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1 | AN ACT concerning health.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 1. Short title. This Act may be cited as the MRSA | ||||||
5 | Screening, Prevention, and Reporting Act for State Residential | ||||||
6 | Facilities. | ||||||
7 | Section 5. Definition. In this Act, "State residential | ||||||
8 | facility" or "facility" means: any Department of Human Services | ||||||
9 | operated residential facility, including any State mental | ||||||
10 | health hospital, State developmental center, or State | ||||||
11 | residential school for the deaf and visually impaired; any | ||||||
12 | Department of Veterans' Affairs operated veterans home; any | ||||||
13 | Department of Corrections operated correctional center, work | ||||||
14 | camp or boot camp, or adult transition center; and any | ||||||
15 | Department of Juvenile Justice operated juvenile center or boot | ||||||
16 | camp.
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17 | Section 10. MRSA control procedures. In order to improve | ||||||
18 | the prevention of infections due to methicillin-resistant | ||||||
19 | Staphylococcus aureus ("MRSA"), every State residential | ||||||
20 | facility shall establish MRSA control procedures that include | ||||||
21 | the following features: | ||||||
22 | (1) Screening and surveillance. |
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1 | (A) All residents, patients, students, or inmates | ||||||
2 | of the facility undergoing intake medical screening | ||||||
3 | and physical examinations shall be carefully evaluated | ||||||
4 | for skin infections through a visual inspection. This | ||||||
5 | screening shall include culturing of skin abscesses, | ||||||
6 | boils, "spider bites", or other suspicious skin | ||||||
7 | conditions when revealed by the visual inspection. | ||||||
8 | (B) Recently hospitalized residents, patients, | ||||||
9 | students, or inmates of the facility shall be screened | ||||||
10 | for infections immediately upon return to the facility | ||||||
11 | and shall be instructed to report any new onset skin | ||||||
12 | infection or fever.
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13 | (C) Residents, patients, students, or inmates of | ||||||
14 | the facility with risk factors such as diabetes, | ||||||
15 | immunocompromised conditions, open wounds, recent | ||||||
16 | surgery, indwelling catheters, implantable devices, | ||||||
17 | chronic skin conditions, or paraplegia with decubiti | ||||||
18 | shall be evaluated for skin infections during routine | ||||||
19 | medical evaluations. | ||||||
20 | (D) All residents, patients, students, or inmates | ||||||
21 | of the facility with skin infections shall be referred | ||||||
22 | to health services for evaluation. | ||||||
23 | (E) Facility health care providers shall consider | ||||||
24 | MRSA infection in the differential diagnosis for all | ||||||
25 | residents, patients, students, or inmates presenting | ||||||
26 | with a skin or soft tissue infection or any other |
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1 | clinical presentation consistent with a staphylococcal | ||||||
2 | infection. | ||||||
3 | (F) Appropriate bacterial cultures shall be | ||||||
4 | obtained in all cases of suspected MRSA infection. | ||||||
5 | (G) No resident, patient, student, or inmate of the | ||||||
6 | facility with a skin or soft tissue infection shall be | ||||||
7 | transferred to another facility until fully evaluated | ||||||
8 | and appropriately treated as described in this | ||||||
9 | subparagraph (G), except when required for reasons of | ||||||
10 | appropriate security or care. Residents, patients, | ||||||
11 | students, or inmates with MRSA infections requiring | ||||||
12 | transfer shall have draining wounds dressed the day of | ||||||
13 | transfer to contain the draining. Escort personnel | ||||||
14 | shall be notified of the resident, patient, student, or | ||||||
15 | inmate's condition and educated on infection control | ||||||
16 | measures. The clinical director of the sending | ||||||
17 | facility or his or her designee shall notify the | ||||||
18 | receiving institution's clinical director or health | ||||||
19 | services administrator of pending transfers of | ||||||
20 | individuals with MRSA. This subparagraph (G) does not | ||||||
21 | apply to discharges and is not intended to limit an | ||||||
22 | individual's right to leave an institutional setting. | ||||||
23 | (2) Reporting. | ||||||
24 | (A) All confirmed MRSA and other | ||||||
25 | antibiotic-resistant infections shall be documented in | ||||||
26 | the resident, patient, student, or inmate's medical |
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1 | record. | ||||||
2 | (B) All confirmed MRSA and other | ||||||
3 | antibiotic-resistant infections shall be reported to | ||||||
4 | the director of the department operating the facility | ||||||
5 | and to the Department of Public Health. The report | ||||||
6 | shall indicate whether the MRSA infection was present | ||||||
7 | on intake or contracted at the facility, if known. | ||||||
8 | (3) Prevention. | ||||||
9 | (A) Education. Employees, residents, patients, | ||||||
10 | students, and inmates of the facility shall be provided | ||||||
11 | with information on the transmission, prevention, | ||||||
12 | treatment, and containment of MRSA infections. | ||||||
13 | (B) Hand Hygiene procedures: Each facility shall | ||||||
14 | develop and implement hand hygiene procedures for | ||||||
15 | employees, residents, patients, students, and inmates | ||||||
16 | of the facility that includes adequate hand-washing | ||||||
17 | equipment and supplies and regular training on | ||||||
18 | effective hand hygiene techniques and education on the | ||||||
19 | importance of hand hygiene. These trainings must be | ||||||
20 | conducted at least once each year and may be conducted | ||||||
21 | in conjunction with other trainings. | ||||||
22 | (C) Sanitation. Each facility shall develop and | ||||||
23 | implement sanitation procedures for cleaning and | ||||||
24 | disinfecting the environment that includes the | ||||||
25 | following: | ||||||
26 | (i) Use of an Environmental Protection Agency |
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1 | (EPA)-registered disinfectant according to the | ||||||
2 | manufacturer's instructions. | ||||||
3 | (ii)
Regularly cleaning or disinfecting | ||||||
4 | washable surfaces in residents', patients', and | ||||||
5 | students' rooms, in inmates' cells, and in shared | ||||||
6 | areas such as showers, fitness areas, and food | ||||||
7 | services areas. | ||||||
8 | (iii)
Cleaning or disinfecting restraining | ||||||
9 | devices after every use. | ||||||
10 | (iv)
Treating all linen (towels, sheets, and | ||||||
11 | similar items) as potentially infectious and | ||||||
12 | following recommendations of the Centers for | ||||||
13 | Disease Control and Prevention for laundering. | ||||||
14 | (D) Personal protective equipment. Employees of | ||||||
15 | the facility shall be provided with personal | ||||||
16 | protective equipment (gloves, eye protection, and | ||||||
17 | gowns) for use when contact with blood, body fluids, or | ||||||
18 | wound drainage is likely. | ||||||
19 | (E) Isolation of residents, patients, students, or | ||||||
20 | inmates with MRSA. Each State residential facility | ||||||
21 | shall develop guidelines for isolating MRSA-diagnosed | ||||||
22 | residents, patients, students, or inmates from others | ||||||
23 | when a clinician determines the individual to be a high | ||||||
24 | risk for spreading the contagion. Residents, patients, | ||||||
25 | students, or inmates diagnosed with MRSA shall be | ||||||
26 | examined by a clinician to determine their risk of |
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1 | contagion to others. The determination about whether | ||||||
2 | to isolate residents, patients, students, or inmates | ||||||
3 | with MRSA infections shall include consideration of | ||||||
4 | the degree to which wound drainage can be contained and | ||||||
5 | the ability or willingness of a resident, patient, | ||||||
6 | student, or inmate to comply with infection control | ||||||
7 | instructions. | ||||||
8 | (4) Infection control.
Upon the diagnosis of a single | ||||||
9 | MRSA case at a State residential facility, that facility | ||||||
10 | shall implement surveillance measures to detect additional | ||||||
11 | MRSA cases through the following procedures: | ||||||
12 | (A) The individual diagnosed with MRSA shall be | ||||||
13 | interviewed to identify potential sources of | ||||||
14 | infections and close contacts. The interview should | ||||||
15 | seek to determine the date of onset and activity | ||||||
16 | immediately before and following onset, including | ||||||
17 | recent hospitalizations, housing, work assignments, | ||||||
18 | sharing of personal hygiene items, sexual contact, | ||||||
19 | participation in close-contact sports, or exposure to | ||||||
20 | other residents, patients, students, or inmates with | ||||||
21 | draining wounds or skin infections. | ||||||
22 | (B) An individual shall not be required to make a | ||||||
23 | copayment for the testing or treatment of a MRSA | ||||||
24 | infection. | ||||||
25 | (C) Employees, residents, patients, students, or | ||||||
26 | inmates of the facility identified as having contact |
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1 | with the infected individual should be examined for | ||||||
2 | signs and symptoms of infection. | ||||||
3 | (D) State residential facility management shall | ||||||
4 | inform all employees of the facility that an occurrence | ||||||
5 | of MRSA infection has been identified. The | ||||||
6 | notification must protect the identity and | ||||||
7 | confidential information of the infected individual. | ||||||
8 | Management shall immediately conduct training on MRSA | ||||||
9 | and hand hygiene, in addition to the training required | ||||||
10 | under subdivision (3)(B) of this Section, unless there | ||||||
11 | has been a confirmed case of MRSA at the facility | ||||||
12 | within the previous 6 months and a training was | ||||||
13 | conducted at that time. | ||||||
14 | (E) State residential facility management shall | ||||||
15 | inform all health care providers evaluating residents | ||||||
16 | or inmates of the facility of the MRSA infection | ||||||
17 | occurrence so they may be on the alert for inmates with | ||||||
18 | skin or soft tissue infections or other evidence of | ||||||
19 | MRSA infections. | ||||||
20 | (F) No resident, patient, student, or inmate with a | ||||||
21 | skin or soft tissue infection shall be transferred to | ||||||
22 | another facility until fully evaluated and | ||||||
23 | appropriately treated as described in this | ||||||
24 | subparagraph (F), except when required for security | ||||||
25 | reasons, medical care, or other special circumstances. | ||||||
26 | Residents, patients, students, or inmates with MRSA |
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1 | infections requiring transfer shall have draining | ||||||
2 | wounds dressed the day of transfer to contain the | ||||||
3 | draining. Escort personnel shall be notified of the | ||||||
4 | resident, patient, student, or inmate's condition and | ||||||
5 | educated on infection control measures. The clinical | ||||||
6 | director of the sending facility or his or her designee | ||||||
7 | shall notify the receiving institution's clinical | ||||||
8 | director or health services administrator of pending | ||||||
9 | transfers of individuals with MRSA. This subparagraph | ||||||
10 | (F) does not apply to discharges and is not intended to | ||||||
11 | limit the individual's right to leave an institutional | ||||||
12 | setting. | ||||||
13 | (5) Treatment.
The Department of Public Health shall | ||||||
14 | develop a MRSA treatment protocol for each department | ||||||
15 | operating a State residential facility. Upon issuance of | ||||||
16 | the protocol by the Department of Public Health, each | ||||||
17 | department operating a State residential facility shall | ||||||
18 | educate all clinical staff at the facility and healthcare | ||||||
19 | vendors for the facility on that protocol.
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20 | Section 15. No authority to make or promulgate rules. | ||||||
21 | Notwithstanding any other rulemaking authority that may exist, | ||||||
22 | neither the Governor nor any agency or agency head under the | ||||||
23 | jurisdiction of the Governor has any authority to make or | ||||||
24 | promulgate rules to implement or enforce the provisions of this | ||||||
25 | Act. If, however, the Governor believes that rules are |
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1 | necessary to implement or enforce the provisions of this Act, | ||||||
2 | the Governor may suggest rules to the General Assembly by | ||||||
3 | filing them with the Clerk of the House and Secretary of the | ||||||
4 | Senate and by requesting that the General Assembly authorize | ||||||
5 | such rulemaking by law, enact those suggested rules into law, | ||||||
6 | or take any other appropriate action in the General Assembly's | ||||||
7 | discretion. Nothing contained in this Act shall be interpreted | ||||||
8 | to grant rulemaking authority under any other Illinois statute | ||||||
9 | where such authority is not otherwise explicitly given. For the | ||||||
10 | purposes of this Act, "rules" is given the meaning contained in | ||||||
11 | Section 1-70 of the Illinois Administrative Procedure Act, and | ||||||
12 | "agency" and "agency head" are given the meanings contained in | ||||||
13 | Sections 1-20 and 1-25 of the Illinois Administrative Procedure | ||||||
14 | Act to the extent that such definitions apply to agencies or | ||||||
15 | agency heads under the jurisdiction of the Governor.
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16 | Section 99. Effective date. This Act takes effect upon | ||||||
17 | becoming law.
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