This week the Senate and House passed the final version of S. 1793, the Ryan White HIV/AIDS Treatment Extension Act of 2009 and the measure is now headed to the President’s desk for signature. First, the good news – the first responder notification provision that was dropped in the 2006 law has been reinstated. However, there have been some changes. As mentioned on the general membership call last week, some within the public health and hospital communities were concerned that notification during a public health emergency would overwhelm staff of hospitals and health departments with paperwork when they should be focusing on patient care. Staff was notified that Advocates was okay with the waiver of the 48 hour rule. However, waiver of the notification provision in its entirety was not in the best interest of first responders. Pushback from some public health groups continued and staff was somewhat sympathetic to their concerns. We continued to push for only the waiver of the 48 hour rule during a federally declared public health emergency but this provision was becoming so controversial there were threats to pull it altogether. The door to complete this was closing very quickly as they wanted to move it through both chambers this week. While this isn’t exactly what we wanted, the provision is back in law and we can work with it.
The final language states that the Secretary may wholly or partially waive the first responder notification provisions during a federally declared public health emergency. We will gather a small group of Advocates Board members, the fire community and possibly a couple of other groups to go in and meet with the Administration officials at HHS to discuss this provision and make sure that they know that the first responder community is okay with waiving the 48 hour rule during a public health emergency but NOT in its entirety.
I have included the final first responder notification provision language below for your review:
`(a) In General- After receiving a notification for purposes of section 2695A or 2695B(d)(2), a designated officer of emergency response employees shall, to the extent practicable, immediately notify each of such employees who--
`(1) responded to the emergency involved; and
`(2) as indicated by guidelines developed by the Secretary, may have been exposed to an infectious disease.
`(b) Certain Contents of Notification to Employee- A notification under this subsection to an emergency response employee shall inform the employee of--
`(1) the fact that the employee may have been exposed to an infectious disease and the name of the disease involved;
`(2) any action by the employee that, as indicated by guidelines developed by the Secretary, is medically appropriate; and
`(3) if medically appropriate under such criteria, the date of such emergency.
`(c) Responses Other Than Notification of Exposure- After receiving a response under paragraph (3) or (4) of subsection (d) of section 2695B, or a response under subsection (g)(1) of such section, the designated officer for the employee shall, to the extent practicable, immediately inform the employee of the response.
`(a) In General- For the purposes of receiving notifications and responses and making requests under this part on behalf of emergency response employees, the public health officer of each State shall designate 1 official or officer of each employer of emergency response employees in the State.
`(b) Preference in Making Designations- In making the designations required in subsection (a), a public health officer shall give preference to individuals who are trained in the provision of health care or in the control of infectious diseases.
`The duties established in this part for a medical facility--
`(1) shall apply only to medical information possessed by the facility during the period in which the facility is treating the victim for conditions arising from the emergency, or during the 60-day period beginning on the date on which the victim is transported by emergency response employees to the facility, whichever period expires first; and
`(2) shall not apply to any extent after the expiration of the 30-day period beginning on the expiration of the applicable period referred to in paragraph (1), except that such duties shall apply with respect to any request under section 2695B(c) received by a medical facility before the expiration of such 30-day period.
`(a) Liability of Medical Facilities, Designated Officers, Public Health Officers, and Governing Entities- This part may not be construed to authorize any cause of action for damages or any civil penalty against any medical facility, any designated officer, any other public health officer, or any governing entity of such facility or officer for failure to comply with the duties established in this part.
`(b) Testing- This part may not, with respect to victims of emergencies, be construed to authorize or require a medical facility to test any such victim for any infectious disease.
`(c) Confidentiality- This part may not be construed to authorize or require any medical facility, any designated officer of emergency response employees, or any such employee, to disclose identifying information with respect to a victim of an emergency or with respect to an emergency response employee.
`(d) Failure To Provide Emergency Services- This part may not be construed to authorize any emergency response employee to fail to respond, or to deny services, to any victim of an emergency.
`(e) Notification and Reporting Deadlines- In any case in which the Secretary determines that, wholly or partially as a result of a public health emergency that has been determined pursuant to section 319(a), individuals or public or private entities are unable to comply with the requirements of this part, the Secretary may, notwithstanding any other provision of law, temporarily suspend, in whole or in part, the requirements of this part as the circumstances reasonably require. Before or promptly after such a suspension, the Secretary shall notify the Congress of such action and publish in the Federal Register a notice of the suspension.
`(f) Continued Application of State and Local Law- Nothing in this part shall be construed to limit the application of State or local laws that require the provision of data to public health authorities.
`(a) In General- The Secretary may, in any court of competent jurisdiction, commence a civil action for the purpose of obtaining temporary or permanent injunctive relief with respect to any violation of this part.
`(b) Facilitation of Information on Violations- The Secretary shall establish an administrative process for encouraging emergency response employees to provide information to the Secretary regarding violations of this part. As appropriate, the Secretary shall investigate alleged such violations and seek appropriate injunctive relief.
`This part shall not apply in a State if the chief executive officer of the State certifies to the Secretary that the law of the State is substantially consistent with this part.'.
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