In 2024, the New Jersey state legislature passed S2188/A1970, a law requiring Public Community Water Systems, owners or operators of certain types of buildings, and others to take action to protect public health by preventing and controlling Legionella in their water systems. This bill is now enshrined in New Jersey state law.
In my most recent post, I covered what this new law means for the state’s Public Water Systems. In this post, I look more closely at the law’s impact on facilities in the state.
Legionnaire’s Disease is on the Rise
Before we get into the law itself, let’s look at why New Jersey state legislators may have felt it necessary to enact legislation. Legionnaire’s disease is the more severe of the respiratory illnesses caused by Legionella. Healthy individuals may not be impacted by exposure to the bacteria, but it can be fatal, especially in immunocompromised people. Estimates of overall fatality rates are around 10%, but they can rise significantly higher when an outbreak occurs in a healthcare setting or assisted living facility. This is one of the reasons state and local governments often have laws mandating the testing of water systems in these facilities. Healthcare facilities that accept Medicaid and Medicare are also required to have a water management plan that addresses Legionella risks.
According to CDC data, cases of Legionnaire’s disease have been on the rise in the United States for at least the last two decades. In 2019, currently the last year for which state data has been published, New Jersey had 318 reported and confirmed cases, or 3.6% of the total U.S. cases. However, since Legionnaire’s disease can look like other respiratory diseases, experts believe it is often misdiagnosed, and the actual numbers are likely to be higher.
Source: Centers for Disease Control
At the Heart of the Matter: Water Management Planning
When it comes to facilities, water management planning lies at the heart of compliance. A Water Management Plan is a strategic document that outlines an organization’s strategy for minimizing the growth and spread of waterborne pathogens. A comprehensive plan identifies potentially hazardous conditions and outlines necessary measures to mitigate these risks.
Legionella is the most common pathogen of concern, but the plan can also focus on other opportunistic waterborne pathogens, such as Pseudomonas, Acinetobacter, Burkholderia, Stenotrophomonas, nontuberculous mycobacteria, and fungi. If you’re new to water management planning, here are a handful of Pace® resources that can help:
Pace® Water Management Planning Services
Info Sheet: Water Management Planning
Webinar: Water Management Planning Strategies in Healthcare
What Types of Facilities Are Required to Comply?
New Jersey’s Legionella law is somewhat unique in that it covers both Public Water Systems (PWS) and facilities, but the differences go deeper than that. Few states have Legionella testing laws, but those that do tend to focus on specific types of facilities, most often schools, daycare facilities, healthcare facilities, and government-owned or operated buildings. New York’s law is broader, but it focuses specifically on testing cooling towers, a frequently suspected source of Legionella infections.
The New Jersey law doesn't cover every type of facility, but it is much broader than other state laws. Section C.26:1A-140 lists the conditions requiring a facility to comply with the law. Many of the usual suspects are included, i.e., hospitals, nursing homes, and assisted living facilities of various types. The law also covers correctional facilities with one or more centralized potable hot water systems.
As older people are the most vulnerable, residential structures catering to an older population are covered. This specifically includes “a residential building with a centralized potable water-heater system that is shared by 25 or more housing units, which serves as subsidized housing designated for individuals who are 62 years of age or older or who have a disability or is designated as senior housing and is subject to the provisions of P.L.1986, c.103 (C.52:27D-330 et seq.)”
But those aren’t the only residential structures covered. High-rise structures with six or more floors as well as buildings serving a transient population with 25 or more housing units. This last group includes hotels and motels as well as some shelters that provide individual units.
The widest net is no doubt cast with the clause requiring any building “containing a whirlpool, spa, pool, open-circuit or closed-circuit cooling tower or evaporative condenser” to comply. These facilities are only required to create a water management plan for the specific device.
Compliance Requirements
The primary section dealing with facilities compliance is found in C.26:1A-140, which requires those facilities to develop an ASHRAE 188-compliant water management plan within twenty-four months. The ASHRAE 188 standard was first published in 2015 and is also known by its title: Legionellosis: Risk Management for Building Water Systems. The standard establishes minimum legionellosis risk management requirements for building water systems.
Other sections of the law impact facilities, e.g., Section C.26:1A-139 (4)d mentions testing that may be mandated by the Department of Health during an outbreak investigation. In addition, the law includes specific requirements for reporting the discovery of Legionella to the appropriate authorities and disclosing it to the public.
We encourage you to refer to the published law and work with your legal counsel to ensure you have a comprehensive understanding of all requirements. Pace® can assist you in meeting these requirements with Legionella testing and Water Management Planning.
