Addressing the Diabetes Epidemic In Manitoba: Making diabetes a reportable disease

We have an epidemic of diabetes in Manitoba as shown by the figures above for the number of new cases in Manitoba each year and the incidence of diabetes year by year. The epidemic is acknowledged by our provincial government on their web site. Worldwide, this epidemic is recognized by the United Nations.

The word epidemic reflects the drastic increase in the number of cases of diabetes in recent years in Manitoba. Normally when we have an epidemic one of the first things that is done is to make the disease reportable so that we can have accurate and up to date information on the progression of the epidemic and to be able to know if efforts to curtail the epidemic are working.

At present information on the incidence of diabetes in Manitoba is not as accurate or as up to date as we need to be able to address the epidemic quickly and forcefully.

On November 25, I introduced Bill 206, the Diabetes Reporting Act (see below) into the Manitoba Legislature. This act makes provisions which ensure diabetes is a reportable disease in Manitoba and ensures that public health authorities in our province have accurate and up to date information on the diabetes epidemic in Manitoba.

Bill 206 is important public policy for two reasons. It starts treating diabetes as an epidemic, and provides a solid basis for improved public policy in addressing the diabetes epidemic. It is a necessary and important step towards more effective approaches to reducing the incidence of diabetes in Manitoba. One result of this will be better health for Manitobans. A second result is that it will start to reduce the present rapidly escalating costs to treat Manitobans with diabetes.

Bill 206
THE DIABETES REPORTING ACT
Table of Contents
Explanatory Note
(Assented to )
WHEREAS diabetes is a serious condition;
AND WHEREAS regional health authorities and the health care system need information about the numbers of people with diabetes in order to provide appropriate services and specialized treatment to people with diabetes;
AND WHEREAS making information on the number and distribution of individuals with diabetes will assist in improving the design and effectiveness of programs to treat and prevent diabetes;
THEREFORE HER MAJESTY, by and with the advice and consent of the Legislative Assembly of Manitoba, enacts as follows:
Definitions
1 The following definitions apply in this Act.
"annual report" means the report prepared by the chief medical officer of health under subsection 6(1). (« rapport annuel »)
"chief medical officer of health" means the person appointed as chief medical officer of health under The Public Health Act. (« médecin hygiéniste en chef »)
"minister" means the minister appointed by the Lieutenant Governor in Council to administer this Act. (« ministre »)
"monthly report" means the report prepared by the chief medical officer of health under section 5. (« rapport mensuel »)
"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act. (« office régional de la santé »)
Duty to report diagnosis to parent or guardian
2 Every physician who diagnoses a child who is 16 years of age or under with diabetes must use his or her best efforts
(a) to advise a parent or guardian of the child of the diagnosis; and
(b) provide the parent or guardian with information about diabetes and the resources that are available to assist persons with diabetes.
Reporting diagnosis to chief medical officer of health
3(1) Every physician who diagnoses a person with diabetes must report the diagnosis to the chief medical officer of health.
Reporting information
3(2) A report under section (1) must be made in writing within 30 days after the diagnosis is made, and must include the person's name, date of birth and place of residence as well as the type of diabetes in question.
Report to be treated confidentially
4 The chief medical officer of health must take reasonable steps to prevent unauthorized access to a physician's report or the unauthorized use or disclosure of information in the report.
Monthly report
5 The chief medical officer of health must prepare a report each month that sets out the total number of people diagnosed with diabetes in the previous month in the province.
Annual report
6(1) The chief medical officer of health must prepare a report each year that
(a) based upon place of residence, breaks down the number of people diagnosed with diabetes by regional health authority; and
(b) reports, to the extent possible, the incidence and prevalance rates for diabetes by regional health authority.
Report must breakdown types of diabetes
6(2) The annual report must also provide information on the specific type of diabetes involved in the reporting required under subsection (1).
Reports must not identify person with diabetes
6(3) The monthly and annual reports must contain only statistical information on the number of persons diagnosed with diabetes and the incidence and prevalance rates for diabetes. The reports must not include the name of a person or other information that could reasonably be expected to identify a person.
Annual report to minister
7(1) The chief medical officer of health must give the minister a copy of the annual report.
Tabling annual report
7(2) The minister must table a copy of the annual report in the Assembly within 15 days after receiving it if the Assembly is sitting or, if it is not, within 15 days after the next sitting begins.
Distributing annual and monthly reports
7(3) The chief medical officer of health must give a copy of the monthly and annual reports to
(a) every regional health authority in the province;
(b) the College of Physicians and Surgeons of Manitoba;
(c) the College of Registered Nurses of Manitoba; and
(d) the Canadian Diabetes Association — Manitoba Region.
Diagnostic guidelines
8 For the purposes of this Act, a diagnosis of diabetes is to be made in accordance with diagnostic guidelines established by regulation.
Regulations
9 The Lieutenant Governor in Council may make regulations
(a) establishing diagnostic guidelines for the diagnosis of diabetes;
(b) respecting any matter the Lieutenant Governor in Council considers necessary or advisable to carry out the purposes of this Act.
Amendments when Public Health Act replaced
10(1) Section 1 of this Act is amended
(a) by repealing the definition "chief medical officer of health"; and
(b) by adding the following definition:
"chief public health officer" means the chief public health officer appointed under section 10 of The Public Health Act. (« médecin hygiéniste en chef »)
10(2) Sections 1, 3, 4, 5, 6 and 7 are amended by striking out "chief medical officer of health" wherever it occurs and substituting "chief public health officer".
C.C.S.M. reference
11 This Act may be referred to as chapter D70 of the Continuing Consolidation of the Statutes of Manitoba.
Coming into force
12(1) This Act, except section 10, comes into force on a day to be fixed by proclamation.
Coming into force: section 10
12(2) Section 10 comes into force on the day that The Public Health Act, S.M. 2006, c. 14, comes into force.

Explanatory Note
This Bill requires a doctor who diagnoses a child with diabetes to tell the parent or guardian of the child about the diagnosis and give information about diabetes. The doctor must also report the diagnosis to the chief medical officer of health.
The chief medical officer of health must prepare monthly and annual reports that set out the number of people diagnosed with diabetes.
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