On January 15, 2006, the New York City Department of Health and Mental Hygiene (the "Health Department") implemented an involuntary program to monitor blood glucose levels of people with diabetes in the name of diabetes prevention without patients' knowledge or informed consent. Furthermore, patients may not opt out of the program. Although patients can eventually opt out of receiving communications from the Health Department, the city will continue to seize patients' confidential medical test results without their informed consent. Via electronic lab reporting, all clinical laboratories that report via the Electronic Clinical Laboratory Reporting System (ECLRS) are now reporting hemoglobin A1C test results and other personal information in an electronic format. The city's A1C mandate is the first-ever required government tracking of a chronic, non-communicable disease in the United States.