HS HCS HB 1477 & 1563 -- MISSOURI HOSPITAL INFECTION CONTROL
ACT (Schaaf)

This substitute creates the Missouri Nosocomial Infection Control
Act of 2004.  The substitute:

(1)  Requires the Department of Health and Senior Services to
include in its list of reported communicable and infectious
diseases methicillin-resistant staphylococcus aureus and
vancomycin-resistant enterococcus;

(2)  Authorizes the department to collect, analyze, and disclose
nosocomial data obtained from hospital patient medical records.
Currently, the department obtains this information to conduct
epidemiological studies;

(3)  Creates various definitions, including "nosocomial
infection," "nosocomial infection incidence rate," "antibiogram,"
and "other facility";

(4)  Requires laboratories performing culture and sensitivity
testing on humans in Missouri to submit data on health care
associated infections to the department.  The data may include
antibiograms.  No later than July 1, 2005, the data must include
the number of patients by hospital, ambulatory surgical center,
or other facility with methicillin-resistant staphylococcus
aureus or vancomycin-resistant enterococcus;

(5)  Requires the Infection Control Advisory Panel to develop a
recommended plan to use laboratory and health care provider data
as a means to enhance the ability of health care providers and
the department to track the incidence and distribution of
preventable infections and to monitor the trends in the
development of antibiotic-resistant microbes;

(6)  Requires the department to collect data on the required
nosocomial infection incidence rates from hospitals, ambulatory
surgical centers, and other facilities which are necessary to
generate the required reports;

(7)  Requires the department to develop rules governing the
collection, risk adjustment, and reporting of nosocomial
infection incidence rates and the types of specified medical
procedures to be monitored by July 1, 2005;

(8)  Requires the department to use data collection methodologies
established by the National Nosocomial Infection Surveillance
Program of the Centers for Disease Control and Prevention;

(9)  Requires the advisory panel to recommend to the department
the appropriateness of implementing all or part of the nosocomial
infection data collection and public reporting requirements;

(10)  Allows the department to implement or not implement the
federal Centers for Disease Control and Prevention's Nosocomial
Infection System or an alternative infection control system;

(11)  Exempts physician's offices from reporting and disclosing
infection incidence rates;

(12)  Requires the department, in consultation with the advisory
panel, to submit quarterly reports of nosocomial infections to
the public.  The department is also required to post the reports
on their web site beginning December 31,  2006.  The reports will
also be distributed on an annual basis to the Governor and the
General Assembly;

(13)  Requires the quarterly reports to reveal risk-adjusted
nosocomial infection incidence rate data for class I surgical
site infections, ventilator associated pneumonia, central-line
bloodstream infections, and other infections;

(14)  Requires information collected on infections to be subject
to confidentiality protections.  However, the information can be
provided in provider-specific form to appropriate facility and
professional licensing authorities for the purpose of licensing
hospitals and ambulatory surgical centers;

(15)  Requires the department to collect and publish nosocomial
infection incidence rates if the Hospital Industry Data Institute
fails to do so by July 31, 2008;

(16)  Requires hospitals, ambulatory surgical centers, and other
facilities to have procedures for monitoring compliance with
infection control regulations;

(17)  Gives infection control officers the authority to require
hospitals to terminate a practice or procedure which does not
meet the standard of care for the prevention of nosocomial
infections;

(18)  Prohibits hospitals and ambulatory surgical centers from
taking retaliatory actions against infection control officers and
other employees who discuss any aspect of care with an agent of
the department concerning potential hospital infection issues or
complaints;

(19)  Requires the department to review and update standards for
an infection control program by July 1, 2005, and specifies the
subject areas for the standards;

(20)  Gives the department access to all data and information
held by hospitals, ambulatory surgical centers, and other medical
facilities relating to their infection control practices.
Facilities that willfully impede access to the information will
be subject to a suspension of all or a portion of state funding;

(21)  Creates an Infection Control Advisory Panel and specifies
the composition of the panel; and

(22)  Prohibits information disclosed by the public for the
purpose of compliance with the substitute from being used to
establish a standard of care in a private civil suit.

FISCAL NOTE:  Estimated Cost on General Revenue Fund of $430,739
in FY 2005, $536,824 in FY 2006, and $550,587 in FY 2007.
Estimated Effect on Other State Funds of a cost of $15,930 to an
income of Unknown in FY 2005, a cost of $10,620 to an income of
Unknown in FY 2006, and a cost of $10,620 to an income of Unknown
in FY 2007.

Missouri House of Representatives
92nd General Assembly, 2nd Regular Session
Last Updated September 23, 2004 at 11:15 am