Preamble
1.00 Scope and Guidelines
2.00 Reporting Requirements
3.00 Guidelines
4.00 Effective Date

Preamble.  The Boston Public Health Commission is charged with protecting, preserving and promoting the health and well-being of all Boston residents, particularly those who are most vulnerable including the responsibility for the investigation, prevention, and control of communicable diseases in Boston, including named pathogens and infectious outbreaks of unspecified etiology.  In carrying out that mission the Board finds as follows:

• All outbreaks of any disease, including those which appear in the Massachusetts Isolation and Quarantine regulations (105 CMR 300.00) must be promptly reported to the local board of health.
• For public health measures to be effective, timely identification of outbreaks is critical.
• A real time surveillance system of hospital and other health care facility emergency and urgent care units will allow for the earliest possible detection of increases in morbidity due to infectious and non-infectious causes.
• Boston currently does not have a real time surveillance system of hospital and other health care facility emergency and urgent care units.

Section 1.00 Scope and definitions.  This regulation shall apply to all hospitals, in the City of Boston that provide emergency or urgent care in the usual course of business.

For the purposes of this regulation and its guidelines, the following terms shall be defined as follows:

• Hospital - any institution, however named, whether conducted for charity or for profit, which is licensed pursuant to M.G.L. c.111 §51 and advertised, announced, established or maintained for the purpose of caring for persons admitted thereto for diagnosis and/or medical, surgical or restorative treatment which is rendered within said institution.
• Health care facility - Any hospital, clinic, community health center, dispensary, institute, or other entity however organized, whether conducted for profit or not for profit, which is advertised, announced, established, or maintained for the purpose of providing medical, surgical, dental, physical rehabilitation, or mental health services
• Emergency Care - Medical care required immediately due to illness or injury with symptoms of sufficient severity that a prudent lay person would believe there is an immediate threat to life or high risk of permanent damage to the individual's health. Emergency conditions are those which require immediate medical treatment at the most accessible hospital equipped to provide emergency services. Emergency care does not include elective, primary, or urgent care.
• Emergency Department - A hospital's Emergency Room or Level I Trauma Center which is located at the same site as the hospital's inpatient department.
• Urgent care facility – Any office, department or clinic of any hospital whose primary purpose is to provide, in the usual course of business, urgent care.
• Urgent care - Services required promptly to prevent impairment of health due to symptoms that a prudent lay person would believe require medical attention, but are not life-threatening and do not pose a high risk of permanent damage to an individual's health.  Urgent care does not include elective, emergency, or routine primary care.
• Visit - A face-to-face meeting between a recipient and a physician, physician’s assistant, nurse practitioner, or registered nurse within a health care setting, for purposes of examination, diagnosis, or treatment.

The report provided pursuant to this regulation shall not include any patient identifying information.

The provisions of this regulation do not amend, modify or otherwise relieve any health care facility of any other regulatory, administrative or statutory reporting requirements.

Section 3.00  Guidelines.  The Executive Director of the Boston Public Health Commission shall issue guidelines, setting forth the format and reporting procedures.

All health care facilities that submit information pursuant to this order shall be provided with a periodic report setting forth in summary format all data collected under this regulation.

Section 4.00  Effective Date.  This regulation shall take effect ninety days from the date of enactment.

Authority.  These regulations are promulgated pursuant to: M.G.L. c. 111, §§ 31, 111, 112, and App. §§ 2-6(b), 2-7(a)(1) and 2-7(a)(15); 105 CMR 300.00 et. seq.

For further information, contact:
Boston Public Health Commission
Communicable Disease Control
1010 Massachusetts Avenue, 2nd Floor
Boston, MA  02118