Select Legal References for Local Health Departments regarding Conduct of Public Health Programs January 2011

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1 Purpose and Use Select Legal References for Local Health Departments regarding Conduct of Public Health Programs January 2011 This document is intended for use as guidance to municipalities and local health departments (LHDs) in determining their statutory authority and responsibility to conduct public health services, programs, or activities. Although we have endeavored to make this list as inclusive as possible, this document is not intended to provide a comprehensive list of required services and programs. The references summarized in the tables below enumerate state mandated requirements for LHDs related to programs eligible for Article 6 reimbursement. Other documents, including the Public Health Law (PHL), New York Codes, Rules and Regulations (NYCRR), and publications of the State Department of Health contain references to other required programs (e.g., Program Operations Guidelines for STD Prevention, New York State Oral Health Plan, and the Environmental Health Manual). References to other sources of New York law are included to provide a comprehensive view of LHDs legal authority and responsibility (e.g., Environmental Conservation Law Article 33- Pesticides; Environmental Conservation Law Article 8- Environmental Quality Review related to the arthropod born disease program). A program s absence from the list should not be interpreted as a declaration that the program is not required by the PHL or NYCRR. Additionally, since this document represents the current content of the PHL and NYCRR, the information is anticipated to change over time. LHDs and county governments contemplating discontinuance of a service, program, or activity should research the current statutory authority of the item, independent of the information provided herein. It is strongly suggested that LHDs consult with their respective county attorneys and verify their conclusions with the State Department of Health before discontinuing a public health service, program, or activity. Select References Concerning the Duties of Local Boards of Health and Local Health Officers A county s legal responsibility to provide public health services is fixed by state statutes and by any agreements or contracts governing the use of grant moneys to provide such services. The term local health officer is defined in the SSC, and means a Commissioner of Health, a public health director, the health director of a county the health director of a county, appointed pursuant to and subject to the provisions of section 356 of the Public Health Law; or the officer of a city having a population of less than 50,000, town, village or consolidated health district who administers and manages public health programs within such jurisdiction and who has the general powers and duties specified in the Public Health Law. See, SSC and PHL 356. Y:\OLHS\PHL References

2 The term "local board of health" means the board of health of a county, part-county, city, village, town or consolidated health district. See, PHL 2. The membership of a board of health can be appointed, can be the Board of Supervisors or a Board of Legislators depending on how the county health department was formed. See, PHL 340, 356. Every local board of health shall, among other things, direct the local health officer in the performance of his or her duties, make orders and regulations necessary for the preservation of life and health and the enforcement of the PHL in the municipality, suppress nuisances, and enforce its orders and regulations. See, PHL , Every local health officer shall make sanitary surveys and inspections, spread information about the prevention of disease and preservation of public health, secure reports of reportable diseases, and enforce within his or her jurisdiction of the provisions of the PHL and SSC. See, PHL 324, Upon the establishment of a board of health for a county or part-county health district, the health district shall, among other things, perform all the duties of a local board of health, including making orders and regulations for the security of life and health in the district, consistent with the PHL and SSC. See, PHL 347. Y:\OLHS\PHL References

3 Community Health Assessment N/A PHL 602.3(b)(4)- Community Health Assessment 10NYCRR State Aid: Amount of Reimbursement 10NYCRR Community Health Assessment Performance Standards 10NYCRR (a)(b)(c)- Municipal Health Service Plan Requirements Disease Control Arthropod- borne Disease Surveillance and Control Public Health Law Article (c) Local Health Officer; general powers and duties Public Health Law Article 6 State Aid to Cities and Counties Public Health Law 201 Functions, powers and duties of the department Public Health Law Control of Communicable Diseases Public Health Law Laboratory Title 10 (Health) of the New York State Codes, Rules and Regulations 10 NYCRR Parts General Provisions Regarding the Payment of State Aid; State Aid for Public Health Services: Counties and Cities 10 NYCRR Part 2- Communicable Diseases 10 NYCRR Part 40- State Aid for Public Health Services: Counties and Cities 10 NYCRR Part 44- State Aid for Approved Vector Surveillance and Control Programs 10 NYCRR Parts 58 and 19- Clinical Laboratories and Blood Banks; Clinical Laboratory Directors 10 NYCRR Infection Control Environmental Conservation Law Article 33- Pesticides Environmental Conservation Law Article 8- Environmental Quality Review Y:\OLHS\PHL References

4 Category Disease Control continued Service Communicable Disease References PHL 324 (c) and (d)- Local health officer; general powers and duties Surveillance, Reporting and PHL Clinical Laboratory and Blood Banking Services; Laboratory Control Business Practices PHL Article 6 State Aid to Cities and Counties Public Health Law Control of Communicable Diseases Title 10 (Health) of the New York State Codes, Rules and Regulations 10 NYCRR Parts General Provisions Regarding the Payment of State Aid; State Aid for Public Health Services: Counties and Cities 10 NYCRR Communicable Diseases: Performance Standard 10 NYCRR Municipal Health Service Plan Requirements 10 NYCRR 2.1- Communicable Diseases Designated: Cases, Suspected Cases and Certain Carriers to be Reported to the State Department of Health HIV Services 10 NYCRR Reporting of Cases, Records 10 NYCRR Notification and Investigation of Outbreaks 10 NYCRR 2.6- Health Officer to Investigate Cases of Communicable Disease, to Ascertain Sources of Infection, to Seek Out Contacts and to Take Other Steps to Reduce Morbidity and Mortality 10 NYCRR Infection Control 10 NYCRR 58 &19- Clinical Laboratories and Blood Banks; Clinical Laboratory Directors State Aid Public Health Law Article 6- State Aid to Cities and Counties 10 NYCRR Parts 39 and 40- General Provisions Regarding the Payment of State Aid; State Aid for Public Health Services: Counties and Cities 10 NYCRR & Human Immunodeficiency Virus (HIV): Performance Standard Y:\OLHS\PHL References

5 Category Disease Control continued Service Immunization Program References 10 NYCRR 2.1, 2.6- Reporting of Cases, Records; Health Officer to Investigate Cases of Communicable Disease, to Ascertain Sources of Infection, to Seek Out Contacts and to Take Other Steps to Reduce Morbidity and Mortality 10 NYCRR and Imunization: Performance Standard; Municipal Public Health Services Plan Requirements 10 NYCRR Subparts 66-1, 66-2, Immunization against Poliomyelitis, Diphtheria, Measles, Mumps and Rubella; Immunization against Measles, Mumps and Rubella for post secondary students; Responsibilities of the Local Health Officer 10 NYCRR Projects and Services Eligible for State Aid PHL 324- Local Health Officer General Powers and Duties Y:\OLHS\PHL References PHL 613- State Aid Immunization PHL Communicable Disease Local Health Officers Duty to Report PHL 2110-City of New York Exceptions PHL Definitions; immunization against poliomyelitis, mumps, measles, diphtheria, rubella, varicella, Haemophilus influenzae type b (Hib), pertussis, tetan PHL Immunization of Certain Post-Secondary Students PHL Immunization; Regulations PHL Statewide Immunization Information System PHL 2190-Short title PHL 2500-Maternal and Child Health; Duties of the Commissioner PHL Commissioner and Council, Powers and Duties PHL Approval of Hospitals, Operating Certificates PHL Health Maintenance Organizations; Powers PHL Immunizations against poliomyelitis, mumps, measles, diphtheria and rubella PHL State Aid; Amount of Reimbursement

6 Disease Control continued Surveillance, Control and Prevention for Rabies and other Zoonotic Diseases Sexually Transmitted Disease Control PHL Rabies PHL Clinical Laboratory and Blood Banking Services; Laboratory Business Practices 10NYCRR Reporting of suspected animals and persons exposed to them 10 NYCRR 58 & 19- Clinical Laboratories and Blood Banks; Clinical Laboratory Directors Agriculture and Markets Law, Article 7 Public Health Law Article Functions powers and duties of the department 206. Commissioner; general powers and duties 1(d), (e), (f), (g), (j) 206 (2)- Commissioner; General Powers and Duties 206 (3)- Commissioner; General Powers and Duties 206 (5)- Commissioner; General Powers and Duties 206 (6) (c)- Commissioner; General Powers and Duties 206 (8)- Commissioner; General Powers and Duties 206 (9)- Commissioner; General Powers and Duties 225. Public Health Council; powers and duties; sanitary code 10NYCRR ; 2.32, State Health Areas; professional and other employees Article 3 324(c) Local Health Officer; general powers and duties Article 5, Titles I V Laboratories Clinical Laboratory and Blood Banking Services; Laboratory Business Practices Y:\OLHS\PHL References

7 Disease Control continued Sexually Transmitted Disease Control Article 6 continued Titles I, II, and III 600 State aid; general requirements 601 Application for State Aid 602, 603 Municipal Public Health Services Plan 604 Supervsion of Public Health Programs 609 State Aid; Laboratories Article 21 Control of Acute Communicable Diseases Title I General Provisions o Communicable Diseases; local boards of health and health officers; powers and duties o Communicable Diseases; physicians and institutions; duty to report o Communicable Diseases; laboratory reports and records o Communicable Diseases; local health officers; duty to report o Communicable Diseases; state institutions duty to report; duty of commissioner Title II Control of Patients o Communicable Diseases; control of dangerous and careless patients; commitment o Communicable Diseases; control of dangerous and careless patients; commitment. Title III Human Immunodeficiency Virus o Contact tracing of cases of AIDS, HIV related illness or HIV infection. Y:\OLHS\PHL References

8 Disease Control continued Sexually Transmitted Disease Control Article 23 Control of Sexually Transmissible Diseases continued Title I Care and Treatment o Venereal Disease; examination or isolation o Venereal Disease; proceedings to compel examination or isolation; confidential records o Venereal Disease; examination of person under arrest o Venereal Disease; treatment or isolation required o Sexually transmissible diseases; treatment facilities; administration o Sexually transmissible diseases; treatment by licensed physician of a hospital; prescriptions o Sexually transmissible diseases; reports and information, confidential o Venereal Disease; person knowing himself to be infected o Venereal Disease; pregnant women; blood test for syphilis o 2308-a. Sexually transmissible diseases; tests for sexually transmissible diseases o Sexually transmissible diseases; violation; penalties o Venereal Disease; certain advertisements o Sexually transmissible disease list Article 27-F HIV and AIDS Related Information o Penalties; immunities. Article 6 Jail Medical Services Policy, Appendix A Y:\OLHS\PHL References

9 Disease Control continued Sexually Transmitted Disease Control continued Tuberculosis Prevention and Control New York State Codes Rules and Regulations Chapter I Sanitary Code o Part 1 General Provisions o Part 2 Communicable Diseases Designation of cases Investigations and determination Reporting of cases; records o Part 12 Maternal and Child Health Control of Disease o Part 23 Sexually Transmitted Diseases (STD) O Part 19- Clinical Laboratory Directors Chapter II Administrative Rules and Regulations O Subchapter B, Parts , o Subchapter D Laboratories, Part 58 O Subchapter H MCH, Part 69-2 umbilical cord blood testing 201 (1) (c) (h)- Functions, Powers and Duties of the Department 206 (1) (d)- Commissioner; General Powers and Duties 324 (c)- Local Health Officer; General Powers and Duties Y:\OLHS\PHL References Clinical Laboratory and Blood Banking Services; Laboratory Business Practices Article 21- Control of Acute Communicable Diseases 2102 (1)- Communicable diseases; Laboratory Reports and Records Communicable Diseases; Local Health Officers; Duty to Report Article 22- Control of Tuberculosis 10 NYCRR Tuberculosis; Performance Standard 10 NYCRR Municipal Public Health Service Plan; Requirements 10 NYCRR 58 & 19- Clinical Laboratories and Blood Banks; Clinical Laboratory Directors 10NYCRR Part 2 --Communicable Diseases 10NYCRR Part Tuberculosis

10 Disease Control continued Chronic Disease- Cancer Prevention and Control Chronic Disease- Cardiovascular Disease Prevention Public Health Law Article 6- State Aid to Cities and Counties Section Cancer Detection and Education Program; Establishment Section Grants to Approved Organizations Section Hospital Reimbursement Provisions; Generally Public Health Law 324- Local Health Officer; General Powers and Duties Public Health Law Clinical Laboratory and Blood Banking Services 10 NYCRR Part 39-General Provisions Regarding the Payment of State Aid 10 NYCRR Chronic Disease; Performance Standard 10 NYCRR Municipal Public Health Service Plan; Requirements 10 NYCRR Parts58 & 19- Clinical Laboratories and Blood Banks; Clinical Laboratory Directors Public Health Law Article 6-State Aid to Cities and Counties Public Health Law 324- Local Health Officer; General Powers and Duties 10 NYCRR Parts39 and Sub part 40-2 [see relevant sections below] ; Chronic Disease; Performance Standards; Municipal Public Health Service Plan; Requirements ; Health Education; Performance Standards; Municipal Public Health Service Plan; Requirements Primary and Preventive Health Care Services; Performance Standard ; Nutrition; Performance Standard; Municipal Public Health Services Plan; Requirements Public Health Law Article 27-B Treatment of Hypertension Public Health Law Laboratory Title I. Mary Lasker Heart and Hypertension Institute (Sections ). Title II. Centers for the treatment of hypertension (Sections ). Y:\OLHS\PHL References

11 Disease Control continued Chronic Disease- Diabetes Prevention and Control Public Health Law Article 6- State Aid for Cities and Counties Public Health Law 324- Local Health Officer; General Powers and Duties Public Health Law Clinical Laboratory and Blood Banking Services; Laboratory Business Practices 10 NYCRR Chronic Disease; Performance Standards 10 NYCRR Municipal Public Health Service Plan; Requirements 10 NYCRR Health Education; Performance Standards Chronic Disease- Tobacco Use Control 10 NYCRR Primary and Preventive Health Care Services; Performance Standard 10 NYCRR Nutrition; Performance Standard 10 NYCRR Part 58 & Part 19- Clinical Laboratories and Blood Banks; Clinical Laboratory Directors PHL Article 6- State Aid for Cities and Counties PHL Section 225- Public Health and Health Planning Council; Powers and Duties; Sanitary Code PHL Article 13-E- Regulation of Smoking in Certain Public Areas PHL Article 13-F- Regulation of Tobacco Products and Herbal Cigarettes; Distribution to Minors Y:\OLHS\PHL References

12 Environmental Health Community Sanitation and Food PHL Article 6- State Aid to Cities and Counties Protection 10 NYCRR Part 39- General Provisions Regarding the Payment of State Aid Subparts 40-1 and General Provisions; Performance Standards for Basic Public Health Services and Minimum Requirements of Municipal Public Health Service Plans PHL Section 201- Functions, Powers and Duties of the Department PHL Section 206- Commissioner; General Powers and Duties PHL Section 225- Public Health and Health Planning Council; Powers and Duties; Sanitary Code PHL Section 570- Declaration of Policy and Statement of Purpose PHL Section 581- Separability PHL Section Food Places; Powers of the Commissioner PHL Section Regulation of Overnight, Summer Day and Traveling Summer Day Camps for Children Definitions PHL Section 1399(d)- Regulation of Housing; Used as Accommodations by Employees of Certain Motels and Hotels 10 NYCRR Part 6, Subparts 6-1, 6-2, 6-3- Swimming Pools; Bathing Beaches; Recreational Aquatic Spray Grounds 10 NYCRR Part 7, Subparts 7-1, 7-2, 7-3, 7-4, 7-5- Temporary Residences (Hotels, Motels, Cabin Colonies); Children s Camps; Campgrounds; Mass Gatherings; Agricultural Fairgrounds 10 NYCRR Part 14, Subparts 14-1, 14-2, 14-4, Food Service Establishments; Temporary Food Service Establishments; Mobile Food Service Establishments and Push Carts; Vending of Food and Beverages 10 NYCRR Part 15- Migrant Farm Worker Housing 10 NYCRR Part 17, 19, 58- Mobile Home Parks; Clinical Laboratory Directors; Clinical Laboratories and Blood Banks MOU DOH and Department of Agriculture and Markets, September NYCRR Part 72, Subpart 72-1, Tanning Facilities Y:\OLHS\PHL References

13 Environmental Health continued Environmental Health Assessment PHL Article 6- State Aid to Cities and Counties 10 NYCRR Part 39- General Provisions Regarding the Payment of State Aid 10 NYCRR 40-1, General Provisions; Performance Standards for Basic Public Health Services and Minimum Requirements of Municipal Public Health Service Plans 10 NYCRR , Environmental Health Assessment; Performance Standard; Municipal Public Health Service Plan; Requirements Environmental Radiation Protection Program 10 NYCRR Environmental Radiation Protections; Performance Standard 10 NYCRR Municipal Public Health Services Plan; Requirements Statutory Authority: Public Health Law, 225- Public Health and Health Planning Council; Powers and Duties; Sanitary Code Y:\OLHS\PHL References

14 Environmental Health Individual Water and Sewage PHL Article 6- State Aid to Cities and Counties continued Systems PHL 201 (1)(l) PHL Standards for Water Wells 10 NYCRR Subparts 40-2 and Performance Standards for Basic Public Health Services and Minimum Requirements of Municipal Public Health Service Plans; Performance Standards for Optional Public Health Services and Minimum Requirements of Municipal Public Health Services Plan PHL Section 225- Public Health and Health Planning Council; Powers and Duties; Sanitary Code PHL Section 502- Environmental Laboratories; Examinations; Certificates of Approval PHL Sections Clinical Laboratory and Blood Banking Services 10 NYCRR Part 55, 58, 19- Approval of Laboratories; Clinical Laboratories and Blood Banks; Clinical Laboratory Directors 10 NYCRR Part 75 and Appendix 75-A- Standards for Individual Water Supply and Individual Sewage Treatment Systems; Wastewater Treatment Standards- Residential Onsite Systems ECL Article 17- Water Pollution Control NYS DOH and NYS DEC MOU, March, 1984 Y:\OLHS\PHL References

15 Environmental Health continued Chemical Emergencies Public Water Supply Protection PHL Article 5 sections 502, Environmental Laboratories; Examinations; Certificates of Approval; Clinical Laboratory and Blood Banking Services PHL Article 6- State Aid to Cities and Counties 10 NYCRR Part 39 and Subparts 40-1 and General Provisions Regarding the Payment of State Aid; General Provisions; Performance Standards for Basic Public Health Services and Minimum Requirements of Municipal Public Health Service Plans 10 NYCRR and Chemical Emergencies; Performance Standard; Municipal Public Health Service Plan; Requirements 10 NYCRR Parts 58 and 19 and Subpart Clinical Laboratory Directors; Clinical Laboratories and Blood Banks; Approval of Laboratories Providing Environmental Analysis Executive Law sec. 20 and 23-Natural and Man-Made Disasters; Policy; Definition; Local Comprehensive Emergency Management Plans PHL Article 6- State Aid to Cities and Counties PHL 201 (1)(e) Supervise and regulate the sanitary aspects of water supplies. PHL Potable Waters. PHL Water Supply Emergency Plans. PHL Annual Water Supply Statement. PHL Drinking Water Revolving Fund. Safe Drinking Water Act 42, USC 300(f) PHL 225- Public Health and Health Planning Council; Powers and Duties; Sanitary Code 10 NYCRR Performance Standards for Basic Public Health Services and Minimum Requirements of Municipal Public Health Service Plans 10 NYCRR Part 5, Subpart 5-1- Drinking Water Supplies; Public Water Supplies 10 NYCRR Part 5, Subpart 5-4- Classification and Certification of Community and Nontransient Noncommunity Water Systems Operators Part 53 Drinking Water State Revolving Fund MOU DOH and Department of Agriculture and Markets, September 2010 Y:\OLHS\PHL References

16 Environmental Health continued Realty Subdivisions PHL Article 5, section 502- Environmental Laboratories; Examinations; Certificates of Approval PHL PHL 201(1)(e) PHL 225(5)(a) Safe Drinking Water Act 42 USC 300(f) Environmental Conservation Law (ECL), PHL Article 6- State Aid to Cities and Counties 10 NYCRR Subpart Performance Standards for Basic Public Health Services and Minimum Requirements of Municipal Public Health Service Plans 10 NYCRR Subpart Approval of Laboratories Performing Environmental Analysis PHL Article 11, Title II- Realty Subdivisions: Water Supply ECL Article 17, Title 15- Realty Subdivisions: Sewage Service 10 NYCRR Part 5, Subpart 5-1- Public Water Supplies 10 NYCRR Part 5, Subpart 5-1, App. 5-B Standards for Water Wells 10 NYCRR Part 5 Subpart 5-1, Appendix 5-D- Special Requirements for Wells Serving Public Water Systems 10 NYCRR Part 5, Subpart 5-2- Water Well Construction 10 NYCRR, Subpart 5-A, Recommended Standards for Water Works 10 NYCRR Part 74- Approval of Realty Subdivisions 10 NYCRR Part 75, Appendix 75-A- Wastewater Treatment Standards- Residential Onsite Systems 10 NYCRR Part 97- Regulations Implementing State Environmental Quality Review NYS DOH and NYS DEC MOU, May, 1982 Y:\OLHS\PHL References

17 Family Health Category Service References Dental Health Education Dental Health Services Family Planning 10 NYCRR Dental Health; Performance Standards 10 NYCRR Municipal Public Health Services Plan; Requirements 10 NYCRR Community Health Assessment; Performance Standards 10 NYCRR Municipal Public Health Service Plan; Requirements 10 NYCRR Dental Health Services; Performance Standard 10 NYCRR Municipal Public Health Service Plan; Requirements New York State Oral Health Plan 10 NYSCRR Dental Health Services; Performance Standard 10 NYSCRR Municipal Public Health Service Plan; Requirements State Education Department Law 903- Students to Furnish Health Certificates; and Dental Health Certificates 10 NYCRR Family Planning; Performance Standard 10 NYCRR Municipal Public Health Services Plan; Requirements Y:\OLHS\PHL References

18 Family Health continued Chronic Disease- Prevention of Injuries and Violence Lead Poisoning Prevention Program Public Health Law Article 6- State Aid to Cities and Counties Public Health Law 324- Local Health Officer; General Powers and Duties 10 NYCRR Part 39 and Sub part General Provisions Regarding the Payment of State Aid; General Provisions 10 NYCRR Injury Prevention and Control; Performance Standard 10NYCRR Municipal Public Health Services Plan; Requirements 10 NYCRR Lead Poisoning; Performance Standard 10 NYCRR Municipal Public Health services Plan; Requirements 10 NYCRR 58 & 19- Clinical Laboratory Directors; Clinical Laboratories and Blood Banks 10 NYCRR Screening and Follow-Up 10 NYCRR Environmental Assessment and Abatement 10 NYCRR Reporting of Blood Lead Levels PHL Clinical Laboratory and Blood Banking Services; Laboratory Business Practices PHL 602, 603-Municipal Public Health Service Plan; Municipal Public Health Service Plan; Implementation PHL 206 (1) (n) and 1370-a PHL 1370-c- Screening by Health Care Providers PHL 1370-d- Lead Screening of Child Care or Pre-School Enrollees PHL 225- Public Health and Health Planning Council; Powers and Duties; Sanitary Code Y:\OLHS\PHL References

19 Family Health Nutrition PHL Section 324(c)- Local Health Officer; General Powers and Duties PHL Clinical Laboratory and Blood Banking Services; Laboratory Business Practices PHL Section 602- Municipal Public Health Service Plan continued 10 NYCRR Part 39- General Provisions Regarding the Payment of State Aid 10 NYCRR Subpart General Provisions 10 NYCRR Section Nutrition; Performance Standards 10 NYCRR Section Municipal Public Health Service Plan; Requirements 10 NYCRR Section 59 & 19- Chemical Analysis of Blood, Urine, Breath or Saliva for Alcoholic Content; Clinical Laboratory Directors Prenatal Care and Infant Mortality 10 NYCRR Prenatal care and infant mortality; performance standard Primary and Preventive Health Services for Children Birth to 21 Public Health Law Clinical Laboratory and Blood Banking Services Public Health Law 602(3)(b)(1)- Municipal Public Health Service Plans; Implementations 10 NYCRR Part 39 and Sub Part General Provisions Regarding the Payment of State Aid; General Provisions 10 NYCRR and Projects and Services Eligible for State Aid; Projects and Services Ineligible for State Aid 10 NYCRR and Primary and Preventive Health Care Services; Performance Standard Y:\OLHS\PHL References

20 Health Education N/A PHL Section 324(c)- Local Health Officer; General Powers and Duties PHL Section 602 (3)(b)(3)- Municipal Public Health Service Plans; Implementations 10 NYCRR Section Projects and Services Eligible for State Aid 10 NYCRR Section Project and Services Ineligible for State Aid 10 NYCRR Section Health Education; Performance Standards In order for clinical services to be provided a LHD must be licensed as an Article 28 facility, and is subject to applicable Art. 28 rules and regulations depending on the scope of services provided. All LHDs that send nurses into the home, regardless of whether or not they operate a Certified Home Health Agency must be licensed under Art. 36, and are subject to applicable Art. 36 rules. Diagnostic and Treatment Services Clinical Services PHL Article 28 Home Health Services Services provided by nurses in the home PHL Article 36 Y:\OLHS\PHL References

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