84R7136 AJZ-F
By: Campbell S.B. No. 1901
A BILL TO BE ENTITLED
AN ACT
relating to emergency response employees or volunteers and others
exposed or potentially exposed to certain diseases or parasites.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Article 18.22(a), Code of Criminal Procedure, is
amended to read as follows:
(a) A person who is arrested for a misdemeanor or felony and
who during the commission of that offense or an arrest following the
commission of that offense causes an emergency response employee or
volunteer, as defined by Section 81.003, Health and Safety Code, [a
peace officer] to come into contact with the person's bodily fluids
shall, at the direction of the court having jurisdiction over the
arrested person, undergo a medical procedure or test designed to
show or help show whether the person has a communicable disease.
The court may direct the person to undergo the procedure or test on
its own motion or on the request of the emergency response employee
or volunteer [peace officer]. If the person refuses to submit
voluntarily to the procedure or test, the court shall require the
person to submit to the procedure or test. Notwithstanding any
other law, the person performing the procedure or test shall make
the test results available to the local health authority and the
designated infection control officer of the affected emergency
response employee or volunteer, and the local health authority or
the designated infection control officer of the affected employee
or volunteer shall notify the emergency response employee or
volunteer [peace officer] of the test result. The state may not use
the fact that a medical procedure or test was performed on a person
under this article, or use the results of the procedure or test, in
any criminal proceeding arising out of the alleged offense.
SECTION 2. Section 607.102, Government Code, is amended to
read as follows:
Sec. 607.102. NOTIFICATION. An [A firefighter or]
emergency response employee or volunteer, as defined by Section
81.003, Health and Safety Code, [medical technician] who is exposed
to methicillin-resistant Staphylococcus aureus or a disease caused
by a select agent or toxin identified or listed under 42 C.F.R.
Section 73.3 is entitled to receive notification of the exposure in
the manner prescribed by Section 81.048, Health and Safety Code.
SECTION 3. Section 81.003, Health and Safety Code, is
amended by adding Subdivisions (1-a), (1-b), and (1-c) to read as
follows:
(1-a) "Emergency response employee or volunteer"
means an individual acting in the course and scope of employment or
service as a volunteer as emergency medical service personnel, a
peace officer, a detention officer, a county jailer, or a fire
fighter.
(1-b) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(1-c) "Designated infection control officer" means
the person serving as an entity's designated infection control
officer under Section 81.012.
SECTION 4. Subchapter A, Chapter 81, Health and Safety
Code, is amended by adding Sections 81.012 and 81.013 to read as
follows:
Sec. 81.012. DESIGNATED INFECTION CONTROL OFFICER. (a) An
entity that employs or uses the services of an emergency response
employee or volunteer shall nominate a designated infection control
officer and an alternate designated infection control officer to:
(1) receive notification of a potential exposure to an
infectious disease from a health care facility;
(2) notify the appropriate health care providers of a
potential exposure to an infectious disease;
(3) act as a liaison between the entity's emergency
response employees or volunteers who may have been exposed to a
reportable disease during the course and scope of employment or
service as a volunteer;
(4) investigate and evaluate an exposure incident,
using current evidence-based information on the possible risks of
communicable disease presented by the exposure incident; and
(5) monitor all follow-up treatment provided to the
affected emergency response employee or volunteer, in accordance
with applicable federal, state, and local law.
(b) The executive commissioner shall adopt rules for the
department to approve the designated infection control officer and
alternate designated infection control officer nominated under
Subsection (a).
Sec. 81.013. CONSIDERATION OF FEDERAL LAW AND REGULATIONS.
The executive commissioner shall review the Ryan White HIV/AIDS
Treatment Extension Act of 2009 (Pub. L. No. 111-87) or any
successor law and any regulations adopted under the law and
determine whether adopting by rule any part of the federal law or
regulations is in the best interest of the state to further achieve
the purposes of this chapter. If the executive commissioner
determines that adopting the federal law or regulations is in the
best interest of the state to further achieve the purposes of this
chapter, the executive commissioner may by rule adopt all or a part
of the federal law or regulations.
SECTION 5. Section 81.046(c), Health and Safety Code, is
amended to read as follows:
(c) Medical or epidemiological information may be released:
(1) for statistical purposes if released in a manner
that prevents the identification of any person;
(2) with the consent of each person identified in the
information;
(3) to medical personnel treating the individual,
appropriate state agencies in this state or another state, a health
authority or local health department in this state or another
state, or federal, county, or district courts to comply with this
chapter and related rules relating to the control and treatment of
communicable diseases and health conditions or under another state
or federal law that expressly authorizes the disclosure of this
information;
(4) to appropriate federal agencies, such as the
Centers for Disease Control and Prevention of the United States
Public Health Service, but the information must be limited to the
name, address, sex, race, and occupation of the patient, the date of
disease onset, the probable source of infection, and other
requested information relating to the case or suspected case of a
communicable disease or health condition; [or]
(5) to medical personnel to the extent necessary in a
medical emergency to protect the health or life of the person
identified in the information; or
(6) to a designated infection control officer.
SECTION 6. The heading to Section 81.048, Health and Safety
Code, is amended to read as follows:
Sec. 81.048. NOTIFICATION OF EMERGENCY RESPONSE EMPLOYEE OR
VOLUNTEER [PERSONNEL, PEACE OFFICERS, DETENTION OFFICERS, COUNTY
JAILERS, AND FIRE FIGHTERS].
SECTION 7. Sections 81.048(b), (c), and (g), Health and
Safety Code, are amended to read as follows:
(b) Notice of a positive test result for a reportable
disease designated under Subsection (a) shall be given to an
emergency response employee or volunteer [medical service
personnel, peace officer, detention officer, county jailer, or fire
fighter] as provided by this section if:
(1) the emergency response employee or volunteer
[medical service personnel, peace officer, detention officer,
county jailer, or fire fighter] delivered a person to a hospital as
defined by Section 74.001, Civil Practice and Remedies Code;
(2) the hospital has knowledge that the person has a
reportable disease and has medical reason to believe that the
person had the disease when the person was admitted to the hospital;
and
(3) the emergency response employee or volunteer
[medical service personnel, peace officer, detention officer,
county jailer, or fire fighter] was exposed to the reportable
disease during the course and scope of the person's employment or
service as a volunteer [of duty].
(c) Notice of the possible exposure shall be given:
(1) by the hospital to the local health authority;
(2) by the hospital to the designated infection
control officer of [local health authority to the director of the
appropriate department of] the entity that employs or uses the
services of the affected emergency response employee or volunteer
[emergency medical service personnel, peace officer, detention
officer, county jailer, or fire fighter]; and
(3) by the local health authority or the designated
infection control officer of the entity that employs or uses the
services of the affected emergency response employee or volunteer
[director] to the employee or volunteer affected.
(g) A hospital that gives notice of a possible exposure
under Subsection (c) or a local health authority or designated
infection control officer that receives notice of a possible
exposure under Subsection (c) may give notice of the possible
exposure to a person other than the affected emergency response
employee or volunteer [emergency medical personnel, a peace
officer, a detention officer, a county jailer, or a fire fighter] if
the person demonstrates that the person was exposed to the
reportable disease while providing emergency care. The executive
commissioner [of the Health and Human Services Commission] shall
adopt rules to implement this subsection.
SECTION 8. Sections 81.050(b) and (h), Health and Safety
Code, are amended to read as follows:
(b) A person whose occupation or whose volunteer service is
included in one or more of the following categories may request the
department or a health authority to order testing of another person
who may have exposed the person to a reportable disease, including
HIV infection:
(1) a law enforcement officer;
(2) a fire fighter;
(3) an emergency medical service employee or
paramedic;
(4) a correctional officer;
(5) an employee, contractor, or volunteer, other than
a correctional officer, who performs a service in a correctional
facility as defined by Section 1.07, Penal Code, or a secure
correctional facility or secure detention facility as defined by
Section 51.02, Family Code; [or]
(6) an employee of a juvenile probation department; or
(7) any other emergency response employee or
volunteer.
(h) The department or the department's designee shall
inform the person who requested the order and the designated
infection control officer of the person who requested the order, if
that person is an emergency response employee or volunteer, of the
results of the test. If the person subject to the order is found to
have a reportable disease, the department or the department's
designee shall inform that person and the person who requested the
order of the need for medical follow-up and counseling services.
The department or the department's designee shall develop protocols
for coding test specimens to ensure that any identifying
information concerning the person tested will be destroyed as soon
as the testing is complete.
SECTION 9. Sections 81.095(a) and (b), Health and Safety
Code, are amended to read as follows:
(a) In a case of accidental exposure of a health care worker
to blood or other body fluids of a patient in a licensed hospital,
the hospital, following a report of the exposure incident, shall
take reasonable steps to test the patient for hepatitis B, [or]
hepatitis C, HIV, or any reportable disease or parasite.
(b) This subsection applies only in a case of accidental
exposure of certified emergency medical services personnel, an
emergency response employee or volunteer [a firefighter, a peace
officer], or a first responder who renders assistance at the scene
of an emergency or during transport to the hospital to blood or
other body fluids of a patient who is transported to a licensed
hospital. The hospital receiving the patient, following a report
of the exposure incident, shall take reasonable steps to test the
patient for hepatitis B, [or] hepatitis C, HIV, or any reportable
disease or parasite if the report shows there is significant risk to
the person exposed. The organization that employs the person or for
which the person works as a volunteer in connection with rendering
the assistance is responsible for paying the costs of the test. The
hospital shall provide the test results to the department or to the
local health authority and to the designated infection control
officer of the entity employing or using the services of an affected
emergency response employee or volunteer, which are responsible for
following the procedures prescribed by Section 81.050(h) to inform
the person exposed and, if applicable, the patient regarding the
test results. The hospital shall follow applicable reporting
requirements prescribed by Subchapter C. This subsection does not
impose a duty on a hospital to provide any further testing,
treatment, or services or to perform further procedures.
SECTION 10. Sections 81.0955(a) and (b), Health and Safety
Code, are amended to read as follows:
(a) This section applies only to the accidental exposure to
the blood or other body fluids of a person who dies at the scene of
an emergency or during transport to the hospital involving an
emergency response employee or volunteer [certified emergency
medical services personnel, a firefighter, a peace officer,] or
another [a] first responder who renders assistance at the scene of
an emergency or during transport of a person to the hospital.
(b) A hospital, certified emergency medical services
personnel, justice of the peace, medical examiner, or a physician
on behalf of the person exposed, following a report of the exposure
incident, shall take reasonable steps to have [test] the deceased
person tested for communicable diseases. The hospital, certified
emergency medical services personnel, justice of the peace, medical
examiner, or physician shall provide the test results to the
department or to the local health authority and to the designated
infection control officer of an affected emergency response
employee or volunteer responsible for following the procedures
prescribed by Section 81.050(h) to inform the person exposed. If
[and, if] applicable, the department or the local health authority
shall inform the next of kin of the deceased person regarding the
test results. The hospital, certified emergency medical services
personnel, or physician shall follow applicable reporting
requirements prescribed by Subchapter C. This subsection does not
impose a duty on a hospital, certified emergency medical services
personnel, medical examiner, or a physician to provide any further
testing, treatment, or services or to perform further procedures.
This subsection does not impose a duty on a justice of the peace to
order that further testing, treatment, or services be provided or
further procedures be performed. The executive commissioner [of the
Health and Human Services Commission] shall adopt rules to
implement this subsection.
SECTION 11. Section 81.102(c), Health and Safety Code, is
amended to read as follows:
(c) Protocols adopted under Subsection (a)(5)(D)
[(a)(4)(D)] must clearly establish procedural guidelines with
criteria for testing that respect the rights of the person with the
infection and the person who may be exposed to that infection. The
protocols may not require the person who may have been exposed to be
tested and must ensure the confidentiality of the person with the
infection in accordance with this chapter.
SECTION 12. Section 81.103(b), Health and Safety Code, is
amended to read as follows:
(b) A test result may be released to:
(1) the department under this chapter;
(2) a local health authority if reporting is required
under this chapter;
(3) the Centers for Disease Control and Prevention of
the United States Public Health Service if reporting is required by
federal law or regulation;
(4) the physician or other person authorized by law
who ordered the test;
(5) a physician, nurse, or other health care personnel
who have a legitimate need to know the test result in order to
provide for their protection and to provide for the patient's
health and welfare;
(6) the person tested or a person legally authorized
to consent to the test on the person's behalf;
(7) the spouse of the person tested if the person tests
positive for AIDS or HIV infection, antibodies to HIV, or infection
with any other probable causative agent of AIDS;
(8) a person authorized to receive test results under
Article 21.31, Code of Criminal Procedure, concerning a person who
is tested as required or authorized under that article;
(9) a person exposed to HIV infection as provided by
Section 81.050; [and]
(10) a county or district court to comply with this
chapter or rules relating to the control and treatment of
communicable diseases and health conditions; and
(11) a designated infection control officer of an
affected emergency response employee or volunteer.
SECTION 13. Section 81.107(a), Health and Safety Code, is
amended to read as follows:
(a) In a case of accidental exposure to blood or other body
fluids under Section 81.102(a)(5)(D) [81.102(a)(4)(D)], the health
care agency or facility may test a person who may have exposed the
health care worker or other emergency response employee or
volunteer to HIV without the person's specific consent to the test.
SECTION 14. Not later than December 1, 2015, the executive
commissioner of the Health and Human Services Commission shall
adopt the rules required by Section 81.012, Health and Safety Code,
as added by this Act.
SECTION 15. This Act takes effect September 1, 2015.