By: Uresti  S.B. No. 1574
         (In the Senate - Filed March 12, 2015; March 23, 2015, read
  first time and referred to Committee on Health and Human Services;
  April 16, 2015, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 9, Nays 0; April 16, 2015,
  sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 1574 By:  Uresti
 
 
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 entity that employs or
  uses the services 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) and (1-b) and amending
  Subdivision (8) 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)  "Designated infection control officer" means
  the person serving as an entity's designated infection control
  officer under Section 81.012.
               (8)  "Reportable disease" means a [includes only a]
  disease that is designated as [or condition included in the list of]
  reportable under Section 81.048 [diseases].
         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 a
  reportable disease from a health care facility;
               (2)  notify the appropriate health care providers of a
  potential exposure to a reportable 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 and the destination hospital of the patient
  who was the source of the potential exposure;
               (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 by rule shall prescribe the
  qualifications required for a person to be eligible to be
  designated as an infection control officer under this section.  The
  qualifications must include a requirement that the person be
  trained as a health care provider or have training in the control of
  infectious and communicable diseases.
         (c)  The entity that employs or uses the services of an
  emergency response employee or volunteer is responsible for
  notifying the local health authorities or local health care
  facilities, according to any local rules or procedures, that the
  entity has a designated infection control officer or alternate
  designated infection control officer. 
         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) and (c), Health and Safety
  Code, and Section 81.048(g), Health and Safety Code, as amended by
  S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, are
  amended to read as follows:
         (b)  Notice of a positive or negative 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 shall adopt rules to implement this subsection.
         SECTION 8.  Section 81.050(b), Health and Safety Code, as
  amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
  2015, and Section 81.050(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:
               (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.
         (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 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.  Section 81.0955(a), Health and Safety Code, and
  Section 89.055(b), Health and Safety Code, as amended by S.B. 219,
  Acts of the 84th Legislature, Regular Session, 2015, 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, a justice of the peace, a 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 reportable [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, 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, medical examiner, 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, a 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 shall adopt rules to
  implement this subsection.
         SECTION 11.  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 12.  Section 81.107(a), Health and Safety Code, as
  amended by S.B. 219, Acts of the 84th Legislature, Regular Session,
  2015, 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), 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 13.  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 14.  This Act takes effect September 1, 2015.
 
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