With the Ryan-White Notification Act gone, what recourse do we have?

[ghurty]

With the Ryan-White Notification Act gone, what recourse do we have if we have been exposed?

Thanks

[Lone Star]

With the Ryan-White Notification Act gone, what recourse do we have if we have been exposed?

Thanks

After I informed my instructor about this very topic, I was quickly told that OSHA's provisions more than make up for any provisions in the Ryan White Care Act. The only problem is that there are organizations that OSHA cannot dictate policy to.

The problem with this and other provisions of the OSHA BBP Standard is that no further details are provided for employers. OSHA states this is a “performance-based” standard, which means that the standard identifies end results that are expected from employers, but doesn’t specifically identify the steps needed to reach those results.

The emergency response provisions of the Ryan White law provided those missing steps. There was a requirement for a designated infection control officer (DICO) for every emergency response employer in the country to be the “go-to” person when exposures occurred. The DICO was responsible for obtaining the disease status of the source patient no later than 48 hours after the exposure. Although the OSHA BBP Standard doesn’t contain these provisions, these are the obvious steps needed to reach the end result expected by OSHA.

Unfortunately, the standard is too ambiguous for some people. A municipal government employer in Kansas, for example, recently wanted proof that there was a legal requirement for them to have a DICO in light of the repeal of the emergency response provisions of the Ryan White law. This indicates that some managers need to see a law that states clearly what’s expected of them. The Ryan White law provided much more clarity than what we’re left with in the post-exposure provisions of the OSHA BBP Standard.

What If OSHA Doesn’t Apply?

Another problem with the OSHA BBP standard is that it doesn’t apply to state and local governmental employees in about half of the states. State and local governmental employees are covered by federal OSHA standards only in states with occupational safety and health plans that have been approved by federal OSHA. Federal OSHA has no jurisdiction over state and local government employees in the following states/territories—which don’t have OSHA-approved plans—Alabama, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Kansas. Louisiana, Maine, Massachusetts, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Texas, West Virginia, Wisconsin, Washington, D.C., and Guam.

http://www.jems.com/news_and_articles/articles/jems/3309/now_what.html

[VentMedic]

With the Ryan-White Notification Act gone, what recourse do we have if we have been exposed?

The the State, local, OSHA and hospital policies and mandates. You should check your company's P&P for exposure guidelines.

The Ryan White Act was not created for EMS. Many in EMS have no idea who Ryan White was or that this piece of legislation even existed until somebody said it was being eliminated.

It is a multi-billion dollar ACT to provide assistance for people living with HIV/AIDS. Back during the early 1990s when this ACT was initiated, HIV was still in its infancy in this country. Through education, we have taken much of the mystery out of exposure. We've come a long way since FFs were afraid to fight an arson fire that destroyed the home of the Ray brothers in 1986.

http://hab.hrsa.gov/about/

http://www.medadvocates.org/adapfund/drug_...n_main.html#new

Finanacial info in brief - full document in above link

http://www.hrsa.gov/about/budgetjustificat...yanWhiteHIV.htm

2005 Reauthorization which should take it through 2010. However, a Federally funded program this huge will be subject to the budget cuts of the government.

http://www.hhs.gov/news/press/2005pres/ryanwhite.html

For the diseases that are most are concerned with, the notification process must all also be reported to the Department of Public Health or some representative agency of the CDC. They will ask the reporting facility if all who had potential exposure were notified. However, the diseases where you should be protected by just standard precautions will not be a priority for them to notify you.

Example of Florida Statute:

http://www.leg.state.fl.us/statutes/index....%3ESection+1025

The 2008 Florida Statutes

Title XXIX

PUBLIC HEALTH Chapter 395

HOSPITAL LICENSING AND REGULATION View Entire Chapter

395.1025 Infectious diseases; notification.--Notwithstanding the provisions in s. 381.004, if, while treating or transporting an ill or injured patient to a licensed facility, an emergency medical technician, paramedic, or other person comes into direct contact with the patient who is subsequently diagnosed as having an infectious disease, it shall be the duty of the licensed facility receiving the patient to notify the emergency medical technician, paramedic, or his or her emergency medical transportation service employer, or other person of the individual's exposure to the patient within 48 hours, or sooner, of confirmation of the patient's diagnosis and to advise him or her of the appropriate treatment, if any. Notification made pursuant to this section shall be done in a manner which will protect the confidentiality of such patient information and shall not include any patient's name.

Edited June 5, 2009 by VentMedic

[ghurty]

Sorry, I should have said the "Notification clause" in the ryan-white act.

Does anyone know how OSHA or state laws effect a volunteer EMT in New Jersey?

Thanks

[VentMedic]

Does anyone know how OSHA or state laws effect a volunteer EMT in New Jersey?

New Jersey has an extensive communicable disease statute,

http://www.state.nj.us/health/cd/documents/njac857.pdf

http://www.state.nj.us/health/cd/techinfo.htm

New Jersey OSHA

http://www.state.nj.us/health/ohs/medical.shtml

Now, you need to check your own P&P manual. You can also ask about infection control policies at the hospitals in your area.

Some of this information should have been mentioned in EMT class.

[ghurty]

Thank you for in the leads. I sent an email to NJ state.

Now, you need to check your own P&P manual.

I am embarrassed to say this but we don't really have any manual. Our SOP's have not been updated in 10 years. I keep on pushing for updates, but the ones in charge just have the "if it aint broke dont fix it" attitude. And that if I think there should be changes, I should develop and rewrite them myself.

I wish I could have sample P&P's and SOP's to use.

Thanks

[VentMedic]

I am embarrassed to say this but we don't really have any manual. Our SOP's have not been updated in 10 years. I keep on pushing for updates, but the ones in charge just have the "if it aint broke dont fix it" attitude. And that if I think there should be changes, I should develop and rewrite them myself.

I wish I could have sample P&P's and SOP's to use.

Thanks

The policies pertaining to exposure reporting will not be in your patient protocol book but rather in your employee or volunteer handbook that outlines what is expected of you or the company. There are also administrative policies that may outline the procedures especially if you know you have been exposed like for a needle stick or body fluids in your eyes. The hospitals you transport will also have an extensive reporting P&P in their infection control manual. Hospitals also have infection control officers who know the regulations and do see they are followed through. Since the majority of infectious patients that you will be exposed to will be taken to the hospital, their infection control person would be your best bet to see how they determine when, who and how if the situation occurs.

Edited June 5, 2009 by VentMedic

[ghurty]

The policies pertaining to exposure reporting will not be in your patient protocol book but rather in your employee or volunteer handbook that outlines what is expected of you or the company. There are also administrative policies that may outline the procedures especially if you know you have been exposed like for a needle stick or body fluids in your eyes.

That is the problem, we do not have any of that at all. I would be writing/developing it from scratch.

The hospitals you transport will also have an extensive reporting P&P in their infection control manual. Hospitals also have infection control officers who know the regulations and do see they are followed through. Since the majority of infectious patients that you will be exposed to will be taken to the hospital, their infection control person would be your best bet to see how they determine when, who and how if the situation occurs.

I will have to contact the main hospitals we transport to and speak to them.

Thanks