April 10, 2018, Introduced by Reps. Faris, Sabo, Hoadley, Cochran, Gay-Dagnogo, Lasinski, Yanez, Sneller and Chirkun and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending section 20191 (MCL 333.20191), as amended by 2010 PA
119.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 20191. (1) If a police officer, fire fighter, individual
licensed under section 20950 or 20952, or another individual
assists an emergency patient who is subsequently transported to a
health facility or transports an emergency patient to a health
facility, and if the emergency patient, as part of the treatment
rendered by the health facility or pursuant to a request made under
subsection (2), is tested for the presence in the emergency patient
of an infectious agent and the test results are positive, or is
tested pursuant to a request made under subsection (2) for the
presence in the emergency patient of the infectious agent of HIV,
or
HBV, or HCV and the test
results are positive or negative, the
health facility shall do all of the following:
(a) Subject to subsection (4) and subdivision (b), if the test
results are positive for an infectious agent and the individual
meets 1 of the following requirements, notify the individual on a
form provided by the department that he or she may have been
exposed to an infectious agent and, if the test results of a test
conducted pursuant to subsection (2) are negative for the
infectious
agent of HIV, or HBV, or HCV, notify the
individual of
that fact:
(i) The individual is a police officer, fire fighter, or
individual licensed under section 20950 or 20952.
(ii) The individual demonstrates in writing to the health
facility that he or she was exposed to the blood, body fluids, or
airborne agents of the emergency patient or participated in
providing assistance to the emergency patient or transportation of
the emergency patient to the health facility. An individual who
makes a request under subsection (2) is exempt from the
requirements of this subparagraph.
(b) Subject to subsection (4), if the test results indicate
that the emergency patient is HIV infected, the health facility
shall not reveal that the infectious agent is HIV unless the health
facility has received a written request for notification from an
individual described in subdivision (a)(i) or (ii). This
subdivision does not apply if the test results indicate that the
emergency patient is not HIV infected.
(c) Subject to subsection (4), on a form provided by the
department, notify the individual described in subdivision (a), at
a minimum, of the appropriate infection control precautions to be
taken and the approximate date of the potential exposure. If the
emergency patient is tested pursuant to a request made under
subsection (2) for the presence in the emergency patient of the
infectious
agent of HIV, or HBV, or HCV, or both, all 3 infectious
agents, and if the test results are positive or negative, the
health facility also shall notify the individual described in
subdivision (a) on the form provided by the department that he or
she
should be tested for HIV infection, or HBV infection, or both,
HCV
infection, or all 3 infections, and
counseled regarding both
all 3 infectious agents.
(2) A police officer, fire fighter, individual licensed under
section 20950 or 20952, or other individual who assists an
emergency patient who is subsequently transported to a health
facility or who transports an emergency patient to a health
facility and who sustains a percutaneous, mucous membrane, or open
wound exposure to the blood or body fluids of the emergency patient
may request that the emergency patient be tested for HIV infection,
or
HBV infection, HCV infection, or both, all 3
infections,
pursuant to this subsection. The police officer, fire fighter,
individual licensed under section 20950 or 20952, or other
individual shall make a request to a health facility under this
subsection in writing on a form provided by the department and
before the emergency patient is discharged from the health
facility.
The request form shall must
be dated and shall contain at
a minimum the name and address of the individual making the request
and a description of the individual's exposure to the emergency
patient's
blood or other body fluids. The request form shall must
contain a space for the information required under subsection (3)
and a statement that the requester is subject to the
confidentiality requirements of subsection (5) and section 5131.
The
request form shall must not contain information that would
identify the emergency patient by name. A health facility that
receives a request under this subsection shall accept as fact the
requester's description of his or her exposure to the emergency
patient's blood or other body fluids, unless the health facility
has reasonable cause to believe otherwise. The health facility
shall make a determination as to whether or not the exposure
described in the request was a percutaneous, mucous membrane, or
open wound exposure pursuant to R 325.70001 to R 325.70018 of the
Michigan
administrative code. Administrative
Code. If the health
facility determines that the exposure described in the request was
a percutaneous, mucous membrane, or open wound exposure, the health
facility
shall test the emergency patient for HIV infection, or
HBV
infection,
or both, HCV infection, or
all 3 infections, as
indicated in the request. A health facility that performs a test
under this subsection may charge the individual requesting the test
for the reasonable and customary charges of the test. The
individual requesting the test is responsible for the payment of
the charges if the charges are not payable by the individual's
employer,
pursuant to under an agreement between the individual and
the employer, or by the individual's health care payment or
benefits plan. A health facility is not required to provide HIV
counseling
pursuant to under section 5133(1) to an individual who
requests that an emergency patient be tested for HIV under this
subsection, unless the health facility tests the requesting
individual for HIV.
(3) A health facility shall comply with this subsection if the
health facility receives a request under subsection (2) and
determines either that there is reasonable cause to disbelieve the
requester's description of his or her exposure or that the exposure
was not a percutaneous, mucous membrane, or open wound exposure and
as a result of the determination the health facility is not
required
to test the emergency patient for HIV infection, or HBV
infection,
or both. HCV infection, or
all 3 infections. A health
facility shall also comply with this subsection if the health
facility receives a request under subsection (2) and determines
that the exposure was a percutaneous, mucous membrane, or open
wound exposure, but is unable to test the emergency patient for HIV
infection, or
HBV infection, or both. HCV
infection, or all 3
infections. The health facility shall state in writing on the
request form the reasons for disbelieving the requester's
description of his or her exposure, the health facility's exposure
determination, or the inability to test the emergency patient, as
applicable. The health facility shall transmit a copy of the
completed request form to the requesting individual within 2 days
after the date the determination is made that the health facility
has reasonable cause to disbelieve the requester's description of
his or her exposure or that the exposure was not a percutaneous,
mucous membrane, or open wound exposure or within 2 days after the
date the health facility determines that it is unable to test the
emergency
patient for HIV infection, or HBV infection, or both.HCV
infection, or all 3 infections.
(4)
The A health facility
shall provide the notification
required
under subsection (1) shall occur within 2 days after the
test results are obtained by the health facility or after receipt
of a written request under subsection (1)(b). The notification
shall
must be transmitted to the potentially exposed individual
or,
upon request of the individual, to the individual's primary care
physician or other health professional designated by the
individual, as follows:
(a) If the potentially exposed individual provides his or her
name and address or the name and address of the individual's
primary care physician or other health professional designated by
the individual to the health facility or if the health facility has
a procedure that allows the health facility in the ordinary course
of its business to determine the individual's name and address or
the name and address of the individual's primary care physician or
other health professional designated by the individual, the health
facility shall notify the individual or the individual's primary
care physician or other health professional designated by the
individual directly at that address.
(b) If the potentially exposed individual is a police officer,
fire fighter, or individual licensed under section 20950 or 20952,
and if the health facility does not have the name of the
potentially exposed individual or the individual's primary care
physician or other health professional designated by the
individual, the health facility shall notify the appropriate police
department, fire department, or life support agency that employs or
dispatches the individual. If the health facility is unable to
determine the employer of an individual described in this
subdivision, the health facility shall notify the medical control
authority or chief elected official of the governmental unit that
has jurisdiction over the transporting vehicle.
(c) A medical control authority or chief elected official
described in subdivision (b) shall notify the potentially exposed
individual or the individual's primary care physician or other
health professional designated by the individual or, if unable to
notify the potentially exposed individual or the individual's
primary care physician or other health professional designated by
the individual, shall document in writing the notification efforts
and reasons for being unable to make the notification.
(5)
The notice required under subsection (1) shall must not
contain information that would identify the emergency patient who
tested positive for an infectious agent or who tested positive or
negative for the presence in the emergency patient of the
infectious
agent of HIV, or HBV, or HCV. The information
contained
in the notice is confidential and is subject to this section, the
rules promulgated under section 5111, and section 5131. A person
who receives confidential information under this section shall
disclose the information to others only to the extent consistent
with the authorized purpose for which the information was obtained.
(6) The department shall promulgate rules to administer this
section. The department shall develop and distribute the forms
required under subsections (1)(a) and (c) and (2).
(7) Except as otherwise provided in this subsection, a person
who discloses information regarding an infectious agent in
violation of subsection (5) is guilty of a misdemeanor. This
subsection does not apply to the disclosure of information
regarding a serious communicable disease or infection, if the
disclosure is subject to rules promulgated under section 5111 or to
section 5131.
(8)
A person or governmental entity that makes a good faith
good-faith effort to comply with subsection (1), (2), (3), or (4)
is immune from any civil liability or criminal penalty based on
compliance or the failure to comply.
(9) As used in this section:
(a) "Emergency patient" means an individual who is transported
to an organized emergency department located in and operated by a
hospital licensed under this article or a facility other than a
hospital that is routinely available for the general care of
medical patients.
(b) "HBV" means hepatitis B virus.
(c)
"HBV infected" or "HBV infection" means the status
of an
individual who is tested as HBsAg-positive.
(d) "HCV" means hepatitis C virus.
(e) "HCV infection" means the status of an individual who has
tested positive for the presence of HCV antibodies or has tested
positive for HBV using an RNA test.
(f)
(d) "Health facility" means a health facility
or agency.
as
defined in section 20106.
(g) (e)
"HIV" means human
immunodeficiency virus.
(h) (f)
"HIV infected" infection" means that term as defined
in section 5101.
(i) (g)
"Infectious agent" means
that term as defined in R
325.9031
of the Michigan administrative code. Administrative Code.
(j) (h)
"Life support agency"
means that term as defined in
section 20906.
(k) (i)
"Serious communicable disease
or infection" means that
term as defined in section 5101.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.