Designated Infection Control Office Joe Schmider, State EMS Director Jill Campbell, Nurse Epidemiologist Department of State Health Services

Senate Bill 1574 This bill is related to emergency response employees or volunteers. Requires the designation of a “designated infection control officer” by each emergency responder organization.

What does this mean to my organization and to me?

NFPA 1581 Each department must assign an infection control officer who is responsible for maintaining a liaison with the fire department physician, the health and safety officer, the infection control representative at health care facilities and other health care regulatory agencies. When notified of an exposure incident, the infection control officer should ensure that notification, verification, treatment and medical follow-up occur. In addition, the infection control officer should ensure that the appropriate exposure report forms are completed.

Texas Health & Safety Code Chapter 81: Communicable Diseases An entity that employs or uses the services of an emergency response employee or volunteer shall nominate a designated infection control officer and an alternate designated infection control officer to 81.012 (a): (1) receive notification of a potential exposure to a reportable disease from a health care facility; (2) notify the appropriate health care providers of a potential exposure to a reportable disease; (3) act as a liaison between the entity's emergency response employees or volunteers who may have been exposed to a reportable disease during the course and scope of employment or service as a volunteer and the destination hospital of the patient who was the source of the potential exposure; (4) investigate and evaluate an exposure incident, using current evidence-based information on the possible risks of communicable disease presented by the exposure incident; and (5) monitor all follow-up treatment provided to the affected emergency response employee or volunteer, in accordance with applicable federal, state, and local law. Point out in the H&S code states nominate DICO and Alternate – 2 position that act in the DICO capacity

Texas Health & Safety Code Chapter 81: Communicable Diseases The entity that employs or uses the services of an emergency response employee or volunteer is responsible for notifying the local health authorities or local health care facilities, according to any local rules or procedures, that the entity has a designated infection control officer or alternate designated infection control officer. 81.012(c) Once an entity has a DICO the entity is to inform LHD or LHC facilities

Emergency Care Provider Exposure Emergency Care Provider Employer Health Care Provider Testing Treatment follow up Patient Joe: In ESD and EMS world is the term Emergency Care Provider understood to be the EMS or Paramedic? When I look at this slide this is what I see our communication during webinar to be let me know is this is what your intent is: During a potential disease exposure to an emergency care provider there are 3 primary players: emergency care provider, the patient and the organization’s designated infection control officer. (Not only players just primary) Steps: Emergency Care Provider experiences a potential disease exposure while performing duties for a patient. Emergency Care Provider follows organization’s guidelines to report potential exposure. Organization’s DICO reviews report and when exposure is confirmed following two things happen simultaneously: Emergency Care Provider is referred to health care provider for evaluation (using current knowledge available on the patient who is also referred to as the source at this point). Decision to test the emergency care provider would be made during the emergency care provider’s initial assessment visit. The DICO start the process to test the patient or source. DICO receives source test results and relays information to appropriate personnel. Emergency Care Provider continues treatment follow up due to exposure, their health care provider can now manage care based on additional information from source testing results. The patient/source should also received appropriate medical management based on testing results. OPTIONAL Comment to complete cycle: emergency care provider returns to work. designated infection control officer

Communication plan? DICO – is in the middle with no clothes on The figures with lab coats represent others player in which the DICO will or may need to communicate with – right? Emergency care provider Local health care provider or facility (i.e. hospital) Local health authority or department Organization’s physician or other appropriate staff

Process for Communication between Emergency Care Provider with exposure Treatment provider and follow up * Patient and or family * Report authority * Employer What are your thoughts for this slide?

What can I say? To who? How much? When? Can I share to who? What can’t I say? Spelled out in the Texas Health and Safety Codes: 81.046, Confidentiality and 81.048, Notification of Emergency Response Employee or Volunteer

Education Opportunities Resources Texas EMS Conference in November Check with your Regional Advisory Councils and Health Services Regions. NFPA 1581 Guide to Managing an emergency service infection control program by the UNITED STATES FIRE ADMINISTRATION ? Joe since this PPT will be on Safe-D website for future viewing, I noticed they have PPT from 2012 still. On bullet one should we change it to read Annual Texas EMS Conference And just verbally state the next conference is schedule for November 2016 and where it will be held.

Texas Trauma Service Areas and Regional Advisory Councils TSA A: Panhandle RAC TSA B: TSA-B RAC TSA C: North Texas RAC TSA D: Big Country RAC TSA E: North Central Texas RAC TSA F: Northeast Texas RAC TSA G: Piney Woods RAC TSA H: Deep East Texas RAC TSA I: Border RAC TSA J: Texas “J” RAC TSA K: Concho Valley RAC TSA L: Central Texas RAC TSA M: Heart of Texas RAC TSA N: Brazos Valley RAC TSA O: Capital Area Trauma RAC TSA P: Southwest Texas RAC TSA Q: Southeast Texas RAC Using laser pointer to outline Q plus R plus S, say: Q+R+S = Population of Minnesota TSA R: East Texas Gulf Coast RAC TSA S: Golden Crescent RAC TSA T: Seven Flags RAC TSA U: Coastal Bend RAC TSA V: Lower Rio Grande Valley RAC

Texas Health Service Regions HSR1 – Lubbock (806) 744-3577      HSR2/3 – Arlington (817) 264-4500      HSR4/5 North – Tyler (903) 595-3585      HSR6/5 South – Houston (713) 767-3000      HSR7 – Temple (254) 778-6744 HSR8 – San Antonio (210) 949-2000      HSR9/10 – El Paso (915) 834-7675      HSR11 – Harlingen (956) 423-0130     

Make sure your Medical Director and Legal entity is involved in the planning! ? Joe what thoughts do you have or do we want to offer comment in setting where organization might not have a medical director or legal resources?

QUESTIONS

Contact information Joe Schmider EMS Director Joseph.Schmider@DSHS.State.Tx.Us office: 512-824-6737 Jill Campbell Nurse Epidemiologist Jill.Campbell@DSHS.State.Tx.Us phone: 254-771-6729