DAR File No. 30282

Health, Epidemiology and Laboratory Services; HIV/AIDS, Tuberculosis Control/Refugee Health

R388-801

AIDS Testing and Reporting for Emergency Medical Services Providers Rule

NOTICE OF PROPOSED RULE

DAR File No.: 30282
Filed: 08/02/2007, 03:28
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The repeal of Rule R388-801 eliminates redundancy. The substance of the rule was moved to the Labor Code under Sections 34A-2-901 through 34A-2-905.

Summary of the rule or change:

The repeal of Rule R388-801 eliminates a redundant rule. This rule is repealed in its entirety.

State statutory or constitutional authorization for this rule:

Section 26-6a-9

Anticipated cost or savings to:

the state budget:

There are no anticipated costs or savings to the state budget. The procedures required under this rule have been followed and will continue to be followed. There will be no savings due to the fact that there will be no change in the procedures currently followed. There will be no additional costs because these procedures are currently in place.

local governments:

There are no anticipated costs or savings to local governments. The procedures required under this rule have been followed and will continue to be followed. There will be no savings due to the fact that there will be no change in the procedures currently followed. There will be no additional costs because these procedures are currently in place.

small businesses and persons other than businesses:

There are no anticipated costs or savings to other persons. The procedures required under this rule have been followed and will continue to be followed. There will be no savings due to the fact that there will be no change in the procedures currently followed. There will be no additional costs because these procedures are currently in place.

Compliance costs for affected persons:

There will be no costs or savings related to the repeal of this rule since the requirements of this rule will continue to exist under Section 34A-2-901.

Comments by the department head on the fiscal impact the rule may have on businesses:

There will be no costs or savings related to the repeal of this rule since the requirements of this rule will continue to exist under Section R34A-2-901. David Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Epidemiology and Laboratory Services; HIV/AIDS, Tuberculosis Control/Refugee Health
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY UT 84116-3231

Direct questions regarding this rule to:

Jennifer Brown at the above address, by phone at 801-538-6131, by FAX at 801-538-9913, or by Internet E-mail at jenniferbrown@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

10/01/2007

This rule may become effective on:

10/08/2007

Authorized by:

David N. Sundwall, Executive Director

R388. Health, Epidemiology and Laboratory Services; HIV/AIDS, Tuberculosis Control/Refugee Health.

[R388-801. AIDS Testing and Reporting for Emergency Medical Services Providers Rule.

R388-801-1. Authority and Purpose.

1. Authority - The AIDS Testing and Reporting for Emergency Medical Services Providers Rule is established under authority of Section 26-6a-9.

2. Purpose - To establish procedures for patient testing and reporting following a significant exposure of an emergency medical services provider.

 

R388-801-2. Definitions.

1. "Department" means the Utah Department of Health.

2. "Designated agent" means a person or persons designated by an agency employing or utilizing emergency medical services providers as employees or volunteers to receive and distribute test results in accordance with this rule.

3. "Disease" means Acquired Immunodeficiency Syndrome, Human Immunodeficiency Virus (HIV) infection, or Hepatitis B antigen positivity.

4. "Emergency medical services (EMS) agency" means an agency, entity or organization that employs or utilizes emergency medical services providers as employees or volunteers.

5. "Emergency medical services provider" means Emergency Medical personnel as defined in Section 26-8a-102, a peace officer as defined in Section 53-13-101, local fire department personnel, or officials or personnel employed by the Department of Corrections or by a county jail, who provide prehospital emergency medical care for an emergency medical services agency either as an employee or as a volunteer.

6. "Patient" means any individual cared for by an emergency medical services provider, including but not limited to victims of accidents or injury, deceased persons, and prisoners or persons in the custody of the Department of Corrections.

7. "Receiving facility" means a hospital, health care or other facility where the patient is delivered by the emergency medical services provider for care.

8. "Significant exposure" means:

8.1. Contact of an emergency medical services provider's broken skin or mucous membrane with a patient's blood or bodily fluids other than tears or perspiration, or;

8.2. That a needle stick, or scalpel or instrument wound has occurred to the emergency medical services provider in the process of caring for a patient.

 

R388-801-3. Emergency Medical Services Provider Responsibility.

1. The EMS provider shall document and report all significant exposures to the receiving facility, the designated agent, and the department. The reporting process is as follows:

1.1. The exposed EMS provider shall complete the department Exposure Report Form (ERF) at the time the patient is delivered and provide a copy to a person at the receiving facility authorized by the facility to receive that form. In the event that the exposed EMS provider does not accompany the patient to the receiving facility, he may report the exposure incident, with information requested on the ERF, by telephone to a person authorized by the facility to receive that form. In this event, the exposed EMS provider shall nevertheless submit a written copy of the ERF within three days to an authorized person of the receiving facility.

1.2. The exposed EMS provider shall, within three days of the incident, also submit copies of the ERF to the designated agent and, by registered mail or in person, to the department.

1.3. The exposed EMS provider should retain a copy of the ERF for his own records, in the event that it is subsequently necessary to file a workers' compensation claim under Sections 26-6a-10 through 26-6a-14.

 

R388-801-4. Receiving Facility Responsibility.

1. The receiving facility shall establish a system to receive ERFs as well as telephoned reports from exposed EMS providers on a 24-hour per day basis. The facility shall also have available, within the receiving facility or on call, trained pre-test counselors for the purpose of obtaining consent and counseling of patients when HIV testing has been requested by EMS providers. The counselor shall contact the patient prior to release from the facility, or if the patient remains in the facility, contact shall be made within 24 hours.

2. Upon notification of exposure, the receiving facility shall request permission from the patient to draw a blood sample for HIV testing. In conjunction with this request, the patient must be advised of his right to refuse testing and be advised that if he refuses to be tested that fact will be forwarded to the department and the designated agent. Testing is authorized only when the patient, his next of kin or legal guardian consents to testing, with the exception that consent is not required from an individual who has been convicted of a crime and is in the custody or under the jurisdiction of the Department of Corrections, or if the patient is dead. If consent is denied, the receiving facility shall complete the ERF and send it to the department. If consent is received, the receiving facility shall draw a sample of the patient's blood and send it, along with the ERF, to the Utah Department of Health, Division of Laboratory Services for testing.

3. The receiving facility shall arrange for Hepatitis B testing according to standard procedures and report the result to the designated agent at the EMS agency.

 

R388-801-5. EMS Agency Responsibility.

The EMS agency shall appoint a representative as designated agent to fulfill the responsibilities specified in these rules.

 

R388-801-6. Designated Agent Responsibility.

1. The designated agent, upon receipt of an ERF from the EMS provider, shall review the details regarding the significant exposure and recommend appropriate measures, if any, considering the most recent Centers for Disease Control guidelines, to EMS agency management.

2. The designated agent, upon receipt of the HIV test result from the department, shall immediately report the result, by case number, not name, to the exposed EMS provider.

3. The designated agent, upon receipt of the Hepatitis B test result from the receiving facility, shall immediately report the result to the exposed EMS provider.

4. The designated agent, upon receipt of refusal of testing, shall report that refusal to the EMS provider.

5. The designated agent shall maintain confidential records in conformance with Section 26-6a-7.

 

R388-801-7. Department Responsibility.

1. The department shall designate a representative or representatives in the Utah Department of Health, Division of Laboratory Services who shall receive the HIV blood sample with a copy of the ERF, conduct the test and report the test result to the Bureau of HIV/AIDS Prevention and Control, and return the copy of the ERF to the Bureau of HIV/AIDS Prevention and Control.

2. The department shall designate a representative(s) in the Bureau of HIV/AIDS Prevention and Control who shall:

2.1. Receive and process copies of all ERF's submitted by the EMS provider or receiving facility to the department;

2.2. Report refusals to test or the results of HIV testing, by case number, not name, to the designated agent; and

2.3. Report HIV test results to the patient and complete all post test counseling required by Chapter 6a, Title 26.

3. The department shall assess to the EMS agency with which the EMS provider is affiliated the actual cost of testing and post test counseling of the patient.

4. The department shall develop and make available a pre-test counseling protocol to all receiving facilities.

 

R388-801-8. Confidentiality Responsibility.

1. Information concerning test results obtained under these rules that identify the patient shall be maintained strictly confidential by the hospital, health care or other facility that received or tested the patient, designated agent, EMS provider, EMS agency, and the department, except as provided by these rules. That information may not be made public upon subpoena, search warrant, discovery proceedings, or otherwise, except as provided by this chapter.

2. The information described in R388-801-8.1 may be released with the written consent of the patient, or if the patient is deceased or incapable of giving informed consent, with the written consent of his next-of-kin, legal guardian, or executor of his estate.

3. Information concerning test results obtained under the authority of these rules may be released in a way that no patient is identifiable.

 

R388-801-9. Penalties.

Penalties for violation of R388-801 are prescribed under Sections 26-6a-7 and 26-23-6.

 

KEY: communicable diseases, AIDS

Date of Enactment or Last Substantive Amendment: September 1, 1996

Notice of Continuation: July 19, 2007

Authorizing, and Implemented or Interpreted Law: 26-6a]