By Bernsen                                             S.B. No. 905
         76R4866 CMR-D                           
                                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, or into a nonneedle sharp, that effectively
1-23     reduces the risk of an exposure incident.
1-24                 (3)  "Governmental unit" means:
 2-1                       (A)  this state and any agency of the state,
 2-2     including a department, bureau, board, commission, or office;
 2-3                       (B)  a political subdivision of this state,
 2-4     including any municipality, county, or special district; and
 2-5                       (C)  any other institution of government,
 2-6     including an institution of higher education.
 2-7                 (4)  "Needleless system" means a device that does not
 2-8     use a needle and that is used:
 2-9                       (A)  to withdraw body fluids after initial venous
2-10     or arterial access is established;
2-11                       (B)  to administer medication or fluids; or
2-12                       (C)  for any other procedure involving the
2-13     potential for an exposure incident.
2-14                 (5)  "Sharp" means an object used or encountered in a
2-15     health care setting that can be reasonably anticipated to penetrate
2-16     the skin or any other part of the body and to result in an exposure
2-17     incident, including a needle device, a scalpel, a lancet, a piece
2-18     of broken glass, a broken capillary tube, an exposed end of a
2-19     dental wire, or a dental knife, drill, or bur.
2-20                 (6)  "Sharps injury" means any injury caused by a
2-21     sharp, including a cut, abrasion, needlestick, or human bite.
2-22           Sec. 81.302.  APPLICABILITY OF SUBCHAPTER.  This subchapter
2-23     applies only to a governmental unit that employs employees who:
2-24                 (1)  provide services in a public or private facility
2-25     providing health care-related services, including a home health
2-26     care organization; or
2-27                 (2)  otherwise have a risk of exposure to blood or
 3-1     other material potentially containing bloodborne pathogens in
 3-2     connection with exposure to sharps.
 3-3           Sec. 81.303.  EXPOSURE CONTROL PLAN.  The department shall
 3-4     establish an exposure control plan designed to minimize exposure of
 3-5     employees described by Section 81.302 to bloodborne pathogens. In
 3-6     developing the plan, the department must consider:
 3-7                 (1)  policies relating to occupational exposure to
 3-8     bloodborne pathogens;
 3-9                 (2)  training and educational requirements for
3-10     employees;
3-11                 (3)  measures to increase vaccinations of employees;
3-12     and
3-13                 (4)  increased use of personal protective equipment by
3-14     employees.
3-15           Sec. 81.304.  MINIMUM STANDARDS.  The board by rule shall
3-16     adopt minimum standards to implement the exposure control plan and
3-17     the other provisions of this subchapter.  The rules shall be at
3-18     least as stringent as the analogous standards adopted by the
3-19     federal Occupational Safety and Health Administration. Each
3-20     governmental unit shall comply with the minimum standards adopted
3-21     under this subchapter.
3-22           Sec. 81.305.  NEEDLELESS SYSTEMS.  (a)  The board by rule
3-23     shall require that a governmental unit implement  needleless
3-24     systems and sharps with engineered sharps injury protection for
3-25     employees.
3-26           (b)  The requirements adopted under Subsection (a) do not
3-27     apply to the use of a needleless system or sharps with engineered
 4-1     sharps injury protection in circumstances in which an evaluation
 4-2     committee established that  use of needleless systems and sharps
 4-3     with engineered sharps protection will jeopardize patient or
 4-4     employee safety with regard to a specific medical procedure. At
 4-5     least half of the members of an evaluation committee established by
 4-6     a governmental unit to implement this subsection must be employees
 4-7     who are health care workers who have contact with patients or
 4-8     provide services.
 4-9           Sec. 81.306.  SHARPS INJURY LOG.  The board by rule shall
4-10     require that information concerning exposure incidents be recorded
4-11     in a written or electronic sharps injury log to be maintained by a
4-12     governmental unit.  This information must include:
4-13                 (1)  the date and time of the exposure incident;
4-14                 (2)  the type and brand of sharp involved in the
4-15     exposure incident; and
4-16                 (3)  a description of the exposure incident, including:
4-17                       (A)  the job classification of the exposed
4-18     employee;
4-19                       (B)  the department or work area where the
4-20     exposure incident occurred;
4-21                       (C)  the procedure that the exposed employee was
4-22     performing at the time of the incident;
4-23                       (D)  how the incident occurred;
4-24                       (E)  the employee's body part that was involved
4-25     in the exposure incident;
4-26                       (F)  whether the sharp had engineered sharps
4-27     injury protection, and if so, whether the protective mechanism was
 5-1     activated and whether the injury occurred before, during, or after
 5-2     the activation of the protective mechanism;
 5-3                       (G)  the employee's opinion, if the sharp did not
 5-4     have engineered sharps injury protection, about whether such a
 5-5     mechanism could have prevented the injury and the employee's reason
 5-6     for the opinion; and
 5-7                       (H)  the employee's opinion about whether any
 5-8     other engineering, administrative, or work practice control could
 5-9     have prevented the injury and the employee's reason for the
5-10     opinion.
5-11           Sec. 81.307.  COMPILATION OF RESOURCES.  (a)  The department
5-12     shall compile and maintain a list of existing needleless systems
5-13     and sharps with engineered sharps injury protection that will be
5-14     available to assist governmental units to comply with this
5-15     subchapter.
5-16           (b)  The sources used in developing the list may include:
5-17                 (1)  the federal Food and Drug Administration;
5-18                 (2)  the Centers for Disease Control and Prevention of
5-19     the United States Department of Health and Human Services;
5-20                 (3)  the National Institute of Occupational Safety and
5-21     Health; and
5-22                 (4)  the United States Department of Veterans Affairs.
5-23           SECTION 2.  (a)  This Act takes effect September 1, 1999.
5-24           (b)  The Texas Board of Health shall adopt the exposure
5-25     control plan and the rules required by Subchapter H, Chapter 81,
5-26     Health and Safety Code, as added by this Act, not later than
5-27     February 1, 2000.
 6-1           SECTION 3.  The importance of this legislation and the
 6-2     crowded condition of the calendars in both houses create an
 6-3     emergency and an imperative public necessity that the
 6-4     constitutional rule requiring bills to be read on three several
 6-5     days in each house be suspended, and this rule is hereby suspended.