Iowa Administrative Code › Agency 641 - Public Health Department › Chapter 11 - Human Immunodeficiency Virus (HIV) Infection and Acquired Immune Deficiency Syndrome (AIDS) › Rule 641-11.23 - Exposures in Non-clinical Settings

Current through Register Vol. 47, No. 3, July 24, 2024
(1) If a care provider sustains a significant
			 exposure from a patient while rendering health care or other services, other
			 than home-health or respite care services, outside of a health care facility or
			 hospital, the care provider shall file a significant exposure report as soon as
			 reasonably possible following the exposure. When the exposure occurred outside
			 a clinical setting, a care provider who has sustained a significant exposure
			 should file this report with the infection control, occupational health, or
			 other designated office of the facility to which the patient was
			 transported.
(2) The source patient
			 to whom the care provider was exposed is deemed to consent to a test to
			 determine if the patient has a contagious or infectious disease and is deemed
			 to consent to notification of the care provider or the designated
			 representative of the results of the test, upon submission of a significant
			 exposure report and certification of the significant exposure by an authorized
			 infection preventionist, occupational health professional, or other
			 professional trained in infectious disease control. No further consent from the
			 source patient is required. However, the source patient shall be notified that
			 an exposure has occurred and shall be told which specific tests are being
			 performed to determine the presence of contagious or infectious diseases. If
			 the source patient is a minor, the minor shall be informed prior to an
			 HIV-related test that, upon positive confirmation of an HIV-related test
			 result, the minor's legal guardian shall be informed of the positive result,
			 pursuant to Iowa Code section
			 141A.7(3).
(3) Hospitals, clinics, or other health care
			 facilities, institutions administered by the department of corrections, and
			 jails shall have written policies and procedures for reviewing and certifying
			 significant exposure report forms, testing a source patient, and notifying a
			 care provider who sustained a significant exposure while rendering health care
			 services or other services to the source patient when the source patient is
			 delivered to the facility and the exposure occurred prior to the delivery. The
			 policies and procedures shall include the possibility for the care provider to
			 designate a representative to whom notification shall be provided and who
			 shall, in turn, notify the care provider. The identity of the designated
			 representative of the care provider shall not be revealed to the source
			 patient. The designated representative shall inform the hospital, clinic, or
			 other health care facility, institution administered by the department of
			 corrections, or jail of those parties who received the notification and,
			 following receipt of this information and upon request of the source patient,
			 the hospital, clinic, or other health care facility, institution administered
			 by the department of corrections, or jail shall inform the source patient of
			 the parties to whom notification was provided.
(4) The hospital, clinic, or other health
			 care facility to whom the source patient is delivered shall conduct the test.
			 If the source patient is delivered to an institution administered by the
			 department of corrections, the test shall be conducted by the staff physician
			 of the institution. If the source patient is delivered to a jail, the test
			 shall be conducted by the attending physician of the jail or the county medical
			 examiner. If the source patient was deemed to consent upon certification of a
			 significant exposure report, the sample and test results shall only be
			 identified by a number.
(5) If a
			 test result is positive, the hospital, clinic, or other health care facility,
			 or other person performing the test shall notify the source patient and make
			 any required reports to the department pursuant to Iowa Code sections
			 139A.3
			 and
			 141A.6.
			 The report to the department shall include the name of the source
			 patient.
(6) If a source patient is
			 diagnosed or confirmed as having a contagious or infectious disease, the
			 hospital, clinic, or other health care facility, or other person performing the
			 test shall notify the care provider or the designated representative of the
			 care provider who shall then notify the care provider. If the source patient is
			 a minor and is diagnosed with HIV infection, the hospital, clinic, or other
			 health facility, or other person performing the test shall notify the legal
			 guardian of the minor.
(7) The
			 notification shall advise the care provider of possible exposure to a
			 particular contagious or infectious disease and recommend that the provider
			 seek medical attention. The notification shall be provided as soon as
			 reasonably possible following determination that the source patient has a
			 contagious or infectious disease. The notification shall not include the name
			 of the source patient unless the patient consents. If the care provider who
			 sustained a significant exposure determines the identity of a source patient
			 who has been diagnosed or confirmed as having a contagious or infectious
			 disease, the identity of the source patient shall be confidential information
			 and shall not be disclosed by the care provider to any other person unless a
			 specific written release is obtained from the source patient.
(8) This rule does not preclude a hospital,
			 clinic, other health care facility, or a health care provider from providing
			 notification to a care provider under circumstances in which the hospital's,
			 clinic's, other health care facility's, or health care provider's policy
			 provides for notification of the hospital's, clinic's, other health care
			 facility's, or health care provider's own employees of exposure to a contagious
			 or infectious disease that is not life-threatening if the notice does not
			 reveal a source patient's name, unless the patient consents.
(9) The infection control, occupational
			 health, or other designated office of the facility shall maintain a record of
			 all significant exposure reports it receives and shall retain each report for a
			 period of five years.
(10) The
			 report form "Report of Exposure to HIV or Other Infectious Disease" is a
			 confidential record pursuant to Iowa Code section
			 141A.9.
(11) The employer of a care provider who
			 sustained a significant exposure shall pay the cost of testing for the source
			 patient and for the testing of the care provider, if the significant exposure
			 was sustained during the course of employment. However, the department shall
			 assist a source patient and an exposed care provider in finding resources to
			 pay for the costs of the testing when a care provider was exposed while
			 rendering direct aid without compensation.
(12) A hospital's, clinic's, other health
			 care facility's, or health care provider's duty to notify under these rules is
			 not continuing. It is limited to the diagnosis of a contagious or infectious
			 disease made in the course of admission, care, and treatment following the
			 rendering of health care services or other services to a patient who was the
			 source of the significant exposure.
(13) Notwithstanding subrule 11.23(12), the
			 hospital, clinic, or other health care facility may notify the exposed care
			 provider if, following discharge from or completion of care or treatment by the
			 hospital, clinic, or other health care facility, the patient who was the source
			 of the significant exposure, and for whom a significant exposure report was
			 submitted that did not result in notification of the exposed care provider,
			 wishes to provide information regarding the source patient's contagious or
			 infectious disease status to the exposed care provider.
(14) Notwithstanding any other provision of
			 law to the contrary, a care provider may transmit cautions regarding contagious
			 or infectious disease information, with the exception of AIDS or HIV pursuant
			 to Iowa Code section
			 80.9B,
			 in the course of the care provider's duties over the police radio broadcasting
			 system under Iowa Code chapter 693 or any other radio-based communications
			 system if the information transmitted does not personally identify an
			 individual.