OAR 333-022-0310: Occupational and Health Care Setting Exposures: Substantial Exposure While Being Administered Health Care

(1) For purposes of this rule the following definitions apply: (a) “Exposure” means contact with a worker’s body fluids. (b) “Local public health administrator (LPHA)” means the public health administrator of the county or district health department for the jurisdiction in which the reported substantial exposure occurred. (c) “Health care” has the meaning given that term in ORS 192.556. (d) “Licensed health care provider” has the meaning given that term in ORS 433.060. (e) “Patient” means an individual who has experienced an exposure or substantial exposure while being administered health care. (f) “Qualified person” means an individual, such as a licensed health care provider, who has the necessary training and knowledge about infectious disease to make a determination about whether an exposure was substantial. (g) "Substantial exposure" means an exposure to blood or certain body fluids that have a potential for transmitting the human immunodeficiency virus based upon current scientific information and may include but is not limited to contact with blood or blood components, semen, or vaginal/cervical secretions through percutaneous inoculation or contact with an open wound, non-intact skin, or mucous membrane of the exposed person. (h) "Worker" means a person who is licensed or certified to provide health care under ORS Chapters 677, 678, 679, 680, 684 or 685, or ORS 682.216, an employee of a health care facility, of a licensed health care provider or of a clinical laboratory, as defined in ORS 438.010, a firefighter, a law enforcement officer, as defined in ORS 414.805, a corrections officer or a parole and probation officer (2) If a patient has experienced an exposure by a worker the worker shall report that exposure immediately to one of the following: (a) The worker’s supervisor or employer, if applicable; (b) The licensed health care facility’s infection control officer or other designated qualified person if the exposure occurred in a licensed health care facility as that term is defined in ORS 442.015; or (c) The LPHA if the worker does not have a supervisor or employer and the exposure did not occur in a licensed health care facility. (3) If a witness to the incident has reason to believe the incident was not reported, the witness shall notify one of the individuals or entities listed in section (2) of this rule and provide details of the incident. (4) The individual to whom a report was made under section (2) or (3) of this rule shall immediately make a determination whether the exposure was substantial and shall provide that determination to the worker in writing. The individual making the determination may rely on the most recent guidance on this topic issued by the federal Centers for Disease Control and Prevention. If the individual to whom the report was made is not qualified to make such a determination the individual must consult with a designated qualified person and that qualified person must then make the determination. The individual making a determination may require the release of records related to the exposure from the worker, a health care facility or a licensed health care provider in order to make his or her determination. (5) If a determination is made that the exposure was substantial, the worker who was the source of the substantial exposure to a patient shall notify the patient in writing within 24 hours of the determination. The worker may request that his or employer, the health care facility if the exposure occurred in a health care facility, or the LPHA provide assistance in making the notification. The notice must include but is not limited to: (a) Details of the exposure; (b) Why it was determined to be substantial; (c) Whether the worker is willing to consent to an HIV test; (d) The worker’s HIV status if the worker consents to that information being included in the notice; (e) Information about how the patient may request the worker be tested for HIV and to whom the patient should make such a request; and (f) A statement that the patient will be responsible for the costs of the worker’s HIV test in accordance with ORS 433.075. (6) If the patient disagrees with a determination that an alleged occupational exposure was not a substantial exposure, the patient may request a second determination from the LPHA. If the LPHA determines that the exposure was substantial, the patient may request that the source person be tested for HIV according to the procedures detailed in subsections (5)(a) through (f). (7) A patient who has received notification in accordance with section (5) of this rule may make a written request for the worker to be tested for HIV to the individual or entity listed in the notice. (8) The individual or entity to whom a request has been made under section (6) of this rule must: (a) Immediately ask the worker to consent to an HIV test; and (b) Inform the patient immediately whether the worker consented to the testing. (9) If the worker consents to an HIV test the worker must submit to a test within 24 hours of being asked to consent. (10) In accordance with ORS 433.075(5) if the worker consents to the HIV test the results of a HIV test shall be reported to the patient by the individual who ordered the test but the results may not identify the worker and the patient is prohibited from redisclosing any information about the results of the test if the worker is known to the patient. (11) Pursuant to ORS 433.065, a patient who has experienced a substantial exposure by a worker shall be offered information about HIV infection, methods of preventing HIV infection, and HIV tests. This information must be provided by the patient's licensed health care provider. Upon request by the patient's health care provider, the LPHA must provide assistance in providing this information to the patient.