BILL REQ. #:  H-3866.2 

Prefiled 12/03/07. Read first time 01/14/08.   Referred to Committee on Health Care & Wellness.

     AN ACT Relating to multidrug resistant organisms; adding a new section to chapter 43.20 RCW; adding a new section to chapter 43.70 RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   The legislature finds that methicillin resistant staphylococcus aureus poses a serious threat to the health of the residents of Washington state. In addition to health care facilities, the infection has been recently identified in community settings such as schools and nursing homes. One recent study estimates that the invasive infection is responsible for over eighteen thousand deaths in the United States in 2005.
     The legislature intends to establish a system for monitoring invasive methicillin resistant staphylococcus aureus and taking measures to prevent its spread in health care settings and the community. The legislature expects the monitoring system to build upon existing reporting mechanisms established through the notifiable conditions system.

NEW SECTION.  Sec. 2   A new section is added to chapter 43.20 RCW to read as follows:
     (1) Every laboratory shall notify the local health jurisdiction of confirmed cases of invasive methicillin resistant staphylococcus aureus and shall cooperate with public health authorities in any investigation of cases or outbreaks.
     (2) Every health care provider who receives notification from a laboratory that a patient has a confirmed case of invasive methicillin resistant staphylococcus aureus shall notify the local health jurisdiction of any known risk factors associated with invasive methicillin resistant staphylococcus aureus as they pertain to the patient and which may assist the local health jurisdiction with the identification of the potential source of the infection. Every health care provider shall cooperate with public health authorities in any investigation of cases or outbreaks.
     (3) Every local health jurisdiction shall:
     (a) Conduct any necessary investigations or other public health interventions for reported cases of invasive methicillin resistant staphylococcus aureus as required by the circumstances; and
     (b) Notify the department of confirmed cases of invasive methicillin resistant staphylococcus aureus as reported and a summary of any responses by the local health jurisdiction.
     (4) The state board shall adopt rules to implement this section, including standards for clinical identification of invasive methicillin resistant staphylococcus aureus by laboratories, requirements for the timing and means of notifications, the contents of notifications, and the responsibilities of local health jurisdictions. The state board shall consider incorporating the notification requirements of this section into existing reporting requirements to minimize the burden on reporting entities.
     (5) The department shall provide regular summaries of the notifications that it receives by geographic location, the frequency of the cases in different types of facilities, and the risk factors associated with the patients affected.
     (6) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
     (a) "Case of invasive methicillin resistant staphylococcus aureus" means an instance of methicillin resistant staphylococcus aureus that has been located in a culture that is derived from a normally sterile body site. A normally sterile body site includes, but is not limited to, blood, cerebrospinal fluid, pleural fluid, pericardial fluid, peritoneal fluid, joint/synovial fluid, bone, or internal body site. The state board may establish standards for including sinus-related methicillin resistant staphylococcus aureus and necrotizing methicillin resistant staphylococcus aureus as cases of invasive methicillin resistant staphylococcus aureus.
     (b) "Health care provider" means any person having direct or supervisory responsibility for the delivery of health care who is licensed or certified by a disciplining authority identified in RCW 18.130.040(2).     
     (c) "Laboratory" means any facility licensed as a medical test site under chapter 70.42 RCW.
     (d) "Local health jurisdiction" means a city, county, city-county, or district public health jurisdiction as defined in chapter 70.05, 70.08, or 70.46 RCW.

NEW SECTION.  Sec. 3   A new section is added to chapter 43.70 RCW to read as follows:
     (1) The department shall provide assistance to local health jurisdictions with the establishment of a strategy to support efforts to prevent the spread of multidrug resistant organisms.
     (2) Each local health jurisdiction shall establish a multidrug resistant organism control strategy, based upon epidemiologic data, which must include:
     (a) An infection control and prevention plan that provides guidelines and education strategies for controlling multidrug resistant infections for health care providers, health care facilities, community institutions, and patients;
     (b) An antibiotic utilization plan that establishes recommendations for health care providers, health care facilities, and patients for the identification and management of skin and soft tissue infections and the appropriate use of antibiotics; and
     (c) An agricultural education plan that addresses the use of antibiotics and veterinary infection control practices to the extent applicable within the local health jurisdiction.
     (3) The multidrug resistant organism control strategy must be developed in coordination with local health care providers, health care facilities, community institutions, and public representatives. The multidrug resistant organism control strategy must be submitted to the department by July 1, 2009, and made publicly available within the local health jurisdiction.