Chapter 3

10 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 1 CHAPTER 3 PUBLIC HEALTH AND SOCIAL SERVICES SOURCE: The former Chapter 3 was repealed by P.L. 22-130:1 (May 31, 1994) and a new Chapter 3 was added by P.L . 22-130:2 (May 31, 1994) establishing a division of Public He alth within the Department of Public Health and Social Services. Article 1. Division of Public Health. Article 2. Vital Statistics. Article 3. Disease Control. Article 4. Maternal and Child Health and Children w ith Special Health Needs. Article 5. Maternal and Child Health Services. Article 6. Services for Children with Special Healt h Needs. Article 7. U.S. Public Health Services. Article 8. Community Health Centers Program. Article 9. Guam Early Learning Council. Article 10. Guam Council on Child Death Review and Prevention (CCDRP). ARTICLE 1 DIVISION OF PUBLIC HEALTH § 3101. Establishment of Division. § 3102. Personnel. § 3103. General Duties. § 3104. Chief Administrative Officer. § 3105. Federal Grants. § 3106. Rule-Making. § 3107. Authority to Set Fees. § 3107.1. Bureau of Health and Nursing Services; Fa mily Planning Program Fees. § 3108. Chief Pharmacists for the Community Health Centers.

Grants. § 3106. Rule-Making. § 3107. Authority to Set Fees. § 3107.1. Bureau of Health and Nursing Services; Fa mily Planning Program Fees. § 3108. Chief Pharmacists for the Community Health Centers. § 3109. Medical Director; Establishment. § 3101. Establishment of Division. There is hereby established a Division of Public He alth (the Division) in the Department of Public Health and So cial Services COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 2 to be administered by the Director of Public Health and Social Services (the Director). The Division through organ ized community effort and applied scientific and technic al knowledge is responsible for working toward the prevention an d control of disease and for promoting health throughout Guam. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3102. Personnel. The Director is authorized to appoint such personne l to act on behalf of the Director and fix their duties for the purposes of carrying out the responsibilities so delegated to t he Division. § 3103. General Duties.

uthorized to appoint such personne l to act on behalf of the Director and fix their duties for the purposes of carrying out the responsibilities so delegated to t he Division. § 3103. General Duties. The general duties of the Division are to: (a) Formulate plans and policies to address the hea lth needs of the community. (b) Implement health programs and services to meet identified health needs of the community. (c) Conduct research and studies to identify commun ity health problems. (d) Provide health services to individuals who are medically and financially in need. (e) Administer grants-in-aid for health programs an d services. (f) Conduct disease surveillance and monitor activi ties to prevent and/or identify health problems. (g) Conduct health promotion and education programs . (h) Serve as the 'State Public Health Agency' for Guam. (i) Establish standards and regulations necessary t o ensure quality health care and the prevention and c ontrol of diseases. § 3104. Chief Administrative Officer. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 3 The Chief Public Health Officer shall be the Chief Administrative Officer of the Division. § 3105.

inistrative Officer. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 3 The Chief Public Health Officer shall be the Chief Administrative Officer of the Division. § 3105. Federal Grants. The Division shall comply with all federal requirem ents and procedures necessary for administration of grants-i n-aid and cooperative agreements. § 3106. Rule-Making. The Director shall, in accordance with the Administ rative Adjudication Law, adopt, amend and repeal rules and regulations necessary to fulfill the duties of the Division. § 3107. Authority to Set Fees. (a) The Director is authorized to establish fees fo r health services in accordance with the Administrative Adju dication Law and as may be required to qualify for grants-in -aid. (b) Fees established by the Department of Public He alth and Social Services shall not be a deterrent to receivi ng health care and shall be based on ability to pay. § 3107.1. Bureau of Health and Nursing Services; F amily Planning Program Fees. (a) The Department of Public Health and Social Serv ices (DPHSS) Bureau of Family Health and Nursing Service s (BFHNS) shall promulgate the required fee schedule for health services

ing Program Fees. (a) The Department of Public Health and Social Serv ices (DPHSS) Bureau of Family Health and Nursing Service s (BFHNS) shall promulgate the required fee schedule for health services provided by the Family Planning (FP) Progr am, in accordance with the Administrative Adjudication Law , and as may be required for continuing qualification and co mpliance for grants-in-aid federally funded by Title X of the Pu blic Health Service Act, 42 U.S.C. § 300, et seq., and other fu nding sources. The fee schedule shall be based on the current Cent ers for Medicare and Medicaid Services fees, and shall be a mended as necessary to maintain continuing compliance. (b) Interim Fee Schedule; Adoption. Notwithstandin g any other provision of law, rule, or regulation to the contrary, the promulgated fee schedule of the Regional Community Health Centers of the Department of Public Health and Soci al Services shall be applicable and shall be assessed for healt h care services COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 4 provided to clients of the FP Program until such ti me as a fee schedule has been duly promulgated specifically for the services

02110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 4 provided to clients of the FP Program until such ti me as a fee schedule has been duly promulgated specifically for the services provided by the FP Program. In the event there is any difference between the Regional Community Health Centers fee s chedule and the current fee schedule of the Centers for Med icare and Medicaid Services, then the fee schedule of the Cen ters for Medicare and Medicaid Services shall be utilized. SOURCE: Added by P.L. 33-188:2 (Sept. 26, 2016). § 3108. Chief Pharmacists for the Community Health Centers. The Department of Public Health and Social Services is authorized to have a Chief Pharmacist for the North ern and Southern Community Health Centers and a Chief Pharm acist for the Central Public Health Facility. SOURCE: Added by P.L. 28-068:II:III:29:b (Sept. 30, 2005). § 3109. Medical Director; Establishment. The Director shall appoint one of the classified ph ysician specialists as Medical Director, to perform collate ral administrative and clinical medical duties for the Department. The Medical Director should be a physician speciali st preferably in a field of practice or multiple

al Director, to perform collate ral administrative and clinical medical duties for the Department. The Medical Director should be a physician speciali st preferably in a field of practice or multiple specialties requ ired by the Department, and an experienced public healthcare se rvices administrator. The Medical Director shall serve at the pleasure of the Director and shall, upon the termination of app ointment as Medical Director, remain in the classified position which said person held prior to appointment as Medical Directo r. Said person shall retain all accrued benefits and leave, and shall be entitled to advancement in pay range and step to wh ich that person is entitled in the position of physician spe cialist. (a) Duties. The duties of the Medical Director may include, but are not necessarily limited to, the ov erall development, management and coordination of administrative policy and support for clinical medi cal services, public healthcare coverage, clinical and nonclinical communicable disease control, and other clinical or nonclinical medical services provided b y the respective Bureaus and programs of the Department. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

inical communicable disease control, and other clinical or nonclinical medical services provided b y the respective Bureaus and programs of the Department. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 5 (b) Compensation. The Director of the Department of Public Health and Social Services is authorized, pu rsuant to negotiations, to add an additional incentive bonus to the base salary of an existing physician specialist who is appointed to directly perform administrative and cl inical collateral duty as the Medical Director of the Depa rtment, up to a maximum amount not to exceed Fifty Thousand Dollars ($50,000), subject to the availability of f unds. SOURCE: Added by P.L. 32-185:2 (Oct. 13, 2014). ---------- ARTICLE 2 VITAL STATISTICS § 3201. Establishment of Office. § 3201.1. Guam Cancer Registry. § 3202. Supervision. § 3203. Personnel. § 3204. Mayors to aid. § 3205. Report. § 3206. Regulations. § 3207. Definitions. § 3208. Duties of the Registrar. § 3209. Forms of Certificates. § 3210. Birth Registration. § 3211. Foundling Registration; Infants of Unknown Parentage. § 3212. Delayed Registration. § 3213.

itions. § 3208. Duties of the Registrar. § 3209. Forms of Certificates. § 3210. Birth Registration. § 3211. Foundling Registration; Infants of Unknown Parentage. § 3212. Delayed Registration. § 3213. Judicial Procedure to Establish Facts of Bi rth. § 3214. Court Reports of Adoption. § 3215. New Certification of Birth Following Adopti on, Legitimation and Paternity Determination. § 3215.1. Certificate of Foreign Birth. § 3216. Death Registration. § 3217. Fetal Death Registration. § 3218. Partial-Birth Abortion and Abortion Report. § 3218.1. The Women's Reproductive Health Informati on Act of 2012. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 6 § 3219. Extension of Time. § 3220. Marriage Registration. § 3221. Court Reports of Divorce and Annulment of Marriage. § 3222. Correction and Amendment of Vital Records. § 3223. Reproduction of Records. § 3224. Same: Microfilm. § 3225. Disclosure of Records. § 3226. Copies of Data from Vital Records. § 3227. Fees for Copies. § 3227.1. Office of Vital Statistics Revolving Fund . § 3228. Duty to Furnish Information Relative to Vit al Events. § 3229. Penalties. § 3230. Burial-Transit Permits. § 3231. Disposition.

or Copies. § 3227.1. Office of Vital Statistics Revolving Fund . § 3228. Duty to Furnish Information Relative to Vit al Events. § 3229. Penalties. § 3230. Burial-Transit Permits. § 3231. Disposition. § 3201. Establishment of Office. There is hereby established within the Department o f Public Health and Social Services an Office of Vital Stati stics which shall install, maintain and operate the system of v ital statistics for Guam. § 3201.1. Guam Cancer Registry. (a) There is hereby established within the Departme nt of Public Health and Social Services ('DPHSS') a Guam Cancer Registry, which shall operate under the supervision of the Division of Public Health, Office of Epidemiology a nd Research, to collect information on all cases of cancer occur ring within Guam, to analyze and compare such data in appropria te ways and to annually prepare and distribute a report on their findings. The qualifications of the Guam Epidemiologist shall be: (1) a Guam physician’s license; or (2) a MD degree from an American Medical Association approved medical school with a minimum of two (2) years of experience in the field of epidemi ology; or (3) a Guam veterinarian’s license with a minimum of

degree from an American Medical Association approved medical school with a minimum of two (2) years of experience in the field of epidemi ology; or (3) a Guam veterinarian’s license with a minimum of two (2) years of experience in the field of epidemi ology; or COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 7 (4) a MPH (epidemiology major) or a graduate degre e in epidemiology or biostatistics, both from a U.S. accredited college or university and with one (1) to two (2) y ears of experience in the field of epidemiology; or (5) a MSPH degree with a focus in epidemiology or analysis and assessment from a U.S. accredited coll ege or university; or (6) a PhD degree in epidemiology from a U.S. accredited college or university; or (7) a graduate degree in epidemiology from a non-U .S. accredited institution, and with at least four (4) years of experience designing, overseeing, implementing, and conducting epidemiological studies related to publi c health; or (8) a non-epidemiology professional graduate degre e, such as a RN, MD/DO, DDS/DMD, DVM, or PhD, from a U.S.

seeing, implementing, and conducting epidemiological studies related to publi c health; or (8) a non-epidemiology professional graduate degre e, such as a RN, MD/DO, DDS/DMD, DVM, or PhD, from a U.S. accredited college or university, with at leas t four (4) years of experience performing epidemiology work un der the guidance of an epidemiologist. (b) Injunctions. In case of noncompliance with the provisions of this Act or with the rules and regula tions of the program, the Director shall notify the respective l icensing Board and may also notify the Attorney General of such noncompliance. The licensing Board shall notify the healthcare professional and may institute suspension of licens e for repeated noncompliance reported by the Director of DPHSS. Th e Attorney General, upon receipt of such notification , may institute an appropriate action or proceeding at law or in eq uity to restrain, correct such noncompliance. For all cases of noncompliance referred to the Attorney General by t he Director of DPHSS, quarterly reports shall be prepared by th e Attorney General and submitted to the Director summarizing t he status of actions taken to correct and comply. SOURCE: Added by P.L.

he Director of DPHSS, quarterly reports shall be prepared by th e Attorney General and submitted to the Director summarizing t he status of actions taken to correct and comply. SOURCE: Added by P.L. 24-198:2 (May 6, 1998). Subsection ( a) amended by P.L. 33-082:1 (Nov. 9, 2015). 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 8 § 3202. Supervision. The Director of Public Health and Social Services ( the Director) has general supervision of vital statisti cs and is responsible for the implementation of the provision s of this article. § 3203. Personnel. The Director shall appoint a Guam Registrar of Vita l Statistics, and such other officers and personnel a s may be required to carry out the provisions of this articl e. Such employees shall be members of the classified servic es of the government of Guam. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3204. Mayors to Aid. Mayors, under the direction of the President of the Mayors’ Council, shall assist in the implementation

'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3204. Mayors to Aid. Mayors, under the direction of the President of the Mayors’ Council, shall assist in the implementation of this article and in doing so shall be governed by this article and by r egulation issued by the Director under the provisions of this Chapter. § 3205. Report. The Director shall make an annual report to the Gov ernor concerning vital statistics and the enforcement of this article, which report shall contain a summary on a municipal district basis of such statistics. § 3206. Regulations. The Director is authorized to adopt, amend and repe al rules and regulations as may be necessary in his judgment , for the purpose of carrying out the provisions of this arti cle. Such rules and regulations, and any other rules and regulation s authorized or required to be issued under this article, shall be adopted and promulgated in accordance with the Administrative A djudication Law. § 3207. Definitions. Unless the context clearly requires otherwise, the following definitions shall apply to this article: COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

dministrative A djudication Law. § 3207. Definitions. Unless the context clearly requires otherwise, the following definitions shall apply to this article: COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 9 (a) Vital Statistics means records of birth, death, fetal death, adoption, marriage, divorce and data related thereto. (b) System of vital statistics includes the registr ation, collection, preservation, amendment and certificati on of vital statistics records and activities related the reto, including the tabulation, analysis and publication of statistical data derived from such records. (c) Filing means the presentation of a certificate, report or other record provided for in this article of a b irth, death, fetal death, adoption, (d) Registration means the acceptance by the Office of Vital Statistics and the incorporation in its offic ial records of certificates, reports or other records provided for in this article, of births, deaths, fetal deaths, adoptions , llegitimation marriages or divorces. (e) Live birth means the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnan cy,

doptions , llegitimation marriages or divorces. (e) Live birth means the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnan cy, which, after such expulsion or extraction, breathes or shows any other evidence of life such as beating of umbil ical cord [heart] or definite movement of the voluntary muscl es, whether or not the umbilical cord has been cut or t he placenta is attached. (f) Fetal death means death prior to the complete expulsion or extraction from its mother of a produc t of human conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the h eart, pulsation of the umbilical cord or definite movemen t of voluntary muscles. (g) Dead body means a lifeless human body or parts of such body or bones thereof from the state of which it reasonably may be concluded that death recently occ urred. (h) Marriage means the legal union between two persons without regard to gender. The legality of the union COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

may be concluded that death recently occ urred. (h) Marriage means the legal union between two persons without regard to gender. The legality of the union COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 10 may be established by civil or religious regulation s, as recognized by the laws of Guam. (i) Divorce or annulment means the final legal dissolution of a marriage, void or otherwise, that is, the separation of spouses by a judicial decree which co nfers on the parties the right to remarriage, according to t he laws of Guam. (j) Physician means a person authorized or licensed to practice the healing art, pursuant to the laws of G uam. (k) Attendant at birth means the physician, midwife , nurse or other person present and assisting in the delivery of a newborn. (l) Institution means any establishment, public or private, which provides in-patient medical, surgica l or diagnostic care or treatment or nursing, custodial or domiciliary care to two (2) or more unrelated indiv iduals, or to which persons are committed by law. (m) Delayed registration of birth means the registr ation of a person's non-recorded birth after the sixth (6 th) year following

more unrelated indiv iduals, or to which persons are committed by law. (m) Delayed registration of birth means the registr ation of a person's non-recorded birth after the sixth (6 th) year following birth. (n) Abortion means the purposeful termination of a human pregnancy after implantation of a fertilized ovum, by any person, including the pregnant woman herself, w ith the intention other than to necessarily produce a live birth or to remove a dead unborn fetus. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Subsectio ns (h) and (i) amended by P.L. 33-065:3 (Aug. 25, 2015). 2013 NOTE: In maintaining the general codification scheme of the GCA the Compiler changed the hierarchy of subsections b eginning with 'Numbers' to 'Lowercase Letters.' § 3208. Duties of the Registrar. (a) The Guam Registrar of Vital Statistics shall: (1) Administer and enforce this article and the rul es and regulations issued hereunder, and issue instruc tions for COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 11 the efficient administration of the Guam system of vital statistics.

ons issued hereunder, and issue instruc tions for COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 11 the efficient administration of the Guam system of vital statistics. (2) Direct and supervise the Guam-wide system of vi tal statistics and the Office of Vital Statistics and b e custodian of its records. (3) Prescribe, with the approval of the Director, a nd distribute such forms as are required by this artic le, and the rules and regulations issued hereunder. (4) Prepare and publish annual reports of vital sta tistics of Guam, and such other reports as may be required by the Director. (5) Prepare, provide, and distribute forms to physicians as required by §§ 3218 and 3218.1 of thi s Article. (6) Ensure the completeness of all forms filed with the Guam Registrar of Vital Statistics pursuant to §§ 3218 and 3218.1 of this Article. (7) Reject incomplete forms filed with the Guam Registrar of Vital Statistics pursuant to §§ 3218 a nd 3218.1 of this Article. (8) Give prompt notice to the filer of the rejectio n of an incomplete form filed with the Guam Registrar of Vital Statistics pursuant to §§ 3218 and 3218.1 of this A rticle that failure to file a

e. (8) Give prompt notice to the filer of the rejectio n of an incomplete form filed with the Guam Registrar of Vital Statistics pursuant to §§ 3218 and 3218.1 of this A rticle that failure to file a completed form within seven (7) d ays will be deemed a failure to file. The notice shall advis e the filer of the penalties for failure to file. (9) Promptly report to the Attorney General of Guam any violations of §§ 3218 and 3218.1 of this Articl e. (10) Promptly report to the Guam Board of Medical Examiners any violations of §§ 3218 and 3218.1 of t his Article. (11) On the first day of each month publish a repor t of the activities of § 3218 of this Article. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 12 (b) The Guam Registrar of Vital Statistics may dele gate such functions and duties vested in him to other em ployees of the Office of Vital Statistics as he may deem neces sary and expedient. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Subitems ( a)(5) through (11) added by P.L. 33-218:2 (Dec. 15, 2016) . 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3209.

1994). Subitems ( a)(5) through (11) added by P.L. 33-218:2 (Dec. 15, 2016) . 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3209. Forms of Certificates. (a) In order to promote and maintain uniformity in the system of vital statistics, the forms of certificat es, reports and other returns required by this article, or by regul ations adopted hereunder, shall include as a minimum the items rec ommended by the Federal agency responsible for national vita l statistics, subject to approval of and modification by the Dire ctor. (b) Each certificate, report and form required to b e filed under this article shall have entered upon its face the date of registration, duly attested. § 3210. Birth Registration. (a) The birth of each and every child born in Guam shall be registered within ten (10) days after birth, as her einafter provided. (b) When a birth occurs in an institution, the pers on in charge of the institution shall obtain the personal data, prepare the certificate and file it with the Office of Vita l Statistics. The physician in attendance shall certify to the facts of birth and provide all medical information

obtain the personal data, prepare the certificate and file it with the Office of Vita l Statistics. The physician in attendance shall certify to the facts of birth and provide all medical information required by the cer tificate within five (5) days after the birth. (c) When a birth occurs outside an institution, the certificate shall be prepared and filed by one (1) of the follo wing in the indicated order of priority: (l) The physician in attendance at or immediately a fter the birth, or in the absence of such a person: (2) The midwife in attendance at or immediately aft er the birth, or in the absence of such a person: COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 13 (3) Any other person in attendance at or immediatel y after the birth, or in the absence of such a person : (4) The father, the mother, or in the absence of th e father or the inability of the mother, the Mayor of the municipal district where the birth occurred. (d) The certificate of live birth for any live birt h occurring on or after forty-five (45) days from the effective date of this section, as amended, shall contain those items nece ssary to establish the fact of the birth and

e birth for any live birt h occurring on or after forty-five (45) days from the effective date of this section, as amended, shall contain those items nece ssary to establish the fact of the birth and shall contain a t least the following information (if known): (1) Full name and sex of newborn child; (2) Date of birth, including month, day, hour and y ear; (3) Planned place of birth and actual place of birt h; (4) Full birth name of father, his social security number, birthplace, and date of birth of, if the ch ild is legitimate. If the child is illegitimate, for so lo ng as the child has not been legitimated, the father’s name o n the birth certificate shall be footnoted as follows: 'T he above named father is not the presumptive father of the c hild and no presumption exists as to any father-child relati onship.' (5) Full birth name of mother, her social security number, birthplace, and date of birth. (6) If multiple birth, the birth order of the newbo rn children. (7) Signature, and relationship to child, of a pare nt or other informant, and the date signed. (8) Name, title, mailing address of attending physi cian and surgeon or principal attendant, signature and certification

d relationship to child, of a pare nt or other informant, and the date signed. (8) Name, title, mailing address of attending physi cian and surgeon or principal attendant, signature and certification of live birth by attending physician and surgeon or principal attendant or certifier, the date signe d, and name and title of certifier of other than attending phys ician and surgeon or principal attendant. (9) Date accepted for registration and signature of registrar. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 14 (e) Informational notice advising mother of newborn of right to support and to have birth certificate mail ed to father: distribution. The Guam Registrar of Vital Statistic s, the Department of Law, and the Guam Memorial Hospital A uthority shall cooperatively develop an informational notice which advises the single mother of a newborn child of her right to child support. The notice shall also advise the mother of her right to have an original certificate of birth mailed to the father free of charge. (f) Legitimation of child. If both the father and m other acknowledge paternity as herein provided, the child shall thereupon be legitimized.

certificate of birth mailed to the father free of charge. (f) Legitimation of child. If both the father and m other acknowledge paternity as herein provided, the child shall thereupon be legitimized. Forms for such acknowledg ment shall be available to all hospitals on Guam and shall be made available at the time of birth to the parents to be filled ou t at the hospital at no cost to the parents. The child may be legitimize d by both parents if both sign the birth certificate or the r equest for issuance of birth certificate, or if both sign a jo int affidavit stating the names, birthdates, addresses, and socia l security numbers of the parents and a statement that they ar e the natural parents of the child. The hospital shall advise the parents as to the procedures for legitimation at the time the chi ld is born. (g) Affidavit of paternity. When a child is born ou t of wedlock, and is not legitimized, and before a birth certificate is issued, the hospital shall request an affidavit of paternity to be executed by the mother stating the name of the pers on who is the father of the child, his birthdate (if known), his social security number (if known), his address (if known), and

of paternity to be executed by the mother stating the name of the pers on who is the father of the child, his birthdate (if known), his social security number (if known), his address (if known), and the names and birthdates of his parents (if known). If the father of the child is unknown it shall be so stated on the affidavit. The affidavit shall be kept on file by the Director of Public Health an d Social Services in the Office of Vital Statistics, and sha ll be available only to the personnel of Public Health, the Attorne y General, the mother, the named father, attorneys therefor, or pu rsuant to court order, which court order may be obtained by any int erested person upon ex parte application to the Superior Co urt of Guam. If the mother notes the name of the father upon suc h affidavit, such affidavit shall not give rise to any presumpti on, except it shall require that the alleged father named therein be given notice of all proceedings involving the welfare of the child, and COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 15 may be used as a basis for requiring a blood test t o determine whether the alleged father is in fact the natural f ather

5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 15 may be used as a basis for requiring a blood test t o determine whether the alleged father is in fact the natural f ather of the child. (h) Each hospital shall provide notaries public fre e of charge at the hospital for the purpose of notarizin g affidavits relating to paternity, or the affidavits may be exe cuted in conformance with § 4308 of Title 6, Guam Code Annot ated, as an unsworn declaration under penalty of perjury and be witnessed by an employee of the hospital or an empl oyee of the Office of Vital Statistics not related to either pa rent. (i) It shall be the duty of the parent(s) in every case to provide all information required on the birth certi ficate and one or the other parent shall sign said certificate to attest to the accuracy of the personal data entered thereon. (j) Upon request, the Director shall accept, for th e purpose of recording births, certified copies of birth cert ificates of children born outside Guam to residents of Guam. (k) When a birth occurs on a moving conveyance and the child is first removed from the conveyance in Guam, the birth shall be registered in Guam and

f children born outside Guam to residents of Guam. (k) When a birth occurs on a moving conveyance and the child is first removed from the conveyance in Guam, the birth shall be registered in Guam and the location where the child is removed from the conveyance shall be considered as the place of birth. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3211. Foundling Registration; Infants of Unknown Parentage. (a) Whoever assumes custody of a living infant of u nknown parentage shall report on a form and in the manner prescribed by the Guam Registrar of Vital Statistics, within seve n (7) days, the following information: (l) The date and place of finding the child; (2) Sex, color or race, and approximate age of the child; (3) Name and address of the person or institution w ith whom the child has been placed for care; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 16 (4) Name given to the child by the custodian; and (5) Other data as may be required by the Guam Registrar of Vital Statistics. (b) The place where the child was found shall be en tered as the place of birth, and the date of

ild by the custodian; and (5) Other data as may be required by the Guam Registrar of Vital Statistics. (b) The place where the child was found shall be en tered as the place of birth, and the date of birth shall be determined by approximation. (c) A report registered under this Section shall co nstitute the certificate of birth for the infant. (d) If the child is identified and a certificate of birth is found or obtained, any report registered under this Secti on shall be sealed and filed and may be opened only by order of a court of competent jurisdiction. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3212. Delayed Registration. (a) Birth: (1) When a birth of a person either born in Guam, o r who is a non-U.S. citizen born in a foreign country and adopted by a resident of Guam has not been register ed, a certificate may be filed in accordance with the reg ulations of the Office of Vital Statistics. Such certificate shall be registered subject to such evidentiary requirements as the Office of Vital Statistics shall by regulation pres cribe to substantiate the alleged facts of birth.

Statistics. Such certificate shall be registered subject to such evidentiary requirements as the Office of Vital Statistics shall by regulation pres cribe to substantiate the alleged facts of birth. (2) certificates of birth registered seven (7) year s or more after the date of occurrence shall be marked 'Delayed' and show on their face the date of delaye d registration. (3) In all instances of delayed birth registration, the following facts concerning the person whose birth i s to be registered are required and must be established: Da te of birth; place of birth; and parentage. (4) When an applicant does not submit the minimum documentation required in the regulation for delaye d registration, or when the Guam Registrar of Vital S tatistics COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 17 finds reason to question the validity or adequacy o f the certificate or the documentary evidence, the Guam R egistrar shall not register the delayed certificate and shal l advise the applicant of the reasons for this action. (5) If the person whose birth is to be recorded be a child under the age of eighteen (18) years, the bir th certificate shall be signed by

shal l advise the applicant of the reasons for this action. (5) If the person whose birth is to be recorded be a child under the age of eighteen (18) years, the bir th certificate shall be signed by one of the following in the indicated order of priority: (A) The attendant at birth; (B) By either parent or adoptive parent; (C) By the child's guardian; or (D) By relatives in the next immediate degree of kindred; provided, that each person signing a certificate shall attest under oath to his belief i n the truth of the statements made concerning the age, birthplace, and parentage of the person whose birth is being recorded. (6) If the person whose birth is to be recorded be of legal age, the date of birth and place of birth sha ll be supported by at least two (2) documents of which on ly one (1) may be an affidavit; the facts of parentage mus t be supported by at least one (1) document which may be one (1) of the two (2) submitted as evidence of the oth er facts. (b) Death and marriage: (1) When a death or marriage in Guam has not been registered, a certificate may be filed in accordanc e with regulations of the Office of Vital Statistics.

f the oth er facts. (b) Death and marriage: (1) When a death or marriage in Guam has not been registered, a certificate may be filed in accordanc e with regulations of the Office of Vital Statistics. Such certificate shall be registered subject to such evidentiary req uirements as the Office shall by regulation prescribe to subs tantiate the alleged facts of death or marriage. (2) Certificates of death and marriage registered o ne (1) year or more after the date of occurrence shall be marked 'Delayed' and shall show on their face the d ate of the delayed registration. SOURCE : Added by P.L. 22-130:2 (May 31, 1994). Subsection (a) amended by P.L. 28-031:2 (April 22, 2005). COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 18 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3213. Judicial Procedure to Establish Facts of Bi rth. (a) If a delayed certificate of birth is rejected under the provisions of § 3212 of this Article, a petition ma y be filed with the Superior Court of Guam for an order establishin g a record of the date and place of birth and the parentage of th e person whose birth

ons of § 3212 of this Article, a petition ma y be filed with the Superior Court of Guam for an order establishin g a record of the date and place of birth and the parentage of th e person whose birth is to be registered. (b) Such petition shall allege: (l) That the person for whom delayed certificate of birth is sought was born in Guam, or is a non-U.S. citizen born in a foreign country and adopted by a resident of Guam; (2) That no record of birth can be found in the Off ice of Vital Statistics; (3) That diligent efforts by the petitioner have fa iled to obtain the evidence required in accordance with § 3 212 of this Article; (4) That the Guam Registrar of Vital Statistics has refused to register a delayed certificate of birth; and (5) Such other allegations as may be required. (c) The petition shall be accompanied by a statemen t of the registration official made in accordance with Subse ction (a)(4) of said § 3212 and all documentary evidence which was submitted to the registration official in support of such reg istration. The petition shall be sworn to by the petitioner. (d) The court shall fix a time and place for hearin g the petition and shall give the registration

tration official in support of such reg istration. The petition shall be sworn to by the petitioner. (d) The court shall fix a time and place for hearin g the petition and shall give the registration official w ho refused to register the petitioner’s delayed certificate of bi rth five (5) days’ notice of said hearing. Such official or his author ized representative, may appear and testify in the proce edings. (e) If the court from the evidence presented finds that the person for whom a delayed certificate of birth is s ought was born in Guam, or is a non-U.S. citizen born in a foreign country and adopted by a resident of Guam, it shall make findin gs as to place COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 19 and date of birth, parentage and such other finding s as the case may require, and shall issue an order on a form pre scribed and furnished by the Guam Registrar of Vital Statistics to establish a record of birth. This order shall include the birth data to be registered, a description of the evidence presented in the manner prescribed by said § 3212, and the date of the cour t’s action.

lish a record of birth. This order shall include the birth data to be registered, a description of the evidence presented in the manner prescribed by said § 3212, and the date of the cour t’s action. (f) The Clerk of the Superior Court shall forward e ach such order to the Guam Registrar of Vital Statistics not later than the tenth (l0th) day of the calendar month following th e month in which it was entered. Such order shall be registere d by the Guam Registrar of Vital Statistics and shall constitute the record of birth, from which copies may be issued in accordanc e with § 3226 of this Article. (g) Any person who objects to the accuracy of any o f the information on a certificate of birth may petition the Superior Court to correct the certificate, using the same pr ocedures as for obtaining a change of name. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Amended by P.L. 28-031:3 (April 22, 2005). 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3214. Court Reports of Adoption. (a) For each adoption decreed by a court of compete nt jurisdiction, the court shall require the preparati on of a certificate of adoption

pursuant to 1 GCA § 420. § 3214. Court Reports of Adoption. (a) For each adoption decreed by a court of compete nt jurisdiction, the court shall require the preparati on of a certificate of adoption on a form prescribed and furnished by t he Guam Registrar of Vital Statistics. The certificate shal l include such facts as are necessary to locate and identify the c ertificate of birth of the person adopted; provide information ne cessary to establish a new certificate of birth of the person adopted, and shall identify the order of adoption and be certifi ed by the clerk of court. For a person born in a foreign country wh o is not a citizen of the United States, and for whom a final order of adoption has been decreed by a court of competent j urisdiction, the court shall require the preparation of a certif icate of foreign birth as provided in § 3215.1. (b) The certificate of adoption shall be filed with the original record of birth, if such record exists, wh ich shall remain COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 20 as a part of the permanent records of the Office of Vital Statistics.

irth, if such record exists, wh ich shall remain COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 20 as a part of the permanent records of the Office of Vital Statistics. (c) Whenever an adoption decree is amended or annul led, the clerk of the court shall prepare a certificate thereof, which shall include such facts as are necessary to identi fy the original adoption report, and the facts amended in the adopt ion decree as shall be necessary to properly amend the birth reco rd. (d) When the Guam Registrar of Vital Statistics re ceives a record of adoption or annulment of adoption or amen dment thereof from a court for a person born elsewhere, s uch record shall be forwarded to the appropriate registration authority in the place of birth of the child adopted. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Subsectio n (a) amended by P.L. 28-031:4 (April 22, 2005). 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. 2014 NOTE: Subsection (a)(1) added by P.L. 28-031:4, incorpor ated into subsection (a) by the Compiler in accordance w ith the authority granted by 1 GCA § 1606. § 3215.

uam' pursuant to 1 GCA § 420. 2014 NOTE: Subsection (a)(1) added by P.L. 28-031:4, incorpor ated into subsection (a) by the Compiler in accordance w ith the authority granted by 1 GCA § 1606. § 3215. New Certification of Birth Following Adopti on, Legitimation and Paternity Determination. (a) The Guam Registrar of Vital Statistics shall es tablish a new certificate of birth for a person when he or sh e receives one (1) of the following: (1) An adoption report as provided in § 3214 of thi s Article, or a certified copy of the decree of adopt ion, together with the information necessary to identify the original certificate of birth and to establish a ne w certificate of birth; (except that a new certificate of birth s hall not be established if so requested by the court decreeing the adoption, the adoptive parents or the adopted perso n); (2) An affidavit of acknowledgment of paternity sig ned by both parents; or (3) A court order determining paternity. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 21 (b) When a new certificate of birth is established, the actual place and date of birth shall be shown.

ning paternity. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 21 (b) When a new certificate of birth is established, the actual place and date of birth shall be shown. It shall be substituted for the original certificate of birth, and thereafter, (l) The original certificate and the evidence of adoption, paternity or legitimation shall not be su bject to inspection, except upon court order or as provided by regulations. (2) Upon receipt of notice of annulment of adoption , the original certificate of birth shall be restored to its place in the files and the new certificate and evidence s hall not be subject to inspection, except upon court order. (c) If no certificate of birth is on file for the p erson for whom a new certificate is to be established under t his section, a delayed certificate of birth shall be filed with th e Office of Vital Statistics as provided in §§ 3212 or 3213 of this a rticle. Before a new certificate of birth is established, except tha t when the date and place of birth and parentage have been establis hed in the adoption proceeding, a delayed certificate shall no t be required.

a new certificate of birth is established, except tha t when the date and place of birth and parentage have been establis hed in the adoption proceeding, a delayed certificate shall no t be required. (d) When a new certificate of birth is established by the Guam Registrar of Vital Statistics, all copies of t he original certificate of birth in the custody of the Office o f Vital Statistics, will be sealed from inspection and opened only upon court order or as provided by regulation. SOURCE : Added by P.L. 22-130:2 (May 31, 1994). Subsecti on (a) amended by P.L. 28-031:5 (April 22, 2005). 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3215.1. Certificate of Foreign Birth. The Guam Registrar of Vital Statistics shall, upon request, establish a new certificate of birth for a person b orn in a foreign country when in receipt of a report of adoption dec reed by a court of competent jurisdiction, proof of the date and place of the person’s birth, and a request from the court, the a dopting parent or parents, or the adopted person if eighteen (18) years of age or over, that such a certificate be prepared.

date and place of the person’s birth, and a request from the court, the a dopting parent or parents, or the adopted person if eighteen (18) years of age or over, that such a certificate be prepared. The cert ificate shall be labeled ‘Certificate of Foreign Birth’ and shall sh ow the actual country of birth. The Certificate of Foreign Birth shall show the COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 22 true or probable foreign country of birth, and shal l state that the certificate is not evidence of United States citize nship for the child for whom it is issued or for the adoptive par ent or parents. After registration of the Certificate of Foreign Bi rth in the new name of the adopted person, the Guam Registrar shal l seal the report of adoption, which shall not be subject to i nspection except upon order of a court of competent jurisdict ion. SOURCE: Added by P.L. 28-031:6 (April 22, 2005). 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. 2014 NOTE: Subsection designation removed to adheare to the Compiler’s general codification scheme in accordanc e with the authority granted by 1

ved and/or altered to 'Guam' pursuant to 1 GCA § 420. 2014 NOTE: Subsection designation removed to adheare to the Compiler’s general codification scheme in accordanc e with the authority granted by 1 GCA § 1606. § 3216. Death Registration. (a) A death certificate for each death which occur s on Guam shall be filed with the Office of Vital Statistics. (b) The Mayor, upon receiving information of any de ath within his municipal district, shall report the sam e immediately to the Office of Vital Statistics, on a prescribed form; provided, that: (1) If the place of death is unknown, a death repor t shall be filed by the Mayor of the municipal distri ct in which a dead body is found and the place where the body is found shall be shown as the place of death; provide d, further (2) That if death occurs in a moving conveyance, a death report shall be filed by the Mayor of the mun icipal district in which the dead body was first removed f rom such conveyance and the location where the body is remov ed from the conveyance shall be shown as the place of death or if taken to an institution, the death certificate s hall be filed by the person in charge of that institution.

n where the body is remov ed from the conveyance shall be shown as the place of death or if taken to an institution, the death certificate s hall be filed by the person in charge of that institution. (c) Death in an institution shall be reported to th e Office of Vital Statistics by the person in charge of that in stitution. (d) Any person who first assumes custody of a dead human body shall report same and file a death certificate with the Office COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 23 of Vital Statistics. He shall obtain the personal d ata from the next of kin or the best qualified person or source avail able and shall obtain the medical certification of cause of death from the person responsible therefor. (e) The medical certification shall be completed an d signed within twenty-four (24) hours after death by a regi stered nurse pursuant to 10 GCA § 12332; or by the physician in charge of the patient’s care for the illness or condition whi ch resulted in death, except when the patient has received no medi cal attention within seventy-two (72) hours prior to death, or wh en inquiry is required in accordance with the Post-Mortem Examina

ch resulted in death, except when the patient has received no medi cal attention within seventy-two (72) hours prior to death, or wh en inquiry is required in accordance with the Post-Mortem Examina tion Act (10 GCA Chapter 81). (f) When death occurred without medical attendance as set forth in paragraph (e) of this section, or when inq uiry is required by the Post-Mortem Examination Act, the Medical Exa miner or his duly authorized representative shall investigat e the cause of death and shall complete and sign the medical certi fication within twenty-four (24) hours after taking charge o f the case. (g) Upon request, the Director shall accept, for pu rposes of recording deaths, certified copies of death certifi cates of residents of Guam who died outside Guam. (h) When a death is presumed to have occurred withi n Guam but the body cannot be located, a death certif icate may be prepared by the Guam Registrar upon receipt of an o rder from a court of competent jurisdiction, which shall includ e the finding of facts required to complete the death certificate . Such a death certificate shall be marked 'presumptive' and shall show on its face the date of registration and shall

h shall includ e the finding of facts required to complete the death certificate . Such a death certificate shall be marked 'presumptive' and shall show on its face the date of registration and shall identify th e court and date of decree. (i) The death certificate of a person shall contain the social security number of the deceased; if none exists, th e certificate shall also state that fact. (j) When a death is presumed to have occurred in an d around the waters of Guam and the body cannot be lo cated, after an official search and rescue attempt has been made by the Guam Fire Department Search and Rescue Unit or the U.S. Coast Guard, a death certificate may be prepared by the Guam COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 24 Registrar upon receipt of an order from a court of competent jurisdiction, or the Medical Examiner, which shall include the finding of facts required to complete the death cer tificate. Such a death certificate shall be marked ‘presumptive’ and shall show on its face the date of registration and shall iden tify the court, or the Medical Examiner, and the date of decree. SOURCE: Added by P.L. 22-130:2 (May 31, 1994).

marked ‘presumptive’ and shall show on its face the date of registration and shall iden tify the court, or the Medical Examiner, and the date of decree. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Subsectio n (i) added by P.L. 24-129:30 (Feb. 16, 1998). Subsection (j) added as subsection (i) by P.L. 24-320:1 (Dec. 28, 1998). R enumbered by Compiler since subsection (i) already exists. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3217. Fetal Death Registration. (a) A fetal death report for each fetal death whic h occurs in Guam after twenty (20) complete weeks of gestation or more or when a fetus weighs three hundred fifty (350) grams or more, shall be filed with the Office of Vital Statistics within twenty- four (24) hours after such delivery and prior to th e removal of the disposition of said fetus; provided, that: (l) If the place of fetal death is unknown, a fetal death certificate shall be filed by the Mayor of the muni cipal district in which the dead fetus was found; or (2) If a fetal death occurs in a moving conveyance, a fetal death report shall be filed by the Mayor of t he municipal district in

yor of the muni cipal district in which the dead fetus was found; or (2) If a fetal death occurs in a moving conveyance, a fetal death report shall be filed by the Mayor of t he municipal district in which the dead fetus was firs t removed or if to an institution, the fetal death report sha ll be filed by the person in charge of that institution. (b) Any physician, midwife or other person in atten dance at or after the delivery of a dead fetus shall file a fetal death report. He shall obtain the personal data from the next of kin or the best qualified person or source available. (c) The medical certification shall be completed an d signed within twenty-four (24) hours after delivery by the physician in attendance at or after delivery, except when inquir y is required by the Post-Mortem Examination Act. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 25 (d) When a fetal death occurs without medical atten dance upon the mother at or after deliver, or when inquir y is required by the Post-Mortem Examination Act, the Medical Exa miner shall investigate the cause of fetal death, and sha ll complete and sign the medical certification within twenty-four (

inquir y is required by the Post-Mortem Examination Act, the Medical Exa miner shall investigate the cause of fetal death, and sha ll complete and sign the medical certification within twenty-four ( 24) hours after taking charge of the case. § 3218. Partial-Birth Abortion and Abortion Report. (a) An individual abortion report for each abortion shall be completed by the mother's attending physician, and shall be transmitted directly to the Office of Vital Statist ics of the Department of Public Health and Social Services. T he report shall be confidential and it shall not contain the name of the mother involved. This report shall include: (1) patient number; (2) name and address of the abortion facility or hospital; (3) date of the abortion; (4) zip code or other residential identification of the pregnant woman; (5) age of the pregnant woman; (6) ethnic origin of the pregnant woman; (7) marital status of the pregnant woman; (8) number of previous pregnancies; (9) number of years of education of the pregnant woman; (10) number of living children; (11) number of previous induced abortions; (12) date of the last induced abortion; (13) date of the last live birth; (14) method of

of education of the pregnant woman; (10) number of living children; (11) number of previous induced abortions; (12) date of the last induced abortion; (13) date of the last live birth; (14) method of contraception used, if any, at the t ime of conception; (15) date of the beginning of the last menstrual pe riod; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 26 (16) medical condition of the pregnant woman at the time of abortion; (17) RH type of the pregnant woman; (18) type of abortion procedure used; (19) complications, if any; (20) type of procedure done after the abortion; (21) type of family planning recommended; (22) type of additional counseling given, if any; (23) signature of attending physician; (24) certification provided for in this Section; an d (25) gestational age, as measured in weeks, of the unborn child terminated by the abortion. (b) An individual complication report for any post- abortion care performed upon a woman shall be completed by the physician providing such post-abortion care. T his report shall include: (1) date of the abortion; (2) name and the address of the medical facility, abortion facility or hospital where the

ted by the physician providing such post-abortion care. T his report shall include: (1) date of the abortion; (2) name and the address of the medical facility, abortion facility or hospital where the abortion wa s performed; and (3) nature of the abortion complication diagnosed o r treated. (c) All abortion reports shall be signed by the att ending physician under penalty of perjury and shall be fil ed with the Guam Registrar of Vital Statistics within seven (7) days from the date of the abortion. All complication reports shal l be signed by the physician providing the post-abortion care unde r penalty of perjury and filed with the Guam Registrar of Vital Statistics within seven (7) days from the date of the post-abo rtion care. (d) A copy of the abortion report shall be made a part of the medical record of the patient in the facility o r hospital in which the abortion was performed. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 27 (e) The Guam Registrar of Vital Statistics shall collect and annually publish a statistical report based on such data from abortions performed in the previous calendar year.

TH AND SOCIAL SERVICES 27 (e) The Guam Registrar of Vital Statistics shall collect and annually publish a statistical report based on such data from abortions performed in the previous calendar year. (f) The Office of Vital Statistics shall make available to physicians performing abortions on Guam, forms for both abortion reports and post-abortion care reports, as provided in Subsections (a) and (b) of this Section. (g) All information in abortion reports and post-ab ortion care reports and the reports themselves shall be confidential. Information and records may be disclosed only in communications between qualified professional perso ns in the provision of services or in statistical form for re search purposes as required by Subsection (e) of this Section. (h) Any person who releases confidential informatio n in violation of Subsection (g) of this Section shall be guilty of a misdemeanor. (i) Any person may bring an action against an indiv idual who has willfully and knowingly released confidenti al information about such person in violation of Subse ction (g) of this Section for the greater of the following amoun ts: (1) Five Hundred Dollars ($500); or (2) Three (3) times the

ased confidenti al information about such person in violation of Subse ction (g) of this Section for the greater of the following amoun ts: (1) Five Hundred Dollars ($500); or (2) Three (3) times the amount of actual damages, if any, sustained by the plaintiff, reasonable attorne y's fees and the costs of the action. It is not a prerequisite to an action under this Subsection that the plaintiff suf fer or be threatened with actual damages. (j) If a physician performs a partial-birth abortion on th e woman, the physician shall report such determination and the reasons for such determination in writing to the me dical care facility in which the abortion is performed for inc lusion in the report of the medical care facility to the Office o f Vital Statistics and to the Guam Board of Medical Examiners, or if the abortion is not performed in a medical care facility, the physician shall report the reasons for such determination in writin g to the Office of Vital Statistics and to the Guam Board of Medica l Examiners as part of the written report made by the physician to the Office COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

in writin g to the Office of Vital Statistics and to the Guam Board of Medica l Examiners as part of the written report made by the physician to the Office COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 28 of Vital Statistics and to the Guam Board of Medica l Examiners. The physician shall retain a copy of the written reports required under this Section for not less than five (5) years. (k) Failure to file a complete individual abortion report for each abortion with the Guam Registrar of Vital Stat istics within seven (7) days from the date of the abortion is a m isdemeanor, pursuant to § 55.65 of Chapter 55, Title 9, Guam Co de Annotated. (l) Subsection (k) does not preclude sanctions, or disciplinary action, or any other appropriate action by the Guam Board of Medical Examiners. (m) The Guam Registrar of Vital Statistics shall receive, ascertain the completeness of, compile, and retain all partial- birth abortion reports filed with her under this Se ction, and collate and evaluate all data gathered therefrom, a nd shall annually publish a statistical report based on such data from partial-birth abortions performed in the previous c alendar year no

ion, and collate and evaluate all data gathered therefrom, a nd shall annually publish a statistical report based on such data from partial-birth abortions performed in the previous c alendar year no later than January 31st of the following calendar year. (n) The Office of Vital Statistics shall make available to physicians performing partial-birth abortions on Gu am and the Guam Board of Medical Examiners forms for partial-b irth abortion reports. (o) All information in partial-birth abortion repor ts the Office of Vital Statistics receives shall be confidential. Information and reports may be disclosed only in communications between qualified professional perso ns in the provisions of services, or in statistical form for research purposes. (p) Any person who releases confidential informatio n in violation of Subsection (o) of this Section shall be guilty of a misdemeanor. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Amended by P.L. 29-115:1 (Nov. 18, 2008), P.L. 32-073:3 (Nov. 27, 2 013). Subsections (j-p) added by P.L. 29-115:2 (Nov. 18, 2008). Subs ections (a)(23) and (24) amended by P.L. 32-217:2 (Dec. 29, 2014, and s ubsection (a)(25) added by P.L. 32-217:2 (Dec.

(Nov. 27, 2 013). Subsections (j-p) added by P.L. 29-115:2 (Nov. 18, 2008). Subs ections (a)(23) and (24) amended by P.L. 32-217:2 (Dec. 29, 2014, and s ubsection (a)(25) added by P.L. 32-217:2 (Dec. 29, 2014), effective 3 0 days after enactment pursuant to P.L. 32-217:3. Subsection (a) amended by P.L. 33- 218:3 (Dec. 15, 2016); subsection (c) amended by P. L. 33-218:4 (Dec. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 29 15, 2016); subsection (e) amended by P.L. 33-218:5 (Dec. 15, 2016); and subsection (k) amended by P.L. 33-218:6 (Dec. 15, 2 016); and subsection (m) amended by P.L. 33-218:7 (Dec. 15, 2016);. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. NOTE: This provision was to become effective sixty (60) days after the 'printed materials' described in § 3218.1 (c) and t he 'checklist certification' described in § 3218.1(c)(5) were app roved by the Department of Public Health and Social Services (DP HSS) pursuant to the rule-making process set forth in Title 5, Chapt er 9, Article 3 of the Guam Code Annotated. P.L. 31-235:4 (Nov. 1, 2012). P.L. 32-089:2 (Nov.

ublic Health and Social Services (DP HSS) pursuant to the rule-making process set forth in Title 5, Chapt er 9, Article 3 of the Guam Code Annotated. P.L. 31-235:4 (Nov. 1, 2012). P.L. 32-089:2 (Nov. 27, 2013) amended the approving authority fro m DPHSS to 'a majority vote of a team consisting of the Director of DPHSS, who shall serve as the Chairperson, the Medical Director of t he DPHSS; and OB/GYN doctor from the Guam Medical Association; a Social Worker from the National Association of Social Workers; an d a Psychiatrist from the Guam Behavioral Health and Wellness Center.' T he 'printed materials' described in § 3218.1 (c) and the 'check list certification' described in § 3218.1(c)(5) were to be approved no later than 120 days after enactment, pursuant to P.L. 32-089:2. § 3218.1. The Women's Reproductive Health Informati on Act of 2012. (a) Definitions. For the purposes of this § 3218.1, the following words and phrases are defined to mean: (1) Abortion means the use or prescription of any instrument, medicine, drug, or other substance or d evice to terminate the pregnancy of a woman known to be preg nant with an intention other than to increase the probab ility of a live

iption of any instrument, medicine, drug, or other substance or d evice to terminate the pregnancy of a woman known to be preg nant with an intention other than to increase the probab ility of a live birth, to preserve the life or health of the c hild after live birth, to act upon an ectopic pregnancy, or to remo ve a dead unborn child who died as the result of natural caus es in utero, accidental trauma, or a criminal assault on a pregnant woman or her unborn child, and which causes the pre mature termination of the pregnancy; (2) Act means the Women's Reproductive Health Information Act of 2012 codified at Title 10 GCA § 3218.1; (3) Complication means that condition which include s but is not limited to hemorrhage, infection, uterin e perforation, cervical laceration, pelvic inflammato ry disease, endometriosis, and retained products. The COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 30 Department may further define the term 'complicatio n' as necessary and in a manner not inconsistent with thi s § 3218.1; (4) Conception means the fusion of a human spermatozoon with a human ovum; (5) Department means the Department of Public Health and Social

essary and in a manner not inconsistent with thi s § 3218.1; (4) Conception means the fusion of a human spermatozoon with a human ovum; (5) Department means the Department of Public Health and Social Services; (6) Facility or medical facility means any public or private hospital, clinic, center, medical school, medical training institution, health care facility, physici an's office, infirmary, dispensary, ambulatory surgical treatmen t center, or other institution or location wherein medical ca re is provided to any person; (7) First trimester means the first twelve (12) wee ks of gestation; (8) Gestational age means the time that has elapsed since the first day of the woman's last occurring menstruation; (9) Hospital means any building, structure, institu tion or place, public or private, whether organized for profit or not, devoted primarily to the maintenance and opera tion of facilities for the diagnosis, treatment and provisi on of medical or surgical care for three (3) or more non- related individuals, admitted for overnight stay or longer in order to obtain medical, including obstetric, psychiatric an d nursing care of illness, disease, injury or deformity, whet her

more non- related individuals, admitted for overnight stay or longer in order to obtain medical, including obstetric, psychiatric an d nursing care of illness, disease, injury or deformity, whet her physical or mental and regularly making available a t least clinical laboratory services and diagnostic x-ray s ervices and treatment facilities for surgery or obstetrical care or other definitive medical treatment; (10) Medical emergency means a condition which, in reasonable medical judgment, so complicates the med ical condition of the pregnant woman as to necessitate t he immediate termination of her pregnancy to avert her death or for which a delay will create a serious risk of substantial and irreversible physical impairment of a major bod ily COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 31 function. No condition shall be deemed a medical emergency if based on a claim or diagnosis that the woman will engage in conduct which would result in her de ath or in substantial and irreversible physical impairment of a major bodily function; (11) Physician means any person licensed to practic e medicine or surgery or osteopathic medicine under t he

de ath or in substantial and irreversible physical impairment of a major bodily function; (11) Physician means any person licensed to practic e medicine or surgery or osteopathic medicine under t he Physicians Practice Act (Title 10 GCA § 12201, et s eq.) or in another jurisdiction of the United States; (12) Pregnant or pregnancy means that female reproductive condition of having an unborn child in the mother's uterus; (13) Qualified person means an agent of a physician who is a psychologist, licensed social worker, lice nsed professional counselor, registered nurse, or physic ian; (14) Records Section means the Guam Memorial Hospital Medical Records Section; (15) Unborn child or fetus each means an individual organism of the species homo sapiens from conceptio n until live birth; (16) Viability means the state of fetal development when, in the reasonable judgment of a physician bas ed on the particular facts of the case before him or her and in light of the most advanced medical technology and informa tion available to him or her, there is a reasonable like lihood of sustained survival of the unborn child outside the body of his or her mother, with or without artificial suppo

echnology and informa tion available to him or her, there is a reasonable like lihood of sustained survival of the unborn child outside the body of his or her mother, with or without artificial suppo rt; and (17) Woman means a female human being whether or not she has reached the age of majority. (b) Informed Consent Requirement. No abortion shall be performed or induced without the voluntary and info rmed consent of the woman upon whom the abortion is to b e performed or induced. Except in the case of a medic al emergency, consent to an abortion is voluntary and informed if and only if: COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 32 (1) at least twenty-four (24) hours before the abor tion, the physician who is to perform the abortion or a q ualified person has informed the woman in person of the foll owing: (A) the name of the physician who will perform the abortion; (B) the following medically accurate information that a reasonable person would consider material to the decision of whether or not to undergo the abortion: (i) a description of the proposed abortion method and (ii) the immediate and long-term medical risks associated with the

d consider material to the decision of whether or not to undergo the abortion: (i) a description of the proposed abortion method and (ii) the immediate and long-term medical risks associated with the proposed abortion method, including but not limited to any risks of infection, hemorrhage, cervical or uterine perforation, and any potential effect upon future capability to conceive as well as to sustain a pregnancy to full term; (C) the probable gestational age of the unborn child at the time the abortion is to be performed; (D) the probable anatomical and physiological characteristics of the unborn child at the time the abortion is to be performed; (E) the medical risks associated with carrying the child to term; (F) any need for anti-Rh immune globulin therapy if she is Rh negative, the likely consequences of refusing such therapy, and the cost of the therapy; (2) at least twenty-four (24) hours before the abor tion, the physician who is to perform the abortion or a q ualified person has informed the woman in person, that: (A) medical assistance benefits may be available for prenatal care, childbirth, and neonatal care an d that more detailed information on the availability of su

has informed the woman in person, that: (A) medical assistance benefits may be available for prenatal care, childbirth, and neonatal care an d that more detailed information on the availability of su ch assistance is contained in the printed materials gi ven to her and described in Subsection (c) of this § 3218. 1; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 33 (B) public assistance may be available to provide medical insurance and other support for her child w hile he or she is a dependent and that more detailed information on the availability of such assistance is contained in the printed materials given to her and described in Subsection (c) of this § 3218.1; (C) public services exist which will help to facilitate the adoption of her child and that more detailed information on the availability of such se rvices is contained in the printed materials given to her and described in Subsection (c) of this § 3218.1; (D) the printed materials in Subsection (c) of this Section 3218.1 describe the unborn child; (E) the father of the unborn child is liable to ass ist in the support of this child, even in instances whe re he has offered to pay for the

tion (c) of this Section 3218.1 describe the unborn child; (E) the father of the unborn child is liable to ass ist in the support of this child, even in instances whe re he has offered to pay for the abortion. In the case of rape or incest, this information may be omitted; and (F) she is free to withhold or withdraw her consent to the abortion at any time without affecti ng her right to future care or treatment and without t he loss of any locally or federally funded benefits to which she might otherwise be entitled. (3) At least twenty-four (24) hours before the abor tion, the physician who is to perform the abortion or a q ualified person has given the woman a copy of the printed ma terials described in Subsection (c) of this § 3218.1. If t he woman is unable to read the materials, they shall be read to her. If the woman asks questions concerning any of the information or materials, answers shall be provided to her in a language she can understand. (4) The information in Subsections (b)(l), (b)(2) a nd (b)(3) of this § 3218.1 is provided to the woman individually and in a private room to protect her p rivacy and maintain the confidentiality of her decision and to ensure that the

(b)(l), (b)(2) a nd (b)(3) of this § 3218.1 is provided to the woman individually and in a private room to protect her p rivacy and maintain the confidentiality of her decision and to ensure that the information focuses on her individual circ umstances and that she has an adequate opportunity to ask que stions. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 34 (5) Prior to the abortion, the woman certifies in w riting on a checklist certification provided by the Depart ment that the information required to be provided under Subse ctions (b)(l), (b)(2) and (b)(3) of this § 3218.1 has been provided. All physicians who perform abortions shall report t he total number of certifications received monthly to the Re cords Section. The Records Section shall make the number of certifications received available to the public on an annual basis. (6) Except in the case of a medical emergency, the physician who is to perform the abortion shall rece ive and sign a copy of the written checklist certification prescribed in Subsection (b)(5) of this § 3218.1 prior to perf orming the abortion.

the physician who is to perform the abortion shall rece ive and sign a copy of the written checklist certification prescribed in Subsection (b)(5) of this § 3218.1 prior to perf orming the abortion. The physician shall retain a copy of the checklist certification in the woman's medical record. (7) In the event of a medical emergency requiring a n immediate termination of the pregnancy, the physici an who performed the abortion shall clearly certify in wri ting the nature of the medical emergency and the circumstanc es which necessitated the waiving of the informed cons ent requirements of this § 3218.1. This certification shall be signed by the physician who performed the emergency termination of pregnancy, and shall be permanently filed in both the patient records maintained by the physicia n performing the emergency procedure and the records maintained by the facility where the emergency proc edure occurred. (8) A physician shall not require or obtain payment from anyone for providing the information and certi fication required by this § 3218.1 until the expiration of t he twenty- four (24) hour reflection period required by this § 3218.1. (c) Publication of Materials.

r providing the information and certi fication required by this § 3218.1 until the expiration of t he twenty- four (24) hour reflection period required by this § 3218.1. (c) Publication of Materials. The Department shall cause to be published printed materials in English and any o ther culturally sensitive languages which the Department deems appropriate within one hundred eighty (180) days af ter this Act becomes law. The printed materials shall be printe d in a typeface large enough to be clearly legible and sha ll be presented in an objective, unbiased manner designed to convey only COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 35 accurate scientific information. On an annual basi s, the Department shall review and update, if necessary, t he following easily comprehensible printed materials: (1) Printed materials that inform the woman of any entities available to assist a woman through pregna ncy, upon childbirth and while her child is dependent, i ncluding but not limited to adoption services. The printed materials shall include a list of the e ntities, a description of the services they offer, and the t elephone numbers of the entities, and

i ncluding but not limited to adoption services. The printed materials shall include a list of the e ntities, a description of the services they offer, and the t elephone numbers of the entities, and shall inform the woman about available medical assistance benefits for prenatal care, childbirth, and neonatal care. The Department shal l ensure that the materials described in this § 3218.1 are comprehensive and do not directly or indirectly pro mote, exclude, or discourage the use of any entity descri bed in this § 3218.1. These printed materials shall state that it is unla wful for any individual to coerce a woman to undergo an abortion. The printed materials shall also state t hat any physician who performs an abortion upon a woman wit hout her informed consent may be liable to her for damag es in a civil action and that the law permits adoptive pare nts to pay costs of prenatal care, childbirth, and neonatal ca re. The printed materials shall include the following state ment: 'The Territory of Guam strongly urges you to contact the resources provided in this booklet before making a final decision about abortion.

he printed materials shall include the following state ment: 'The Territory of Guam strongly urges you to contact the resources provided in this booklet before making a final decision about abortion. The law requires that your physician or his or her agent give you the opportunity to call agencies and service providers like these before you undergo an abortion.' (2) Printed materials that include information on t he support obligations of the father of a child who is born alive, including but not limited to the father's le gal duty to support his child, which may include child support payments and health insurance, and the fact that pa ternity may be established by written declaration of patern ity or by COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 36 court action. The printed material shall also stat e that more information concerning paternity establishment and child support services and enforcement may be obtained by calling the Office of the Attorney General of Guam, Child Support Enforcement Division. (3) Printed materials that inform the pregnant woma n of the probable anatomical and physiological charac teristics of an unborn child at two

rney General of Guam, Child Support Enforcement Division. (3) Printed materials that inform the pregnant woma n of the probable anatomical and physiological charac teristics of an unborn child at two (2) - week gestational in crements from fertilization to full term, including color ph otographs of the developing unborn child at two (2) - week ge stational increments. The descriptions shall include informa tion about brain and heart functions, the presence of ex ternal members and internal organs during the applicable s tages of development, and any relevant information on the possibility of the child's survival at several and equidistant increments throughout a full term pregnancy. If a photograph is not available, a picture must contain the dimensions of the unborn child and must be anatomic ally accurate and realistic. The materials shall be obj ective, nonjudgmental, and designed to convey only accurate scientific information about the unborn child at th e various gestational ages. (4) Printed materials which contain objective information describing the various surgical and dru g- induced methods of abortion, as well as the immedia te and long-term medical risks commonly

ages. (4) Printed materials which contain objective information describing the various surgical and dru g- induced methods of abortion, as well as the immedia te and long-term medical risks commonly associated with ea ch abortion method including but not limited to the ri sks of infection, hemorrhage, cervical or uterine perforat ion or rupture, any potential effect upon future capabilit y to conceive as well as to sustain a pregnancy to full term, the possible adverse psychological effects associated w ith an abortion, and the medical risks associated with car rying a child to term. (5) A checklist certification to be used by the phy sician or a qualified person under Subsection (b)(5) of th is § 3218.1, which will list all the items of informatio n which are to be given to the woman by the physician or a qualified person under this § 3218.1. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 37 (d) Cost of Materials. The Department shall make av ailable the materials enumerated in Subsection (c) of this § 3218.1 for purchase by the physician or qualified person who i s required to provide these materials to women pursuant to Subsec tion (b)(3) of this

e materials enumerated in Subsection (c) of this § 3218.1 for purchase by the physician or qualified person who i s required to provide these materials to women pursuant to Subsec tion (b)(3) of this § 3218.1 at such cost as reasonably determi ned by the Department. No claim of inability to pay the cost charged by the Department for these materials will excuse any part y from complying with the requirements set forth in this § 3218.1. (e) Emergencies. When a medical emergency compels t he performance of an abortion or termination of pregna ncy, the physician shall inform the woman, before the aborti on if possible, of the medical indications supporting the physician's judgment that an immediate abortion or termination of pregnancy is necessary to avert her death or that a twenty-four (24) hour delay would cause substantial and irrever sible impairment of a major bodily function. (f) Criminal Penalties. Any person who intentionall y, knowingly, or recklessly violates this Act is guilt y of a misdemeanor. (g) Civil and Administrative Claims. In addition to whatever remedies are available under the common la w or statutory laws of Guam, failure to comply with the requirements of this

of a misdemeanor. (g) Civil and Administrative Claims. In addition to whatever remedies are available under the common la w or statutory laws of Guam, failure to comply with the requirements of this Act shall: (1) in the case of an intentional violation of the Act, constitute prima facie evidence of a failure to obt ain informed consent. When requested, the court shall allow a woman upon whom an abortion was performed or attemp ted to be performed allegedly in violation of this Act to be identified in any action brought pursuant to this A ct using solely her initials or the pseudonym 'Jane Doe.' F urther, with or without a request, the court may close any proceedings in the case from public attendance, and the court may enter other protective orders in its disc retion to preserve the privacy of the woman upon whom the abo rtion was performed or attempted to be performed allegedl y in violation of this Act. (2) Provide a basis for professional disciplinary a ction COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 38 under 10 GCA § 11110. (3) Provide a basis for recovery for the woman for the wrongful death of her unborn child under Title 7 GC A § 12109,

ALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 38 under 10 GCA § 11110. (3) Provide a basis for recovery for the woman for the wrongful death of her unborn child under Title 7 GC A § 12109, whether or not the unborn child was born ali ve or was viable at the time the abortion was performed. SOURCE: Added by P.L. 31-235:2 (Nov. 1, 2012). 2013 NOTE: This provision was to become effective sixty (60) days after the 'printed materials' described in § 3218.1 (c) and the 'checklist certification' described in § 3218.1(c)(5) were app roved by the Department of Public Health and Social Services (DP HSS) pursuant to the rule-making process set forth in Title 5, Chapt er 9, Article 3 of the Guam Code Annotated. P.L. 31-235:4 (Nov. 1, 2012). P.L. 32-089:2 (Nov. 27, 2013) amended the approving authority fro m DPHSS to 'a majority vote of a team consisting of the Director of DPHSS, who shall serve as the Chairperson, the Medical Director of t he DPHSS; and OB/GYN doctor from the Guam Medical Association; a Social Worker from the National Association of Social Workers; an d a Psychiatrist from the Guam Behavioral Health and Wellness Center.' T he 'printed materials' described in §

Medical Association; a Social Worker from the National Association of Social Workers; an d a Psychiatrist from the Guam Behavioral Health and Wellness Center.' T he 'printed materials' described in § 3218.1 (c) and the 'check list certification' described in § 3218.1(c)(5) were to be approved no later than 120 days after enactment, pursuant to P.L. 32-089:2. 2012 NOTE: Subsection designations in subsection (b) were alte red to adhere to the Compiler’s alpha-numeric scheme in ac cordance with the authority granted by 1 GCA § 1606. § 3219. Extension of Time. The Office of Vital Statistics may, by regulation, and upon such conditions as it may prescribe to assure compl iance with the purposes of this article, provide for the extension of the periods prescribed in §§ 3216 and 3217 of this article for the filing of death certificates, fetal death reports and medical certifications of cause of death in cases in which compliance with th e applicable prescribed period would result in undue hardship. § 3220. Marriage Registration. (a) A record of each marriage performed on Guam sh all be filed with the Guam Registrar of Vital Statistics a s provided in this section.

ould result in undue hardship. § 3220. Marriage Registration. (a) A record of each marriage performed on Guam sh all be filed with the Guam Registrar of Vital Statistics a s provided in this section. (b) The officer who issues the marriage license sha ll prepare the license and certificate on the form prescribed and furnished by the Office of Vital Statistics upon the basis of information COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 39 obtained from the parties to be married, who shall attest to the information by their signatures. (c) Every person authorized by the laws of Guam to perform a marriage shall certify the fact of marriage and f ile the record of such marriage with the Office of Vital Statistics w ithin ten (10) days after the ceremony. This certificate shall be signed by the witnesses, and another signed copy shall be given t o the parties marrying. (d) The officer issuing marriage licenses shall com plete and forward to the Guam Registrar of Vital Statistics, on or before the fifteenth (15th) day of each month, copies of t he applications and licenses filed with him during the preceding ca lendar month.

d forward to the Guam Registrar of Vital Statistics, on or before the fifteenth (15th) day of each month, copies of t he applications and licenses filed with him during the preceding ca lendar month. (e) The Director shall accept, for the purpose of r ecordation, certified copies of records of marriages performed outside Guam in which one (1) or both parties are residents of G uam. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3221. Court Reports of Divorce and Annulment of Marriage. (a) For each divorce and annulment of marriage gran ted by the courts of Guam, a report shall be filed with th e Office of Vital Statistics by the clerk of court. (b) On or before the fifteenth (15th) day of each m onth, the clerk of court shall forward to the Office of Vital Statistics the report of each divorce and annulment of marriage gr anted during the preceding calendar month and such related repor ts as may be required by regulations issued under this article. (c) The information necessary to prepare the report shall be furnished with the petition to the clerk of court b y the parties, petitioner or their legal representative

ons issued under this article. (c) The information necessary to prepare the report shall be furnished with the petition to the clerk of court b y the parties, petitioner or their legal representative on forms p rescribed and furnished by the Guam Registrar of Vital Statistics . 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3222. Correction and Amendment of Vital Records. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 40 (a) A certificate or record registered under this a rticle may be amended only in accordance with this article and regulations thereunder, adopted by the Department to protect th e integrity and accuracy of vital statistics records. (b) A certificate that is amended under this sectio n shall be marked 'Amended,' except as provided in paragraphs (b) and (d) of this section. The date of amendment and a su mmary description of the evidence submitted in support of the amendment shall be endorsed on or made a part of th e record. The Office of Vital Statistics shall prescribe by r egulation the conditions under which additions or minor correctio ns shall be made to birth

ent shall be endorsed on or made a part of th e record. The Office of Vital Statistics shall prescribe by r egulation the conditions under which additions or minor correctio ns shall be made to birth certificates within one (l) year afte r the date of birth without the certificates being considered as amended. (c) Upon receipt of a certified copy of a court ord er changing the name of a person born in Guam, and upo n request of such person or his parent, guardian or legal rep resentative, the Office of Vital Statistics shall amend the certific ate of birth to reflect the new name. (d) Upon request and receipt of a sworn acknowledgm ent of paternity of a child born out of wedlock, signed by both parents, the Guam Registrar of Vital Statistics shall amend a certificate of birth to show such paternity, if paternity is not s hown on the certificate. The surname of the child shall then be changed to that of the father, but the certificate shall not be mar ked 'Amended'. (e) Upon receipt of a sworn statement from the phys ician performing the surgery certifying the sex of an ind ividual has been changed by surgical procedure, and upon writte n request of an individual born in Guam, the

a sworn statement from the phys ician performing the surgery certifying the sex of an ind ividual has been changed by surgical procedure, and upon writte n request of an individual born in Guam, the sex of the individu al shall be amended on the birth certificate to reflect such ch ange. The name of the individual may be changed as provided i n paragraph (c) of this section. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3223. Reproduction of Records. To preserve original documents, the Guam Registrar of Vital Statistics is authorized to prepare typewritt en, photographic or other reproductions of original records and file s in his office. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 41 Such a reproduction, when certified by him and seal ed with an official government seal, shall be accepted as the original and official record. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3224. Same: Microfilm. To preserve original records, the Guam Registrar i s authorized and directed to microfilm all vital reco rds.

orial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3224. Same: Microfilm. To preserve original records, the Guam Registrar i s authorized and directed to microfilm all vital reco rds. All such reproductions shall be equally admissible as compet ent evidence in all courts of Guam or in any administrative proc eeding as the original itself whether the original is in existenc e or not. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3225. Disclosure of Records. (a) To protect the integrity, the confidentiality, the validity and the evidentiary value of Vital Statistics Recor ds, to insure their proper use and to insure the efficient and pr oper administration of the Vital Statistics system, it s hall be unlawful for any person to permit inspection of, or to discl ose information contained in Vital Statistics Records, or to copy o r issue a copy of all or part of any such record, except as author ized by regulation or as provided for by this article. (b) The Office of Vital Statistics may authorize th e disclosure of data contained in Vital Statistics Re cords for research purposes; provided, that

by regulation or as provided for by this article. (b) The Office of Vital Statistics may authorize th e disclosure of data contained in Vital Statistics Re cords for research purposes; provided, that request for such be first approved by the Director. (c) Information in Vital Statistics Records, such a s birth occurring out of wedlock or length of pregnancy, ma y not be disclosed except as provided for in this article, b y regulation or upon court order. (d) Appeals from decisions of the Guam Registrar re fusing to disclose information, or to permit inspection of or copying of records under the authority of this section and reg ulations issued hereunder shall be made to the Director, whose deci sions shall be binding upon the Guam Registrar. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 42 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3226. Copies of Data from Vital Records. In accordance with § 3225 of this article, and the regulations adopted pursuant thereto: (a) The Office of Vital Statistics shall upon requ est, issue a certified copy of any certificate or record in his

ccordance with § 3225 of this article, and the regulations adopted pursuant thereto: (a) The Office of Vital Statistics shall upon requ est, issue a certified copy of any certificate or record in his custody or of a part thereof. Each copy issued shal l show the date of registration; and copies issued from re cords marked 'Delayed,' 'Amended' or 'Court Order' shall be similarly marked and show the effective date. (b) A certified copy of a certificate or any part thereof, issued in accordance with paragraph (a) of this sec tion, shall be considered for all purposes the same as the orig inal, and shall be prima facie evidence of the facts therein stated; provided, that the evidentiary value of the certifi cate or record filed more than one (l) year after the event , or a record which has been amended shall be determined b y the judicial or administrative body or official before whom the certificate is offered as evidence. (c) The National Center for Health Statistics shall be furnished such copies or data as it may require for national statistics; provided, that the government of Guam s hall be reimbursed for the cost of furnishing such data; an d provided, further, that such data

such copies or data as it may require for national statistics; provided, that the government of Guam s hall be reimbursed for the cost of furnishing such data; an d provided, further, that such data shall not be used for other than statistical purposes by the National Center fo r Health Statistics unless so authorized by the Office of Vi tal Statistics. (d) Federal, state or other territorial governmenta l branches and other public or private agencies may, upon request, be furnished copies of data for statistica l purposes upon such terms or conditions as may be prescribed by the Office of Vital Statistics. (e) No person shall prepare or issue any certificat e which purports to be an original, certified copy or copy of a certificate of birth, death or fetal death, except as authorized in this article or regulations adopted hereunder. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 43 § 3227. Fees for Copies. (a) The Director shall, by regulation, establish fe es for certified copies of certificates or records issued; for the search of the files or records when no copy or information is available; for processing a change of name by court order and

blish fe es for certified copies of certificates or records issued; for the search of the files or records when no copy or information is available; for processing a change of name by court order and othe r means; for amending records; and for filing a delayed certific ate of birth or marriage. (b) Fees collected under this Section by the Office of Vital Statistics shall be deposited in the Office of Vita l Statistics Revolving Fund, for expenditure as provided pursuan t to § 3227.1 of this Chapter. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Amended by P.L. 31-213:2 (May 10, 2012). § 3227.1. Office of Vital Statistics Revolving Fun d. (a) There is hereby established an Office of Vital Statistics Revolving Fund (Fund) to be maintained by the Guam Registrar, Office of Vital Statistics, of the Department of Pu blic Health & Social Services. The Fund shall be established and maintained in a bank account separate and apart from the Gener al Fund or any other bank account(s) of the government of Guam , and shall not be co-mingled with, or a part of, the General F und. All funds due or accruing to the account from whatever source (s), as provided or authorized pursuant to applicable

rnment of Guam , and shall not be co-mingled with, or a part of, the General F und. All funds due or accruing to the account from whatever source (s), as provided or authorized pursuant to applicable law, inclusive of any interest, shall be deposited in the Fund in its entirety immediately upon receipt by the government of Guam. The Fund shall not be subject to the transfer authority of I Maga’lahen Guåhan. It is further provided that: (1) The Guam Registrar of the Office of Vital Statistics, of the Department of Public Health & So cial Services shall report monthly and maintain full com pliance with all financial reporting requirements of the go vernment of Guam pursuant to applicable law; and (2) Any and all collections deposited into and/or expenditures from the Fund shall be reported to I Maga’lahen Guåhan and the Speaker of I Liheslaturan Guåhan . COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 44 (b) Independent Records and Accounts. The Fund sha ll be maintained separate and apart from all other govern ment funds; have an independent records and accounts concerning the Fund; and audited by the Public Internal Auditor or the D epartment of

ha ll be maintained separate and apart from all other govern ment funds; have an independent records and accounts concerning the Fund; and audited by the Public Internal Auditor or the D epartment of Interior for each fiscal year and shall provide I Maga’lahen Guåhan and the Speaker of I Liheslaturan Guåhan with a copy of the audited report. (c) Deposits / Continuing Appropriation. All monie s collected for products and services rendered by the Office of Vital Statistics shall be accounted for and deposit ed into the Fund and shall be available to pay for the expenses of the Office of Vital Statistics. All monies in the Fund are he reby deemed appropriated on a continuing basis and shall not la pse, and shall not be subject to appropriation constraints in orde r to be expended. (d) Application. All monies deposited in the Fund s hall be available to be expended and shall be used solely i n support of the functions of and to pay the expenses of the Off ice of Vital Statistics. The Fund may also be used for, but is not limited to, the following expenses which shall be directly and solely applicable to the functions and operations of the O ffice of Vital Statistics: (1) payment(s)

nd may also be used for, but is not limited to, the following expenses which shall be directly and solely applicable to the functions and operations of the O ffice of Vital Statistics: (1) payment(s) for procurement and maintenance of contractual services for equipment and/or technolog y support, for the direct use and exclusive benefit o f the Office of Vital Statistics; (2) payment(s) for supplies; (3) payment(s) for any other expenses, which if remains unpaid may result in an emergency situation within the Office of Vital Statistics, as approved by the Director; (4) additional personnel, as may be necessary to supplement and address the staffing requirements of the Office of Vital Statistics; provided, however, that all authorized personnel positions, regardless of wheth er the position(s) is currently filled or vacant, which ar e budgeted for in the FY 2012 Budget Appropriation for the Exe cutive Branch with monies from the General Fund, any Speci al COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 45 Fund and/or Federal funds, shall continue to be pai d from these funding sources, and not from the Fund; (5) procurement, upgrade and/or maintenance

SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 45 Fund and/or Federal funds, shall continue to be pai d from these funding sources, and not from the Fund; (5) procurement, upgrade and/or maintenance of computer system(s); and (6) payment(s) for burials arranged by the Director pursuant to § 3231 of this Chapter 3, and § 4A103 o f Chapter 4A Title 10, Guam Code Annotated. (e) The Director shall submit an annual spending pl an for the Fund in accordance with and at the same time as the Bureau of Budget and Management Research budget call. (f) The Guam Registrar of the Office of Vital Stati stics, via the Director, shall, by no later than the 20th day of each month, submit a financial report relative to the status an d activities of the Fund. The monthly report shall be submitted, v ia the Office of I Maga’lahen Guåhan , to the Speaker of I Liheslaturan Guåhan , and the Chairpersons of the Committee on Finance, and the Committee on Health of I Liheslaturan Guåhan . The report shall, at a minimum, contain: (1) all expenditures and encumbrances (monthly and year to date); (2) funds received and source(s); (3) status of accounts receivable for outstanding d ebts and/or delinquent

, at a minimum, contain: (1) all expenditures and encumbrances (monthly and year to date); (2) funds received and source(s); (3) status of accounts receivable for outstanding d ebts and/or delinquent payment obligations owed to the O ffice of Vital Statistics; and (4) any and all other pertinent information relativ e to the Fund. (g) The Office of Vital Statistics Revolving Fund s hall be included in the government of Guam annual audit rev iew and report. SOURCE: Added by P.L. 31-213:3 (May 10, 2012). 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. 2015 NOTE: In subsection (d)(6), the reference to § 4501 of Chapter 4A of Title 10 GCA was changed to § 4A103 pursuant to authority granted by 1 GCA § 1606. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 46 § 3228. Duty to Furnish Information Relative to Vit al Events. Any person having knowledge of the facts, shall fu rnish such information as he may possess regarding any bi rth, death, fetal death, marriage or divorce, upon demand of th e Guam Registrar of Vital Statistics.

having knowledge of the facts, shall fu rnish such information as he may possess regarding any bi rth, death, fetal death, marriage or divorce, upon demand of th e Guam Registrar of Vital Statistics. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3229. Penalties. (a) (l) Any person who willfully and knowingly make s any false statement in a report, record or certificate required to be filed under this article or in an application fo r amendment thereof or who willfully and knowingly supplies false information intending that such info rmation be used in the preparation of any such report, reco rd or certificate, or amendment thereof; or (2) Any person who without lawful authority and wit h intent to deceive, makes, alters, amends or mutilat es any report, record or certificate required to be filed under this article or certified copy of such report, record or certificate; or (3) Any person who willfully and knowingly uses or attempts to use or furnish to another for use, for any purpose of deception, any certificate, record, report or ce rtified copy thereof so made, altered, amended or mutilated; or (4) Any person

es or attempts to use or furnish to another for use, for any purpose of deception, any certificate, record, report or ce rtified copy thereof so made, altered, amended or mutilated; or (4) Any person who, with the intention to deceive, willfully uses or attempts to use any certificate o f birth or certified copy of a record of birth, knowing that s uch certificate or certified copy was issued upon a rec ord which is false in whole or in part, or which relates to t he birth of another person; or (5) Any person who willfully and knowingly furnishe s a certificate of birth or certified copy of a recor d of birth with the intention that it be used by a person othe r than the person to whom the record of birth relates, shall b e guilty of a misdemeanor. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 47 (b) (l) Any person who refuses to provide informat ion required by this article; or (2) Any person who willfully and knowingly transpo rts or accepts for transportation; interment or other d isposition a dead body without an accompanying permit as requi red by this article; or (3) Any person who willfully neglects or violates a ny of the provisions of this

portation; interment or other d isposition a dead body without an accompanying permit as requi red by this article; or (3) Any person who willfully neglects or violates a ny of the provisions of this article, or refuses to pe rform any of the duties imposed upon him by this article, shall be guilty of a petty misdemeanor. § 3230. Burial-Transit Permits. (a) No dead human body or fetus attaining twenty ( 20) weeks of gestation or more shall be buried, deposit ed in a crypt, mausoleum or vault, cremated, removed from Guam or otherwise disposed of, unless a burial-transit perm it has first been issued therefor by the Office of Vital Statist ics. Such permit shall be presented to the person in charge of the c emetery, crematorium or other place of disposition, and shal l be promptly returned by him to the Office of Vital Statistics a fter such burial, cremation or other disposition with a certification that the body was disposed of in accordance with the burial-trans it permit. (b) The Guam Registrar shall not issue a burial-tra nsit permit for the disposition of any dead body in any place other than in a cemetery, crematorium, crypt or mausoleum which is in compliance with the

The Guam Registrar shall not issue a burial-tra nsit permit for the disposition of any dead body in any place other than in a cemetery, crematorium, crypt or mausoleum which is in compliance with the regulations for cemeteries, cre matoriums, crypts or mausoleums established by the Director. E ach burial- transit permit shall include the cemetery plot numb er, crypt number or other information which will designate th e exact location to which the body will be taken. (c) The Guam Registrar shall issue burial-transit p ermits for disposition of bodies outside Guam or for burial at sea only when such disposition complies with regulations est ablished by the Director for this purpose. (d) Any person first assuming custody of a dead bod y or fetus shall obtain a burial-transit prior to final disposition or removal from Guam within seventy-two (72) hours aft er death. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 48 (e) Burial-transit permits shall be issued provided that first a certificate of death or fetal death has been filed with the Office in accordance with §§ 3216 and 3217 of this article.

AL SERVICES 48 (e) Burial-transit permits shall be issued provided that first a certificate of death or fetal death has been filed with the Office in accordance with §§ 3216 and 3217 of this article. (f) A permit issued under the law of any state whic h accompanies a dead human body or fetus brought into Guam for final disposition shall be the authority to dispose of said body or fetus; provided, that the Director, in the protecti on of the public health, having consideration of the cause of death or other special conditions, may, in his discretion, order s uch form of burial or disposition of a dead body or fetus as he deems necessary. (g) No dead human body or remains shall be disinter red for reburial or other purpose from any cemetery, crypt, mausoleum or vault without a permit from the Office of Vital Statistics. Such disinterments must comply with regulations establis hed by the Director of the disinterment of human bodies or rem ains. 2017 NOTE: References to 'territory' and 'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3231. Disposition. The right to control the disposition of a dead huma n body and the duty of burial or other disposition and

'territorial' removed and/or altered to 'Guam' pursuant to 1 GCA § 420. § 3231. Disposition. The right to control the disposition of a dead huma n body and the duty of burial or other disposition and the liability for the reasonable cost shall be pursuant to the provisions of § 4A102 and § 4A103 of Chapter 4A of 10 GCA. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Amended by P.L. 31-046:3 (May 23, 2011). 2015 NOTE: The reference to §§ 4502 and 4503 of Chapter 4A o f Title 10 GCA was changed to §§ 4A102 and 4A103 pursuant t o authority granted by 1 GCA § 1606. 2013 NOTE: Subsection designation deleted to adhere to the C ompiler’s general codification scheme in accordance to the au thority granted by 1 GCA § 1606. ---------- ARTICLE 3 DISEASE CONTROL § 3301. Definitions. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 49 § 3302. Duty to Report. § 3303. Same: Dispensaries, Hospitals, etc. § 3304. Same: Laboratories. § 3305. Same: Keeper of Boarding or Lodging Houses. § 3306. Same: Master of Vessels; Captain of Aircraf t. § 3307. Investigation. § 3308. Same: Access to Records, Reports, etc. § 3309. Isolation and Quarantine: Regulations. § 3310.

or Lodging Houses. § 3306. Same: Master of Vessels; Captain of Aircraf t. § 3307. Investigation. § 3308. Same: Access to Records, Reports, etc. § 3309. Isolation and Quarantine: Regulations. § 3310. Same: Authority of Director. § 3311. Placarding. § 3312. Violation of Isolation or Quarantine. § 3313. Chief of Police. § 3314. Disinfection of Premises. § 3315. Destruction of Property. § 3316. Compensation. § 3317. Closing of Schools. § 3318. Disposal of Bodies. § 3319. Responsibility of Person in Charge of Minor . § 3320. Willful Exposure. § 3321. Concealing Disease. § 3322. Vaccination and Immunization. § 3323. Prenatal Test. § 3324. Reports as to Prenatal Test. § 3325. Prevention of Blindness at Childbirth. § 3326. Immunization Audit. § 3326.1. Guam Immunization Registry. § 3327. Same: Confidentiality. § 3328. Autopsy. § 3329. Testing for Tuberculosis. § 3330. Testing of Juveniles for Human Immunodefici ency Virus, and Other Sexually Transmitted Diseaes upon Conviction or Adjudication of Having Committed Act or Acts of Criminal Sexual Assault. § 3331. Disclosure of Test Results. § 3332. Notice of Risk of Sexually Transmitted Dise ase. § 3333. Restricting Entry into Guam. § 3301.

n of Having Committed Act or Acts of Criminal Sexual Assault. § 3331. Disclosure of Test Results. § 3332. Notice of Risk of Sexually Transmitted Dise ase. § 3333. Restricting Entry into Guam. § 3301. Definitions. As used in this article: COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 50 (a) Communicable Disease includes any of the following diseases or conditions which are dangerou s to public health: (1) Acquired Immune Deficiency Syndrome (AIDS) (2) Amebiasis (amoebic dysentery); (3) Anthrax; (4) Brucellosis (undulant fever); (5) Chancroid; (6) Chickenpox; (7) Cholera; (8) Clonorchiasis (liver-fluke); (9) Conjunctivitis, acute infectious (pink eye); (10) Dengue; (11) Diarrhea of newborn (epidemic infantile); (12) Diphtheria; (13) Encephalitis, primary (infectious); (14) Erysipelas; (15) Favus; (16) Filariasis; (17) Fish (ciguatera) poisoning; (18) Fish (scombroid) poisoning; (19) Glanders (farcy); (20) Gonorrhea; (21) Gonorrheal ophthalmia; (22) Granuloma inguinale; (23) Hepatitis A (Infectious) (24) HIV-seropositive condition; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

(19) Glanders (farcy); (20) Gonorrhea; (21) Gonorrheal ophthalmia; (22) Granuloma inguinale; (23) Hepatitis A (Infectious) (24) HIV-seropositive condition; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 51 (25) Hepatitis B (Serum); (26) Hookworm disease; (27) Impetigo contagious (in institution); (28) Influenza; (29) Kerato-Conjunctivitis (Infectious); (30) Leprosy (Hansen's Disease); (31) Leptospirosis (Weil's disease or hemorrhagic jaundice); (32) Malaria; (33) Measles (rubeola); (34) Melioidosis (35) Meningitis, aseptic; (36) Meningitis, cerebrospinal (meningococcic); (37) Meningitis, other infectious; (38) Mononucleosis, infectious; (39) Mumps; (40) Paratyphoid fever; (41) Pertussis (whooping cough); (42) Plague; (43) Poliomyelitis, acute anterior (infantile paralysis); (44) Psittacosis-ornithosis; (45) Puerperal septicemia; (46) Rabies; (47) Relapsing fever; (48) Rheumatic fever (active); (49) Rickettsial disease; (50) Ringworm of the scalp (tinea capitis); COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 52 (51) Rubella (German measles); (52) Salmonellosis; (53) Scabies; (54) Severe Acute Respiratory Syndrome (SARS)

pitis); COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 52 (51) Rubella (German measles); (52) Salmonellosis; (53) Scabies; (54) Severe Acute Respiratory Syndrome (SARS) (55) Scarlet Fever; (56) Septic sore throat (streptococcus); (57) Shigellosis (bacillary dysentery); (58) Smallpox; (59) Syphilis; (60) Tetanus; (61) Trachoma; (62) Trichinosis; (63) Tuberculosis (pulmonary); (64) Tuberculosis (other than pulmonary); (65) Tularemia; (66 Typhoid fever; (67) Typhus fever; (68) Yaws; (69) Yellow fever (70) Any other disease deemed by the Director to be dangerous to the public health may be added by regulation. (71) In the event of any severe communicable disease with pandemic potential which is identified and declared by the U.S. Center for Disease Control and Prevention (CDC) to be critically dangerous to publ ic health and safety, and CDC mandates, directives, instructions and protocol criteria are being implemented in a national effort to combat the spre ad of the disease, the disease shall be immediately ad ded, COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

nstructions and protocol criteria are being implemented in a national effort to combat the spre ad of the disease, the disease shall be immediately ad ded, COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 53 and shall not require prior promulgation by regulat ion as a requisite for inclusion when time is of the es sence in ensuring the health and safety of the public. Subsequent promulgation by regulation may follow when practicable. (b) Isolation means the separation of persons suffe ring a communicable disease or carriers of such a diseas e from other persons for the period of communicability in such places and under such conditions as will prevent th e transmission of the causative agent; and (c) Quarantine means the limitation of freedom of movement of those who have been exposed to a communicable disease, whether a person or animal, f or a period of time equal to the longest usual incubatio n period of the disease, in such manner as to prevent effect ive contacts with those not so exposed. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). New Item (a)(55) (SARS) added by P.L. 27-007:1 (Apr. 9, 2003); remai ning items renumbered pursuant to P.L.

fect ive contacts with those not so exposed. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). New Item (a)(55) (SARS) added by P.L. 27-007:1 (Apr. 9, 2003); remai ning items renumbered pursuant to P.L. 27-007:2. Subsection ( a)(71) added by P.L. 32-221:3 (Dec. 20, 2014). § 3302. Duty to Report. Any person licensed or registered to practice any healing art under Chapter 12 of this Title who has knowledge of or suspects the presence of any communicable disease or any oth er disease dangerous to the public health, shall report the sa me to the Director within forty-eight (48) hours after diagno sis, unless a different time is prescribed by regulation, togethe r with the name, age, village of residence and sex of the pers on afflicted, the house or other place in which such person may b e found, and such other information as may be required by regula tion. § 3303. Same: Dispensaries, Hospitals, etc. The superintendent, chief medical officer, nurse i n charge or other person in charge of any hospital, clinic, dis pensary, infirmary, medical aid station or other establishme nt providing medical care, either to the general public or other wise, who has knowledge of the presence of any

any hospital, clinic, dis pensary, infirmary, medical aid station or other establishme nt providing medical care, either to the general public or other wise, who has knowledge of the presence of any communicable disea se or any other disease dangerous to the public health shall report the same COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 54 to the Director in accordance with § 3302 of this a rticle. When the patient is hospitalized, the person in charge o f the hospital in which he is hospitalized shall make the report. 3304. Same: Laboratories. The director, administrator, chief officer or other person in charge of any laboratory, public or private, perfor ming any test or examinations upon persons or their blood, urine, feces or any other body products shall, upon identification or s uspected identification of an etiologic agent, antigen, anti body or any other substance or combination of substances genera lly accepted as being diagnostic of the presence of a communicab le disease, shall report same to the Director in accordance wit h § 3302 of this article. § 3305. Same: Keeper of Boarding or Lodging Houses.

epted as being diagnostic of the presence of a communicab le disease, shall report same to the Director in accordance wit h § 3302 of this article. § 3305. Same: Keeper of Boarding or Lodging Houses. Any owner, keeper or other person in charge of the operation of a hotel, boarding house or dormitory s hall immediately report to the Director the presence the rein of any person he has reason to believe to be sick of, or t o have died of any contagious, infectious, communicable or other d isease dangerous to the public health. § 3306. Same: Master of Vessels; Captain of Aircraf t. Any master of a vessel or captain of an aircraft s hall immediately report to the Director or his represent ative the presence aboard such vessel or aircraft of any pers on such master or captain has reason to believe to be sick of or t o have died of any communicable disease. § 3307. Investigation. When a complaint is made or a reasonable belief ex ists that a communicable disease or other disease dangerous t o the public health prevails in any house or elsewhere which has not been reported, the Director shall make an inspection for the purpose of discovering whether any such disease exists. § 3308.

ous t o the public health prevails in any house or elsewhere which has not been reported, the Director shall make an inspection for the purpose of discovering whether any such disease exists. § 3308. Same: Access to Records, Reports, etc. When the Director has reason to believe that a communicable disease exists but that full and compl ete COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 55 information as required by § 3302 of this article h as not been provided, the Director or his representative may ex amine any and all records or reports deemed necessary to full y investigate the disease. § 3309. Isolation and Quarantine: Regulations. (a) Isolation and quarantine shall be imposed in a ccordance with regulations. Such regulations shall designate the disease for which isolation or quarantine is necessary, and suc h other requirements concerning diagnosis, treatment, relea se and other pertinent matters as may be necessary. (b) The regulations shall also provide for isolation an d quarantine, voluntary and involuntary, for the know n incubation period, as determined by the U.S.

her pertinent matters as may be necessary. (b) The regulations shall also provide for isolation an d quarantine, voluntary and involuntary, for the know n incubation period, as determined by the U.S. Center for Diseas e Control and Prevention (CDC), of any communicable disease which is identified and declared by the CDC to be critically dangerous to public health and safety; and CDC mandates, directi ves, instructions and protocol criteria are being declar ed and implemented in a national effort to combat the spre ad of the disease. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Subsectio n (b) added by P.L. 32-221:2 (Dec. 20, 2014). 2015 NOTE: Subsection (b) was added as subsection (a) by P.L. 32- 221:2, but was redesignated by the Compiler pursuan t to the authority of 1 GCA § 1606. § 3310. Same: Authority of Director. (a) Notwithstanding § 3309 of this article, when a person has or is reasonably suspected of having or is reas onably suspected of being a carrier of any communicable di sease or any other disease dangerous to the public health, the D irector may impose isolation of such person and may impose quar antine on anyone who has had contact with such person.

communicable di sease or any other disease dangerous to the public health, the D irector may impose isolation of such person and may impose quar antine on anyone who has had contact with such person. The ex tent and duration of isolation and quarantine imposed in a g iven case and release therefrom shall be within the discretion of the Director, depending upon the disease. The Director may, in hi s discretion, determine the persons subject to isolation and quar antine, specify the places or areas to which or in which they are r estricted in their movements, prescribe other conditions and req uirements to COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 56 be observed, decide the duration of isolation and q uarantine and release therefrom and issue other necessary instruc tions. He shall insure that provisions are made for medical observa tion of such persons as frequently as necessary during isolation and quarantine or amend the degree thereof and other re strictions imposed in connection therewith at any time. (b) When a person has or is reasonably suspected of having or is reasonably suspected of being a carrier of an y communicable disease or any

re strictions imposed in connection therewith at any time. (b) When a person has or is reasonably suspected of having or is reasonably suspected of being a carrier of an y communicable disease or any other disease dangerous to the public health, the Director may, in his discretion and for the safety of the public, remove such person, with or w ithout his consent, to a licensed hospital or other designated premises for the purpose of isolation and treatment until the di sease is no longer communicable by such person. If the Director should determine that removal of such person is not practi cable, such person may be allowed to remain where he is and the Director may take such measures as he may deem advisable to provide for his care for the public health by way of isolation and quarantine. (c) Notwithstanding § 3309 of this Article, the Dir ector may, in his discretion and for the health and safet y of the public, remove such person, with or without his consent for isolation and quarantine, voluntary and involuntary, for the duration of the known incubation period, as determined by the U.S.

et y of the public, remove such person, with or without his consent for isolation and quarantine, voluntary and involuntary, for the duration of the known incubation period, as determined by the U.S. Center for Disease Control and Prevention (CDC), of any severe communicable disease which is identified and declar ed by the CDC to be critically dangerous to public health and safety, and for which CDC mandates, directives, instructions an d protocol criteria are being declared and implemented in a na tional effort to combat the spread of the disease. (1) The Director shall base the minimum duration of the incubation period upon the period of time deter mined to be appropriate and necessary by the U.S. Center for Disease Control and Prevention. (2) The duration of isolation and quarantine for th e incubation period shall be deemed to include an add itional period of time as is necessary for testing and conf irmation that the person does not have, or no longer is the carrier of a communicable disease. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 57 SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Subsection ( c) added by P.L. 32-221:4 (Dec. 20, 2014).

icable disease. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 57 SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Subsection ( c) added by P.L. 32-221:4 (Dec. 20, 2014). § 3311. Placarding. When a person has been isolated or quarantined and is restricted thereby to his residence or other buildi ng, the Director may place in a conspicuous position on the exterior of the premises where such person is isolated or quarantin ed a placard having printed on it in large letters the name of t he disease and warning all unauthorized persons to remain off the premises. Such placard shall be in both English and Chamorro and in any other languages the Director deems appropriate. No person shall remove, deface or destroy such placard until author ized by the Director. Except as authorized by the Director or b y regulation, no person shall enter or leave any premises which h as been placarded. § 3312. Violation of Isolation or Quarantine. No person who has been isolated or quarantined sha ll leave the premises or area to which he has been restricte d without the written permission of the Director until he has bee n released from such isolation or quarantine. § 3313.

or quarantined sha ll leave the premises or area to which he has been restricte d without the written permission of the Director until he has bee n released from such isolation or quarantine. § 3313. Chief of Police. Upon the request of the Director, it shall be the duty of the Chief of Police to act and assist in the enforcemen t of isolation and quarantine, using such force as may be reasonab ly necessary. § 3314. Disinfection of Premises. The Director may, if he deems it advisable, order the premises and contents thereof in which any person h as been ill or has died of a communicable disease or any other roo m, building, premises or area, any contents thereof, which may b e infective by contact with any communicable disease, to be dis infected and purified in such manner as he may direct. It shall be the duty of the owner or occupant of such premises to comply wi th any such order. § 3315. Destruction of Property. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 58 The Director may destroy any infective clothing, b edding or other article which cannot be made safe by disinfec tion.

COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 58 The Director may destroy any infective clothing, b edding or other article which cannot be made safe by disinfec tion. He shall furnish to the owner thereof a receipt showing the number, character, condition and estimated value of the art icle so destroyed. A copy of such receipt shall be retained by the Director. § 3316. Compensation. Upon the presentation of the original receipt for articles destroyed under § 3315 of this article and approval by the Attorney General, the Director shall pay to the own er of such property, out of such appropriations of the Departm ent as may be available, the value of such destroyed articles. § 3317. Closing of School. During an epidemic or threatening epidemic or when a dangerous communicable disease is unusually prevale nt, the Director may close any public or private school and prohibit any public or private gathering for such time as may be necessary in the interest of the public health. § 3318. Disposal of Bodies. The Director, in his discretion, may require that the body of a person, who has died of a communicable disease or any other disease dangerous to the

of the public health. § 3318. Disposal of Bodies. The Director, in his discretion, may require that the body of a person, who has died of a communicable disease or any other disease dangerous to the public health, be buried o r cremated immediately or within such period of time and in co nformity with such procedures for the protection of the publ ic health, as he may designate. § 3319. Responsibility of Person in Charge of Minor . Where any person suffering from a communicable dis ease is required to remain isolated or quarantined or to do or refrain from doing any act or thing whereby spread of the d isease may be enhanced or such person because of his tender ag e or of physical or mental disability is unable to comprehe nd or comply with such requirements, it shall be the duty of the parent, guardian or other person, including any attendant h aving such patient under his care, custody or control to compl y or cause compliance with the isolation or quarantine so impo sed and pertinent provisions of this article. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 59 § 3320. Willful Exposure.

iance with the isolation or quarantine so impo sed and pertinent provisions of this article. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 59 § 3320. Willful Exposure. No person having a communicable disease or any oth er disease dangerous to the public health or being in charge of any other person afflicted with such a disease, shall w illfully expose himself or such person in any public place, street or highway except as may be authorized by the Director. § 3321. Concealing Disease. No person shall conceal any person having any communicable disease or any other disease dangerous to the public health, including any venereal disease. No p arent, guardian or other person having custody or care of a minor child shall conceal the fact of a minor child having any such disease. § 3322. Vaccination and Immunization. (a) No student shall be permitted to attend any pu blic or private school, college or university within Guam u nless evidence is presented to the enrolling officer of s uch school, college or university that the student child is fre e from any communicable diseases, and has had all the required vaccinations or immunizations as the Director

the enrolling officer of s uch school, college or university that the student child is fre e from any communicable diseases, and has had all the required vaccinations or immunizations as the Director shall in conformity with Advisory Committee on Immunization Practice (‘ACIP’) of the United States Department of Human S ervices and the American Academy of Pediatrics (‘AAP’); pro vided, that in the event that the recommendations of the ACIP a nd the AAP differ, the Department shall determine which recomm endations shall apply, except that exemption may be granted t o a student in a case: (1) when the vaccination or immunization would be against his or her religious beliefs and would not constitute a contagious health risk for the public at large, a s certified annually prior to commencement of the school year b y the Director in consultation with a Guam Licensed physi cian or by a Guam licensed physician; or (2) upon certification by a parent or guardian of a student who is a minor, that such vaccination or immunization would be against their religious belie f and would not constitute a contagious health risk for t he public COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

s a minor, that such vaccination or immunization would be against their religious belie f and would not constitute a contagious health risk for t he public COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 60 at large, as certified annually prior to commenceme nt of the school year by the Director in consultation with a Guam licensed physician or by a Guam Licensed physician; or (3) when a student who has been certified by a Guam licensed medical doctor that said student should be exempt from this Section where medical contraindication to his or her receiving a specific vaccine exists. (b) Certificates of medical and religious exemption shall be kept on file in Bureau of Communicable Diseases Con trol of the Department. A copy of the certificate for medical a nd religious exemption shall be included in the student’s record at the school. (c) The Director shall notify enrolling officers of all schools and shall notify all parents by public media of any changes to the existing immunization schedules no later than March 1 of each year to allow for the smooth opening of traditional ly scheduled schools.

shall notify all parents by public media of any changes to the existing immunization schedules no later than March 1 of each year to allow for the smooth opening of traditional ly scheduled schools. (d) The Director shall require vaccination and immu nization of any person or persons suspected as carriers of a communicable disease upon entering or leaving Guam which the Director believes may present a risk to the public health of Guam. In case of an epidemic or to control a possib le epidemic of a communicable disease, the Director may direct that the general population be vaccinated and immunized agai nst said disease. Students who are not immunized for whateve r reason may be excluded from schools at the direction of th e Director in case of an epidemic or to control a possible epidem ic. (e) (1) Nothing herein shall be construed or interp reted as to prevent the Guam Department of Education (GDOE) from implementing a School-Located Vaccination (SLV ) program in any school or institution of higher lear ning on Guam for the purpose of administering vaccines requ ired by Subsection (a).

on (GDOE) from implementing a School-Located Vaccination (SLV ) program in any school or institution of higher lear ning on Guam for the purpose of administering vaccines requ ired by Subsection (a). Such SLV program may additionally include, but not be limited to, the administering o f human papillomavirus (HPV) vaccines, annual influenza (fl u shot) vaccines, or any other vaccines not required by Sub section (a), but recommended by the United States Centers f or Disease Control and Prevention (CDC). Such SLV COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 61 programs may be implemented in public schools, individually or on a system-wide basis. GDOE may en roll in the federally-funded Vaccine for Children (VFC) program, overseen by the Department of Public Healt h and Social Services Immunization Program, as a provider . The Department of Public Health and Social Services Immunization Program may assist GDOE at the start o f the SLV Program by providing medical and ancillary supp lies (syringes, needles, gloves, biohazard bags, sharps container, band aids, and alcohol prep pads) and may assist in meeting compliance for storage and handling, provide

medical and ancillary supp lies (syringes, needles, gloves, biohazard bags, sharps container, band aids, and alcohol prep pads) and may assist in meeting compliance for storage and handling, provide requir ed digital loggers, a proper transport cooler, and if funding is available, a medical/pharmaceutical grade refrigera tor. (2) To the extent allowable and practical, the Guam Department of Education may bill any health insuran ce/plan company, Medicaid, the Medically Indigent Program ( MIP), the Child Health Insurance Program (CHIP), or any o ther party providing coverage for which the child is cov ered for the cost of the vaccines/immunizations, supplies to administer vaccines/immunizations, the administerin g of the vaccines/immunizations, and other permitted costs. The Guam Department of Education is not permitted to bi ll any party for any vaccines or supplies that were receiv ed through federal programs or donations where the acc eptance of such vaccines and supplies prohibits such billin g. Revenues realized from such billing activities shal l be used to cover the costs of the Guam Department of Educat ion related to the SLV program, and maintained in a sep arate fund and

such billin g. Revenues realized from such billing activities shal l be used to cover the costs of the Guam Department of Educat ion related to the SLV program, and maintained in a sep arate fund and bank account. Billing and accounting servi ces may be administered by the Department of Administration or may be outsourced to a private accounting firm. All receipts, expenditures, and financial statements sh all be subject to audit and review periodically as determi ned by the Guam Office of Public Accountability. SOURCE: Added by P.L. 22-130:2 (May 31, 1994). Repealed and reenacted by P.L. 24-154:2 (Apr. 9, 1998). Subsecti on (a) amended by P.L. 24-335:2 (Dec. 30, 1998). Subsection (e) added by P.L. 35-102:1 (Oct. 29, 2020). COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 62 2021 NOTE: Subitem designations added pursuant to the authori ty of 1 GCA § 1606. 2013 NOTE: Numbers and/or letters were altered to adhere to the Compiler’s alpha-numeric scheme in accordance to 1 GCA § 1606. § 3323. Prenatal Test. Any licensed physician attending a pregnant woman for a condition relating to her pregnancy during the peri od of gestation or at delivery shall take or

rdance to 1 GCA § 1606. § 3323. Prenatal Test. Any licensed physician attending a pregnant woman for a condition relating to her pregnancy during the peri od of gestation or at delivery shall take or cause to be taken a sa mple of the blood of such woman and submit such sample to the Department’s laboratory or other laboratory approve d by the Director for a standard serologic test for syphilis . Any other person permitted by law to attend pregnant women, b ut not permitted by law to take blood samples, shall cause a sample of blood of every pregnant woman attended by him to be taken by a duly licensed physician or at a lab approved by the Director for a standard serologic test for syphilis. Such samples of blood shall be taken at the time of the first visit of the preg nant woman or within fourteen (14) days thereafter. Every pregnan t woman shall permit such samples of her blood to be taken as in this section. § 3324. Report as to Prenatal Test. In reporting any birth or stillbirth, any physicia n or other person required to make such reports shall state in a report accompanying the certificate whether, according to his knowledge or information, a blood test for syphilis has

th, any physicia n or other person required to make such reports shall state in a report accompanying the certificate whether, according to his knowledge or information, a blood test for syphilis has been made upon a specimen of blood taken from the woman who bore the child for which the birth or stillbirth certifi cate is filed and the approximate date when the specimen was taken. T he Director is authorized to investigate the circumstances surr ounding the birth of any baby on whose mother no serologic test , as required by the provisions of this article, appears to have been taken. § 3325. Prevention of Blindness at Childbirth. Any physician, midwife, or any other person in att endance at childbirth immediately after birth shall adminis ter a one percent (1%) silver nitrate solution to both eyes o f the newborn child. Preparations other than one percent (1%) sil ver nitrate may COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 63 be used only on approval of the Director and subjec t to such conditions and restrictions as the Director may imp ose. § 3326. Immunization Audit. Annually, the Director shall conduct an immunizati on audit.

only on approval of the Director and subjec t to such conditions and restrictions as the Director may imp ose. § 3326. Immunization Audit. Annually, the Director shall conduct an immunizati on audit. Sample audits shall be conducted on public health c linic records, private clinic records and private physicians' reco rds to determine if: (a) One (1) consolidated immunization record is pos ted on the inside front cover of the patient's medical record if the patient is under the age of eighteen (18); and (b) If the record of any child found to be deficien t in immunizations indicates: (1) That progress towards immunization is being made; (2) A record of scheduled return appointment for the child; or (3) A reason for the lack of immunization. § 3326.1. Guam Immunization Registry. (a) All health care providers performing immunizations to children and adults shall submit immunization reports to the Department of Public Health and Social Services (De partment) in a manner compliant with the guidelines for submi ssions issued by the Department, which shall , at a minimum, indicate the name, date, age, and gender, and specific immunizat ion received by the patient.

nner compliant with the guidelines for submi ssions issued by the Department, which shall , at a minimum, indicate the name, date, age, and gender, and specific immunizat ion received by the patient. (1) All immunization records and reports made for the purposes of compliance with this Section that d irectly or indirectly identify a person shall be kept confidential and shall not be disclosed, except under the following conditions: (A) the person identified, the person’s legal guardian, or in the case of a minor, the minor’s pa rent or legal guardian consents; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 64 (B) disclosure is deemed necessary by the Director of the Department to carry out the purpose s and intent of this Chapter; (C) a court directs upon its determination that disclosure is necessary for the conduct of proceedi ngs before it; (D) the disclosure is made between the person’s healthcare provider and payer to obtain reimburseme nt for services rendered to the person; provided, that disclosure shall be made only if the provider informs the person that a reimbursement claim will be made to the person’s payer, the person is afforded an

rvices rendered to the person; provided, that disclosure shall be made only if the provider informs the person that a reimbursement claim will be made to the person’s payer, the person is afforded an opportunity to pay the reimbursement directly, and the person does not pay; or (E) the Department of Public Health and Social Services releases aggregate immunization informatio n that does not disclose any identifying information of persons whose information is maintained in the registry. (2) Registry information shall be limited to patient name, demographic information, and contact informat ion; information specific to immunizations or medication received by the patient, including types, manufactu rers, lots numbers, expiration dates, anatomical sites of administration, routes of administration, vaccine information statement publication dates, doses, dat es administered, the patient’s history of vaccine, pre ventable diseases, and contraindications, precautions, adver se reactions to, or comments regarding immunization or medications; and the name and contact information o f the vaccination administrator or medication provider an d the patient’s healthcare provider.

reactions to, or comments regarding immunization or medications; and the name and contact information o f the vaccination administrator or medication provider an d the patient’s healthcare provider. (3) The Department of Public Health and Social Services shall adopt administrative, physical, and technical measures to ensure the security of the registry; pr otect the confidentiality, integrity, and availability of reg istry data; and prevent unauthorized access to registry informa tion. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 65 (b) Purpose for Access to Registry Information; Acc ess not Disclosure. (1) Notwithstanding Subsection (a)(1), it shall not be a disclosure for the persons listed in Paragraphs ( 2), (3), (4) and (5) of this Subsection to have limited access t o registry information for the purposes specified in each Subs ection. (2) Registry information regarding specific individuals in the registry may be accessed by auth orized healthcare providers who are treating, have treated , or have been assigned to treat those individuals; by author ized employees of these healthcare providers; and, by au thorized DPHSS health personnel

lthcare providers who are treating, have treated , or have been assigned to treat those individuals; by author ized employees of these healthcare providers; and, by au thorized DPHSS health personnel assigned to monitor the immunization or health status of those individuals for the purposes of: (A) recording the administration of any vaccination, including the pandemic influenza vacci ne; (B) determining the immunization history of a patient to deliver healthcare treatment accordingly ; (C) notifying individuals or parents or legal guardians of the need to schedule a visit for an immunization; (D) generating official immunization records; (E) ensuring compliance with mandatory immunization requirements; (F) recording the distribution of the prophylactic and treatment medications administered or dispensed in preparation for, and in response to, a potential ly catastrophic disease threat; or (G) complying with the Guam Immunization Program. (3) Registry information regarding specific individuals in the registry may be accessed by scho ol and post-secondary school personnel authorized by the D irector of Public Health and Social Services, the Superinte ndent of the Guam Department of

ividuals in the registry may be accessed by scho ol and post-secondary school personnel authorized by the D irector of Public Health and Social Services, the Superinte ndent of the Guam Department of Education, or the administra tor of COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 66 a private or post-secondary school for the purpose of ensuring compliance with mandatory student immuniza tion requirements. (4) Registry information regarding specific individuals in the registry may be accessed by auth orized health organizations that have been contracted to p rovide health insurance or health plan coverage for those individuals; provided, that access is limited to only the enrollees, members, subscribers, and insured of the authorized health organization, and for the purpose of producing an immunization assessment report by the authorized health organization. (5) Registry information regarding specific individuals in the registry may be accessed by the Department, or agents of the Department, for the pu rposes of: (A) ensuring compliance with mandatory immunization requirements; (B) performing immunization related quality improvement or quality

the Department, or agents of the Department, for the pu rposes of: (A) ensuring compliance with mandatory immunization requirements; (B) performing immunization related quality improvement or quality assessment activities; (C) complying with Guam Vaccines for Children and/or other provided vaccine programs, vaccine ordering and accountability policies and procedures ; (D) producing aggregate immunization assessment reports to monitor and improve public health; (E) supporting efforts to prevent and manage outbreaks of vaccine-preventable diseases, includin g pandemic influenza; (F) assisting the Department in the event of a public health emergency; or (G) managing and maintaining the Guam Immunization Registry system. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 67 (6) The use of the registry information accessed pursuant to this Section shall be limited to an authorized vendor for registry development, maintenance and su pport. (c) Registry Record Requirements. The establishment of an individual’s record in the registry shall not require the prior consent of a patient, the consent of the legal guar dian of a patient, or the consent of a patient’s

uirements. The establishment of an individual’s record in the registry shall not require the prior consent of a patient, the consent of the legal guar dian of a patient, or the consent of a patient’s parent or le gal guardian in the case of a minor or dependent. The Department shall make available to the patient or patient’s parent or leg al guardian in the case of a minor or dependent, via the patient’s hea lth care provider or birthing hospital, a written descriptio n of the purpose and benefits of the Guam Immunization Registry, as well as the procedure for refusing inclusion in the registry. SOURCE: Added by P.L. 32-073:2 (Nov. 27, 2013) as 10 GCA 3210.1. Codified to this section by the Compiler pursuant t o 1 GCA § 1606. 2015 NOTE: Subsection designation (c)(1) was altered to subs ection (c) to adhere to the Compiler’s general codification sc heme pursuant to the authority granted by 1 GCA § 1606. § 3327. Same: Confidentiality. The immunization audit shall be done by the Directo r who may delegate his duty. The Director shall be respon sible for assuring that the confidentiality of individual pat ient records is preserved.

The immunization audit shall be done by the Directo r who may delegate his duty. The Director shall be respon sible for assuring that the confidentiality of individual pat ient records is preserved. The Department shall be responsible for compiling a statistical report of the audit. § 3328. Autopsy. The Director may order an autopsy to determine if the deceased died of a communicable disease or whenever , in his direction, the public interest justifies it. § 3329. Testing for Tuberculosis. (a) No student shall be permitted to attend any p ublic or private school, college, or university within Guam unless they have on file with the enrolling officer of such sch ool, college or university a report of a Tuberculosis ('TB') skin t est result. (b) If the student is entering from the United Stat es or states or its territories, such test must have been conduc ted within one year prior to enrollment. If the student is enterin g from an area COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 68 other than the United States or its states or terri tories, such test must have been conducted within six (6) months prio r to enrollment.

EALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 68 other than the United States or its states or terri tories, such test must have been conducted within six (6) months prio r to enrollment. (c) If a student has had a positive TB skin test, a Certificate of Tuberculosis Evaluation must be obtained from th e Department. If this certificate indicates that the student is TB contagious the student shall be permitted entrance to school only after he or she is certified as noncontagious by th e Department. 2014 NOTE: Subsection designations were added by the Compiler in accordance with the authority granted by 1 GCA § 16 06. § 3330. Testing of Juveniles for Human Immunodefici ency Virus, and Any Other Sexually Transmitted Diseases upon Conviction or Adjudication of Having Committed Act or Acts of Criminal Sexual Assault. The court shall issue an order requiring a juvenil e, who has been certified to the criminal court for prosecutio n as an adult and convicted of criminal sexual conduct, as define d in §§ 25.15, 25.20, 25.25, and 25.30 of Title 9, Guam Code Annot ated, or a juvenile adjudicated to have committed an act or ac ts of criminal sexual conduct or placed in a deferred

duct, as define d in §§ 25.15, 25.20, 25.25, and 25.30 of Title 9, Guam Code Annot ated, or a juvenile adjudicated to have committed an act or ac ts of criminal sexual conduct or placed in a deferred admission st atus for criminal sexual conduct, to submit to testing to de termine the presence of human immunodeficiency virus (HIV), or any other sexually transmitted disease, if the victim request s the test. SOURCE: Added by P.L. 23-071:2 (Feb. 27, 1996). 2013 NOTE: Subsection designation deleted to adhere to the C ompiler’s general codification scheme in accordance to the au thority granted by 1 GCA § 1606. § 3331. Disclosure of Test Results. The date and results of a test performed under Sec tion 3330 of this Chapter must be made available, on request, to the victim or, if the victim is a minor, to the victim's paren t or guardian and positive test results shall be reported to the Dire ctor of Public Health, as required under §§ 3302, 3303, and 3304 o f this Chapter. Data regarding administration and results of the test shall not be accessible to any other person for any purpose and shall not be maintained in any record of the court or court services or any other record

garding administration and results of the test shall not be accessible to any other person for any purpose and shall not be maintained in any record of the court or court services or any other record COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 69 SOURCE: Added by P.L. 23-071:3 (Feb. 27, 1996). § 3332. Notice of Risk of Sexually Transmitted Dise ase. (a) Notice required. A hospital shall give a writte n notice about sexually transmitted diseases to a person rec eiving medical services in the hospital who reports or evidences a sexual assault or other unwanted sexual contact or sexual penetrat ion. When appropriate, the notice must be given to the parent or guardian of the victim. (b) Contents of notice. The Chief of Police, or his designee, in consultation with sexual assault victim advocate s and health care professionals, shall develop the notice requir ed by subsection (a). The notice must inform the victim o f: (1) the risk of contracting sexually transmitted di seases as a result of a sexual assault; (2) the symptoms of sexually transmitted diseases; (3) recommendations for periodic testing for the diseases, where appropriate; (4) locations

y transmitted di seases as a result of a sexual assault; (2) the symptoms of sexually transmitted diseases; (3) recommendations for periodic testing for the diseases, where appropriate; (4) locations where confidential testing is done an d the extent of the confidentiality provided; (5) information necessary to make an informed decision whether to request a test of the offender under 10 GCA § 3330; and (6) other medically relevant information. SOURCE: Added by P.L. 23-071:4 (Feb. 27, 1996). § 3333. Restricting Entry into Guam. (a) Upon declaration by the United States Centers for Disease Control and/or the World Health Organizatio n that a health-related epidemic or outbreak has taken place in a jurisdiction, or issues a health advisory on a juri sdiction, I Maga’lahen Guåhan, with the advice from the Director of Public Health and Social Services, may, through Executive Order, declare a public health emergency and restrict entr y into Guam those individuals who have been in the affected jur isdiction for more than one (1) week and do not possess a recogni zed and COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

and restrict entr y into Guam those individuals who have been in the affected jur isdiction for more than one (1) week and do not possess a recogni zed and COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 70 certified document that attests that they have been tested for the specific disease and determined not to be infected. The date of the test must not be more than one (1) week from th e date of their entry into Guam. (b) Any individual who enters into Guam without the proper documentation, shall be quarantined pursuant to this Section and §§19604 and 19605 of Article 6, Chapter 19 of Title 10, Guam Code Annotated. (c) Any and all costs associated with the quarantin e and/or treatment of individuals who unlawfully enter Guam pursuant to this Act will be the responsibility of the individu al and the carrier that the individual contracted to travel to Guam with. (d) Once the entry restriction is imposed, it will remain in effect until I Maga’lahen Guåhan , with the advice from the Director of Public Health and Social Services, issu es a written order rescinding the Executive Order. SOURCE: Added by P.L. 29-107:1 (Aug. 22, 2008).

l I Maga’lahen Guåhan , with the advice from the Director of Public Health and Social Services, issu es a written order rescinding the Executive Order. SOURCE: Added by P.L. 29-107:1 (Aug. 22, 2008). ---------- ARTICLE 4 MATERNAL AND CHILD HEALTH AND CHILDREN WITH SPECIAL NEEDS § 3401. Designation of Department of Public Health and Social Services as Cooperative Agency. § 3401. Designation of Department of Public Health and Social Services as Cooperative Agency. The Department of Public Health and Social Service s is hereby designated as the agency to cooperate with t he duly constituted Federal authorities in the administrati on of these parts of the Social Security Act which relate to ma ternal and child health services and the care and treatment of children with special health needs and is authorized to receive a nd expend all funds made available by the Federal government or f rom any other source for the purpose provided in this artic le; provided, that all plans, rules and regulations, or agreement s adopted in COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 71 connection therewith shall be subject to the approv al of the Governor.

les and regulations, or agreement s adopted in COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 71 connection therewith shall be subject to the approv al of the Governor. ---------- ARTICLE 5 MATERNAL AND CHILD HEALTH SERVICES § 3501. Maternal and Child Health Programs: Administration and Purposes. § 3502. Guam Plan for Maternal and Child Health Ser vices: Formulation, Adoption and Approval. § 3503. Provisions to Be Included in Guam Plan. § 3504. Duties of Director. § 3505. Maternal and Child Health Service Funds: Cu stody and Expenditures. § 3501. Maternal and Child Health Programs: Administration and Purposes. (a) The Department of Public Health and Social Ser vices (the Department) is hereby designated as the agency to administer a maternal and child health program in G uam. (b) The purposes of such program shall be to develo p, extend and improve health services, and to provide for development of demonstration services. § 3502. Guam Plan for Maternal and Child Health Ser vices: Formulation, Adoption and Approval. (a) The Department hereby empowered and authorized : (l) To formulate, adopt and administer a detailed p lan or plans for the purposes

and Child Health Ser vices: Formulation, Adoption and Approval. (a) The Department hereby empowered and authorized : (l) To formulate, adopt and administer a detailed p lan or plans for the purposes specified in § 3501 of th is article. (2) To make and adopt all such rules and regulation s not inconsistent with the provisions of §§ 3501 thr ough 3505 of this article, inclusive, or of the Social S ecurity Act, as are or may be necessary for the administration o f such plan or plans and the administration of this articl e. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 72 (b) Such plan or plans and the rules and regulation s when formulated shall be submitted to the Secretary of H ealth and Human Services for approval, and when approved by t he Secretary shall thereupon be made effective by the Department in accordance with the Administration Adjudication Law. § 3503. Provisions to Be Included in Guam Plan. Such plan or plans shall include therein provision s for: (a) Financial participation by Guam. (b) Administration of such plans or plans by the Department.

03. Provisions to Be Included in Guam Plan. Such plan or plans shall include therein provision s for: (a) Financial participation by Guam. (b) Administration of such plans or plans by the Department. (c) Such methods of administration as are necessary for efficient operation of such plan or plans. (d) Maintenance of records and preparation as are necessary for efficient operation of such plan or p lans. (e) Cooperation with medical, health, nursing and welfare groups and organizations for the purpose of extending and improving maternal and child health. (f) Receiving and expending in the manner provided herein in accordance with such plan or plans, all f unds made available by the Federal government or from any oth er source for such purposes. (g) Cooperating with the Federal government, throug h its appropriate agency or instrumentality, in devel oping, extending and improving such services, and in the administration of such plan or plans and developmen t of demonstration services among groups in special need . (h) Carrying out the purposes specified in § 3501 o f this article. § 3504. Duties of Director.

tration of such plan or plans and developmen t of demonstration services among groups in special need . (h) Carrying out the purposes specified in § 3501 o f this article. § 3504. Duties of Director. (a) The Director of Public Health and Social Servic es (the Director) shall be the administrative officer of th e agency with respect to the administration and enforcement of th e provisions of this article, and of the plan or plans formulate d and adopted in COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 73 accordance therewith and all such rules and regulat ions necessary thereto. (b) The Director is hereby empowered and directed t o administer and enforce all rules and regulations ad opted for the efficient operations of the plan or plans formulate d for the purposes of this article. (c) The Director shall, from time to time as direct ed by the Secretary of Health and Human Services make such re ports in such form and containing such information as the Se cretary of Health and Human Services shall require. (d) The Director shall from time to time, pursuant to the rules and regulations of the Secretary of Health an d Human Services and of the Secretary

cretary of Health and Human Services shall require. (d) The Director shall from time to time, pursuant to the rules and regulations of the Secretary of Health an d Human Services and of the Secretary of the Treasury, requ isition and cause to be deposited with the Treasurer of Guam al l moneys allotted to Guam by the Federal government for the purposes of this article, and shall cause to be paid out of the treasury the moneys therein deposited for such purposes. § 3505. Maternal and Child Health Service Funds: Cu stody and Expenditures. (a) The Treasurer of Guam is hereby made custodian of all moneys allotted to Guam by the Federal government, or received from other sources, for the purposes of maternal an d child health services. (b) The Treasurer shall receive and provide for the proper custody of such moneys and is authorized to deposit such moneys in the same manner as other public moneys ar e deposited. (c) Such moneys shall be disbursed only upon certif ication by the Director. ---------- ARTICLE 6 SERVICES FOR CHILDREN WITH SPECIAL HEALTH NEEDS COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 74 § 3601.

only upon certif ication by the Director. ---------- ARTICLE 6 SERVICES FOR CHILDREN WITH SPECIAL HEALTH NEEDS COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 74 § 3601. Program for Services for Children with Spec ial Health Needs: Administration and Purposes. § 3602. Guam Plan for Services for Children with Sp ecial Health Needs: Formulation, Adoption and Approval. § 3603. Provisions to be Included in Plan. § 3604. Duties of Director. § 3605. Services for Children with Special Health N eeds: Custody and Expenditure. § 3606. Department Authorized to Enter into Coopera tive Agreements with Federal Government. § 3601. Program for Services for Children with Spec ial Health Needs: Administration and Purposes. (a) The Department of Public Health and Social Serv ices (the Department) is hereby designated as the agency to administer a program of service for children with a disability(ies) or special health need(s). (b) The purpose of such program shall be to develop , extend, and improve services for locating such chil dren, to provide medical, surgical, corrective and other ser vices and care, to provide facilities for diagnosis, hospitalizatio n and

to develop , extend, and improve services for locating such chil dren, to provide medical, surgical, corrective and other ser vices and care, to provide facilities for diagnosis, hospitalizatio n and aftercare. § 3602. Guam Plan for Services for Children with Sp ecial Health Needs: Formulation, Adoption and Approval. (a) The Department is hereby empowered and authoriz ed: (l) To formulate, adopt and administer a detailed p lan or plans for the purposes specified in § 3601 of th is article. (2) To make and adopt all such rules and regulation s, not inconsistent with the provisions of §§ 3601 thr ough 3605 of this article, inclusive, or of the Social S ecurity Act, as are or may be necessary for the administration o f such plan or plans and the administration of this Articl e. (b) Such plan or plans and the rules and regulation s, when formulated, shall be submitted to the Secretary of Health and Human Services for approval, and when approved by t he Secretary shall thereupon be made effective in acco rdance with the Administration Adjudication Law. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 75 § 3603. Provisions to Be Included in Plan.

be made effective in acco rdance with the Administration Adjudication Law. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 75 § 3603. Provisions to Be Included in Plan. Such plan or plans shall include therein provisions for: (a) Financial participation by Guam. (b) Administration of such plan or plans by the Department. (c) Such methods of administration as are necessary for efficient operation of such plan or plans. (d) Maintenance of records and preparation, submission and filing of reports of services render ed. (e) Cooperation with medical, health, nursing and welfare groups and organizations, and with any agen cy charged with administration of laws providing for vocational rehabilitation of physically handicapped children. (f) Receiving and expending in the manner provided herein in accordance with such plan or plans, all f unds made available by the Federal government, or from any ot her source for such purposes. (g) Cooperating with the Federal government, throug h its appropriate agency or instrumentality, in devel oping, extending and improving such services and in the administration of such plan or plans.

(g) Cooperating with the Federal government, throug h its appropriate agency or instrumentality, in devel oping, extending and improving such services and in the administration of such plan or plans. (h) Carrying out the purposes specified in § 3601 o f this article. § 3604. Duties of Director. (a) The Director of Public Health and Social Servic es (the Director) shall be the administrative officer of th e agency with respect to the administration and enforcement of th e provisions of this article, and of the plan or plans formulate d and adopted in accordance therewith, and all such rules and regula tions necessary thereto. (b) The Director is hereby empowered and directed t o administer and enforce all rules and regulations ad opted for the COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 76 efficient operations of the plan or plans formulate d for the purposes of this article. (c) The Director shall, from time to time as direct ed by the Secretary of Health and Human Services make such re ports, in such form and containing such information as the Se cretary of Health and Human Services shall require.

time to time as direct ed by the Secretary of Health and Human Services make such re ports, in such form and containing such information as the Se cretary of Health and Human Services shall require. (d) The Director of Public Health and Social Servic es shall from time to time, pursuant to the rules and regula tions of the Secretary of Health and Human Services and of the S ecretary of the Treasury, requisition and cause to be deposited with the Treasurer of Guam all moneys allotted to Guam by th e Federal government for the purposes of this article, and sh all cause to be paid out of the treasury the moneys therein deposit ed for such purposes. § 3605. Services for Children with Special Health N eeds: Custody and Expenditure. (a) The Treasurer of Guam is hereby made custodian of all moneys allotted to Guam by the Federal government, or received from other sources, for the purposes of services fo r children with special health needs. (b) The Treasurer of Guam shall receive and provide for the proper custody of such moneys and is authorized to deposit such moneys in the same manner as other public moneys ar e deposited.

lth needs. (b) The Treasurer of Guam shall receive and provide for the proper custody of such moneys and is authorized to deposit such moneys in the same manner as other public moneys ar e deposited. (c) Such moneys shall be disbursed only upon certif ication by the Director. § 3606. Department Authorized to Enter into Agreeme nts with Federal Government. The Department is hereby authorized to enter into a cooperative agreement or agreements with the United States Department of Health and Human Services prescribing the manner, terms and conditions of cooperation with su ch Department of Health and Human Services in providin g for the identification, diagnosis and treatment of children with special health needs. Such agreements may define the amount s which Guam and the Federal government will contribute und er the COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 77 agreement and the Department shall be bound and gov erned by such agreement or agreements. ---------- ARTICLE 7 U.S. PUBLIC HEALTH SERVICES § 3701. Designation of the Department as Cooperativ e Agency. § 3702. Public Health and Social Services Programs: Administration and Purposes. § 3703.

---------- ARTICLE 7 U.S. PUBLIC HEALTH SERVICES § 3701. Designation of the Department as Cooperativ e Agency. § 3702. Public Health and Social Services Programs: Administration and Purposes. § 3703. Guam Plan for Public Health Services. § 3704. Provisions to be included in Guam Plan. § 3705. Duties of Director. § 3706. Public Health Service Funds: Custody and Expenditures. § 3701. Designation of Department as Cooperative Ag ency. The Department of Public Health and Social Service s (the Department) is hereby designated as the agency to c ooperate with the United States Public Health Service in the administration of those parts of the Public Health Service Act, as amended, which relate to grants and services for pu blic health purposes, and is authorized to apply for, receive a nd expend all funds made available by the Federal government, or from any other source for the purposes provided in this arti cle. § 3702. Public Health Services Programs: Administra tion and Purposes. (a) The Department is hereby designated as the agen cy to administer U.S. Public Health Services programs in Guam.

his arti cle. § 3702. Public Health Services Programs: Administra tion and Purposes. (a) The Department is hereby designated as the agen cy to administer U.S. Public Health Services programs in Guam. (b) The purpose of such programs shall be to develo p, extend and improve public health services. § 3703. Guam Plan for Public Health Services. (a) The Department is hereby empowered and authoriz ed: COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 78 (l) To formulate, adopt, subject to the approval of the Governor, and administer a detailed plan or plans f or the purpose specified in § 3702 of this article. (2) To make and adopt such rules and regulations, subject to the approval of the Governor, not incons istent with the provisions of §§ 3702 through 3706, inclus ive, or of the Public Health Service Act, as are or may be necessary for the administration of this article. (b) Such plan or plans and the rules and regulation s when formulated shall be submitted to the Secretary of H ealth and Human Services, and when approved by the Secretary shall thereupon be made effective by the Department, purs uant to the Administrative Adjudication Law. § 3704.

itted to the Secretary of H ealth and Human Services, and when approved by the Secretary shall thereupon be made effective by the Department, purs uant to the Administrative Adjudication Law. § 3704. Provisions to be Included in Guam Plan. Such plan or plans shall include therein provision s for: (a) Financial participation by Guam. (b) Administration of such plan or plans by the Department. (c) Such methods of administration as are necessary for efficient operation of such plan or plans. (d) Maintenance of records and preparation, submission and filing of reports of services render ed. (e) Cooperation with medical, health, nursing and welfare groups and organizations for the purpose of extending and improving public health. (f) Receiving and expending in the manner provided herein in accordance with such plan or plans, all f unds made available by the Federal government or from any oth er source for such purposes. (g) Cooperating with the Federal government, throug h its appropriate agency or instrumentality, in devel oping, extending and improving such services and in the administration of such plan or plans, and developme nt of demonstration services.

throug h its appropriate agency or instrumentality, in devel oping, extending and improving such services and in the administration of such plan or plans, and developme nt of demonstration services. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 79 (h) Carrying out the purposes specified in § 3702 o f this article. § 3705. Duties of Director. (a) The Director of Public Health and Social Servi ces (the Director) shall be the administrative officer of th e agency with respect to the administration and enforcement of th e provisions of this article, and of the plan or plans formulate d and adopted in accordance therewith and all such rules and regulat ions necessary thereto. (b) The Director is hereby empowered and directed t o administer and enforce all rules and regulations ad opted for the efficient operations of the plan or plans formulate d for the purposes of this article. (c) The Director shall from time to time, as direct ed by the Secretary of Health and Human Services, make such r eports, in such form and containing such information as the Se cretary shall require.

(c) The Director shall from time to time, as direct ed by the Secretary of Health and Human Services, make such r eports, in such form and containing such information as the Se cretary shall require. (d) The Director shall from time to time, pursuant to the rules and regulations of the Secretary of Health an d Human Services, requisition and cause to be deposited wit h the Treasurer of Guam all moneys allotted to Guam by th e Federal government for the purposes of this article, and sh all cause to be paid out of the treasury the moneys therein deposit ed for such purposes. § 3706. Public Health Service Funds: Custody and Expenditures. (a) The Treasurer of Guam is hereby made custodian of all moneys allotted to Guam by the Federal Government, or received from other sources, for the purposes of pu blic health services. (b) The Treasurer of Guam shall receive and provide for the proper custody of such moneys and is authorized to deposit such moneys in the same manner as other public moneys ar e deposited. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 80 (c) Such moneys shall be disbursed only upon certif ication by the Director.

er as other public moneys ar e deposited. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 80 (c) Such moneys shall be disbursed only upon certif ication by the Director. ---------- ARTICLE 8 COMMUNITY HEALTH CENTERS PROGRAM SOURCE: This Article added by P.L. 24-248:2 (Aug. 14, 199 8). § 3801. Legislative Intent and Purpose. § 3802. Title. § 3803. Program. § 3804. Personnel. § 3805. General Duties. § 3806. Federal Grants. § 3807. Authority to Set Fees. § 3808. Establishment of Regional Community Health Centers. § 3809. Continuing Service. § 3810. Urgent Care Service. § 3811. Revolving Fund. § 3812. Fee Schedule. § 3813. Advisory Council on Community Health Center s. § 3814. Duties of Council. § 3815. Repeal. § 3816. Effective Date. § 3817. Severability. § 3801. Legislative Intent and Purpose. It is the intent of I Liheslaturan Guahan to provide permanent guidelines to govern the creation, operat ion and maintenance of Guam’s community health centers for the purpose of providing basic quality health care to t he people of Guam in a joint partnership between government agen cies and/or private entities. § 3802. Title.

am’s community health centers for the purpose of providing basic quality health care to t he people of Guam in a joint partnership between government agen cies and/or private entities. § 3802. Title. This Act shall be known as, ‘The Community Health Centers Act of 1998.’ COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 81 § 3803. Program. There is hereby established within the Department of Public Health and Social Services (Department) Bureau of P rimary Care Services (Bureau) a Community Health Center Pr ogram (Program) to be administered on a collateral duty b asis by the Health Services Administrator of the Bureau, and wh o shall serve as the Community Health Center Chief Executiv e Officer of the Program. The Program shall cover two (2) reg ions of Guam (northern and southern). With the collateral d uty, the Community Health Center Chief Executive Officer’s a dditional role shall include adherence to the following nineteen (19) federal program requirements as stipulated in Exhib it A: (a) development and implementation of a needs assessment; (b) implementing required and additional primary health care services; (d) adhering to staffing

ram requirements as stipulated in Exhib it A: (a) development and implementation of a needs assessment; (b) implementing required and additional primary health care services; (d) adhering to staffing requirements; (e) conducting accessible hours of operation and location; (f) after hours coverage; (g) hospital admitting privileges and continuum of care; (h) sliding fee discount; (i) quality improvement/quality assurance plan; (j) key management staff; (k) contractual/affiliation agreements; (l) collaborative relationships; (m) financial management and control policies; (n) billing and collection; (o) budget; (p) program data reporting systems; (q) scope of project; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 82 (r) board authority; (s) board composition; and (t) conflict of interest. SOURCE: Added by P.L. 24-248:2 (Aug. 14, 1998), amended b y P.L. 32-231:2 (Dec. 30, 2014). 2015 NOTE: Pursuant to P.L. 32-231:4 (Dec. 29, 2014), Exhib it A referenced in this section is codified as Article 4 of Chapter 6, of Title 26, Guam Administrative Rules and Regulations.

. 30, 2014). 2015 NOTE: Pursuant to P.L. 32-231:4 (Dec. 29, 2014), Exhib it A referenced in this section is codified as Article 4 of Chapter 6, of Title 26, Guam Administrative Rules and Regulations. Subsection designations were altered to adhere to t he Compiler’s alpha- numeric scheme pursuant to the authority granted by 1 GCA § 1606. § 3804. Personnel. There shall be assigned sufficient number of administrative personnel, as may be determined by the Community He alth Center Chief Executive Officer, to provide staff as sistance on a full-time basis to Guam Community Health Centers, a nd ensure that the general duties assigned to the Guam Commun ity Health Centers are adequately administered. It is further provided: (a) There is hereby established within the Program, the administrative position of Community Health Cen ter Chief Executive Officer, who shall be responsible for managing the overall operations, finances, personne l, and facilities of the community health centers in accor dance with the mission, vision, values, Advisory Council approved policies, Strategic Plan, and other operat ional policies, and as further delineated in the position description adopted as Exhibit B

dance with the mission, vision, values, Advisory Council approved policies, Strategic Plan, and other operat ional policies, and as further delineated in the position description adopted as Exhibit B pursuant to this Act, and whic h may be amended pursuant to Subsection (d) of this Secti on. (1) Salary. The salary of the Community Health Center Chief Executive Officer shall be based upon the national standard of Community Health Center Chief Executive Officers of Federally Qualified Health Centers in the U.S., subject to availability of fun ds for FY 2015, and included in all subsequent budgets. (b) There is hereby established within the Program, the senior administrative financial position of Chi ef Financial Officer. The responsibility of the posit ion shall COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 83 include, but is not limited to, assisting the Chief Executive Officer and the Advisory Council on Community Healt h Centers in the development, implementation and coordination of the Program’s financial policy, fun d management, internal audits, billings and collectio n, and, the performance of all other associated administrat ive functions and

lementation and coordination of the Program’s financial policy, fun d management, internal audits, billings and collectio n, and, the performance of all other associated administrat ive functions and tasks as are necessary in directly pr oviding and ensuring sound fiscal stability and support for the Program, and as further delineated in the position description adopted as Exhibit C pursuant to this A ct, and which may be amended pursuant to Subsection (d) of this Section. (1) Salary. The salary of the Chief Financial Officer shall be based upon the national standard for the position, as found within the Community Health Center instrumentality of a U.S., subject to availa bility of funds for FY 2015, and included in all subsequen t budgets. (c) There is hereby established within the Program, the administrative and clinical position of Medical Director. The responsibility of the position shall include, but is not limited to, assisting the Community Health Center C hief Executive Officer and the Advisory Council on Commu nity Health Centers in the development, implementation a nd coordination of the Program’s medical services poli cy and the performance of associated administrative

r and the Advisory Council on Commu nity Health Centers in the development, implementation a nd coordination of the Program’s medical services poli cy and the performance of associated administrative tasks, and directly providing clinical medical support for all medical services provided by the Program, and as further de lineated in the position description adopted as Exhibit D pu rsuant to this Act, and which may be amended pursuant to Subs ection (d) of this Section. The Medical Director shall preferably be a board certified or board eligible physician specialist in a medical field deemed to be an appropriate, requisite field of practice, or multiple field specialties, as is necessary to b est meet the mandates and needs of the Program, and as further delineated in the position description adopted as E xhibit D COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 84 pursuant to this Act, and which may be amended purs uant to Subsection (d) of this Section. Preferable consideration for selection as the Medic al Director shall be given to a board certified or board eligible physician specialist with experience as a primary c are family practice physician.

referable consideration for selection as the Medic al Director shall be given to a board certified or board eligible physician specialist with experience as a primary c are family practice physician. (1) Salary. The salary of the Medical Director shall be based upon the national standard for Community Health Center Medical Directors in the U.S., subject to availability of funds for FY 2015, and included in all subsequent budgets. (d) Amendment of Position Description. The Advisory Council on Community Health Centers shall , in keeping with the provisions of Article 3- Rule Maki ng Procedures, of Chapter 9, Title 5, Guam Code Annota ted, review and amend, as may be necessary, the position descriptions adopted pursuant to Subsections (a), ( b), and (c) of this Section. SOURCE: Added by P.L. 24-248:3 (Aug. 14, 1998), amended b y P.L. 32-231:3 (Dec. 30, 2014). 2015 NOTE: The exhibits referred to in subsections (a), (b) , and (c) are attachments to Public Law 32-231. § 3805. General Duties. The general duties of the Bureau for the Program a re: (a) to oversee the maintenance and operation of all existing community health centers and implement mea sures approved and promulgated by the

s. The general duties of the Bureau for the Program a re: (a) to oversee the maintenance and operation of all existing community health centers and implement mea sures approved and promulgated by the Advisory Council on Community Health Centers; (b) to maintain and initiate the updating of Fees Schedule in effect; (c) to initiate the budgetary requirements, for bot h Federal and local funding, of the Program; (d) to account for all generated revenues and prepa re periodic reports required; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 85 (e) to administer the Community Health Center Revolving Fund for the Director of the Department a nd initiate the required periodic Statement of Conditi on of such Fund; (f) to provide administrative support and refer mat ters needing advice to the Advisory Council on Community Health Centers; (g) to establish additional community health center s and services required by the community for basic me dical care that private clinics are either saturated or n ot meeting the demand of the community or unavailable in the a rea of pediatric care, prenatal care, infectious disease c are, urgent care and to other areas that

te clinics are either saturated or n ot meeting the demand of the community or unavailable in the a rea of pediatric care, prenatal care, infectious disease c are, urgent care and to other areas that the Director designate s as a community requirement, but are inadequately being provided to the community; (h) to obtain a listing of all persons with health insurance coverage from their respective health ins urance company or providers; and (i) to perform other duties as may be assigned by t he Director of the Department. § 3806. Federal Grants. The Bureau shall comply with all Federal requireme nts and procedures necessary for the administration of gran t programs. The Director shall have the authority to apply for Federal Grants. § 3807. Authority to Set Fees. The Director is authorized to establish fees for h ealth care services in accordance with the Administrative Adju dication Law and as may be required to qualify for grant pro grams. The fees shall not be deterrent to receiving health car e. The fees shall be no less than the Medicare Regional Fees establis hed under Title XVIII of the Social Security Act. § 3808. Establishment of Regional Community Health Centers .

ceiving health car e. The fees shall be no less than the Medicare Regional Fees establis hed under Title XVIII of the Social Security Act. § 3808. Establishment of Regional Community Health Centers . The following Regional Community Health Centers established in the past by virtue of Executive Orde rs specifically COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 86 issued for the purpose shall hereafter be governed by the provisions of this Act: (a) the Southern Regional Community Health Center (‘SRCHC’), located in the village of Inarajan, whic h is tasked to provide quality comprehensive primary hea lth care services to the residents of the Southern vill ages of Guam; (b) the Northern Regional Community Health Center (‘NRCHC’), located in the Village of Dededo, which is tasked to provide quality comprehensive primary hea lth care services to the residents of the Northern vill ages of Guam; and (c) such other regional community health centers th at may later be established by the Director for simila r purpose. The administrative rules and regulations that may b e promulgated to improve the operation and maintenanc e of all regional community health

later be established by the Director for simila r purpose. The administrative rules and regulations that may b e promulgated to improve the operation and maintenanc e of all regional community health centers on Guam shall be in conformance with the provisions of this Article. In case of conflict, the provisions of this Article shall prev ail. The overall management, budgeting, cash and property accounting , and operating oversight of all regional community healt h centers shall be exercised by the Director of the Departmen t of Public Health and Social Services to whom the Bureau head reports to, namely, the Chief Public Health Officer of the Divi sion of Public Health. § 3809. Contractual Service. The Director may enter into a contractual agreemen t with other government agencies or health care provider(s ) to provide either, totally or partially, Community Health Cent er services. The Director shall also negotiate contractual agree ment for reimbursement of services by the beneficiaries of H ealth Insurance Providers or Health Maintenance Organizat ion or other entities providing health benefits, or shall allow those government agencies or health care providers to see k

eneficiaries of H ealth Insurance Providers or Health Maintenance Organizat ion or other entities providing health benefits, or shall allow those government agencies or health care providers to see k reimbursement for their services rendered in the Co mmunity Health Centers. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 87 § 3810. Urgent Care Service. The Community Health Center shall provide urgent c are service based on the unavailability of such service in the community and shall enter into a contractual agreem ent with the Guam Memorial Hospital Authority or other health ca re providers to provide such service. The urgent care service must be adequate to meet the following medical care: (a) conditions that are non-emergency in nature (Emergency conditions are those illness that may re sult in the loss of life or limb if not treated immediately .); (b) services are competent to manage and treat pati ents of all ages; (c) the facility shall have at least basic pharmacy , radiology, laboratory and patient transport to move cases that require a higher level of patient care managem ent; (d) the facility shall be certifiable by either the Joint

at least basic pharmacy , radiology, laboratory and patient transport to move cases that require a higher level of patient care managem ent; (d) the facility shall be certifiable by either the Joint Commission of Accreditation of Health Organization or Health Care Financing Administration, or equivalent certifying health care organization acceptable by t he Health Planning Council of the Division of Health Planning of DISID; and (e) the urgent care service shall consider initiall y opening at least five (5) days a week between the h ours of 6:00 p.m. to 11:00 p.m. and extend the hours and/or days as the demand arises and availability of resources. Th e Director shall evaluate at least annually the servi ce hours and/or days and make necessary adjustment based on the community needs and availability of resources in consultation with the Council. § 3811. Revolving Fund. (a) Community Health Center Revolving Fund. There is hereby established a Community Health Center Revolv ing Fund (Fund) to be maintained by the Administrator, Commu nity Health Centers, of the Department of Public Health & Social Services.

d. There is hereby established a Community Health Center Revolv ing Fund (Fund) to be maintained by the Administrator, Commu nity Health Centers, of the Department of Public Health & Social Services. The Fund shall be established and mainta ined in a bank account apart and separate from the General Fu nd or any COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 88 other bank account(s) of the government of Guam, an d shall not be co-mingled with, or a part of, the General Fund. All funds due or accruing to the account from whatever source (s), as provided or authorized pursuant to applicable law, inclusive of any interest, shall be deposited in the Fund in its entirety immediately upon receipt by the government of Guam. (1) The Administrator of Community Health Centers, of the Department of Public Health & Social Service s shall report monthly and maintain full compliance with al l financial reporting requirements of the government of Guam pursuant to applicable law. (2) Any and all collections deposited into and/or expenditures from the Fund shall be reported to the members of the Advisory Council of Community Health Centers.

of Guam pursuant to applicable law. (2) Any and all collections deposited into and/or expenditures from the Fund shall be reported to the members of the Advisory Council of Community Health Centers. (b) Independent Records and Accounts. The Fund shal l be maintained separate and apart from all other govern ment funds; have an independent records and accounts concerning the Fund; and audited by the Public Internal Auditor or the D epartment of Interior for each fiscal year and shall provide I Maga’lahen Guahan and the Council a copy of the audited report. (c) Deposits. All monies collected for products and services rendered at the community health centers s hall be accounted for and deposited into the Fund and avail able to pay for the expenses of the community centers. (d) Application. All monies deposited in the Fund s hall be available to be used to pay for the expenses of the community center allowable by Federal regulations and guideli nes as the non-Federal share of project costs in accordance wi th the Department’s grant from the U.S. Department of Heal th and Human Services. The Fund may also be used for the following expenses: (1) payment(s) for contractual services; (2)

s in accordance wi th the Department’s grant from the U.S. Department of Heal th and Human Services. The Fund may also be used for the following expenses: (1) payment(s) for contractual services; (2) payment(s) for supplies; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 89 (3) payment(s) for any other expenses, which if remains unpaid may result in an emergency situation as approved by the Board in a resolution; (4) the Fund shall be reimbursed from other appropriated fund sources for any expenditure made as a result of circumstances outlined in Subsection (3) if the expenditure was budgeted from said appropriated sou rce; and (5) board stipends, as provided by applicable law. (e) Accounts Receivables. The Community Health Centers Administrator, in consultation with the Cou ncil, is hereby authorized to pursue accounts receivables pa yment in whatever manner allowable by law, including contrac tual services for collection. The Community Health Cent ers Administrator shall promulgate rules and regulation s through the Administrative Adjudication Law governing collectio n and reduction of uncollectible accounts receivables.

Community Health Cent ers Administrator shall promulgate rules and regulation s through the Administrative Adjudication Law governing collectio n and reduction of uncollectible accounts receivables. (f) The Community Health Centers Administrator shal l submit an annual spending plan for the Fund in acco rdance with and at the same time as the Bureau of Budget and Ma nagement Research budget call. (g) The Community Health Center Council shall, by n o later than the 20th day of each month, submit a fin ancial report relative to the status and activities of the Commun ity Health Center Revolving Fund. The monthly report shall be submitted, via the Office of I Maga’lahi , to the Speaker of I Liheslaturan Guåhan , and the Chairpersons of the Committee on Finance, and the Committee on Health of I Liheslaturan Guåhan . The report shall, at a minimum, contain: (1) all expenditures and encumbrances (monthly and year-to-date); (2) funds received and source(s); (3) status of accounts receivable for outstanding d ebts and/or delinquent payment obligations owed to the Community Health Center(s); and COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

d and source(s); (3) status of accounts receivable for outstanding d ebts and/or delinquent payment obligations owed to the Community Health Center(s); and COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 90 (4) any and all other pertinent information relativ e to the Fund. (h) The Community Health Center Revolving Fund shal l be included in the government of Guam annual audit review and report. SOURCE: Added by P.L. 24-248:2 (Aug. 14, 1998). Subsecti on (a) amended by P.L. 30-106:2 (Mar. 12, 2010). Subsecti ons (c), (d) and (e) amended by P.L. 30-108:2 (Mar. 12, 2010). Subsecti ons (f) and (g) added by P.L. 30-108:3 (Mar. 12, 2010). Subsection (g) repealed and reenacted by P.L. 30-194:2 (Aug. 28, 2010). Subsec tion (h) added by P.L. 30-194:3 (Aug. 28, 2010). § 3812. Fee Schedule. (a) The Department is hereby authorized to implemen t a fee schedule. The provision of this Act shall be repealed upon subsequent submission and approval of the fee sched ule through the Administrative Adjudication Law. The fee sched ule must give discounts accordingly to the Federal Income Poverty Guideline.

ed upon subsequent submission and approval of the fee sched ule through the Administrative Adjudication Law. The fee sched ule must give discounts accordingly to the Federal Income Poverty Guideline. (b) Individuals or families whose income falls belo w the federal poverty guidelines shall apply for subsidiz ed medical services through the Medically Indigent Program or other medically subsidized program. (1) The Program shall submit a billing claim to the Guam Medically Indigent Program Administrator for t he necessary amount to recover the cost of services re ndered to the Medically Indigent Program patients at the fee schedule rates established for reimbursement pursuant to app licable law, rules and regulations. (A) Notwithstanding any other provision of law, rule or regulation, for the purposes of billing and collections, the Community Regional Health Centers Program shall be deemed apart and separate from the Department, and the Guam Medically Indigent Program shall promptly remit payment to the Program as reimbursement for services rendered to MIP patients, for deposit into the Community Health Cen ter Revolving Fund. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

promptly remit payment to the Program as reimbursement for services rendered to MIP patients, for deposit into the Community Health Cen ter Revolving Fund. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 91 SOURCE: Added by P.L. 24-248:2 (Aug. 14, 1998). Amended b y P.L. 31-176:2 (Feb. 3, 2012). § 3813. Advisory Council on Community Health Center s. (a) Council Established. There shall be establishe d within the Bureau an Advisory Council on Community Health Centers (ACouncil @) to serve in an advisory capacity for each Region. The Council shall consist of seven (7) members appointe d by I Maga’lahen Guahan [Governor]. Members of the Council shall include a Village Mayor from the Region of the Comm unity Health Center and one (1) of the Municipal Planning Council member from the Region, other than the Mayor or the Mayor’s staff, which shall serve their term as long as they are serving in their respective positions. The other members of th e Council shall serve for four (4) years; provided that, of t he members first appointed two (2) shall serve for two (2) years and three (3) shall serve for four (4) years. (b) Officers; Meeting Requirements.

shall serve for four (4) years; provided that, of t he members first appointed two (2) shall serve for two (2) years and three (3) shall serve for four (4) years. (b) Officers; Meeting Requirements. The Council sha ll annually elect a Chairperson, Vice-Chairperson and Recorder from among its membership. The Council shall meet a t least quarterly at such time and place as the Chairperson may designate. Meetings shall be well publicized and sh all be open to the public. The Director or the Division Head, or b oth, shall be present on all Council meetings. Executive sessions are permitted only in accordance with the Open Governme nt Law. Four (4) members shall constitute a quorum of the C ouncil for the transaction of business. The concurrence of a m ajority of the members present shall constitute official action of the Council. (c) Compensation. The compensation that members of the Advisory Council may receive shall be the compensat ion provided by Guam law. § 3814. Duties of Council. The Council shall review and approve the plans and programs of the Community Health Center by the Bure au and for that purpose shall perform the following duties: (a) review and make recommendation of

he Council shall review and approve the plans and programs of the Community Health Center by the Bure au and for that purpose shall perform the following duties: (a) review and make recommendation of the Bureau’s annual budget for the Community Health Center; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 92 (b) review and make recommendation of the Bureau’s three (3) - year Plan and its annual update for the Community Health Center; (c) periodically review available and needed servic es provided by the Center; (d) promote the utilization and assistance of inter ested persons, including recovered clients, volunteering their service to the patients of the Center in whatever q ualified service they can provide; and (e) review and comment on all new and renewed Federal grants application. (f) Shall approve by resolution all expenditures allowed in § 3811 of this Chapter greater than Five Thousand Dollars ($5,000); (g) may approve by resolution a Memorandum of Understanding between the Community Health Centers and the Department of Revenue and Taxation to garnish i ncome tax refunds of recipients of products and services rendered by the Community Health

of Understanding between the Community Health Centers and the Department of Revenue and Taxation to garnish i ncome tax refunds of recipients of products and services rendered by the Community Health Centers who have not fulfil led their payment obligation for said products and serv ices. The Board shall adopt a policy to govern the referr al of such tax refund garnishment requests to the Department o f Revenue and Taxation. SOURCE: Added by P.L. 24-248:2 (Aug. 14, 1998). Subsectio ns (f) and (g) added by P.L. 30-108:4 (Mar. 12, 2010). 2012 NOTE: In maintaining the general codification scheme of t he GCA the Compiler changed the hierarchy of subsections b eginning with 'Numbers' to 'Lowercase Letters' in this chapter. § 3815. Repeal. Executive Order Nos. 70-25 and 86-05 pertaining to the Southern Regional Community Health Center are hereb y repealed. § 3816. Effective Date. The provisions contained in this Act shall take ef fect upon enactment. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 93 § 3817. Severability. If any of the provisions of this Act or the applic ation thereof to any person or circumstance are held invalid, suc h invalidity shall

. 3. PUBLIC HEALTH AND SOCIAL SERVICES 93 § 3817. Severability. If any of the provisions of this Act or the applic ation thereof to any person or circumstance are held invalid, suc h invalidity shall not affect any other provision or application of this Act, which can be given effect without the invalid provi sion or application, and to this end the provisions of this Act are severable. ---------- ARTICLE 9 GUAM EARLY LEARNING COUNCIL SOURCE: Entire Article added by P.L. 31-062:2 (May 24, 201 1). § 3901. Composition of Early Learning Council Membership. § 3902. Goals and Objectives of the Early Learning Council. § 3903. Roles and Responsibilities. § 3901. Composition of Early Learning Council Membership. (a) Members of the Early Learning Council shall be comprised of representatives from the following key child serving agencies, including government agencies and private organizations, directly and indirectly involved in supporting the quality health care and education of children birth to eight (8) and their families, to develop a coordinated, effic ient, and cost- effective Early Childhood Comprehensive System: (1) the Parent Information Resource Center (PIRC); (2) non-profit

irth to eight (8) and their families, to develop a coordinated, effic ient, and cost- effective Early Childhood Comprehensive System: (1) the Parent Information Resource Center (PIRC); (2) non-profit organizations providing services and supports to children, birth to eight (8), and their families; (3) private child care providers; (4) the Guam Medical Society; (5) the Department of Public Health and Social Services; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 94 (6) the Guam Department of Education- Head Start, Early Intervention: Part C, Preschool Special Educa tion: Part B, Section 619; (7) the Guam Behavioral Health and Wellness Center; (8) the Guam Department of Labor; (9) the University of Guam; (10) the Guam Community College; (11) the Guam Memorial Hospital; (12) Guam Legislative Committee Chairpersons, including, but not limited to, the Committees on Ed ucation, Health and Human Services; (13) the Catholic Social Service; (14) at a minimum, three (3) parent representatives , of which at least one (1) is a parent/guardian or fami ly member of a person with developmental disabilities; (15) the Mayors Council of Guam; (16) Sanctuary, Inc.;

three (3) parent representatives , of which at least one (1) is a parent/guardian or fami ly member of a person with developmental disabilities; (15) the Mayors Council of Guam; (16) Sanctuary, Inc.; and (17) the Superior Court of Guam. (b) Co-chairmanship of the Council will be shared between the Governor’s designee and the Project Dir ector of Project Tinituhon , Guam's Early Childhood Comprehensive System. In the event, however, of the completion o f Project Tinituhon , the second co-chairperson shall be selected by du ly appointed Council members. 2013 NOTE: P.L. 32-024:2 (May 6, 2013) renamed the Departmen t of Mental Health & Substance Abuse to the Guam Behavio ral Health and Wellness Center. Reference to the Department of Me ntal Health & Substance Abuse was changed to Guam Behavioral Heal th and Wellness Center pursuant to P.L. 32-024:4. § 3902. Goals and Objectives of the Early Learning Council. (a) The Council has the following as its goals: (1) to increase supports and services for young children and their families by strengthening cross- agency COL5/19/202110 GCA HEALTH AND SAFETY CH. 3.

(a) The Council has the following as its goals: (1) to increase supports and services for young children and their families by strengthening cross- agency COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 95 coordination, involving public and private entities , to ensure delivery of comprehensive services for young childr en and their families; and (2) to expand and refine Guam’s Policy Agenda for Early Learning- Birth to Eight (8). (b) The Council has the following objectives to sup port these goals: (1) to strengthen collaboration among governance entities that oversee and coordinate subsystems; (2) to leverage funding streams to maximize resources; (3) to develop and implement a mechanism for cross- agency data collection for monitoring and reporting ; (4) to create cross-agency standards for child and family outcomes; (5) to define professional development structures t o ensure an appropriately skilled systems workforce; and (6) to expand awareness of and access to parent education and family supports. § 3903. Roles and Responsibilities. The Council will oversee and ensure the effective a nd efficient collaboration within Guam’s Early Childho od

f and access to parent education and family supports. § 3903. Roles and Responsibilities. The Council will oversee and ensure the effective a nd efficient collaboration within Guam’s Early Childho od Comprehensive System and is empowered to: (a) make recommendations on the most effective policy direction and methods to improve the coordin ation, quality, and delivery of quality health care and ed ucation services for young children on Guam; (b) critically examine and prioritize funding in su pport of child and family outcomes; (c) promote and support the acquisition of funding opportunities, through government and private organizations, in support of the overall vision and mission of the Early Childhood Comprehensive System; COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 96 (d) provide input to the Strategic Management Team of Guam’s Early Childhood Comprehensive System to ensu re the collaboration and integration of data collectio n and evaluation, leveraging of resources and funding, an d public awareness and education on the importance of early childhood; (e) provide the Governor and Legislature with an annual 'State of Early Childhood Health and

raging of resources and funding, an d public awareness and education on the importance of early childhood; (e) provide the Governor and Legislature with an annual 'State of Early Childhood Health and Educati on on Guam' Brief; (f) establish policies and procedures for the effic ient and effective decision-making processes in support of their responsibilities; (g) regularly review goals and objectives to ensure they are responsive and relevant to the evolving needs o f Guam’s youngest children and their families; and (h) carry out the responsibilities mandated and out lined in the national legislation, 'Improving Head Start for School, Readiness Act of 2007' (P.L. 110-134), Sect ion 642B(b) and others assigned by the Governor of Guam . 2015 NOTE: Subsection designations were altered to adhere to the Compiler’s general codification scheme in accordanc e to the authority granted by 1 GCA § 1606. ---------- ARTICLE 10 GUAM COUNCIL ON CHILD DEATH REVIEW AND PREVENTION (CCDRP) SOURCE: Article 10 added by P.L. 32-030:2 (May 10, 2013). § 31001. Short Title. § 31002. Definistions. § 31003. Access to Information. § 31004. Exception. § 31005.

DEATH REVIEW AND PREVENTION (CCDRP) SOURCE: Article 10 added by P.L. 32-030:2 (May 10, 2013). § 31001. Short Title. § 31002. Definistions. § 31003. Access to Information. § 31004. Exception. § 31005. Use of Child Death Review Information and Records. § 31006. Immunity from Liability. COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 97 § 31007. Funding Authorization. § 31001. Short Title. This Act may be cited as the 'Child Death Review an d Prevention Act of 2013.' § 31002. Definitions. (a) As used in this Article: (1) Child means a person less than eighteen years o f age. (2) Family means: (A) each legal parent; (B) the natural/biological mother; (C) the natural/biological father; (D) each parent’s spouse or former spouses; (E) each sibling or person related by consanguinity or marriage; (F) each person residing in the same dwelling unit; and (G) any other person who, or legal entity that, is a child’s legal or physical custodian or guardian, or who is otherwise responsible for the child’s care, othe r than the authorized agency that assumes such a legal sta tus or relationship with the child, as defined under § 4202, Article 2, Chapter 4, Title 19,

therwise responsible for the child’s care, othe r than the authorized agency that assumes such a legal sta tus or relationship with the child, as defined under § 4202, Article 2, Chapter 4, Title 19, Guam Code Annotated . (3) Council on Child Death Review and Prevention (CCDRP) means the Council members who are multidisciplinary and multiagency representatives a ppointed by I Maga’lahen Guåhan [Governor of Guam] and any other entity/representative invited by the Director or the Director’s designated representatives as appropriat e for each child death review, to include, at a minimum: (A) Department of Public Health and Social Services: COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 98 (i) Director, or the Director’s designated representatives; (ii) Bureau of Family Health and Nursing Services – Maternal and Child Health; (iii) Bureau of Social Services Administration – Child Protective Services; (iv) Emergency Medical Services; and (v) Office of Vital Statistics; (B) Medical Examiner, or designee; (C) Department of Mental Health and Substance Abuse; (D) Guam Police Department; (E) Guam Early Learning Council; (F) Attorney General of Guam, or

Vital Statistics; (B) Medical Examiner, or designee; (C) Department of Mental Health and Substance Abuse; (D) Guam Police Department; (E) Guam Early Learning Council; (F) Attorney General of Guam, or designee; (G) Guam Memorial Hospital Authority; (H) Local Pediatrician; (I) Military Representative; (J) Parent/Community Stakeholder; and (K) I Liheslaturan Guåhan (the Guam Legislature) Chairperson of the Committee on Health and Human Services, or designee. (4) Child death review information means information regarding the child and child’s family, including, but not limited to: (A) social, medical, and legal histories; (B) death and birth certificates; (C) law enforcement investigative data; (D) medical examiner or coroner investigative data; (E) parole and probation information and COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 99 records; (F) information and records of social service agencies; (G) educational records; and (H) health/mental health care institution information. (5) Department means the Department of Public Health and Social Services. (6) Director means the Director of the Department o f Public Health and Social Services, or the

care institution information. (5) Department means the Department of Public Health and Social Services. (6) Director means the Director of the Department o f Public Health and Social Services, or the Director’ s designated representatives. (7) Provider of medical care means any health/men tal health practitioner who provide, or a facility thro ugh which is provided, any medical evaluation or treatment, i ncluding dental and mental health evaluation or treatment. (8) Service provider(s) means any practitioner/provider who provides, or a facility t hrough which it is provided, any social and legal services . § 31003. Access to Information. (a) Upon written request of the Director, all provi ders of social, medical, and legal services, and local agen cies, shall disclose to the Department, and those individuals a ppointed by the Director to participate in the review of child death, child death review information regarding the circumstance s of a child’s death so that the Department may conduct a multidisciplinary and multiagency review of child d eaths. (b) To the extent that this Section conflicts with other state confidentiality laws, this Section shall prevail. § 31004. Exception.

nduct a multidisciplinary and multiagency review of child d eaths. (b) To the extent that this Section conflicts with other state confidentiality laws, this Section shall prevail. § 31004. Exception. Information regarding an ongoing civil or criminal investigation shall be disclosed at the discretion of the applicable local or federal law enforcement agency. § 31005. Use of Child Death Review Information and COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 100 Records. (a) Except as otherwise provided in this Article, a ll child death review information acquired by the Department during its review of child deaths pursuant to this Article, is confidential and may only be disclosed as necessary to carry out the purposes of this Article. (b) Child death review information and statistical compilations of data that do not contain any inform ation that would permit the identification of any person shall be public records. (c) The CCDRP shall submit a report of child death review information and statistical compilations of data th at do not contain any information that would permit the ident ification of any person to I Liheslaturan Guåhan (the Guam

port of child death review information and statistical compilations of data th at do not contain any information that would permit the ident ification of any person to I Liheslaturan Guåhan (the Guam Legislature) on an annual basis. (d) No individual participating in the Department’s multidisciplinary and multiagency review of a child ’s death may be questioned in any civil or criminal proceeding r egarding information presented in or opinions formed as a re sult of a child death review meeting. Nothing in this Subsection sh all be construed to prevent a person from testifying to in formation obtained independently of the Department’s multidis ciplinary and multiagency review of a child’s death, or which is public information, or where disclosure is required by law or court order. (e) Child death review information held by the Depa rtment as a result of child death reviews conducted under this Article are not subject to subpoena, discovery, or introduc tion into evidence in any civil or criminal proceeding, excep t that child death review information otherwise available from o ther sources is not immune from subpoena, discovery, or introduc tion into evidence through those sources

r criminal proceeding, excep t that child death review information otherwise available from o ther sources is not immune from subpoena, discovery, or introduc tion into evidence through those sources solely because they were provided as required by this Article. § 31006. Immunity from Liability. All agencies and individuals participating in the r eview of child deaths pursuant to this Article shall not be held civilly or COL5/19/202110 GCA HEALTH AND SAFETY CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES 101 criminally liable for providing the information req uired under this Article. § 31007. Funding Authorization. Funding to implement and conduct the provisions and activities authorized pursuant to this Article shal l be expended from the annual fiscal year appropriation to the Of fice of Vital Statistics, and/or from the Office of Vital Statist ics Revolving Fund (Title 10 GCA, Chapter 3, Article 2, § 3227.1) . ---------- COL5/19/2021