DEPARTMENT OF COMMUNITY HEALTH

                             BUREAU OF EPIDEMIOLOGY

                        COMMUNICABLE AND RELATED DISEASES

(By authority conferred on the department of  community  health  by  sections 
5111 and 9227 of 1978 PA 368 and Executive  Reorganization  Order  Nos.1996-1 
and 1997-4, MCL 333.5111, 333.9227, 330.3101, 333.26324 and 333.5114.


R 325.171   Definitions.
  Rule 1. (1) As used in these rules:
  (a) "Appropriate local health department" means the local health department 
that has jurisdiction where an individual who has a disease or condition that 
is required to be reported resides or the  local  health  department  of  the 
county in which the service facility is located.
  (b) "Code" means 1978 PA 368, MCL 333.1101.
  (c) "Communicable" means capable of being transmitted  from  individual  to 
individual, from animal to individual, or from an inanimate reservoir  to  an 
individual.
  (d) "Department" means the Michigan department of community health.
  (e) "Designated condition" means any condition  that  is  designated  in  R 
325.172 as any of the following:
  (i) A serious communicable disease.
  (ii) A serious infection.
  (iii) A communicable disease.
  (iv) An infection.
  (v) A noncommunicable disease.
  (f) "Director" means the state director of community health or his  or  her 
designee.
  (g) "Epidemic" means any increase in the number of cases, above the  number 
of expected cases, of  any  disease,  infection,  or  other  condition  in  a 
specific time period, area, or demographic segment of the population.
  (h) "Local health officer" means the health officer, or  designee,  in  the 
appropriate local health department.
  (i) "Medical and epidemiological information" means any of the following:
  (i) Medical histories.
  (ii) Results of examinations.
  (iii) Findings on laboratory tests.
  (iv) Diagnoses.
  (v) Treatments employed.
  (vi) Outcomes.
  (vii) The description and source of suspected causative agents.
  (viii) Any other information that is pertinent to an investigation which is 
requested by the local health department or the department in the  course  of 
that investigation.
  (j)  "Novel influenza" is defined as any strains or subtypes  of  influenza 
viruses not included in the current year influenza vaccine formulation.
  (k) "Venereal disease" means any of the following:
  (i) Syphilis.
  (ii) Gonorrhea.
  (iii) Chancroid.
  (iv) Lymphogranuloma venereum.
  (v) Granuloma inguinale.
  (2) Unless the context requires otherwise or as further clarified in  these 
rules, terms defined in the code have the same meanings when  used  in  these 
rules.

  History:  1993 AACS; 1999 AACS; 2009 MR 19, Eff. Oct. 2, 2009.


R 325.172  Designation and classification of diseases and infections.
  Rule 2. (1) All of the  following  conditions  are  designated  as  serious 
communicable diseases:
  (a) Acquired immunodeficiency syndrome (AIDS).
  (b) Amebiasis.
  (c) Anaplasmosis.
  (d) Anthrax.
  (e)  Arboviral  Disease  (includes  West   Nile   virus,   Eastern   equine 
encephalitis, Western Equine Encephalitis, Powossan, St. Louis  encephalitis, 
California-group (Lacrosse encephalitis).
  (f) Aseptic (viral) meningitis.
  (g) Avian Influenza.
  (h) Blastomycosis.
  (i) Botulism.
  (j) Brucellosis.
  (k) Campylobacter enteritis.
  (l) Chancroid.
  (m) Chickenpox (Varicella).
  (n) Chlamydial disease, genital.
  (o) Cholera.
  (p) Coccidioidomycosis.
  (q) Cryptococcosis.
  (r) Cryptosporidiosis.
  (s) Cyclosporiasis.
  (t) Dengue fever.
  (u) Diphtheria.
  (v) Ehrlichiosis. 
  (w) Encephalitis, viral.
  (x) Escherichia coli, Shiga toxin positive - serotype O157:H7 and others.
  (y) Giardiasis.
  (z) Glanders.
  (aa) Gonorrhea.
  (bb) Granuloma inguinale (Donovanosis).
  (cc) Haemophilus influenzae disease, meningitis, or epiglottitis.
  (dd) Hantavirus pulmonary syndrome. 
  (ee) Hemolytic Uremic syndrome (HUS), postdiarrheal.
  (ff) Hepatitis A.
  (gg) Hepatitis B. 
  (hh) Hepatitis C.
  (ii) Hepatitis D.
  (jj) Hepatitis E.
  (kk) Histoplasmosis.
  (ll) Human immunodeficiency virus (HIV).
  (mm) Influenza.
  (nn) Legionellosis.
  (oo) Leprosy.
  (pp) Leptospirosis.
  (qq) Listeriosis.
  (rr) Lyme disease.
  (ss) Lymphogranuloma venereum.
  (tt) Malaria.
  (uu) Measles (Rubeola).
  (vv) Meningococcal disease, meningitis, or meningococcemia.
  (ww) Meningitis, other bacterial.
  (xx) Mumps. 
  (yy) Orthopox virus (includes smallpox and Monkeypox).
  (zz) Pertussis.
  (aaa) Plague.
  (bbb) Poliomyelitis, paralytic.
  (ccc) Psittacosis.
  (ddd) Q fever.
  (eee) Rabies, human.
  (fff) Rickettsial disease.
  (ggg) Rocky Mountain spotted fever.
  (hhh) Rubella.
  (iii) Rubella syndrome, congenital.
  (jjj) Salmonellosis.
  (kkk) Severe Acute Respiratory Syndrome (SARS).
  (lll) Shigellosis.
  (mmm) Spongioform encephalopathy (includes Creutzfeldt-Jakob disease).
  (nnn) Staphylococcus aureus infections,  vancomycin  intermediate/resistant 
VISA/VRSA).
  (ooo)  Staphylococcus   aureus   infections  methicillin  resistant  (MRSA) 
(outbreaks only).
  (ppp)    Streptococcus    pneumoniae     infections,     sterile     sites, 
susceptible/resistant.
  (qqq) Streptococcal infections, Streptococcus pyogenes   group  A,  sterile 
sites.
  (rrr) Syphilis. 
  (sss) Tetanus.
  (ttt) Trachoma.
  (uuu) Trichinosis.
  (vvv) Tuberculosis.
  (www) Tularemia.
  (xxx) Typhoid fever.
  (yyy) Typhus.
  (zzz) Vibriosis.
  (aaaa) Viral hemorrhagic fevers, (includes Lassa fever  and  Congo  Crimean 
hemorrhagic fever). 
  (bbbb) Yellow fever.
  (cccc)Yersinia enteritis.
  (dddd) The unusual occurrence, outbreak,  or  epidemic  of  any  condition, 
including healthcare-associated infections.
  (2) All of  the  following  are  designated  as  serious  infections  if  a 
laboratory confirms their presence in an individual:
  (a) Anaplasma phagocytophilum.
  (b) Arbovirus.
  (c) Bacillus anthracis.
  (d) Bordetella pertussis.
  (e) Borrelia burgdorferi.
  (f) Brucella species.
  (g) Calymmatobacterium granulomatis.
  (h) Campylobacter species.
  (i) Chlamydophila psittaci.
  (j) Chlamydia trachomatis.
  (k) Clostridium botulinum.
  (l) Clostridium tetani.
  (m) Coccidiodes immitis.
  (n) Corynebacterium diphtheriae.
  (o) Coxiella burnetii.
  (p) Cryptococcus neoformans.
  (q) Cryptosporidium species.
  (r) Cyclospora species.
  (s) Dengue Virus.
  (t) Ehrlichia species.
  (u) Encephalitis (viral).
  (v) Entamoeba histolytica.
  (w) Escherichia coli,  shiga toxin positive - serotype O157:H7 and others.
  (x) Francisella tularensis.
  (y) Giardia lamblia.
  (z) Haemophilus ducreyi.
  (aa) Haemophilus influenzae type B, sterile sites or in patients less  than 
15 years of age.
  (bb) Hantavirus.
  (cc) Hemorrhagic fever viruses.
  (dd) Hepatitis A, IgM.
  (ee) Hepatitis B surface antigen.
  (ff)  HIV (Confirmed  positive  HIV  serology  and  detection  tests;   CD4 
counts/percents and all viral loads on people already known to be infected).
  (gg)Histoplasma capsulatum.
  (hh) Influenza virus.
  (ii) Legionella species.
  (jj) Leptospira species.
  (kk) Listeria monocytogenes.
  (ll) Meningitis, other bacterial.
  (mm) Measles (Rubeola) virus.
  (nn) Mumps virus.
  (oo) Mycobacterium bovis.
  (pp) Mycobacterium  leprae.
  (qq) Mycobacterium tuberculosis.
  (rr) Neisseria gonorrhoeae.
  (ss) Neisseria meningitidis.
  (tt)  Novel influenza.
  (uu) Orthopox viruses.
  (vv) Plasmodium species.
  (ww) Poliovirus.
  (xx) Rabies virus.
  (yy) Rickettsia ricketsii.
  (zz) Rickettsia species.
  (aaa) Rubella virus.
  (bbb) Salmonella species.
  (ccc) SARS coronavirus.
  (ddd) Shigella species.
  (eee) Spongioform encephalopathy (includes Creutzfeldt-Jakob disease).
  (fff) Staphylococcus aureus, vancomycin intermediate/resistant VISA/VRSA.
  (ggg) Staphylococcus aureus, methicillin resistant - outbreak only.
  (hhh) Streptococcus pneumoniae, sterile sites, susceptible/resistant.
  (iii) Streptococcus pyogenes invasive, group A, sterile sites.
  (jjj)Treponema pallidum.
  (kkk) Trichinella spiralis.
  (lll) Varicella virus (Chickenpox).
  (mmm) Vibrio species.
  (nnn) Yellow fever virus.
  (ooo) Yersinia enterocolitica.
  (ppp) Yersinia pestis.
  (qqq) The unusual occurrence, outbreak, or epidemic of any infection.
  (3) All of the  following  conditions  are  designated  as  noncommunicable 
diseases:
  (a) Guillain-Barre syndrome.
  (b) Kawasaki disease.
  (c) Reye's syndrome.
  (d) Rheumatic fever.
  (e) Toxic shock syndrome.

  History:  1993 AACS; 1999 AACS; 2005 AACS; 2009 MR 19, Eff. Oct. 2, 2009.


R 325.173  Reporting and surveillance requirements.
  Rule 3. (1) A physician shall report each case of  a  serious  communicable 
disease specified in R  325.172,  except  for  human  immunodeficiency  virus 
infection  and  acquired  immunodeficiency  syndrome,  within  24  hours   of 
diagnosis or discovery, to  the  appropriate  health  department.   Reporting 
requirements  for  human  immunodeficiency  virus  infection   and   acquired 
immunodeficiency syndrome are set out in MCL 333.5114 and  subrules  (12)  to 
(14) of this rule. 
  (2) A physician  shall  report  the  unusual  occurrence  of  any  disease, 
infection, or condition that threatens the health of the  public,  within  24 
hours of diagnosis or discovery, to the appropriate local health department. 
  (3) A physician  shall  report  noncommunicable  diseases  specified  in  R 
325.172 within 3 days of diagnosis or discovery,  to  the  appropriate  local 
health department.
  (4) A physician may report any disease, infection, or condition that is not 
included in subrule (1), (2), or (3) of this rule to  the  appropriate  local 
health department according to the physician's medical judgment.
  (5) A laboratory shall report, within 24 hours of discovery,  both  of  the 
following to the appropriate local health department:
  (a) Laboratory evidence of any serious infection  specified  in  R  325.172 
except for human immunodeficiency virus which is governed by MCL 333.5114.
  (b) Laboratory evidence of any other disease, infection, or condition  that 
is judged by the laboratory director to  indicate  that  the  health  of  the 
public is threatened. A laboratory in this state that receives  or  processes 
specimens to be tested for the listed agents shall report a result confirming 
presence of a listed agent, even if the testing  is  not  done  on-site,  for 
example, the specimen is shipped to an out-of-state reference laboratory  for 
testing.
  (6) When a physician or laboratory director  suspects  the  presence  of  a 
designated condition, but does not have sufficient information to confirm its 
presence, the physician or laboratory shall report the  designated  condition 
as suspect to the appropriate local health department.  Upon confirmation  of 
the designated condition, a physician or laboratory director shall report the 
condition as confirmed to the appropriate local health department.
  (7) A health facility infection control committee  shall  develop  policies 
and procedures to ensure the appropriate reporting of  designated  conditions 
by physicians who treat individuals at that facility and by  laboratories  at 
that facility.
  (8) All of the following individuals may report to  the  appropriate  local 
health department any designated condition or any other  disease,  infection, 
or condition which comes to their professional attention and  which  poses  a 
threat to the health of the public:
  (a) An administrator, epidemiologist,  or  infection  control  professional 
from a health care facility or other institution.
  (b) A dentist.
  (c) A nurse.
  (d) A pharmacist.
  (e) A physician's assistant.
  (f) A veterinarian.
  (g) Any other health care professional.
  (9) A primary or secondary school, child  daycare  center,  or  camp  shall 
report, within  24  hours  of  suspecting,  both  of  the  following  to  the 
appropriate local health department:
  (a) The occurrence  among  those  in  attendance  of  any  of  the  serious 
communicable  diseases   specified   in   R   325.172,   except   for   human 
immunodeficiency virus  and  acquired  immunodeficiency  syndrome  which  are 
governed by MCL 333.5131.
  (b) The unusual occurrence, outbreak, or epidemic among those in attendance 
of any disease, infection, or condition.
  (10) A report shall be directed to the appropriate local health department. 
 A report may be written, oral, or transmitted by electronic media. A  report 
shall be transmitted in a manner prescribed or approved  by  the  appropriate 
local health department.
  (11) Except as provided in subrules (13) and (14) of this rule, a  required 
report by a physician shall contain all of the following information:
  (a) The patient's full name.
  (b) The patient's residential address, including street, city,  village  or 
township, county, and zip code.
  (c) The patient's telephone number.
  (d) The patient's date of birth, age, sex, race, and ethnic origin.
  (e) The name of the disease, infection, or condition reported.
  (f) The  estimated  date  of  the  onset  of  the  disease,  infection,  or 
condition, where applicable.
  (g) The identity of the reporting person.
  (h) Pertinent laboratory results.
  (i) Any other information considered by the physician to be related to  the 
health of the public.
  (12) Acquired  immunodeficiency  syndrome  (AIDS),  human  immunodeficiency 
virus (HIV) infection, tuberculosis, and venereal disease shall  be  reported 
by completing forms provided by the department. 
  (13)  In addition to reporting  requirements  under  section  5114  of  the 
public health code  for  acquired  immunodeficiency  syndrome  (AIDS),  human 
immunodeficiency  virus  (HIV)  infection,  a  physician  shall  report,   if 
available, the ethnicity and country of birth, if known, of the test subject.
  (14)  Nothing in these rules is intended to  limit  use  or  disclosure  of 
information needed by the department or local health department to carry  out 
its responsibilities under the public health code as authorized by,  but  not 
limited to, MCL 333.5131.
  (15) Viral  influenza  need  only  be  reported  by  the  number  of  cases 
identified during a specified time period or when influenza is  suspected  to 
have caused or contributed to mortality in a person aged less than 18  years, 
or if the infected individual traveled outside of North America within the  2 
weeks prior to symptom onset.
  (16) A required report by a laboratory shall contain all of  the  following 
information,  except  for   human   immunodeficiency   virus   and   acquired 
immunodeficiency syndrome, which are governed by MCL 333.5114:
  (a) The patient's full name.
  (b) The patient's residential address, including street, city,  village  or 
township, county, and zip code.
  (c) The patient's telephone number.
  (d) The patient's date of birth or age.
  (e) The patient's sex.
  (f) The specific laboratory test, date performed, and the results.
  (g) The name and address of the reporting laboratory.
  (h) The name, address, and telephone number of the ordering person.
  (17) To the extent that the information is readily available, a  report  of 
an unusual occurrence, outbreak, or epidemic  of  a  disease,  infection,  or 
other condition shall include all of the following information:
  (a) The nature  of  the  confirmed  or  suspected  disease,  infection,  or 
condition.
  (b) The approximate number of cases.
  (c) The approximate illness onset dates.
  (d) The location of the outbreak.
  (18) Within 24 hours of receiving a report, a local health department shall 
communicate the report of  an  individual  who  has  a  serious  communicable 
disease specified in R 325.172 or a serious infection specified in R  325.172 
to the department and any  other  Michigan  jurisdiction  if  the  individual 
resides in that other jurisdiction.
  (19) Within 3 days of receiving a report, a local health  department  shall 
communicate the report of an individual who  has  a  noncommunicable  disease 
specified in R 325.172 to the department and another Michigan jurisdiction if 
the individual resides in that other jurisdiction.
  (20) Within 24 hours of receiving a report that concerns an individual  who 
resides outside of this state, a local health department  shall  forward  the 
report to the department.
  (21) Reports of designated conditions acquired  by  residents  of  a  local 
health department's jurisdiction  shall  be  recorded  by  the  local  health 
officer and shall be forwarded to the department in a format specified by the 
department.

  History:  1993 AACS; 2005 AACS; 2009 MR 19, Eff. Oct. 2, 2009.


R  325.174   Investigation  of  diseases,    infections,    epidemics,    and 
situations with potential for causing diseases.
  Rule 4. (1) The local health department that has  jurisdiction   where   an 
individual who has a reported condition resides or  where   an   illness   or 
infection is being or may be spread shall  initiate   an   investigation   as 
necessary.
  (2) An investigator who presents official identification   of   the   local 
health department or  the  department  shall  promptly   be   provided   with 
medical and epidemiologic information pertaining to any of the  following:
  (a) Individuals who have designated conditions or   other   conditions   of 
public health significance.
  (b) Individuals, whether ill or well, who are part of a group  in  which an 
unusual occurrence, outbreak, or epidemic has occurred.
  (c) Individuals who are not known to have  a   designated   condition   but 
whose medical or epidemiological information is  needed   for   investigation 
into the cause of the occurrence of the condition.
  (d) Individuals who were potentially exposed to a designated  condition.
  (e) Individuals who have a declared critical health  problem  pursuant   to 
the provisions of Act No. 312 of the Public Acts of 1978,  being  S325.71  et 
seq. of the Michigan Compiled Laws.
  (3) Requests for individual medical  and   epidemiologic   information   to 
validate the completeness  and  accuracy  of   reporting   are   specifically 
authorized. Information released in response to a request made  by  type   of 
disease, infection, or condition or diagnostic code  category   may   include 
information about individuals who are not the primary focus of the request if 
it  is  not  reasonably  possible   to   delete   it   from   the   requested 
information.
  (4) A representative of the local health department   or   the   department 
may obtain human, animal, environmental, or other types   of   specimens   or 
cause such specimens  to  be  obtained  by   appropriate   means,   including 
venipuncture, in the course of an investigation  of   a   reported   disease, 
infection, or condition.
  (5) The local health  department  shall  transmit  the   results   of   its 
investigation of a report of an unusual occurrence of  illness,  outbreak, or 
epidemic to the department by an immediate informal report   that   shall  be 
followed by progress reports and a final report. The reports  shall  be in  a 
format that is acceptable to the department.

  History:  1993 AACS.


R  325.175   Procedures for physicians and schools for  control  of  diseases 
and infections.
  Rule 5. (1) A physician or  other  person  who  attends  to   a   case   of 
communicable disease shall arrange for   appropriate   barrier   precautions, 
treatment, or isolation if needed to prevent the spread   of   infection   to 
other household members, patients, or the community. A  physician  or   other 
person who seeks information on  appropriate   precautionary   measures   may 
request the  local  health  officer  or  the  department   to   provide   the 
necessary information. Appropriate isolation or  other  barrier   precautions 
may be instituted for a case or a suspected case of  disease,  infection,  or 
other condition by the local health officer or the department as necessary to 
protect the public health.
  (2) When a school official reasonably suspects  that  a   student   has   a 
designated condition, except for AIDS, HIV  infection,  and   noncommunicable 
diseases, the official may exclude the student for a  period  sufficient   to 
obtain a determination by a physician or local health officer   as   to   the 
presence of a designated condition. The local health  officer  may   initiate 
the exclusion from school of a student who has a  designated   condition.   A 
student may be returned to school when a physician or  local  health  officer 
indicates that the  student  does  not  represent  a  risk   to   the   other 
students.

  History:  1993 AACS.


R 325.176  Immunizations required of children  attending  group  programs  or 
entering school.
  Rule 6. (1) As used in this rule:
  (a) "Certificate of  immunization"  means  a  medical,  health  department, 
school, or personal record which indicates the dates  when  each  dose  of  a 
vaccine was given to an  individual  and  which  is  certified  by  a  health 
professional or local health department.
  (b) "Exemption" means a temporary or permanent waiver of 1 or more  of  the 
specific immunization requirements for medical, religious, or other reasons.
  (c) "Medical exemption" means a written statement from a physician  that  a 
vaccination is  medically  contraindicated  for  a  particular  child  for  a 
specified period of time.
  (d) "Religious or other exemption"  means  a  written  statement  which  is 
signed by the parent, guardian, or person in loco parentis of a child,  which 
certifies  that  immunization  is  in  conflict  with  religious   or   other 
convictions of the signer, and which includes the name and date of  birth  of 
the child.
  (e) "Vaccine" means an agent  for  immunization  against  an  infection  or 
disease caused by an infectious agent.
  (2) A child who is 2 months through 3 months of age and who  is  registered 
in a program of group residence or care shall have received at least  all  of 
the following vaccines:
  (a) One dose of any appropriate diphtheria vaccine.
  (b) One dose of any appropriate tetanus vaccine.
  (c) One dose of any appropriate pertussis vaccine.
  (d) One dose of any appropriate poliovirus vaccine.
  (e) One dose of any appropriate Haemophilus influenzae type B vaccine.
  (f) One dose of any appropriate hepatitis B vaccine or a laboratory finding 
of hepatitis B immunity or disease satisfies this requirement.
  (g) One dose of any appropriate pneumococcal conjugate vaccine.		
 (3) A child who is 4 months through 5 months of age and who is registered in 
a program of group residence or care shall have received at least all of  the 
following vaccines:
  (a) Two doses of any appropriate diphtheria vaccine.
  (b) Two doses of any appropriate tetanus vaccine.
  (c) Two doses of any appropriate pertussis vaccine.
  (d) Two doses of any appropriate poliovirus vaccine.
  (e) Two doses of any appropriate Haemophilus influenzae type B vaccine.
  (f) Two doses of any  appropriate  hepatitis  B  vaccine  or  a  laboratory 
finding of hepatitis B immunity or disease satisfies this requirement. 
  (g) Two doses of any appropriate pneumococcal conjugate vaccine.
  (4) A child who is 6 months through 15 months of age and who is  registered 
in a program of group residence or care shall have received at least  all  of 
the following vaccines:
  (a) Three doses of any appropriate diphtheria vaccine.
  (b) Three doses of any appropriate tetanus vaccine.
  (c) Three doses of any appropriate pertussis vaccine.
  (d) Two doses of any appropriate poliovirus vaccine.
  (e) Two doses of any appropriate Haemophilus influenzae type B vaccine.
  (f) Two doses of any  appropriate  hepatitis  B  vaccine  or  a  laboratory 
finding of hepatitis B immunity or disease satisfies this requirement.
  (g) Pneumococcal conjugate vaccine as shown by either of the following:
  (i) Three doses of any appropriate pneumococcal conjugate vaccine.
  (ii) Receipt of an age  appropriate  complete  series  of  any  appropriate 
pneumococcal conjugate vaccine.
  (5) A child who is 16 months through 18 months of age and who is registered 
in a program of group residence, care, or  camping  shall  have  received  at 
least all of the following vaccines:
  (a) Three doses of any appropriate diphtheria vaccine.
  (b) Three doses of any appropriate tetanus vaccine.
  (c) Three doses of any appropriate pertussis vaccine.
  (d) Two doses of any appropriate poliovirus vaccine.
  (e) Haemophilus Influenzae type B vaccine age as shown  by  either  of  the 
following:
  (i) Receipt of 1 dose of any  appropriate  haemophilus  influenzae  type  B 
vaccine at or after 15 months of age.
  (ii) Receipt of a complete series of any appropriate haemophilus influenzae 
type B vaccine.
  (f) One dose of any appropriate live measles vaccine at or after 12  months 
of age. A laboratory finding of measles immunity satisfies this requirement.
  (g) One dose of any appropriate live mumps vaccine at or after 12 months of 
age. A laboratory finding of mumps immunity satisfies this requirement.
  (h) One dose of any appropriate live rubella vaccine at or after 12  months 
of age. A laboratory finding of rubella immunity satisfies this requirement.
  (i) Two doses of any  appropriate  hepatitis  B  vaccine  or  a  laboratory 
finding of hepatitis B immunity or disease satisfies this requirement. 
  (j ) Pneumococcal conjugate vaccine as shown by either of the following:
  (i) Four doses of any appropriate pneumococcal conjugate vaccine.
  (ii) Receipt of an age  appropriate  complete  series  of  any  appropriate 
pneumococcal conjugate vaccine. 
  (6) A child who is 19 months through 4 years of age and who  is  registered 
in a program of group residence, care, or  camping  shall  have  received  at 
least all of the following vaccines:
  (a) Four doses of any appropriate diphtheria vaccine.
  (b) Four doses of any appropriate tetanus vaccine.
  (c) Four doses of any appropriate pertussis vaccine.
  (d) Three doses of any appropriate poliovirus vaccine.
  (e) Haemophilus influenzae type  B  vaccine  as  shown  by  either  of  the 
following:
  (i) Receipt of 1 dose of any  appropriate  Haemophilus  influenzae  type  B 
vaccine at or after 15 months of age.
  (ii) Receipt of a complete series of any appropriate Haemophilus influenzae 
type B vaccine.
  (f) One dose of any appropriate live measles vaccine at or after 12  months 
of age. A laboratory finding of measles immunity satisfies this requirement.
  (g) One dose of any appropriate live mumps vaccine at or after 12 months of 
age. A laboratory finding of mumps immunity satisfies this requirement.
  (h) One dose of any appropriate live rubella vaccine at or after 12  months 
of age. A laboratory finding of rubella immunity satisfies this requirement.
  (i) Three doses of any appropriate hepatitis  B  vaccine  or  a  laboratory 
finding of hepatitis B immunity or disease satisfies this requirement.
  (j) Have evidence of varicella immunity as shown by any of the following:
  (i) One dose of any appropriate varicella vaccine at or after 12 months  of 
age.
  (ii) Laboratory evidence of varicella immunity.
  (iii) A parent, guardian, person in loco parentis, or  physician  statement 
that the child has had varicella disease.
  (k) Effective January 1, 2007, pneumococcal conjugate vaccine as  shown  by 
either of the following:
   (i) Four doses of any appropriate pneumococcal conjugate vaccine.
   (ii) Receipt of an age appropriate  complete  series  of  any  appropriate 
pneumococcal conjugate vaccine.
  (iii) Receipt of 1 dose of any appropriate pneumococcal  conjugate  vaccine 
at or after 24 months of age.
  (7) A child who is 5 years of age and who is registered  in  a  program  of 
group residence, care, or camping shall have received at  least  all  of  the 
following vaccines:
  (a) Four doses of any appropriate diphtheria vaccine.
  (b) Four doses of any appropriate tetanus vaccine.
  (c) Four doses of any appropriate pertussis vaccine.
  (d) Three doses of any appropriate poliovirus vaccine.
  (e) One dose of any appropriate live measles vaccine at or after 12  months 
of age. A laboratory finding of measles immunity satisfies this requirement.
  (f) One dose of any appropriate live mumps vaccine at or after 12 months of 
age. A laboratory finding of mumps immunity satisfies this requirement.
  (g) One dose of any appropriate live rubella vaccine at or after 12  months 
of age. A laboratory finding of rubella immunity satisfies this requirement.
  (h) Three doses of any appropriate hepatitis  B  vaccine  or  a  laboratory 
finding of hepatitis B immunity or disease satisfies this requirement.
  (i) Have evidence of varicella immunity as shown by any of the following:
  (i) One dose of any appropriate varicella vaccine at or after 12 months  of 
age.
  (ii) Laboratory evidence of varicella immunity.
  (iii) A parent, guardian, person in loco parentis, or  physician  statement 
that the child has had varicella disease.
  (8) A child who is 4 years through 6 years  of  age  and  who  is  entering 
school shall  be  in  compliance  with  all  of  the  following  immunization 
requirements:
  (a) Have received 4 doses of any appropriate diphtheria vaccine and,  if  a 
dose was not received on or after the fourth  birthday,  a  booster  dose  at 
school entry.
  (b) Have received 4 doses of any appropriate tetanus vaccine and, if a dose 
was not received on or after the fourth birthday, a booster  dose  at  school 
entry.
  (c) Have received 4 doses of any appropriate pertussis vaccine  and,  if  a 
dose was not received on or after the fourth  birthday,  a  booster  dose  at 
school entry.
  (d) Have received 4 doses of any appropriate polio vaccine. If dose  3  was 
administered after the fourth birthday only 3 doses are required.
  (e) Have evidence of measles immunity as shown by either of the following:
  (i) Two doses of any appropriate live measles vaccine  received  after  the 
first birthday, not less than 28 days apart.
  (ii) Laboratory evidence of measles immunity.
  (f) Have evidence of mumps immunity as shown by either of the following:
  (i) Two doses of any appropriate live  mumps  vaccine  received  after  the 
first birthday, not less than 28 days apart.
  (ii) Laboratory evidence of mumps immunity.
  (g) Have evidence of rubella immunity as shown by either of the following:
  (i) Two doses of any appropriate live rubella vaccine  received  after  the 
first birthday, at least 28 days apart.
  (ii) Laboratory evidence of rubella immunity.
  (h) Three doses of any appropriate hepatitis  B  vaccine  or  a  laboratory 
finding of hepatitis B immunity or disease satisfies this requirement.
  (I) Have evidence of varicella immunity as shown by any of the following:
  (i) Beginning January 1, 2010, two doses of any appropriate live  varicella 
vaccine at or after 12 months of age.
  (ii) Laboratory evidence of varicella immunity.
  (iii) A parent, guardian, person in loco parentis, or  physician  statement 
that the child has had varicella disease.
  (9) A child who is 7 through 18 years of age and who is entering school  or 
enrolled in grade 6, shall  be  in  compliance  with  all  of  the  following 
immunization requirements:
  (a) Have received 4 doses of any appropriate diphtheria vaccine -  3  doses 
if the first dose was received on or after the seventh birthday.
  (b) Have received 4 doses of any appropriate tetanus vaccine - 3  doses  if 
the first dose was received on or after the seventh birthday. 
  (c) Beginning January 1, 2010, have received a dose of Tdap vaccine  on  or 
after the 11th birthday if 5 years have lapsed since the last dose of tetanus 
or diphtheria containing vaccine.
  (d) Have received 3 doses of any appropriate poliovirus vaccine.
  (e) Have evidence of measles immunity as shown by either of the following:
  (i) Two doses of any appropriate live measles vaccine  received  after  the 
first birthday, not less than 28 days apart.
  (ii) Laboratory evidence of measles immunity.
  (f) Have evidence of mumps immunity as shown by either of the following:
  (i) Two doses of any appropriate live  mumps  vaccine  received  after  the 
first birthday, not less than 28 days apart.
  (ii) Laboratory evidence of mumps immunity.
  (g) Have evidence of rubella immunity as shown by either of the following:
  (i) Two doses of any appropriate live rubella vaccine  received  after  the 
first birthday, not less than 28 days apart.
  (ii) Laboratory evidence of rubella immunity.
  (h) Receipt of a complete series of any appropriate hepatitis B vaccine  or 
a laboratory finding of  hepatitis  b  immunity  or  disease  satisfies  this 
requirement.
  (i) Have evidence of varicella immunity as shown by any of the following:
  (i) Beginning January 1, 2010, two doses of any appropriate live  varicella 
vaccine at or after 12 months of age.
  (ii) Laboratory evidence of varicella immunity.
  (iii) A parent, guardian, person in loco parentis, or  physician  statement 
that the child has had varicella disease.
  (j) Beginning January 1, 2010, individual 11 years of  age  or  older  have 
received 1 dose of meningococcal conjugate vaccine upon entry into 6th grade. 
  (10) To satisfy the requirements in subrules (2) to (9) of this rule,  each 
vaccine shall have been administered in accordance  with  the  manufacturer's 
instructions. A 4-day grace leniency is  allowed  on  the  minimum  ages  and 
intervals for each vaccine.
  (11) If the requirements  for  immunization  cannot  be  completed  due  to 
medical reasons within 4 months of admittance, a child shall be permitted  to 
remain enrolled in a school or group program for a reasonable length of  time 
that is consistent with good medical practice.  A  statement  requesting  the 
enrollment of the child beyond the  exclusion  date  shall  be  signed  by  a 
physician or local health officer and shall certify that the child is in  the 
process  of  complying  with  all  immunization  requirements.  This  medical 
exemption  shall  be  filed  with  the  child's  school  or   group   program 
immunization records until it can be replaced with proof  that  the  vaccines 
for which an exemption was granted have been received. Upon completion of the 
required immunizations, a parent shall present the school  or  group  program 
with a certificate of immunization.
  (12) When presented with a medical exemption, religious or other exemption, 
the administrator of a child's school or operator of a child's group  program 
shall recognize the exemption status of the child.
  (13) A standard record of the  immunizations  required  by  this  rule  and 
exemptions shall be maintained by every  school  for  every  pupil  on  forms 
supplied by the department. When a  pupil  transfers  to  another  school  or 
school district, the record of immunization, or a true copy  of  the  record, 
shall be sent to the new school by the original school.
  (14) All of the following information shall  be  provided  to  fulfill  the 
requirements of section 9209(1) of the code:
  (a) A listing, by child, of the number of doses of each vaccine received.
  (b) The date of each immunization for each vaccine received in the series.
  (c) A listing, by type of exemption  granted,  of  the  children  who  have 
exemptions.
  (15) Not less than 95% of  entering  students  in  a  school  --  less  the 
entering students who have medical, religious, or other exemptions  --  shall 
have received vaccinations as outlined in subrules (8) and (9) of this rule.
  (16) A principal of a school or operator of  a  group  program  shall  make 
immunization records available for inspection by  authorized  representatives 
of the department or the  appropriate  local  health  department.  The  local 
health officer shall also make public clinic immunization  records  available 
to local schools or  group  programs  for  the  purpose  of  verifying  pupil 
immunizations.
  (17) A  requirement  for  immunization  with  a  specific  vaccine  may  be 
suspended temporarily at the request of the department director  for  reasons 
of inadequate vaccine supply.

  History:  1993 AACS; 1994 AACS; 1995 AACS; 1999 AACS; 2006 AACS; 2009 MR 19,
Oct. 2, 2009.


R  325.177   Provision of care by local health   departments   for   venereal 
disease; maintenance of test records after provision of pregnancy  care.
  Rule 7. (1) As used in this  rule,  "venereal  disease   case"   means   an 
individual who is diagnosed or treated for venereal disease on  the  basis of 
symptoms, signs, or laboratory tests.
  (2)  A  local  health  department  shall  provide   for   the    diagnosis, 
treatment, and case intervention of  venereal  disease   cases   within   its 
jurisdiction. Through  direct  service  or  referrals,   the   local   health 
department shall ensure that professional  care  and   case   follow-up   are 
provided without regard to race, age, sex, national origin, or income. All of 
the following services shall be provided for the diagnosis,   treatment,  and 
case intervention of venereal disease cases:
  (a) Relevant medical history and physical examination.
  (b) Diagnostic tests.
  (c) Treatment utilizing guidelines provided by the department.
  (d) Follow-up examination and testing.
  (e) Patient education.
  (f) Identification and notification of sexual contacts.
  (g)  The  examination  and  treatment  of  sexual   contacts   and    other 
designated high-risk individuals exposed to venereal disease cases.
  (h) The maintenance of records for not less than 5 years  after  the   last 
reactive test in syphilis cases and for not less than 1  calendar  year,  not 
including the present year, for other venereal diseases.
  (3) Records of test results that are obtained under section  5123  of   the 
code shall be maintained for not less than  3  calendar   years   after   the 
termination of pregnancy.

  History:  1993 AACS.


R 325.178   State aid for tuberculosis patients.
  Rule 8. (1) As used in this rule:
  (a) "Form" means a form furnished by the department.
  (b) "Hospital" means a hospital or nursing home that  is  approved  by  the 
department for receipt of state aid for tuberculosis patients.
  (c) "Tuberculosis patient" means a patient who has  laboratory-confirmed or 
clinically or radiographically suspect tuberculosis.
  (2) An official application form that is signed  by  the   patient  or  the 
parent or guardian or person in loco parentis, a physician,  and  the  health 
officer of the jurisdiction in which the patient is  found  or  is  domiciled 
shall be on  file  in  the  hospital  at  the  time  of  admission  for  each 
tuberculosis patient in  the  hospital,  except  for  any  of  the  following 
patients:
  (a) A private paying tuberculosis patient.
  (b) A tuberculosis patient who is committed to the hospital by the  probate 
court in accordance with the provisions of  sections 5203, 5205, and 5207  of 
the code.
  (c) A tuberculosis patient who is  transferred  from  another  hospital  in 
accordance with the provisions of subrule (4) of this rule.
  (d) A patient who is admitted for a non-tuberculosis condition and  who  is 
later suspected of having, or proven to  have, tuberculosis.  With respect to 
this subdivision, the  health  officer  of  the  jurisdiction  in  which  the 
tuberculosis patient is domiciled shall be immediately notified and liability 
for care shall not be incurred until the health  officer approves  such  care 
by signing a form.  The health  officer shall not be  required  to  sign  the 
form retroactively, thereby  obligating  public  funds  for  the  care  of  a 
tuberculosis patient who was not properly reported in a timely manner.
  (3) A hospital admission report form  shall  be  sent  to  the   department 
within 4 days after the admission of  a  tuberculosis  patient,  including  a 
private tuberculosis patient.  A resident  of  the  state  at  large  may  be 
admitted  to  an  approved  tuberculosis  hospital  in  accordance  with  the 
procedure set forth in  this  rule.   An  application  form  for  care  as  a 
state-at-large tuberculosis patient shall be completed and  submitted to  the 
department as soon as possible after admission.
  (4) The administrator of a hospital shall send a hospital discharge  report 
form to the department within 4 days after the transfer, discharge, or  death 
of a tuberculosis patient, including a private  tuberculosis  patient.   When 
the day of discharge can be anticipated, the administrator  of  the  hospital 
shall notify the local health  officer  of  the  jurisdiction  in  which  the 
tuberculosis patient plans to live of the probable date of discharge.  When a 
tuberculosis  patient  leaves  the  hospital  against  medical  advice,   the 
administrator shall, within 24 hours thereafter, notify both the local health 
officer of the county responsible for  the  tuberculosis  patient's  hospital 
care  and  the  local  health  officer  of  the  jurisdiction  to  which  the 
tuberculosis patient is believed to have gone.  State  and  county  financial 
responsibility for a tuberculosis patient who is admitted as  a  tuberculosis 
case or suspect case shall terminate as of the date the patient is  found  to 
not have tuberculosis.
  (5) Voucher forms shall be sent to the department for reporting  individual 
county charge tuberculosis patients who are treated in  accordance  with  the 
law.  The report shall contain all of the following information:
  (a) The name of each patient.
  (b) The county to which the voucher is payable.
  (c) The beginning and ending dates of the period of  time  covered  by  the 
report.
  (d) The amount of subsidy calculated at  the  rate  established  by  law.   
Subsidy will be paid from the day of admission or clinical suspicion, but not 
for the day of  discharge.   The  original  copy  of  the  voucher  shall  be 
forwarded to the county clerk or clerk of the board of auditors of the county 
that is to receive the subsidy payments.  The clerk, after  affixing  his  or 
her signature, shall send the original to the department.
  (6) When a decision of the state  family  independence  agency  as  to  the 
county of domicile has been rendered in accordance  with  the  provisions  of 
section 5303 of the code and the county determined to be responsible fails to 
adhere thereto, payments shall not be made to that county  for  the  care  of 
tuberculosis patients in any hospital until payment for the cases in question 
has been made.
  (7)  Voucher  forms  for  state-at-large  tuberculosis  patients  shall  be 
processed the same as county vouchers, except  that  instead  of  the  county 
treasurer, the payee will be the hospital where care  is  received.   Payment 
will be made at the medicaid interim cost charge  percentage  rate  for  each 
hospital that was in effect at the  time  of  admission.   Payments  will  be 
cost-settled in conjunction with the  department’s  medicaid  program.   Each 
hospital shall provide a copy of an audit report covering  the  time  periods 
for which reimbursement was made.  In addition, hospitals  shall  notify  the 
department of any audit adjustments related to  tuberculosis  reimbursements. 
Payment will not be made for hospitalization until the application  form  has 
been received and approved by the department. If an individual is  readmitted 
to a hospital, a second application form shall be sent to the department  for 
each  subsequent  admission  of  a  nonveteran  state-at-large   tuberculosis 
patient. It is not necessary to submit  a  second  form  for  a  tuberculosis 
patient whose care has been  previously  authorized  as  care  for  a  state- 
at-large tuberculosis patient  on  the  basis  of  his  or  her  having  been 
honorably discharged from the military  service  of  the  United  States.   A 
voucher shall bear the certification of the director of patient accounts that 
any  future  collections  from  another  source  shall  be  credited  to  the 
department.  If subsequent investigation shows that  a  tuberculosis  patient 
authorized and paid for as a state-at-large tuberculosis patient was a  legal 
responsibility of a county in  this  state,  the  proper  adjustment  to  the 
state-at-large account shall be made immediately by  the  hospital.   Further 
state-at-large payments will not be made to the hospital until the adjustment 
has been made.
  (8)  Payments  for  outpatient  services  for  state-at-large  tuberculosis 
patients will not be made until a properly completed case report form and  an 
approved state-at-large application form are on file with the department.
To secure payment for services and drugs, the payee shall submit a form, on a 
quarterly basis, listing the names of tuberculosis patients served, the  type 
of service, and the cost.  Costs shall be based on the  latest  fee  schedule 
provided by the department.
  (9) Failure to comply with any requirement of these rules or of the code is 
grounds for withholding state payments to the county or the hospital  failing 
to comply.

  History:  1993 AACS; 1999 AACS.


R325.179 Submission of tuberculosis laboratory specimens and test results.
  Rule 9.  (1) For the purpose of this rule, "preliminary  result"  includes, 
but is not limited to, results from nucleic acid amplification tests, nucleic 
acid or other genetic probe tests, chromatographic or other such  tests  that 
may be performed prior to final culture identification of a clinical specimen.
 (2) A laboratory that initially receives any clinical specimen which  yields 
Mycobacterium tuberculosis complex, or yields a preliminary result indicative 
of Mycobacterium tuberculosis complex, is responsible for ensuring  that  the 
following are submitted:
  (a) All preliminary results and any interpretation of those results to  the 
appropriate local health department.
  (b) The first Mycobacterium tuberculosis  complex  isolate,  or  subculture 
thereof, from the patient being tested for tuberculosis, to the department.
  (c) Any Mycobacterium tuberculosis complex isolate, or subculture  thereof, 
from a follow-up specimen, collected 90 days or more after the collection  of 
the first Mycobacterium tuberculosis complex positive specimen. 

  History:  1993 AACS; 2009 MR 19, Eff. Oct. 2, 2009.


R 325.179a.  Submission of other designated conditions specimens.
Rule 9a.  (1) A laboratory shall submit to the department the  first  isolate 
or subculture thereof, or specimen where appropriate, from the patient  being 
tested, any of the following:
  (a) Specimens suspected to contain and  suspect  isolates  of  any  of  the 
following:
  (i) Bacillus anthracis.
  (ii) Brucella species.
  (iii) Burkholderia pseudomallei.
  (iv) Burkholderia mallei.
  (v) Clostridridium botulinum.
  (vi) Coxiella burnetii.
  (vii) Francisella tularensis.
  (viii) Orthopox viruses (including smallpox and monkey pox).
  (ix) Yersinia pestis.
  (b) Specimens that contain and isolates any of the following:
  (i) Corynebacterium diphtheriae.
  (ii) Escherichia coli 0157:H7 and all other shiga toxin positive serotypes.
  (iii) Haemophilus influenzae (only if isolate  collected  from  a  normally 
sterile site or if patient is less than 15 years of age).
  (iv) Listeria monocytogenes.
  (v) Neisseria meningtidis  (only  if  isolate  collected  from  a  normally 
sterile site)
  (vi) Novel influenza.
  (vii) Salmonella species including Typhi.
  (viii) Severe Acute Respiratory Syndrome (SARS) coronavirus.
  (ix) Shigella species.
  (x) Staphylococcus aureus (only vancomycin intermediate and resistant).
  (xi) Vibrio cholera.
  (xii) Vibrio paphemolyticus.
  (xii) Vibrio vulnificus.

  History: 2009 MR 19, Eff. Oct. 2, 2009.


R 325.179b.  Submission of HIV laboratory specimens.
  Rule 9b.  (1) A laboratory that receives any clinical specimen which yields 
results indicative of infection with human immunodeficiency  virus  (HIV)  is 
responsible for ensuring that specimens are submitted to the department or to 
a laboratory designated by the department.   These specimens include  any  of 
the following:
  (a)  Remnant  specimens  from   all   positive   western   blot   (WB)   or 
immunofluorescent antibody (IFA) confirmed tests.
  (b) Remnant specimens from  viral  detection  or  quantitation  tests  upon 
request by the department within 3 months from specimen collection  date,  if 
available.
  (c) Remnant specimens from multiple reactive rapid enzyme immunoassay (EIA) 
tests that together constitute an HIV diagnosis.

  History: 2009 MR 19, Eff. Oct. 2, 2009.


R 325.180 Procedures for control of rabies; disposition of rabid animals.
  Rule 10. (1) For the purposes of this rule, animals  that  are  subject  to 
rabies testing are any nonhuman mammals, except  for  rabbits  or  hares  and 
rodents other than woodchucks.
  (2) As used in this rule, "owner"  means  a  person  who  has  a  right  of 
property ownership of an animal, who keeps or  harbors  an  animal,  who  has 
custody of an animal, or who permits an animal to  remain  on  or  about  any 
premises occupied by the person.
  (3) Any laboratory in this state that conducts examinations of animals  for 
rabies shall report all of the following data to the department within 7 days 
after examination:
  (a) Species of animal.
  (b) Name and address of the owner of the animal.
  (c) Name and address of the person who submits the specimen.
  (d) Name and address of the individuals who have been exposed to the animal 
or the name and address of the owner of the pet that has been exposed to  the 
animal.
  (e) Date and results of the examination.
  (4) A physician who performs a postmortem on the body of an individual  who 
died of rabies or who was suspected of  dying  of  rabies  shall  immediately 
submit nonpreserved portions of the hippocampus major and spinal cord to  the 
department for rabies examination.  A history of the case shall accompany the 
specimens.
  (5) An animal that  has  bitten  an  individual  or  otherwise  potentially 
exposed an individual to rabies shall be handled pursuant to  the  provisions 
of the publication entitled "Compendium of  Animal   Rabies   Control,  2008" 
issued by the national  association  of  state  public  health  veterinarians 
(NASPHV).  The provisions of the publication entitled "Compendium  of  Animal 
Rabies Control, 2008" are adopted by reference in these rules.  Copies of 
this publication may be obtained from the State Public  Health  Veterinarian, 
Communicable Disease Epidemiology Division, Bureau of Epidemiology,  Michigan 
Department of Community Health, 201  Townsend  Street,  5th  Floor,  Lansing, 
Michigan 48909 at no cost as of the time of adoption of these rules.
  (6) Any person who  has  knowledge  of  an  animal  bite  where  rabies  is 
suspected shall, within 24 hours of the biting incident, report the  bite  to 
the appropriate local health department and to the  local  health  department 
where the bite occurred.  The report  shall  include  all  of  the  following 
information:
  (a) Animal species inflicting the bite.
  (b) Animal owner's name, address, and telephone number.
  (c) Vaccination status of the animal.
  (d) Date and location of the biting incident.
  (e) Name, address, and telephone number of the individual bitten.
  (f) Site of the bite on the body.
  (g) Name of the reporter of the bite.
  (7) Upon request by the department or local health department,  any  person 
who has information  regarding  the  identity,  whereabouts,  or  vaccination 
status of  an  animal  that  that  has  bitten  an  individual  or  otherwise 
potentially exposed an individual to rabies, or information about  the  owner 
of the animal, shall provide information about the  animal  or  the  animal's 
owner to the department or local health department. 

  History:  1993 AACS; 1999 AACS; 2009 MR 19, Eff. Oct. 2, 2009.


R  325.181   Confidentiality of reports, records, and  data   pertaining   to 
testing, diagnosis, care, treatment, reporting and research.
  Rule 11. (1) This rule applies to the designated  conditions,  except   for 
human immunodeficiency virus (HIV) infection  and  acquired  immunodeficiency 
syndrome (AIDS).
  (2)  Medical  and  epidemiological  information   which    identifies    an 
individual and which is gathered in connection with   an   investigation   is 
confidential and is not open to public inspection  without  the  individual's 
consent or  the  consent  of  the  individual's   guardian,   unless   public 
inspection is necessary to protect the public health as   determined   by   a 
local health officer or the director.
  (3) Medical and  epidemiological  information  that  is   released   to   a 
legislative body shall not contain information that  identifies  a   specific 
individual.

  History:  1993 AACS.


R  325.199   Rescissions.
  Rule 99. (1) R 325.763 to R 325.773, R 325.775,  R 325.781  to  325.784,  R 
325.786, R 325.801 to R 325.818, R 325.820 to R 325.898,  and  R  325.901  of 
the Michigan Administrative Code, appearing on pages 1763  to  1775   of  the 
1979 Michigan Administrative Code, are rescinded.
  (2) R 325.3401  to  R 325.3409  of  the   Michigan   Administrative   Code, 
appearing on pages 284 to 286 of the 1981 Annual Supplement   to   the   1979 
Michigan Administrative Code, are rescinded.
  (3) R 325.3501  to  R 325.3513  of  the   Michigan   Administrative   Code, 
appearing on pages 2012 to 2015 of the 1979  Michigan   Administrative   Code 
and page 286 of the 1981 Annual Supplement to the Code, are rescinded.
  (4) R 325.9001  to  R 325.9011  of  the   Michigan   Administrative   Code, 
appearing on pages 290 to 292 of the 1981 Annual Supplement   to   the   1979 
Michigan Administrative Code and pages 195  to  197  of   the   1984   Annual 
Supplement to the Code, are rescinded.

  History:  1993 AACS.