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.