Current through Register Vol. 47, No. 6, September 18, 2024
This program provides active statewide surveillance for
congenital and inherited disorders. These disorders may include birth defects,
neuromuscular disorders, metabolic disorders, and all stillbirths. The program
also may conduct active statewide surveillance of live births without a
reportable congenital or inherited disorder to serve as controls for
epidemiological surveys. Surveillance activities for specific congenital and
inherited disorders will be conducted for the period of time that adequate
financial support is available.
(1)
Definitions.
a. Birth
defects shall be defined as any major structural abnormality or metabolic
disorder that may adversely affect a child's health and development. The
abnormality or disorder must be diagnosed or its signs and symptoms must be
recognized within the first two years of life.
b. Neuromuscular disorders shall be defined
as Duchenne, Becker, congenital, distal, Emery-Dreifuss, fascioscapulohumeral,
limb-girdle, myotonic, and oculopharyngeal muscular dystrophies.
c. Rescinded IAB 4/3/2013, effective
5/8/2013.
d. Stillbirths shall be
defined as an unintended fetal death occurring after a gestational period of 20
completed weeks or an unintended fetal death of a fetus with a weight of 3 5 0
or more grams. Stillbirth is synonymous with fetal death.
e. A reportable congenital or inherited
disorder occurring in a miscarriage or pregnancy may be included in the
IRCID.
(2)
Surveillance policy.
a.
Congenital disorders, including birth defects, occurring in Iowa are reportable
conditions, and records of these disorders shall be abstracted pursuant to
641-1.3
(139A) and maintained in the IRCID. Congenital disorders surveillance shall be
performed in order to determine the occurrence and trends of such disorders, to
determine co-occurring conditions and treatments through annual follow-up
abstraction, to conduct thorough and complete epidemiological surveys to
identify environmental and genetic risk factors for congenital disorders, to
contribute to prevention strategies, and to assist in the planning for and
provision of services to children with congenital disorders and their
families.
b. Records for
neuromuscular disorders shall be abstracted pursuant to
641-1.3
(139A) and maintained in the IRCID. Neuromuscular disorders surveillance for
individuals of all ages shall be performed in order to determine the occurrence
and trends of the selected neuromuscular disorders, to determine co-occurring
conditions and treatments through annual follow-up abstraction, to conduct
thorough and complete epidemiological surveys through annual long-term
follow-up, and to assist in the planning for and provision of services to
individuals with selected neuromuscular disorders and their families.
c. Rescinded IAB 4/3/2013, effective
5/8/2013.
d. Stillbirths occurring
in Iowa are reportable conditions, and records of these stillbirths shall be
abstracted pursuant to
641-1.3
(139A) and maintained in the IRCID. Stillbirth surveillance shall be performed
in order to determine the occurrence and trends of stillbirths, to conduct
thorough and complete epidemiological surveys to identify environmental and
genetic risk factors for stillbirths, and to assist in the planning for and
provision of services to prevent stillbirths.
(3)
IRCID activities.
a. The center shall establish an agreement
with the University of Iowa to implement the activities of the IRCID.
b. The IRCID shall use the birth defects,
neuromuscular disorders, metabolic disorders, and stillbirth coding schemes
developed by the Centers for Disease Control and Prevention (CDC).
c. The IRCID staff shall review hospital
records, clinical charts, physician's records, vital records, prenatal records,
and fetal death evaluation protocols pursuant to
641-1.3
(139A), information from the INSP, RGCS, NMP, and the IMPSP, and any other
information that the IRCID deems necessary and appropriate for congenital and
inherited disorders surveillance.
(4)
Department
responsibility.
a. When a live
infant's medical records are ascertained by the IRCID, the department or its
designee shall inform the parent or legal guardian by letter that this
information has been collected and provide the parent or guardian with
information about services for which the child and family may be
eligible.
b. The center and the
IRCID shall annually release aggregate medical and epidemiological information
to medical personnel and appropriate state and local agencies for the planning
and monitoring of services for children with congenital or inherited disorders
and their families.
(5)
Confidentiality and disclosure of information. Reports,
records, and other information collected by or provided to the IRCID relating
to a person known to have or suspected of having a congenital or inherited
disorder are confidential records pursuant to Iowa Code sections
22.7 and
136A.7.
a. Personnel of the IRCID and the department
shall maintain the confidentiality of all information and records used in the
review and analysis of congenital or inherited disorders, including information
which is confidential under Iowa Code chapter 22 or any other provisions of
state law.
b. IRCID staff are
authorized pursuant to
641-1.3
(139A) to gather all information relevant to the review and analysis of
congenital or inherited disorders. This information may include, but is not
limited to, hospital records, physician's records, clinical charts, vital
records, prenatal records, fetal death evaluation protocols, information from
the INSP, RGCS, NMP, and the IMPSP, and any other information that the IRCID
deems necessary and appropriate for congenital and inherited disorders
surveillance. IRCID staff are permitted to review hospital records, clinical
charts, physician's records, vital records, and prenatal records, information
from the INSP, RGCS, NMP, and IMPSP and any other information that the IRCID
deems necessary and appropriate for live births without a reportable congenital
or inherited disorder to serve as controls for epidemiological
surveys.
c. No individual or
organization providing information to the IRCID in accordance with this rule
shall be deemed or held liable for divulging confidential
information.
(6)
Access to information in the IRCID. The IRCID and the
department shall not release confidential information except to the following,
under the following conditions:
a. The parent
or guardian of an infant or child for whom the report is made and who can
demonstrate that the parent or guardian has received the notification
letter.
b. An Early ACCESS service
coordinator or an agency under contract with the department to administer the
children with special health care needs program, upon receipt of written
consent from the parent or guardian of the infant or child.
c. A local health care provider, upon receipt
of written consent from the parent or guardian of the infant or
child.
d. A representative of a
federal agency, to the extent that the information is necessary to perform a
legally authorized function of that agency or the department. The information
provided shall not include the personal identifiers of an infant or child with
a reportable congenital or inherited disorder.
e. Researchers, in accordance with the
following:
(1) All proposals for research
using the IRCID data to be conducted by persons other than program staff shall
first be submitted to and accepted by the researcher's institutional review
board. Proposals shall then be reviewed and approved by the department and the
IRCID's internal advisory committee before research can commence.
(2) The IRCID shall submit to the IRCID's
internal advisory committee for approval a protocol describing any research
conducted by the IRCID in which the IRCID deems it necessary to contact case
subjects and controls.
f. A representative of a state agency, to the
extent that the information is necessary to perform a legally authorized
function of that agency or the department. The state agency will be subject to
confidentiality regulations that are the same as or more stringent than those
in the state of Iowa.