Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 258 - RULES FOR THE CONTROL OF NOTIFIABLE DISEASES AND CONDITIONS › Section 144-258-1 - PURPOSE AND DEFINITIONS

Current through 2024-29, July 17, 2024
A.
Purpose.
This rule governs the reporting of, and responses to,
				certain diseases, clusters of unusual cases of a disease or outbreaks of
				disease, epidemics, and Public Health Threats. The Department may impose
				substitute and additional requirements and take other actions for the
				protection of the public health during Extreme Public Health Emergencies and
				Health Emergencies.
B.
Definitions.
As used in this rule, unless the context indicates
				otherwise, the following terms have the following meanings:
1.
Blood Bank
means a medical
				facility designed, equipped and staffed to produce, process, store or
				distribute human whole blood or blood derivatives for transfusion or treatment
				purposes.
2.
Carrier
means a person identified as harboring a specific infectious agent and who
				serves as a potential source of infection.
3.
Case
means a person infected
				with a particular infectious agent or having a particular disease as diagnosed
				by a Health Care Provider.
4.
Child Care Facility
means any home, institution or facility
				subject to licensure by the State of Maine, Department of Health and Human
				Services Office of Child and Family Services, to provide childcare, pursuant to
				 22 MRS
				§§8301 -
				8308.
5.
Commissioner
means the
				Commissioner of the Department of Health and Human Services, State of
				Maine.
6.
Communicable
				Disease
means an illness or condition due to a specific infectious agent
				or its toxic products which arises through transmission of that agent or its
				products from a reservoir to a susceptible host.
7.
Confinement
means involuntary
				isolation of a Non-Compliant Person by judicial order, or by order of the
				Department pursuant to
				22 MRS
				§820(1)(B), for a
				period of time and in such places and under such conditions as to prevent the
				transmission of the infection to others, to assure that the individual may
				receive a complete course of treatment, and to limit activities that may place
				others at risk of acquiring infection.
8.
Contact
means an individual
				who has been exposed to an infectious person in a manner which places the
				individual, given the specific organism involved, at risk of
				infection.
9.
Correctional
				Facility
means penal, jail and/or correctional institution administered
				by the Department of Corrections, State of Maine, or by a county.
10.
Department
means the State
				of Maine, Department of Health and Human Services, Maine Center for Disease
				Control and Prevention.
11.
Designated Health Care Facility
means a nursing facility,
				residential care facility, intermediate care facility for persons with
				intellectual disabilities, multi-level health care facility, hospital, or home
				health agency subject to licensure by the State of Maine, Department of Health
				and Human Services Division of Licensing and Certification.
12.
Educational Institution
means any institution, public or private, directed to the education and
				training of students, including, but not limited to, primary, secondary, and
				post-secondary schools.
13.
Electronic Laboratory Reporting (ELR)
means the automated
				transmission of laboratory-related data from commercial, public health,
				hospital, and other labs to the Department through an electronic health records
				(EHR) system or a Laboratory Information Management System (LIMS). Electronic
				reporting requires compliance with current standards found at
https://www.cdc.gov/elr/technicalstandards.html
.
14.
Emergency Department
means
				any department or facility of a hospital that either (1) is licensed by the
				Department's Division of Licensing and Certification as an emergency
				department; (2) is held out to the public as providing treatment for emergency
				medical conditions; or (3) actually provided treatment for emergency medical
				conditions on an urgent basis on one-third or more of the visits to the
				department in the preceding calendar year.
15.
Emerging Disease or
				Condition
means any infection or condition that has newly appeared in a
				population or has existed but is rapidly increasing in incidence or geographic
				range.
16.
Environmental
				Disease
means any abnormal condition or disorder aggravated or caused by
				exposure to an environmental hazard.
17.
Environmental Hazard
means a
				chemical, physical agent, biomechamical stress or or biological toxin that is
				present in the environment and that has an adverse effect on human
				health.
18.
Environmentally
				Related Health Effects
mean chronic diseases, birth defects,
				developmental disabilities and other noninfectious health effects that may be
				related to exposure to environmental hazards.
19.
Epidemic
means an increase,
				often sudden, in the number of cases of a disease above what is normally
				expected in that population in that area.
20.
Exposure
means direct
				contact or interaction with an environmental, biological hazard, infectious
				agent or toxic agent affecting or being taken into the body.
21.
Extreme Public Health
				Emergency
means a state of emergency declared by the Governor of the
				State of Maine pursuant to
				22 MRS
				§802(2-A) and 37-B MRS
				§742 based upon the occurrence or imminent threat of widespread exposure
				to a highly infectious or toxic agent or environmental hazard that poses an
				imminent threat of substantial harm to the population of the State.
22.
Health Alert Network (HAN)
means the secure, web-based communication system used by the Maine Center for
				Disease Control and Prevention to exchange information within and between their
				respective agencies and external parties through public health alerts,
				advisories and updates serving to notify and inform individuals about critical
				health alerts and to assist with disease surveillance and other public health
				needs.
23.
Health and
				Environmental Testing Laboratory
(HETL) means the public health
				laboratory, located within the State of Maine Department of Health and Human
				Services, Maine Center for Disease Control and Prevention.
24.
Health Care Facility
means a
				facility, institution, or agency subject to licensure by the Department of
				Health and Human Services, Division of Licensing and Certification to provide
				health care.
25.
Health Care
				Provider
means a nurse practitioner, physician or physician assistant
				subject to licensure by the State of Maine.
26.
Health Emergency
means a
				declaration by the Department, arising from an actual or threatened epidemic or
				public health threat for which the Department may adopt emergency rules for the
				protection of the public health, pursuant to
				22 MRS
				§802(2).
27.
Health Level Seven or HL7
				messaging
means the use of a set of international standards for the
				transfer of clinical and administrative data between software applications used
				by various healthcare providers, providing a system for sharing and processing
				information in a uniform and consistent manner.
28.
Health Officer
means a local
				or municipal health officer appointed either pursuant to
				22 MRS
				§451, or who is designated by the
				Department, to enforce the public health functions of this rule.
29.
Hospital
means an
				institution that primarily provides acute care to inpatients, by or under the
				supervision of physicians, diagnostic services and therapeutic services for
				medical diagnosis, treatment and care of injured, disabled or sick persons or
				rehabilitation services for the rehabilitation of injured, disabled or sick
				persons. 'Hospital' also includes psychiatric and tuberculosis hospitals."
				22 MRS
				§328(14). Hospital
				means any acute care facility subject to licensure by the Department of Health
				and Human Services, Division of Licensing and Certification.
30.
Incubation Period
means the
				period of time that is generally agreed to be the longest time between exposure
				to an infectious agent and the onset of infection and/or symptoms.
31.
Infection Preventionist
means any person designated by a hospital, nursing home, medical clinic or any
				other health care facility as having responsibility for prevention, detection,
				reporting, and control of infections within the facility.
32.
Infectious Person
means a
				person who is diagnosed as having a communicable disease and who, after
				appropriate medical evaluation or testing, is determined to be a potential
				source of infection to others, given conditions necessary for transmission of
				the disease.
33.
Intervention
means a public health action taken to reduce risk to
				public health or safety after receipt and evaluation of information of reported
				or suspect cases.
34.
Invasive
means the isolation of a
specific
				organism
from a normally sterile body site such as blood,
				cerebrospinal fluid (CSF), pleural fluid, peritoneal fluid, pericardial fluid,
				bone, joint/synovial fluid, or other internal body site (e.g. lymph node,
				brain) that normally contains no microorganisms.
35.
Investigation
means a
				systematic inquiry or examination of potential disease-causing agents or
				disease incidence.
36.
Isolation
means the separation, for the period of communicability,
				of an infectious person or animal from others in places and under conditions to
				prevent or limit the direct or indirect transmission of the infectious agent to
				those who are susceptible or who may spread the agent to others.
37.
Medical Laboratory
means any
				facility subject to certification, within Maine or out-of-state, that receives,
				forwards or analyzes specimens of material from the human body, or referred
				cultures of specimens from the human body.
38.
Non-Compliant Person
means
				an individual diagnosed with, recognized as having, or strongly suspected of
				having a Notifiable Disease or Condition who does not comply with prescribed
				care and public health recommendations.
39.
Notifiable Disease or
				Condition
means any communicable, zoonotic, occupational or
				environmental disease, the occurrence or suspected occurrence of which is
				required to be reported to the Department pursuant to 22 MRS Chapter 250,
				§§821-825, listed in Appendix A of this rule or declared a temporary
				Notifiable Disease or Condition, in accordance with Section
				2(E) of this
				rule.
40.
Nurse
				Practitioner
means an individual who is licensed as a registered
				professional nurse and approved to practice as an advanced practice registered
				nurse by the Maine State Board of Nursing pursuant to 32 MRS Chapter
				31.
41.
Nursing Home
means a nursing facility or home subject to licensure by the Department of
				Health and Human Services, Division of Licensing and Certification.
42.
Outbreak
means a situation
				in which a Notifiable Disease or Condition is observed in excess of what is
				expected, compared to the usual frequency of the disease or condition in the
				same geographic area, among a specified population, during a similar period of
				time.
43.
Pharmacist
means a pharmacist subject to licensure in the State of Maine by the Board of
				Registration in Pharmacy pursuant to 32 MRS Chapter 117.
44.
Physician
means a physician
				registered and licensed in the State of Maine by either the Board of Licensure
				in Medicine pursuant to 32 MRS Chapter 48 or by the Board of Osteopathic
				Licensure pursuant to 32 MRS Chapter 36.
45.
Physician Assistant
means a
				physician assistant licensed in the State of Maine by either the Board of
				Licensure in Medicine pursuant to 32 MRS Chapter 48 or by the Board of
				Osteopathic Licensure pursuant to 32 MRS Chapter 36.
46.
Prescribed Care
means
				isolation, quarantine, examination, vaccination, medical care or treatment
				ordered by the Department or by court order.
47.
Public Health Threat
means
				any condition or behavior that can reasonably be expected to place others at
				significant risk of exposure to a toxic agent or environmental hazard or
				infection with a notifiable disease or condition.
48.
Public Health Worker
means
				State public health employees or designated contractors of the Department,
				including but not limited to, epidemiologists, disease intervention
				specialists, public health educators, public health nurses, municipal public
				health officials, or other public health professionals.
49.
Quarantine
means the
				limitation, by the Department, of freedom of movement of individuals or
				contacts who have been exposed to a communicable disease or condition, for a
				period of time equal to the longest incubation period of the disease or
				condition to which they have been exposed, for the purpose of preventing
				exposure of other individuals.
50.
State Epidemiologist
means the chief medical epidemiologist of the
				State of Maine, as designated by the Department.
51.
Surveillance
means the
				systematic ongoing collection, collation and analysis of data for public health
				purposes and the timely dissemination of public health information for
				assessment and public health response as necessary.
52.
Toxic Agent
means a chemical
				or physical substance that, under certain circumstances or exposure, may cause
				harmful effects to living organisms.
53.
Vaping
means the action or
				practice of inhaling and exhaling the vapor produced by an electronic cigarette
				or similar device, including but not limited to e-cigs, e-hookahs, mods, vape
				pens, vapes, tank systems, and electronic nicotine delivery systems (ENDS).
54.
Veterinarian
means a person subject to licensure in the State of Maine by the Board of
				Veterinary Medicine pursuant to 32 MRS Chapter 71-A.
55.
Zoonotic Disease
means a
				disease or condition that may cause serious illness, disability or death, the
				infectious agent of which may be passed or carried, directly or indirectly,
				from an animal to a person.