Effective - 28 Aug 2014
191.631. Testing for disease, consent deemed given, when — hospital to conduct testing, written policies and procedures required — notification for confirmed exposure, by whom — limitations on testing and duties of hospitals, coroners, and medical examiners — rules. — 1. (1) Notwithstanding any other law to the contrary, if an emergency care provider or a Good Samaritan sustains an exposure from a person while rendering emergency health care services, the person to whom the emergency care provider or Good Samaritan was exposed is deemed to consent to a test to determine if the person has a communicable disease and is deemed to consent to notification of the emergency care provider or the Good Samaritan of the results of the test, upon submission of an exposure report by the emergency care provider or the Good Samaritan to the hospital where the person is delivered by the emergency care provider.
(2) The hospital where the source patient is delivered shall conduct the test. The sample and test results shall only be identified by a number and shall not otherwise identify the person tested.
(3) A hospital shall have written policies and procedures for notification of an emergency care provider or Good Samaritan pursuant to this section. The hospital shall include local representation of designated infection control officers during the process to develop or review such policies. The policies shall be substantially the same as those in place for notification of hospital employees. The policies and procedures shall include designation of a representative of the emergency care provider to whom notification shall be provided and who shall, in turn, notify the emergency care provider. The identity of the designated local infection control officer of the emergency care provider shall not be disclosed to the source patient tested. The designated local infection control officer shall inform the hospital of those parties who receive the notification, and following receipt of such information and upon request of the person tested, the hospital shall inform the person of the parties to whom notification was provided.
(4) A coroner and medical examiner shall have written policies and procedures for notification of an emergency care provider and Good Samaritan pursuant to this section. The coroner or medical examiner shall include local representation of a designated infection control officer during the process to develop or review such policies. The policies shall be substantially the same as those in place for notification of coroner or medical examiner employees. The policies and procedures shall include designation of a representative of the emergency care providers to whom notification shall be provided and who shall, in turn, notify the emergency care provider. The identity of the designated local infection control officer of the emergency care provider shall not be disclosed to the source patient tested. The designated local infection control officer shall inform the coroner or medical examiner of those parties who receive the notification, and following receipt of such information and upon request of the person tested, the coroner or medical examiner shall inform the person of the parties to whom notification was provided.
2. If a person tested is diagnosed or confirmed as having a communicable disease pursuant to this section, the hospital, coroner, or medical examiner shall notify the emergency care provider, Good Samaritan or the designated local infection control officer of the emergency care provider who shall then notify the care provider.
3. The notification to the emergency care provider or the Good Samaritan shall advise the emergency care provider or the Good Samaritan of possible exposure to a particular communicable disease and recommend that the emergency care provider or Good Samaritan seek medical attention. The notification shall be provided as soon as is reasonably possible following determination that the individual has a communicable disease. The notification shall not include the name of the person tested for the communicable disease unless the person consents. If the emergency care provider or Good Samaritan who sustained an exposure determines the identity of the person diagnosed or confirmed as having a communicable disease, the identity of the person shall be confidential information and shall not be disclosed by the emergency care provider or the Good Samaritan to any other individual unless a specific written release is obtained by the person diagnosed with or confirmed as having a communicable disease.
4. This section does not require or permit, unless otherwise provided, a hospital to administer a test for the express purpose of determining the presence of a communicable disease; except that testing may be performed if the person consents and if the requirements of this section are satisfied.
5. This section does not preclude a hospital, coroner, or medical examiner from providing notification to an emergency care provider or Good Samaritan under circumstances in which the hospital's, coroner's, or medical examiner's policy provides for notification of the hospital's, coroner's, or medical examiner's own employees of exposure to a communicable disease that is not life-threatening if the notice does not reveal a patient's name, unless the patient consents.
6. A hospital, coroner, or medical examiner participating in good faith in complying with the provisions of this section is immune from any liability, civil or criminal, which may otherwise be incurred or imposed.
7. A hospital's duty of notification pursuant to this section is not continuing but is limited to diagnosis of a communicable disease made in the course of admission, care, and treatment following the rendering of health care services to which notification pursuant to this section applies.
8. A hospital, coroner, or medical examiner that performs a test in compliance with this section or that fails to perform a test authorized pursuant to this section is immune from any liability, civil or criminal, which may otherwise be incurred or imposed.
9. The department shall adopt rules to implement this section. The department may determine by rule the communicable diseases for which testing is reasonable and appropriate and which may be administered pursuant to this section. No rule or portion of a rule promulgated under the authority of this section shall become effective unless it has been promulgated pursuant to chapter 536.
10. The agency which employs or sponsors the emergency care provider who sustained an exposure pursuant to this section shall pay the costs of testing for the person who is the source of the exposure and of the testing of the emergency care provider if the exposure was sustained during the course of the provider's expected duties.
11. All emergency care providers shall respond to and treat any patient regardless of the status of the patient's HIV or other communicable disease infection.
12. Ambulance services and emergency medical response agencies licensed under chapter 190 shall establish and maintain local policies and provide training regarding exposure of personnel to patient blood and body fluids as well as general protection from communicable diseases. The training provided and the policies established shall be in substantial compliance with the appropriate CDC and OSHA guidelines.
13. Hospitals, long-term care facilities licensed under chapter 198, and other medical facilities and practitioners who transfer patients known to have a communicable disease or to be subject to an order of quarantine or an order of isolation shall notify the emergency care providers who are providing the transportation services of the potential risk of exposure to a communicable disease, including communicable diseases of a public health threat.
14. The department shall promulgate regulations regarding all of the following:
(1) The type of exposure that would prompt notification of the emergency care provider or Good Samaritan, which shall cover, at a minimum, methods of potential transmission of any diseases designated under P.L. 101-381 or diseases additionally identified from the department's list of communicable diseases;
(2) The process to be used by the emergency care provider, Good Samaritan, licensed facility, coroner, medical examiner, and designated infection control officer for the reports required by this section, the process to be used to evaluate requests received from emergency care providers and Good Samaritans, and for informing emergency care providers and Good Samaritans as to their obligations to maintain the confidentiality of information received; and
(3) The method by which emergency care providers and Good Samaritans shall be provided information and advice in a timely manner related to the risk of infection from communicable diseases as a result of aid or medical care.
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(L. 2002 S.B. 1107, A.L. 2014 S.B. 852)
Structure Missouri Revised Statutes
Title XII - Public Health and Welfare
Chapter 191 - Health and Welfare
Section 191.005 - Information exchange between departments, rulemaking authority.
Section 191.025 - Health care compact.
Section 191.127 - Land may be leased for farming or grazing — procedure.
Section 191.150 - Purchase of food limited to use of institution inmates.
Section 191.160 - Board and living quarters for employees of institutions.
Section 191.170 - Mistreatment of inmates — penalty.
Section 191.180 - Furnishing unfit food to institution — penalty.
Section 191.190 - Accessory to mistreatment of inmates or furnishing of unwholesome food — penalty.
Section 191.210 - Attendance of patient by private physician.
Section 191.211 - Funding of certain programs.
Section 191.213 - Additional funding sources for certain programs.
Section 191.228 - Physician and pharmacist not subject to discipline for cooperation.
Section 191.300 - Definitions.
Section 191.315 - Genetics program to be established by department — rules authorized — procedure.
Section 191.335 - Hemophilia program established — state assistance, when.
Section 191.362 - Appropriately trained employees to have completed course in dialysis techniques.
Section 191.365 - Sickle cell anemia — purposes of program — financial assistance, when.
Section 191.375 - Cystic fibrosis, program for care and treatment — financial assistance, when.
Section 191.380 - Cystic fibrosis, duties of department.
Section 191.500 - Definitions.
Section 191.510 - Contracts for loans to include terms.
Section 191.515 - Requirements for application.
Section 191.520 - Maximum amount of loans — source of funds.
Section 191.525 - Number of loans available — to whom — length of loans.
Section 191.530 - Interest on loans — repayment terms — temporary deferral.
Section 191.535 - Termination of course of study, effect.
Section 191.540 - Repayment schedules — breach of contract.
Section 191.545 - Recovery — actions for.
Section 191.550 - Approval of contracts.
Section 191.603 - Definitions.
Section 191.605 - Department to designate as areas of need — factors to be considered.
Section 191.607 - Qualifications for eligibility established by department.
Section 191.609 - Contract for repayment of loans, contents.
Section 191.615 - Application for federal funds — insufficient funds, effect.
Section 191.630 - Definitions.
Section 191.650 - Definitions.
Section 191.653 - HIV testing performed by whom, how — consultation with subject required, when.
Section 191.665 - Discrimination prohibited, exceptions.
Section 191.680 - Maintaining a nuisance, abatement to be ordered, when.
Section 191.683 - Reports to general assembly by department of health and senior services.
Section 191.692 - Premarital HIV testing, rulemaking authorized, when.
Section 191.695 - Rulemaking authority, department of health and senior services — procedure.
Section 191.710 - MO HealthNet program and SCHIPS to focus on premature infant health care.
Section 191.711 - Education publications to be prepared, contents — distribution.
Section 191.748 - Shaken baby syndrome video, required viewing, when.
Section 191.755 - Department to post resources on website, content.
Section 191.756 - Grants awarded by board of health and senior services — eligibility criteria.
Section 191.758 - Information to be made available by physician to pregnant women, when.
Section 191.765 - Definitions.
Section 191.769 - Areas not considered public places.
Section 191.771 - Person in control of public places or public meetings, duties.
Section 191.773 - Violators, guilty of infraction.
Section 191.800 - Definitions.
Section 191.803 - Boards of education to establish breakfast program — rules — waiver, procedure.
Section 191.805 - Hardship grant program, distribution of, rules.
Section 191.815 - Administrative rules, procedure.
Section 191.828 - Evaluations, effect of initiatives.
Section 191.839 - Education programs for persons with no or inadequate health insurance.
Section 191.843 - Authorizes grants for regional research consortia in a distressed community.
Section 191.900 - Definitions.
Section 191.907 - Original source of information to receive a portion of any recovery.
Section 191.908 - Whistleblower protections — violations, penalty.
Section 191.914 - False report or claim, penalty.
Section 191.915 - Breast-feeding information provided, when, by whom.
Section 191.931 - Early intervention services available — report, content.
Section 191.937 - Rulemaking authority, procedure.
Section 191.990 - Diabetes goals and benchmarks — report, contents.
Section 191.1050 - Definitions.
Section 191.1056 - Fund created, use of moneys.
Section 191.1075 - Definitions.
Section 191.1080 - Council created, purpose, members, terms, duties — report — expiration date.
Section 191.1085 - Program established, purpose — website information — rulemaking authority.
Section 191.1100 - Citation of law — definitions.
Section 191.1102 - Additional licensure not required, when — inapplicability.
Section 191.1104 - Display of license or certificate, how satisfied.
Section 191.1140 - Treatment of chronic, common, and complex diseases, program authorized, purpose.
Section 191.1145 - Definitions — telehealth services authorized, when.
Section 191.1146 - Physician-patient relationship required, how established.
Section 191.1150 - Citation of law — definitions — designation of caregiver, when — requirements.
Section 191.1164 - Citation of law — definitions.
Section 191.1167 - Contracts, policies, or procedures in violation of act deemed null and void.
Section 191.1168 - Severability clause.
Section 191.1601 - Citation of law.
Section 191.1603 - Definitions.
Section 191.1604 - Long-term dignity savings account, use, requirements.
Section 191.1606 - Reporting, forms — rulemaking authority.
Section 191.1607 - Financial institutions, requirements — no responsibility or liability, when.