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Legislative Update

 

State Needle Safety Legislation

States that have passed needle safety legislation (21):

California: California was the first state to pass needle safety legislation-- AB 1208, signed into law in September 1998. The law mandated that the state's bloodborne pathogens standard--California has its own state OSHA plan--be revised to require the use of safety devices. The revised standard went into effect July 1, 1999. For a detailed discussion of California's legislation, see AEP vol. 4, no. 1 ("California Leads the Way with Health Care Worker Safety Law") and vol. 4, no. 2 ("California's Transition to Safety Devices").


Alaska: Alaska's bill, SB 261, was signed by the governor on June 1, 2000. Alaska has a state OSHA plan, and the bill requires the department of labor to revise the state's bloodborne pathogens standard to mandate that needleless systems and sharps with engineered sharps injury protection (ESIP) be included as engineering and work practice controls. The bill allows an exception for patient safety. The bill also requires that "a written exposure control plan include an effective procedure for identifying and selecting existing needleless systems and sharps with ESIP," and that the plan "be updated when necessary to reflect progress in implementing needleless systems and sharps with ESIP." It also requires that a sharps injury log be kept with detailed information on exposure incidents. The bill takes effect January 1, 2001.

Arkansas: Arkansas's bill, HB 1356, was signed by the governor on 2/27/01. Essentially it speeds up the process of implementing safer devices that is required by federal OSHA's revised Bloodborne Pathogens standard. Noting that "considerable time" will elapse before the revised standard is fully implemented, it declares a public emergency, and requires that hospitals begin "purchasing needleless systems or sharps with engineered sharps injury protections or both for use in high risk areas with the goal of ensuring that within 18 months after the effective date of this act [that is June 1, 2001] all high risk areas shall be supplied exclusively" with safer devices. "High risk areas" are defined as emergency departments, operating rooms, and intensive care units in acute care hospitals. In declaring an emergency, the bill states that it is "necessary for the preservation of the public peace, health and safety."

Connecticut: Connecticut's bill, HB 5911, was signed by the governor on June 1, 2000. This is an expenditure bill for the Department of Public Health, which includes a passage (Section 6) on needlestick prevention. The bill states that "Each health care facility or institution licensed by the Department of Public Health… if advised by the federal Occupational Safety and Health Administration, and each health care facility or institution that employs state employees, shall use only injectable equipment having self-contained secondary precautionary type sheathing devices or alternate devices designed to prevent accidental needlestick injuries." The term "injectable equipment" is not further defined and is potentially problematic; however, by referring to "alternate devices designed to prevent" needlesticks, the bill seems to be including all categories of sharp needle devices. The bill allows an exception for prefilled syringes.

Georgia: Georgia's bill, HB 1448, signed into law on April 20, 2000, requires the Department of Human Resouces to adopt a bloodborne pathogens standard to cover public employees that is "at least as prescriptive" as that of federal OSHA. The standard must include a requirement that "the most effective available needleless systems and sharps with engineered sharps injury protection be included as engineering and work practice controls in all facilities employing public employees." Exceptions are included for lack of market availability and risk to patient safety. The bill also includes requirements regarding written exposure control plans, sharps injury logs, training of health care workers on safety devices, establishment of device evaluation committees, and maintenance of a list of safety devices.

Iowa: Iowa's bill, SB 2302, signd into law on April 25, 2000, requires the state department of public health, in cooperation with the labor commission, to "conduct a study of state and federal laws and regulations relating to protection of persons who may at risk of needlestick injuries in the course of employment... The department shall submit a report to the governor and general assembly by December 15, 2000, which shall include any recommendations for changes in state laws or rules... to improve protective measures relating to needlestick injuries."

Maine: Maine's bill, HB 1532, was signed into law on April 14, 2000. The original version, requiring the implementation of safety devices, was rejected and a two-part resolution was passed instead. The first part requires the state department of labor to adopt federal OSHA's revised compliance directive for the bloodborne pathogens standard as a state rule governing public sector workplaces. (Maine has a federal OSHA plan, and federal OSHA does not cover public sector employees.) The second part requires the department of labor and the department of human services to conduct a survey of public and private health care providers to determine whether they are using safe needle devices, and how they plan to comply with federal OSHA's revised compliance directive. The results of the survey must be submitted to the legislature by 2/1/01; a committee will then determine whether further legislative action is needed. The bill was given "emergency" status, which means its provisions are effective immediately. Asked about the scope and force of "resolutions," Maine state legislative aide Deborah Friedman replied, "Resolves have the same force as a law, but are not codified in the statute books."

Maryland: Maryland passed two bills related to needle safety, HB 287 and HB 360. The first one, HB 287, signed into law in May 1999, called for a study group to make recommendations for needlestick injury prevention by the end of 1999. The group's resulting report called for a revision of the state's bloodborne pathogens standard to require the use of safer needles (Maryland has a state OSHA plan). HB 360, introduced in February 2000, was originally written to mandate this change; however, the version that was enacted on 5/11/00 required, instead, that federal OSHA's revised compliance directive for the bloodborne pathogens standard be adopted as state regulation. Update: as of July 2001, Maryland has decided to adopt, by reference, federal OSHA's revised bloodborne pathogens standard (29 CFR 1910.1030). The revised regulation will be effective in Maryland by October 2001.

Massachusetts: Massachusetts' bill, HB 5394, was signed by the governor on August 17, 2000. The bill was filed by the Massachusetts Nurses Association, whose president, Karen Daley, was occupationally infected with HIV and HCV from a needlestick. She provided dramatic testimony in a public hearing that helped the bill move more quickly through the legislative process.

The bill requires "the use, at all acute and non-acute hospitals, of only such devices which minimize the risk of injury to health care workers from needlesticks and sharps," and states that "sharps injury prevention technology shall be included as engineering or work practice controls." The bill also mandates that "written exposure control plans be developed … that include an effective procedure for identifying and selecting existing sharps prevention technology" and that the plans "be updated when necessary to reflect progress in sharps prevention technology." Sharps injury logs must be kept by each facility, including information on the type and brand of device involved in an exposure incident, and data from the logs must be reported annually to the state's department of public health. The bill establishes an advisory committee which, among other tasks, will develop a list of devices with engineered sharps injury protection. The bill includes an exception for "circumstances in which the technology does not promote employee or patient safety or interferes with a medical procedure."

Minnesota: Minnesota's bill, SB 1202, signed into law on April 10, 2000, calls for written exposure control plans to be reviewed at least annually and whenever necessary to reflect "changes in technology that eliminate or reduce exposure to bloodborne pathogens." The exposure control plan must "document consideration and implementation of appropriate commercially available and effective engineering controls, for example needleless systems and sharps with engineered sharps injury protection, designed to eliminate or minimize exposure." Employers must "establish procedures to document the route of exposures and the circumstances under which an exposure incident occurred." The bill includes a 3-year compliance period for manufacturers of prefilled syringes.

Missouri: Missouri's bill, SB 266, signed into law on July 12, 2001, covers state and municipal health care facilities, which are not subject to federal OSHA standards. The law requires that the Department of Health adopt a bloodborne pathogens standard, equivalent to federal OSHA's revised bloodborne pathogens standard, for "ocupational exposures of public employees to blood or infectious materials." It says that "a requirement must be included that the most effective needleless systems be used except in certain circumstances." State facilities must maintain sharps injury logs, and the Department of Health "must maintain a list of needleless systems and sharps with engineered sharps injury protection," and "report annually on needle safety." The bill states that any public employer violating these provisions "will be subject to a reduction or loss of state funding." The bill is effective August 28, 2001.

New Hampshire: New Hampshire's bill, HB 1244, signed by the governor on May 26, 2000, requires the commissioner of labor, in conjunction with the commissioner of health and human services, to adopt rules to protect health care workers in the public sector from occupational exposure to blood. The law also requires that a 10-member advisory council be established to advise the commissioners on the rules. The act is effective January 1, 2001.

New Jersey: New Jersey's bill, A 3546, signed into law on January 4, 2000, requires that within 12 months, health care facilities use "only needles and other sharp devices with integrated safety features . . . cleared and approved . . . by the Food and Drug Admininstration and . . . commercially available for distribution." The law allows 36 months for manufacturers of prefilled syringes to comply; it also provides for a waiver procedure allowing health care workers to use conventional (non-safety) devices if it can be shown that using a safety device would have a "negative impact" on patient safety or "the success of a specific medical procedure." This law appears to be the strongest state needlestick prevention legislation passed to date.

New York: New York’s bill, A. 7144, the "New York State Sharps Safety Act," was signed by the governor on November 1, 2000. The following is the bill summary from New York’s legislative website: "Adds new article 13-G to the public health law requiring use of safer sharps and needles by health care facilities and in all health care settings and establishing an advisory committee to report to the Governor and Legislature on the development of safer medical sharps and needles." The bill requires that the Commissioner of Health make regulations governing the use of sharps in health care facilities, and states that "Regulations under this article shall prohibit the use of sharps that do not incorporate engineered sharps injury protection." The bill provides exceptions to using safety devices for lack of market availability, risk to patient safety or effectiveness of a medical procedure, and lack of evidence showing that a safety device is more effective than a conventional device. The act is effectively immediately. The Commissioner of Health has one year to develop the regulations, which will take effect six months after they are made.

Ohio: Ohio's bill, SB 183, was signed by the governor on July 6, 2000. The bill requires state and other public health care facilities to "include, as part of the employer's engineering and work practice controls, needleless systems, sharps … with engineered sharps injury protection, and other devices that comply with [OSHA's] bloodborne pathogens standard." The bill also mandates that public employers develop and implement a written exposure control plan that is updated at least once a year to reflect progress in implementing safer devices, and requires employers to provide training in the use of safer devices. It also directs that a state committee be established to study "methods by which public health care workers can be protected from exposure incidents" and to create a list of sharp devices with engineered sharps injury protection. It requires that the Public Employment Risk Reduction Advisory Commission adopt a rule and a standard for the prevention of exposure incidents within six months. The bill provides exceptions to adoption of safer devices for market availability and patient safety, and allows five years for manufacturers of prefilled syringes to comply.

Oklahoma: Oklahoma's bill, HB 2139, was signed by the governor on June 5, 2000. The bill requires that a needlestick injury prevention committee, appointed by the state, submit proposed rules for preventing needlestick injuries and implementing devices with engineered sharps injury protection; these rules must contain a requirement that "sharps prevention technology be included as engineering or work practice controls in high exposure areas." However, the bill states that the proposed permanent rules don't have to be submitted until March 2004-almost four years from now-although it also says that "emergency rules" have to be in place by that date. Further weakening the bill is a clause stating that if the needlestick prevention committee "determines that there is a sufficient use of sharps prevention technology in the state, prior to the promulgation of rules… the Committee shall recommend… that the proposed rules not be promulgated." It is unclear how "sufficent use" will be determined. Given the long lead time and qualifying language in this bill, it appears that it will have little or no immediate impact on the safety of frontline health care workers.

Pennsylvania: Pennsylvania's bill, HB 454, was signed by the governor on December 13, 2001. The bill requires the state department of health to establish a bloodborne pathogens standard to cover public employees, with the same requirements as those for employees in the private sector. "Public employee" is defined as "an employee of the Commonwealth or a political subdivision employed in a health care facility, home health care organization or other facility providing health care-related services." The standard "shall be at least as prescriptive as the standard promulgated by the Federal Occupational Safety and Health Administration" and has to include "a requirement that needleless systems and sharps with engineered sharps injury protection be included as engineering and work practice controls." It also must require that the department of health maintain a list of available safety devices and that "each public employee receive education on the use of an engineering control before a control is introduced into the clinical setting." The bill is effective April 13, 2002; the standard must be promulgated within six months of the effective date of the bill. Includes three-year exemption for prefilled syringes.

Rhode Island: Rhode Island passed two laws, H. 5906 and H. 6311, both titled "Needlestick Safety and Injury Prevention Act"; they became law on 7/13/01. The language in both bills is largely identical to that of federal OSHA's revised Bloodborne Pathogens Standard. Queries about the reason for two bills, sent to their respective sponsors (Rep. Elizabeth Dennigan, Rep. Donald Reilly), went unanswered. Rhode Island, like Missouri, is under federal OSHA, so the purpose of the bills is most likely to extend the Bloodborne Pathogen Standard's coverage to state and local employees.

Tennessee: Tennessee's bill, SB 1023, signed into law in March 1999, covers the public and private sectors; it calls for the state health and labor commissioners to review sharps injury prevention technology and determine those work settings "where standards require" that safety devices be implemented. It provides that safety devices will not be required where the employer can demonstrate that such technology is "medically contraindicated" or is "no more effective than alternative measures used by an employer to prevent exposure incidents." The bill also requires that written exposure control plans be revised to reflect improvements in sharps prevention technology. In January 2000, as a follow-up to SB 1023, the Tennessee Department of Labor issued a Notice of Proposed Rulemaking that addresses the issue of when sharps injury prevention technology must be used.

Texas: Texas' bill, HB 2085, signed into law in June 1999, covers state or government-run health care facilities, which are not subject to federal OSHA standards. The law amends the Texas Health and Safety Code to "recommend that governmental units [state agencies] implement needleless systems and sharps with engineered sharps injury protection" to protect employees at risk of bloodborne pathogen exposure. It also mandates that state agencies maintain sharps injury logs, with information on the date and time of the exposure incident, the type and brand of device involved, and a description of the incident. The bill states that this data is to be collected by the state and made available in aggregate form. The bill also requires that the state health department maintain a list of safety-engineered sharp devices and needleless systems. The bill was effective September 1, 1999.

West Virginia: West Virginia's bill, HB 4298, signed into law on April 3, 2000, states that health care facilities "must, as a part of [their] procedures for injury prevention, ensure the provision of services to individuals through the use of "hollow-bore needle devices or other technology known to minimize the risk of needlestick injury to health care workers," and says further that "sharp injury prevention technology must be included as engineering or work practice controls." It allows for exceptions, including patient safety, interference with a medical procedure, and evidence that the technology is not more effective than alternative measures. It also allows three years for manufacturers of prefilled syringes to comply. The bill creates a state Needlestick Injury Prevention Advisory Committee; requires the director of the state division of health to propose rules for minimizing needlestick and sharp injury risk; requires the director to prepare a list of devices with engineered sharps injury protection; and requires health care facilities to keep a sharps injury log, and report the data annually to the director of health.

Last Updated 12/18/02.