Minnesota Session Laws - 1989, Regular Session

  

                         Laws of Minnesota 1989 

                        CHAPTER 154-S.F.No. 1031 
           An act relating to health; establishing notice 
          requirements for emergency medical services personnel 
          who are first responders; providing safeguards for 
          first responders against exposure to infectious 
          diseases; proposing coding for new law in Minnesota 
          Statutes, chapter 144. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 

                         NOTICE AND TESTING OF

                  EMERGENCY MEDICAL SERVICES PERSONNEL
    Section 1.  [144.761] [DEFINITIONS.] 
    Subdivision 1.  [SCOPE OF DEFINITIONS.] For purposes of 
this chapter, the following terms have the meanings given them.  
    Subd. 2.  [HIV.] "HIV" means the human immunodeficiency 
virus, the causative agent of AIDS. 
    Subd. 3.  [HEPATITIS B.] "Hepatitis B" means the hepatitis 
B virus. 
    Subd. 4.  [EMERGENCY MEDICAL SERVICES AGENCY.] "Emergency 
medical services agency" means an agency, entity, or 
organization that employs or uses emergency medical services 
personnel as employees or volunteers licensed or certified under 
sections 144.801 to 144.8091. 
    Subd. 5.  [EMERGENCY MEDICAL SERVICES PERSONNEL.] 
"Emergency medical services personnel" means: 
    (1) individuals employed to provide prehospital emergency 
medical services; 
    (2) persons employed as licensed police officers under 
section 626.84, subdivision 1, who experience a significant 
exposure in the performance of their duties; 
    (3) firefighters, paramedics, emergency medical 
technicians, licensed nurses, rescue squad personnel, or other 
individuals who serve as employees or volunteers of an ambulance 
service as defined by sections 144.801 to 144.8092, who provide 
prehospital emergency medical services; 
    (4) crime lab personnel receiving a significant exposure 
while involved in a criminal investigation; and 
    (5) correctional guards, including security guards at the 
Minnesota security hospital, employed by the state or a local 
unit of government who experience a significant exposure to an 
inmate who is transported to a facility for emergency medical 
care. 
    Subd. 6.  [PATIENT.] "Patient" means an individual who is 
received by a facility and who receives the services of 
emergency medical services personnel.  Patient includes, but is 
not limited to, victims of accident or injury, or deceased 
persons.  
    Subd. 7.  [SIGNIFICANT EXPOSURE.] "Significant exposure" 
means: 
    (1) contact of broken skin or mucous membrane of emergency 
medical services personnel with a patient's blood, amniotic 
fluid, pericardial fluid, peritoneal fluid, pleural fluid, 
synovial fluid, cerebrospinal fluid, semen, vaginal secretions, 
or bodily fluids grossly contaminated with blood; 
    (2) a needle stick, scalpel or instrument wound, or other 
wound inflicted by an object that is contaminated with blood, 
and that is capable of cutting or puncturing the skin of 
emergency medical services personnel; or 
    (3) an exposure that occurs by any other method of 
transmission recognized by contemporary epidemiological 
standards as a significant exposure. 
    Subd. 8.  [FACILITY.] "Facility" means a licensed hospital 
and freestanding emergency medical care facility licensed under 
sections 144.50 to 144.56 that receives a patient cared for by 
emergency medical services personnel. 
    Sec. 2.  [144.762] [NOTIFICATION PROTOCOL FOR EXPOSURE TO 
HIV AND HEPATITIS B.] 
    Subdivision 1.  [NOTIFICATION PROTOCOL REQUIRED.] Every 
facility that receives a patient shall adopt a postexposure 
notification protocol for emergency medical services personnel 
who have experienced a significant exposure.  
    Subd. 2.  [REQUIREMENTS FOR PROTOCOL.] The postexposure 
notification protocol must include the following: 
    (1) a method for emergency medical services personnel to 
notify the facility that they may have experienced a significant 
exposure from a patient that was transported to the facility.  
The facility shall provide to the emergency medical services 
personnel a significant exposure report form to be completed by 
the emergency medical services personnel in a timely fashion; 
    (2) a process to investigate whether a significant exposure 
has occurred.  This investigation must be completed within 72 
hours of receipt of the exposure report; 
    (3) if there has been a significant exposure, a process to 
determine whether the patient has hepatitis B or HIV infection; 
    (4) if the patient has an infectious disease that could be 
transmitted by the type of exposure that occurred, or, if it is 
not possible to determine what disease the patient may have, a 
process for making recommendations for appropriate counseling 
and testing to the emergency medical services personnel; 
    (5) compliance with applicable state and federal laws 
relating to data practices, confidentiality, informed consent, 
and the patient bill of rights; and 
    (6) a process for providing counseling for the patient to 
be tested and for the emergency medical services personnel 
filing the exposure report. 
     Subd. 3.  [IMMUNITY.] A facility is not civilly or 
criminally liable for actions relating to the notification of 
emergency medical services personnel if the facility has made a 
good faith effort to adopt and follow a notification protocol. 
    Sec. 3.  [144.763] [COUNSELING REQUIREMENTS.] 
    With regard to testing for HIV infection, facilities shall 
ensure that pretest counseling, notification of test results, 
and posttest counseling are provided to all patients tested and 
to emergency medical services personnel requesting notification. 
    Sec. 4.  [144.764] [RESPONSIBILITY FOR TESTING; COSTS.] 
    The facility that receives a patient shall ensure that 
tests under sections 1 to 10 are performed.  The emergency 
medical services agency that employs the emergency medical 
services personnel who request testing under sections 1 to 10 
must pay for the cost of counseling, testing, and costs 
associated with the testing of the patient and of the emergency 
medical services personnel. 
    Sec. 5.  [144.765] [PATIENT'S RIGHT TO REFUSE TESTING.] 
    Upon notification of a significant exposure, the facility 
shall ask the patient to consent to blood testing to determine 
the presence of the HIV virus or the hepatitis B virus.  The 
patient shall be informed that the test results without 
personally identifying information will be reported to the 
emergency medical services personnel.  The patient shall be 
informed of the right to refuse to be tested.  If the patient 
refuses to be tested, the patient's refusal will be forwarded to 
the emergency medical services agency and to the emergency 
medical services personnel.  The right to refuse a blood test 
under the circumstances described in this section does not apply 
to a prisoner who is in the custody or under the jurisdiction of 
the commissioner of corrections. 
    Sec. 6.  [144.766] [DEATH OF PATIENT.] 
    If a patient who is the subject of a reported significant 
exposure dies before an opportunity to consent to blood testing 
under sections 1 to 10, the facility shall conduct a test of the 
deceased person for hepatitis B and HIV infection.  Consent of 
the deceased person's representative is not necessary for 
purposes of this section.  
    Sec. 7.  [144.767] [TEST RESULTS; REPORTS.] 
    Subdivision 1.  [REPORT TO EMPLOYER.] Results of tests 
conducted under this section shall be reported by the facility 
to a designated agent of the emergency medical services agency 
that employs or uses the emergency medical services personnel 
and to the emergency medical services personnel who report the 
significant exposure.  The test results shall be reported 
without personally identifying information. 
    Subd. 2.  [REPORT TO PATIENT.] The facility that receives 
the patient shall inform the patient or, if the patient is 
deceased, the representatives of the deceased person, of test 
results for all tests conducted under this chapter. 
    Sec. 8.  [144.768] [TEST INFORMATION CONFIDENTIALITY.] 
    Subdivision 1.  [PRIVATE DATA.] Information concerning test 
results obtained under this chapter is, with respect to patients 
and employees of persons in the private sector, private and 
confidential information and, with respect to patients and 
employees of state agencies, statewide systems, or political 
subdivisions, private data. 
    Subd. 2.  [CONSENT TO RELEASE INFORMATION.] A facility 
shall not disclose to emergency medical services personnel 
personally identifying information about a patient without a 
written release signed by the patient or a personal 
representative of the decedent. 
    Sec. 9.  [144.769] [PENALTY FOR UNAUTHORIZED RELEASE OF 
PATIENT INFORMATION.] 
    Any unauthorized release, by an individual or agency 
described in section 1, subdivision 4 or 5, of personally 
identifying information under sections 1 to 10 is a 
misdemeanor.  This section does not preclude the patient from 
pursuing remedies and penalties under sections 13.08 and 13.09 
or other private causes of action against an individual, state 
agency, statewide system, political subdivision, or person 
responsible for releasing private data, or confidential or 
private information on the patient or employee. 
    Sec. 10.  [144.7691] [DUTIES OF THE COMMISSIONER.] 
    Subdivision 1.  [TECHNICAL CONSULTATION.] The commissioner 
shall provide technical consultation for: 
    (1) development of an exposure report form to be used by 
the facility; 
    (2) development of a postexposure notification protocol to 
be adopted by the facility; 
    (3) training and education of emergency medical services 
personnel on infectious disease guidelines and protocols for 
emergency medical services personnel to use to prevent 
transmission of infectious disease; 
    (4) development of recommendations for counseling and 
testing the patient and emergency medical services personnel; 
and 
    (5) a mechanism for the facility to notify the patient of 
the results of the test. 
    Subd. 2.  [RULEMAKING AUTHORITY.] The commissioner may 
adopt rules to carry out sections 1 to 10.  The commissioner may 
by rule add other infectious diseases to section 2, subdivision 
2, clause (3). 
    Sec. 11.  [EFFECTIVE DATE.] 
    Sections 1 to 10 are effective July 1, 1989. 
    Presented to the governor May 16, 1989 
    Signed by the governor May 19, 1989, 4:45 p.m.