10-144 C.M.R. ch. 258, § 1 - PURPOSE AND DEFINITIONS

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.

Notes

10-144 C.M.R. ch. 258, § 1