About Mandatory Disease Reporting in California
Why Report
Reporting is essential for disease control and public safety. Delay or failure to report has contributed to preventable secondary transmission and disease outbreaks in the past.
Reporting enables disease surveillance, whose primary objectives are to:
- raise alerts to the presence of dangerous diseases or conditions;
- determine the extent of morbidity within the community;
- evaluate risk of transmission;
- intervene rapidly when appropriate;
- protect the health of patients and the public.
In addition, it's the law. Penalties for not reporting can be severe.
For example, the Medical Board of California (MBC) has made failure for physicians to report in a timely manner a citable offense under California Business and Professions Code. MBC may discipline a licensee's failure to report as unprofessional conduct, with possible misdemeanor criminal charges incurring fine (up to $1,200) or imprisonment (60 to 180 days) or both fine and imprisonment (Business and Professions Code, Medical Practice Act - BPC Sections 2234, 2314, 2315).
Who Must Report
State law Title 17, California Code of Regulations (17CCR) details who must report a human or animal with a case or suspected case of a dangerous disease or condition.
Persons mandated to report under 17CCR include laboratories (Section 2505), health care providers (Sections 2500), officials of most types of schools (Section 2508), and anyone with knowledge related to possible rabies (Section 2606). State law defines a “health care provider" as a physician and surgeon, veterinarian, podiatrist, nurse practitioner, physician assistant, registered nurse, nurse midwife, school nurse, infection control practitioner, medical examiner, coroner, or dentist.
Who is responsible to report in multi-provider settings?
Per 17CCR §2500(c): "The administrator of each health facility, clinic or other setting where more than one health care provider may know of a case, a suspected case or an outbreak of disease within the facility shall establish and be responsible for administrative procedures to assure that reports are made to the local health officer."
Where and How to Report
Reports must be submitted to the local health department (LHD) of the patient's jurisdiction of residence. All southern California counties plus cities of Pasadena and Long Beach operate their own LHDs. Contact information for LHDs is below.
- LA County DPH: LAC DPH Health Professionals Reportable Diseases and Conditions
- Pasadena: Pasadena Healthcare Provider Disease Reporting
- Long Beach: Long Beach Epidemiology and Communicable Disease Control
- Other jurisdictions in California: LHD Communicable Disease Contact Information maintained by the California Conference of Local Health Officers (CCLHO)
- Other jurisdictions in the USA: Directory of Local Health Departments maintained by the National Association of County Health Officials (NACCHO)
What to Report and When
17CCR specifies the required timeframes for mandatory reporting. Certain diseases and situations are considered emergencies and must be reported immediately. Refer to the LA County Department of Public Health (DPH) Reportable Diseases and Conditions Webpage for Health Professionals and the Reportable Conditions List For Laboratories to see which diseases and conditions require reporting and the mandated reporting timelines.
In addition to the mandates in 17CCR, local health jurisdictions can require additional diseases or conditions to be reported locally. For LA County DPH, these are:- Acute Flaccid Myelitis (AFM)
- Baylisascaris (raccoon roundworm)
- Carbapenem-resistant Enterobacteriaceae (CRE) including Klebsiella sp., E. coli, and Enterobacter sp., in acute care hospitals or skilled nursing facilities
- Chagas
- Congenital cytomegalovirus (cCMV)
- Nontuberculous mycobacteria (extrapulmonary)
- Streptococcus pneumoniae
- Streptococcus pyogenes
Patient Confidentiality Concerns
See California DPH (June 15, 2012): Letter To All California Health Care Providers: HIPAA and Public Health Disclosures.
Related Codes and Regulations
California Code of Regulations, Title 17. Public Health
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Division 1. State Department of Health Services
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Chapter 4. Preventive Medical Service
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Subchapter 1. Reportable Diseases and Conditions
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Article 1. Reporting
- § 2500. Reporting to the Local Health Authority.
- § 2501. Investigation of a Reported Case, Unusual Disease, or Outbreak of Disease.
- § 2502. Reports by Local Health Officer to State Department of Public Health.
- § 2504. Report by Health Care Provider of Out-of-State Laboratory Findings.
- § 2505. Notification by Laboratories.
- § 2508. Reporting by Schools.
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Article 1. Reporting
- Subchapter 2.5. Disorders Characterized by Lapses of Consciousness
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Subchapter 1. Reportable Diseases and Conditions
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Chapter 4. Preventive Medical Service
California Medical Practice Act: Business and Professions Code - BPC. Division 2. Healing Arts.
California Health and Safety Code-HSC
- Division 102: Vital Records and
Health Statistics.
- Part 2. Population and Public Health Surveillance
- Division 103. Disease Prevention and Health Promotion
- Part 5. Environmental and Occupational Epidemiology
- Division 105. Communicable Disease Prevention and Control.
- Part 4. Human Immunodeficiency Virus (HIV)
- Part 6. Veterinary Public Health and Safety.
Section 121585.
- Declaration of Rabies Areas (CDPH). As referenced by 17CCR § 2606 for required reports of animal bites to humans in “rabies areas”
- Division 106. Personal Health Care (Including Maternal, Child, and Adolescent)
- Part 5. Hereditary Diseases/Congenital Defects
- Chapter 1. Genetic Prevention Services
- Part 5. Hereditary Diseases/Congenital Defects
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