Pennsylvania is asking the public to weigh in on a proposed overhaul of its communicable-disease regulations. The proposal runs roughly 500 pages, and public comments are being accepted through Sept. 21.

Upper Merion Area Spotlight is breaking the proposal down a few sections at a time so readers can better understand what the rules say now, what the Department of Health wants to change, and why the Department says those changes are needed.

This series is informational. Our goal is not to tell readers whether the proposed changes are good or bad, but to help them understand what they are being asked to consider.

Missed Part 1?
Read it here.

Missed Part 2?
Read it here.

Review the full proposal and public-comment information:
https://www.irrc.state.pa.us/regulations/RegSrchRslts.cfm?ID=3505

Public comment deadline: Sept. 21

With roughly one week remaining for public comment, Part 3 of our series turns to a provision that would directly affect schools across Pennsylvania.

The proposed regulations include an entirely new section devoted specifically to contact tracing and what the Department of Health calls “partner services” in schools.

Under proposed Section 27.60c, schools would be required to provide the Department of Health or a local health authority with what the proposal calls “reasonable and timely access” to a person for contact tracing or partner services.

That access could occur while classes are in session, while the person is otherwise on school property, or while attending a school function.

The proposal goes further.

It would also require school employees and officials to permit health authorities to meet and speak privately with a student or other person under certain circumstances.

So what exactly is changing?

Pennsylvania’s existing Chapter 27 already places a number of communicable-disease responsibilities on schools.

For example, schools are currently required to exclude students and certain staff members who are suspected of having specified communicable diseases. The current regulations specifically address diseases such as measles and establish conditions for exclusion and return to school. School nurses also have disease-reporting responsibilities under existing rules.

But there is not currently a Section 27.60c establishing a specific set of contact-tracing rules for schools.

The Department acknowledges that directly.

In its explanation of the proposal, DOH describes Section 27.60c as new and says it is being added because there has been confusion in the past about whether existing contact-tracing provisions specifically apply to schools.

The first requirement is relatively straightforward.

A school would have to provide the Department or local health authority with reasonable and timely access to a person for contact tracing or partner services.

That could include access:

DOH says the words “reasonable and timely” are intended to give schools some flexibility.

According to the Department, a school could arrange access at a time that works for both the school and the student, provided that the timing still allows health officials to conduct their investigation within the infectious period of the disease involved.

The Department also acknowledges that complying with the new requirement could disrupt the school day, although it says the amount of disruption would depend on the disease or condition being investigated.

This is likely to be the provision that attracts the most attention from parents.

Proposed Section 27.60c(b) says a person, including a school employee or official, would have to permit the Department or local health authority to meet and speak with a student or other person in private.

It would also prohibit that school employee or official from interfering with the student or other person’s ability to exercise an existing right to consent to certain medical or health services under Pennsylvania law.

That deserves some important context.

The proposal does not create a new general right for children to consent to medical care without their parents.

Pennsylvania law has long allowed minors to consent on their own to certain medical and health services involving pregnancy, sexually transmitted diseases and other diseases that are required to be reported under Pennsylvania’s Disease Prevention and Control Law.

The statute says that for those specific services, “the consent of no other person shall be necessary.”

Existing Chapter 27 regulations also state that a minor may consent to medical and health services to determine the presence of or treat a sexually transmitted disease or another reportable disease, infection or condition.

What is new is that the proposed school regulation would expressly say that school employees or officials cannot interfere with a student exercising that already-existing right during contact tracing or partner services.

That is an important distinction.

No.

The proposed language is tied specifically to contact tracing and partner services under Chapter 27.

It is not a general authorization for state officials to pull students out of class for unrelated interviews.

The purpose would have to involve a disease, infection or condition being investigated under Pennsylvania’s communicable-disease regulations.

The proposal also uses the phrase “reasonable and timely access,” rather than giving health officials unlimited access whenever they choose.

Still, the proposal clearly gives health authorities more explicit authority inside schools than Chapter 27 spells out today.

The proposed section contains one more requirement.

A person, including a school employee or official, could not obstruct or interfere with the Department or local health authority while it is conducting contact tracing or partner services.

DOH says contact tracing can be time-sensitive because officials may need to reach potentially exposed people while a disease remains transmissible.

The Department says that is why the work must be able to proceed without obstruction.

The Department’s explanation is unusually direct.

DOH says there has been “confusion in the past” about whether Pennsylvania’s existing communicable-disease regulations specifically apply to schools when officials are conducting contact tracing or partner services.

The new section is intended to remove that uncertainty.

DOH also argues that contact tracing is an important tool for interrupting disease transmission and preventing additional cases.

The current measles outbreak provides an obvious example of how those rules could come into play.

Measles can spread quickly in schools and other group settings. If a student or staff member were infected, health officials could need to determine who had close contact with that person, whether those individuals were susceptible to infection, and whether additional steps were necessary.

The proposed regulation is intended to make clear that schools must cooperate with that process.

For a district such as Upper Merion Area School District, the practical change would be that the school’s obligation to cooperate with state or local health authorities during contact tracing would be spelled out much more specifically.

Schools would have to provide timely access to people who need to be contacted.

That could happen during the school day or at school events.

School employees could not obstruct the investigation.

And under certain circumstances, health officials could speak privately with a student, including in connection with rights that students already possess under Pennsylvania law.

Those are substantive requirements.

But it is equally important to separate them from things the proposal does not do.

It does not create the underlying Pennsylvania law allowing minors to consent to certain disease-related medical services.

It does not give health officials unrestricted authority to question students about unrelated matters.

And it does not mean every disease investigation would involve private interviews with students.

This is exactly why the Spotlight began this series.

Pennsylvania is asking residents to comment on a major rewrite of the rules governing how the state responds to communicable diseases.

Most residents are unlikely to read all 500 pages.

But provisions like this one could affect what happens inside their child’s school during the next disease investigation.

That makes understanding the details worthwhile before deciding whether the proposed language goes too far, does not go far enough, or strikes the right balance.

That judgment belongs to readers.

Our job is to show you what is actually being proposed.

Part 4 will conclude the series by looking at another significant area of the proposal: access to medical records and immunization reporting.

We will also bring the four-part series together before the Sept. 21 deadline and provide readers with the information needed to submit comments directly to the state.

Pennsylvania is accepting public comments on Regulation #10-242, Communicable and Noncommunicable Diseases, through Sept. 21.

Review the complete proposal and public-comment information HERE

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Thank you for reading,

Corey