As cases of measles continue to skyrocket across Pennsylvania, the department of health is seeking to broaden its authority over infectious disease outbreaks. Health officials have submitted a sweeping overhaul of regulations that govern how diseases are reported and the scope of actions available to health officials seeking to intervene.
The proposal has drawn the ire of several Republican lawmakers who are calling for more input from the General Assembly.
The new regulations, which must be approved by the state's Independent Regulatory Review Commission, have been described by the health department as a "modernization" of Pennsylvania's public health regulations, which have not been meaningfully updated since 2001.
"Comprehensive amendments to the regulations are needed to expand the list of reportable diseases, infections and conditions, to address changing standards and recommendations from experts, such as the [Centers for Disease Control and Prevention] and the [American Academy of Pediatrics], and to ensure the overall public health and safety by reducing the risk and spread of diseases, infections and conditions," the department said in a June analysis of the proposal.
The 500-page overhaul seeks to strengthen reporting requirements for health providers surrounding vaccine administration and data sharing about infectious diseases.
The proposal would nearly double the list of diseases, infections and conditions that are required to be reported to the state health department. Currently, the state requires labs and providers to report 63 diseases, infections or conditions. The proposal would increase that number to 116.
The new regulations would also significantly change the language that governs the health department's disease-control procedures. Under the proposal, the department would have more authority to take action for the purpose of preventing, containing or mitigating a disease outbreak.
The health department's argument for expanding the circumstances under which it can impose public health measures ties back to a legal battle over whether a statewide mask mandate could be imposed upon schools during the COVID-19 pandemic. The state's Supreme Court ruled that the health department could not impose a mask mandate, but noted that the agency could change its regulations to allow for such a measure in the future.
Though the changes are under review as the state records more than 500 cases of measles in a statewide outbreak, the process of drafting the new regulations began in 2024. Nearly 100 people have been hospitalized with measles and health officials reported last week that two people have died amid infections.
The proposed regulations have drawn criticism from state Republican lawmakers who argue that under the changes, the health department could be given unchecked power at the cost of individual civil liberties.
In a statement, Pennsylvania House Republican leader Jesse Topper compared the regulations to "oppressive COVID-era policies," and urged Gov. Josh Shapiro to withdraw the proposal entirely.
Republican Rep. Jill Cooper, who represents Westmoreland County, said in a statement the proposed changes "threaten to revive the worst aspects of pandemic-era overreach." She took issue specifically with a provision that explicitly allows the health department to conduct contact tracing in schools.
The proposal would also change where the department can investigate disease outbreaks. The new regulations include several additional examples such as an apartment building, school, college or university. Under the current regulations, the department is permitted to enter a "house, health care facility, building or other premises" to carry out investigative measures such as contact tracing.
But Cooper fears the change could result in minor students speaking to health officials without their parents' knowledge or approval.
"Mothers and fathers have an unassailable right to oversee the upbringing, healthcare and well-being of their children," she said. "Stripping parental knowledge and consent from school interactions to conduct contact tracing or offer medical treatments runs entirely counter to our values."
The Pennsylvania Department of Health declined to respond to WESA's questions about whether the proposal envisions department representatives interviewing children without parent approval.
Allegheny County Rep. Arvind Venkat, a Democrat and an emergency room physician, doubted the proposal was designed to cut parents out of the conversation.
"I think many of my Republican colleagues are taking the most extreme interpretation of this regulatory proposal," he said. "That doesn't mean they're wrong, but it certainly doesn't mean they're right either."
Venkat stressed that the regulatory change process is far from over and said he encourages the public to submit their comments to the state's independent regulatory review commission.
"My initial impression is that we should want to involve parents in discussions with their children," Venkat said. "I think that may be an example where public comment can get us to a better place than the initial proposal."
The commission's recommendations would be reviewed by committees in the House and Senate before taking effect.
The lengthy proposal also envision providers reporting health data faster and in some cases requiring the sharing of some data that is currently shared voluntarily. The proposal would require healthcare providers to report when an immunization is administered. Many providers do this voluntarily, but according to the department's analysis, roughly 4,750 providers would be required to establish a reporting process.
Under the proposal, the state would officially align itself with the childhood immunization schedule outlined by the American Academy of Pediatrics rather than the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. Notably, the latter authority has sought to decrease the number of recommended childhood vaccines.
Venkat applauded the change, noting it aligns with his legislation that requires Pennsylvania insurers to continue to cover a list of vaccines determined by the state health department and professional medical societies regardless of federal changes.
"The federal government seems to be undermining evidence-based practices when it comes to stopping communicable diseases, and the recommendations about vaccines," Venkat said.
Venkat said he'd like to see the proposed new regulations be refined by public input and that he would support amendments that "strike the right balance," but he dismissed fears raised by Republican lawmakers that the changes would automatically infringe on civil liberties.
"When you're talking about communicable diseases, what you do affects me and what I do affects you," Venkat said. "Generally, your individual rights stop when they adversely affect others, including their health and well-being. And so the real question is, what do we owe each other in terms of stopping the spread of communicable diseases in Pennsylvania?
We're getting a lesson in that right now with measles," Venkat said.
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