New Jersey Administrative Code › Title 8 - HEALTH › Chapter 52 - PUBLIC HEALTH PRACTICE STANDARDS OF PERFORMANCE FOR LOCAL BOARDS OF HEALTH IN NEW JERSEY › Appendix - APPENDIX

Current through Register Vol. 56, No. 14, July 15, 2024
PROGRAMMATIC GUIDELINES FOR BEST PRACTICES
I. Environmental Health Activities
Recreational Bathing
(a) The local board of health shall:
1. Conduct a sanitation and safety program at public bathing places
				(that is, swimming pools, lakes, rivers and ocean bathing places), based upon the
				current "Recreational Bathing" regulations contained in the State Sanitary Code (see
				N.J.A.C. 8:26);
2. Inspect, using an inspection form designed by the Department of
				Health and Senior Services, each public bathing place at least twice during the
				operating season, make follow-up inspections when deficiencies are found, and take
				necessary enforcement actions;
3. Assure sanitary surveys of natural bathing areas as indicated by
				bacterial counts and/or epidemiological evidence;
4. Inspect public spas and/or whirlpools at least yearly in
				accordance with the provisions of the Recreational Bathing regulations (N.J.A.C.
				8:26); and
5. Conduct investigations within 24 hours of all deaths and serious
				injuries and report such occurrences as outlined in the Recreational Bathing
				Regulations (N.J.A.C. 8:26) on a form developed by the Department of Health and
				Senior Services.
Campgrounds
(a) The local board of health shall:
1. Conduct a sanitation and safety program for campgrounds based
				upon State law and Chapter II of the State Sanitary Code (N.J.A.C. 8:22-1 );
				and
2. Inspect each campground at least annually to insure compliance;
				conduct follow-up inspections and initiate enforcement action as necessary.
Youth camps
(a) The local board of health shall conduct a youth camp sanitation
				and safety program (N.J.A.C. 8:25) and shall:
1. Inspect each youth camp once prior to opening; and
2. Perform necessary follow-up inspections at the request of
				Consumer and Environmental Health Services; and
3. Submit copies of each inspection to Consumer and Environmental
				Health Services, Department of Health and Senior Services.
Food surveillance
(a) The local board of health shall maintain surveillance of retail
				food establishments, food and beverage vending machines and shall:
1. Conduct a retail food establishment program based upon State laws
				and regulations, including Chapter 12 of the State Sanitary Code and local
				ordinances, if applicable (N.J.A.C. 8:24);
2. Inspect retail food establishments using forms approved by the
				Department of Health and Senior Services at least once a year, inspect vending
				machines dispensing potentially hazardous foods at least once a year and those
				dispensing non-potentially hazardous foods on a complaint basis or as required by
				local ordinance;
3. Initiate appropriate enforcement action to secure compliance with
				State law and local ordinance; collect and prepare evidence for legal action; follow
				a protocol for taking appropriate enforcement actions to secure compliance (such as
				abatement letters, administrative hearings, summons, court actions and
				condemnations);
4. Maintain food establishment and vending machines files at the
				local health agency office containing inspection reports, food sample reports, and
				reports of enforcement actions taken and other pertinent data associated with the
				program;
5. Provide for, or conduct training courses for food service
				supervisors using curricula approved by the Department of Health and Senior Services
				such as the Food Manager's Certification Program;
6. Collect samples and provide for laboratory analyses of any food
				suspected of being associated with a foodborne illness or, as necessary, any food
				suspected of being adulterated, misbranded or unwholesome;
7. Embargo all food known or suspected of being adulterated,
				misbranded, unwholesome or associated with foodborne illness within the meaning of
				local ordinance or State law;
8. Assist the Department of Health and Senior Services upon request
				in conducting recalls and recall effectiveness checks of foods found to be
				contaminated, adulterated or misbranded; and
9. Condemn and supervise the destruction or otherwise dispose of
				food which is adulterated, misbranded, unwholesome or associated with foodborne
				illness within the provisions of local ordinance or State law.
Occupational health (operative January 1, 1989)
(a) The local board of health shall conduct an occupational health
				program operative January 1, 1989; and shall:
1. Maintain a comprehensive profile of all employers in each
				designated four digit Standard Industrial Classification (SIC) operating in local
				jurisdiction. This profile should utilize Department of Labor and Right to Know data
				filed (see N.J.A.C. 8:59) and include for each employer:
Name of company, SIC Code
Address of company,
Number of employees,
Major product or service,
Right to Know Data--DEP/DOH,
History of emergency calls,
History of complaints;
2. Maintain a list of all information and/or agency occupational
				health resources and make appropriate referrals in response to requests for
				information or complaints;
3. Train or obtain at least one staff person in Occupational Health
				and Industrial Hygiene through a continuing education program provided or made
				available by the Occupational Health Services of the Department of Health and Senior
				Services;
4. Conduct initial and follow-up interviews, utilizing standardized
				procedures and forms developed by the Department of Health and Senior Services, upon
				receipt of reports of occupational disease cases (8:57-1.13 ); and
5. Conduct preliminary surveys in response to reported occupational
				diseases or referrals from the Department of Health and Senior Services, using
				standardized forms provided by the Department of Health and Senior Services to
				record observations and collect information. (These standardized forms shall be
				forwarded to the Department of Health and Senior Services' Occupational Health
				Services for follow-up).
Public health nuisances
(a) The local board of health shall conduct a public health nuisance
				program to include the following:
1.Investigations of public health nuisances including, but not
				limited to, noxious weeds, housing, solid waste, and insect and rodents, which shall
				be conducted in accordance with applicable State laws and local ordinances, which
				are at least equivalent to the "Weed Control Code of New Jersey," the "Solid Waste
				Code of New Jersey," and the "Public Health Nuisance Code of New Jersey (1953),"
				exclusive of Section 2.1 (a) and (b) (which are model codes available from the
				Department of Health);
2. Conduct complaint investigations and surveys to identify
				nuisances, and through appropriate follow-up, ensure abatement in accordance with
				State law and local ordinances;
3. Maintain and make available educational information on the
				prevention and abatement of public health nuisances; and
4. Maintain current files on all public health nuisances which shall
				include the investigation, follow-up, abatement and enforcement action taken in each
				instance.
II. Communicable Disease Activities
Reportable diseases
(a) The local board of health shall conduct a program for the
				surveillance, investigation and control of reportable diseases and shall:
1. Document episodes of reportable diseases including occupational
				diseases and/or incidents and transmit the information to the State and other
				agencies as required by chapter 2, Reportable Diseases (N.J.A.C. 8:57-1 ) of the
				State Sanitary Code and N.J.S.A. 26:4;
2. Conduct prompt investigations of reportable illnesses as well as
				unusual manifestations of disease not listed as reportable in chapter 2 of the State
				Sanitary Code (N.J.A.C. 8:57-1 ) and institute appropriate control measures and
				promptly report all findings to the Department of Health and Senior Services;
3. Disseminate and exchange information relative to outbreaks of
				disease with physicians, hospitals, boards of education, and other responsible
				health agencies as appropriate; and
4. Analyze reported data to provide a basis upon which to plan and
				evaluate an effective program for the prevention and control of infectious diseases.
Immunization
(a) The local board of health shall promote and provide
				immunizations for protection against childhood vaccine-preventable diseases and
				shall:
1. Promote and provide primary and booster immunizations to
				preschool and school age children for protection against diseases in accordance with
				current recommendations of the Department of Health and Senior Services;
2. Assist all schools, with an emphasis on preschool facilities, in
				implementing and enforcing the immunization requirements contained in Chapter 14, of
				the State Sanitary Code (N.J.A.C. 8:57-4 ) by providing immunization services and
				conducting periodic surveys and representative record audits every year;
3. Secure prompt reporting of vaccine-preventable disease as
				required by chapter 2 of the State Sanitary Code (8:57-1.2
				); and
4. Utilize vaccine information statement forms and maintain related
				documentation for individuals receiving State-issued vaccines according to State
				Directives and in compliance with Federal law.
Rabies and zoonosis control
(a) The local board of health shall conduct a program for the
				control of rabies and other zoonoses and shall:
1. Require rabies vaccination of dogs to comply with current rabies
				statutory requirements and encourage the vaccination of cats, and provide for rabies
				vaccination clinics at least once a year;
2. Ensure that a report of an annual canvass of all dogs owned,
				kept, or harbored within the limits of the respective municipality is received by
				the local board of health by September 1 of each year.
3. Inspect kennels, pet shops, shelters and pounds, to ensure
				compliance with the State laws and regulations prescribed by the Department of
				Health and Senior Services, and ensure that licenses issued to these facilities are
				in compliance with existing laws;
4. Report and investigate animal bites, ensure that persons bitten
				are advised to see a physician, quarantine biting animals as indicated and report
				immediately to the Department of Health and Senior Services clinically suspicious
				cases of rabies in animals as determined by a veterinarian, ensure availability of
				impounding facility where biting animals may be appropriately quarantined and
				observed for rabies;
5. Ensure that heads of animals that have died within 10 days after
				biting a person are delivered immediately to the Department of Health and Senior
				Services' Public Health and Environmental Laboratories for examination (Unwanted
				dogs or cats or any another animal which has bitten a human may be sacrificed
				immediately and the head promptly delivered to the Public Health and Environmental
				Laboratories for examination);
6. Provide an organized program for control of stray dogs and other
				animals;
7. Inspect annually, or more often if necessary, records of dealers
				in psittacine birds as required by chapter 3 of the State Sanitary Code (N.J.A.C.
				8:23); and
8. Initiate appropriate enforcement actions to secure compliance
				with the State rabies statutes, collect and prepare evidence for legal action.
Tuberculosis control
(a) The local board of health shall control the spread of
				tuberculosis and shall:
1. Ensure that all of the tuberculosis control services or services
				elements listed in the "Guidelines for Ambulatory or Outpatient Tuberculosis
				Control" (available at the New Jersey Department of Health and Senior Services) are
				available and accessible to all persons living within the jurisdiction of the local
				agency;
2. Secure prompt reporting of tuberculosis and transmit reports as
				required by the State Sanitary Code (8:57-1.2 ) and encourage
				the reporting of suspects;
3. Ensure effective treatment and continuing medical supervision of
				suspect and diagnosed cases of tuberculosis;
4. Ensure that contracts are identified and brought to examination,
				diagnostic conclusion, and treatment in accordance with the policy of the Department
				of Health and Senior Services;
5. Ensure the provision of preventive therapy in accordance with
				current recommendations of the Department of Health and Senior Services;
6. Ensure reporting of the current status of diagnosed cases of
				tuberculosis in accordance with the policy of the Department of Health and Senior
				Services using forms provided by the State;
7. Provide for the discharge from tuberculosis supervision of
				patients whose treatment has been completed in accordance with current
				recommendations by the Department of Health and Senior Services;
8. Provide for testing using currently approved intradermal
				tuberculin tests, of pupils, teachers, employees, and volunteers in the non-public
				schools, and for follow-up of those in both the public and non-public schools as
				recommended in the current edition of "School Tuberculin Testing in New Jersey,"
				published by the Department of Health and Senior Services; and
9. Analyze data to provide a basis upon which to plan and evaluate
				an effective program for the prevention and control of tuberculosis.
Sexually transmitted diseases
(a) The local board of health shall control sexually transmitted
				diseases and shall:
1. Provide for medical services for all persons seeking medical care
				for Sexually Transmitted Disease (STD);
2. Secure prompt reporting of any case of STD and forward reports
				immediately to the Department of Health and Senior Services, Communicable Disease
				Field Program, as required by chapter 2 of the State Sanitary Code (8:57-1.2 );
3. Provide interview and investigation services to priority STD
				cases in accordance with the policy established by the Department of Health and
				Senior Services and report results of these services on appropriate forms provided
				by the Department;
4. Provide counseling to all patients infected with STD and treated
				at public health department STD clinics, to include, but not be limited to, disease
				prevention, sex partner referral, need for follow-up testing, and appropriate action
				to take when symptoms appear;
5. Provide public education services to the community or target
				population; and
6. Analyze reported data and provide a basis upon which to plan and
				evaluate an effective program for the prevention and control of sexually transmitted
				diseases.
Human Immunodeficiency Virus (HIV) infection
(a) The local board of health shall administer a planned program to
				prevent and control HIV infection and shall:
1. Utilizing seroprevalence and case reporting data provided by the
				Department of Health and Senior Services, identify ways to reach persons at high
				risk within the community and develop and implement a strategy to disseminate HIV
				prevention and control information to these groups;
2. Maintain supplies of educational materials to meet information
				requests on the transmission, prevention and control of HIV;
3. Provide or arrange for other suitable local health education
				resources (for example, Planned Parenthood, Red Cross) to conduct education programs
				addressing the epidemiology, prevention and control of HIV to civic and community
				organizations and occupationally at risk groups utilizing State prepared or
				equivalent curricula;
4. Provide or arrange for in-service training addressing the
				epidemiology, prevention and control of HIV to all local health department
				personnel;
5. Develop and implement a protocol to refer individuals concerned
				about their HIV status to counseling and testing sites and other health care
				providers;
6. Refer HIV infected persons and their families seeking services to
				appropriate provider agencies such as mental health, drug treatment and other social
				service agencies; and
7. Participate in the planning, development and implementation of a
				county or regional program to control HIV infection and the progression to
				AIDS.
III. Maternal and Child Health Activities
Infants and preschool children
(a) The local board of health shall provide health supervision for
				infants and preschool children and shall:
1. Provide child health conferences for comprehensive preventive
				health care of infants and preschool children, with particular emphasis on the
				medically indigent, based upon the current Department of Health and Senior Services
				publication, "Guidelines For the Child Health Conference";
2. Prepare a Child Health Service Report CH-7 or subsequent form
				number for each session, and submit promptly on at least a quarterly basis to the
				Maternal and Child Health Program in the New Jersey Department of Health and Senior
				Services;
3. Maintain an informational and outreach service to encourage
				physicians, hospitals and social agencies to refer families to the child health
				conference, women, infants and children supplemental Food Program (WIC) and the
				public health nursing agency; and
4. Provide for information and guidance on physical, emotional,
				nutritional, and cognitive development of infants and preschool children through
				child health conferences and home nursing visits.
Childhood lead poisoning
(a) The local board of health shall provide for the prevention and
				control of lead poisoning in young children and shall:
1. Conduct a program, the major components of which shall
				include:
i. Case identification;
ii. Medical management;
iii. Environmental surveillance; and
iv. Education in conformance with
				24:14A-1 et seq. and chapter 13 of the
				State Sanitary Code (N.J.A.C. 8:51-7.7 ). (Also, a current issue of "Preventing Lead
				Poisoning in Children, a statement by the Centers for Disease Control" and findings
				of the New Jersey Physician Task Force on Lead Poisoning shall be used as guidelines
				for program delivery as appropriate.)
2. Develop a program plan based on elements in (a)1 above and on the
				degree of risk in the community as identified through the "Community Health Profile"
				and "Community Hazard Score for Lead Poisoning in Children" issued by the Department
				of Health and Senior Services;
3. Conduct case finding efforts among children one through five
				years of age by annual blood testing in accordance with approved collection
				techniques in such settings as child health conferences, WIC clinics, day care
				centers, nursery schools and door-to-door in high risk neighborhoods, with testing
				priority given to children at higher risk including:
i. Those one through three years of age;
ii. Those residing in or frequenting housing units or other sites
				where lead-based paint may be present;
iii. Those whose parents or other household members may be
				occupationally or otherwise exposed to lead sources;
iv. Those at increased risk of exposure to lead sources for whatever
				reason;
v. Those with a history of pica or increased lead absorption;
				and
vi. Those who are siblings of a child with increased lead
				absorption;
4. Assure that confirmed positive test results based on current risk
				classification standards is immediately referred to medical supervision and that a
				child so referred shall receive on-going, medical management as appropriate;
5. Conduct environmental surveillance among patient cases
				identified; and
i. Provide staff capable of conducting environmental
				investigations;
ii. Assure that, simultaneous with referral for medical attention,
				an environmental investigation will be initiated to identify the probable source(s)
				of lead exposure and to ensure the expedient and safe removal of the lead
				hazard(s);
iii. Assure that along with the owner of the property wherein the
				child resides, the parent or guardian of the child shall be notified in writing and
				kept abreast as to the findings of the environmental investigation and subsequent
				surveillance;
iv. Ensure that during periods when actual renovation work is
				underway, the affected child or children are removed from the premises; and
6. Provide a program of education directed toward parents, the
				general public, physicians and other health personnel regarding lead intoxication,
				sources of lead in the environment and control measures; and
i. Assure the provision of appropriate counseling and instruction to
				parents of lead intoxicated children and to parents of children at risk by trained
				professional personnel; and
ii. Assure the provision of adequate in-service training and
				continuing education of program personnel.
Improved pregnancy outcome
(a) The local board of health shall reduce infant mortality by
				improving access to prenatal care and related services in accordance with guidelines
				established by the Department of Health and Senior Services and shall:
1. Maintain an information and referral system for those requesting
				family planning, or prenatal and WIC services, to include:
i. A file of all providers of such services in the jurisdiction;
				and
ii. An active referral file;
2. Maintain a liaison with prenatal clinic services, family planning
				clinics, WIC school nurses, school health educators, and others;
3. Provide public health nursing services as requested by agencies
				for prenatal follow-up to high risk women who are determined to be medically
				indigent, to include, at a minimum:
i. Pregnancy counseling;
ii. Prenatal information;
iii. Follow-up of all referred positive pregnancy tests to promote
				initiation of prenatal care in the first trimester as requested by agencies;
iv. Nursing support and education through prenatal and postpartum
				home nursing visits as needed; and
v. Referrals as appropriate to WIC or other nutrition services,
				social services, and family planning services;
4. Establish and maintain a community outreach and education program
				targeting high risk women including adolescents to encourage and facilitate early
				entrance into prenatal care; and
5. Cooperate with the Department of Health and Senior Services,
				Newborn Biochemical Screening Program to locate and secure repeat specimens from
				infants when the sample cannot be obtained through the normal channels of a hospital
				and/or physician.
IV. Adult Health Services Activities
Cancer services
(a) The local board of health shall provide cancer prevention for
				populations at high risk according to criteria outlined in the Department of Health
				and Senior Services' publication "Adult Health Services Guidelines" and as
				identified through the Community Health Profile and shall:
1. Provide screening personnel to meet the criteria for staffing as
				specified in the "Adult Health Services Guidelines";
2. Establish a coordinated plan for counseling, referral and
				follow-up of all persons with non-negative screening results;
3. Provide screening services yearly for three percent of women ages
				15 to 34 and the three percent of women ages 35 to 64 who are at high risk for
				cervical cancer;
4. Provide education services yearly for five percent of women ages
				15 to 34 and five percent of women 35 and older to receive instruction in these
				particular areas;
i. The risk factors for cervical cancer and breast cancer;
ii. The importance of the Pap Smear in the early detection of
				cervical cancer (in accordance with the American Cancer Society Guidelines on
				cervical cancer screening);
iii. The importance of comprehensive breast cancer screening which
				include mammography at intervals specified by the American Cancer Society Guidelines
				and a physical breast examination by a health care professional;
iv. Breast self examination as one component in a total health care
				awareness program; and
v. Dietary and lifestyle modifications to reduce the risks of breast
				and cervical cancer.
5. Provide yearly instruction to three percent of individuals over
				age 40 in these particular areas:
i. The risk factors for colon/rectal cancer;
ii. The importance of compliance with the guidelines on colon/rectal
				cancer prescribed in Department of Health and Senior Services' Adult Health Services
				Guidelines; and
iii. The dietary and lifestyle modification to reduce the risk of
				colon/rectal cancer;
6. Provide annual reports to the State on the demographic
				characteristics of populations receiving screening and/or education services and the
				results of these screening programs;
7. Serve as a community resource to disseminate information
				available from the State on types of screening services available;
8. Provide for cancer-related continuing education for nursing and
				other program personnel at least once every three years. Include current
				cancer-related information in the orientation of all newly-hired cancer program
				staff to be involved in Cancer Services; and
9. Offer smoking prevention and cessation programs as defined in the
				"Adult Health Services Guidelines" (N.J.A.C. 8:52-6 ).
Diabetes services
(a) The local board of health shall provide for diabetes education
				services per the Department of Health and Senior Services' "Adult Health Services
				Guidelines" and shall:
1. Conduct public education related to diabetes and its risk factors
				such as age, obesity and family history;
2. Conduct diabetes risk assessment on all adult clients who utilize
				clinical or hypertension or cancer screening services, and counsel, refer, and
				follow-up clients where appropriate;
3. Educate or appropriately refer known diabetics to available
				diabetes-related education and other community resources (such as ophthalmologist,
				podiatrist, etc.); and
4. Provide for diabetes-related continuing education for nursing and
				other program staff at least once every three years, and include current
				diabetes-related information in the orientation of all newly-hired staff to be
				involved in Diabetes Services.
Cardiovascular disease services
(a) The local board of health shall provide cardiovascular disease
				control services according to the Department of Health and Senior Services "Adult
				Health Services Guidelines" and shall:
1. Provide hypertension screening services yearly to one percent of
				the high risk population;
2. Provide cardiovascular risk factor assessment and counseling on
				all individuals screened for hypertension and include the following areas:
i. Family history of cardiovascular disease;
ii. Smoking;
iii. Excessive cholesterol intake;
iv. Obesity;
v. Diabetes; and
vi. Exercise, and counsel, refer and follow-up clients where
				appropriate;
3. Provide cardiovascular health education programs for the general
				public;
4. Provide cardiovascular health education programs for hypertensive
				individuals; and
5. Provide for cardiovascular-related continuing education for
				nursing and other program staff at least once every three years, and include current
				cardiovascular-related information in the orientation of all newly-hired staff to be
				involved in cardiovascular disease services.
Health services for older adults
(a) The local board of health shall provide for a health program at
				locations selected by the health department which identifies the health needs of
				adults age 65 and older, and shall:
1. Provide a health needs assessment yearly on one percent of the
				non-institutionalized elderly in accordance with "Guidelines for Health Services for
				Older Adults" contained in the Adult Health Services Guidelines (available at the
				New Jersey Department of Health and Senior Services);
2. Provide education on alcohol abuse and medication
				management;
3. Follow-up and make referrals as appropriate for abnormal
				screening results or for needs identified in the individual's history and/or
				intake;
4. Assure participation at service sites through advance
				notification (for example: publicity);
5. Provide for gerontology related continuing education for staff at
				least once every three years, and include current gerontology related information in
				the orientation program for all new staff providing these services; and
6. Provide immunizations (for example, influenza and pneumococcal
				vaccines) at the discretion of the local health agency in accordance with the
				Immunization Practices Advisory Committee of the U.S. Public Health Service.
V. Health Education/Health Promotion
(a) A structured program shall be provided by the Health Educator or
				Field Representative, Health Education, in accordance with community health
				education needs, which shall include health components for Alcohol Abuse Control,
				Drug Abuse Control, Smoking Prevention and Cessation, Nutrition, Injury Control, and
				Physical Fitness and Exercise and shall include the following:
1. An assessment of health education needs and identification of
				target population based on information from the New Jersey Department of Health and
				Senior Services Community Health Profile and other relevant health related
				data;
2. Written health education program plans with measurable objectives
				for the six components in (a) above, based on the Health Promotion Guidelines,
				contained in the Adult Health Services Guidelines and other identified health
				education needs;
3. Identification and involvement of local leadership in the
				planning, implementation, and maintenance of needed health education services and
				programs to include collaboration with other agencies serving the community where
				such opportunities exist, and consultation with content specialists in the six
				required components in (a) above; and other areas as needed;
4. Application of appropriate health education interventions to
				provide for the effective implementation of health education programs (that is,
				community development, skill development, simulation, peer group discussion,
				behavior modification, lecture, media awareness, programmed learning, individual
				instruction, etc.);
5. Integration of a health education component into health
				department programs and services, covering the six required promotion topics in (a)
				above;
6. Consultation and training in the application of health education
				techniques for the professional staff of the health department;
7. Evaluation and report of the degree of success in achieving
				predetermined health education objectives; and
8. The health educator or Field Representative, Health Education
				shall serve as a community health information resource.
Public health nursing
(a) Provision of public health nursing services shall include the
				following:
1. The services of a public health nurse director or supervisor to
				assess, plan, implement and evaluate public health nursing services in accordance
				with community health needs;
2. Up-to-date written objectives, policies and procedures developed
				in cooperation with the health officer, for each activity in which there is nursing
				participation which relate to the overall goals of the local health agency;
3. The maintenance and use of individual, family and other service
				records according to current professional standards;
4. Orientation in-service and continuing education programs for
				nursing staff;
5. Annual reports of services rendered which include pertinent
				statistics and descriptive narrative as related to objectives; and
6. Integration, in conjunction with the health educator, of the
				relevant components of the health promotion program into all activities involving
				public health nursing services.