No. 28288 (New Rule): R612-10. HIV, Hepatitis B and C Testing and Reporting for Emergency Medical Services Providers

DAR File No.: 28288
Filed: 10/14/2005, 03:30
Received by: NL

 

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this new rule is to establish procedures pursuant to Section 78-29-102 for source patient testing and reporting following a significant exposure of an emergency medical services provider.

 

Summary of the rule or change:

The proposed rule defines terms and establishes procedures to be followed by emergency medical service providers, their employers, and testing facilities for the reporting and testing of exposures to Human Immunodeficiency Virus (HIV), Hepatitis B, and Hepatitis C.

 

State statutory or constitutional authorization for this rule:

Sections 78-29-102 and 78-29-104

 

Anticipated cost or savings to:

the state budget:

Although the proposed rule shifts costs of testing from the Department of Health to the Division of Risk Management, the rule does not increase or decrease the overall cost of such testing. Consequently, there will be no net savings or cost to the state budget.

 

local governments:

Testing requirements would average approximately $50 per exposure with approximately 200 exposures per year, for an aggregate cost of $10,000 per year to local government.

 

other persons:

The rule will not impose any additional aggregate costs on other persons, because this rule narrowly applies to agency Emergency Medical Service providers work primarily for local governments.

 

Compliance costs for affected persons:

Governmental entities will incur testing costs of approximately $50 for each event in which one of its emergency service personnel is exposed to the diseases covered by this rule. The Commission does not anticipate any other compliance costs.

 

Comments by the department head on the fiscal impact the rule may have on businesses:

This rule is limited in application to emergency service personnel employed by government agencies. The rule does not apply to business employees and will have no fiscal impact on business. R. Lee Ellertson, Commissioner

 

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Labor Commission
Industrial Accidents
HEBER M WELLS BLDG
160 E 300 S
SALT LAKE CITY UT 84111-2316

 

Direct questions regarding this rule to:

Joyce Sewell at the above address, by phone at 801-530-6988, by FAX at 801-530-6804, or by Internet E-mail at [e-mail]

 

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/01/2005

 

This rule may become effective on:

12/02/2005

 

Authorized by:

R Lee Ellertson, Commissioner

 

 

RULE TEXT

R612. Labor Commission, Industrial Accidents.

R612-10. HIV, Hepatitis B and C Testing and Reporting for Emergency Medical Services Providers.

R612-10-1. HIV, Hepatitis B and C Testing and Reporting for Emergency Medical Services Providers.

A. Authority - The HIV, Hepatitis B and C Testing and Reporting for Emergency Medical Services Providers rule is established under the authority of U.C.A. Section 78-29-104.

B. Purpose - To establish procedures pursuant to U.C.A. Section 78-29-102 for source patient testing and reporting following a significant exposure of an emergency medical services provider.

C. Definitions

1. Department means the Utah Labor Commission.

2. Contact means designated person(s) within the emergency medical services agency or the employer of the emergency medical services provider.

3. Disease means Human Immunodeficiency Virus, acute or chronic Hepatitis B or Hepatitis C infections.

4. Emergency medical services provider means Emergency Medical personnel as defined in Section 26-8a-102, a public safety officer, local fire department personnel, or personnel employed by the Department of Corrections or by a county jail, who provide prehospital Emergency medical care for an emergency medical services agency either as an employee or a volunteer.

5. Emergency medical services (EMS) agency means an agency, entity, or organization that employs or utilizes emergency medical services providers as defined in (4) as employees or volunteers.

6. Source Patient means any individual cared for by a prehospital emergency medical services provider, including but not limited to victims of accidents or injury, deceased persons, and prisoners or persons in the custody of the Department of Corrections.

7. Receiving facility means a hospital, health care or other facility where the patient is delivered by the emergency medical services provider for care.

8. "Significant Exposure" and "Significantly Exposed" mean:

a. exposure of the body of one person to the blood or body fluids visibly contaminated by blood of another person by:

1. percutaneous injury, including a needle stick or cut with a sharp object or instrument; or

2. contact with an open wound, mucous membrane, or nonintact skin because of a cut, abrasion, dermatitis, or other damage; or

b. exposure that occurs by any other method of transmission defined by the Department of Health as a significant exposure.

D. Emergency Medical Services Provider Responsibility.

1. The EMS provider shall document and report all significant exposures to the receiving facility and contact as defined in (C) (2).

2. The reporting process is as follows:

a. The exposed EMS provider shall complete the Exposure Report Form (ERF) at the time the patient is delivered to the receiving facility and provide a copy to the person at the receiving facility authorized by the facility to receive the form. In the event the exposed EMS provider does not accompany the source patient to the receiving facility, he/she may report the exposure incident, with information requested on the ERF, by telephone to a person authorized by the facility to receive the form. In this event, the exposed EMS provider shall nevertheless submit a written copy of the ERF within three days to an authorized person of the receiving facility.

b. The exposed EMS provider shall, within three days of the incident, submit a copy of the ERF to the contact as defined in (C) (2).

E. Receiving Facility Responsibility:

1. The receiving facility shall establish a system to receive ERFs as well as telephoned reports from exposed EMS providers on a 24-hour per day basis. The facility shall also have available or on call, trained pre-test counselors for the purpose of obtaining consent and counseling of source patients when HIV testing has been requested by EMS providers. The receiving facility shall contact the source patient prior to release from the facility to provide the individual with counseling or, if unable to provide counseling, provide the source patient with phone numbers for a trained counselor to provide the counseling within 24 hours.

2. Upon notification of exposure, the receiving facility shall request permission from the source patient to draw a blood sample for disease testing, as defined in (C) (3). In conjunction with this request, the source patient must be advised of his/her right to refuse testing and be advised that if he/she refuses to be tested that fact will be forwarded to the EMS agency or employer of EMS provider. The source patient shall also be advised that if he/she refuses to be tested, the EMS agency or provider may seek a court order to compel the source patient to submit to a blood draw for the disease testing.

Testing is authorized only when the source patient, his/her next of kin or legal guardian consents to testing, with the exception that consent is not required from an individual who has been convicted of a crime and is in the custody or under the jurisdiction of the Department of Corrections, or if the source patient is dead. If consent is denied, the receiving facility shall complete the ERF and send it to the EMS agency or employer of the EMS provider. If consent is received, the receiving facility shall draw a sample of the source patient's blood and send it, along with the ERF, to a qualified laboratory for testing.

3. The laboratory that the receiving facility has sent source patient's blood draw to shall send the disease test results, by Case ID number, to the EMS agency or employer of the EMS provider.

F. EMS Agency/Employer Responsibility:

1. The EMS agency/employer, upon receipt of the disease tests, from the receiving facility laboratory, shall immediately report the result, by case number, not name, to the exposed EMS provider.

2. The EMS agency/employer, upon the receipt of refusal of testing by the source, shall report that refusal to the EMS provider.

3. The agency/employer or its insurance carrier shall pay for the EMS provider and the source patient testing for the covered diseases per the Labor Commission fee schedule.

4. The EMS agency/employer shall maintain the records of any disease exposures contained in this rule per the OSHA Blood Borne Pathogen standards.

 

KEY: workers' compensation, administrative procedures, reporting, settlements

2005

34A-2-101 et seq.

34A-3-101 et seq.

34A-1-104

78-29-102

78-29-104