641—1.16 (139A) Agriculturally related injury.
	 1.16(1) Who is required to report.
	  a.   	 Health care providers are required to report all cases of agriculturally related injury attended by them.
	  b.   	 Clinics, hospitals and other health care facilities are required to report all cases of agriculturally related injury treated at their facility.
	  c.   	 Health care providers who reside and health care facilities that are located outside the state of Iowa shall report all cases of agriculturally related injury of an Iowa resident that are attended or treated by them.
	  d.   	 Medical examiners are required to report their investigatory findings of any death occurring within the state of Iowa which was caused by or otherwise involved a reportable agriculturally related injury.
	 1.16(2) What to report. Each report shall contain all of the following information:
	  a.   	 The patient’s name.
	  b.   	 The patient’s address.
	  c.   	 The patient’s date of birth.
	  d.   	 The sex of the patient.
	  e.   	 The race and ethnicity of the patient.
	  f.   	 The patient’s marital status.
	  g.   	 The patient’s telephone number.
	  h.   	 If the patient is female, whether the patient is pregnant.
	  i.   	 In the case of occupational conditions, the name of the patient’s employer.
	  j.   	 The date that the injury occurred.
	  k.   	 The name and address of the health care provider who diagnosed and treated the injury, and the name of the reporting site, clinic, or hospital.
	  l.   	 Injury diagnosis and description, including diagnostic and external cause of injury codes utilizing the international classification of diseases (ICD) coding system.
	  m.   	 Severity of injury.
	 1.16(3) How to report.
	  a.   	 All data shall be reported to the department at least quarterly using formats approved by the department. Reports, using the Iowa Agricultural Injury Report Form found at www.idph.state.ia.us, may be submitted by facsimile to (515)281-4529, or by mail to the Iowa Department of Public Health, Bureau of Lead Poisoning Prevention, Occupational Safety and Health Surveillance Program, Lucas State Office Building, 321 E. 12th Street, Des Moines, Iowa 50319-0075. Information may also be reported by telephone to 1-800-972-2026 during normal office hours.
	  b.   	 Trauma centers may report using the Iowa Trauma Patient Registry COLLECTOR software by indicating “Yes” for farm and agriculturally related injury. For more information about using the Iowa Trauma Patient Registry for reporting, contact the Iowa Department of Public Health Bureau of Emergency Medical Services at 1-800-728-3367.
[ARC 8231B, IAB 10/7/09, effective 11/11/09]