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Public Health Reporting Guidelines

Published on . Last modified on August 12, 2016

California Code of Regulations, Tittle 17, Section 2500, requires healthcare providers knowing of or in attendance on a case or suspected case of any of the diseases or conditions listed below to report to the local health department within the indicated timeframe.  The Monterey County Health Department’s Division of Communicable Disease Prevention and Control places the highest priority on preserving the confidentiality of whom it serves.  Public health officials rely on healthcare providers, laboratorians, and other public health personnel to report the occurrence of notifiable diseases to their local health departments.  Timely and accurate reporting of disease provides public health data necessary to reduce and prevent morbidity.  For example, removing individuals from sensitive occupations such as food handling prevents the spread of diseases such as salmonellosis and hepatitis A.  Similarly, the detection and treatment of patients with tuberculosis, the identification and treatment of asymptomatic carriers of typhoid or gonorrhea, and the rapid immunization of people exposed to vaccine-preventable diseases are additional examples of successful public health prevention and intervention made possible by the timely reporting of communicable disease.  Failure to report can result in increased disease in the community, increased absences from work or school, increased costs for diagnosis and treatment, increased hospitalization, and increased poor health outcomes. 

The guidelines below are for medical providers.  Members of the public who wish to report a public health emergency or health risk should call 831-755-4521 Monday through Friday from 8:00 a.m. to 5:00 p.m. and 9-1-1 outside of normal business hours.  Members of the public with a medical emergency should always call 9-1-1 first. 

Medical Providers: What to Report (updated May 24, 2016)

Click here to view a list of reportable diseases and conditions as well as the time frames in which they must be reported. 

How to Report

For Clusters, Outbreaks, and Diseases that Require Immediate Reporting by Telephone:

Please call 831-755-4521 immediately.  During weekends, after normal business hours or on holidays, please call 831-755-5100 for immediate reporting and ask for the Hazardous Materials Team.

For Diseases that Require Reporting within 1 Working Day by Telephone:

Please call 831-755-4521.

For Diseases that Require Reporting within 1 to 7 Days by Electronic Transfer (including FAX), Telephone, or Mail:

1. Select the appropriate Confidential Morbidity Report (CMR) form based on the disease/condition you are reporting.  

  • Use the CMR-General Form for reporting all conditions except tuberculosis and conditions reportable to the DMV.  Please indicate the disease at the top of the page under CONDITION BEING REPORTED.
  • Use the CMR-TB form  to report suspected and confirmed cases of tuberculosis.
  • Use the HIV Adult Case Report Form (ACRF) to report HIV infections among individuals 13 years of age and older.  Completed ACRFs should be mailed to the address below via traceable mail or delivered by courier.   Please do not fax HIV information.  Note: acute HIV infections must be reported by telephone within 1 working day of identification.
  • Use the CMR-DMV form to report Lapses of Consciousness or Control, Alzheimer’s Disease or other conditions which may impair the ability to operate a motor vehicle safely (pursuant to H&S 103900).  Please indicate specific disorder under CONDITION BEING REPORTED.
  • Use the CMR-Animal Patients form to report communicable diseases for animal patients.
  • Use the Animal Bite Report Form to report incidents of people being bitten by animals.

2. Complete Form (type electronically and print or print and complete by hand), and fax the completed form to either the Monterey County Communicable Disease Unit at 831-754-6682 or to the Monterey County Health Department Tuberculosis Control Unit at 831-796-1272.  Reports can also be mailed to:

Monterey County Health Department

ATTN: Communicable Disease Unit
1270 Natividad Road
Salinas, CA  93906

If you are a multi-provider facility and interested in using a web-based portal to submit CMRs to the Health Department, please call 831-755-4503.

For Laboratories (updated June 2016):

The California Code of Regulations, Title 17, Section 2505, requires laboratories to report laboratory testing results suggestive of specified diseases of public health importance to the local health department.  In addition, Title 17 Section 2505 (I) requires clinical laboratories to submit a culture or specimen to the local public health laboratories for certain disease and conditions.

Laboratory findings are reportable to the local health officer of the health jurisdiction where the healthcare provider who first submitted the specimen is located within 1 hour (List (e)(1) diseases) or within 1 working day (List (e)(2) diseases) from the time that the laboratory notifies that healthcare provider or other person authorized to receive the report.

Click here for a list of test results that must be reported to the local health department.

Additional Laboratory Requirements:

Click here for a list of conditions for which clinical specimens must be submitted to the local public health laboratory.

Laboratory reports must made in writing and give the following information:

  • Date the specimen was obtained.
  • Patient identification number.
  • Specimen accession number or other unique specimen identifier.
  • Laboratory findings for the test performed.
  • The date that any positive laboratory findings were identified.
  • The name, gender, address, telephone number (if known), and age or date of birth of the patient.
  • The name, address, and telephone number of the healthcare provider who ordered the test.

 Disease Reporting Frequently Asked Questions (FAQs)

What is the legal basis for disease reporting in California?

Disease reporting requirements have been set forth by the California Legislature in Title 17 of the California Code of Regulations (CCR).  Title 17 requires that health care providers report certain diseases to the local health authority using the Confidential Morbidity Report (CMR).  CCR Title 17, Section 2500 describes reportable disease requirements in detail and is available ONLINE. Click on Title 17 Public Health, Chapter 4, Preventive Medical Services, Article 1, Reporting, and see Sections 2500-2511. For HIV non-name reporting, see Section 2641.5, and for Alzheimer’s Disease and Related Disorders, see Sections 2800-2812.

What diseases must be reported?

Refer to the back (page 2) of the Confidential Morbidity Report (CMR) for a complete and current list of all reportable diseases and conditions.

Who must report diseases?

According to Title 17 of the California Code of Regulations, healthcare providers include physicians, podiatrists, nurse practitioners, physician assistants, registered nurses, nurse midwives, school nurses, infection control practitioners, medical examiners, coroners, veterinarians and dentists. These health care providers are required to report certain diseases to the local health authority. Title 17, Section 2500 describes reportable disease requirements in detail (refer to ‘What is the Legal Basis for Reporting in California’ FAQ above.)

Why must healthcare providers report?

Failure to report a reportable disease is a citable offense for health care providers. However, this is not and should not be the primary motivating factor for reporting. Health care providers are the first and only line of defense in recognizing emerging public health issues. The window of opportunity afforded by early reporting directly impacts the effectiveness of any public health response. Reporting of other diseases (e.g., sexually transmitted diseases including HIV) also directly determines federal and state funds that communities may receive for prevention, treatment and case management.

How quickly must diseases be reported?

Refer to the back (page 2) of the CMR for required deadlines. In general, any disease that may require an immediate public health response (e.g., measles) must be called in ASAP 24/7. Other diseases may be reported by CMR within one working day or within seven calendar days according to page two of the CMR.

How does the Health Insurance Portability and Accountability Act (HIPAA) affect disease reporting?

HIPAA does not preclude disease reporting and, in fact, makes special allowances for the transfer of Public Health Information (PHI) to the local health authority.

Don’t labs report all of these diseases anyway?

NO! Title 17 requires health care providers to submit a CMR for all reportable diseases, regardless of whether or not it is also reported by the lab. Labs are only required to report a subset of diseases. Additionally, labs often lack demographic information, risk information, and a clinical interpretation of the lab results all of which are required for an appropriate public health response.  

Should I wait for lab confirmation before reporting a disease?

For diseases that require an immediate public health response (e.g., measles), DO NOT WAIT TO REPORT – REPORT THESE DISEASES AS SOON AS THEY ARE SUSPECTED. Unusual illnesses or illnesses that may be related to an outbreak or bioterrorism should also be reported as soon as they are identified. For all other diseases where an immediate public health response is not required (e.g., sexually transmitted diseases, hepatitis C), report when diagnosis is confirmed.

What if my patient is not a resident of Monterey County?

If the patient was examined or treated in Monterey County, then report to the Monterey County Health Department as required in Title 17 of the California Code of Regulations. Local health departments in California routinely forward the reports to the appropriate jurisdiction as needed.  

Is someone available to answer communicable disease questions?

Monterey County Health Department Communicable Disease Unit staff are available to answer questions related to communicable disease during business hours by calling 831-755-4521.  Please be aware that we do not have an infectious disease physician on staff and cannot provide clinical consultations.  We can, however, link you to appropriate consultation services or provide you with the most current diagnostic and treatment recommendations.

What diseases have been reported in Monterey County in the past?

Visit the Monterey County Communicable Disease Unit’s website (www.mtyhd.org/cd) and click on a topic under Reports and Data.