Reportable Diseases Nurse's Function Code 152

1. Reportable Diseases Nurse's Function Code 152

2. Who?: Local Health Department (LHD) nurses. What?: Function code to identify time used by nurses related to time for reportable diseases. When?: When providing reportable diseases services Where?: Local Health Departments that utilize CDP as a billing service provider, etc. Why?: For the purpose of gathering informational data about time usage a nurse provides. Also to include time spent for documentation of reportable/communicable diseases into the DSM. How?: By placing function code in appropriate place on time sheet. Example: cost center code to also include function code when doing reportable disease cases. 2 Who, What, When, Where, Why & How?

3. The use of a function code is a means by which the Reportable Diseases section of the Infectious Diseases Branch will be able to collect data and monitor how much time is used by LHD nurses when providing services related to reportable /communicable diseases. There presently is no funding mechanism and often reportable disease issues are not addressed in a timely manner or as the emergency they might become if not addressed immediately. For example nurse has other clinic responsibilities. With the use of a function code there would be a way to review data regarding time given and provide a means for justifying the need for an increase in dollars provided to the LHD for the purpose of hiring nursing staff specifically for prevention and investigation of reportable/communicable diseases. 3 Introduction

4. Reinforce and establish the importance of the role nurses play in the investigation and prevention of the spread of reportable diseases. Provide a means for tracking and identifying clinical time utilized by LHD nurses when providing services and investigation specific to reportable diseases/conditions. To establish a base for identifying and collecting data regarding the hours used by nurses during clinic times to investigate reportable disease issues. To possibly afford the LHD another means for funding nursing staff time used specifically for reportable diseases. A periodic report of data collected will be reviewed by the Reportable Diseases section manager to determine if there is a need to seek funding. 4 Objectives

5. Definitions • Epidemiology: the branch of medicine dealing with the incidence and prevalence of disease in large populations and with detection of the source and cause of epidemics of infectious disease. Types of Reportable Diseases services: • Surveillance:- is the systematic collection, reviewing, analysis, interpretation and dissemination of data regarding health conditions and events, for the purpose of promoting action to prevent diseases and injuries and to promote public health. • Outbreak: is the occurrence of cases of a reportable/communicable disease in a particular area and period of time, which is in excess of the expected number of cases. • Case: An illness or condition determined to be a reportable disease or condition on the basis of clinical or laboratory criteria or both, often required to meet the Centers for Disease Control and Prevention (CDC) case definitions for public health surveillance. 5

6. Definitions (cont’d) • NEDSS: National Electronic Disease Surveillance System aka NBS. The Kentucky web-based system used for entering data electronically related to the surveillance and reporting of diseases for public health safety and investigation. Part of the CDC – NBS (NEDSS Based System) for reporting cases to CDC • Kentucky Reportable Disease Form *(EPID 200 reviewed 10/2012) - is the form provided by the Department for Public Health for the purpose of obtaining reportable disease information from health care providers, hospital infection preventionists to the local or state health department. The form is referred to as a “report form” or “case report” form or *“EPID 200”. 6

7. Logistics How can we track nurses' time spent in disease surveillance? • Add a function code for "investigating and reporting reportable diseases". For example, function code number is 152 and the nurse in the health department spent 3 hours following a reported case of mumps in a adult, the time coded would be to 810-152. • Reports should be available by function (code 152), employee category (nurses), employee name, adult or child investigation, health department, date of the investigation and amount of time spent that day in investigation (indicate on time sheet). • Time spent by local health department employees in reportable disease surveillance and investigation is coded to the cost centers listed below (Administrative Reference, Financial Management). • If the activities aren’t related to 806 TB or 807 STD, then the time is coded to 800 Pediatric/Adolescent if the reportable disease (s) involved concern the less than 21 age group. 7

8. Logistics (cont’d) • Time is coded to 810 Adult if the reportable disease (s) concern the 21 and older age group. • Reportable disease surveillance and investigation will be recognizable by the 152 function code added to the appropriate cost center. • Please note that the 152 function code for the time being will be used only by nurses involved in outbreak investigation, surveillance and data entry into the DSM electronic reporting system and using 800 and 810 cost centers (see the Reportable Diseases list below for those diseases/conditions where this function code would be used). 8

9. Cost Centers Samples (DO’s) • 800 PEDIATRIC/ADOLESCENT SERVICES (UNDER AGE 21) - Expenditures made for group activities reported in the Patient Services Supplemental Reporting System; reportable disease activities; identification, prevention and control of outbreaks and epidemics including rapid response activities; school fluoride; training and assistance; and management of these activities are directly charged to this Cost Center. • 810 ADULT SERVICES (AGE 21 AND OVER) - Expenditures made for Adult group activities reported in the Patient Services Supplemental Reporting System; reportable disease activities; identification, prevention and control of outbreaks; training and assistance; and management of these activities will be directly charged to this Cost Center. 9

10. Cost Centers Samples (Don’ts) • 801: CHILDHOOD IMMUNIZATION – Expenditures made to provide non-personal health Community Immunization Services as required in the annual Immunization grant application to the Federal Centers for Disease Control and Prevention. • 806: TUBERCULOSIS SERVICES - Expenditures for Tuberculosis reportable disease activities; identification, prevention and control of outbreaks and epidemics; TB group activities reported in the Patient Services Supplemental Reporting System; training and assistance; and management of these activities will be directly charged to this Cost Center. • 807: SEXUALLY TRANSMITTED DISEASE (SERVICES - Expenditures for STD reportable disease activities; identification, prevention and control of outbreaks and epidemics; STD group activities reported in the Patient Services Supplemental Reporting System; training and assistance; and management of these activities will be directly charged to this Cost Center. 10

11. Anthrax Arboviral Disease* Neuroinvasive Non-Neuroinvasive Botulism Brucellosis Campylobacteriosis Cholera Cryptosporidiosis Diphtheria E. coli shiga toxin positive (STEC) Haemophilus influenzae invasive disease Hansen’s disease Hantavirus infection Hepatitis A Listeriosis Measles Meningococcal infections Pertussis Plague Poliomyelitis Psittacosis Q Fever Rabies, animal Rabies, human Rubella Rubella syndrome, congenital Salmonellosis Shigellosis **Syphilis, primary, secondary, early latent or congenital Tetanus Tularemia Typhoid Fever Vibrio parahaemolyticus Vibrio vulnificus Yellow Fever 11 Reportable Diseases List in KentuckyReport Within Twenty Four (24) Hours

12. Reportable Diseases List in Kentucky (cont’d)Report in one business day • Foodborne outbreak • Hepatitis B infection in a pregnant woman or child born in or after 1992 • Hepatitis B, acute • Mumps • Streptococcal Toxic Shock Syndrome (STSS) • Toxic Shock Syndrome • **Tuberculosis • Waterborne outbreak 12

13. **AIDS **Chancroid **Chlamydia trachomatis infection Ehrlichiosis **Gonorrhea **Granuloma inguinale Hepatitis C, acute Histoplasmosis **HIV infection Lead poisoning Legionellosis Lyme disease **Lymphogranuloma venereum Malaria Rabies, post exposure prophylaxis Rocky Mountain spotted fever Streptococcal Pneumoniae Invasive( IPD, Streptococcal Pneumoniae) **Syphilis, other than primary, secondary, early latent or congenital Toxoplasmosis ** Has own cost center 13 Reportable Diseases List in Kentucky (cont’d)Report within five (5) business days.

16. Questions Any questions ? Reviewed 10/26/12 16