76R15195 E
By Ehrhardt, Maxey, Hochberg, Coleman H.B. No. 1646
Substitute the following for H.B. No. 1646:
By Maxey C.S.H.B. No. 1646
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the standards for occupational exposure of public
1-3 employees to bloodborne pathogens.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Chapter 81, Health and Safety Code, is amended by
1-6 adding Subchapter H to read as follows:
1-7 SUBCHAPTER H. BLOODBORNE PATHOGEN EXPOSURE CONTROL PLAN
1-8 Sec. 81.301. DEFINITIONS. In this subchapter:
1-9 (1) "Bloodborne pathogens" means pathogenic
1-10 microorganisms that are present in human blood and that can cause
1-11 diseases in humans. The term includes hepatitis B virus, hepatitis
1-12 C virus, and human immunodeficiency virus.
1-13 (2) "Engineered sharps injury protection" means:
1-14 (A) a physical attribute that is built into a
1-15 needle device used for withdrawing body fluids, accessing a vein or
1-16 artery, or administering medications or other fluids and that
1-17 effectively reduces the risk of an exposure incident by a
1-18 mechanism such as barrier creation, blunting, encapsulation,
1-19 withdrawal, retraction, destruction, or another effective
1-20 mechanism; or
1-21 (B) a physical attribute built into any other
1-22 type of needle device, into a nonneedle sharp, or into a nonneedle
1-23 infusion safety securement device that effectively reduces the risk
1-24 of an exposure incident.
2-1 (3) "Governmental unit" means:
2-2 (A) this state and any agency of the state,
2-3 including a department, bureau, board, commission, or office;
2-4 (B) a political subdivision of this state,
2-5 including any municipality, county, or special district; and
2-6 (C) any other institution of government,
2-7 including an institution of higher education.
2-8 (4) "Needleless system" means a device that does not
2-9 use a needle and that is used:
2-10 (A) to withdraw body fluids after initial venous
2-11 or arterial access is established;
2-12 (B) to administer medication or fluids; or
2-13 (C) for any other procedure involving the
2-14 potential for an exposure incident.
2-15 (5) "Sharp" means an object used or encountered in a
2-16 health care setting that can be reasonably anticipated to penetrate
2-17 the skin or any other part of the body and to result in an exposure
2-18 incident, including a needle device, a scalpel, a lancet, a piece
2-19 of broken glass, a broken capillary tube, an exposed end of a
2-20 dental wire, or a dental knife, drill, or bur.
2-21 (6) "Sharps injury" means any injury caused by a
2-22 sharp, including a cut, abrasion, or needlestick.
2-23 Sec. 81.302. APPLICABILITY OF SUBCHAPTER. This subchapter
2-24 applies only to a governmental unit that employs employees who:
2-25 (1) provide services in a public or private facility
2-26 providing health care-related services, including a home health
2-27 care organization; or
3-1 (2) otherwise have a risk of exposure to blood or
3-2 other material potentially containing bloodborne pathogens in
3-3 connection with exposure to sharps.
3-4 Sec. 81.303. EXPOSURE CONTROL PLAN. The department shall
3-5 establish an exposure control plan designed to minimize exposure of
3-6 employees described by Section 81.302 to bloodborne pathogens. In
3-7 developing the plan, the department must consider:
3-8 (1) policies relating to occupational exposure to
3-9 bloodborne pathogens;
3-10 (2) training and educational requirements for
3-11 employees;
3-12 (3) measures to increase vaccinations of employees;
3-13 and
3-14 (4) increased use of personal protective equipment by
3-15 employees.
3-16 Sec. 81.304. MINIMUM STANDARDS. The board by rule shall
3-17 adopt minimum standards to implement the exposure control plan and
3-18 the other provisions of this subchapter. The rules shall be
3-19 analogous to standards adopted by the federal Occupational Safety
3-20 and Health Administration. Each governmental unit shall comply
3-21 with the minimum standards adopted under this subchapter.
3-22 Sec. 81.305. NEEDLELESS SYSTEMS. (a) The board by rule
3-23 shall recommend that governmental units implement needleless
3-24 systems and sharps with engineered sharps injury protection for
3-25 employees.
3-26 (b) The recommendation adopted under Subsection (a) does not
3-27 apply to the use of a needleless system or sharps with engineered
4-1 sharps injury protection in circumstances and in a year in which an
4-2 evaluation committee has established that the use of needleless
4-3 systems and sharps with engineered sharps protection will
4-4 jeopardize patient or employee safety with regard to a specific
4-5 medical procedure or will be unduly burdensome. A report of the
4-6 committee's decision shall be submitted to the department annually.
4-7 (c) At least half of the members of an evaluation committee
4-8 established by a governmental unit to implement Subsection (b) must
4-9 be employees who are health care workers who have direct contact
4-10 with patients or provide services on a regular basis.
4-11 (d) The rules adopted under Subsection (a) may not prohibit
4-12 the use of a prefilled syringe that is approved by the federal Food
4-13 and Drug Administration. This subsection expires May 1, 2003.
4-14 Sec. 81.306. SHARPS INJURY LOG. (a) The board by rule
4-15 shall require that information concerning exposure incidents be
4-16 recorded in a written or electronic sharps injury log to be
4-17 maintained by a governmental unit. This information must be
4-18 reported to the department and must include:
4-19 (1) the date and time of the exposure incident;
4-20 (2) the type and brand of sharp involved in the
4-21 exposure incident; and
4-22 (3) a description of the exposure incident, including:
4-23 (A) the job classification or title of the
4-24 exposed employee;
4-25 (B) the department or work area where the
4-26 exposure incident occurred;
4-27 (C) the procedure that the exposed employee was
5-1 performing at the time of the incident;
5-2 (D) how the incident occurred;
5-3 (E) the employee's body part that was involved
5-4 in the exposure incident; and
5-5 (F) whether the sharp had engineered sharps
5-6 injury protection and, if so, whether the protective mechanism was
5-7 activated and whether the injury occurred before, during, or after
5-8 the activation of the protective mechanism.
5-9 (b) Information regarding which recommendations under
5-10 Section 81.305(a) were adopted by the governmental entity shall be
5-11 included in the log.
5-12 (c) All information and materials obtained or compiled by
5-13 the department in connection with a report under this section are
5-14 confidential and not subject to disclosure under Section 552.001 et
5-15 seq., Government Code, and not subject to disclosure, discovery,
5-16 subpoena, or other means of legal compulsion for their release by
5-17 the department. The department shall make available, in aggregate
5-18 form, the information described in Section 81.305(b) and this
5-19 section, provided that the name and other information identifying
5-20 the facility is deleted and the information is provided according
5-21 to public health regions established by the department.
5-22 Sec. 81.307. DEVICE REGISTRATION. (a) The department, in
5-23 accordance with rules adopted by the board, shall implement a
5-24 registration program for existing needleless systems and sharps
5-25 with engineered sharps injury protection.
5-26 (b) The department shall compile and maintain a list of
5-27 existing needleless systems and sharps with engineered sharps
6-1 injury protection that are available in the commercial marketplace
6-2 and registered with the department to assist governmental units to
6-3 comply with this subchapter.
6-4 (c) The department shall charge a fee to register a device
6-5 in an amount established by the board. The fees collected under
6-6 this section may be appropriated only to the department to
6-7 implement this subchapter.
6-8 SECTION 2. (a) Except as provided by Subsection (e) of this
6-9 section, this Act takes effect September 1, 1999.
6-10 (b) The Texas Board of Health shall adopt the exposure
6-11 control plan and the rules required by Subchapter H, Chapter 81,
6-12 Health and Safety Code, as added by this Act, not later than
6-13 September 1, 2000.
6-14 (c) Except as provided by Subsection (d) of this section, a
6-15 governmental unit, as defined by Subdivision (3), Section 81.301,
6-16 Health and Safety Code, as added by this Act, shall comply with
6-17 Subchapter H, Chapter 81, Health and Safety Code, as added by this
6-18 Act, not later than January 1, 2001.
6-19 (d) The Texas Department of Health may, in accordance with
6-20 rules adopted by the Texas Board of Health, waive the application
6-21 of Subchapter H, Chapter 81, Health and Safety Code, as added by
6-22 this Act, to a rural county if the department finds that the
6-23 application of the subchapter to the county would be unduly
6-24 burdensome. A waiver granted under this subsection expires
6-25 December 31, 2001. For purposes of this subsection, "rural county"
6-26 means a county that:
6-27 (1) has a population of 50,000 or less; or
7-1 (2) has a population of more than 50,000 but:
7-2 (A) does not have located within the county a
7-3 general or special hospital licensed under Chapter 241, Health and
7-4 Safety Code, with more than 100 beds; and
7-5 (B) was not, based on the 1990 federal census,
7-6 completely included within an area designated as urbanized by the
7-7 Bureau of the Census of the United States Department of Commerce.
7-8 (e) This Act takes effect only if a specific appropriation
7-9 for the implementation of this Act is provided in H.B No. 1
7-10 (General Appropriations Act), Acts of the 76th Legislature, Regular
7-11 Session, 1999. If no specific appropriation is provided in H.B.
7-12 No. 1, the General Appropriations Act, this Act has no effect.
7-13 SECTION 3. In adopting the initial rules establishing the
7-14 duties of an evaluation committee under Subsection (c), Section
7-15 81.305, Health and Safety Code, as added by this Act, the Texas
7-16 Board of Health shall consider the duties of similar committees in
7-17 existence on the effective date of this Act.
7-18 SECTION 4. The importance of this legislation and the
7-19 crowded condition of the calendars in both houses create an
7-20 emergency and an imperative public necessity that the
7-21 constitutional rule requiring bills to be read on three several
7-22 days in each house be suspended, and this rule is hereby suspended.