By KATHERINE WEST and JAMES R. CROSS

In 1990, the Ryan White Comprehensive AIDS Resources Emergency Act, Public Law 101-381, was enacted into law. Although this law deals primarily with funding for HIV/AIDS programs throughout the country, Subpart B contains key provisions for fire/EMS personnel regarding notification of possible exposure to communicable diseases. This portion of the law, often referred to as the Ryan White Notification Law, requires every emergency response entity in the country to have a designated infection control officer (DICO) to serve as the liaison between emergency responders involved in exposure incidents and medical facilities to which the source patients in the exposures are transported. This covers emergency responders including firefighters, EMTs, paramedics, police officers, and volunteers. The law also outlines the role and responsibilities for this individual, which are extensive and comprehensive. Since this individual is charged with the postexposure follow-up and deals with infection control issues, the DICO title seemed appropriate.

The law requires medical facilities to provide the disease status of source patients as soon as possible and no later than 48 hours after an exposure has been reported to the facilities by the DICO of the responder involved in the exposure. The law also requires that medical facilities contact the DICO of the transporting entity that delivered a patient suspected for or diagnosed with pulmonary tuberculosis. This essentially ended a dual standard of care for postexposure medical follow-up that had existed across the country for many years. The law also afforded coverage to fire/EMS agencies that were not covered under the Occupational Safety and Health Administration's (OSHA's) Bloodborne Pathogen Standard (29 CFR 1910.1030). The Centers for Disease Control and Prevention (CDC) was charged under the law with developing a list of diseases that must be reported by medical facilities to DICOs. The list includes bloodborne diseases [HIV and hepatitis B (HBV)], airborne diseases (tuberculosis), and uncommon or rare diseases (rabies, meningitis, plague, hemorrhagic fevers, and diphtheria).

Because the Ryan White Notification Law provided federal funding for HIV/AIDS programs, the U.S. Congress was required to pass reauthorizations periodically to appropriate funds. There have been several reauthorizations since the law was passed in 1990; each included the emergency response provisions of the law. However, these provisions were stricken from the 2006 reauthorization. After much work by a coalition of emergency response organizations, including the International Association of Fire Fighters, the International Association of Fire Chiefs, the National Association of Emergency Medical Technicians, the National Volunteer Fire Council, and the National Association of State Emergency Medical Services Officials, the law's emergency response provisions were reinstated in its reauthorization on October 1, 2009.

Displaying 1/5 Page 1, 2, 3, 4, 5 Next>
View Article as Single page