HB 909 — Legionnaires' Disease Prevention Study.

GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2021 H 21 HOUSE BILL 909 Committee Substitute Favorable 8/31/21 Short Title:

Legionnaires' Disease Prevention Study.Act.

Representative Turner.

For a complete list of sponsors, refer to the North Carolina General Assembly web site.

MayEnvironment, 11,if 2021favorable, AAppropriations, BILLif TOfavorable, BERules, ENTITLEDCalendar, ANand ACTOperations TOof DIRECTthe THEHouse DEPARTMENTMay OF11, HEALTH2021 ANDA HUMANBILL SERVICES TO STUDYBE OPTIONSENTITLED AVAILABLEAN TOACT REDUCECONCERNING THE RISKPREVENTION OF LEGIONNAIRES' DISEASEDISEASE. IN THE STATE AND MAKE LEGISLATIVE RECOMMENDATIONS TO THE GENERAL ASSEMBLY.

Whereas,The Legionnaires'General diseaseAssembly is a serious respiratory disease and a form of pneumoniaNorth principallyCarolina causedenacts: by the inhalation of the bacterium Legionella pneumophila in microscopic water droplets;

and5 Whereas,PART Legionnaires'I. disease is a significant public health threat having mortality rates of 10% within the general population and with significantly higher mortality rates in at-risk populations, a group that has dramatically increased in size due to the long-term respiratory impacts of the COVID-19 pandemic;

andTITLE Whereas,OF thereACT haveSECTION been1.1. multiple outbreaks of Legionnaires' disease in North Carolina;

andThis Whereas,act itshall hasbe beenknown establishedand bymay scientificbe evidencecited thatas improperthe management"Legionnaires' ofDisease buildingPrevention waterAct." systems9 mayPARTII.POWERSANDDUTIESOFTHEDEPARTMENTOFHEALTHANDHUMAN causeSERVICES orSECTION2.1.(a) contributeChapter130A tooftheGeneral theStatutesis proliferationamended ofbyaddinganew LegionellaArticle pneumophilato andread: can result in Legionnaires' disease;

and"Article Whereas,10A. national studies have shown that 90% of Legionnaires' disease outbreaks could have been prevented by more effective water management;

and"Legionnaires' Whereas,Disease thePrevention AmericanAct. Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) recently developed new guidance about how to minimize the risk of Legionnaires' disease from building water systems;

Now,"§ therefore,130A-331. The General Assembly of North Carolina enacts:

SECTIONDefinitions. 1.(a) The Department of Health and Human Services shall conduct a study to determine what actions the State may take to reduce the risk of Legionnaires' disease in North Carolina by minimizing the growth and transmission of waterborne Legionella pneumophila.

AsThe partfollowing ofdefinitions theapply study,in thethis DepartmentArticle: shall:

(1) IdentifyCovered allbuilding. current measures in place to reduce the risk of Legionnaires' disease, including State and federal statutory and regulatory requirements relating to building water systems and public water systems.

For– A building or facility that (i) meets the purposescriteria ofdescribed thisin section,the "buildingAmerican waterSociety systems"of areHeating, potableRefrigeration, and nonpotableAir-Conditioning waterEngineers systems(ASHRAE)Standard188-2018 locatedor in(ii)is asubject buildingto orregulation on-site.bythe federal Centers for Medicare and Medicaid Services.

(2) CompareDepartment. the State's current statutory and regulatory framework to the recommendations contained in ASHRAE Standard 188-2018, Legionellosis:

Risk– ManagementThe forDepartment Buildingof WaterHealth Systems and ASHRAEHuman GuidelineServices. *H909-v-2* General Assembly Of North Carolina Session 2021 12-2020:

Managingthe(3) RiskLegionella ofculture. Legionellosis Associated with Building Water Systems and other pertinent guidance documents and literature.

SECTION– 1.(b) The Departmentquantification shallof reportculturable itsLegionella findingspneumophila andbacteria recommendations,in includinga anywater legislativesample. or regulatory proposals, to the Joint Legislative Oversight Committee on Health and Human Services no later than April 1, 2022.

SECTION(4) 2.Legionnaires' disease.

The– sumA ofpulmonary tendisease thousandcaused dollarsby ($10,000) in nonrecurring funds for the 2021-2022Legionella fiscalpneumophila yearbacterium. is appropriated from the General Fund to the Department of Health and Human Services to carry out the study required by this act.

SECTION(5) 3.Public water system.

This– actAs isdefined effectivein whenG.S. it becomes law.

Page130A-313(10). 2 House Bill 909-Second Edition

"§ 130A-331.3.

Mandatory water management plan for minimizing growth and transmission of Legionella pneumophila in covered buildings.

(a) The Department shall instruct owners and operators of covered buildings that theyare required to establish and operate a water management plan by October 1, 2022, that includes validation testing of water to minimize the growth and transmission of Legionella pneumophila in the covered building's water system consistent with the American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE) Standard 188-2018.

As part of the water management plan required by this section, owners and operators shall retain a copy of the *H909-v-1* General Assembly Of North Carolina Session 2021 sampling and management plan and sampling results for at least three years.

Owners and operators shall provide to the Department a copy of their water management plan and sampling results.

The Department shall issue a certificate of compliance to each owner or operator upon receipt of a water management plan and sampling results that comply with the provisions of this section.

(b) Owners and operators of covered buildings shall make the water management plan implemented pursuant to subsection (a) of this section available for inspection upon request to any department or agency with licensing or inspection authority over the covered building.

(c) In addition to the sampling and testing required as part of a water management plan established and operated in accordance with subsection (a) of this section, an owner or operator of a covered building shall conduct Legionella pneumophila culture sampling and analysis of the covered building's water system in a time frame to be determined by the Department upon any of the following:

(1) A determination bythe Department of Health and Human Services that one or more cases of Legionnaires' disease are, or may be, associated with the covered building.

(2) Any other conditions specified in the rules developed by the Department pursuant to G.S.

130A-331.5.

(d) In conducting any required sampling and testing, each owner and operator of a covered building shall ensure that any Legionella pneumophila culture analysis is performed by a laboratory that is approved to perform the analysis by the North Carolina Wastewater/Groundwater LaboratoryCertification program in the Water Sciences Section of the Department of Environmental Quality.

"§ 130A-331.5.

Rules.

The Department of Health and Human Services shall adopt rules to implement the provisions of this Article.