CS FOR SENATE BILL NO. 261(HES) "An Act relating to needle stick and sharps injury protections and the use of safe needles by health care facilities and health care professionals; relating to the vaccination of health care workers against diseases transmitted by bloodborne pathogens; and providing for an effective date." Co-Chair Torgerson introduced the new committee substitute for SB 261, work draft #1-LS175\K, Cramer, 4/14/00. SENATOR KIM ELTON explained the changes made to the work draft, providing a definition of "work practice controls" and a "front line health care worker". Additionally, the work draft provides further detail regarding the exceptions. The details have been taken mostly from California regulations. Senator Elton noted that he had worked in collaboration with Senator Pete Kelly and that the changes would enhance the bill and provide some assurances for health care workers. He pointed out that the bill would establish a protocol in how the State handles federal mandates. In response to Senator P. Kelly, Senator Elton explained the federal compliance directive. He advised that the U.S. Congress is currently working on similar legislation as before the Committee. A compliance directive could be amended since there is further work provided by Occupational Safety and Health Administration (OSHA). Senator Adams MOVED that the work draft version "K" be the document before the Committee. There being NO OBJECTION, it was adopted. Senator Leman voiced concern with the impacts of the legislation on health care facilities throughout the State. He questioned if the legislation would create further burdens in attempting to meet OSHA requirements. Senator P. Kelly interjected that some hospitals and clinics already have these procedures in place. The legislation clarifies that if you do have it already in effect, the legislative requirements would not need to be adopted. Co-Chair Torgerson questioned the fiscal impact. Senator Elton commented that the changes made would not effect the fiscal impact. The money note should have been updated to a zero fiscal note. Senator Adams MOVED to report CS SB 261 (FIN) out of Committee. Senator P. Kelly OBJECTED for a brief at-ease. Senator Phillips noted a conflict of interest and asked to refrain from voting. Senator Adams WITHDREW the MOTION to move the bill from Committee. There being NO OJBECTION, the bill was before the Committee for discussion. Senator Leman stated that the small clinics would be required to meet the OSHA requirements. He MOVED an amendment to Page 6, deleting Line #21; Line #24, the title would be "Exemption for Small Employers" and Line #27, would delete "until January 1, 2003". That action would guarantee that it would take a positive move from a future legislature to reinstate the requirements. Co-Chair Torgerson recommended that Section 2, Line #21 be left in the bill. Senator Elton pointed out that the net effect of the amendment would not exempt the smaller clinics from using sharp needle devices. However, the effect would exempt smaller clinics from having a front line health worker involved in the process determing what devices would work best for each patient. It would exempt the small clinics from maintaining a sharp needle used by health care workers. He emphasized that under the proposed requirement, the small clinics would be have the same requirements as a hospital, however, the only difference would be that the front line health care worker would not be involved in determining which device should be used. Senator Leman stated that the small clinic could still do that, however, the mandate would be removed. Senator Adams OBJECTED to the proposed language change. A roll call vote was taken on the motion. IN FAVOR: Leman, Wilken, Kelly, Green, Donley, Parnell, Torgerson OPPOSED: Adams Senator Phillips abstained from voting. The MOTION PASSED (7-1). Senator Adams MOVED to report the amended CS SB 261 (FIN) out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS SB 261 (FIN) was reported out of Committee with a "do pass" recommendation and with a zero fiscal note by the Department of Health and Social Services.