitive test results from the same patient do not need to be reported except those for mycobacterial infections.
(2) Notifiable conditions or isolates.
(A) Confirmed and suspected human cases of the following
diseases and[/] infections are reportable:
(i) acquired immune deficiency syndrome (AIDS);
(ii) amebic meningitis and encephalitis;
(iii) anaplasmosis;
(iv) ancylostomiasis;
(v) anthrax;
(vi) arboviral infections, including[, but not limited to,] those caused by California serogroup
virus, chikungunya virus, dengue virus, Eastern equine encephalitis
(EEE) virus, St. Louis encephalitis (SLE) virus, Western equine encephalitis
(WEE) virus, yellow fever virus, West Nile (WN) virus, and Zika virus;
(vii) ascariasis;
(viii) babesiosis;
(ix) botulism, adult and infant;
(x) brucellosis;
(xi) campylobacteriosis;
(xii) Candida auris;
(xiii) carbapenem resistant Enterobacteriaceae (CRE);
(xiv) Chagas disease;
(xv) chancroid;
(xvi) chickenpox (varicella);
(xvii) Chlamydia trachomatis infection;
(xviii) Cronobacter spp. in infants, invasive;
(xix) cryptosporidiosis;
(xx) cyclosporiasis;
(xxi) diphtheria;
(xxii) echinococcosis;
(xxiii) ehrlichiosis;
(xxiv) fascioliasis;
(xxv) gonorrhea;
(xxvi) Haemophilus
influenzae,[,] invasive;
(xxvii) Hansen's disease (leprosy);
(xxviii) hantavirus infection;
(xxix) hemolytic uremic syndrome (HUS);
(xxx) hepatitis, including hepatitis A, acute hepatitis B infection, hepatitis B acquired perinatally (child), any hepatitis B infection identified prenatally or at delivery (mother), acute hepatitis C infection, and acute hepatitis E infection;
(xxxi) human immunodeficiency virus (HIV) infection;
(xxxii) influenza-associated pediatric mortality;
(xxxiii) legionellosis;
(xxxiv) leishmaniasis;
(xxxv) listeriosis;
(xxxvi) Lyme disease;
(xxxvii) malaria;
(xxxviii) measles (rubeola);
(xxxix) melioidosis;
(xl) meningococcal infection, invasive;
(xli) mumps;
(xlii) novel coronavirus;
(xliii) novel influenza;
(xliv) paragonimiasis;
(xlv) pertussis;
(xlvi) plague;
(xlvii) poliomyelitis, acute paralytic;
(xlviii) poliovirus infection, non-paralytic;
(xlix) prion diseases, such as Creutzfeldt-Jakob disease (CJD);
(l) Q fever;
(li) rabies;
(lii) rubella (including congenital);
(liii) salmonellosis, including typhoid fever;
(liv) Shiga toxin-producing Escherichia coli infection;
(lv) shigellosis;
(lvi) smallpox;
(lvii) spotted fever group rickettsioses (such as Rocky Mountain spotted fever);
(lviii) streptococcal disease: Streptococcus pneumoniae,[,] invasive;
(lix) syphilis;
(lx) Taenia solium and undifferentiated Taenia infections, including cysticercosis;
(lxi) tetanus;
(lxii) tick-borne relapsing fever;
(lxiii) trichinosis;
(lxiv) trichuriasis;
(lxv) tuberculosis ([(]Mycobacterium
tuberculosis complex);
(lxvi) tuberculosis infection;
(lxvii) tularemia;
(lxviii) typhus;
(lxix) vancomycin-intermediate Staphylococcus aureus (VISA);
(lxx) vancomycin-resistant Staphylococcus aureus (VRSA);
(lxxi) Vibrio infection, including cholera (specify species);
(lxxii) viral hemorrhagic fever; and
(lxxiii) yersiniosis.
(B) In addition to individual case reports, any outbreak, exotic disease, or unusual group expression of disease that may be of public health concern should be reported by the most expeditious means.
(3) Minimal reportable information requirements. The
minimal information that must [shall] be reported
for each disease is as follows.[:]
(A) AIDS, chancroid, Chlamydia
trachomatis infection, gonorrhea, HIV infection, and syphilis must [shall] be reported in accordance with Subchapter
F of this chapter (relating to Sexually Transmitted Diseases Including
Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency
Virus (HIV)).[;]
(B) For [for] tuberculosis disease
- complete name, date of birth, physical address and county of residence,
country of origin, and information on which diagnosis was
based or suspected. In addition, if known, radiographic or diagnostic
imaging results and dates [date(s)]; all information
necessary to complete the most recent versions of department reporting
forms: Report of Case and Patient Services, Report of Follow-up and
Treatment for Contacts to TB Cases and Suspects,[;]
and Report of Verified Case of Tuberculosis; laboratory results used
to guide prescribing, monitoring, or modifying antibiotic
treatment regimens for tuberculosis, including [to
include, but not limited to,] liver function studies, renal
function studies, and serum drug levels; pathology reports related
to diagnostic evaluations of tuberculosis; reports of imaging or radiographic
studies; records of hospital or outpatient care, including [to include, but not limited to,] histories and physical examinations,
discharge summaries, and progress notes; records of medication
administration, including [to include, but not limited
to,] directly observed therapy (DOT) records, and drug toxicity
and monitoring records; a listing of other patient medications to
evaluate the potential for drug-drug interactions; and copies of court
documents related to court-ordered [court ordered] management of tuberculosis.
(C) For [for] contacts to a known
case of tuberculosis - complete name,[;] date
of birth,[;] physical address,[;]
county of residence,[;] evaluation and disposition,[;] and all information necessary to complete the
most recent versions of department reporting forms: Report of Follow-up
and Treatment for Contacts to TB Cases and Suspects[;]
and Report of Case and Patient Services.[;]
(D) For [for] other persons identified
with tuberculosis infection - complete name,[;]
date of birth,[;] physical address and county
of residence,[;] country of origin,[;] diagnostic information,[;] treatment
information,[;] medical and population risks,[;] and all information necessary to complete the most recent version
[versions] of the department's [department
] reporting form,[:] Report of Case and
Patient Services.
(E) For [for] hepatitis B (chronic
and acute) identified prenatally or at delivery - mother's name, address,
telephone number, age, date of birth, sex, race and ethnicity, preferred
language, hepatitis B laboratory test results; estimated delivery
date or date and time of birth; name and phone number of delivery
hospital or planned delivery hospital; name of infant; name, phone
number, and address of medical provider for infant; date, time, formulation,
dose, manufacturer, and lot number of hepatitis B vaccine and hepatitis
B immune globulin administered to infant.[;]
(F) For [for] hepatitis A, B,
C, and E - name, address, telephone number, age, date of birth, sex,
race and ethnicity, disease, diagnostic indicators (diagnostic lab
results, including all positive and negative hepatitis panel results,
liver function tests, and symptoms), date of onset, pregnancy status,
and physician or practitioner name, address, and telephone
number.[;]
(G) For [for] hepatitis B, perinatal
infection - name of infant; date of birth; sex; race and[;] ethnicity; name, phone number, and address of
medical provider for infant; date, time, formulation, dose, manufacturer,
and lot number of hepatitis B vaccine and hepatitis B immune globulin
administered to infant;[,] and hepatitis
B laboratory test results.[;]
(H) For [for] chickenpox - name,
date of birth, sex, race and ethnicity, address, date of onset, and
varicella vaccination history.[;]
(I) For [for] Hansen's disease
- name; date of birth; sex; race and ethnicity; disease type; place
of birth; address; telephone number; date entered Texas; date entered
U.S.; education and [/]employment; insurance
status; location and inclusive dates of residence outside U.S.; date
of onset and history prior to diagnosis; date of initial biopsy and
result; disease type (i.e., tuberculoid, borderline, and
lepromatous); date initial drugs prescribed and name of
drugs; name, date of birth, and relationship of household
contacts; and name, address, and telephone number of physician or
practitioner.[;]
(J) For [for] novel influenza
investigations occurring during an influenza pandemic-[-]minimal
reportable information on individual cases, a subset of cases or aggregate
data will be specified by the department.[;]
(K) For [for] all other notifiable
conditions listed in paragraph (2)(A) of this subsection - name, address,
telephone number, age, date of birth, sex, race and ethnicity, disease,
diagnostic indicators (diagnostic lab results, specimen source, test
type, and clinical indicators), date of onset, and physician or practitioner
name, address, and telephone number.[; and]
(L) Other [other] information
may be required as part of an investigation in accordance with Texas
Health and Safety Code[,] §81.061.
(4) Diseases requiring submission of cultures. Pure cultures, or specimens as indicated below, must be submitted and accompanied by a current department Specimen Submission Form for:
(A) anthrax (Bacillus anthracis);
(B) botulism, adult and infant (Clostridium botulinum);
(C) brucellosis (Brucella species);
(D) Candida auris;
(E) diphtheria (Corynebacteria diphtheriae from any site);
(F) all Haemophilus influenzae, invasive, in children under five years old (Haemophilus influenzae from normally sterile sites);
(G) listeriosis (Listeria monocytogenes);
(H) meningococcal infection, invasive (Neisseria meningitidis from normally sterile sites or purpuric lesions);
(I) plague (Yersinia pestis);
(J) salmonellosis, including typhoid fever (Salmonella species);
(K) Shiga toxin-producing Escherichia coli infection (E.coli O157:H7, isolates or specimens from cases where Shiga toxin activity is demonstrated);
(L) Staphylococcus aureus with a vancomycin minimum inhibition concentration (MIC) greater than 2 micrograms per milliliter (µg/mL);
(M) all Streptococcus pneumoniae, invasive, in children under five years old (Streptococcus pneumoniae from normally sterile sites);
(N) tuberculosis (Mycobacterium tuberculosis complex);
(O) tularemia (Francisella tularensis);
(P) vibriosis (Vibrio species); and
(Q) any outbreak, exotic disease, or unusual group expression of disease that may be of public health concern may require submission of cultures or specimens.
[(4) Diseases requiring submission
of cultures. For all anthrax (Bacillus anthracis); botulism, adult
and infant (Clostridium botulinum); brucellosis (Brucella species);
Candida auris; diphtheria (Corynebacteria diphtheria from any site);
all Haemophilus influenzae, invasive, in children under five years
old (Haemophilus influenzae from normally sterile sites); listeriosis
(Listeria monocytogenes); meningococcal infection, invasive (Neisseria
meningitidis from normally sterile sites or purpuric lesions); plague
(Yersinia pestis); salmonellosis, including typhoid fever (Salmonella
species); Shiga toxin-producing Escherichia coli infection (E.coli
O157:H7, isolates or specimens from cases where Shiga toxin activity
is demonstrated); Staphylococcus aureus with a vancomycin MIC greater
than 2 µg/mL; all Streptococcus pneumoniae, invasive, in children
under five years old (Streptococcus pneumoniae from normally sterile
sites); tuberculosis (Mycobacterium tuberculosis complex); tularemia
(Francisella tularensis); and vibriosis (Vibrio species) - pure cultures
(or specimens as indicated in this paragraph) shall be submitted accompanied
by a current department Specimen Submission Form.]
(5) Laboratory reports. Reports from laboratories must
[shall] include patient name, identification number,
address, telephone number, age, date of birth, sex, race and ethnicity;
specimen submitter name, address, and phone number; specimen type;
date specimen collected; disease test and test result; normal test
range; date of test report; and physician or practitioner name and
telephone number.
(b) Animals.
(1) Clinically diagnosed or laboratory-confirmed animal
cases of the following diseases are reportable: anthrax, arboviral
encephalitis, tuberculosis (Mycobacterium
tuberculosis complex) in animals other than those housed in
research facilities, and plague. All [Also, all]
non-negative rabies tests performed on animals from Texas at laboratories
located outside of Texas must [shall] be reported. All [; all] non-negative rabies tests performed
in Texas must [will] be reported by the laboratory
conducting the testing. In addition to individual case reports, any
outbreak, exotic disease, or unusual group expression of disease which
may be of public health concern should be reported by the most expeditious means.
(2) The minimal information that must [shall
] be reported for each disease includes species and number of
animals affected, disease or condition, name and phone number of the
veterinarian or other person in attendance, and the animal [animal(s)] owner's name, address, and phone number. Other information
may be required as part of an investigation in accordance with Texas
Health and Safety Code[,] §81.061.
§97.4.When and How to Report a Condition or Isolate.
(a) Humans.
(1) The following notifiable conditions are public
health emergencies and suspect cases must [shall]
be reported immediately by telephone [phone]
to the local health authority or the appropriate Department of State
Health Services regional epidemiology office:
(A) anthrax;
(B) botulism;
(C) diphtheria;
(D) measles (rubeola);
(E) melioidosis;
(F) meningococcal infection, invasive;
(G) novel coronavirus;
(H) novel influenza;
(I) poliomyelitis, acute paralytic;
(J) plague;
(K) rabies;
(L) smallpox;
(M) tularemia;
(N) vancomycin-intermediate Staphylococcus aureus (VISA);
(O) vancomycin-resistant Staphylococcus aureus (VRSA);
(P) viral hemorrhagic fever;
(Q) yellow fever; and
(R) any outbreak, exotic disease, or unusual group expression of disease that may be of public health concern.
(2) The following notifiable conditions must [shall] be reported by electronic data transmission [fax] or telephone [phone] within one working
day of identification as a suspected case:
(A) brucellosis;
(B) Candida auris;
(C) carbapenem resistant Enterobacteriaceae (CRE);
(D) hepatitis A, acute;
(E) hepatitis B, perinatal infection;
(F) influenza-associated pediatric mortality;
(G) mumps;
(H) pertussis;
(I) poliovirus infection, non-paralytic;
(J) Q fever;
(K) rubella (including congenital);
(L) syphilis infection in pregnant females;
(M) tuberculosis ([(]Mycobacterium
tuberculosis complex); and
(N) Vibrio infection (including cholera).
(3) AIDS, chancroid, Chlamydia trachomatis infection, gonorrhea, HIV infection, and syphilis must [shall] be reported in accordance with Subchapter F of this chapter (relating to Sexually Transmitted Diseases Including Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV)).
(4) Tuberculosis antibiotic susceptibility results must [should] be reported by laboratories no later than one week after they first become available.
(5) For all other notifiable conditions not listed in paragraphs (1) - (4) of this subsection, reports of disease must [ shall] be made no later than one week after a case or suspected case is identified.
(A) The preferred option for reporting is electronic
data transmission, but reports [Transmittal] may
be made by telephone or[,] fax.
Any electronic data transmission of the report must provide protection
against unauthorized disclosure and utilize a format prescribed by
the receiving agency[, mail, courier, or electronic transmission].
[(i) If by mail or courier, the reports
shall be on a form provided by the department and placed in a sealed
envelope addressed to the attention of the appropriate receiving source
and marked "Confidential."]
[(ii) Any electronic transmission of the reports must provide at least the same degree of protection against unauthorized disclosure as those of mail or courier transmittal, be by express written agreement with the receiving agency, utilize a format prescribed by the receiving agency, and be validated as accurate.]
(B) A health information exchange (HIE) organization
as defined by Texas Health and Safety Code[,] §182.151,
may transmit reports on behalf of providers required to report in §97.2(a)
- (d) of this chapter [title ](relating to Who
Shall Report) in accordance with Texas Health and Safety Code[,]
Chapter 182, Subchapter D,[.] Health Information
Exchanges, and all other state and federal law as follows.[:]
(i) The receiving agency has published message standards.
(ii) A method of secure transmission has been established between the HIE and the receiving agency, and transmissions have been tested with the receiving agency and established as meeting the data exchange standards and conveying information accurately.
(iii) Reporting by the HIE has been requested and authorized
by the appropriate health care provider, practitioner, physician,
facility, clinical laboratory, or other person [who is]
required to report health-related information.
(iv) HIE reports may be made in addition to but do [shall] not replace reports listed in paragraphs (1) - (2) of
this subsection.
(6) All diseases requiring submission of cultures in §97.3(a)(4)
of this chapter [title] (relating to What Condition
to Report and What Isolates to Report or Submit) must [shall
] be submitted as they become available.
(b) Animals. Reportable conditions affecting animals must [shall] be reported within one working day following
the diagnosis.
§97.6.Reporting and Other Duties of Local Health Authorities and Regional Directors.
(a) The purpose of this section is to provide procedures for local health authorities and regional directors to report a disease to the Department of State Health Services (department) central office.
(b) Those notifiable conditions identified as public
health emergencies in §97.4(a) of this chapter [title
] (relating to When and How to Report a Condition
or Isolate) must [shall] be reported immediately
to the department by telephone at (888) 963-7111.
(c) AIDS, chancroid, Chlamydia
trachomatis infection, gonorrhea, HIV infection, and
syphilis must [shall] be reported in accordance
with Subchapter F of this chapter (relating to Sexually Transmitted
Diseases Including Acquired Immune Deficiency Syndrome (AIDS) and
Human Immunodeficiency Virus (HIV)).
(d) For notifiable conditions not listed in subsections
(b) and (c) of this section, the local health authority or the department's
regional director collects [shall collect] reports
of disease and transmits [transmit] the information
listed in §97.3(a)(3) of this chapter [title]
(relating to What Condition to Report and What Isolates to Report
or Submit) at weekly intervals, as directed by the department.
(e) The preferred option for reporting is electronic
data transmission, but reports may be made by telephone or fax. [Transmittal may be by telephone, mail, courier, or electronic transmission.]
[(1) If by mail or courier, the reports
shall be on a form provided by the department and placed in a sealed
envelope addressed to the attention of the appropriate receiving source
and marked "Confidential."]
(1) [(2)] Any electronic data transmission
of the report [reports] must provide [at
least the same degree of] protection against unauthorized disclosure, and utilize a format prescribed by the receiving agency [as
those of mail or courier transmittal].
(2) For any notifiable condition reported by telephone, the person reporting must follow-up with an electronic data transmission through an approved electronic means within 24 hours of the original notification.
(f) The health authority must [shall]
notify health authorities in other jurisdictions of a case or outbreak
of a communicable disease [that has been reported] if the
case resides in another jurisdiction or there is cause to believe
transmission of a disease may have occurred in another jurisdiction.
The department will [shall] assist the health
authority in providing such notifications upon request. The health
authority of the area where the case or outbreak is diagnosed must [shall] report the case or outbreak to the department on the
same basis as other reports.
(g) The health authority upon identification of a case
or upon receipt of notification or report of disease, must [shall] take such action and measures as may be necessary to
conform with the appropriate control measure standards. The health
authority may, upon identification of a case or upon report
of a communicable disease in a child attending a public or private
child-care facility or a school, notify the owner or operator
of the child-care facility or the school administrator. The commissioner
is authorized to amend, revise, or revoke any control measure or action
taken by the health authority, if necessary or desirable
in the administration of a regional or statewide public health program or policy.
(h) The health authority is empowered to close any
public or private child-care facility, school, or other
place of public or private assembly when in his or her opinion such
closing is necessary to protect the public health; and such school
or other place of public or private assembly must [shall]
not reopen until permitted by the health authority who caused its closure.
(i) Persons reporting notifiable conditions in animals must [shall] be referred to the central office or
the appropriate regional office of the department's Zoonosis Control Branch.
The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.
Filed with the Office of the Secretary of State on July 24, 2024.
TRD-202403354
Cynthia Hernandez
General Counsel
Department of State Health Services
Earliest possible date of adoption: September 8, 2024
For further information, please call: (512) 776-7676