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Rachel Cicigline

Public Health Specialist, New York State Department of Health

Rachel Cicigline Rachel Cicigline is a public health specialist with over 15 years of experience in environmental science and public health. Rachel’s knowledge touches on a broad range of topics including environmental multimedia compliance, hazardous materials, environmental health and safety, public health support and chronic illness. She started with the Bureau of Water Supply Protection at the New York State Department of Health in November 2018, where she provides cooling tower compliance public support, water management plan review, outreach and education development, and oversight on several other projects involving communication and compliance related to New York State’s Protection Against Legionella regulation. Rachel holds a Bachelor of Science in applied biology and science writing from The Sage Colleges in Albany, NY.

Reviewing the Do’s and Don’ts of Water Management Plans

Co-Presenter: Martin Zartarian

Abstract: A sound water management plan (WMP) is critical for preventing legionellosis in health care facilities, where case fatality rates can reach 30%. New York State regulation 10 NYCRR Subpart 4-2, Protection Against Legionella, requires that all hospitals and residential nursing homes adopt and implement a WMP. As part of the nosocomial outbreak investigation response, the New York State Department of Health has developed a protocol for reviewing and scoring WMPs, and for providing feedback to health care facilities. Using a sample of 50 facilities, we compared scores from original WMP reviews to resubmissions after feedback. Approximately half of the facilities transitioned from their own WMP format to using the recommended template for their resubmissions. Facilities that used the template for their resubmission scored significantly higher on both their initial plan and their resubmission than those that did not.

We will describe the scoring protocol and summarize the results from the quantitative analysis and then discuss which components of a WMP are the most critical from both facility management and public health response perspectives. For example, failing to list specific sampling locations can negatively impact the ability to track changes in water quality over time, resulting in unnecessary delays and errors during outbreak investigations. Actual excerpts from scored WMPs will clearly illustrate the do’s and don’ts of drafting and implementing WMPs.