Contact With Communicable Diseases by First Responders or Emergency Medical Person and Mortuary Personnel

PURPOSE: This rule defines the procedures for notification to a first responder or emergency medical person and mortuary personnel who are exposed to an individual who is human immunodeficiency virus seropositive, hepatitis B infected or infected with any other reportable communicable disease as listed in 19 CSR 20-20.020(1)–(5). (1) The following definitions shall be used in administering this rule: (A) Authorized personnel—any individual who has the authority to hire or fire and demote or promote employees for a corporation, entity or organization; (B) Emergency medical person—a licensed attendant who has been specially trained in emergency cardiac and noncardiac care, and who has successfully completed an emergency service training program certified by the Department of Health as meeting the requirements of sections 190.100–190.190, RSMo and any individual providing emergency medical services who is licensed under Chapters 334 and 335, RSMo; (C) Employee—a wage earner or volunteer providing emergency care; (D) Employer—one who provides gainful work for wage earners and volunteers in the emergency care area; (E) Exposure—any contact with an individual who is human immunodeficiency virus (HIV) seropositive or infected with any other reportable communicable disease as listed in 19 CSR 20-20.020(1)–(5), when the contact is consistent with the known means of transmission and occurs within the period of communicability of the disease; (F) Facility—a facility licensed under Chapter 197 or 198, RSMo. (G) First responder—an individual with training in first aid or emergency medical care, who is associated with a police department, sheriff's department, fire service or ambulance service and who is routinely dispatched to the scene of an accident or unforeseen emergency medical incident prior to or with the arrival of a licensed, staffed and equipped ambulance; (H) Mortuary personnel—those persons having direct contact with a corpse prior to completion of embalming, cremating or enclosing the corpse in a sealed casket; and (I) To notify—within forty-eight (48) hours after confirming potential exposure, the facility shall report the potential exposure by phone or in person to the employer(s)/funeral director of the potentially exposed employee(s)/mortuary personnel. (2) If a facility admits a patient who was in an emergency rescue operation, received medical treatment or was transported to the facility by a first responder or an emergency medical person and is subsequently diagnosed as HIV seropositive or infected with any other reportable communicable disease as listed in 19 CSR 20-20.020(1)–(5), the facility, after confirming the presence of the disease, shall notify the employer(s) of the potentially exposed employee(s). The employer(s) shall be provided with the ambulance run number, police incident report or sufficient information to enable identification of the potentially exposed employee without reference to the patient’s name. Notifications shall remain confidential and shall be released to authorized personnel only. (3) If mortuary personnel remove a corpse from a facility or provide care to the corpse and the facility subsequently determines the presence at the time of death of HIV seropositivity or infection with any other reportable communicable disease as listed in 19 CSR 20-20.020(1)–(5), the facility shall notify the funeral director of the mortuary personnel’s contact. (4) The employer/funeral director shall investigate the potential exposure of the employee/mortuary personnel to determine if it was consistent with the known means of transmission and occurred within the period of communicability of the disease in question. (A) If the exposure was consistent with the known means of transmission and occurred within the period of communicability, the employer/funeral director shall notify the employee/mortuary personnel within forty-eight (48) hours. (B) The employer/funeral director shall instruct the employee/ mortuary personnel to contact the facility for medical direction. AUTHORITY: sections 190.100–190.190 and 191.653, RSMo 1994.* Original rule filed July 18, 1989, effective Nov. 11, 1989. ** *Original authority: 190.100, RSMo 1973, amended 1987, 1989; 190.105–190.115, RSMo 1973; 190.120, RSMo 1973, amended 1980; 190.125–190.135, RSMo 1973; 190.140, RSMo 1973, amended 1987; 190.141, RSMo 1989; 190.145, RSMo 1973, amended 1975; 190.150–190.160, RSMo 1973; 190.165, RSMo 1973, amended 1978; 190.171, RSMo 1978; 190.175–190.180, RSMo 1973; 190.185, RSMo 1973, amended 1989, 1993; 190.190, RSMo 1973; and 191.653, RSMo 1988. **Pursuant to Executive Order 21-09, 19 CSR 20-20.090, section (2) was suspended from April 14, 2020 through December 31, 2021.