REPORT TITLE: Epidemiologic Investigations DESCRIPTION: Expands the department of health's ability to investigate significant causes of illness that threaten the public health. Protects the confidentiality of information received by the department. Appropriates funds to conduct a response action to include soil testing for Village Park and West Loch Fairways. (HB1138 CD1) 1138 HOUSE OF REPRESENTATIVES H.B. NO. H.D. 1 TWENTIETH LEGISLATURE, 1999 S.D. 2 STATE OF HAWAII C.D. 1 ________________________________________________________________ ________________________________________________________________ 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 "�1- 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 20 representative of the director for the purpose of conducting such 1138 Page 2 H.D. 1 H.B. NO. S.D. 2 C.D. 1 1 an investigation. The authorized representative may only view 2 the limited portion of the patient's medical record which is 3 directly relevant in time and scope to the subject of the 4 investigation. 5 (c) No person, health care provider, or medical facility 6 that provides information requested by an authorized 7 representative of the director for the purpose of conducting an 8 investigation under this section shall be held civilly or 9 criminally liable for providing that information to the 10 department. 11 (d) All information provided to the department under this 12 section shall be kept strictly confidential, except as the 13 director determines is necessary to protect the public health and 14 safety. Access to confidential records shall be restricted to 15 those individuals specifically authorized to participate in any 16 given investigation. However, epidemiologic and statistical 17 information with no individual identifying information may be 18 released to the public. The identities of individuals whose 19 medical records are investigated shall be disclosed only to those 20 persons authorized by the director or the director's 21 representative to conduct a specific investigation under this 22 section or determined by the director to be necessary to protect 23 the health and safety of the public." 1138 Page 3 H.D. 1 H.B. NO. S.D. 2 C.D. 1 1 SECTION 3. Section 321-1, Hawaii Revised Statutes, is 2 amended to read as follows: 3 "�1-1 General powers and duties of the department.(a) 4 The department of health shall have general charge, oversight, 5 and care of the health and lives of the people of the State. 6 (b) The department may conduct epidemiologic investigations 7 of diseases and injuries that threaten or are deemed by the 8 department to threaten the public health and safety. 9 [(b)] (c) The department shall have authority in matters of 10 quarantine and other health matters and may declare and enforce 11 quarantine when none exists and modify or release quarantine when 12 it is established. 13 [(c)] (d) When it is determined that there is imminent 14 danger of epidemic or serious outbreak of communicable disease, 15 the department may refuse, modify, or limit attendance at any 16 school in the State. 17 [(d)] (e) When in the judgment of the director, there is 18 deemed to be a potential health hazard, the department, through 19 the director, may take precautionary measures to protect the 20 public through the imposition of an embargo or the detention of 21 products regulated by the department, or the removal of products 22 regulated by the department from the market, or the declaration 23 of quarantine; provided that the director must find evidence of a 1138 Page 4 H.D. 1 H.B. NO. S.D. 2 C.D. 1 1 health hazard within seventy-two hours of the action taken or 2 rescind the action. The director shall make public the findings. 3 [(e)] (f) All county health authorities, sheriffs, police 4 officers, and all other officers and employees of the State, and 5 every county thereof, shall enforce the rules of the department. 6 All such powers in health matters as have been or may be 7 conferred upon any county shall be concurrent with those of the 8 department. 9 [(f)] (g) The department may establish charges and collect 10 fees for any of its services; provided that the department shall 11 not refuse to provide services to any person due to the person's 12 inability to pay the fee for the service. The department, 13 through the director, shall make an annual report to the 14 governor, showing in detail all its expenditures and 15 transactions, and such other information regarding the public 16 health as the department may deem of special interest. 17 [(g)] (h) The department, during the prevalence of any 18 severe pestilence or epidemic, shall publish a weekly report of 19 the public health. 20 [(h)] (i) The department shall establish and administer 21 programs, and adopt rules as deemed necessary, for the prevention 22 of domestic and sexual violence and the protection and treatment 23 of victims of domestic and sexual violence." 1138 Page 5 H.D. 1 H.B. NO. S.D. 2 C.D. 1 1 PART II 2 SECTION 4. The purpose of this part is to appropriate funds 3 for the department of health to conduct a response action, which 4 shall include soil sample surveys as part of an epidemiologic 5 investigation into the causes of an apparent disturbing and as 6 yet unexplained pattern of physical and learning disabilities of 7 children in the Village Park and West Loch Fairways communities. 8 The legislature finds that, as the population of the State 9 grows, housing developments and residential areas are being 10 constructed on former agricultural lands or on locations formerly 11 used by the military. This situation is certain to increase as 12 agriculture declines and additional lands become available for 13 residential development. Environmental health hazards in the 14 soil, such as residue from pesticides, can remain undetected 15 until significant clusters of disease or illness are identified. 16 Secret underground military facilities, such as tunnels or 17 bunkers, in which were stored arms or chemicals, are also capable 18 of causing environmental health hazards. 19 The legislature finds that significant clusters of illness 20 or disease are not readily identifiable until some commonality 21 occurs, such as proximate neighbors comparing notes or children 22 of the same age level entering a single neighborhood school being 23 enrolled in special education classes. 1138 Page 6 H.D. 1 H.B. NO. S.D. 2 C.D. 1 1 The legislature further finds that when a significant 2 cluster or increase of illness or disease occurs in a school and 3 is identified by the faculty, it should be the responsibility of 4 the principal and faculty to report their suspicions to the 5 department of health. The department of health, working in 6 cooperation with the department of education, should be 7 responsible for the related health services. 8 Of particular concern to the legislature is the Village Park 9 and West Loch Fairways communities. Village Park is a 10 subdivision of approximately two thousand families, and West Loch 11 Fairways is a subdivision of approximately seven hundred twenty 12 families, who share a common health phenomenon. Many of the 13 Village Park and West Loch Fairway families and children have 14 varying degrees of disabilities and illnesses that are more than 15 coincidence. One out of ten children has some physical or 16 learning disability, or both, that requires special needs 17 education. Physical disabilities include Downs Syndrome, trisomy 18 8 and trisomy 18, spina bifida, heart abnormalities, leukemia, 19 and respiratory ailments. Learning disabilities include mental 20 retardation, hearing, emotional, visual, speech and language, 21 attention deficit disorder, hyperactivity, oppositional defiant 22 disorder, multiple handicaps, and autism. 23 The purpose of this part is to appropriate funds to the 1138 Page 7 H.D. 1 H.B. NO. S.D. 2 C.D. 1 1 department of health to conduct soil testing for Village Park and 2 West Loch Fairways as part of an epidemiologic investigation to 3 determine if physical and learning disabilities of children are 4 caused by the soil. 5 SECTION 5. There is appropriated out of the environmental 6 response revolving fund under section 128D-2, Hawaii Revised 7 Statutes, the sum of $220,000 or so much thereof as may be 8 necessary for fiscal year 1999-2000 for the department of health 9 to conduct a response action, which shall include soil testing at 10 Village Park and West Loch Fairways to determine if the soil is a 11 cause of the illnesses, and the physical and learning 12 disabilities of children and families living in Village Park and 13 West Loch Fairways. The testing shall be completed by December 14 15, 1999. 15 The sum appropriated shall be expended by the department of 16 health. 17 SECTION 6. 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 7. Statutory material to be repealed is bracketed. 1138 Page 8 H.D. 1 H.B. NO. S.D. 2 C.D. 1 1 New statutory material is underscored. 2 SECTION 8. This Act shall take effect upon its approval; 3 provided that section 5 shall take effect on July 1, 1999.