Section 693.10  Definitions

 

"Act" means Illinois Sexually Transmissible Disease Control Act [410 ILCS 325].

 

"Blood Bank" means any facility or location at which blood or plasma is procured, furnished, donated, processed, stored or distributed.

 

"Certified Local Health Department" means a local health department that is certified pursuant to 77 Ill. Adm. Code 600.210 of the Certified Local Health Department Code.

 

"Contact" means:

 

An individual who has been in direct sexual contact with an individual infected with a sexually transmitted infection (STI);

 

An individual who has been in direct sexual or needle contact with a person with AIDS or HIV infection;

 

An individual who has undergone artificial insemination, a blood transfusion or an organ or tissue transplantation donated by a person with human immunodeficiency virus (HIV) infection.

 

"Critical Period" means the time interval for which an individual infected with an STI is asked to recall sexual or needle-sharing contacts. Ideally, the critical period covers the time from the earliest date an individual could have been infected with an STI up to the date of diagnosis or treatment.

 

The critical period for syphilis is based on the disease stage at the time of diagnosis:

 

Primary − four months and one week;

 

Secondary − eight months (34 weeks);

 

Early non-primary non-secondary (NPNS) – 12 months, unless a credible primary or secondary history can be established.

 

The critical period for chlamydia, gonorrhea and chancroid is 60 days before the date of specimen collection and should be extended through the date of      treatment if the patient was not treated at the time the specimen was collected.

 

The critical period for HIV is 12 months before the date of diagnosis.

 

"Department" means the Illinois Department of Public Health. (Section 3 of the Act)

 

"Designated Agent" means an organization designated by the Department, or a local health department in cities with a population of 1,000,000 or more, to conduct public health activities under a written agreement with the Department.

 

"Epidemiologic Information" means information, obtained through the counseling and partner services process, regarding possible exposure to an STI.

 

"Expedited Partner Therapy" means to prescribe, dispense, furnish or otherwise provide prescription antibiotic drugs to the partner or partners of persons clinically diagnosed as infected with a sexually transmissible infection, without physical examination of the partner or partners.

 

"Exposure-Prone Invasive Procedure" means an invasive procedure involving digital palpation of a needle tip in a body cavity, or the simultaneous presence of a health care professional's fingers and a needle or other sharp instrument or object in a poorly visualized or highly confined anatomical site.

 

"Health Care Contact" means any the following:

 

An individual who has undergone exposure-prone invasive procedures performed by an HIV infected health care professional when the Department has determined that there is or may have been potential risk of HIV transmission from the health care professional to that individual;

 

A health care professional who has performed exposure-prone invasive procedures for a person infected with HIV when the Department has determined that there is or may have been potential risk of HIV transmission from the infected person to the health care professional.  (Section 5.5(c) of the Act)

 

"Health Care Facility" means any institution, building or agency or portion of any institution, building or agency, whether public or private (for-profit or nonprofit), that is used, operated or designed to provide health services, medical treatment or nursing, rehabilitative or preventive care to any person or persons.

 

"Health Care Professional" means any of the following:

 

A physician licensed to practice medicine in all its branches;

 

a licensed physician assistant;

 

a licensed advanced practice registered nurse; [410 ILCS 325/3(4)]

 

a licensed dentist;

 

a licensed podiatrist;

 

a licensed nurse or other person licensed or certified to provide health care services of any kind; or

 

an individual certified to provide HIV testing and counseling by a state or local public health department.

 

"HIV Infection" means infected with HIV, as evidenced by a positive or reactive supplemental laboratory test result.

 

"HIV Test" means an HIV test method approved by the federal Food and Drug Administration (FDA) or validated under a laboratory's Clinical Laboratory Improvement Amendments of 1988 (CLIA) certification.

 

"Invasive Procedure" means surgical entry into tissues, cavities or organs or repair of major traumatic injuries associated with any of the following:

 

An operating or delivery room, emergency department, or outpatient setting, including both physicians' and dentists' offices;

 

Cardiac catheterizations and angiographic procedures;

 

Vaginal or cesarean delivery or other invasive obstetrical procedure during which bleeding may occur; or

 

Manipulation or excision of any oral or perioral tissue, including tooth structure, during which bleeding or the potential for bleeding exists.

 

"Isolation" means the physical separation and confinement of an individual who is infected or reasonably believed to be infected with an STI from non-isolated individuals to prevent the transmission of the STI to non-isolated individuals.

 

"Laboratory" means a CLIA-approved or -licensed facility, other than a blood bank, at which tests are performed to determine the presence of infection with an STI.

 

"Local Health Department" means the full-time official health department or board of health having jurisdiction over a particular area. (Section 3 of the Act)

 

"Noncompliant" means that a person who is infected with an STI and is aware of his/her infection and is engaging in behaviors or activities that place others at risk of exposure to the STI.

 

"Partner Services" means services offered to persons diagnosed with HIV, syphilis, gonorrhea or chlamydia and to their partners.  These services include, but are not limited to, interviewing infected individuals to elicit and subsequently notify sex and needle sharing partners of possible exposure or potential risk of exposure to infection, facilitating testing and treatment of exposed partners, and providing referrals to support services as needed.

 

"Quarantine" means the act of making a place or a location off limits to the public to prevent the probable spread of syphilis, gonorrhea, chlamydia, HIV or chancroid. (Section 7(a) of the Act)

 

"Self-Refer" means for a person infected with an STI to notify his/her contacts of their possible exposure to an STI and to refer contacts to appropriate health care professionals for counseling, testing and treatment, if indicated.

 

"Sexually Transmissible Infection" or "STI" means, as defined by the Centers for Disease Control and Prevention, an infection that can be acquired or transmitted through sexual activity.

 

"Susceptible" means capable of becoming infected with the etiologic agent of an STI.

 

"Suspected Case" means a person who is reasonably believed to be infected with an STI, based on medical or epidemiologic information.

 

"Treatment" means services for prevention, diagnosis and medical management of STIs, including examination, laboratory testing, medication, counseling and immunization.

 

(Source:  Amended at 46 Ill. Reg. 20063, effective December 2, 2022)

 

Section 693.15  Incorporated and Referenced Materials

 

The following materials are incorporated or referenced in this Part:

 

a)         Illinois Statutes

 

1)         Illinois Sexually Transmissible Disease Control Act [410 ILCS 325]

 

2)         Department of Public Health Act [20 ILCS 2305]

 

3)         Consent by Minors to Medical Procedures Act [410 ILCS 210]

 

4)         AIDS Confidentiality Act [410 ILCS 305]

 

5)         Unified Code of Corrections [730 ILCS 5/5-5-3]

 

6)         Hypodermic Syringes and Needles Act [720 ILCS 635]

 

7)         Criminal Code of 1961 [720 ILCS 5]

 

8)         Freedom of Information Act [5 ILCS 140]

 

9)         Nurse Practice Act [225 ILCS 65]

 

b)         Illinois Administrative Rules

 

1)         HIV/AIDS Confidentiality and Testing Code (77 Ill. Adm. Code 697) (see Sections 693.20(b), 693.30(c) and (e) and 693.100(b)(4) and (6) of this Part)

 

2)         Practice and Procedure in Administrative Hearings (77 Ill. Adm. Code 100) (see Section 693.35 of this Part)

 

3)         Certified Local Health Department Code (77 Ill. Adm. Code 600) (see Section 693.10 of this Part)

 

4)         Control of Communicable Diseases Code (77 Ill. Adm. Code 690)

 

c)         Other Codes, Guidelines and Standards

 

1)         2008 Revised Surveillance Case Definitions for HIV Infection Among Adults, Adolescents, and Children Aged Less than 18 Months and for HIV Infection and AIDS Among Children Aged 18 Months to 13 Years − United States, 2008, Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR), December 5, 2008, Vol. 57, No. RR-10;1-8

 

2)         Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR), November 7, 2008, Vol. 57, No. RR-9

 

3)         "Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR), July 12, 2001, Vol. 40, No. RR-8

 

d)         Federal Statutes

 

1)         Spousal Notification Requirements of the Ryan White CARE Reauthorization Act of 1996 (Public Law 104-146)

 

2)         Clinical Laboratory Improvement Amendments of 1988 (CLIA) (42 USC 263a)

 

e)         All incorporations by reference of federal guidelines refer to the guidelines on the date specified and do not include any amendments or editions subsequent to the date specified.

 

(Source:  Amended at 38 Ill. Reg. 20788, effective October 15, 2014)

 

Section 693.20  Reportable STIs and Laboratory Results

 

a)         The following shall be considered reportable STIs:

 

1)         Acquired Immunodeficiency Syndrome (AIDS), as defined by the Centers for Disease Control and Prevention of the United States Public Health Service, in 2008 Revised Surveillance Case Definitions for HIV Infection Among Adults, Adolescents, and Children Aged Less than 18 Months and for HIV Infection and AIDS Among Children Aged 18 Months to 13 Years.

 

2)         HIV Infection (see Section 693.10 for a definition);

 

3)         Syphilis;

 

4)         Gonorrhea;

 

5)         Chlamydia; and

 

6)         Chancroid.

 

b)         The following shall be considered reportable STI laboratory results:

 

1)         An HIV test with a confirmed reactive or confirmed positive result (see 77 Ill. Adm. Code 697.100(b)).

 

2)         A microscopic or serologic test for syphilis, either presumptive or confirmatory, that is weakly reactive, reactive or positive.

 

3)         An FDA-approved or laboratory-validated test for chlamydia, gonorrhea or chancroid that is reactive or positive.

 

4)         CD4+ (T4) lymphocyte results (counts and percentages) of any value.

 

5)         HIV viral load results, both detectable and undetectable.

 

(Source:  Amended at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.30  Reporting

 

a)         Every health care professional shall report each case in which the health care professional has diagnosed or treated a case of AIDS, HIV infection, syphilis, gonorrhea, chlamydia, or chancroid.

 

1)         The reportable STI case report shall state the name, address and telephone number of the health care professional and the date of the report.  The STI case report shall be submitted within seven days after the diagnosis or treatment. 

 

2)         If the health care professional diagnoses or treats a reportable STI in a county or city governed by a local health department, the STI report shall be sent to that local health department.  In all other cases, the STI report shall be sent directly to the Department.

 

3)         For cases of AIDS or HIV infection, the report shall be completed by a health care professional or designee using the Department's Adult HIV/AIDS Confidential Case Report for a person age 13 or older, or the Department's Pediatric HIV/AIDS Confidential Case Report for a person under age 13. For HIV or AIDS, the report shall include the following information:

 

A)        The individual's name, nine digit Social Security Number, current address, telephone number, age, date of birth, age at diagnosis, current vital status (alive or dead (date of death)), race, ethnicity, sex, current gender, country of birth, residence at diagnosis, facility where diagnosis of HIV or AIDS was established;

 

B)        Patient risk history;

 

C)        Laboratory results of HIV tests;

 

D)        Information concerning the presence and method of diagnosis of AIDS indicator disease;

 

E)        Each successive AIDS indicator disease (e.g., Pneumocystis carinii pneumonia, Kaposi's sarcoma or esophageal candidiasis), regardless of whether the case is known or thought to have been previously reported in another state or health jurisdiction;

 

F)         For reports submitted by health care facilities, the name and telephone number of the individual completing the form, if different from the health care professional;

 

G)        Information concerning treatment services and referrals and, for women, information on both the current pregnancy status and births after 1977, and for prenatal cases, information about birth history;

 

H)        Whether the HIV-infected individual has had any exposure-prone invasive procedures performed on him or her and, if so, the types of invasive procedures and the names, addresses and telephone numbers of the health care professionals who performed those invasive procedures;

 

I)         Whether the HIV-infected individual is a health care professional; if so, the type of health care professional and whether the individual has performed exposure-prone invasive procedures; and

 

J)         Whether post-test counseling or partner services have taken place or whether assistance is needed from the local health department or the Department.

 

4)         For cases of syphilis, gonorrhea, chlamydia, and chancroid, the report shall be completed by a health care professional or designee and shall be reported electronically or on a case report form furnished by the Department, or by a local health department in cities with a population of 1,000,000 or more.  The report shall state the following:

 

A)        The name, address, and telephone number of the health care professional;

 

B)        The date of the report;

 

C)        The STI-infected individual's name, address, telephone number, date of birth, race, ethnicity, sex, and pregnancy status;

 

D)        The diagnosis, diagnostic classification, and any laboratory findings; and

 

E)        The medication name and dosage that the individual is receiving, has received, or will receive, and whether treatment has been completed.

 

b)         Every laboratory and blood bank, through its Director, shall report each instance in which the laboratory or blood bank performed a test for a reportable STI that concluded with a reportable laboratory result.

 

1)         Within seven days after the reportable laboratory test result is obtained, the laboratory or blood bank shall report to the Department, or to the local health department in cities with a population of 1,000,000 or more. The laboratory or blood bank shall report electronically or on a form furnished by the Department, or by the local health department in cities with a population of 1,000,000 or more.

 

2)         For reportable STI laboratory tests, the report shall state the name and address of the laboratory or blood bank and the date of the report, as well as the following information:

 

A)        The name, address and telephone number of the health care professional or other person who submitted the specimen for testing (not applicable to blood banks);

 

B)        The STI-infected individual's name, address, telephone number, date of birth, race, ethnicity, sex, and pregnancy status, as provided by the health care professional or other person who submitted the specimen for testing; and

 

C)        The date the tests were performed, the laboratory results, and the method employed.

 

3)         A hospital or laboratory shall report to the Department, either electronically or on a form furnished by the Department, all HIV viral load results, both detectable and undetectable, and all subtype and sequence data from antiviral drug resistance testing.  The report shall state the name and address of the laboratory or blood bank and the date of the report, as well as the following information:

 

A)        The name, address and telephone number of the health care professional or other person who submitted the specimen for testing (not applicable to blood banks);

 

B)        The HIV-infected individual's name, address, telephone number, date of birth, race, ethnicity and sex, as provided by the health care professional or other person who submitted the specimen for testing; and

 

C)        The date the tests were performed, the laboratory results, and the method employed.

 

4)         A hospital or laboratory shall report to the Department, either electronically or on a form furnished by the Department, all CD4+ (T4) lymphocyte test results, including count and percentages of any value, which the Department will match against the statewide HIV/AIDS Registry to select only those cases known to the Registry.  The report shall state the name and address of the laboratory or blood bank and the date of the report, as well as the following information:

 

A)        The name, address and telephone number of the health care professional or other person who submitted the specimen for testing (not applicable to blood banks);

 

B)        The HIV-infected individual's name, address, telephone number, date of birth, race, ethnicity and sex, as provided by the health care professional or other person who submitted the specimen for testing; and

 

C)        The date the tests were performed, the laboratory results, and the method employed.

 

5)         In addition to the above reporting requirements:

 

A)        If the subject of the test is under 12 years of age, any reactive or positive test result, if not reported electronically to the Department, shall be reported to the Department by telephone immediately or as soon as Department business hours permit at 217-524-5983 for HIV/AIDS test results and 217-782-2747 for all other reportable STI test results.

 

B)        Every laboratory and blood bank shall report the total number of tests performed for reportable STIs each week by sex to the Department, or to the local health department in cities with a population of 1,000,000 or more.  This report shall be made electronically or on a reporting form furnished by the Department, or by the local health department in cities with a population of 1,000,000 or more.

 

c)         All persons required to report pursuant to this Part shall maintain the strict confidentiality of all information and records relating to known or suspected cases of STIs in accordance with the AIDS Confidentiality Act, Section 693.100 of this Part, and 77 Ill. Adm. Code 697.140 (HIV/AIDS Confidentiality and Testing Code − Nondisclosure of the Identity of a Person Tested or Test Results).

 

d)         For each case report of a reportable STI that it receives, pursuant to this Section, the local health department shall report electronically, if available, or forward a copy of the report to the Department within seven days after receiving the report.  The local health department shall assure the completeness and accuracy of the report form.  The local health department shall record the reporting source on the case report form.

 

(Source:  Amended at 46 Ill. Reg. 20063, effective December 2, 2022)

 

Section 693.35  Fines and Penalties

 

a)         The Department, after notice and an opportunity for a hearing, may fine any health care professional, laboratory or blood bank that violates Section 693.30 of this Part or Section 4 of the Act.  The fine shall be $500 for each violation.  Based upon the evidence presented at the hearing, fines shall be imposed based upon malicious intent, negligence and incompetence.  Following service of a Notice of Violation by the Department, the respondent health care professional, laboratory or blood bank shall have 10 business days in which to request a hearing.  All proceedings under this subsection shall be governed by the Department's Practice and Procedure in Administrative Hearings.

 

b)         The Department shall report each violation of Section 4 of the Act or Section 693.30 of this Part to the regulatory agency responsible for licensing a health care professional or a laboratory to which these provisions apply.  (Section 4(d) of the Act)

 

(Source:  Amended at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.40  Counseling and Partner Services

 

Upon receipt of a reportable STI report from a health care professional or laboratory, a local health department, designated agent or the Department, as applicable, shall conduct a counseling session and offer partner services in accordance with guidelines established by the Centers for Disease Control and Prevention of the U.S. Public Health Service, Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection, as follows:

 

a)         Counseling and partner services shall be provided only by staff of a local health department, designated agent or the Department, as applicable, who have completed a Department-approved training, or a training approved by the local health department in cities with a population of 1,000,000 or more.

 

b)         Any person diagnosed with early syphilis or HIV/AIDS by any health care professional, or any person diagnosed with gonorrhea or chlamydia by a local health department or designated agent shall be counseled and offered partner services by the local health department, designated agent, or Department, as applicable. "Early syphilis" means primary, secondary or early non-primary non-secondary (NPNS) syphilis of less than one year's duration.

 

c)         Any person diagnosed with chlamydia or gonorrhea by a health care professional other than a local health department shall be counseled and offered partner services as resources permit and within the discretion of the local health department, designated agent or Department, as applicable.

 

d)         Counseling of reportable STI cases and partner services shall be conducted in a confidential manner, and shall be documented either in electronic format or on forms furnished by the Department, or by the local health department in cities with a population of 1,000,000 or more.

 

e)         All records regarding counseling of reportable STI cases and partner services shall be confidential, and shall at all times be maintained in the same manner as those maintained for reported cases of STIs as required in Section 693.100 of this Part.

 

f)         For reportable STI cases, counseling and partner services shall be provided by the local health department, designated agent or the Department, as applicable, and shall include the following:

 

1)         An offer of assistance, with the consent of the infected person, in locating and referring contacts for counseling, testing and treatment, if indicated. All infected persons refusing assistance shall be strongly encouraged to notify their critical period sex and needle-sharing (HIV/AIDS) contacts of their possible exposure to STI, and to refer these contacts for counseling, testing and treatment, if indicated.

 

2)         For each identified contact, the counselor shall discuss with the infected person the time period of exposure and the likelihood of STI transmission based on the type of sexual or needle-sharing practice involved. Notification and referral shall be provided to contacts for whom sufficient information to identify and notify the person is available.  When contacts can be linked to a website encounter, the counselor will be authorized to implement an Internet Notification Protocol to confer with and refer for clinical services contacts linked to an infected person.  Internet Partner Notification (IPN) services shall be provided only by staff of a local health department, designated agent, or the Department, when applicable, who have completed Department-approved IPN training, or IPN training approved by the local health department in cities with a population of 1,000,000 or more.

 

3)         Persons choosing to self-refer their contacts shall receive intensive individualized instruction and counseling in methods to provide this notification and referral.

 

4)         STI contacts identified through the counseling and partner services process shall be counseled confidentially regarding the possibility of infection and methods to prevent the spread of infection, and shall be referred for testing and treatment, if indicated.

 

5)         For STIs, if the person is legally unable to agree to counseling because of age or legal incompetence, consent and participation in counseling shall be requested of the individual's parent or legal guardian.  If, in the professional judgment of the counselor, the person is legally able to agree to, but appears to be incapable of understanding and competently acting on, the counseling, participation in counseling shall be requested of a parent or other person chosen by the client.

 

g)         For the interview and investigation process concerning health care contacts:

 

1)         Patients

 

A)        An individual who has had exposure-prone invasive procedures performed on him or her shall be provided an explanation of the potential risks of HIV transmission to health care professionals during the performance of invasive procedures and the legal requirements for notification of the health care professionals who have performed invasive procedures on that individual;

 

B)        The individual shall be asked to identify the specific invasive procedures that have been performed on him or her, along with the name of the facility or location at which the procedure was performed, and the name, address and telephone number of the health care professional who performed the procedure; and

 

C)        The individual shall be offered the opportunity to self-notify those health care professionals within 45 days, in accordance with the notification procedures described in Section 693.45 of this Part.  If the individual declines the opportunity to self-notify his or her health care professionals, or fails to do so in accordance with the requirements of this Part, the case shall be referred to the Department for notification of contacts.  The Department will notify contacts in a timely manner.

 

2)         Health Care Professionals

 

A)        An individual who is a health care professional or has worked as a health care professional shall be interviewed to determine whether the type of health care practiced by the individual involves the performance of invasive procedures, and whether the individual has or is likely to have performed invasive procedures;

 

B)        If the individual's type of health care practice involves the performance of invasive procedures but the individual has not or is not likely to have performed invasive procedures, he or she shall be provided with written information concerning the use of universal precautions and the recommendations of the Centers for Disease Control and Prevention concerning the prevention of HIV transmission in the health care setting.  The individual shall also be advised to refrain from performing exposure-prone invasive procedures, except in accordance with the recommendations of an expert review panel that has been convened pursuant to the Centers for Disease Control and Prevention's Recommendations for Preventing Transmission of HIV and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures (see Section 693.15(c)(3) of this Part);

 

C)        If the individual has or is likely to have performed invasive procedures, the local health department shall refer the case to the Department for risk assessment and follow-up;

 

D)        The Department will interview the health care professional or the professional's estate to complete the investigation and assess the potential risk of HIV transmission from the professional to his or her patients, based on the professional's practice and the types and frequencies of invasive procedures performed.  Others may be interviewed as necessary to complete the investigation and assess the potential risk of HIV transmission from the professional to his or her patients;

 

E)        The Department will provide the health care professional with an explanation of the potential risks of HIV transmission to patients during the performance of invasive procedures and the legal requirements for notification of patients whom the Department determines may have been at risk of HIV transmission from the health care professional;

 

F)         If the invasive procedures performed by the health care professional were not exposure-prone invasive procedures, and no other potential risk of transmission was identified by the Department, the entity performing the investigation process shall provide the health care professional with information concerning the use of universal precautions and the recommendations of the Centers for Disease Control and Prevention concerning the prevention of HIV transmission in the health care setting.  The health care professional shall also be advised to refrain from any future performance of exposure-prone invasive procedures, except in accordance with the recommendations of an expert review panel convened pursuant to the Centers for Disease Control and Prevention's Recommendations for Preventing Transmission of HIV and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures (see Section 693.15(c)(3) of this Part);

 

G)        If any of the invasive procedures performed by the health care professional were exposure-prone invasive procedures, or the Department identifies any other potential risk of transmission to patients, the Department will advise the health care professional that these patients must be notified of their potential risk of exposure to HIV.  The health care professional shall be given the opportunity to submit any information and comments to the Department concerning the notification, and shall be offered the opportunity to self-notify his or her patients within 45 days, in accordance with the notification procedures described in Section 693.45 of this Part;

 

H)        If the health care professional declines the opportunity to self-notify his or her patients, or fails to do so in accordance with the requirements of this Part, he or she shall provide the Department with complete and immediate access to any records that identify or may lead to the identification of his or her patients and the actual health care that was rendered. The Department will review but will not copy or seize the provider's records.  The Department will identify and notify in a timely manner all patients who received exposure-prone invasive procedures or have otherwise been determined by the Department to have been at risk for HIV transmission; and

 

I)         The health care professional shall also be advised to discontinue performance of exposure-prone invasive procedures except in accordance with the recommendations of an expert review panel convened pursuant to the Centers for Disease Control and Prevention's Recommendations for Preventing Transmission of HIV and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures (see Section 693.15(c)(3) of this Part).

 

(Source:  Amended at 46 Ill. Reg. 20063, effective December 2, 2022)

 

Section 693.45  Notification of Health Care Contacts

 

a)         The Department will develop a form letter, which the Department will use to notify health care contacts pursuant to Section 693.40 of this Part and that will be offered to individuals choosing to self-notify their health care contacts.  The letter will include a list of facilities where HIV counseling and testing are available and information about HIV transmission and laboratory tests, and will recommend that the recipient contact his or her personal physician or one of the counseling and testing facilities listed.

 

1)         For contacts who are patients, the letter will identify the type of health care professional with whom the recipient had contact, without naming the specific health care professional.

 

2)         For contacts who are health care professionals, the letter will state that the recipient is believed to have performed an exposure-prone invasive procedure on a patient who has been reported to the Department as a case with HIV, without naming the patient.

 

3)         The letter will also advise the recipient as to applicable confidentiality requirements.

 

b)         The Department will provide notification by first-class mail, with the envelope marked "confidential".  Case subjects or their representatives choosing to self-notify will be encouraged to utilize the same method and may use the Department's return address instead of their own.

 

c)         Within 10 days after completing self-notification, the case subject or his or her representative shall submit a written, signed statement to the local health department or the Department, whichever is applicable, describing the dates and methods of notification and the number of contacts notified, and including a copy of the notification letter, if different from the Department-generated form. Self-notification shall be completed within 45 days after the date on which the Department or the local health department advised the individual that notification was necessary.

 

(Source:  Amended at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.50  Physical Examination and Medical Treatment for Syphilis, Gonorrhea, Chlamydia, HIV or Chancroid

 

a)         The Department and certified local health departments may examine or cause to be examined persons reasonably believed to be infected with or to have been exposed to a reportable STI. (Section 6(a) of the Act)

 

b)         Persons with syphilis, gonorrhea, chlamydia, or chancroid shall report for complete treatment to a physician licensed under the provisions of the Medical Practice Act of 1987, or shall submit to treatment at a facility provided by a certified local health department or other public facility until the disease is noncommunicable or the Department or the certified local health department determines that the person does not present a real and present danger to the public health. This subsection shall not be construed to require the Department or the certified local health department to pay for or provide such treatment.  (Section 6(b) of the Act)

 

c)         Persons with HIV shall report for treatment to a physician licensed under the provisions of the Medical Practice Act of 1987, or shall submit to treatment at a facility provided by a certified local health department or other public facility.  This subsection shall not be construed to require the Department or the certified local health department to pay for or provide such treatment.  (Section 6(b) of the Act).

 

1)         The certified local health department or designated agent shall attempt to determine whether a person within its jurisdiction whose laboratory test indicates infection with or sexual exposure to syphilis, gonorrhea, chlamydia or chancroid has received medical treatment prescribed and rendered to the extent that the infection is no longer communicable by that person;

 

2)         If a medical examination or appropriate treatment has not been provided, the certified local health department shall request that individual to report for examination or treatment at a specific date, time and location, or otherwise submit verifiable proof of examination or treatment by a specific date.  For persons with HIV, if a medical examination or treatment has not been provided, the certified local health department shall request that individual to consider examination, testing and treatment;

 

3)         If the individual is known to have been exposed to an infection listed in subsection (a) within the maximum incubation period, the certified local health department shall request that individual to seek early preventive/presumptive treatment and testing;

 

4)         The certified local health department shall document all unsuccessful and successful attempts to secure a medical examination and appropriate medical treatment and testing for an individual.  Documentation shall include the dates, times, locations and forms of communication, including the individual's responses, and a detailed narrative of the process.

 

d)         A certified local health department or designated agent shall notify the Department of any case in which it:

 

1)         knows on the basis of laboratory or epidemiologic evidence that a person within its jurisdiction is presently infectious to others, is engaging in conduct or activities that place others at risk of exposure to the STI or has stated his or her intention to do so, and has refused the examination or medical treatment that has been prescribed for the contagion control of that STI; and

 

2)         has exhausted its means of obtaining compliance with this Section.

 

e)         No person shall be apprehended, examined or treated for syphilis, gonorrhea, chlamydia, HIV or chancroid against his or her will, except upon the presentation of a warrant duly authorized by a court of competent jurisdiction.  In requesting the issuance of such a warrant, the Department or certified local health department shall show by a preponderance of the evidence that the person is infectious and that a real and present danger to the public health and welfare exists unless the warrant is issued and shall show that all other reasonable means of obtaining compliance have been exhausted and that no other less restrictive alternative is available.  (Section 6(c) of the Act) The Department does not delegate the responsibility to seek a court order to a delegated agency.  

 

1)         In determining whether no less restrictive means exist, the court shall consider evidence showing that, under the circumstances presented by the case in which an order is sought, apprehension, examination or treatment is the measure provided for in guidelines issued by the Centers for Disease Control and Prevention. 

 

2)         The court shall require any proceedings authorized by this Section to be conducted in camera.  A record shall be made of such proceedings but shall be sealed, impounded and preserved in the records of the court, to be made available to the reviewing court in the event of an appeal. (Section 6(c) of the Act)

 

3)         The individual shall be given a written notice of any court proceedings conducted under this Section. The notice shall follow the procedures listed in 77 Ill. Adm. Code 690.1330 (Control of Communicable Diseases Code).

 

f)         Any person who knowingly or maliciously disseminates any false information or report concerning the existence of syphilis, gonorrhea, chlamydia, HIV or chancroid under this Section is guilty of a Class A misdemeanor. (Section 6 (d) of the Act)

 

(Source:  Amended at 38 Ill. Reg. 20788, effective October 15, 2014)

 

Section 693.60  Quarantine and Isolation for Syphilis, Gonorrhea, Chlamydia, HIV and Chancroid

 

a)         The Department or certified local health department may order a person to be isolated or a place to be quarantined and made off limits to the public to prevent the probable spread of syphilis, gonorrhea, chlamydia, HIV or chanchroid, until such time as the condition can be corrected or the danger to the public health is eliminated or reduced in such a manner that no substantial danger to the public's health any longer exists. (Section 7(a) of the Act) The determination that action is required shall be based on the following:

 

1)         The Department or certified local health department has reason to believe that a person infected with syphilis, gonorrhea, chlamydia, HIV or chanchroid is noncompliant and is likely to spread syphilis, gonorrhea, chlamydia, HIV or chanchroid if not detained for isolation;

 

2)         The Department or the certified local health department has reason to believe that a place where there is significant sexual activity is likely to contribute to the spread of syphilis, gonorrhea, chlamydia, HIV or chanchroid if quarantine procedures are not initiated; and

 

3)         The Department or the certified local health department has first made efforts, which shall be documented, to obtain voluntary compliance with requests for medical examination, testing, treatment and counseling of a noncompliant person infected with syphilis, gonorrhea, chlamydia, HIV or chanchroid or the owner of a place where there is significant sexual activity that is likely to contribute to the spread of syphilis, gonorrhea, chlamydia, HIV or chanchroid.

 

b)         No person may be ordered to be isolated, and no place may be ordered to be quarantined, except with the consent of such person or owner of such place or upon the order of a court of competent jurisdiction and upon proof by the Department or certified local health department, by clear and convincing evidence, that the public's health and welfare are significantly endangered by a person with syphilis, gonorrhea, chlamydia, HIV or chancroid or by a place where there is a significant amount of sexual activity likely to spread syphilis, gonorrhea, chlamydia, HIV or chancroid, and upon proof that all other reasonable means of correcting the problem have been exhausted and no less restrictive alternative exists. (Section 7(b) of the Act)

 

1)         A "significant danger to the public's health", for purposes of this Section, means that the continued operation or existence of the place in question would result in irreparable injury to individuals engaging in sexual activity at that place.

 

2)         The order and procedure for quarantine and isolation for purposes of this Section shall be the same as the order and procedure for quarantine and isolation set forth in 77 Ill. Adm. Code 690.1330 (Control of Communicable Diseases Code). 

 

3)         Any person who knowingly or maliciously disseminates any false information or report concerning the existence of syphilis, gonorrhea, chlamydia, HIV or chanchroid in connection with the Department's power of quarantine and isolation is guilty of a Class A misdemeanor.  (Section 7(d) of the Act)

 

(Source:  Amended at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.70  Counseling and Education for AIDS and HIV (Repealed)

 

(Source:  Repealed at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.80  Isolation for AIDS and HIV (Repealed)

 

(Source:  Repealed at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.90  Quarantine (Repealed)

 

(Source:  Repealed at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.100  Confidentiality

 

a)         All information and records held by the Department and local health departments or designated agents relating to known or suspected cases of STIs shall be strictly confidential and exempt from inspection and copying under the Freedom of Information Act.  The Department and local health departments or designated agents shall not disclose information and records held by them relating to known or suspected cases of STIs publicly or in any action of any kind in any court or before any tribunal, board or agency. (Section 8(a) of the Act)

 

b)         Information and records contained in databases maintained by the Department, certified local health departments, or designated agents containing the information described in subsection (a) shall not be released for the purposes of matching with other State agency databases, except to the Illinois Department of Healthcare and Family Services for the sole purpose of treatment of a person living with HIV subject to state, federal and tribal confidentiality statutes and regulations.

 

c)         The information shall not be released or made public by the Department, local health departments or designated agents, or by a court or parties to a lawsuit upon revelation by subpoena, or by a court conducting proceedings authorized by Section 6(c) of the Act, except that release of the information may be made under the following circumstances:

 

1)         When made with the consent of all persons to which the information applies (Section 8(a)(1) of the Act);

 

2)         When made for statistical purposes and medical or epidemiologic information is summarized so that no person can be identified and no names are revealed (Section 8(a)(2) of the Act);

 

3)         When made to medical personnel, the Department, local health departments or designated agents for care and treatment purposes, including for the purposes of ensuring that medical providers can attempt to re-engage persons with HIV in care and to provide partner services, appropriate State agencies expressly charged in the Act and this Part with enforcement of the provisions of the Act, or courts of appropriate jurisdiction to enforce the provisions of the Act and this Part (Section 8(a)(3) of the Act);

 

4)         When authorized by 77 Ill. Adm. Code 697.210 (HIV/AIDS Confidentiality and Testing Code);

 

5)         When authorized by the AIDS Confidentiality Act.

 

d)         A court hearing a request for the issuance of a warrant as authorized in Section 6(c) of the Act shall conduct those proceedings in camera.  A record shall be made of authorized proceedings but shall be sealed, impounded and preserved in the records of the court, to be made available to the reviewing court in the event of an appeal. (Section 8(c) of the Act)

 

e)         No employee of the Department, a local health department, or designated agent shall be examined in a civil, criminal, special or other proceeding concerning the existence or contents of pertinent records of a person examined, tested, or treated for an STI, or a contact of the person, by the Department, a local health department or designated agent pursuant to the provisions of the Act, or concerning the existence or contents of reports received from a health care professional or health care facility, pursuant to the provisions of the Act, without the consent of the person examined, tested or treated, or a contact to an STI, except in proceedings under Sections 6 and 7 of the Act.  (Section 8(d) of the Act)

 

f)         All information and records held by the Department, a local health department, or designated agent pertaining to health care contact risk assessment and notification activities shall be strictly confidential and exempt from copying and inspection under the Freedom of Information Act.  The information and records shall not be released or made public by the Department, a local health department, or designated agent, and shall not be admissible as evidence, nor discoverable in any action of any kind in any court or before any tribunal, board, agency or person and shall be treated in the same manner as the information and those records subject to the provisions of Part 21 of the Code of Civil Procedure (Product Liability) [735 ILCS 5] except under the following circumstances:

 

1)         When disclosure is made with the written consent of all persons to whom this information pertains;

 

2)         When authorized under Section 8 of the Act to be released under court order or subpoena pursuant to Section 12-5.01 of the Criminal Code of 1961; or

 

3)         When disclosure is made by the Department for the purpose of seeking a warrant authorized by Sections 6 and 7 of the Act.  The disclosure shall conform to the requirements of Section 8(a) of the Act. (Section 5.5 of the Act)

 

g)         Any person who knowingly or maliciously disseminates any information or report concerning the existence of any disease under Section 5.5 of the Act is guilty of a Class A Misdemeanor. (Section 5.5(d) of the Act)

 

(Source:  Amended at 44 Ill. Reg. 15764, effective September 1, 2020)

 

Section 693.110  Examination and Treatment of Prisoners

 

a)         A local health department or the Department may enter any State, county or municipal detention facility located within its jurisdiction for the purpose of interviewing, examining, testing or treating any prisoner, detainee or parolee known to have or suspected of having an STI.  A detention facility shall cooperate with the local health department or the Department and provide the space necessary for interviewing, examining, testing or treating any prisoner, detainee or parolee known or suspected of having an STI.

 

b)         Interviewing, examination, testing or treatment shall be voluntary on the part of the prisoner, detainee or parolee, unless the Department obtains a court-issued warrant pursuant to Section 693.50 of this Part.  In cases of noncompliant behavior, the Department may also seek court-ordered isolation pursuant to Section 693.60 of this Part.

 

c)         Any health care professional attending or examining prisoners, detainees or parolees at detention facilities shall follow the reporting requirements of Section 693.30 of this Part, except that reporting to the local health department or Department, where applicable, shall be made within seven days after diagnosing or treating a reportable STI.  The superintendent or other administrator of the detention facility shall provide the health care professional with all reportable information required by the report form or this Part to ensure that a complete report is filed with the appropriate health authority.

 

d)         Nothing in this Section shall be construed as relieving the Department of Corrections or any county or municipality of their primary responsibility for providing medical services for prisoners under their jurisdiction, including treatment for STIs. (Section 9(b) of the Act)

 

e)         Subsections (a) and (b) do not apply to any examination, testing or treatment performed pursuant to Section 5-5-3(g) or (h) of the Unified Code of Corrections.  Section 5-5-3 of the Unified Code of Corrections requires HIV testing of defendants convicted under Sections 11-14, 11-15, 11-15.1, 11-16, 11-17, 11-18, 11-18.1, 11-19, 11-19.1, 11-19.2, 12-13, 12-14, 12-14.1, 12-15 or 12-16 of the Criminal Code of 1961, or Section 1 or 2 of the Hypodermic Syringes and Needles Act.

 

(Source:  Amended at 38 Ill. Reg. 20788, effective October 15, 2014)

 

Section 693.120  Certificate of Freedom from STIs

 

No health care professional, local health department, designated agent or other person, including the Department, shall issue certificates of freedom from STIs to or for any person.

 

(Source:  Amended at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.130  Treatment of Minors

 

A minor 12 years of age or older who may have come into contact with any STI may give consent to the furnishing of medical care or counseling related to the diagnosis or treatment of, or vaccination against, an STI.  [410 ILCS 210/4]

 

(Source:  Amended at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.140  Control Measures (Repealed)

 

(Source:  Repealed at 37 Ill. Reg. 8762, effective June 12, 2013)

 

Section 693.150  Expedited Partner Therapy (EPT)

 

a)         Persons with a clinical diagnosis of chlamydia, gonorrhea, or trichomoniasis, preferably confirmed with a laboratory test, are eligible for EPT. 

 

b)         Sex partners of patients treated for chlamydia, gonorrhea, or trichomoniasis, who were exposed within the previous 60 days and who are unable or unlikely to seek medical care are eligible for EPT.  If there were no sex partners within the previous 60 days, the most recent sex partner is eligible.

 

c)         Health care professionals who provide EPT shall comply with Sections 4 and 5 of the Act. (Section 6(e)(2) of the Act) 

 

d)         EPT is not contraindicated but is a last resort for pregnant partners.  Health care professionals shall attempt to contact the pregnant partner and ensure that she is referred for medical care.

 

e)         Health care professionals who provide EPT shall provide counseling for the patient and written materials provided by the Department to be given by the patient to the partner or partners that include, at a minimum, the following:

 

1)         A warning that a woman who is pregnant or might be pregnant must not take certain antibiotics and must immediately contact a health care professional for an examination, and a recommendation for such an examination;

 

2)         Information about the antibiotic and dosage provided or prescribed; clear and explicit allergy and side effect warnings, including a warning that a partner who has a history of allergy to the antibiotic or the pharmaceutical class of antibiotic must not take the antibiotic and must be immediately examined by a health care professional, and a recommendation for such an examination;

 

3)         Information about the treatment and prevention of sexually transmissible

infections;

 

4)         The requirement of abstinence until a period of time after treatment to prevent infecting others;

 

5)         Notification of the:

 

A)        importance of the partner or partners of the patient receiving examination and testing for HIV and other sexually transmissible infections; and

 

B)        available resources;

 

6)         Notification of the risk to self, others, and the public health if the sexually transmissible infection is not completely and successfully treated;

 

7)         The responsibility of the partner or partners to inform his or her sex partner or partners of the risk of sexually transmissible infection and the importance of prompt examination and treatment. (Section 6(e)(3) of the Act)

 

f)         A healthcare professional prescribing, dispensing, furnishing, or otherwise providing in good faith without fee and compensation prescription antibiotics to partners under this Section and providing counseling and written materials as required by subsection (e) shall not be subject to civil or professional liability, except for willful and wanton misconduct.  A health care professional shall not be subject to civil or professional liability for choosing not to provide expedited partner therapy. (Section (6)(e)(5) of the Act)

 

g)         Educational materials will instruct all EPT recipients to seek care for STI and to seek HIV testing, regardless of whether they take the medication.

 

h)         Medication may be dispensed directly to the patient for delivery to the partner or partners.  If the partner or partners are unable or unlikely to seek medical care, the prescription for the medication may be provided to the patient to be delivered to the partner or partners. A combination of partner strategies may be used; for example, a patient with several partners may refer one partner to a health care professional, but take EPT for other partners.

 

(Source:  Amended at 46 Ill. Reg. 20063, effective December 2, 2022)