DAR File No. 32456

Human Services, Child and Family Services

R512-32

Children with Reportable Communicable Diseases

NOTICE OF PROPOSED RULE

DAR File No.: 32456
Filed: 03/19/2009, 11:34
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule is being changed to add the purpose statement and authority citation, to update steps to be taken when it is discovered that a child has a communicable disease, and to make other nonsubstantive changes for consistency purposes.

Summary of the rule or change:

The proposed changes to this rule add the purpose statement and authority citation under a new Section R512-32-1. All following sections are renumbered. The amendment also makes general wording changes for consistency purposes, and updates procedures to be taken when it is discovered that a child in the state's custody has a communicable disease.

State statutory or constitutional authorization for this rule:

Sections 62A-4a-102, 62A-4a-105, 26-6-3, 26-6-18, and 26-6-27

Anticipated cost or savings to:

the state budget:

None. There will be no increase in costs or savings to the state budget because the procedural changes contained in the rules do not require any increased staff time from the prior procedures or add any additional costs to the agency.

local governments:

None--There will be no increase in costs or savings to local government because it was determined that this rule does not apply to local government.

small businesses and persons other than businesses:

None--There will be no increase in costs or savings to small businesses because it was determined that this rule does not apply to small businesses.

Compliance costs for affected persons:

None--It was determined that there are no compliance costs for affected persons associated with implementing the changes to this rule.

Comments by the department head on the fiscal impact the rule may have on businesses:

There will be no cost or savings on businesses because it was determined that this rule does not apply to businesses. Lisa-Michele Church, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Human Services
Child and Family Services
120 N 200 W
SALT LAKE CITY UT 84103-1500

Direct questions regarding this rule to:

Carol Miller at the above address, by phone at 801-557-1772, by FAX at 801-538-3993, or by Internet E-mail at CAROLMILLER@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

05/15/2009

This rule may become effective on:

05/22/2009

Authorized by:

Duane Betournay, Director

R512. Human Services, Child and Family Services.

R512-32. Children with Reportable Communicable Diseases.

R512-32-1. Purpose and Authority.

(1) The purpose of this rule is to establish standards for confidentiality and testing of children with reportable communicable diseases.

(2) This rule is authorized by Section 62A-4a-102.

 

R512-32-2[1]. Definitions.

(1) "Communicable Disease" means any infectious condition reportable to the Utah Department of Health, pursuant to Section 26-6-3. These diseases are listed in the Code of Communicable Disease Rules (R386-702-2 and R386-702-3). In addition, for the purposes of this rule, human immunodeficiency virus (HIV) seropositivity will be considered a communicable disease. Non-reportable minor illnesses such as strep, flu, and colds are excluded from this definition.

(2) "Primary care medical[P]provider" means a person authorized and licensed to supply the daily needs of children in the custody of the Division of Child and Family Services (Child and Family Services). (Other divisions of the Department, for example, the Division of Juvenile Justice Services, shall function under separate communicable disease rules for those youth within their custody and jurisdiction.)

(3) "UDHS" means the Utah Department of Human Services.

(4) ["DCFS"]"Child and Family Services" means the Division of Child and Family Services.

(5) "UDOH" means the Utah Department of Health, Bureau of Epidemiology or Bureau of Communicable Disease Control[HIV/AIDS Prevention and Control].

(6) "HIV Screening" means a laboratory test (Elisa Test) to detect evidence of infection with the HIV; the causative agent of acquired immunodeficiency syndrome (AIDS).

(7) "HIV Seropositivity" means the presence in an individual, as detected by confirmatory laboratory testing (Western Blot Test), of an antibody or antigen to the HIV.

(8) "High Risk Behaviors" means behaviors which may include injectable drug use, sharing intravenous needles and syringes, multiple sex partners, unprotected sex that increase the risks of contracting Hepatitis B, AIDS, HIV disease, and sexually transmitted diseases such as[:] gonorrhea, syphilis, chancroid, granuloma inguinale, chlamydial infections, pelvic inflammatory disease, and lymphogranuloma venereum.

(9) "Children at Risk" means an infant or child born to parent(s) engaging in or who have a history of engaging in high risk behaviors, or a child or youth who has been sexually abused by a person who engages in or has a history of engaging in high risk behaviors.

(10) "Contact" means an individual who has been exposed to a communicable disease through a known mode of transmission.

(11) "Controlled" means a classification of information (medical, psychiatric, or psychological) under the Government Records Access and Management Act (GRAMA), Section 63G-2-304.

 

R512-32-3[2]. Confidentiality.

(1) In accordance with Section 26-6-27, records containing personal identifiers and information regarding communicable disease are confidential. Such information shall not be disclosed to any person (including UDHS personnel) who does not have a valid and objective need to know. Such persons who may have a valid and objective need to know may include: [the Division of ]Child and Family Services administrators, program [specialists]administrators, supervisor, and caseworker, the foster parent or provider, UDOH, the Guardian ad Litem, the Juvenile Court Judge, and persons providing psychological or medical treatment.

(2) Due to the GRAMA[ Act] and state confidentiality laws, any documentation in the case record regarding HIV status or any other communicable disease information must be filed under the "Medical/[]Assessment" section of the case record.

 

R512-32-4[3]. Identification and Testing of Children with Communicable Disease.

(1) Testing at Agency's Request.

(a) Many medical or laboratory tests to detect communicable disease, including HIV screening, are not routinely performed as part of physical or medical examinations of children in the custody of [DCFS]Child and Family Services. When [DCFS]Child and Family Services has custody and guardianship of a child who may have a communicable disease, the State has the authority to obtain a medical evaluation to determine the child's communicable disease status.

(b) If a foster parent or provider has a reasonable belief that a foster child or the foster child's parent may have a communicable disease, the foster parent or provider shall promptly discuss it with the caseworker.

(c) If the caseworker has a reasonable belief that the child may have a communicable disease, the caseworker is required to contact UDOH promptly for consultation.

(d) A "reasonable belief" includes the following: information received that may indicate the child or the child's parent may be at risk from engaging in or having a history of engaging in high risk behaviors as defined in R512-32-1(8)[(H)], a child who may be at risk as defined in R512-32-1(9)[(I)], or medical information received by the caseworker, foster parent, or provider.

(e) Communicable disease testing requires written, informed consent. If [DCFS]Child and Family Services has custody and guardianship of a child, [the State (DCFS)]Child and Family Services has the authority to provide written, informed consent for communicable disease testing. If a child under the custody and guardianship of [DCFS]Child and Family Services refuses to be tested, the caseworker is required to contact UDOH, the local health department, and the Attorney General's office immediately upon hearing of the refusal.

(f) When a parent of a child in the custody of [DCFS]Child and Family Services is known or reports to be involved in high risk behaviors, the caseworker shall contact UDOH for consultation.

(g) All contacts with UDOH shall be documented in the child's case record and filed under the ["medical assessment"]"Medical/Assessment" section of that record.

(2) Testing at Minor's Request.

(a) A minor may seek HIV testing without parental or UDHS consent. When the minor requests the test, the right to disclose test results belongs to the minor (Section 26-6-18). If the minor chooses to disclose the test results to UDHS, UDHS cannot disclose the test results to any other person, including the Guardian Ad Litem. Upon disclosure to UDHS of a positive test result, the caseworker shall contact UDOH for consultation and follow up.

(b) When a record of HIV testing is subpoenaed, the caseworker shall immediately contact the Attorney General's office or the [DCFS program specialist]Child and Family Services program administrator or deputy director[DCFS assistant director].

 

R512-32-5[4]. Preparation for Placement in Foster or Out-of-Home Care.

(1) Prior to placing a child with a communicable disease, or upon discovering that a child has a communicable disease, the [DCFS] caseworker, in collaboration with the Fostering Healthy Children RN, will[ shall] contact the Local Health Department (LHD) in their area[UDOH] for consultation to define the precautions necessary to mitigate any health risks to others. After consultation with the LHD[UDOH] and prior to placing the child, the [DCFS] caseworker shall hold a professional staffing, including the child's primary care medical provider (as defined in R512-32-1, Definitions), to identify the best placement to meet the child's needs. Once a placement is identified, a Child and Family Team Meeting will be held to address the child's health issues and make sure the caregiver is willing to participate in maintaining the safety of all involved. Additional education and training will be provided as necessary.[staff the case with their supervisor, assistant director, the provider (as defined in R512-32-1, Definitions), as well as the DCFS program specialist or DCFS assistant director to assess the health risk to the child, to the provider, and to any other persons in the home. After the consultation with the team, UDOH, the caseworker, and the provider shall define the precautions necessary to mitigate the health risk.]

 

R512-32-6[5]. Considerations Regarding Placement of a Child With a Communicable Disease.

(1) A provider's decision to accept placement of a child with a communicable disease shall be made with sufficient knowledge of the specific risks involved, as well as any special accommodations or care requirements. Prior to making this decision, the caseworker shall refer the provider to UDOH for consultation on the nature of the disease, modes of transmission, appropriate infection control measures, special care requirements, and universal precautions.

(2) If, after consultation, the provider accepts the placement, a Communicable Disease Information Acknowledgement form shall be signed by the provider and placed in his or her file, as well as the child's case record under the [Medical Section]"Medical/Assessment" section of that record.

(3) If a minor is discovered to have a communicable disease after placement, the consultation and documentation described in R512-32-5(1)[(A)] and R512-32-5(2)[(B)] shall be accomplished without delay.

 

R512-32-7[6]. Pick-Up Orders.

(1) Pick-up orders filed with the Juvenile Court may state that the youth is engaging, or has a history of engaging, in [h]High [r]Risk [b]Behaviors. The order or supplementary forms cannot include information that the child has or may have a communicable disease.

 

R512-32-8[7]. Returning a Minor to the Parent's Custody.

(1) If a minor in [DCFS]Child and Family Services custody tests positive for the HIV disease and the minor is being returned home, UDOH shall be responsible for informing natural parents of the child's positive test. Both caseworker and UDOH shall coordinate the placement of the child back home. The caseworker shall assist the parents in planning for the child's care and medical follow up needs.

(2) If a minor in [DCFS]Child and Family Services custody tests positive for a communicable disease other than HIV disease and the minor is being returned home, the caseworker is responsible for informing the natural parents of the child's positive test and if needed, referring them to UDOH for consultation and appropriate medical resources.

 

R512-32-9[8]. When a Minor in Custody Has Been Exposed to a Person Who Has Tested Positive.

(1) When a minor in the custody of [DCFS]Child and Family Services is identified by [the Health Department]UDOH as having been exposed to a person who has tested positive, UDOH shall contact the [DCFS foster care specialist]Child and Family Services program administrator or [assistant]deputy director who shall then contact the appropriate caseworker. The caseworker shall contact UDOH to arrange for the minor to be tested and counseled. The caseworker and provider will follow up on recommended medical treatment and other necessary services.

 

KEY: child welfare, foster care

Date of Enactment or Last Substantive Amendment: [1993]2009

Notice of Continuation: September 19, 2007

Authorizing, and Implemented or Interpreted Law: 62A-4a-102; 62A-4a-105, 63G-2-304, 26-6-3, 26-6-18, 26-6-27