TITLE 25.HEALTH SERVICES

Part 1. DEPARTMENT OF STATE HEALTH SERVICES

Chapter 96. BLOODBORNE PATHOGEN CONTROL

The Executive Commissioner of the Health and Human Services Commission, on behalf of the Department of State Health Services (department), adopts amendments to §§96.101, 96.201 - 96.203, 96.301 - 96.304, 96.401, 96.402, 96.501 and the repeal of 96.601, concerning the applicability, minimum standards, safety recommendations, device registration procedures and fees, and sharps injury logs of bloodborne pathogen exposure control plans. The amendments to §§96.301, 96.401, and 96.501 are adopted with changes to the proposed text as published in the January 6, 2006, issue of the Texas Register (31 TexReg 79). Sections 96.101, 96.201 - 96.203, 96.302 - 96.304, 96.402, and the repeal of 96.601 are adopted without changes, and the sections will not be republished.

BACKGROUND AND PURPOSE

The amendments and repeal are necessary to comply with Health and Safety Code, §§81.301 - 81.307, which require the department to establish an exposure control plan designed to minimize exposure of employees to bloodborne pathogens and to implement a registration program for needleless systems and sharps with engineered sharp injury protections; and House Bill 2292, 78th Legislature, Regular Session, 2003, §2.42, added Health and Safety Code, §12.0112, which requires that the term for licenses issued or renewed after January 1, 2005, will be two years.

Government Code, §2001.039, requires that each state agency review and consider for readoption each rule adopted by that agency pursuant to the Government Code, Chapter 2001 (Administrative Procedure Act). Sections 96.101, 96.201 - 96.203, 96.301 - 96.304, 96.401, 96.402, 96.501, and 96.601 have been reviewed, and the department has determined that reasons for adopting the sections continue to exist because rules on this subject are needed and required by law. Section 96.601 is repealed because the rule is no longer necessary.

SECTION-BY-SECTION SUMMARY

Amendments to §96.101 add more components to the definitions of "Governmental unit" and also provide additional information concerning the contracting of the Hepatitis B, C, and Human immunodeficiency viruses; §§96.201 - 96.203, 96.301 - 96.304, 96.401, 96.402, and 96.501 update and correct the department's reference from the "Texas Department of Health" to the "Department of State Health Services"; §§96.202, 96.303, and 96.401 provide a new website for information on bloodborne pathogen control; amendments to §96.301 and §96.501 reflect changes in the Department of State Health Services' organizational unit names and commissioner titles; amendments to §96.302 and §96.304 add a two-year period for registration and renewal fees; §96.301 and §96.501 are amended to delete reference to issuance of waivers.

Section 96.601 is repealed because the reference to the effective date of the rules is no longer relevant.

COMMENTS

The department, on behalf of the commission, has reviewed and prepared responses to the comments received regarding the proposed rules during the comment period, which the commission has reviewed and accepts. The commenter was an individual representing the Texas AIDS Network. The commenter was not against the rules in their entirety; however, the commenter asked about the continuation of rules that had an expiration date.

Comment: Concerning Safety Recommendation Waiver for Undue Burden in §96.301(b), the commenter asked why the May 1, 2003, prohibition date was extended for the use of prefilled syringes approved by the Federal Food and Drug Administration.

Response: The commission agrees that the waiver for prohibition of the use of the prefilled syringe approved by the Federal Food and Drug Administration shall be continued because certain medications including immunization vaccines and antibiotics are available only in a prefilled syringe. There was no change made as a result of this comment.

Comment: Concerning Waiver for Rural Counties in §96.501, the commenter asked why the 2001 date for the waivers for rural counties was extended.

Response: The commission agrees that waivers should no longer be granted and this section has been amended to reflect this in the final version of the rules. The legislation that authorized the granting of waivers has expired (Chapter 1411, 76th Legislature §26.02).

The department staff, on behalf of the commission, provided comments and the commission has reviewed and agrees to the following changes.

Change: Concerning §96.301(b), Waiver for Undue Burden, staff noted that the legislature provision which allowed this waiver expired in 2001 and this section has been amended to reflect the changes. The legislation that authorized the granting of waivers has expired (Chapter 1411, 76th Legislature, §26.02).

Change: Concerning §96.401(f), the Internet address was corrected to "http://www.dshs.state.tx.us/idcu/health/bloodborne_pathogens/reporting/" instead of "http://www.dshs.state.tx.us/ideas/bloodborne_pathogens/reporting/".

LEGAL CERTIFICATION

The Department of State Health Services General Counsel, Cathy Campbell, certifies that the rules, as adopted, have been reviewed by legal counsel and found to be a valid exercise of the agencies' legal authority.

25 TAC §§96.101, 96.201 - 96.203, 96.301 - 96.304, 96.401, 96.402, 96.501

STATUTORY AUTHORITY

The adopted amendments are authorized by Health and Safety Code, Subchapter H, Bloodborne Pathogen Exposure Control Plan, §§81.301 - 81.307. Specifically, §§81.303 - 81.304 requires the department by rule to establish and implement an exposure control plan designed to minimize exposure of employees to bloodborne pathogens; §81.305 which requires the department to recommend that governmental units implement needleless systems and sharps with engineered sharps injury protection for employees; §81.306 which requires that the department by rule require that information concerning exposure incidents be recorded in a log; and §81.307 which requires that the department by rule implement a registration program for existing needleless systems and sharps with engineered sharp injury protections; Health and Safety Code, §12.0112, which requires that the term for licenses issued or renewed after January 1, 2005, will be two years; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001.

§96.301.Safety Recommendations.

(a) The Department of State Health Services (department) recommends that governmental units implement needleless systems and sharps with engineered sharps injury protection for employees.

(b) Waivers shall not be granted. The provisions in the legislation which allowed the department to grant waivers, has expired (Chapter 1411, 76th Legislature, §26.02).

(c) The use of a prefilled syringe that is approved by the Federal Food and Drug Administration may not be prohibited.

(d) Evaluation committee.

(1) At least half of the members of an evaluation committee established by a governmental unit to implement subsection (b) of this section must be employees who are health care workers who have direct contact with patients or provide services on a regular basis.

(2) Whenever possible, the governmental entity establishing the evaluation committee shall consider using committees with similar duties already in existence.

§96.401.Sharps Injury Log.

(a) The chief administrative officer for each facility within a governmental unit shall report, as required by this section, each employee, as defined in §96.101(7) of this title (relating to Definitions), who sustains a contaminated sharps injury, as defined in §96.101(5) of this title. The chief administrative officer of the governmental unit may designate an employee for each facility within the governmental unit to serve as the reporting officer.

(b) Information concerning each contaminated sharps injury shall be recorded in a written or electronic sharps injury log which shall be maintained by a governmental unit, in accordance with Health and Safety Code, Chapter 81, Subchapter H, and this chapter.

(c) The following information must be recorded in the sharps injury log:

(1) name and address of facility where injury occurred;

(2) name and phone number of the chief administrative officer or reporting officer;

(3) date and time of the injury;

(4) age and sex of the injured employee;

(5) type and brand of sharp involved;

(6) original intended use of the sharp;

(7) whether the injury occurred before, during, or after the sharp was used for its original intended purpose;

(8) whether the exposure was during or after the sharp was used;

(9) whether the device had engineered sharps injury protection, as defined in §96.101(9)(A) and (B) of this title (relating to Definitions), and if yes, was the protective mechanism activated and did the exposure incident occur before, during, or after activation of the protective mechanism;

(10) whether the injured person was wearing gloves at the time of the injury;

(11) whether the injured person had completed a hepatitis B vaccination series;

(12) whether a sharps container was readily available for disposal of the sharp;

(13) whether the injured person received training on the exposure control plan during the 12 months prior to the incident;

(14) the involved body part;

(15) the job classification of the injured person;

(16) the employment status of the injured person;

(17) the location/facility/agency and the work area where the sharps injury occurred; and

(18) a listing of the implemented needleless systems and sharps with engineered sharps injury protection for employees available within the governmental entity.

(d) Information contained in subsection (c)(1) - (17) of this section concerning each contaminated sharps injury shall be reported not later than ten working days after the end of the calendar month in which it occurred.

(e) A chief administrative officer for each facility within a governmental unit or the designee shall report the contaminated sharps injury to the local health authority where the facility is located. The local health authority, acting as an agent for the Department of State Health Services (department), shall receive and review the report for completeness, and submit the report to the department. If no local health authority is appointed for the jurisdiction where the facility is located, the report shall be made to the regional director of the Department of State Health Services (department) regional office in which the facility is located.

(f) A contaminated sharps injury shall be reported on the department's Contaminated Sharps Injury Reporting Form or through an electronic means established by the department. Copies of the Contaminated Sharps Injury Reporting Form can be obtained on the Internet at http://www.dshs.state.tx.us/idcu/health/bloodborne_pathogens/reporting/ or from the Department of State Health Services regional offices.

§96.501.Waiver for Rural Counties.

Waivers shall not be granted. The provisions in the legislation which allowed the department to grant waivers, has expired (Chapter 1411, 76th Legislature, §26.02).

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 3, 2006.

TRD-200603586

Cathy Campbell

General Counsel

Department of State Health Services

Effective date: July 23, 2006

Proposal publication date: January 6, 2006

For further information, please call: (512) 458-7111 x6972


25 TAC §96.601

STATUTORY AUTHORITY

The adopted repeal is authorized by Health and Safety Code, Subchapter H, Bloodborne Pathogen Exposure Control Plan, §§81.301 - 81.307. Specifically, §§81.303 - 81.304 requires the department by rule to establish and implement an exposure control plan designed to minimize exposure of employees to bloodborne pathogens; §81.305 which requires the department to recommend that governmental units implement needleless systems and sharps with engineered sharps injury protection for employees; §81.306 which requires that the department by rule require that information concerning exposure incidents be recorded in a log; and §81.307 which requires that the department by rule implement a registration program for existing needleless systems and sharps with engineered sharp injury protections; Health and Safety Code, §12.0112, which requires that the term for licenses issued or renewed after January 1, 2005, will be two years; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on July 3, 2006.

TRD-200603587

Cathy Campbell

General Counsel

Department of State Health Services

Effective date: July 23, 2006

Proposal publication date: January 6, 2006

For further information, please call: 458-7111 x6972