11-168

§11-168-1
§11-168--2
§11-168-3
§11-168-4
§11-168-5
§11-168-6
§11-168-7
§11-168-8
§11-168-9
§11-168-10
§11-168-11
§11-168-12
§11-168-13
TITLE 11
DEPARI'MENT OF HEALTH
CHAPTER 168
HANSEN'S DISEASE
Purpose
Definitions
Notification
Examination
Treatment
Hospitalization
Transfers
Leave
Visiting
Employment
Outpatient follow-up care and discharge· from.the
outpatient service
Penalty
Severability
§11-168-2
Historical Note. 	Chapter 168 of Title 11, Administrative Rules, 	is based
substantially u:i;:on Chapter 27, Public Health Regulations, Department of
Health. 	[Eff. 	12/31/69 	R NOV O5 	1981
§11-168-1. 	Purpose. 	The purpose of this chapter is to establish rules
governing the care and treatment of persons afflicted with Hansen's Disease.
[Eff. NOV 	O5 	g 	(Auth: 	HRS §326-24) 	(Imp: 	HRS §326-24)
§11-168-2 	Definitions. 	Unless othe:nvise indicated in the context,
the following definitions shall apply:
"Carmunicable form or stage" means that form or stage of Hansen's
Disease durir1g ,which viable acid-fast organisms 	(mycobacterium leprae) 	are
demonstrable in scrapings of skin or in tissue specirnens in transmissible
form and number.
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§11-168-2
"Contact" means an individual who has been exposed to a person afflicted
with corrmunicable Hansen's disease, 	or a child born to a patient under treat-
ment for Hansen's disease in a corrmunicable stage.
"Deparbnent" means the department of health of the State of Hawaii.
"Director" means the director of health of the State of Hawaii, 	and
includes any officer, employee or agent of the department authorized by
the director to act in his behalf.
"Hansen's disease" means a chronic disease produced by the mycobacterium
leprae, and characterized primarily by alterations and destructive changes
in the skin and nerve structures of the human body, appearing in either a
corrmunicable form or stage or a non-corrmunicable form or stage.
"Physician" means a person duly licensed to practice medicine and
surgery in the State of Hawaii. 	[Eff. N V O 5 1~81 (Auth: 	HRS §326-24)
(Imp: 	HRS §326-24)
§11-168-3 	Notification. 	(a) 	Any physician having under his care
or supervision a person with a disease believed to be Hansen's disease shall
report the disease promptly to the department.
(b) 	The superintendent or management of any hospital in which a diagno-
sis of Hansen's disease is made after admission shall promptly inform the
attending physician and report the diagnosis to the department. 	This does
not relieve the physician of the primary responsibility for notifying the
deparbnent.
(c) 	Any person in charge of a laboratory in which the examination
of any specimen yields evidence of the possible presence of Hansen's disease
shall report such findings to the department. 	[Eff. 	OV 	5 	(Auth:
HRS: §326-24) 	(Imp: 	HRS §326-24)
.§11-168-4 	Examination. 	(a) 	Any person reported as having Hansen's
disease or suspected of having Hansen's disease shall be referred by his
physician for examination by a consultant skilled in the examination and
diagnosis of Hansen's disease as agreed upon by the patient or his physician
and the director.
(b) 	Any person who does not accept the examination findings and recom-
mendations of the consultant may request an examination by a panel of three
physicians, one selected by and representing the person who is requesting
the examination, one representing the Hawaii Medical Association and one
representing the department. 	At least two of the three physicians must
be known to be skilled in the diagnosis and management of Hansen's disease.
The findings and recorrmendations of the panel will prevail.
(c) 	Any person who believes he may have Hansen's disease may request
the director for an examination by a consultant representing the director
to determine whether he has or does not have Hansen's disease.
(d) 	Contacts will be referred for examination and re-examination as
may be required to insure prompt treabnent should any evidence of Hansen's
disease appear. 	[Eff. 	OV 	O 	(Auth: 	HRS §326-24) 	(Imp: 	HRS §326-
24)
§11-168-5 	Treabnent. 	(a) 	Any person who has Hansen's disease will
receive treabnent either as an outpatient under the supervision of a
physician approved by the director, or, 	if so recorn:nended, 	in a hospital
or other place established by the department for the care and treabnent
of ~--~r,~~ afflicted with Hansen's disease.
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~.l..L-.168-8
(b) 	The department shall make arrangements for the care and treatment
of Hansen's disease patients in other hospitals, 	nursing hanes or "care"
homes as the condition of the patient and the need for special services
may indicate.
(c) 	Prophylactic chemotherapy and other preventive measures may
be recorrmended for contacts who have been exposed to infection. 	[Eff.
NOV 	O 5 19811 	(Auth: 	HRS §§326-1, 	326-3, 	326-24) 	(Imp: 	HRS §§326-1,
326-3, 	326-24)
§11-168-6 	Hospitalization. 	(a) 	The hospitalization of persons
having Hansen's disease may be recanmended for initiation of chemotherapy,
for the treatment of canplications of Hansen's disease for the correction
of defonnities due to Hansen's disease, or for certain rehabilitation
measures best carried out within a hospital. 	The need for hospitalization
will be established on the basis of medical condition, hane environment,
need for special services, and other related medico-social factors.
(b) 	Whenever the director considers that hospitalization is
necessary for the protection of the public health, he may direct that
the patient be hospitalized.
(c) 	'Any person who has been hospitalized or is under treatment for
Hansen's disease and believes that he no longer needs to be hospitalized
or treated, may request an examination by a panel of three physicians,
one selected by and representing the patient, 	one representing the Hawaii
Medical Association and one representing the department. 	At least two
of the three physicians must be kno:,m to be skilled in the diagnosis and
management of Hansen's disease. 	The examination will take place within
15 days after receiving a written request for such· an examination. 	The
decision of a majority of the panel will detennine the future status of
the patient. 	A person so examined may not request a second examination
until after an interval of at least three months. 	[Eff. 	NOV 	O 5 198}
(Auth: 	HRS §§326-1, 	326-3, 	326-24) 	(Imp: 	HRS §§326-1, 	326-3, 	326-24)
§11-168-7 	Transfers. 	(a) 	The transfer of a patient fran any
hospital for the care and treatment of Hansen's disease to any other
hospital for the further care and treatment of Hansen's disease or any
other medical or surgical condition may be made upon recom:nendation of
the attending physician and with the consent of the patient. 	If a medical
or surgical emergency arises and the patient is incapable of being
consulted, 	such transfer may be made without his consent.
(b) 	'Any patient upon request may have his residence transferred
from Hale :Mohalu at Leahi Hospital to Kalaupapa Settlement or fran Kalaupapa
Settlement to Hale :Mohalu at Leahi Hospital, 	except that patients admitted
to Hale :Mohalu subsequent to 30 June 1969 must apply to the director and
would r§qllire his approval for transfer to Kalaupapa Settlement.
[Eff. NOV 	O 5 198~ 	(Auth: 	HRS §§326-1, 	326-3, 	326-11, 	326-13, 	326-24)
(Imp: 	HRS §§326-1, 	326-3, 	326-11, 	326-13, 	326-24)
§11-168-8 	Leave. 	A patient hospitalized with the carmu:nicable form
or stage of Hansen's disease may be granted leave for a period up to one
week for personal or humanitarian reasons. 	Leave will be granted on
condition that adequate measures are taken to prevent exposure of
susceptible persons, especially children under 16 years of age, 	to
infection, and that the person on leave follows the instructions of the
health authority having jurisdiction over the area in which he will
temporarily reside. 	[Eff. NOV 	O 5 19 	(Auth: 	HRS §§326-1, 	326-24)
(Imp: 	HRS §§326-1, 326-24)
168-3
~ fl ,;;

§11-168-9 	Visiting. 	A permit issued by the director is required for
any persons visiting or remaining in any place set apart for the treatment
of persons having the caro:nunicable fonn of Hansen's disease. 	Permits
will be issued for valid reason to adults upon request. 	Permits for escorted
minors over 16 years of age will be issued to parents or guardians on
request for valid reason. 	[Eff. NOV 	O 5 19~1 	(Auth: 	HRS 326-24, 	326-26)
(Imp: 	HRS §§326-24, 	326-26)
§11-168-10 	Employment. 	There shall be no restriction on the type
of employment that may be engaged in by any person with the non-communicable
fonn or stage of Hansen's disease. 	[Eff. NOV 	O 5 19]81 	(Auth: 	HRS §§326-21,
326-22, 	326-24) 	(Imp: 	HRS §§326-21, 	326-22, 	326-24)
§11-168-11 	outpatient follow-up care and discharge from the outpatient
service. 	Patients shall continue on outpatient follow-up care until the
likelihood of any further complications of Hansen's disease have passed.
Contacts may be discharged fran the outpatient service after medical exami-
nations show no evidence of Hansen' s disease. 	[Ef f. NOV Q 5 19 811 	(Auth:
HRS §326-24) 	(Imp: 	HRS §326-24)
§11-168-12 	Penalty. 	Any person who violates the provisions of this
chapter shall be fined not more than five hundred dollars or imprisoned for
not more than one year, or both. 	[Eff.NOV 	O 5 19J81 (Auth: 	HRS §326-24)
(Imp: 	HRS §326-39)
§11-168-13 	Severability. 	If any provision of this chapter, or the
application of any provision of this chapter to any person or circumstance,
is held invalid, 	the application of such provision to other persons or
circumstances, and the remainder of this chapter, 	shall not be affected
thereby. 	[Eff. NOV 	O 5 19811 	(Auth: 	HRS §326-24) 	(Imp: 	HRS §326-24)
168-4