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SMEMSIC News

Ryan White Act

24-Oct-09 21:52 | Bob Cesario
During the reauthorization of the Ryan White Care Act in 2006, the
emergency-response provisions that mandates that source patient test
results be provided to the designated infection control officer (DICO)
of the emergency response employee involved in an exposure incident were
removed. State hospital associations were quick in advising their
constituents that providing such information to emergency responders
could represent a violation of HIPAA.  Since that time, many “first
responder” organizations (including NASEMSO through Advocates for EMS)
have been working with Congressional staff to have these provisions
reinstated, including revised language to include provisions for other
infectious diseases such as tuberculosis, hepatitis C, pandemic
influenza, and clarifying language on rapid testing…

Well, that has finally occurred —  please see the following summary
for your information.  I have also attached a copy of the act.

Ryan White Act

The Ryan White HIV/AIDS Treatment and Extension Act of 2009 passed the
House yesterday by a vote of 408 to 9.  The Senate passed the bill
earlier this week so the bill now goes to President Obama for his
signature into law. There are several new additions to the Ryan White
Act which affect emergency care - and specifically emergency responders.


It is important to note that the ‘list’ established under Sec. 2695
is very powerful - it essentially determines what infectious diseases
should be considered ‘potentially life-threatening’. The list is
also used to determine whether or not emergency responders must be
notified of an exposure.  

The entire bill can be found at this link http://bit.ly/2YZs1o

Here are the sections affecting emergency care and emergency
responders:

The bill adds a new section to Ryan White - “Part G Notification of
Possible Exposure to Infectious Diseases”

Within 180 days after enactment, Section 2695 Requires the Secretary of
HHS to complete the development of:

1.  a list of potentially life-threatening infectious diseases,
including emerging infectious diseases, to which emergency response
employees may be exposed in responding to emergencies (The list
developed shall also include a specification of those infectious
diseases on the list that are routinely transmitted through airborne or
aerosolized means.)
2.  guidelines describing the circumstances in which such employees may
be exposed to such diseases, taking into account the conditions under
which emergency response is provided;
3.  guidelines describing the manner in which medical facilities should
make determinations when an emergency responder is requesting a
determination as to whether or not a patient he/she transported had an
infectious disease

This list will then be distributed to the public and the states

NOTE: This list is very important because it is relied heavily upon in
determining whether or not a responder has been exposed to an infectious
disease.

The bill also reestablishes some of the notification provisions that
were struck during the last Ryan White authorization. This is good news
for emergency responders. Specifically, the bill requires Prompt
notification - not later than 48 hours after determination is made - to
emergency responders when:

A patient is transported and it is determined that the patient has an
airborne infectious disease AND WHEN
A patient that is transported by emergency responders dies at or before
reaching the medical facility, the medical facility ascertaining the
cause of death shall notify the designated officer of the emergency
response employees who transported the victim to the initial medical
facility of any determination by the medical facility that the victim
had an airborne infectious disease.

The bill also contains a provision for emergency responders to request
a determination as to whether or not a patient had an infectious
disease. Basically the provision states that:

1.  The employee must first make a request
2.  The request is then examined, facts are collected by a designated
officer
3.  The designated officer then makes a determination - if the
designated officer feels that an exposure may have occurred then he/she
submits a request to the medical facility
4.  Once the medical facility receives the request, it has 48 hours to
respond
5.  The medical facility will make a determination, based on the
information possessed by the facility, regarding whether or not the
emergency responder was exposed to an infectious disease that appears on
the list (created above).
6.  The medical facility can make 3 determinations, Notification of
Exposure, Finding of No Exposure, Insufficient information
7.  If a finding of insufficient information is made, the public health
officer for the community in which the medical facility is located can
also evaluate the request if the designated officer submits the request
to him/her.
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Comments

  • 30-Nov-09 09:35 | Bob Cesario
    Just in case you may have missed it, the Ryan White Act was reauthorized in October. President Obama signed the law on October 30, 2009 to reinstate this very important law for emergency responders. The following is a summary of what occurred and was posted in the November edition of NAEMSO, Washington Update:

    During the reauthorization of the Ryan White Care Act in 2006, the emergency-response provision that mandates that source patient test results be provided to the designated infection control officer (DICO) of the emergency response employee involved in an exposure incident were removed. State hospital associations were quick in advising their constituents that providing such information to emergency responders could represent a violation of HIPAA. Since that time, many “first responder” organizations (including NASEMSO through Advocates for EMS) have been working with Congressional staff to have these provisions reinstated, including revised language to include provisions for other infectious diseases such as tuberculosis, hepatitis C, pandemic influenza, and clarifying language on rapid testing. There are several new additions to the Ryan White Act that affect emergency care – and specifically emergency responders. Please note the list established under Section 2695 essentially determines what infectious diseases should be considered "potentially life-threatening." The list also is used to determine whether or not emergency responders must be notified of an exposure.
    • The text of the bill can be found here.
    http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:s1793enr.txt.pdf
    • Download a Summary of the Ryan White HIV/AIDS Treatment and Extension Act of 2009 here.
    http://www.nasemso.org/documents/RyanWhiteSummaryOct2009.pdf
    S. 1793 was signed into law (Public Law No: 111-87) by President Obama on October 30, 2009.
    Link  •  Reply
 

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