The Legal Landscape: HAI Public Reporting in the United States

Abstract

1. Julie Reagan, PhD, JD, MPH 1. Georgia Southern University, Jiann-Ping Hsu College of Public Health, Statesboro, GA 2. Rodney E. Rohde, PhD, MS, SV, SM (ASCP)CM, MBCM[⇑][1] 1. Clinical Laboratory Science Program, College of Health Professions, Texas State University, San Marcos, TX 3. Amber Hogan Mitchell, DrPH, MPH, CPH 1. The International Safety Center, Apopka, FL 4. Marilyn Felkner, DrPH, MT(ASCP) 1. Emerging and Acute Infectious Disease Branch (EAIDB), Infectious Disease Control Unit, Texas Department of State Health Services (DSHS), Austin, TX 5. Pat Tille, PhD, MT(ASCP) 1. Medical Laboratory Science, College of Pharmacy, South Dakota State University, SD 1. Address for Correspondence: Rodney E. Rohde, PhD, MS, SV, SM (ASCP)CM, MBCM, Professor & Chair, CLS Program; Associate Dean for Research, Clinical Laboratory Science Program, College of Health Professions, Texas State University, 601 University Drive, San Marcos, TX 78666, 512-245-2562, 512-245-7860, rrohde{at}txstate.edu 1. Discuss the role of federal influences on state-level HAI program initiatives and reporting activities. 2. Describe the progression of state-level initiatives to reduce HAIs from 2004 to the current date. 3. Describe core provisions of state HAI reporting laws: surveillance, collection system, healthcare settings subject to the laws, types of infections reported, public reporting requirements, and advisory committee structure. 4. Identify healthcare worker infection and illness reporting mandates. INTRODUCTION Since early 2000, there has been a “growing interest in the use of law as a tool to address” healthcare-associated infections (HAIs) in the U.S.1 All 50 states and two territories have HAI programs established within their public health agencies.2 Likewise, the majority of states have HAI public reporting laws.3-4 HAI data is being reported from hospitals in all 50 states, either voluntarily or under state or federal legal reporting mandates.5 Additionally, while the current national focus is on reporting HAIs in the patient population, requirements for reporting infections and illness in the healthcare worker population also exists. The purpose of this article is to provide a review of the federal and state-level legal environment applicable to HAI prevention in the context of the overall response to HAIs. Federal Influences To fully grasp state-level HAI program initiatives and reporting activities, it is important first to understand the many federal influences. Through the U.S. Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC), the federal government plays a central role in the control and prevention of HAIs. From 2004 to 2008, states began to recognize the need for state policies aimed at HAI prevention.4 Several states made significant strides toward HAI surveillance and prevention as the awareness of the public health impact of HAIs grew. However, due to budget constraints and the associated poor economic conditions starting in 2008, most states were unable to implement or further develop their HAI programs. Significant improvements… ABBREVIATIONS: ACA – The Patient Protection and Affordable Care Act, CDC – Centers for Disease Control and Prevention, CMS – Centers for Medicare and Medicaid Services, CLABSI – central line-associated bloodstream infection, CAUTI – catheter-associated urinary tract infection, CRE – Carbepenem-resistant Enterobacteriaceae, HAIs – healthcare-associated infections, HHS – U.S. Department of Health and Human Services, IQR – Inpatient Quality Reporting Program, MRSA -- Methicillin Resistant Staphylococcus aureus , NHSN – National Healthcare Safety Network, OSHA – Occupational Safety and Health Administration, VAP – ventilator-associated pneumonia 1. Discuss the role of federal influences on state-level HAI program initiatives and reporting activities. 2. Describe the progression of state-level initiatives to reduce HAIs from 2004 to the current date. 3. Describe core provisions of state HAI reporting laws: surveillance, collection system, healthcare settings subject to the laws, types of infections reported, public reporting requirements, and advisory committee structure. 4. Identify healthcare worker infection and illness reporting mandates. [1]: #corresp-1