Updated Notifiable Conditions Regulations Delayed Until January 2023

Change of Law: Hospital Action Required

To:	Hospital Chief Information Officers, Chief Medical Officers, Chief Quality Officers, Laboratory Directors, Legal Counsel, and Government Affairs Staff
From:	David Streeter, Policy Director, Clinical and Data DavidS@wsha.org | (206) 216-2508
Subject:	Updated Notifiable Conditions Regulations Delayed Until January 2023

 

Purpose

The purpose of this bulletin is to inform hospitals that the revisions to Washington State’s Notifiable Conditions regulations in chapter 246-101 WAC are delayed until January 1, 2023. The delayed regulatory revisions:

• Require health care facilities, health care providers, and laboratories to collect extensive patient race, language, and ethnicity data;
• Clarify the reporting process for conditions deemed notifiable and eliminate phone calls as a reporting method; and
• Add 21 new conditions to the list of conditions that are deemed notifiable to local health jurisdictions (LHJ) and the Department of Health (DOH).

WSHA recommends hospital use the time provided by the delay to prepare for compliance with the revised regulations in advance of new January 1, 2023 effective date. Preparations may include developing new procedures for collecting and reporting the expanded patient demographic data and adjusting electronic health record systems (EHR) to store the additional patient data.

The delay will provide DOH additional time to complete its’ technical work to implement the updated regulations. The new effective date will also align with the effective date for HB 1272 (2021), which requires hospitals to collect and report new patient demographic information. DOH currently anticipates its technical work to implement the regulations will be complete in October 2022. WSHA will continue to seek status updates on this work.

WSHA supported DOH’s request to the Washington State Board of Health (WSBOH) to delay the effective date for the updated Notifiable Conditions regulations. We are pleased WSBOH adopted the new effective date because it will provide hospitals with additional time to prepare for compliance.

Recommendations

1. Review this bulletin, WSHA’s previous Notifiable Conditions bulletin, and chapter 246-101 WAC to understand the forthcoming changes to Washington State’s Notifiable Conditions regulations.
2. Share this bulletin with relevant staff so they are aware of the delay for the forthcoming changes.
3. Plan for changes to your patient data collection process and data reporting workflow to comply with the new requirements.

Applicability/Scope

The updated notifiable conditions regulations apply to:

• Health care facilities including hospitals licensed under chapter 70.41 RCW, ambulatory surgical centers licensed under chapter 70.230 WAC, and “Clinics, or other settings where one or more health care providers practice,” among other facilities;
• Health care providers licensed under Title 18 RCW and “Military personnel providing health care within the state regardless of licensure;” and
• Laboratories licensed under chapter 70.42 RCW.

Please see WSHA’s previous bulletin for more information about the regulations’ applicability.

Overview

Washington State’s Notifiable Conditions regulations list the health conditions that must be reported to LHJs and DOH; the information that is reported; and the reporting process. The current rules took effect in 2011 and the updates finalized by WSBOH earlier this year will now take effect January 1, 2023.

The updated regulations require health care providers, health care facilities, and laboratories to collect demographic information from patients and report it with each notifiable condition case. This new requirement will provide public health agencies with information that can help target responses to disease outbreaks that impact specific racial and ethnic communities.

The updated regulations also add 21 new health conditions to the list of conditions that are notifiable to DOH and LHJs. Additionally, the new regulations make several important changes to the notifiable condition reporting process. Please see WSHA’s previous bulletin for more information about the changes to the Notifiable Conditions regulations.

DOH requested the delay to January 1, 2023 due to “technical challenges” to complete the work necessary to implement the new regulations. DOH wrote to WSBOH, “DOH has identified 19 IT systems that will need updating to implement the new Notifiable Conditions rules. DOH IT staff and communicable disease staff’s capacity to update these IT systems has been impeded by the relentless demands of the COVID-19 pandemic.” DOH also recommended the January 1, 2023 effective date to align implementation with HB 1272, which also requires hospitals to collect new patient demographic information that will be submitted through the Comprehensive Hospital Abstract Reporting System (CHARS).

Next Steps

Hospitals should begin preparing to comply with the revised regulations in advance of the new January 1, 2023 effective date. Preparations may include:

• Developing procedures for collecting and reporting the expanded patient data; and
• Adjusting EHR systems to be able to store the additional data collected from patients.

DOH started its implementation work to prepare for the high volume of data it will receive and process. DOH anticipates its’ work will be complete by October 2022, which would leave time for hospitals to incorporate DOH’s new systems and forms into their workflow in advance of the January 1, 2023 effective date. WSHA will continue to seek status updates from DOH. Hospitals should watch for updates from WSBOH, DOH, and WSHA as the effective date for the revised regulations gets closer. Questions about the revised regulations may be submitted via email to notifiableconditions@sboh.wa.gov.

DOH does not anticipate advising hospitals on how to develop their internal data collection and reporting procedures. However, WSHA is currently working with hospitals that are piloting processes to improve collection of patient demographic data through culturally sensitive methods. As part of that work, WSHA has compiled a list of resources hospitals can use to plan for patient data collection. Please contact Abby Berube for information and additional resources.

Background

According to WSBOH’s Concise Explanatory Statement, “the purpose of rulemaking within chapter 246-101 WAC is to better protect public health by improving public health authorities’ understanding of emerging conditions, allowing more thorough case investigations, and improving the public health response to infectious and noninfectious conditions.” The updated regulations were initially effective January 31, 2022, however WSBOH delayed the effective date to January 1, 2023 to provide DOH additional time to implement the new rules.

During the rule making process, WSHA recommended WSBOH delay the revised regulations’ implementation to ensure alignment where appropriate with HB 1272 and to account for the COVID-19 pandemic. This resulted in the initial January 31, 2022 effective date for the updated Notifiable Conditions regulations. When DOH requested delaying the effective date to January 1, 2023, WSHA supported the request through a letter to WSBOH and comments at WSBOH’s November 10, 2021 meeting. In the letter and comments, WSHA requested WSBOH provide at least a 120-day window between the completion date for DOH’s technical work and the date hospitals begin reporting to ensure hospitals are prepared for reporting. DOH testified in response that the October 2022 completion date should provide sufficient time for hospitals and other reporting entities to incorporate DOH’s new systems and forms into their workflow.

WSHA’s 2021 New Law Implementation Guide

Please visit WSHA’s new law implementation guide online. The Government Affairs team is hard at work preparing resources and information on the high-priority bills that passed in 2021 to help members implement the new laws, as well as links to resources such as this bulletin. In addition, you will find the Government Affairs team’s schedule for the release of upcoming resources on other laws and additional resources for implementation.

References

• WSHA Bulletin: Beginning January 1, 2023 – New Data Requirements for Revised Notifiable Conditions Regulations
• Chapter 246-101 WAC– includes the current rules and the revisions effective January 1, 2023
• Washington State Department of Health Letter: “Extend Effective Date for Notifiable Conditions Rules (Chapter 246-101 WAC)”
• Washington State Board of Health Memo: “Effective Date Extension Request- Notifiable Conditions Chapter 246-101 WAC”
• Concise Explanatory Statement
• Washington State Board of Health Notifiable Conditions Rules Webpage
• Washington State Department of Health Notifiable Conditions Webpage
• Race, Ethnicity, and Language Resources