Confidential Morbidity Report (CMR)

Timely reporting of certain diseases and conditions is legally mandated by the California Code of Regulations (CCR Title 17). The HIPAA privacy explicitly permits disclosures to public health authorities for public health activities. If you need assistance reporting a Title 17 disease/condition or have questions about which diseases are reportable, please contact the Communicable Disease Unit. Please note unusual diseases and outbreaks of any disease are reportable to the Health Department.

 A complete reporting guide will be available on this website in the near future.

 How to Report a Disease

 To report a communicable disease or other reportable condition:

 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.
  • Use the CMR-TB  form to report Tuberculosis
  • Use the CMR-LOC  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 Adult HIV form to report HIV/AIDS in individuals >12 years of age.

 2. Complete the form (type electronically and print or print and complete by hand) and fax it to Monterey County Communicable Disease Unit at 831-754-6682.  Non-urgent reports can also be mailed to the Health Department.

Monterey County Health Department

ATTN: Communicable Disease Unit

1270 Natividad Road

Salinas, CA 93906

 Phone: 831-755-4521

Confidential Fax: 831-754-6682

If the disease requires immediate reporting during business hours, please call 831-754-4521.  During weekends and after hours, please call 831-755-5100 for immediate reporting and ask for the on-call Health Officer.

Suspected outbreaks of any kind should be immediately reported by calling 831-755-4521 or 831-755-4698.  After normal business hours, please call 831-755-5100 and ask for the on-call Health Officer.  Do not wait to confirm the outbreak before reporting.

Schools, Daycares, and Other Educational Settings:

Schools, daycares, and other educational settings should report using the 2013-2014 School Year Report Form.  For questions about when to report, see the Guidelines for Reporting Illnesses in Educational and Daycare Setttings.

 

WHAT HAPPENS WHEN YOU REPORT A DISEASE

The Monterey County Communicable Disease Unit receives reports of over 80 legally reportable diseases and conditions. Certain critical diseases must be reported within one hour to the Health Department while others require same day notification or notification within one week. See the list of legally reportable diseases on page two of the Confidential Morbidity Report (CMR) form for reporting timeframes.

After we receive an infectious disease report, we immediately take action to protect the health of Monterey County residents and visitors.

 Investigation

  • Case Investigation:
    • Interview cases and clinicians to identify risk factors and other potential contacts.
    • Evaluate patients/contacts in sensitive occupations or settings that may pose a public health concern (e.g., food handlers, daycare attendees, healthcare workers).
  • Source Investigation:
    • Conduct an epidemiologic investigation to identify the source of infection and how it is being spread.
  • Lab Testing:
    • Provide guidance on obtaining lab tests to confirm diagnosis.
    • Facilitate approvals for obtaining specialized tests performed at the Monterey County Public Health Laboratory and/or state and federal public health laboratories.

 Infection Control

  • Recommendations:
    • Work with infection control practitioners to recommend measures to control and prevent the spread of disease in healthcare settings.
    • Information and Education:
      • Provide information to cases, contacts, and the general public to prevent and control the spread of disease in community settings.
      • In the event of an infectious disease emergency, provide continued infection control guidance and recommendations.
      • State and National Notification:
      • Coordinate notification of state and national health officials, emergency medical responders, and law enforcement, as necessary.

Treatment and Prophylaxis 

  • Post-exposure and Preventative Treatment:
    • Assess the need for and recommend preventative treatments such as antibiotics and vaccines.
    • In the case of mass exposure to a treatable infectious agent, active the local system for providing mass treatment and/or prophylaxis.

Communication with Clinicians

  • Health Alerts:
    • Send Health Alerts, Advisories, and Updates to clinicians regarding infectious disease situations of public health concerns.
  • Analysis of Surveillance Data:
    • Analyze and disseminate public health surveillance data to clinicians and the general public.

 

DISEASE REPORTING FRQUENTLY 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.

  1. 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 HEALTH CARE 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 ACCOUNTABILTY 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 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 for consultation and to answer questions related to communicable disease during business hours by calling 831-755-4521.

WHAT DISEASES HAVE BEEN REPORTED IN MONTEREY COUNTY IN THE PAST?

Visit the Health Department's main website (www.mtyhd.org) and click "Data".

Assigned Staff