Amend CSHB 2085 by adding the following appropriately
numbered sections:
SECTION Chapter 81, Health and Safety Code, is amended by
adding Subchapter H to read as follows:
SUBCHAPTER H. BLOODBORNE PATHOGEN EXPOSURE CONTROL PLAN
Sec. 81.301. DEFINITIONS. In this subchapter:
(1) "Bloodborne pathogens" means pathogenic
microorganisms that are present in human blood and that can cause
diseases in humans. The term includes hepatitis B virus, hepatitis
C virus, and human immunodeficiency virus.
(2) "Engineered sharps injury protection" means:
(A) a physical attribute that is built into a
needle device used for withdrawing body fluids, accessing a vein or
artery, or administering medications or other fluids and that
effectively reduces the risk of an exposure incident by a mechanism
such as barrier creation, blunting, encapsulation, withdrawal,
retraction, destruction, or another effective mechanism; or
(B) a physical attribute built into any other
type of needle device, into a nonneedle sharp, or into a nonneedle
infusion safety securement device that effectively reduces the risk
of an exposure incident.
(3) "Governmental unit" means:
(A) this state and any agency of the state,
including a department, bureau, board, commission, or office;
(B) a political subdivision of this state,
including any municipality, county, or special district; and
(C) any other institution of government,
including an institution of higher education.
(4) "Needleless system" means a device that does not
use a needle and that is used:
(A) to withdraw body fluids after initial venous
or arterial access is established;
(B) to administer medication or fluids; or
(C) for any other procedure involving the
potential for an exposure incident.
(5) "Sharp" means an object used or encountered in a
health care setting that can be reasonably anticipated to penetrate
the skin or any other part of the body and to result in an exposure
incident, including a needle device, a scalpel, a lancet, a piece
of broken glass, a broken capillary tube, an exposed end of a
dental wire, or a dental knife, drill, or bur.
(6) "Sharps injury" means any injury caused by a
sharp, including a cut, abrasion, or needlestick.
Sec. 81.302. APPLICABILITY OF SUBCHAPTER. This subchapter
applies only to a governmental unit that employs employees who:
(1) provide services in a public or private facility
providing health care-related services, including a home health
care organization; or
(2) otherwise have a risk of exposure to blood or
other material potentially containing bloodborne pathogens in
connection with exposure to sharps.
Sec. 81.303. EXPOSURE CONTROL PLAN. The department shall
establish an exposure control plan designed to minimize exposure of
employees described by Section 81.302 to bloodborne pathogens. In
developing the plan, the department must consider:
(1) policies relating to occupational exposure to
bloodborne pathogens;
(2) training and educational requirements for
employees;
(3) measures to increase vaccinations of employees;
and
(4) increased use of personal protective equipment by
employees.
Sec. 81.304. MINIMUM STANDARDS. The board by rule shall
adopt minimum standards to implement the exposure control plan and
the other provisions of this subchapter. The rules shall be
analogous to standards adopted by the federal Occupational Safety
and Health Administration. Each governmental unit shall comply
with the minimum standards adopted under this subchapter.
Sec. 81.305. NEEDLELESS SYSTEMS. (a) The board by rule
shall recommend that governmental units implement needleless
systems and sharps with engineered sharps injury protection for
employees.
(b) The recommendation adopted under Subsection (a) does not
apply to the use of a needleless system or sharps with engineered
sharps injury protection in circumstances and in a year in which an
evaluation committee has established that the use of needleless
systems and sharps with engineered sharps injury protection will
jeopardize patient or employee safety with regard to a specific
medical procedure or will be unduly burdensome. A report of the
committee's decision shall be submitted to the department annually.
(c) At least half of the members of an evaluation committee
established by a governmental unit to implement Subsection (b) must
be employees who are health care workers who have direct contact
with patients or provide services on a regular basis.
(d) The rules adopted under Subsection (a) may not prohibit
the use of a prefilled syringe that is approved by the federal Food
and Drug Administration. This subsection expires May 1, 2003.
Sec. 81.306. SHARPS INJURY LOG. (a) The board by rule
shall require that information concerning exposure incidents be
recorded in a written or electronic sharps injury log to be
maintained by a governmental unit. This information must be
reported to the department and must include:
(1) the date and time of the exposure incident;
(2) the type and brand of sharp involved in the
exposure incident; and
(3) a description of the exposure incident, including:
(A) the job classification or title of the
exposed employee;
(B) the department or work area where the
exposure incident occurred;
(C) the procedure that the exposed employee was
performing at the time of the incident;
(D) how the incident occurred;
(E) the employee's body part that was involved
in the exposure incident; and
(F) whether the sharp had engineered sharps
injury protection and, if so, whether the protective mechanism was
activated and whether the injury occurred before, during, or after
the activation of the protective mechanism.
(b) Information regarding which recommendations under
Section 81.305(a) were adopted by the governmental entity shall be
included in the log.
(c) All information and materials obtained or compiled by
the department in connection with a report under this Section are
confidential and not subject to disclosure under Section 552.001,
et seq., Government Code and not subject to disclosure, discovery,
subpoena, or other means of legal compulsion for their release by
the department. The department shall make available, in aggregate
form, the information described in Sec. 81.305 (b) and this
Section, provided that the name and other information identifying
the facility is deleted, and the information is provided according
to public health regions established by the Texas Department of
Health.
Sec. 81.307. DEVICE REGISTRATION. (a) The department, in
accordance with rules adopted by the board, shall implement a
registration program for existing needleless systems and sharps
with engineered sharps injury protection.
(b) The department shall compile and maintain a list of
existing needleless systems and sharps with engineered sharps
injury protection that are available in the commercial marketplace
and registered with the department to assist governmental units to
comply with this subchapter.
(c) The department shall charge a fee to register a device
in an amount established by the board. The fees collected under
this section may be appropriated only to the department to
implement this subchapter.
SECTION (a) Except as provided by Subsection (e) of this
section, this Act takes effect September 1, 1999.
(b) The Texas Board of Health shall adopt the exposure
control plan and the rules required by Subchapter H, Chapter 81,
Health and Safety Code, as added by this Act, not later than
September 1, 2000.
(c) Except as provided by Subsection (d) of this section, a
governmental unit, as defined by Subdivision (3), Section 81.301,
Health and Safety Code, as added by this Act, shall comply with
Subchapter H, Chapter 81, Health and Safety Code, as added by this
Act, not later than January 1, 2001.
(d) The Texas Department of Health may, in accordance with
rules adopted by the Texas Board of Health, waive the application
of Subchapter H, Chapter 81, Health and Safety Code, as added by
this Act, to a rural county if the department finds that the
application of the subchapter to the county would be unduly
burdensome. A waiver granted under this subsection expires
December 31, 2001. For purposes of this subsection, "rural county"
means a county that:
(1) has a population of 50,000 or less; or
(2) has a population of more than 50,000 but:
(A) does not have located within the county a
general or special hospital licensed under Chapter 241, Health and
Safety Code, with more than 100 beds; and
(B) was not, based on the 1990 federal census,
completely included within an area designated as urbanized by the
Bureau of the Census of the United States Department of Commerce.
(e) Subchapter H, Chapter 81, Health and Safety Code, as
added by this Act, takes effect only if a specific appropriation
for the implementation of Subchapter H, Chapter 81, Health and
Safety Code, as added by this Act is provided in HB 1 (General
Appropriations Act), Acts of the 76th Legislature, Regular Session,
1999. If no specific appropriation is provided in HB 1, the
General Appropriations Act, then Subchapter H, Chapter 81, Health
and Safety Code, as added by this Act has no effect.
SECTION In adopting the initial rules establishing the
duties of an evaluation committee under Subsection (c), Section
81.305, Health and Safety Code, as added by this Act, the Texas
Board of Health shall consider the duties of similar committees in
existence on the effective date of this Act.