23-07.5 Bloodborne Pathogen Testing

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CHAPTER 23-07.5BLOODBORNE PATHOGEN TESTING23-07.5-01. Definitions. In this chapter, unless the context otherwise requires:1."Bloodborne pathogen" means a microorganism that is present in human blood or in<br>other bodily fluid or tissue which can cause a disease in humans, including the<br>hepatitis B virus, the hepatitis C virus, and the human immunodeficiency virus, and<br>for which testing is recommended by the United States public health service.2."Exposed individual" means an individual, including a patient, health care provider,<br>firefighter, peace officer, correctional officer, court officer, law enforcement officer,<br>emergency medical technician, laboratory personnel, or an individual trained and<br>authorized by law or rule to render emergency medical assistance or treatment,<br>including an individual rendering aid under chapter 32-03.1, who is exposed to a<br>bloodborne pathogen.3."Exposure" means a percutaneous injury, including a needle stick or cut with a sharp<br>object; contact with blood, bodily fluid, or tissue of a mucous membrane or nonintact<br>skin, including exposed skin that is chapped, abraded, or afflicted with dermatitis; or<br>contact with other bodily fluids that are potentially infectious as determined under<br>guidelines of the United States public health service.4."Health care" means any services included in the furnishing to an individual of<br>hospitalization, or medical or dental care, or any services incident to the furnishing of<br>that care or hospitalization, as well as the furnishing to an individual of any other<br>services for the purpose of preventing, alleviating, curing, or healing human illness<br>or injury.5."Health care provider" means an individual licensed, certified, or otherwise<br>authorized by the law of this state to provide health care and includes personnel at<br>the state crime laboratory or any commercial or research laboratory that handles<br>blood, bodily fluid, or tissues.6."Informed consent for testing" means that the individual to be tested for bloodborne<br>pathogens has been informed of the nature of the testing; the reason for the testing;<br>the relevant risks, benefits, and potential alternatives for testing; and the individual<br>has granted permission to be tested.7."Personal representative" means any person who has authority under law to act on<br>behalf of an individual or deceased individual in making decisions related to health<br>care or health information.8."Test subject" means the individual who is the source of the blood, other bodily<br>fluids, or tissue that caused the exposure.23-07.5-02. Informed consent for testing - Exception.1.Except when testing is otherwise permitted by law, a health care provider, blood<br>bank, blood center, or plasma center may not subject an individual who is the source<br>of an exposure to a test for bloodborne pathogens unless the subject of the test or<br>the subject's personal representative if the subject is a minor or is incapacitated first<br>provides informed consent for testing.2.If an individual who is the source of an exposure has had blood drawn that is<br>available for testing and the individual has refused to grant consent to have that<br>individual's blood tested for bloodborne pathogens, that individual's blood may be<br>subjected to a test for the presence of bloodborne pathogens, without thatPage No. 1individual's consent, if a physician or other qualified health care provider based on<br>available information determines and certifies in writing that the individual had an<br>exposure and before testing the test subject is informed that the test subject's blood<br>may be tested for the presence of bloodborne pathogens; that the test results may<br>not be disclosed without the test subject's authorization, except to the exposed<br>individual, the individual's health care provider, and any other person as authorized<br>by law; that if the exposed individual knows the identity of the test subject, the<br>exposed individual may not disclose the identity of the test subject except for the<br>purpose of having the test performed; and that a record of the test results may be<br>kept in the exposed individual's medical record only if the record does not reveal the<br>test subject's identity. Each exposed individual who had an exposure and to whom<br>test results are disclosed must first be given a document indicating the exposed<br>individual's understanding that the exposed individual may not disclose the test<br>subject's identity and that disclosing this information constitutes a class C felony.3.If an individual who is the subject of an exposure is incapable of giving informed<br>consent for testing under this section, that consent may be obtained from the<br>individual's personal representative.If an individual who is the subject of anexposure dies without an opportunity to consent to testing, collection of appropriate<br>specimens and testing for the presence of bloodborne pathogens must be<br>conducted as soon as reasonably possible. Results of these tests must be provided<br>to the physician providing care for the individual who experienced the exposure. If a<br>facility that received the individual who died fails to test for the presence of<br>bloodborne pathogens as required under this subsection because the facility was not<br>aware of the exposure or it was not reasonably possible to conduct testing, the<br>facility shall provide the physician providing care for the exposed individual or health<br>care provider testing results of any bloodborne pathogen present in any medical<br>records of the deceased individual which are in the facility's control as soon as<br>reasonably possible. If there are no testing results for bloodborne pathogens within<br>that facility and there is reason to believe that results are available from another<br>facility, the facility that received the deceased individual shall attempt to obtain<br>testing results of bloodborne pathogens of the deceased individual as soon as<br>reasonably possible from the facility where it is believed results exist.The testresults must be provided to the physician providing care for the individual who<br>experienced the exposure.4.A test for bloodborne pathogens must be conducted according to recommendations<br>of the United States public health service. Any testing done pursuant to subsection<br>2 or 3 must be conducted in a reasonably expedient manner. The district court in<br>the county where the alleged exposure occurred or in which the individual to be<br>tested resides shall issue an order directing the individual who was the source of an<br>exposure to have blood drawn to be tested for bloodborne pathogens. An affidavit<br>from a physician or other qualified health care provider showing that an exposure<br>has occurred is prima facie evidence of those facts.The affidavit may not beexcluded as hearsay if the affidavit is based on evidence generally relied on by a<br>health care provider, including statements from the provider's patient. The record of<br>any court hearing conducted under this subsection is confidential. The court shall<br>issue an order requiring testing under this subsection if:a.The court finds probable cause to believe that the individual petitioning for the<br>testing had an exposure with the test subject;b.The petition substitutes a pseudonym for the true name of the test subject;c.The court provides the test subject with notice and reasonable opportunity to<br>participate in the proceeding if the person is not already a party to the<br>proceeding;d.The proceedings are conducted in camera; andPage No. 2e.The court imposes appropriate safeguards against unauthorized disclosure<br>which must specify the individuals who have access to the information, the<br>purposes for which the information may be used, and appropriate prohibition on<br>future disclosure.5.If the court issues an order for testing, the court may order the confinement of the<br>test subject until blood is drawn for testing or issue an order establishing reasonable<br>security for the individual's attendance at the test site. This order may be modified<br>or extended.6.A health care provider who subjects an individual to an exposure must notify the<br>individual of the exposure.A health care provider witnessing an exposure mayreport the exposure pursuant to any appropriate facility or employer guidelines to<br>which the provider may be subject. The knowing failure to inform an individual of an<br>exposure or refusal to submit to testing as required under this chapter may be<br>considered by a health care provider's licensing board to constitute conduct that may<br>subject the licensee to disciplinary action.7.The exposed individual shall pay the expense of testing. However, if the exposure<br>occurs at an employee's workplace, the worker's employer shall pay the expense of<br>testing unless otherwise provided by subdivision b of subsection 10 of section<br>65-01-02.If the individual to be tested is convicted of a crime relating to theexposure or the exposure occurred during an arrest or other contact with the<br>exposed individual in the course of that individual's official duties, a court may order<br>the individual to be tested to pay for the testing.23-07.5-03. Written consent to disclosure. 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height:815px; text-align:center;\"\u003eLoading PDF...\u003c/div\u003e\u003cscript type=\"text/javascript\"\u003e var pdf_url = 'https://law.justia.com/codes/north-dakota/2009/t23/pdf/t23c075.pdf'; $(document).ready(function() { var embedwindow = $(\"#embed_document\"); if ($.browser.msie){ embedwindow.html('\u003cembed src=\"'+pdf_url+'\" width=\"100%\" height=\"100%\"\u003e\u003c/embed\u003e'); } else { embedwindow.html('\u003ciframe style=\"width:100%; height:100%;\" src=\"https://docs.google.com/gview?url='+window.escape(pdf_url)+'\u0026embedded=true\" frameborder=\"0\"\u003e\u003c/iframe\u003e'); } });\u003c/script\u003e\u003cbr\u003e\u003cbr\u003e\u003cnoframes\u003eCHAPTER 23-07.5BLOODBORNE PATHOGEN TESTING23-07.5-01. Definitions. In this chapter, unless the context otherwise requires:1.\u0026quot;Bloodborne pathogen\u0026quot; means a microorganism that is present in human blood or in\u003cbr\u003eother bodily fluid or tissue which can cause a disease in humans, including the\u003cbr\u003ehepatitis B virus, the hepatitis C virus, and the human immunodeficiency virus, and\u003cbr\u003efor which testing is recommended by the United States public health service.2.\u0026quot;Exposed individual\u0026quot; means an individual, including a patient, health care provider,\u003cbr\u003efirefighter, peace officer, correctional officer, court officer, law enforcement officer,\u003cbr\u003eemergency medical technician, laboratory personnel, or an individual trained and\u003cbr\u003eauthorized by law or rule to render emergency medical assistance or treatment,\u003cbr\u003eincluding an individual rendering aid under chapter 32-03.1, who is exposed to a\u003cbr\u003ebloodborne pathogen.3.\u0026quot;Exposure\u0026quot; means a percutaneous injury, including a needle stick or cut with a sharp\u003cbr\u003eobject; contact with blood, bodily fluid, or tissue of a mucous membrane or nonintact\u003cbr\u003eskin, including exposed skin that is chapped, abraded, or afflicted with dermatitis; or\u003cbr\u003econtact with other bodily fluids that are potentially infectious as determined under\u003cbr\u003eguidelines of the United States public health service.4.\u0026quot;Health care\u0026quot; means any services included in the furnishing to an individual of\u003cbr\u003ehospitalization, or medical or dental care, or any services incident to the furnishing of\u003cbr\u003ethat care or hospitalization, as well as the furnishing to an individual of any other\u003cbr\u003eservices for the purpose of preventing, alleviating, curing, or healing human illness\u003cbr\u003eor injury.5.\u0026quot;Health care provider\u0026quot; means an individual licensed, certified, or otherwise\u003cbr\u003eauthorized by the law of this state to provide health care and includes personnel at\u003cbr\u003ethe state crime laboratory or any commercial or research laboratory that handles\u003cbr\u003eblood, bodily fluid, or tissues.6.\u0026quot;Informed consent for testing\u0026quot; means that the individual to be tested for bloodborne\u003cbr\u003epathogens has been informed of the nature of the testing; the reason for the testing;\u003cbr\u003ethe relevant risks, benefits, and potential alternatives for testing; and the individual\u003cbr\u003ehas granted permission to be tested.7.\u0026quot;Personal representative\u0026quot; means any person who has authority under law to act on\u003cbr\u003ebehalf of an individual or deceased individual in making decisions related to health\u003cbr\u003ecare or health information.8.\u0026quot;Test subject\u0026quot; means the individual who is the source of the blood, other bodily\u003cbr\u003efluids, or tissue that caused the exposure.23-07.5-02. Informed consent for testing - Exception.1.Except when testing is otherwise permitted by law, a health care provider, blood\u003cbr\u003ebank, blood center, or plasma center may not subject an individual who is the source\u003cbr\u003eof an exposure to a test for bloodborne pathogens unless the subject of the test or\u003cbr\u003ethe subject's personal representative if the subject is a minor or is incapacitated first\u003cbr\u003eprovides informed consent for testing.2.If an individual who is the source of an exposure has had blood drawn that is\u003cbr\u003eavailable for testing and the individual has refused to grant consent to have that\u003cbr\u003eindividual's blood tested for bloodborne pathogens, that individual's blood may be\u003cbr\u003esubjected to a test for the presence of bloodborne pathogens, without thatPage No. 1individual's consent, if a physician or other qualified health care provider based on\u003cbr\u003eavailable information determines and certifies in writing that the individual had an\u003cbr\u003eexposure and before testing the test subject is informed that the test subject's blood\u003cbr\u003emay be tested for the presence of bloodborne pathogens; that the test results may\u003cbr\u003enot be disclosed without the test subject's authorization, except to the exposed\u003cbr\u003eindividual, the individual's health care provider, and any other person as authorized\u003cbr\u003eby law; that if the exposed individual knows the identity of the test subject, the\u003cbr\u003eexposed individual may not disclose the identity of the test subject except for the\u003cbr\u003epurpose of having the test performed; and that a record of the test results may be\u003cbr\u003ekept in the exposed individual's medical record only if the record does not reveal the\u003cbr\u003etest subject's identity. Each exposed individual who had an exposure and to whom\u003cbr\u003etest results are disclosed must first be given a document indicating the exposed\u003cbr\u003eindividual's understanding that the exposed individual may not disclose the test\u003cbr\u003esubject's identity and that disclosing this information constitutes a class C felony.3.If an individual who is the subject of an exposure is incapable of giving informed\u003cbr\u003econsent for testing under this section, that consent may be obtained from the\u003cbr\u003eindividual's personal representative.If an individual who is the subject of anexposure dies without an opportunity to consent to testing, collection of appropriate\u003cbr\u003especimens and testing for the presence of bloodborne pathogens must be\u003cbr\u003econducted as soon as reasonably possible. Results of these tests must be provided\u003cbr\u003eto the physician providing care for the individual who experienced the exposure. If a\u003cbr\u003efacility that received the individual who died fails to test for the presence of\u003cbr\u003ebloodborne pathogens as required under this subsection because the facility was not\u003cbr\u003eaware of the exposure or it was not reasonably possible to conduct testing, the\u003cbr\u003efacility shall provide the physician providing care for the exposed individual or health\u003cbr\u003ecare provider testing results of any bloodborne pathogen present in any medical\u003cbr\u003erecords of the deceased individual which are in the facility's control as soon as\u003cbr\u003ereasonably possible. If there are no testing results for bloodborne pathogens within\u003cbr\u003ethat facility and there is reason to believe that results are available from another\u003cbr\u003efacility, the facility that received the deceased individual shall attempt to obtain\u003cbr\u003etesting results of bloodborne pathogens of the deceased individual as soon as\u003cbr\u003ereasonably possible from the facility where it is believed results exist.The testresults must be provided to the physician providing care for the individual who\u003cbr\u003eexperienced the exposure.4.A test for bloodborne pathogens must be conducted according to recommendations\u003cbr\u003eof the United States public health service. Any testing done pursuant to subsection\u003cbr\u003e2 or 3 must be conducted in a reasonably expedient manner. The district court in\u003cbr\u003ethe county where the alleged exposure occurred or in which the individual to be\u003cbr\u003etested resides shall issue an order directing the individual who was the source of an\u003cbr\u003eexposure to have blood drawn to be tested for bloodborne pathogens. An affidavit\u003cbr\u003efrom a physician or other qualified health care provider showing that an exposure\u003cbr\u003ehas occurred is prima facie evidence of those facts.The affidavit may not beexcluded as hearsay if the affidavit is based on evidence generally relied on by a\u003cbr\u003ehealth care provider, including statements from the provider's patient. The record of\u003cbr\u003eany court hearing conducted under this subsection is confidential. The court shall\u003cbr\u003eissue an order requiring testing under this subsection if:a.The court finds probable cause to believe that the individual petitioning for the\u003cbr\u003etesting had an exposure with the test subject;b.The petition substitutes a pseudonym for the true name of the test subject;c.The court provides the test subject with notice and reasonable opportunity to\u003cbr\u003eparticipate in the proceeding if the person is not already a party to the\u003cbr\u003eproceeding;d.The proceedings are conducted in camera; andPage No. 2e.The court imposes appropriate safeguards against unauthorized disclosure\u003cbr\u003ewhich must specify the individuals who have access to the information, the\u003cbr\u003epurposes for which the information may be used, and appropriate prohibition on\u003cbr\u003efuture disclosure.5.If the court issues an order for testing, the court may order the confinement of the\u003cbr\u003etest subject until blood is drawn for testing or issue an order establishing reasonable\u003cbr\u003esecurity for the individual's attendance at the test site. This order may be modified\u003cbr\u003eor extended.6.A health care provider who subjects an individual to an exposure must notify the\u003cbr\u003eindividual of the exposure.A health care provider witnessing an exposure mayreport the exposure pursuant to any appropriate facility or employer guidelines to\u003cbr\u003ewhich the provider may be subject. The knowing failure to inform an individual of an\u003cbr\u003eexposure or refusal to submit to testing as required under this chapter may be\u003cbr\u003econsidered by a health care provider's licensing board to constitute conduct that may\u003cbr\u003esubject the licensee to disciplinary action.7.The exposed individual shall pay the expense of testing. However, if the exposure\u003cbr\u003eoccurs at an employee's workplace, the worker's employer shall pay the expense of\u003cbr\u003etesting unless otherwise provided by subdivision b of subsection 10 of section\u003cbr\u003e65-01-02.If the individual to be tested is convicted of a crime relating to theexposure or the exposure occurred during an arrest or other contact with the\u003cbr\u003eexposed individual in the course of that individual's official duties, a court may order\u003cbr\u003ethe individual to be tested to pay for the testing.23-07.5-03. Written consent to disclosure. 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