1.1                          A bill for an act 
  1.2             relating to health; establishing protocol for 
  1.3             occupational exposure to bloodborne pathogens in 
  1.4             certain settings; providing criminal penalties; 
  1.5             amending Minnesota Statutes 1998, sections 13.99, 
  1.6             subdivision 38, and by adding a subdivision; 72A.20, 
  1.7             subdivision 29; 144.4804, by adding a subdivision; 
  1.8             214.18, subdivision 5, and by adding a subdivision; 
  1.9             214.19, subdivision 1; and 611A.19, subdivisions 1 and 
  1.10            2; proposing coding for new law in Minnesota Statutes, 
  1.11            chapters 144; and 241; repealing Minnesota Statutes 
  1.12            1998, sections 144.761; 144.762; 144.763; 144.764; 
  1.13            144.765; 144.766; 144.767; 144.768; 144.769; and 
  1.14            144.7691. 
  1.15  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.16     Section 1.  Minnesota Statutes 1998, section 13.99, 
  1.17  subdivision 38, is amended to read: 
  1.18     Subd. 38.  [HEALTH TEST RESULTS.] Health test results 
  1.19  obtained under chapter 144 are classified under section ~~144.768~~ 
  1.20  144.7611. 
  1.21     Sec. 2.  Minnesota Statutes 1998, section 13.99, is amended 
  1.22  by adding a subdivision to read: 
  1.23     Subd. 65f.  [BLOOD TEST RESULTS.] Blood test results 
  1.24  obtained under sections 241.33 to 241.342 are classified under 
  1.25  section 241.339. 
  1.26     Sec. 3.  Minnesota Statutes 1998, section 72A.20, 
  1.27  subdivision 29, is amended to read: 
  1.28     Subd. 29.  [HIV TESTS; CRIME VICTIMS.] No insurer regulated 
  1.29  under chapter 61A or 62B, or providing health, medical, 
  1.30  hospitalization, or accident and sickness insurance regulated 
  2.1   under chapter 62A, or nonprofit health services corporation 
  2.2   regulated under chapter 62C, health maintenance organization 
  2.3   regulated under chapter 62D, or fraternal benefit society 
  2.4   regulated under chapter 64B, may: 
  2.5      (1) obtain or use the performance of or the results of a 
  2.6   test to determine the presence of the human immunodeficiency 
  2.7   virus (HIV) antibody performed on an offender under section 
  2.8   611A.19 or performed on a crime victim who was exposed to or had 
  2.9   contact with an offender's bodily fluids during commission of a 
  2.10  crime that was reported to law enforcement officials, in order 
  2.11  to make an underwriting decision, cancel, fail to renew, or take 
  2.12  any other action with respect to a policy, plan, certificate, or 
  2.13  contract; 
  2.14     (2) obtain or use the performance of or the results of a 
  2.15  test to determine the presence of the human immunodeficiency 
  2.16  virus (HIV) antibody performed on ~~a patient pursuant to sections~~ 
  2.17  ~~144.761 to 144.7691, or performed on emergency medical services~~ 
  2.18  ~~personnel pursuant to the protocol under section 144.762,~~ 
  2.19  ~~subdivision 2,~~ an individual according to sections 144.7601 to 
  2.20  144.7615 or 241.33 to 241.342 in order to make an underwriting 
  2.21  decision, cancel, fail to renew, or take any other action with 
  2.22  respect to a policy, plan, certificate, or contract~~; for~~ 
  2.23  ~~purposes of this clause, "patient" and "emergency medical~~ 
  2.24  ~~services personnel" have the meanings given in section 144.761~~; 
  2.25  or 
  2.26     (3) ask an applicant for coverage or a person already 
  2.27  covered whether the person has:  (i) had a test performed for 
  2.28  the reason set forth in clause (1) or (2); or (ii) been the 
  2.29  victim of an assault or any other crime which involves bodily 
  2.30  contact with the offender. 
  2.31     A question that purports to require an answer that would 
  2.32  provide information regarding a test performed for the reason 
  2.33  set forth in clause (1) or (2) may be interpreted as excluding 
  2.34  this test.  An answer that does not mention the test is 
  2.35  considered to be a truthful answer for all purposes.  An 
  2.36  authorization for the release of medical records for insurance 
  3.1   purposes must specifically exclude any test performed for the 
  3.2   purpose set forth in clause (1) or (2) and must be read as 
  3.3   providing this exclusion regardless of whether the exclusion is 
  3.4   expressly stated.  This subdivision does not affect tests 
  3.5   conducted for purposes other than those described in clause (1) 
  3.6   or (2), including any test to determine the presence of the 
  3.7   human immunodeficiency virus (HIV) antibody if such test was 
  3.8   performed at the insurer's direction as part of the insurer's 
  3.9   normal underwriting requirements. 
  3.10     Sec. 4.  Minnesota Statutes 1998, section 144.4804, is 
  3.11  amended by adding a subdivision to read: 
  3.12     Subd. 8.  [TUBERCULOSIS NOTIFICATION.] If an emergency 
  3.13  medical services person, as defined in section 144.7601, 
  3.14  subdivision 4, is exposed to a person with active tuberculosis 
  3.15  during the performance of duties, the treatment facility's 
  3.16  designated infection control coordinator shall notify the 
  3.17  emergency medical services agency's exposure control officer by 
  3.18  telephone and by written correspondence.  The facility's 
  3.19  designated infection control coordinator shall provide the 
  3.20  emergency medical services person with information about 
  3.21  screening and, if indicated, follow-up. 
  3.22     Sec. 5.  [144.7601] [DEFINITIONS.] 
  3.23     Subdivision 1.  [SCOPE OF DEFINITIONS.] For purposes of 
  3.24  sections 144.7601 to 144.7615, the following terms have the 
  3.25  meanings given them. 
  3.26     Subd. 2.  [BLOODBORNE PATHOGENS.] "Bloodborne pathogens" 
  3.27  means pathogenic microorganisms that are present in human blood 
  3.28  and can cause disease in humans.  These pathogens include, but 
  3.29  are not limited to, hepatitis B virus (HBV), hepatitis C virus 
  3.30  (HCV), and human immunodeficiency virus (HIV). 
  3.31     Subd. 3.  [EMERGENCY MEDICAL SERVICES AGENCY.] "Emergency 
  3.32  medical services agency" means an agency, entity, or 
  3.33  organization that employs or uses emergency medical services 
  3.34  persons as employees or volunteers. 
  3.35     Subd. 4.  [EMERGENCY MEDICAL SERVICES PERSON.] "Emergency 
  3.36  medical services person" means an individual who provides 
  4.1   out-of-hospital emergency medical services during the 
  4.2   performance of the person's duties, including: 
  4.3      (1) an individual employed or receiving compensation to 
  4.4   provide out-of-hospital emergency medical services such as a 
  4.5   firefighter, paramedic, emergency medical technician, licensed 
  4.6   nurse, rescue squad person, or other individual who serves as an 
  4.7   employee or volunteer of an ambulance service as defined under 
  4.8   chapter 144E or a member of an organized first responder squad 
  4.9   that is formally recognized by a political subdivision in the 
  4.10  state; 
  4.11     (2) an individual employed as a licensed peace officer 
  4.12  under section 626.84, subdivision 1; 
  4.13     (3) an individual employed as a crime laboratory worker 
  4.14  while working outside the laboratory and involved in a criminal 
  4.15  investigation; and 
  4.16     (4) any other individual who renders emergency care or 
  4.17  assistance at the scene of an emergency or while an injured 
  4.18  person is being transported to receive medical care and who is 
  4.19  acting as a good samaritan under section 604A.01. 
  4.20     Subd. 5.  [SOURCE INDIVIDUAL.] "Source individual" means 
  4.21  any individual, living or dead, whose blood, tissue, or 
  4.22  potentially infectious body fluids may be a source of bloodborne 
  4.23  pathogen exposure to an emergency medical services person.  
  4.24  Examples include, but are not limited to, a victim of an 
  4.25  accident, injury, or illness or a deceased person. 
  4.26     Subd. 6.  [SIGNIFICANT EXPOSURE.] "Significant exposure" 
  4.27  means contact, in a manner supported by the most current 
  4.28  recommendations of the United States Public Health Service at 
  4.29  the time an evaluation takes place, that includes: 
  4.30     (1) percutaneous injury, contact of mucous membrane or 
  4.31  nonintact skin, or prolonged contact of intact skin; and 
  4.32     (2) contact, in a manner that may transmit a bloodborne 
  4.33  pathogen, with blood, tissue, or potentially infectious body 
  4.34  fluids. 
  4.35     Subd. 7.  [FACILITY.] "Facility" means a hospital licensed 
  4.36  under sections 144.50 to 144.56 or a freestanding emergency 
  5.1   medical care facility licensed under Laws 1988, chapter 467, 
  5.2   that receives an emergency medical services person for 
  5.3   evaluation for significant exposure or a source individual cared 
  5.4   for by an emergency medical services person. 
  5.5      Sec. 6.  [144.7602] [CONDITIONS FOR APPLICABILITY OF 
  5.6   PROCEDURES.] 
  5.7      Subdivision 1.  [REQUEST FOR PROCEDURES.] An emergency 
  5.8   medical services person or emergency medical services agency may 
  5.9   request that a facility follow the procedures of sections 
  5.10  144.7601 to 144.7615 when an emergency medical services person 
  5.11  may have experienced a significant exposure to a source 
  5.12  individual. 
  5.13     Subd. 2.  [CONDITIONS.] A facility shall follow the 
  5.14  procedures outlined in sections 144.7601 to 144.7615 when all of 
  5.15  the following conditions are met:  
  5.16     (1) the facility determines that significant exposure has 
  5.17  occurred, following the protocol under section 144.7614; 
  5.18     (2) the licensed physician for the emergency medical 
  5.19  services person needs the source individual's bloodborne 
  5.20  pathogen test results to begin, continue, modify, or discontinue 
  5.21  treatment, in accordance with the most current guidelines of the 
  5.22  United States Public Health Service, because of possible 
  5.23  exposure to a bloodborne pathogen; and 
  5.24     (3) the emergency medical services person consents to 
  5.25  provide a blood sample for testing for a bloodborne pathogen.  
  5.26  If the emergency medical services person consents to blood 
  5.27  collection, but does not consent at that time to bloodborne 
  5.28  pathogen testing, the facility shall preserve the sample for at 
  5.29  least 90 days.  If the emergency medical services person elects 
  5.30  to have the sample tested within 90 days, the testing shall be 
  5.31  done as soon as feasible. 
  5.32     Subd. 3.  [LOCATING SOURCE INDIVIDUAL.] If the source 
  5.33  individual is not received by a facility but the facility is 
  5.34  providing treatment to the emergency medical services person, 
  5.35  the emergency medical services agency shall make reasonable 
  5.36  efforts to locate the source individual and inform the facility 
  6.1   of the source individual's identity and location.  The facility 
  6.2   shall make a reasonable effort to contact the source individual 
  6.3   in order to follow the procedures in sections 144.7601 to 
  6.4   144.7615.  The emergency services agency and facilities may 
  6.5   exchange private data about the source individual as necessary 
  6.6   to fulfill their responsibilities under this subdivision, 
  6.7   notwithstanding any provision of law to the contrary. 
  6.8      Sec. 7.  [144.7603] [INFORMATION REQUIRED TO BE GIVEN TO 
  6.9   INDIVIDUALS.] 
  6.10     Subdivision 1.  [INFORMATION TO SOURCE INDIVIDUAL.] (a) 
  6.11  Before seeking any consent required by the procedures under 
  6.12  sections 144.7601 to 144.7615, a facility shall inform the 
  6.13  source individual that the source individual's bloodborne 
  6.14  pathogen test results, without the individual's name, address, 
  6.15  or other uniquely identifying information, shall be reported to 
  6.16  the emergency medical services person if requested, and that 
  6.17  test results collected under sections 144.7601 to 144.7615 are 
  6.18  for medical purposes as set forth in section 144.7609 and may 
  6.19  not be used as evidence in any criminal proceedings.  
  6.20     (b) The facility shall inform the source individual that 
  6.21  the individual may refuse to provide a blood sample and that the 
  6.22  source individual's refusal may result in a request for a court 
  6.23  order to require the source individual to provide a blood sample.
  6.24     (c) The facility shall inform the source individual that 
  6.25  the facility will advise the emergency medical services person 
  6.26  of the confidentiality requirements and penalties before 
  6.27  disclosing any test information. 
  6.28     Subd. 2.  [INFORMATION TO EMS PERSON.] Before disclosing 
  6.29  any information about the source individual, the facility shall 
  6.30  inform the emergency medical services person of the 
  6.31  confidentiality requirements of section 144.7611 and that the 
  6.32  person may be subject to penalties for unauthorized release of 
  6.33  information about the source individual under section 144.7612. 
  6.34     Sec. 8.  [144.7604] [DISCLOSURE OF POSITIVE BLOODBORNE 
  6.35  PATHOGEN TEST RESULTS.] 
  6.36     If the conditions of sections 144.7602 and 144.7603 are 
  7.1   met, the facility shall ask the source individual and the 
  7.2   emergency medical services person if they have ever had a 
  7.3   positive test for a bloodborne pathogen.  The facility must 
  7.4   attempt to get existing test results under this section before 
  7.5   taking any steps to obtain a blood sample or to test for 
  7.6   bloodborne pathogens.  The facility shall disclose the source 
  7.7   individual's bloodborne pathogen test results to the emergency 
  7.8   medical services person without the source individual's name, 
  7.9   address, or other uniquely identifying information. 
  7.10     Sec. 9.  [144.7605] [CONSENT PROCEDURES GENERALLY.] 
  7.11     (a) For purposes of sections 144.7601 to 144.7615, whenever 
  7.12  the facility is required to seek consent, the facility shall 
  7.13  follow its usual procedure for obtaining consent from an 
  7.14  individual or an individual's representative consistent with 
  7.15  other law applicable to consent.  
  7.16     (b) Consent from a source individual's representative for 
  7.17  bloodborne pathogen testing of a blood sample obtained from the 
  7.18  source individual is not required if the facility has made 
  7.19  reasonable efforts to obtain the representative's consent and 
  7.20  consent cannot be obtained within 24 hours of a significant 
  7.21  exposure.  
  7.22     (c) If testing of the source individual's blood occurs 
  7.23  without consent because the source individual is unable to 
  7.24  provide consent or has left the facility and cannot be located, 
  7.25  and the source individual's representative cannot be located, 
  7.26  the facility shall provide the information required in section 
  7.27  144.7603 to the source individual or representative whenever it 
  7.28  is possible to do so.  
  7.29     (d) If a source individual dies before an opportunity to 
  7.30  consent to blood collection or testing under sections 144.7601 
  7.31  to 144.7615, the facility does not need consent of the deceased 
  7.32  person's representative for purposes of sections 144.7601 to 
  7.33  144.7615. 
  7.34     Sec. 10.  [144.7606] [TESTING OF AVAILABLE BLOOD.] 
  7.35     Subdivision 1.  [PROCEDURES WITH CONSENT.] If the source 
  7.36  individual is or was under the care or custody of the facility 
  8.1   and a sample of the source individual's blood is available with 
  8.2   the consent of the source individual, the facility shall test 
  8.3   that blood for bloodborne pathogens with the consent of the 
  8.4   source individual, provided the conditions in sections 144.7602 
  8.5   and 144.7603 are met. 
  8.6      Subd. 2.  [PROCEDURES WITHOUT CONSENT.] If the source 
  8.7   individual has provided a blood sample with consent but does not 
  8.8   consent to bloodborne pathogen testing, the facility shall test 
  8.9   for bloodborne pathogens if the emergency medical services 
  8.10  person or emergency medical services agency requests the test, 
  8.11  provided all of the following criteria are met: 
  8.12     (1) the emergency medical services person or emergency 
  8.13  medical services agency has documented exposure to blood or body 
  8.14  fluids during performance of that person's occupation or while 
  8.15  acting as a good samaritan under section 604A.01; 
  8.16     (2) the facility has determined that a significant exposure 
  8.17  has occurred under section 144.7614, subdivision 2, and a 
  8.18  licensed physician for the emergency medical services person has 
  8.19  documented in the emergency medical services person's medical 
  8.20  record that bloodborne pathogen test results are needed for 
  8.21  beginning, modifying, continuing, or discontinuing medical 
  8.22  treatment for the emergency medical services person as 
  8.23  recommended by the most current guidelines of the United States 
  8.24  Public Health Service; 
  8.25     (3) the emergency medical services person provides a blood 
  8.26  sample for testing for bloodborne pathogens as soon as feasible; 
  8.27     (4) the facility asks the source individual to consent to a 
  8.28  test for bloodborne pathogens and the source individual does not 
  8.29  consent; 
  8.30     (5) the facility has provided the source individual with 
  8.31  all of the information required by section 144.7603; and 
  8.32     (6) the facility has informed the emergency medical 
  8.33  services person of the confidentiality requirements of section 
  8.34  144.7611 and the penalties for unauthorized release of source 
  8.35  information under section 144.7612. 
  8.36     Subd. 3.  [FOLLOW-UP.] The facility shall inform the source 
  9.1   individual and the emergency medical services person of their 
  9.2   own test results.  The facility shall inform the emergency 
  9.3   medical services person of the source individual's test results 
  9.4   without the source individual's name, address, or other uniquely 
  9.5   identifying information. 
  9.6      Sec. 11.  [144.7607] [BLOOD SAMPLE COLLECTION FOR TESTING.] 
  9.7      Subdivision 1.  [WITH CONSENT.] (a) If a blood sample is 
  9.8   not otherwise available, the facility shall obtain consent from 
  9.9   the source individual before collecting a blood sample for 
  9.10  testing for bloodborne pathogens.  The consent process shall 
  9.11  include informing the source individual that the individual may 
  9.12  refuse to provide a blood sample and that the source 
  9.13  individual's refusal may result in a request for a court order 
  9.14  under subdivision 2 to require the source individual to provide 
  9.15  a blood sample.  
  9.16     (b) If the source individual consents to provide a blood 
  9.17  sample, the facility shall collect a blood sample and test the 
  9.18  sample for bloodborne pathogens.  
  9.19     (c) The facility shall inform the emergency medical 
  9.20  services person about the source individual's test results 
  9.21  without the individual's name, address, or other uniquely 
  9.22  identifying information.  The facility shall inform the source 
  9.23  individual of the test results.  
  9.24     (d) If the source individual refuses to provide a blood 
  9.25  sample for testing, the facility shall inform the emergency 
  9.26  medical services person of the source individual's refusal. 
  9.27     Subd. 2.  [PROCEDURES WITHOUT CONSENT.] (a) An emergency 
  9.28  medical services agency, or, if there is no agency, an emergency 
  9.29  medical services person, may bring a petition for a court order 
  9.30  to require a source individual to provide a blood sample for 
  9.31  testing for bloodborne pathogens.  The petition shall be filed 
  9.32  in the district court in the county where the source individual 
  9.33  resides or is hospitalized.  The petitioner shall serve the 
  9.34  petition on the source individual at least three days before a 
  9.35  hearing on the petition.  The petition shall include one or more 
  9.36  affidavits attesting that: 
 10.1      (1) the facility followed the procedures in sections 
 10.2   144.7601 to 144.7615 and attempted to obtain bloodborne pathogen 
 10.3   test results according to those sections; 
 10.4      (2) a licensed physician knowledgeable about the most 
 10.5   current recommendations of the United States Public Health 
 10.6   Service has determined that a significant exposure has occurred 
 10.7   to the emergency medical services person; and 
 10.8      (3) a physician with specialty training in infectious 
 10.9   diseases, including HIV, has documented that bloodborne pathogen 
 10.10  test results are needed for beginning, continuing, modifying, or 
 10.11  discontinuing medical treatment for the emergency medical 
 10.12  services person. 
 10.13     (b) Facilities shall cooperate with petitioners in 
 10.14  providing any necessary affidavits to the extent that facility 
 10.15  staff can attest under oath to the facts in the affidavits. 
 10.16     (c) The court may order the source individual to provide a 
 10.17  blood sample for bloodborne pathogen testing if: 
 10.18     (1) there is probable cause to believe the emergency 
 10.19  medical services person has experienced a significant exposure 
 10.20  to the source individual; 
 10.21     (2) the court imposes appropriate safeguards against 
 10.22  unauthorized disclosure that must specify the persons who have 
 10.23  access to the test results and the purposes for which the test 
 10.24  results may be used; 
 10.25     (3) a licensed physician for the emergency medical services 
 10.26  person needs the test results for beginning, continuing, 
 10.27  modifying, or discontinuing medical treatment for the emergency 
 10.28  medical services person; and 
 10.29     (4) the court finds a compelling need for the test 
 10.30  results.  In assessing compelling need, the court shall weigh 
 10.31  the need for the court-ordered blood collection and test results 
 10.32  against the privacy interests of the source individual.  The 
 10.33  court shall also consider whether the involuntary blood 
 10.34  collection and testing would serve the public interest. 
 10.35     (d) The court shall conduct the proceeding in camera unless 
 10.36  the petitioner or the source individual requests a hearing in 
 11.1   open court or the court determines that a public hearing is 
 11.2   necessary to the public interest and the proper administration 
 11.3   of justice. 
 11.4      (e) The source individual has the right to counsel in any 
 11.5   proceeding brought under this subdivision. 
 11.6      Sec. 12.  [144.7608] [NO DISCRIMINATION.] 
 11.7      A facility shall not base decisions about admission to a 
 11.8   facility or the provision of care or treatment on any 
 11.9   requirement that the source individual consent to bloodborne 
 11.10  pathogen testing under sections 144.7601 to 144.7615. 
 11.11     Sec. 13.  [144.7609] [USE OF TEST RESULTS.] 
 11.12     Bloodborne pathogen test results of a source individual 
 11.13  obtained under sections 144.7601 to 144.7615 are for diagnostic 
 11.14  purposes and to determine the need for treatment or medical care 
 11.15  specific to a bloodborne pathogen-related illness of an 
 11.16  emergency medical services person.  The test results may not be 
 11.17  used as evidence in any criminal proceedings. 
 11.18     Sec. 14.  [144.7611] [TEST INFORMATION CONFIDENTIALITY.] 
 11.19     Subdivision 1.  [PRIVATE DATA.] Information concerning test 
 11.20  results obtained under sections 144.7601 to 144.7615 is 
 11.21  information protected from disclosure without consent under 
 11.22  section 144.335 with respect to private facilities and private 
 11.23  data as defined in section 13.02, subdivision 12, with respect 
 11.24  to public facilities. 
 11.25     Subd. 2.  [CONSENT TO RELEASE INFORMATION.] No facility, 
 11.26  individual, or employer shall disclose to an emergency medical 
 11.27  services person the name, address, or other uniquely identifying 
 11.28  information about a source individual without a written release 
 11.29  signed by the source individual or the source individual's 
 11.30  legally authorized representative.  The facility shall not 
 11.31  record the name, address, or other uniquely identifying 
 11.32  information about the source individual's test results in the 
 11.33  emergency medical services person's medical records. 
 11.34     Sec. 15.  [144.7612] [PENALTY FOR UNAUTHORIZED RELEASE OF 
 11.35  INFORMATION.] 
 11.36     Any unauthorized release by an individual, facility, or 
 12.1   agency of a source individual's name, address, or other uniquely 
 12.2   identifying information under sections 144.7601 to 144.7615 is a 
 12.3   misdemeanor.  This section does not preclude the source 
 12.4   individual from pursuing remedies and penalties under sections 
 12.5   13.08, 13.09, or 144.335, or other private causes of action 
 12.6   against an individual, state agency, statewide system, political 
 12.7   subdivision, or person responsible for releasing private data or 
 12.8   information protected from disclosure. 
 12.9      Sec. 16.  [144.7613] [RESPONSIBILITY FOR TESTING AND 
 12.10  TREATMENT; COSTS.] 
 12.11     (a) The facility shall ensure that tests under sections 
 12.12  144.7601 to 144.7615 are performed if requested by the emergency 
 12.13  medical services person or emergency medical services agency, 
 12.14  provided the conditions set forth in sections 144.7601 to 
 12.15  144.7615 are met.  
 12.16     (b) The emergency medical services agency that employs the 
 12.17  emergency medical services person who requests testing under 
 12.18  sections 144.7601 to 144.7615 must pay or arrange payment for 
 12.19  the cost of counseling, testing, and treatment of the emergency 
 12.20  medical services person and costs associated with the testing of 
 12.21  the source individual.  
 12.22     (c) A facility shall have a protocol that states whether 
 12.23  the facility will pay for the cost of counseling, testing, or 
 12.24  treatment of a person acting as a good samaritan under section 
 12.25  604A.01. 
 12.26     Sec. 17.  [144.7614] [PROTOCOLS FOR EXPOSURE TO BLOODBORNE 
 12.27  PATHOGENS.] 
 12.28     Subdivision 1.  [EMS AGENCY REQUIREMENTS.] The emergency 
 12.29  medical services agency shall have procedures for an emergency 
 12.30  medical services person to notify a facility that the person may 
 12.31  have experienced a significant exposure from a source 
 12.32  individual.  The emergency medical services agency shall also 
 12.33  have a protocol to locate the source individual if the facility 
 12.34  has not received the source individual and the emergency medical 
 12.35  services agency knows the source individual's identity. 
 12.36     Subd. 2.  [FACILITY PROTOCOL REQUIREMENTS.] Every facility 
 13.1   shall adopt and follow a postexposure protocol for emergency 
 13.2   medical services persons who have experienced a significant 
 13.3   exposure.  The postexposure protocol must adhere to the most 
 13.4   current recommendations of the United States Public Health 
 13.5   Service and include, at a minimum, the following: 
 13.6      (1) a process for emergency medical services persons to 
 13.7   report a significant exposure in a timely fashion; 
 13.8      (2) a process for a licensed physician who is knowledgeable 
 13.9   about the most current recommendations of the United States 
 13.10  Public Health Service, or a health care worker assigned by that 
 13.11  licensed physician, to determine whether a significant exposure 
 13.12  has occurred; 
 13.13     (3) if there has been a significant exposure, a process to 
 13.14  determine whether the source individual has a bloodborne 
 13.15  pathogen through disclosure of test results, or through blood 
 13.16  collection and testing as required by sections 144.7601 to 
 13.17  144.7615; 
 13.18     (4) a process for providing appropriate counseling 
 13.19  regarding the likelihood of bloodborne pathogen transmission and 
 13.20  follow-up recommendations according to the most current 
 13.21  recommendations of the United States Public Health Service, 
 13.22  recommendations for testing, and treatment to the emergency 
 13.23  medical services person; 
 13.24     (5) a process for providing appropriate counseling 
 13.25  regarding the likelihood of bloodborne pathogen transmission and 
 13.26  follow-up recommendations according to the most current 
 13.27  recommendations of the United States Public Health Service, 
 13.28  recommendations for testing, and treatment to the source 
 13.29  individual; and 
 13.30     (6) compliance with applicable state and federal laws 
 13.31  relating to data practices, confidentiality, informed consent, 
 13.32  and the patient bill of rights. 
 13.33     Sec. 18.  [144.7615] [PENALTIES AND IMMUNITY.] 
 13.34     Subdivision 1.  [CIVIL REMEDIES.] An emergency medical 
 13.35  services person or source individual who suffers any damage as a 
 13.36  result of a violation of the requirements of sections 144.7601 
 14.1   to 144.7615 may bring an action against a facility to cover any 
 14.2   damages sustained, plus costs and reasonable attorney fees.  The 
 14.3   district court may enjoin a violation or proposed violation of 
 14.4   sections 144.7601 to 144.7615.  The court may make any order or 
 14.5   judgment as may be necessary to ensure compliance with sections 
 14.6   144.7601 to 144.7615.  This subdivision does not authorize a 
 14.7   civil action brought by the representative of a deceased source 
 14.8   individual. 
 14.9      Subd. 2.  [PENALTIES.] Any facility or person who willfully 
 14.10  violates the provisions of sections 144.7601 to 144.7615 is 
 14.11  guilty of a misdemeanor. 
 14.12     Subd. 3.  [IMMUNITY.] A facility, licensed physician, and 
 14.13  designated health care personnel are immune from liability in 
 14.14  any civil, administrative, or criminal action relating to the 
 14.15  disclosure of test results to an emergency medical services 
 14.16  person or emergency medical services agency and the testing of a 
 14.17  blood sample from the source individual for bloodborne pathogens 
 14.18  if a good faith effort has been made to comply with sections 
 14.19  144.7601 to 144.7615. 
 14.20     Sec. 19.  Minnesota Statutes 1998, section 214.18, is 
 14.21  amended by adding a subdivision to read: 
 14.22     Subd. 3a.  [HCV.] "HCV" means the hepatitis C virus. 
 14.23     Sec. 20.  Minnesota Statutes 1998, section 214.18, 
 14.24  subdivision 5, is amended to read: 
 14.25     Subd. 5.  [REGULATED PERSON.] "Regulated person" means a 
 14.26  licensed dental hygienist, dentist, physician, nurse who 
 14.27  maintains current registration as a registered nurse or licensed 
 14.28  practical nurse, podiatrist, a registered dental assistant, a 
 14.29  physician's assistant, and for purposes of sections 214.19, 
 14.30  subdivisions 4 and 5; 214.20, paragraph (a); and 214.24, a 
 14.31  chiropractor.  
 14.32     Sec. 21.  Minnesota Statutes 1998, section 214.19, 
 14.33  subdivision 1, is amended to read: 
 14.34     Subdivision 1.  [PERMISSION TO REPORT.] A person with 
 14.35  actual knowledge that a regulated person has been diagnosed as 
 14.36  infected with HIV ~~or~~, HBV, or HCV may file a report with the 
 15.1   commissioner. 
 15.2      Sec. 22.  [241.33] [DEFINITIONS.] 
 15.3      Subdivision 1.  [SCOPE OF DEFINITIONS.] For purposes of 
 15.4   sections 241.33 to 241.342, the following terms have the meaning 
 15.5   given them. 
 15.6      Subd. 2.  [BLOODBORNE PATHOGENS.] "Bloodborne pathogens" 
 15.7   means pathogenic microorganisms that are present in human blood 
 15.8   and can cause disease in humans.  These pathogens include, but 
 15.9   are not limited to, hepatitis B virus (HBV), hepatitis C virus 
 15.10  (HCV), and human immunodeficiency virus (HIV). 
 15.11     Subd. 3.  [INMATE.] "Inmate" means an individual in the 
 15.12  custody or under the jurisdiction of the commissioner of 
 15.13  corrections or a local correctional authority. 
 15.14     Subd. 4.  [CORRECTIONAL FACILITY.] "Correctional facility" 
 15.15  means a state or local correctional facility. 
 15.16     Subd. 5.  [CORRECTIONS EMPLOYEE.] "Corrections employee" 
 15.17  means an employee of a state or local correctional agency. 
 15.18     Subd. 6.  [SIGNIFICANT EXPOSURE.] "Significant exposure" 
 15.19  means contact, in a manner supported by recommendation of the 
 15.20  United States Public Health Service most current at the time 
 15.21  these evaluations take place, that includes: 
 15.22     (1) percutaneous injury, contact of mucous membrane or 
 15.23  nonintact skin, or prolonged contact of intact skin; and 
 15.24     (2) contact, in a manner which may transmit a bloodborne 
 15.25  pathogen, with blood, tissue, or other body fluids. 
 15.26     Sec. 23.  [241.331] [CONDITIONS FOR APPLICABILITY OF 
 15.27  PROCEDURES.] 
 15.28     Subdivision 1.  [REQUEST FOR PROCEDURES.] A corrections 
 15.29  employee may request that the procedures of sections 241.33 to 
 15.30  241.342 be followed when the corrections employee may have 
 15.31  experienced a significant exposure to an inmate. 
 15.32     Subd. 2.  [CONDITIONS.] The correctional facility shall 
 15.33  follow the procedures in sections 241.33 to 241.342 when all of 
 15.34  the following conditions are met:  
 15.35     (1) a licensed physician determines that a significant 
 15.36  exposure has occurred following the protocol under section 
 16.1   241.341; 
 16.2      (2) the licensed physician for the corrections employee 
 16.3   needs the inmate's bloodborne pathogens test results to begin, 
 16.4   continue, modify, or discontinue treatment in accordance with 
 16.5   the most current guidelines of the United States Public Health 
 16.6   Service, because of possible exposure to a bloodborne pathogen; 
 16.7   and 
 16.8      (3) the corrections employee consents to providing a blood 
 16.9   sample for testing for a bloodborne pathogen. 
 16.10     Sec. 24.  [241.332] [INFORMATION REQUIRED TO BE GIVEN TO 
 16.11  INDIVIDUALS.] 
 16.12     Subdivision 1.  [INFORMATION TO INMATE.] (a) Before seeking 
 16.13  any consent required by the procedures under sections 241.33 to 
 16.14  241.342, a correctional facility shall inform the inmate that 
 16.15  the inmate's bloodborne pathogen test results, without the 
 16.16  inmate's name or other uniquely identifying information, shall 
 16.17  be reported to the corrections employee if requested and that 
 16.18  test results collected under sections 241.33 to 241.342 are for 
 16.19  medical purposes as set forth in section 241.338 and may not be 
 16.20  used as evidence in any criminal proceedings.  
 16.21     (b) The correctional facility shall inform the inmate that 
 16.22  the correctional facility will advise the corrections employee 
 16.23  of the confidentiality requirements and penalties before the 
 16.24  employee's health care provider discloses any test results. 
 16.25     Subd. 2.  [INFORMATION TO CORRECTIONS EMPLOYEE.] Before 
 16.26  disclosing any information about the inmate, the correctional 
 16.27  facility shall inform the corrections employee of the 
 16.28  confidentiality requirements of section 241.339 and that the 
 16.29  person may be subject to penalties for unauthorized release of 
 16.30  test results about the inmate under section 241.34. 
 16.31     Sec. 25.  [241.333] [DISCLOSURE OF POSITIVE BLOODBORNE 
 16.32  PATHOGEN TEST RESULTS.] 
 16.33     If the conditions of sections 241.331 and 241.332 are met, 
 16.34  the correctional facility shall ask the inmate if the inmate has 
 16.35  ever had a positive test for a bloodborne pathogen.  The 
 16.36  correctional facility must attempt to get existing test results 
 17.1   under this section before taking any steps to obtain a blood 
 17.2   sample or to test for bloodborne pathogens.  The correctional 
 17.3   facility shall disclose the inmate's bloodborne pathogen test 
 17.4   results to the corrections employee without the inmate's name or 
 17.5   other uniquely identifying information. 
 17.6      Sec. 26.  [241.334] [CONSENT PROCEDURES GENERALLY.] 
 17.7      (a) For purposes of sections 241.33 to 241.342, whenever 
 17.8   the correctional facility is required to seek consent, the 
 17.9   correctional facility shall obtain consent from an inmate or an 
 17.10  inmate's representative consistent with other law applicable to 
 17.11  consent.  
 17.12     (b) Consent is not required if the correctional facility 
 17.13  has made reasonable efforts to obtain the representative's 
 17.14  consent and consent cannot be obtained within 24 hours of a 
 17.15  significant exposure.  
 17.16     (c) If testing of available blood occurs without consent 
 17.17  because the inmate is unconscious or unable to provide consent, 
 17.18  and a representative cannot be located, the correctional 
 17.19  facility shall provide the information required in section 
 17.20  241.332 to the inmate or representative whenever it is possible 
 17.21  to do so.  
 17.22     (d) If an inmate dies before an opportunity to consent to 
 17.23  blood collection or testing under sections 241.33 to 241.342, 
 17.24  the correctional facility does not need consent of the inmate's 
 17.25  representative for purposes of sections 241.33 to 241.342. 
 17.26     Sec. 27.  [241.335] [TESTING OF AVAILABLE BLOOD.] 
 17.27     Subdivision 1.  [PROCEDURES WITH CONSENT.] If a sample of 
 17.28  the inmate's blood is available, the correctional facility shall 
 17.29  ensure that blood is tested for bloodborne pathogens with the 
 17.30  consent of the inmate, provided the conditions in sections 
 17.31  241.331 and 241.332 are met. 
 17.32     Subd. 2.  [PROCEDURES WITHOUT CONSENT.] If the inmate has 
 17.33  provided a blood sample, but does not consent to bloodborne 
 17.34  pathogens testing, the correctional facility shall ensure that 
 17.35  the blood is tested for bloodborne pathogens if the corrections 
 17.36  employee requests the test, provided all of the following 
 18.1   criteria are met: 
 18.2      (1) the corrections employee and correctional facility has 
 18.3   documented exposure to blood or body fluids during performance 
 18.4   of the employee's work duties; 
 18.5      (2) a licensed physician has determined that a significant 
 18.6   exposure has occurred under section 241.341 and has documented 
 18.7   that bloodborne pathogen test results are needed for beginning, 
 18.8   modifying, continuing, or discontinuing medical treatment for 
 18.9   the corrections employee as recommended by the most current 
 18.10  guidelines of the United States Public Health Service; 
 18.11     (3) the corrections employee provides a blood sample for 
 18.12  testing for bloodborne pathogens as soon as feasible; 
 18.13     (4) the correctional facility asks the inmate to consent to 
 18.14  a test for bloodborne pathogens and the inmate does not consent; 
 18.15     (5) the correctional facility has provided the inmate and 
 18.16  the corrections employee with all of the information required by 
 18.17  section 241.332; and 
 18.18     (6) the correctional facility has informed the corrections 
 18.19  employee of the confidentiality requirements of section 241.339 
 18.20  and the penalties for unauthorized release of inmate information 
 18.21  under section 241.34. 
 18.22     Subd. 3.  [FOLLOW-UP.] The correctional facility shall 
 18.23  inform the inmate whose blood was tested of the results.  The 
 18.24  correctional facility shall inform the corrections employee's 
 18.25  health care provider of the inmate's test results without the 
 18.26  inmate's name or other uniquely identifying information. 
 18.27     Sec. 28.  [241.336] [BLOOD SAMPLE COLLECTION FOR TESTING.] 
 18.28     Subdivision 1.  [PROCEDURES WITH CONSENT.] (a) If a blood 
 18.29  sample is not otherwise available, the correctional facility 
 18.30  shall obtain consent from the inmate before collecting a blood 
 18.31  sample for testing for bloodborne pathogens.  The consent 
 18.32  process shall include informing the inmate that the inmate may 
 18.33  refuse to provide a blood sample and that the inmate's refusal 
 18.34  may result in a request for a court order under subdivision 2 to 
 18.35  require the inmate to provide a blood sample.  
 18.36     (b) If the inmate consents to provide a blood sample, the 
 19.1   correctional facility shall collect a blood sample and ensure 
 19.2   that the sample is tested for bloodborne pathogens.  
 19.3      (c) The correctional facility shall inform the corrections 
 19.4   employee's health care provider about the inmate's test results 
 19.5   without the inmate's name or other uniquely identifying 
 19.6   information.  The correctional facility shall inform the inmate 
 19.7   of the test results.  
 19.8      (d) If the inmate refuses to provide a blood sample for 
 19.9   testing, the correctional facility shall inform the corrections 
 19.10  employee of the inmate's refusal. 
 19.11     Subd. 2.  [PROCEDURES WITHOUT CONSENT.] (a) A correctional 
 19.12  facility or a corrections employee may bring a petition for a 
 19.13  court order to require an inmate to provide a blood sample for 
 19.14  testing for bloodborne pathogens.  The petition shall be filed 
 19.15  in the district court in the county where the inmate is 
 19.16  confined.  The correctional facility shall serve the petition on 
 19.17  the inmate before a hearing on the petition.  The petition shall 
 19.18  include one or more affidavits attesting that: 
 19.19     (1) the correctional facility followed the procedures in 
 19.20  sections 241.33 to 241.342 and attempted to obtain bloodborne 
 19.21  pathogen test results according to those sections; 
 19.22     (2) a licensed physician knowledgeable about the most 
 19.23  current recommendations of the United States Public Health 
 19.24  Service has determined that a significant exposure has occurred 
 19.25  to the corrections employee; and 
 19.26     (3) a physician has documented that bloodborne pathogen 
 19.27  test results are needed for beginning, continuing, modifying, or 
 19.28  discontinuing medical treatment for the corrections employee. 
 19.29     (b) Facilities shall cooperate with petitioners in 
 19.30  providing any necessary affidavits to the extent that facility 
 19.31  staff can attest under oath to the facts in the affidavits. 
 19.32     (c) The court may order the inmate to provide a blood 
 19.33  sample for bloodborne pathogen testing if: 
 19.34     (1) there is probable cause to believe the corrections 
 19.35  employee has experienced a significant exposure to the inmate; 
 19.36     (2) the court imposes appropriate safeguards against 
 20.1   unauthorized disclosure that must specify the persons who have 
 20.2   access to the test results and the purposes for which the test 
 20.3   results may be used; 
 20.4      (3) a licensed physician for the corrections employee needs 
 20.5   the test results for beginning, continuing, modifying, or 
 20.6   discontinuing medical treatment for the corrections employee; 
 20.7   and 
 20.8      (4) the court finds a compelling need for the test 
 20.9   results.  In assessing compelling need, the court shall weigh 
 20.10  the need for the court-ordered blood collection and test results 
 20.11  against the privacy interests of the inmate.  The court shall 
 20.12  also consider whether involuntary blood collection and testing 
 20.13  would serve the public interests. 
 20.14     (d) The court shall conduct the proceeding in camera unless 
 20.15  the petitioner or the inmate requests a hearing in open court or 
 20.16  the court determines that a public hearing is necessary to the 
 20.17  public interest and the proper administration of justice. 
 20.18     (e) The inmate may arrange for counsel in any proceeding 
 20.19  brought under this subdivision. 
 20.20     Sec. 29.  [241.337] [NO DISCRIMINATION.] 
 20.21     A correctional facility shall not withhold care or 
 20.22  treatment on the requirement that the inmate consent to 
 20.23  bloodborne pathogen testing under sections 241.33 to 241.342. 
 20.24     Sec. 30.  [241.338] [USE OF TEST RESULTS.] 
 20.25     Bloodborne pathogen test results of an inmate obtained 
 20.26  under sections 241.33 to 241.342 are for diagnostic purposes and 
 20.27  to determine the need for treatment or medical care specific to 
 20.28  a bloodborne pathogen-related illness.  The test results may not 
 20.29  be used as evidence in any criminal proceedings. 
 20.30     Sec. 31.  [241.339] [TEST INFORMATION CONFIDENTIALITY.] 
 20.31     Test results obtained under sections 241.33 to 241.342 are 
 20.32  private data as defined in sections 13.02, subdivision 12, and 
 20.33  13.85, subdivision 2. 
 20.34     Sec. 32.  [241.34] [PENALTY FOR UNAUTHORIZED RELEASE OF 
 20.35  INFORMATION.] 
 20.36     Unauthorized release of the inmate's name or other uniquely 
 21.1   identifying information under sections 241.33 to 241.342 is a 
 21.2   misdemeanor.  This section does not preclude the inmate from 
 21.3   pursuing remedies and penalties under sections 13.08 and 13.09 
 21.4   or other private causes of action against an individual, state 
 21.5   agency, statewide system, political subdivision, or person 
 21.6   responsible for releasing private data or confidential or 
 21.7   private information on the inmate. 
 21.8      Sec. 33.  [241.341] [PROTOCOL FOR EXPOSURE TO BLOODBORNE 
 21.9   PATHOGENS.] 
 21.10     Correctional facilities shall follow applicable 
 21.11  Occupational Safety and Health Administration guidelines under 
 21.12  Code of Federal Regulations, title 29, part 1910.1030, for 
 21.13  bloodborne pathogens.  Postexposure protocols for corrections 
 21.14  employees who experience a significant exposure must adhere to 
 21.15  the most current recommendations by the United States Public 
 21.16  Health Service. 
 21.17     Sec. 34.  [241.342] [IMMUNITY.] 
 21.18     A correctional facility, licensed physician, and designated 
 21.19  health care personnel are immune from liability in any civil, 
 21.20  administrative, or criminal action relating to the disclosure of 
 21.21  test results of an inmate to a corrections employee and the 
 21.22  testing of a blood sample from the inmate for bloodborne 
 21.23  pathogens if a good faith effort has been made to comply with 
 21.24  sections 241.33 to 241.342. 
 21.25     Sec. 35.  Minnesota Statutes 1998, section 611A.19, 
 21.26  subdivision 1, is amended to read: 
 21.27     Subdivision 1.  [TESTING ON REQUEST OF VICTIM.] (a) Upon 
 21.28  the request or with the consent of the victim, the prosecutor 
 21.29  shall make a motion in camera and the sentencing court shall 
 21.30  issue an order requiring an adult convicted of or a juvenile 
 21.31  adjudicated delinquent for violating section 609.342 (criminal 
 21.32  sexual conduct in the first degree), 609.343 (criminal sexual 
 21.33  conduct in the second degree), 609.344 (criminal sexual conduct 
 21.34  in the third degree), 609.345 (criminal sexual conduct in the 
 21.35  fourth degree), or any other violent crime, as defined in 
 21.36  section 609.1095, to submit to testing to determine the presence 
 22.1   of human immunodeficiency virus (HIV) antibody if:  
 22.2      (1) the crime involved sexual penetration, however slight, 
 22.3   as defined in section 609.341, subdivision 12; or 
 22.4      (2) evidence exists that the broken skin or mucous membrane 
 22.5   of the victim was exposed to or had contact with the offender's 
 22.6   semen or blood during the commission of the crime in a manner 
 22.7   which has been demonstrated epidemiologically to transmit the 
 22.8   human immunodeficiency virus (HIV).  
 22.9      (b) When the court orders an offender to submit to testing 
 22.10  under paragraph (a), the court shall order that the test be 
 22.11  performed by an appropriate health professional ~~who is trained~~ 
 22.12  ~~to provide the counseling described in section 144.763,~~ and that 
 22.13  no reference to the test, the motion requesting the test, the 
 22.14  test order, or the test results may appear in the criminal 
 22.15  record or be maintained in any record of the court or court 
 22.16  services.  
 22.17     Sec. 36.  Minnesota Statutes 1998, section 611A.19, 
 22.18  subdivision 2, is amended to read: 
 22.19     Subd. 2.  [DISCLOSURE OF TEST RESULTS.] The date and 
 22.20  results of a test performed under subdivision 1 are private data 
 22.21  as defined in section 13.02, subdivision 12, when maintained by 
 22.22  a person subject to chapter 13, or may be released only with the 
 22.23  subject's consent, if maintained by a person not subject to 
 22.24  chapter 13.  The results are available, on request, to the 
 22.25  victim or, if the victim is a minor, to the victim's parent or 
 22.26  guardian and positive test results shall be reported to the 
 22.27  commissioner of health.  Any test results given to a victim or 
 22.28  victim's parent or guardian shall be provided by a health 
 22.29  professional ~~who is trained to provide the counseling described~~ 
 22.30  ~~in section 144.763~~.  Data regarding administration and results 
 22.31  of the test are not accessible to any other person for any 
 22.32  purpose and shall not be maintained in any record of the court 
 22.33  or court services or any other record.  After the test results 
 22.34  are given to the victim or the victim's parent or guardian, data 
 22.35  on the test must be removed from any medical data or health 
 22.36  records maintained under section 13.42 or 144.335 and destroyed. 
 23.1      Sec. 37.  [REPEALER.] 
 23.2      Minnesota Statutes 1998, sections 144.761; 144.762; 
 23.3   144.763; 144.764; 144.765; 144.766; 144.767; 144.768; 144.769; 
 23.4   and 144.7691, are repealed.