DEPARTMENT OF COMMUNITY HEALTH  
BUREAU OF EPIDEMIOLOGY  
DIVISION OF ENVIRONMENTAL HEALTH  
REPORTING OF TRAUMATIC INJURIES  
(By authority conferred on the community public health agency by sections 5111  
and 2226[d] of 1978 PA 368, MCL 333.5111 and MCL 333.2226[d],section 8 of 1978  
PA 312,  
MCL 325.78, MCL 333.2233, MCL 333.2221 and Executive  
Reorganization Order No. 1996-1, MCL 330.3101.)  
R 325.301 Definitions.  
Rule 1. (1) As used in these rules:  
(a) "Department" means the Michigan department of community health.  
(b) "External cause-of-injury codes" means the standard codes adopted by  
reference in R 325.302(1).  
(c) "Health facility" means any facility or agency licensed in Michigan under  
Article 17 of the public health code, MCL 333.20101 to 333.22260 that provides health  
care services. It includes an ambulance, aircraft transport, non-transport prehospital life  
support, or medical first response operation; clinical laboratory; county medical care  
facility; freestanding surgical outpatient facility; health maintenance organization;  
nursing home; home for the aged; hospital; nursing home; hospice; and hospice  
residence.  
(d) "Health professional" means a person licensed under article 15 of the public  
health code, MCL 333.16101 to 333.18838, in medicine, osteopathic medicine, as a  
physician's assistant, or nurse practitioner.  
(e) "Local health department" means a public health department established under  
article 24 of the public health code, MCL 333.2401 to 333.2498, to protect the public  
health and prevent disease within a specific geographic area.  
(f) "Nature-of-injury codes" means the standard codes adopted by reference in R  
325.302(1).  
(g) "Patient" means any injured person who receives medical attention, care, or  
treatment for that injury.  
(h) "Protected health information" means any individually identified health  
information, whether oral or recorded in any form or medium that is created or received  
by a health care provider, health plan, public health authority, employer, life insurer,  
school or university, or health care clearinghouse;  
and, relates to the past, present, or future physical or mental health or condition of  
an individual; the provision of health care to an individual; or the past, present, or future  
payment for the provision of health care to an individual.  
(i) "Public health investigation" means the collection of  
medical,  
epidemiologic, exposure, and other information to determine the magnitude and causes of  
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specific illnesses or injuries, which is used to determine appropriate actions to  
prevent or mitigate additional illness or injury.  
(j) "Traumatic injury" means bodily damage resulting from exposure to physical  
agents such as mechanical energy, thermal energy, ionizing radiation, or resulting  
from the deprivation of basic environmental requirements such as oxygen or heat.  
Mechanical energy injuries include acceleration and deceleration injuries, blunt trauma,  
and penetrating wound injuries.  
History: 2010 AACS.  
R 325.302 Adoption by reference.  
Rule 2. (1) The department adopts by reference the following standards which are  
available for inspection at the department of community health; division of  
environmental health, 201 Townsend, Lansing, Michigan 48909. The standard codes as  
published by the World Health Organization at http://www.who.int, classify  
injuries based on the type injury, as specified in either of the following:  
(a) International Classification of Diseases Ninth Revision Clinical  
Modification; 1975 for $45.50.  
(b) International Classification of Diseases and Related Health Problems, Tenth  
Revision; 1992 for $390.00.  
(2) Copies of the standards adopted in subrule (1) of this rule can be obtained  
from the department of community health at the cost noted in subrule (1) of these rules,  
plus $20.00 for shipping and handling.  
History: 2010 AACS.  
R 325.303 Reportable information.  
Rule 3. (1) Reportable information is specifically related to patients with traumatic  
injuries.  
(2) The health professional or health facility shall submit its report in a format that  
ensures the inclusion of the information listed under subdivisions (a) to (c) of this  
subrule.  
(a) All of the following information, with respect to the patient, shall be provided:  
(i) Last and first name and middle initial.  
(ii) Sex.  
(iii) Race, if available.  
(iv) Ethnic group, if available.  
(v) Birth date or age.  
(vi) Street address, city, and state of residence.  
(vii) Telephone number.  
(viii) If the individual is a minor, the name of a parent or guardian.  
(ix) Work-relatedness of the injury.  
(x) Name and address of his or her employer, if injury is work-related.  
(xi) The date of injury.  
(xii) The date of diagnosis of the injury.  
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(xiii) Nature (type) of injury or injuries, and corresponding nature-of-injury  
codes, if available.  
(xiv) Cause and intentionality of injury, and corresponding external cause-of-  
injury codes, if available.  
(xv) Brief narrative of the injury event and any other information considered  
by the health professional or health facility to be relevant to public health response to  
the event.  
(b) Name, address, and telephone number of the health professional that  
diagnosed or treated the patient for their injury.  
(c) Name, address, and telephone number of the reporting health professional  
or health facility.  
History: 2010 AACS.  
R 325.304 Reporting responsibilities.  
Rule 4. (1) Traumatic injuries are not required to be reported unless requested by  
the department or local health department.  
(2) The department or local health department will notify health professionals  
and health facilities in writing when reporting of 1 or more types of traumatic injuries is  
requested. The following apply to injury reports requested by the department or local  
health department:  
(i) Reports shall be submitted within the time frame requested by the department  
or local health department, but no later than 10 days following the request.  
(ii) Except as provided in subrule (3) of this rule, reports shall be provided only  
to the department or local health department that makes the request.  
(2) Reports may be provided by health professionals or health facilities in the  
absence of a department or local health department request, when the reporting entity  
believes that public health investigation is needed to protect the public.  
(3) Nothing in this rule shall be construed to relieve a health professional or  
health facility from reporting to any other entity as required by state, federal, or local  
statutes or regulations or in accordance with accepted standard of practice.  
History: 2010 AACS.  
R 325.305 Investigation and quality assurance.  
Rule 5. (1) The department or local health department, upon receiving a report  
under R 325.304, may investigate to determine the accuracy of the report and collect  
additional information from health professionals and health facilities pertaining to, but  
not limited to, risk factors, medical condition, and circumstances of injury.  
(2) The department and local public health departments shall collaborate in the  
development of procedures for processing injury reports and conducting follow-up  
investigations to ensure efficient, non-duplicative, and effective public health response.  
(3) Requests for individual medical and epidemiologic information to validate  
the completeness and accuracy of reporting are specifically authorized by the  
department in accordance with this rule.  
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(4) A health facility shall keep copies of protected health information from  
reported injury cases in secure storage when not in use. Information stored  
electronically shall be maintained on a secure server accessible only by appropriate  
department or local health department program staff through password protected user  
accounts.  
(5) Reports may be released to other state, local, or federal agencies for those  
agencies to administer and enforce provisions of laws or rules to protect individuals  
from conditions associated with the injury. Protected health information may be  
released to other governmental agencies and bona fide agents of the state that comply  
with the confidentiality requirements of R 325.306.  
(6) Confidential information obtained during the public health investigation  
may be exchanged between the department and the local health department with  
jurisdiction where an injury or injuries occurred.  
(7) Nothing in this rule shall be construed to relieve or preempt any other entities  
from investigating injury hazards under state, federal, or local statutes or regulations.  
History: 2010 AACS.  
R 325.306 Confidentiality of reports.  
Rule 6. (1) Reports submitted to the department or local health department under R  
325.304 are not public records and are exempt from disclosure pursuant to the  
freedom of information act, section 13 of 1976 PA 442, MCL 15.231.  
(2) The department and local health departments shall maintain the  
confidentiality of all reports and shall not release reports, including protected health  
information or any information that may be used to directly link the information to a  
particular individual, except as allowed in R 325.305(5), unless the department or  
local health department has received written consent from the individual, or from the  
individual's parent or legal guardian, authorizing the release of information.  
(3) Medical and epidemiological information that is released to a legislative  
body shall not contain information that identifies a specific individual. Aggregate  
epidemiological information concerning the public health, which is released to the  
public for informational purposes only, shall not contain information that allows  
individuals to be identified.  
History: 2010 AACS.  
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;