FIRST REGULAR SESSION
HOUSE COMMITTEE SUBSTITUTE FOR
SENATE COMMITTEE SUBSTITUTE FOR
SENATE BILL NO. 266
91ST GENERAL ASSEMBLY
Reported from the Committee on Children, Families, and Health, May 3, 2001, with recommendation that the House Committee Substitute for Senate Committee Substitute for Senate Bill No. 266 Do Pass.
TED WEDEL, Chief Clerk
AN ACT
To amend chapters 191 and 192, RSMo, by adding thereto four new sections relating to the department of health.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapters 191 and 192, RSMo, are amended by adding thereto four new sections, to be known as sections 191.332, 191.714, 191.938 and 192.729, to read as follows:
191.332. 1. By January 1, 2002, the department of health shall, subject to appropriations, expand the newborn screening requirements in section 191.331 to include potentially treatable or manageable disorders, including cystic fibrosis, galactosemia, biotinidase deficiency, congenital adrenal hyperplasia, maple syrup urine disease (MSUD) and other amino acid disorders, glucose-6-phosphate degydrogenase deficiency (G-6-PD), MCAD and other fatty acid oxidation disorders, methylmalonic acidemia, propionic acidemia, isovaleric acidemia and glutaric acidemia Type I.
2. The department of health may promulgate rules to implement the provisions of this section. No rule or portion of a rule promulgated pursuant to the authority of this section shall become effective unless it has been promulgated pursuant to chapter 536, RSMo.
191.714. 1. As used in this section, the following terms shall mean:
(1) "Blood-borne pathogens", any pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV);
(2) "Employer", any employer having public employees with occupational exposure to blood or other material potentially containing blood-borne pathogens;
(3) "Frontline health care worker", a nonmanagerial employee responsible for direct patient care with potential occupational exposure to sharps-related injuries;
(4) "Public employee", an employee of the state or local governmental unit, or agency thereof, employed in a health care facility, home health care organization or other facility providing health care related services.
2. The department of health shall, no later than six months from the effective date of this section, adopt a blood-borne pathogen standard governing occupational exposure of public employees to blood and other potentially infectious materials that meets the standard in 29 CFR 1910.1030 and shall include a requirement that the most effective available needleless systems and sharps with engineered sharps injury protection be included as engineering and work practice controls. However, such engineering controls shall not be required if:
(1) None are available in the marketplace; or
(2) An evaluation committee, described in subsection 5 of this section, determines by means of objective product evaluation criteria that use of such devices will jeopardize patient or employee safety with regard to a specific medical procedure.
3. The use of a drug or biologic that is prepackaged with an administration system or used in a prefilled syringe and is approved for commercial distribution or investigational use by the federal Food and Drug Administration shall be exempt from the provisions of this section until June 1, 2004.
4. The sharps injury log maintained pursuant to this section shall include:
(1) The date and time of the exposure incident;
(2) The type and brand of sharp involved in the exposure incident;
(3) A description of the exposure incident to include:
(a) The job classification of the exposed employee;
(b) The department or work area where the exposure incident occurred;
(c) The number of hours worked at the time of the exposure incident;
(d) The procedure that the exposed employee was performing at the time of the incident;
(e) How the incident occurred;
(f) The body part involved in the exposure incident; and
(g) If the sharp had engineered sharps injury protection, whether the protective mechanism was activated, and whether the injury occurred before the protective mechanism was activated, during activation of the mechanism or after activation of the mechanism.
5. The evaluation committee established pursuant to this section shall have at least half of the members be frontline health care workers from a variety of occupational classifications and departments, including but not limited to nurses, nurse aides, technicians, phlebotomists and physicians, selected by the state-certified representative of such workers to advise the employer on the implementation of the requirements of this section. Members of the committee shall be trained in the proper method of utilizing product evaluation criteria prior to the commencement of any product evaluation.
6. Any reference in 29 CFR 1910.1030 to the assistant secretary shall, for purposes of this section, mean the director of the department of health.
7. Any person may report a suspected violation of this section or 29 CFR 1910.1030 to the department of health. If such report involves a private employer, the department shall notify the federal Occupational Safety and Health Administration of the alleged violation.
8. The department of health shall compile and maintain a list of needleless systems and sharps with engineered sharps injury protection which shall be available to assist employers in complying with the requirements of the blood-borne pathogen standard adopted pursuant to this section. The list may be developed from existing sources of information, including but not limited to the federal Food and Drug Administration, the federal Centers for Disease Control and Prevention, the National Institute of Occupational Safety and Health and the United States Department of Veterans Affairs.
9. By February first of each year, the department of health shall issue an annual report to the governor, state auditor, president pro tem of the senate, speaker of the house of representatives and the technical advisory committee on the quality of patient care and nursing practices on the use of needle safety technology as a means of reducing needlestick injuries. By February fifteenth of each year, such report shall be made available to the public on the department of health's Internet site.
10. Any employer who violates the provisions of this section shall be subject to a reduction in or loss of state funding as a result of such violations.
191.938. 1. There is hereby established an "Automated External Defibrillator Advisory Committee" within the department of health, subject to appropriations.
2. The committee shall advise the department of health, the office of administration and the general assembly on the advisability of placing automated external defibrillators in public buildings, especially in public buildings owned by the state of Missouri or housing employees of the state of Missouri, with special consideration to state office buildings accessible to the public.
3. The committee shall issue an initial report no later than June 1, 2002, and a final report no later than December 31, 2002, to the department of health, the office of administration and the governor's office. The issues to be addressed in the report shall include, but need not be limited to:
(1) The advisability of placing automated external defibrillators in public buildings and the determination of the criteria as to which public buildings should have automated external defibrillators and how such automated external defibrillators' placement should be accomplished;
(2) Projections of the cost of the purchase, placement and maintenance of any recommended automated external defibrillator placement;
(3) Discussion of the need for, and cost of, training personnel in the use of automated external defibrillators and in cardiopulmonary resuscitation;
(4) The integration of automated external defibrillators with existing emergency service.
4. The committee shall be composed of the following members appointed by the director of the department of health:
(1) A representative of the department of health;
(2) A representative of the division of facilities management in the office of administration;
(3) A representative of the American Red Cross;
(4) A representative of the American Heart Association;
(5) A physician who has experience in the emergency care of patients.
5. The department of health member shall be the chair of the first meeting of the committee. At the first meeting, the committee shall elect a chairperson from its membership. The committee shall meet at the call of the chairperson, but not less than four times a year.
6. The department of health shall provide technical and administrative support services as required by the committee. The office of administration shall provide technical support to the committee in the form of information and research on the number, size, use and occupancy of buildings in which employees of the state of Missouri work.
7. Members of the committee shall receive no compensation for their services as members, but shall be reimbursed for expenses incurred as a result of their duties as members of the committee.
8. The committee shall adopt written bylaws to govern its activities.
9. The automated external defibrillator advisory committee shall terminate on June 1, 2003.
192.729. 1. There is hereby established a state systemic lupus erythematosus program in the department of health. Subject to appropriations, the lupus program shall:
(1) Track and monitor the incidents of lupus occurring throughout the state;
(2) Identify medical professionals and providers that are knowledgeable or specialize in the treatment of lupus and related diseases or illnesses; and
(3) Promote lupus research and public awareness through collaborations with academic partners throughout the state and local boards, including the Missouri chapter of the lupus foundation.
2. The department may utilize or expand existing programs such as the office of women's health, the office of minority health and the state arthritis program established in sections 192.700 to 192.727 to meet the requirements of this section.
3. The department may promulgate rules to implement the provisions of this section. No rule or portion of a rule promulgated pursuant to the authority of this section shall become effective unless it has been promulgated pursuant to chapter 536, RSMo.