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Health Care Availability and Access Committee
Filed: 3/4/2008
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09500HB4303ham001 |
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LRB095 16104 DRJ 47418 a |
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| AMENDMENT TO HOUSE BILL 4303
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| AMENDMENT NO. ______. Amend House Bill 4303 by replacing |
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| everything after the enacting clause with the following:
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| "Section 1. Short title. This Act may be cited as the MRSA |
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| Screening, Prevention, and Reporting Act for State Residential |
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| Facilities. |
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| Section 5. Definition. In this Act, "State residential |
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| facility" or "facility" means: any Department of Human Services |
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| operated residential facility, including any State mental |
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| health hospital, State developmental center, or State |
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| residential school for the deaf and visually impaired; any |
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| Department of Veterans' Affairs operated veterans home; any |
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| Department of Corrections operated correctional center, work |
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| camp or boot camp, or adult transition center; and any |
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| Department of Juvenile Justice operated juvenile center or boot |
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| camp.
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09500HB4303ham001 |
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LRB095 16104 DRJ 47418 a |
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| Section 10. MRSA control program. In order to improve the |
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| prevention of infections due to methicillin-resistant |
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| Staphylococcus aureus ("MRSA"), every State residential |
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| facility shall establish an MRSA control program that includes |
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| the following features: |
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| (1) Screening and surveillance. |
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| (A) All residents, patients, students, or inmates |
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| of the facility undergoing intake medical screening |
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| and physical examinations shall be carefully evaluated |
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| for skin infections. This screening shall include |
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| culturing of skin abscesses, boils, "spider bites", or |
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| other suspicious skin conditions. |
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| (B) Recently hospitalized residents, patients, |
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| students, or inmates of the facility shall be screened |
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| for infections immediately upon return to the facility |
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| and shall be instructed to report any new onset skin |
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| infection or fever.
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| (C) Residents, patients, students, or inmates of |
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| the facility with risk factors such as diabetes, |
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| immunocompromised conditions, open wounds, recent |
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| surgery, indwelling catheters, implantable devices, |
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| chronic skin conditions, or paraplegia with decubiti |
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| shall be evaluated for skin infections during routine |
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| medical evaluations. |
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| (D) All residents, patients, students, or inmates |
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09500HB4303ham001 |
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LRB095 16104 DRJ 47418 a |
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| of the facility with skin infections shall be referred |
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| to health services for evaluation. |
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| (E) Facility health care providers shall consider |
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| MRSA infection in the differential diagnosis for all |
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| residents, patients, students, or inmates presenting |
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| with a skin or soft tissue infection or any other |
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| clinical presentation consistent with a staphylococcal |
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| infection. |
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| (F) Appropriate bacterial cultures shall be |
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| obtained in all cases of suspected MRSA infection. |
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| (G) No resident, patient, student, or inmate of the |
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| facility with a skin or soft tissue infection shall be |
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| transferred to another facility until fully evaluated |
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| and appropriately treated except when required for |
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| reasons of appropriate security or care. Residents, |
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| patients, students, or inmates with MRSA infections |
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| requiring transfer shall have draining wounds dressed |
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| the day of transfer to contain the draining. Escort |
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| personnel shall be notified of the resident, patient, |
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| student, or inmate's condition and educated on |
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| infection control measures. The clinical director of |
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| the sending facility or his or her designee shall |
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| notify the receiving institution's clinical director |
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| or health services administrator of pending transfers |
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| of individuals with MRSA. |
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| (2) Reporting. |
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09500HB4303ham001 |
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LRB095 16104 DRJ 47418 a |
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| (A) All confirmed MRSA and other |
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| antibiotic-resistant infections shall be documented in |
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| the resident, patient, student, or inmate's medical |
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| record. |
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| (B) All confirmed MRSA and other |
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| antibiotic-resistant infections shall be reported to |
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| the director of the department operating the facility |
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| and to the Department of Public Health. The report |
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| shall indicate whether the MRSA infection was present |
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| on intake or contracted at the facility, if known. |
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| (3) Prevention. |
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| (A) Education. Employees, residents, patients, |
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| students, and inmates of the facility shall be provided |
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| with information on the transmission, prevention, |
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| treatment, and containment of MRSA infections. |
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| (B) Hand Hygiene program: Each facility shall |
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| develop and implement a hand hygiene program for |
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| employees, residents, patients, students, and inmates |
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| of the facility that includes adequate hand-washing |
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| equipment and supplies and regular training on |
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| effective hand hygiene techniques and education on the |
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| importance of hand hygiene. These trainings must be |
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| conducted at least once each year and may be conducted |
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| in conjunction with other trainings. |
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| (C) Sanitation. Each facility shall develop and |
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| implement a sanitation program for cleaning and |
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09500HB4303ham001 |
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LRB095 16104 DRJ 47418 a |
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| disinfecting the environment that includes the |
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| following: |
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| (i) Use of an Environmental Protection Agency |
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| (EPA)-registered disinfectant according to the |
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| manufacturer's instructions. |
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| (ii)
Regularly cleaning or disinfecting |
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| washable surfaces in residents', patients', and |
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| students' rooms, in inmates' cells, and in shared |
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| areas such as showers, fitness areas, and food |
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| services areas. |
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| (iii)
Cleaning or disinfecting restraining |
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| devices after every use. |
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| (iv)
Treating all linen (towels, sheets, and |
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| similar items) as potentially infectious and |
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| following recommendations of the Centers for |
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| Disease Control and Prevention for laundering. |
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| (D) Personal protective equipment. Employees of |
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| the facility shall be provided with personal |
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| protective equipment (gloves, eye protection, and |
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| gowns) for use when contact with blood, body fluids, or |
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| wound drainage is likely. |
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| (E) Isolation of residents, patients, students, or |
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| inmates with MRSA. Each State residential facility |
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| shall develop guidelines for isolating MRSA-diagnosed |
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| residents, patients, students, or inmates from others |
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| when a clinician determines the individual to be a high |
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LRB095 16104 DRJ 47418 a |
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| risk for spreading the contagion. Residents, patients, |
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| students, or inmates diagnosed with MRSA shall be |
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| examined by a clinician to determine their risk of |
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| contagion to others. The determination about whether |
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| to isolate residents, patients, students, or inmates |
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| with MRSA infections shall include consideration of |
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| the degree to which wound drainage can be contained and |
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| the ability or willingness of a resident, patient, |
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| student, or inmate to comply with infection control |
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| instructions. |
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| (4) Infection control.
Upon the diagnosis of a single |
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| MRSA case at a State residential facility, that facility |
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| shall implement surveillance measures to detect additional |
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| MRSA cases through the following procedures: |
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| (A) The individual diagnosed with MRSA shall be |
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| interviewed to identify potential sources of |
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| infections and close contacts. The interview should |
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| seek to determine the date of onset and activity |
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| immediately before and following onset, including |
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| recent hospitalizations, housing, work assignments, |
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| sharing of personal hygiene items, sexual contact, |
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| participation in close-contact sports, or exposure to |
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| other residents, patients, students, or inmates with |
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| draining wounds or skin infections. |
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| (B) An individual shall not be required to make a |
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| copayment for the testing or treatment of an MRSA |
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09500HB4303ham001 |
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LRB095 16104 DRJ 47418 a |
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| infection. |
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| (C) Employees, residents, patients, students, or |
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| inmates of the facility identified as having contact |
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| with the infected individual should be examined for |
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| signs and symptoms of infection. |
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| (D) State residential facility management shall |
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| inform all employees of the facility of the MRSA case. |
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| The notification must protect the identity of the |
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| infected individual. Management shall immediately |
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| conduct a training program on MRSA and hand hygiene, in |
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| addition to the training program required under |
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| subdivision (3)(B) of this Section, unless there has |
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| been a confirmed case of MRSA at the facility within |
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| the previous 6 months and a training was conducted at |
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| that time. |
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| (E) State residential facility management shall |
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| inform all health care providers evaluating residents |
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| or inmates of the facility of the MRSA case so they may |
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| be on the alert for inmates with skin or soft tissue |
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| infections or other evidence of MRSA infections. |
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| (F) No resident, patient, student, or inmate with a |
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| skin or soft tissue infection shall be transferred to |
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| another facility until fully evaluated and |
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| appropriately treated except when required for |
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| security reasons, medical care, or other special |
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| circumstances. Residents, patients, students, or |
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09500HB4303ham001 |
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LRB095 16104 DRJ 47418 a |
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| inmates with MRSA infections requiring transfer shall |
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| have draining wounds dressed the day of transfer to |
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| contain the draining. Escort personnel shall be |
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| notified of the resident, patient, student, or |
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| inmate's condition and educated on infection control |
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| measures. The clinical director of the sending |
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| facility or his or her designee shall notify the |
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| receiving institution's clinical director or health |
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| services administrator of pending transfers of |
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| individuals with MRSA. |
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| (5) Treatment.
The Department of Public Health shall |
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| develop an MRSA treatment protocol for each department |
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| operating a State residential facility. Upon issuance of |
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| the protocol by the Department of Public Health, each |
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| department operating a State residential facility shall |
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| educate all clinical staff at the facility and healthcare |
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| vendors for the facility on that protocol.
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| Section 99. Effective date. This Act takes effect upon |
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| becoming law.".
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