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    Maryland Register
    Issue Date:  February 2, 2018
    Volume 45 • Issue 3 • Pages 161—162
    Title 10
    Subtitle 06 DISEASES
    10.06.01 Communicable Diseases and Related Conditions of Public Health Importance
    Authority: Health-General Article, §§2-104(b), 18-102, 18-201, 18-202, and 18-205, Annotated Code of Maryland
    Notice of Proposed Action
    The Secretary of Health proposes to amend Regulation .03 under COMAR 10.06.01 Communicable Diseases and Related Conditions of Public Health Importance.
    Statement of Purpose
    The purpose of this action is to require health care providers, institutions, and laboratories to report to local health departments—and local health departments to report to the Department of Health—positive results received for any individuals tested for latent tuberculosis infection (LTBI) within their jurisdictions, rather than only positive results for people who are contacts to active tuberculosis cases and B-waiver designated immigrants and refugees.
    Comparison to Federal Standards
    There is no corresponding federal standard to this proposed action.
    Estimate of Economic Impact
    I. Summary of Economic Impact. This proposal is not expected to have a direct economic impact on the Department. The Department already receives latent tuberculosis infection (LTBI) testing result reports for a subset of those tested. This proposal will result in increased results received by the Department; however, these results can be received with existing resources. There may be an economic impact on local health departments because they will be required to submit an increased volume of LTBI reports to the Department.
    Revenue (R+/R-)
    II. Types of Economic Impact.
    Expenditure (E+/E-)

    A. On issuing agency:
    B. On other State agencies:
    C. On local governments:
    Benefit (+)
    Cost (-)

    D. On regulated industries or trade groups:
    E. On other industries or trade groups:
    F. Direct and indirect effects on public:
    III. Assumptions. (Identified by Impact Letter and Number from Section II.)
    C. Local Health Departments may have increased costs associated with increased LTBI reporting. LTBI reporting is performed both by hard copy and electronically, and the process for reporting will not change as a result of this proposal. The magnitude of this impact is indeterminate at this time because the magnitude of increased reporting is unknown.
    D. Laboratories, and any other entities that do LTBI testing including corrections, occupational health centers, long-term care facilities and schools or universities may have increased costs associated with increased LTBI reporting.
    Economic Impact on Small Businesses
    The proposed action has minimal or no economic impact on small businesses.
    Impact on Individuals with Disabilities
    The proposed action has no impact on individuals with disabilities.
    Opportunity for Public Comment
    Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through March 5, 2018. A public hearing has not been scheduled.
    .03 Reportable Diseases, Conditions, Outbreaks, and Unusual Manifestations; Submitting Clinical Materials.
    A.—B. (text unchanged)
    C. List of Reportable Diseases and Conditions.
    Diseases and Conditions
    Laboratory Evidence of
    Submit Clinical Materials to the Department3
    Within 1 Working Day
    (1)—(51) (text unchanged)
    (52) Mycobacteriosis, other than tuberculosis and leprosy
    Mycobacterium [spp.] species, other than Mycobacterium tuberculosis complex or Mycobacterium leprae
    (53)—(76) (text unchanged)
    (77) Tuberculosis, active disease, and suspected active tuberculosis6
    Mycobacterium tuberculosis complex
    (77-1) Tuberculosis, latent infection (LTBI)7
    Mycobacterium tuberculosis complex, latent infection7
    (78)—(82) (text unchanged)
    (83) Vibriosis, [non-cholera7] non-cholera8
    All non-cholera Vibrio [species7] species8
    (84)—(85) (text unchanged)
    1.— 6. (text unchanged)
    7. Latent tuberculosis infection as indicated when:
    (a) There is a positive result on an Interferon Gamma Release Assay, Tuberculin Skin Test, or any other test indicating tuberculosis infection; and
    (b) Active or suspected tuberculosis has been ruled out.
    [7.] 8. (text unchanged)
    Secretary of Health