Report Title:

Health; Facility-Acquired Infections Disclosure

Description:

Requires a health facility to collect information regarding facility-acquired infection rates at its facility and submit quarterly reports to DOH, and requires DOH to summarize the quarterly reports and publish an annual report.

THE SENATE

S.B. NO.

1086

TWENTY-THIRD LEGISLATURE, 2005

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO health.

 

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

SECTION 1. Nosocomial infections are infections that are acquired in a hospital. The Centers for Disease Control and Prevention estimated that in 1995, nosocomial infections cost $4,500,000,00 and contributed to more than eighty-eight thousand deaths. Hospital-acquired infections lead to prolonged hospital stays that take up scarce health resources. Estimates have not improved over time. The estimated United States economic burden from nosocomial infections in 2002 was $6,700,000,000.

Hospital-acquired infections are attributed to different forces such as antimicrobial use in hospitals and long-term nursing facilities, failure of hospital personnel to follow basic infection control, and patients becoming increasingly immunocompromised.

States across the country are enacting legislation to require health facilities to publicly disclose their rate of nosocomial infections as a means of pressuring them to reduce the risk of infection. This also empowers the public to make informed consumer choices based on hospital safety in the critical area of health care.

The purpose of this Act is to require a health facility to collect information regarding facility-acquired infection rates at its facility and submit quarterly reports to the department of health, and to require the department of health to summarize the health facility quarterly reports and publish an annual report.

SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"Chapter

health facility infections

§   -1 Definitions. As used in this chapter, unless the context otherwise requires:

"Department" means the department of health.

"Director" means the director of health.

"Health facility" means any one of the facilities that constitute the division of community hospitals and any private hospital.

"Facility-acquired infection" means a localized or systemic condition that results from adverse reaction to the presence of an infectious agent or its toxin and that was not present or incubating at the time of admission to the health facility.

§   -2 Health facility reports. (a) A health facility shall collect data on facility-acquired infection rates for specific clinical procedures as determined by the department including the following categories:

(1) Surgical site infections;

(2) Ventilator-associated pneumonia;

(3) Central line-related bloodstream infections;

(4) Urinary tract infections; and

(5) Other categories as provided under section    -3(g).

(b) A health facility shall submit quarterly reports on its facility-acquired infection rates to the department. Quarterly reports shall:

(1) Be submitted according to a format approved by the department;

(2) Be submitted to the department by April 30, July 31, October 31, and January 31 each year for the prior quarter;

(3) Cover a period ending not earlier than one month prior to submission of the report; and

(4) Be made available to the public at each health facility and through the department;

The first quarterly report shall be due on October 31, 2006.

(c) If the health facility is a division or subsidiary of another entity that owns or operates other health facilities or related organizations, the quarterly report shall be for the specific division or subsidiary and not for the other entity.

§   -3 Advisory committee. (a) The director shall appoint an advisory committee, including representatives from:

(1) Public and private health facilities, including hospital infection control departments;

(2) Direct care nursing staff;

(3) Physicians;

(4) Epidemiologists with expertise in facility-acquired infections;

(5) Academic researchers;

(6) Consumer organizations;

(7) Health insurers;

(8) Health maintenance organizations;

(9) Organized labor; and

(10) Purchasers of health insurance, such as employers.

(b) The advisory committee shall have a majority of members representing interests other than health facilities.

(c) The advisory committee shall assist the department in the development of all aspects of the department's methodology for collecting, analyzing, and disclosing the information collected under this chapter, including collection methods, formatting, and methods and means for release and dissemination.

(d) In developing the methodology for collecting and analyzing the infection rate data, the department and advisory committee shall consider existing methodologies and systems for data collection, such as the Centers for Disease Control's National Nosocomial Infection Surveillance Program, or its successor; provided that the department's discretion to adopt a methodology shall not be limited or restricted to any existing methodology or system.

(e) The data collection and analysis methodology shall be disclosed to the public along with any public disclosure of facility-acquired infection rates.

(f) The department and the advisory committee shall evaluate on a regular basis the quality and accuracy of health facility information reported under this chapter and the data collection, analysis, and dissemination methodologies.

(g) The department, after consultation with the advisory committee, may require health facilities to collect data on facility-acquired infection rates in categories additional to those set forth in section    -2.

§   -4 Department reports. (a) The department shall annually submit to the legislature a report summarizing the health facility quarterly reports and shall publish the annual report. The first annual report shall be submitted and published in October 31, 2006. The department may issue quarterly informational bulletins at its discretion, summarizing all or part of the information submitted in the health facility quarterly reports.

(b) All reports issued by the department shall be risk adjusted.

(c) The annual report shall compare the risk-adjusted facility-acquired infection rates, collected under section    -2, for each individual health facility in the State. The department, in consultation with the advisory committee, shall make this comparison as easy to comprehend as possible. The report shall also include an executive summary, written in plain language that shall include:

(1) A discussion of findings;

(2) Conclusions; and

(3) Trends concerning the overall state of health facility-acquired infections in the State, including a comparison to prior years.

(d) The report may include policy recommendations, as appropriate.

(e) The department shall publicize the report and its availability as widely as practical to interested parties, including hospitals, providers, media organizations, health insurers, health maintenance organizations, purchasers of health insurance, organized labor, consumer or patient advocacy groups, and individual consumers.

(f) The annual report shall be made available to any person upon request.

(g) No health facility report or department disclosure shall contain any information that alone or in combination with other reasonably available information may be used to identify a patient, employee, or licensed health care professional in connection with a specific infection incident.

§   -5 Privacy. (a) Notwithstanding any other provision of law, a patient's right of confidentiality shall not be violated in any manner. Patient social security numbers and any other information, which alone or in combination with other reasonably available information could be used to identify an individual patient, shall not be released.

§   -6 Penalties. (a) A determination by the director that a health facility violated the provisions of this chapter may result in a fine of up to $1,000 per day per violation for each day the health facility is in violation.

(b) The director is authorized to impose the penalty pursuant to this section.

§   -7. Rules. The director may adopt rules pursuant to chapter 91 necessary for the purposes of this chapter."

SECTION 3. This Act shall take effect upon its approval.

INTRODUCED BY:

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