HBA-NMO H.B. 1646 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 1646 By: Ehrhardt Public Health 3/31/1999 Introduced BACKGROUND AND PURPOSE The International Health-Care-Worker Safety Center at the University of Virginia reports that approximately one million accidental needle sticks occur each year nationally. Nurses, physicians, and medical maintenance staff report the highest incidence of these accidents. These accidents can expose persons to bloodborne pathogens such as the hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV), and can also be costly to the health care industry. H.B. 1646 requires the Texas Department of Health to establish an exposure control plan to minimize exposure of health care industry workers to bloodborne pathogens. The plan includes the establishment, by rule, of minimum standards, needleless systems, and injury logs. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Board of Health in SECTION 1 (Sections 81.304, 81.305, and 81.306, Health and Safety Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Chapter 81, Health and Safety Code, by adding Subchapter H, as follows: SUBCHAPTER H. BLOODBORNE PATHOGEN EXPOSURE CONTROL PLAN Sec. 81.301. DEFINITIONS. (1) Defines "bloodborne pathogens" as pathogenic microorganisms that are present in human blood and that can cause diseases in humans, including the hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV). Defines "engineered sharps injury protection" as a physical attribute built into a needle device that reduces the risk of an exposure incident. Defines "governmental unit." Defines "needleless system." Defines "sharp" as an object used or encountered in a health care setting that can be reasonably anticipated to penetrate the body and result in an exposure incident. Defines "sharps injury." Sec. 81.302. APPLICABILITY OF SUBCHAPTER. Provides that this subchapter applies only to a governmental unit that employs those who provide services in a public or private facility providing health care-related services, or otherwise have a risk of exposure to blood or other material potentially containing bloodborne pathogens in connection with exposure to sharps. Sec. 81.303. EXPOSURE CONTROL PLAN. Requires the Texas Department of Health (TDH) to establish an exposure control plan (plan) designed to minimize exposure of employees described by Section 81.302 to bloodborne pathogens. Sets forth considerations that TDH must consider in developing the plan. Sec. 81.304. MINIMUM STANDARDS. Requires the Texas Board of Health (board), by rule, to adopt minimum standards to implement the plan and the other provisions of this subchapter. Requires that the rules be at least as stringent as the analogous standards adopted by the federal Occupational Safety and Health Administration. Requires each governmental unit to comply with the minimum. Sec. 81.305. NEEDLESS SYSTEMS. (a) Requires the board, by rule, to require that a governmental unit implement needleless systems and sharps with engineered sharps injury protection for employees. (b) Provides that these requirements do not apply to the use of a needleless system or sharps with engineered sharps injury protection in circumstances in which an evaluation committee established that use of needleless systems and sharps with engineered sharps protection will jeopardize patient or employee safety with regard to a specific medical procedure. Provides that at least half of the members of an evaluation committee established by a governmental unit to implement this subsection must be employees who are health care workers who have contact with patients or provide services. Sec. 81.306. SHARPS INJURY LOG. Requires the board, by rule, to require that information concerning exposure incidents be recorded in a written or electronic sharps injury log to be maintained by a governmental unit. Specifies what information must be included. Sec. 81.307. COMPILATION OF RESOURCES. Requires TDH to compile and maintain a list of existing needleless systems and sharps with engineered sharps injury protection that will be available to assist governmental units to comply with this subchapter. Authorizes that the sources used in developing the list include the federal Food and Drug Administration, the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services, the National Institute of Occupational Safety and Health, and the U.S. Department of Veterans Affairs. SECTION 2. Effective date: September 1, 1999. Requires the board to adopt the plan and the rules required by Subchapter H, Chapter 81, Health and Safety Code, not later than February 1, 2000. SECTION 3. Emergency clause.