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Submission of Specimens for Rabies Serologic Testing

Authorized requester status for rabies serologic testing:

New York State law requires that specimens sent to laboratories for the purpose of human clinical testing be accompanied by a request bearing the name of a person authorized* to request the test and use the results. It has been decided that this requirement applies to serum submitted to the rabies laboratory for determination of rabies antibody titer for the management of patients receiving pre- or postexposure rabies immunizations. All results will be reported only to the authorized requestor, persons authorized to receive such test results by a note on the original order, or as required by other standards. Your cooperation will be appreciated upon implementation of this practice, effective June 1, 2007. For all specimens received without the necessary authorization, the lab will contact the submitter who will be asked to identify the appropriate authorized requestor. Those who may initially have difficulty in arranging for an authorized submitter to order these tests may find advice or assistance in resolving the problem available at the local health department (LHD).

The name and "authorizing title or status" (e.g., M.D., P.A., or county health director/commissioner) must be on the order, but the order does not require an original signature of the authorized requestor. The authorized submitter must be in a position to: attest to the medical necessity of the order for the test; assure the reporting of the result; and to provide recommendations for the appropriate follow up or management related to the related activities of the tested individual. We have been advised that in the list below, designees of the state, county or city health commissioner refers only to staff members of the agency that qualify under one of the other categories listed, that the commissioner has designated to act on his/her behalf. Thus, for example, the designee cannot be a veterinarian practicing in the county.

There will be a check box and space on the form to authorize release of a duplicate copy of the results to someone other than the submitter. This will permit the laboratory to report to the person or agency that is identified in that space. Electronic access to reports may be available to frequent submitters through the Department of Health's Health Provider Network (HPN). Inquire by calling the Electronic Clinical Laboratory Reporting System help desk at 866-325-7743 and request access to CLIMS via an HPN account.

*As specified in 10 NYCRR Subpart 58-1.7, laboratories may examine specimens only at the request of a licensed physician or other persons authorized by law to use laboratory findings in their practice or performance of official duties. Persons authorized to order tests and receive directly the results of clinical laboratory testing of specimens accepted from New York State:

Attorney Tests must be for (i) use in the routine discovery process in a civil proceeding (e.g., tort case, Family Court case); and/or (ii) pursuant to an established client/attorney relationship (e.g., determination of biological relationships for child support, estate settlement or immigration; toxicological analysis to substantiate or refute alcohol or drug impairment)

Chiropractor Tests must be within the scope of practice of chiropractic as defined by the NYS Education Department

Commissioner or an official designee, including State Commissioner of Health and county and city counterpart Testing must be a necessary adjunct to a Public Health Law mandated or officially sanctioned public health activity

Coroner Tests must be related to the medical-legal investigation of a death

Court Judge Tests must be for use in a legal proceeding under his/her jurisdiction, including paternity tests ordered pursuant to the Family Court Act

Dentist Tests must be within the scope of practice of dentistry as defined by the NYS Education Department (NYS SED)

Government-operated public health agency or local health unit Testing must be a necessary adjunct to an officially sanctioned public health activityt

Government, foreign (Consulate or embassy) Limited to testing to substantiate or refute claims of familial relationship for purposes of establishing eligibility for immigration

Layperson (test subject) who has capacity to consent to health care Tests must be for same purpose as a test or collection device that has been approved or cleared by the FDA for sale or distribution on a direct or over-the-counter basis without a prescription from a qualified health care practitioner (Note: the ordering medical practitioner must authorize release of any other testing to laypersons, with the exception of blood typing and Rh determinations) Does not currently apply to rabies serology

Nurse Midwife Tests must be within the scope of practice of midwifery as defined by the NYS Education Department and within the scope of a practice agreement between midwife and physician or midwife and hospital

Nurse Practitioner (does not apply to an RN or LPN without NP certification) Provided tests are within the scope of professional services recognized under the NP's specialty area(s) of certification and within the protocols specified in his or her practice agreement with collaborating physician

Parole Officer Limited to tests to determine the presence or absence of a substance whose use is prohibited by the conditions of release established by the board of parole

Physician (includes osteopathic physician) Tests must be within the scope of practice of medicine as defined by NYS SED

Physician Assistant and Specialist Assistant Tests must be within the scope of practice of medicine as defined by NYS SED as practiced by the supervising physician

Podiatrist Tests must be within the scope of practice of podiatry as defined by NYS SED

Police Officer Limited to tests for alcohol or drug impairment to support arrest charges or an official investigation conducted under the NYS Vehicle and Traffic Law

Probation Officer Limited to tests to determine the presence or absence of a substance whose use is prohibited by the conditions of release established by the NYS Division of Probation & Correctional Alternativest