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1992/08/11 City Council ResolutionRESOLUTION NO. 92-135 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF ROHNERT PARK ADOPTING AN INFECTIOUS DISEASE CONTROL POLICY AND PROCEDURE WHEREAS, the United States Department of Labor Occupational Safety and Health Administration (OSHA) recently issued a new rule on protecting workers from the dangers of bloodborne pathogens; and WHEREAS, the federal standards for same became effective on March 6, 1992; and WHEREAS, OSHA requires a written exposure plan be developed that, among other things, identifies the jobs at risk and how to limit potential exposure; and WHEREAS, the City of Rohnert Park is required to have a recordkeeping plan and training program in place; and WHEREAS, in compliance with federal standards, the City will continue to provide the required protective clothing and equipment as well as a Hepatitis B Vaccination Program; and WHEREAS, the City of Rohnert Park is committed to complying with all applicable laws providing for the safety and welfare of its employees and /or volunteers. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Rohnert Park hereby adopts the attached "Infectious Disease Control Policy and Procedure" to ensure compliance. DULY AND REGULARLY ADOPTED this 11th day of August 0 1992. CITY OF ROHNERT PARK C17V AWA&PARK Mayor ATTEST: Depute CiVi "Cl EG4� 01- '501 OR € H AYE k� OPKINS��E�L'L` A3E SFIP;O AYE AYES (3 NOES_ (o) ASSEN (2) e ABSTAIN (0) CITY OF ROHNERT PARK INFECTIOUS DISEASE CONTROL POLICY AND PROCEDURES TABLE OF CONTENTS PURPOSE....................... ..............................2 ARTICLE I ......... ........... ..............................3 Exposure Determination and Follow -Up ARTICLE II .................... ..............................6 Vaccinations ARTICLE III ................... ..............................6 Personal Protective Equipment ARTICLEIV .................... ..............................8 Work Practice Controls ARTICLE V ..................... ..............................9 Labeling ARTICLE VI .................... ..............................9 Training ARTICLE VII ................... ..............................9 Housekeeping ARTICLE VIII ................... .............................10 Recordkeeping 1 CITY OF ROHNERT PARK INFECTIOUS DISEASE CONTROL POLICY AND PROCEDURE PURPOSE It is the intent of the City of Rohnert Park to minimize or eliminate employee risk of exposure to potentially infectious diseases by establishing guidelines for the use of universal precautions for all incidents involving occupational exposure to infectious diseases; establishing standard procedures for the reporting of incidents involving occupational exposure to infectious diseases; and, to provide training and vaccinations to all employees who are considered to have occupational exposure to potentially infectious diseases. For purposes of this policy, all bodily fluids, including blood, semen, vaginal secretions, blood contaminated bodily fluids or any other bodily fluid, shall be treated as potentially infectious. The following job classifications and all employees in those classifications will be considered to have occupational exposure: Public Safety Officer Trainee Public Safety Officer Public Safety Reserve Officer Public Safety Sergeant Public Safety Supervisor (Lt.) Community Services Officer community Services Officer Assistant Emergency Medical Technician Evidence Technician /Property Specialist Fire Equipment Maintenance Worker Volunteer Auxiliary Firefighter Fire Service Specialist Maintenance Helper Maintenance Worker I, II and III Arborist Senior Equipment Mechanic Equipment Mechanic K The following job classifications and all employees in those job classifications will be considered to have some occupational exposure: Public Safety Division Commander Director of Public Safety Animal Health Technician Part -Time Animal Shelter Assistant Superintendent of Public Works Assistant Superintendent of Public Works Part -Time Laborer Volunteer Police Service Aide Lifeguard /Cashier I & II Instructor /Lifeguard I & II Pool Cashier Senior Lifeguard Pool Manager Administrative Assistant I (Public Safety) Recreation Activities Recreation Aide Recreation Coordinator Recreation Program Specialist Recreation Supervisor Water System Supervisor Sports Center Coordinator ARTICLE I Exposure Determination and Follow -Up A. In order to determine if exposure has occurred, the employee must come into contact with blood, semen, vaginal secretions, bodily fluids contaminated with blood, or any other bodily fluids from a person with an infectious disease. Further, there must be a portal of entry by which contaminated bodily fluids can enter the human body. Portals of entry can be through needlesticks, lacerations, open wounds (non- intact skin), weeping lesions, the mouth and mucous membranes (eyes and nose). B. If exposure to an infectious disease is determined, the employee shall wash the affected area with soap and water. If the affected area is the nose or eyes (mucous membranes), flush with lukewarm water. C. Report exposure incident to a supervisor. D. The employee shall be sent or taken to Santa Rosa Memorial Hospital, Petaluma Valley Hospital or North Bay Corporate Health Services for medical follow -up and appropriate treatment. 3 1) If the employee was exposed to droplets of sputum, concern will be in regard to the transmission of an airborne disease such as Tuberculosis. 2) If the employee was bitten and the skin broken, minimum treatment will be to test the employee for Hepatitis B antibodies. 3) If the employee was exposed to blood or other bodily fluids contaminated with blood, the employee will be strongly encouraged to ask for HIV and HBV testing to establish a baseline status. 4) Employees refusing blood collection and testing of blood will sign a refusal form. 5) If the employee consents to blood collection but not testing, the blood sample will be preserved at the Department of Public Safety's Evidence Room for ninety (90) days. Employee may elect within that time to have blood tested. 6) If employee requests HIV testing, Santa Rosa Memorial Hospital or Petaluma Valley Hospital, Sonoma County Health Department,-North Bay Corporate Health Services, or the employee's private physician may perform the test and provide pre -test counseling (as required) and prevention information. 7) If the HIV test is performed by Santa Rosa Memorial Hospital, Petaluma Valley Hospital or North Bay Corporate Health Services, results will be sent to the employee's personal physician or healthcare provider who will provide post -test counseling (as required). 8) Employees who are tested for HIV are encouraged to seek counseling /information provided by the Sonoma County Health Department, hospital or clinic. 9) Evaluation of infectious diseases reported shortly after any exposure will be provided to the exposed employee. 10) The employee shall complete the Infection Control Log Book at Santa Rosa Memorial Hospital or Petaluma Valley Hospital or clinic. E. To insure timely submission of forms, the Supervisor will fill out and submit the Supervisor's Report of Injury and accompanying Claim Form (Workers' Compensation Form). F. The employee's supervisor shall: 1) Insure that first aid and medical evaluation are obtained for the exposed employee. 4 G. 2) Make every effort to ascertain the identity and status of the source person. 3) If known, provide identity and status of source person. 4) Advise the employee of the confidentiality of such identity and status information. Medical condition or status shall not be disclosed to non -peace officer or non - medical personnel, except as provided by law. Willful or negligent disclosure to unauthorized persons may result in civil or criminal penalties and departmental discipline. 5) Provide necessary information to the healthcare professional evaluating the exposed employee such as, a copy of this policy; a documented description of the manner in which the employee was exposed; source person's infectious status, if known. 6) Insure that the status of the source person, if known, is relayed to other medical or law enforcement personnel who may have contact with such person (hospital and /or jail personnel). 7) Complete or insure the completion of the following forms; Occupational Injury or Illness (Form 5020); Supervisor's Report of Injury; Employer's Report of Injury; Report of Request and Decision for HIV Testing (DHS 8559) Infection Control Log at Santa Rosa Memorial Hospital or Petaluma Valley Hospital; Sonoma County Department of Health (Form 332). The Supervisor of the exposed employee and /or the Personnel Office shall follow -up on the first business day after the exposure incident by: 1) Insuring exposed employee is provided with a Workers' Compensation Claim Form, that the Immediate Supervisor's Report of Injury has been completed and the appropriate parties are informed, i.e. the Personnel Office. 2) Insuring the follow -up evaluation for the exposed employee is handled adequately in compliance with confidentiality "Privacy Reportt°, State of California Department of Health Services Code 199.20. 3) Making every effort to determine the identity and status of the source person, if not already known. 4) Assisting the exposed employee in obtaining a forced blood test of the source person in accordance with Section 199 -97 of the Health and Safety Code or Section 1524.1 of the Penal Code. 5 5) obtaining and providing the exposed employee with a copy of the evaluating healthcare professional's written opinion within fifteen (15) days of the completion of the evaluation. ARTICLE II Vaccinations A. The City shall make the Hepatitis B antibody vaccination series available to all employees who have occupational exposure unless such employees have already received the complete series, antibody testing reveals the employee has immunity to Hepatitis B, the employee signs a waiver that they don't want the series at the present time, or the vaccination is inadvisable for medical reasons. B. The Hepatitis B antibody vaccination series will start within ten (10) days of the employee's assignment to the position having occupational exposure. The first vaccination will be followed in one month by the second vaccination, five months following the first vaccination, the third and final vaccination will be given. C. An employee who begins the Hepatitis B antibody vaccination series but does not complete the series will be responsible for reimbursing /paying for the entire series. D. Employees who refuse the Hepatitis B antibody vaccination series will be required to sign a waiver. E. An employee who initially refuses the vaccination series may begin the series at a later date at no cost to the employee. F. If an additional booster, vaccination is recommended, such booster will be provided at no cost to the employee. ARTICLE III Personal Protective Equipment A. The City of Rohnert Park provides to all Public Safety personnel the following personal protective equipment; disposable exam gloves; gowns, masks, and eye protection; pocket masks with one -way valves and /or oxygen powered resuscitators, and bag valve masks. B. All personnel shall use the provided personal protective equipment. However, an employee may decline its use if based on the employee's professional judgment, that in a R specific incident, the protective equipment would prevent the delivery of emergency care and would pose a hazard to the safety of the employee, co- worker, or victim. The non- use of personal protective equipment will be investigated and documented to determine whether procedural changes can be made to prevent future occurrences of non -use. C. The City shall provide and have accessible in appropriate sizes personal protective equipment including alternate gloves such as vinyl or hypoallergenic gloves for such employees who need them. D. When personal protective equipment has been contaminated by blood or other bodily fluids, it will be placed in an infectious waste bag and turned over to ambulance staff, if present. If there is no ambulance staff in attendance, employees will dispose of contaminated personal protective equipment by placing equipment in a plastic bag properly labeled as infectious waste and transport it to Santa Rosa Memorial Hospital or Petaluma Valley Hospital for disposal. E. The City will repair or replace personal protective equipment as needed. F. If a garment is contaminated by blood or other bodily fluids, the garment shall be removed as soon as practical and placed in a properly marked infectious waste bag. G. After an incident, all personal protective equipment shall be removed prior to leaving the scene. Employees shall wash their hands and store contaminated equipment in a properly marked infectious waste bag. H. Employee shall wear disposable exam gloves when contact with blood or other bodily fluids, mucous membranes, and non - intact skin can be reasonably anticipated. Gloves shall also be worn when handling or touching contaminated surfaces. I. Disposable gloves shall be replaced as soon as practical when contaminated with blood or other bodily fluids or when they are torn, punctured or their barrier protection is otherwise compromised. J. Disposable gloves are for single use only. Do no wash or decontaminate for re -use. K. Masks in combination with eye protection devices such as goggles or glasses with solid side shields shall be worn whenever splashes, spray, spatter, or droplets of blood or other bodily fluids may be generated and eye, nose, mouth, or non - intact skin contamination can reasonably be anticipated. 7 L. Gowns shall be worn whenever splashes, spray, or spattered blood or other bodily fluids may be generated and contamination to uniform clothing can reasonably be anticipated. ARTICLE IV Work Practice Controls A. Employees shall wear personal protective equipment provided by the City when contact with blood or any other bodily fluids can be reasonably anticipated. B. Employees shall wash their hands immediately after removal of gloves or other personal protective equipment. C. Employees shall wash with soap and water or appropriate disinfectant or flush with water any mucous membranes (mouth, nose, eyes) immediately following contact with blood or any other bodily fluid. D. Employees shall use precaution when handling needles, scalpels or any other sharp instrument contaminated by blood or other bodily fluids. Needles shall not be recapped, bent or broken. Contaminated needles or other sharps shall be placed in an appropriate sharps container and given to the ambulance staff, if present, or taken to Santa Rosa Memorial Hospital or Petaluma Valley Hospital for disposal. E. Bandages, disposable gloves, etc. that have been contaminated by blood or other bodily fluids will be placed in red bags marked "Infectious Waste." The bags shall be properly sealed to prevent leakage while handling or transporting. The infectious waste bag shall be transported to a hospital, with ambulance if possible, and turned over to emergency department staff for disposal. If the infectious waste bag becomes contaminated, place inside a second infectious waste bag and seal prior to releasing for transport. F. Equipment that has been contaminated by blood or other bodily fluids shall be thoroughly examined and decontaminated as necessary before placing the equipment back in service. Appropriate personal protective equipment shall be worn during decontamination of equipment. G. Equipment that remains contaminated shall be clearly labeled to insure that all employees are aware of status of equipment, see Article V of this policy. Such contaminated equipment shall be decontaminated or disposed of as quickly as possible. 0 ARTICLE V Labeling A. Warning labels shall be affixed to containers of regulated waste, refrigerators or freezers containing blood or other bodily fluids that are potentially infectious material as well as other containers used to store, transport or ship blood or other bodily fluids. B. Warning labels shall be fluorescent orange or orange red with lettering or symbols in a contrasting color. C. The lettering will say "BIOHAZARD" and the symbol will be the standard for that type hazard. D. Red bags or red containers may be substituted for labels. E. Labels shall also be placed on any contaminated equipment. ARTICLE VI Training A. Training shall be provided annually to all employees who are incumbents of occupational exposure positions. B. Training shall be conducted at an understandable level. C. Training shall include an explanation of the symptoms and modes of transmission of bloodborne and other infectious diseases. D. Training shall include handling and disposal of contaminated materials and cleaning and sterilization techniques. E. Training shall include information related to legal requirements, standards, and expectations. F. Training shall include review and explanation of this policy. G. Training instruction shall be provided by appropriate professional personnel. ARTICLE VII Housekeeping A. All equipment, environment, and work surfaces shall be 01 cleaned and decontaminated after contact with blood or other bodily fluids. B. Immediately after completion of any incident involving blood or other bodily fluids, contaminated equipment surfaces shall be decontaminated with the proper disinfectant. C. It shall be the shift supervisor's responsibility to insure that all bins, pails, cans or any other receptacle intended for re -use shall be inspected for contamination and that such receptacles are decontaminated immediately, or as soon as practical after being contaminated by blood or other bodily fluids. D. Contaminated sharps shall be disposed of immediately or as soon as practical in a sharps container. E. Sharps containers shall remain upright throughout use, replaced regularly and not allowed to overfill. F. When moving containers of contaminated sharps, the containers shall remain closed to prevent spillage or protrusion of contents during handling or transporting. G. Reusable sharps containers shall not be opened, emptied, or cleaned manually or in any other manner that would expose employees to the risk of injury. H. Contaminated laundry shall be placed in an infectious waste bag at the site of use or as soon as is practical. I. Employees shall use appropriate personal protective equipment when handling contaminated laundry. J. When the contaminated laundry is sent to an off -site cleaner, the bagged laundry shall be clearly labeled as contaminated by blood or other bodily fluid, if known. ARTICLE VIII Recordkeeping A. Medical records will be maintained by the Personnel Office and /or North Bay Corporate Health Services and shall include a copy of the employee's Hepatitis B antibody vaccination; medical validation of employee's inability to receive such vaccinations; and, if vaccinations are declined, a copy of employee's waiver form. B. Medical records will also contain copies of results of testing examinations, follow -up procedures, written opinions /evaluations, and any other information provided by healthcare professionals in regard to an exposure incident. 10 C. Medical records shall be kept confidential and may not be disclosed or reported without the employee's written consent or as may be required by law. D. Medical records shall be kept for the duration of the employee's employment with the City of Rohnert Park plus thirty (30) years. E. Training records will be maintained by each department and shall include the dates of annual training sessions; contents or summary of training sessions; the names, addresses, and qualifications of training instructors; and, the names and titles of all employees receiving the training. F. Training records will be made available in accordance with existing law. 11