Los Angeles County Municipal Code Part V Regulations

SEC. 22 - REGULATIONS FOR COMMUNICABLE DISEASE ADMISSIONS IN HEALTH CARE FACILITIES

Patients with the following diagnoses or suspected diseases may not be admitted to any health facility nor treated in any health facility other than the Communicable Disease Unit of the Los Angeles General Medical Center:

Cholera

Diphtheria

Lassa Fever

Marburg Virus

Plague

Relapsing Fever (louse-borne)

Smallpox

Typhus Fever (louse-borne)

Yellow Fever

In addition, hospitalization at the Communicable Disease Unit, Los Angeles General Medical Center is urged for patients with the following diseases:

Botulism

Chicken pox (with complications)

Encephalitis, including VEE and other arbovirus encephalides

Measles (Rubeola with complications)

Meningococcal Meningitis

Mumps (with complications)

Poliomyelitis

Rabies

Scarlet Fever (severe)

Tetanus

Typhoid Fever

*Vaccinia, Generalized and Progressive: Eczema Vaccinatum

Whooping Cough (Pertussis, if severe and under 3 years of age)

*Important only if smallpox not suspected

(Ord. 2024-0001 § 6, 2024.)

SEC. 23 - SUSPECTED OR DIAGNOSED COMMUNICABLE DISEASE WHICH MAY BE ADMITTED TO AND REMAIN IN ACUTE CARE HOSPITALS OR OTHER HEALTH FACILITIES

Any patient with a communicable disease listed as a Reportable Disease may remain in the facility providing Title 22 regulations are met for adequate isolation except those specifically listed in Sec. 22. In addition, patients who are asymptomatic carriers of salmonella, typhoid or shigella must not be discharged to skilled nursing or intermediate care facilities unless prior written approval has been obtained from the Chief, Acute Communicable Disease Control.

SEC. 24 - REGULATIONS REGARDING COMMUNICABLE DISEASES IN SKILLED NURSING FACILITIES

Persons with a communicable disease shall not be admitted or cared for unless the following are met:

Any patient diagnosed as having a reportable, communicable disease or being in a carrier state, who the attending physician determines is a potential danger to other patients or personnel, shall be accommodated in a room provided with a separate toilet, handwashing facility, soap dispenser and individual towels.

The skilled nursing facility shall adopt and observe written procedures approved by the local health officer. Such procedures shall be posted at the nurses' station or other appropriate location. The procedures shall outline the technique to be used in the care of patients with a communicable disease, and shall include:

Handwashing upon entering and leaving patient's room.

Proper handling and disposal of infectious material.

Procedures for medical and nursing personnel providing for proper techniques.

Health education provided to the patient.

Proper handling of dishes.

Proper handling of patient care equipment.

Patients who are asymptomatic carriers of salmonella, typhoid, or shigella are not to be admitted to nor remain in these facilities unless prior written approval has been obtained from the Chief, Acute Communicable Disease Control.

SEC. 25 - REGULATIONS REGARDING COMMUNICABLE DISEASE IN INTERMEDIATE CARE FACILITIES

No patient with a communicable disease may be admitted to nor permitted to remain in an Intermediate Care Facility.

Patients acquiring a communicable disease while in the facility shall be transferred to an appropriate facility as soon as possible. While awaiting transfer, the following requirements shall be met:

Any patient diagnosed as having a reportable communicable disease or being in a carrier state who the attending physician determines is a potential danger to other patients or personnel, shall be accommodated in a room provided with a separate toilet, handwashing facility, soap dispenser and individual towels.

The intermediate care facility shall adopt and observe written procedures approved by the local health officer. Such procedures shall be posted at the nurses' station or other appropriate location. The procedures shall outline the technique to be used in the care of patients with a communicable disease and shall include:

Handwashing upon entering and leaving patient's room.

Proper handling and disposal of infectious material.

Procedures for medical and nursing personnel providing for proper isolation techniques.

Health education provided to the patient.

Proper handling of dishes.

Proper handling of patient care equipment.

SEC. 26 - INFECTION CONTROL POLICIES

The Infection Control Committee should establish the facility's isolation polices, based on guidelines, A through H, in Sec. 27, enforce their implementation and approve all procedures. Policies and procedures should be reviewed annually and revised as necessary.

An employee health program, outlining routine communications, should be developed by the committee. Immunizations available to all hospital personnel should include diphtheria-tetanus, measles, influenza, and rubella. All employees, especially women of child-bearing age, should be tested for rubella susceptibility, appropriately counseled, and offered rubella immunizations. Rubella susceptible individuals should not be employed in high risk areas unless immunized. High risk personnel, such as those working in the renal dialysis units, should be informed of the risk of hepatitis and related infections and health services should be available to them. Tuberculin non-reactors in a health care facility should be skin tested at least every 6 months and more often if in a high risk area. An x-ray should be obtained if the skin test is positive. Consideration for antituberculous treatment should be given to all reactors an definitely to convertors. If antituberculous treatment is refused, yearly check x-ray is advisable routinely and as necessary for respiratory symptoms.

Stool examinations are strongly recommended pre-employment for food handlers to rule out amoeba, salmonella, etc. Periodic examinations to detect asymptomatic carriers, in general, are unnecessary. Rather, employee education, stressing personal hygiene, and removal of the employee from work when ill with diarrhea, etc., should be strictly enforced. Personnel with cutaneous lesions or other overt infections should not be allowed to care for patients, especially those in nurseries, on the burn unit, or in areas where there are patients with decreased host resistance, nor should such personnel be allowed to prepare or serve food.

SEC. 27 - REFERENCES

A Manual for the Control of Communicable Diseases in California, California State Department of Health.

American Hospital Association: Infection Control in the Hospital.

Benenson, A.S. (ed).: Control of Communicable Diseases in Man, American Public Health Association.

General Acute Care Hospital Regulations, Title 22, Division 5, Chapter 1.

Guidelines for Infection Control Programs, Skilled Nursing Facility, California State Department of Health.

Intermediate Care Facilities Regulations, Title 22, Division 5, Chapter 4.

Isolation Techniques for Use in Hospitals, U.S. Department of Health, Education and Welfare, Public Health Service, Center for Disease Control.

Skilled Nursing Facilities Regulations, Title 22, Division 5, Chapter 3.