Epidemiologic Investigations

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)

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



 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      "321-    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

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 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."

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                                     H.B. NO.           S.D. 2
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 1      SECTION 3.  Section 321-1, Hawaii Revised Statutes, is
 2 amended to read as follows:
 3      "321-1  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

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 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."

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 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.

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 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

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                                     H.B. NO.           S.D. 2
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 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.

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                                     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.