HB4303 Engrossed LRB095 16104 DRJ 42122 b

1     AN ACT concerning health.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 1. Short title. This Act may be cited as the MRSA
5 Screening, Prevention, and Reporting Act for State Residential
6 Facilities.
 
7     Section 5. Definition. In this Act, "State residential
8 facility" or "facility" means: any Department of Human Services
9 operated residential facility, including any State mental
10 health hospital, State developmental center, or State
11 residential school for the deaf and visually impaired; any
12 Department of Veterans' Affairs operated veterans home; any
13 Department of Corrections operated correctional center, work
14 camp or boot camp, or adult transition center; and any
15 Department of Juvenile Justice operated juvenile center or boot
16 camp.
 
17     Section 10. MRSA control procedures. In order to improve
18 the prevention of infections due to methicillin-resistant
19 Staphylococcus aureus ("MRSA"), every State residential
20 facility shall establish MRSA control procedures that include
21 the following features:
22         (1) Screening and surveillance.

 

 

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1             (A) All residents, patients, students, or inmates
2         of the facility undergoing intake medical screening
3         and physical examinations shall be carefully evaluated
4         for skin infections through a visual inspection. This
5         screening shall include culturing of skin abscesses,
6         boils, "spider bites", or other suspicious skin
7         conditions when revealed by the visual inspection.
8             (B) Recently hospitalized residents, patients,
9         students, or inmates of the facility shall be screened
10         for infections immediately upon return to the facility
11         and shall be instructed to report any new onset skin
12         infection or fever.
13             (C) Residents, patients, students, or inmates of
14         the facility with risk factors such as diabetes,
15         immunocompromised conditions, open wounds, recent
16         surgery, indwelling catheters, implantable devices,
17         chronic skin conditions, or paraplegia with decubiti
18         shall be evaluated for skin infections during routine
19         medical evaluations.
20             (D) All residents, patients, students, or inmates
21         of the facility with skin infections shall be referred
22         to health services for evaluation.
23             (E) Facility health care providers shall consider
24         MRSA infection in the differential diagnosis for all
25         residents, patients, students, or inmates presenting
26         with a skin or soft tissue infection or any other

 

 

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1         clinical presentation consistent with a staphylococcal
2         infection.
3             (F) Appropriate bacterial cultures shall be
4         obtained in all cases of suspected MRSA infection.
5             (G) No resident, patient, student, or inmate of the
6         facility with a skin or soft tissue infection shall be
7         transferred to another facility until fully evaluated
8         and appropriately treated as described in this
9         subparagraph (G), except when required for reasons of
10         appropriate security or care. Residents, patients,
11         students, or inmates with MRSA infections requiring
12         transfer shall have draining wounds dressed the day of
13         transfer to contain the draining. Escort personnel
14         shall be notified of the resident, patient, student, or
15         inmate's condition and educated on infection control
16         measures. The clinical director of the sending
17         facility or his or her designee shall notify the
18         receiving institution's clinical director or health
19         services administrator of pending transfers of
20         individuals with MRSA. This subparagraph (G) does not
21         apply to discharges and is not intended to limit an
22         individual's right to leave an institutional setting.
23         (2) Reporting.
24             (A) All confirmed MRSA and other
25         antibiotic-resistant infections shall be documented in
26         the resident, patient, student, or inmate's medical

 

 

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1         record.
2             (B) All confirmed MRSA and other
3         antibiotic-resistant infections shall be reported to
4         the director of the department operating the facility
5         and to the Department of Public Health. The report
6         shall indicate whether the MRSA infection was present
7         on intake or contracted at the facility, if known.
8         (3) Prevention.
9             (A) Education. Employees, residents, patients,
10         students, and inmates of the facility shall be provided
11         with information on the transmission, prevention,
12         treatment, and containment of MRSA infections.
13             (B) Hand Hygiene procedures: Each facility shall
14         develop and implement hand hygiene procedures for
15         employees, residents, patients, students, and inmates
16         of the facility that includes adequate hand-washing
17         equipment and supplies and regular training on
18         effective hand hygiene techniques and education on the
19         importance of hand hygiene. These trainings must be
20         conducted at least once each year and may be conducted
21         in conjunction with other trainings.
22             (C) Sanitation. Each facility shall develop and
23         implement sanitation procedures for cleaning and
24         disinfecting the environment that includes the
25         following:
26                 (i) Use of an Environmental Protection Agency

 

 

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1             (EPA)-registered disinfectant according to the
2             manufacturer's instructions.
3                 (ii) Regularly cleaning or disinfecting
4             washable surfaces in residents', patients', and
5             students' rooms, in inmates' cells, and in shared
6             areas such as showers, fitness areas, and food
7             services areas.
8                 (iii) Cleaning or disinfecting restraining
9             devices after every use.
10                 (iv) Treating all linen (towels, sheets, and
11             similar items) as potentially infectious and
12             following recommendations of the Centers for
13             Disease Control and Prevention for laundering.
14             (D) Personal protective equipment. Employees of
15         the facility shall be provided with personal
16         protective equipment (gloves, eye protection, and
17         gowns) for use when contact with blood, body fluids, or
18         wound drainage is likely.
19             (E) Isolation of residents, patients, students, or
20         inmates with MRSA. Each State residential facility
21         shall develop guidelines for isolating MRSA-diagnosed
22         residents, patients, students, or inmates from others
23         when a clinician determines the individual to be a high
24         risk for spreading the contagion. Residents, patients,
25         students, or inmates diagnosed with MRSA shall be
26         examined by a clinician to determine their risk of

 

 

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1         contagion to others. The determination about whether
2         to isolate residents, patients, students, or inmates
3         with MRSA infections shall include consideration of
4         the degree to which wound drainage can be contained and
5         the ability or willingness of a resident, patient,
6         student, or inmate to comply with infection control
7         instructions.
8         (4) Infection control. Upon the diagnosis of a single
9     MRSA case at a State residential facility, that facility
10     shall implement surveillance measures to detect additional
11     MRSA cases through the following procedures:
12             (A) The individual diagnosed with MRSA shall be
13         interviewed to identify potential sources of
14         infections and close contacts. The interview should
15         seek to determine the date of onset and activity
16         immediately before and following onset, including
17         recent hospitalizations, housing, work assignments,
18         sharing of personal hygiene items, sexual contact,
19         participation in close-contact sports, or exposure to
20         other residents, patients, students, or inmates with
21         draining wounds or skin infections.
22             (B) An individual shall not be required to make a
23         copayment for the testing or treatment of a MRSA
24         infection.
25             (C) Employees, residents, patients, students, or
26         inmates of the facility identified as having contact

 

 

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1         with the infected individual should be examined for
2         signs and symptoms of infection.
3             (D) State residential facility management shall
4         inform all employees of the facility that an occurrence
5         of MRSA infection has been identified. The
6         notification must protect the identity and
7         confidential information of the infected individual.
8         Management shall immediately conduct training on MRSA
9         and hand hygiene, in addition to the training required
10         under subdivision (3)(B) of this Section, unless there
11         has been a confirmed case of MRSA at the facility
12         within the previous 6 months and a training was
13         conducted at that time.
14             (E) State residential facility management shall
15         inform all health care providers evaluating residents
16         or inmates of the facility of the MRSA infection
17         occurrence so they may be on the alert for inmates with
18         skin or soft tissue infections or other evidence of
19         MRSA infections.
20             (F) No resident, patient, student, or inmate with a
21         skin or soft tissue infection shall be transferred to
22         another facility until fully evaluated and
23         appropriately treated as described in this
24         subparagraph (F), except when required for security
25         reasons, medical care, or other special circumstances.
26         Residents, patients, students, or inmates with MRSA

 

 

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1         infections requiring transfer shall have draining
2         wounds dressed the day of transfer to contain the
3         draining. Escort personnel shall be notified of the
4         resident, patient, student, or inmate's condition and
5         educated on infection control measures. The clinical
6         director of the sending facility or his or her designee
7         shall notify the receiving institution's clinical
8         director or health services administrator of pending
9         transfers of individuals with MRSA. This subparagraph
10         (F) does not apply to discharges and is not intended to
11         limit the individual's right to leave an institutional
12         setting.
13         (5) Treatment. The Department of Public Health shall
14     develop a MRSA treatment protocol for each department
15     operating a State residential facility. Upon issuance of
16     the protocol by the Department of Public Health, each
17     department operating a State residential facility shall
18     educate all clinical staff at the facility and healthcare
19     vendors for the facility on that protocol.
 
20     Section 15. No authority to make or promulgate rules.
21 Notwithstanding any other rulemaking authority that may exist,
22 neither the Governor nor any agency or agency head under the
23 jurisdiction of the Governor has any authority to make or
24 promulgate rules to implement or enforce the provisions of this
25 Act. If, however, the Governor believes that rules are

 

 

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1 necessary to implement or enforce the provisions of this Act,
2 the Governor may suggest rules to the General Assembly by
3 filing them with the Clerk of the House and Secretary of the
4 Senate and by requesting that the General Assembly authorize
5 such rulemaking by law, enact those suggested rules into law,
6 or take any other appropriate action in the General Assembly's
7 discretion. Nothing contained in this Act shall be interpreted
8 to grant rulemaking authority under any other Illinois statute
9 where such authority is not otherwise explicitly given. For the
10 purposes of this Act, "rules" is given the meaning contained in
11 Section 1-70 of the Illinois Administrative Procedure Act, and
12 "agency" and "agency head" are given the meanings contained in
13 Sections 1-20 and 1-25 of the Illinois Administrative Procedure
14 Act to the extent that such definitions apply to agencies or
15 agency heads under the jurisdiction of the Governor.
 
16     Section 99. Effective date. This Act takes effect upon
17 becoming law.