Introduced by Representatives Donovan of Burlington, Donahue of Northfield, Head of S. Burlington, Myers of Essex, Rodgers of Glover, Shaw of Derby and Wright of Burlington
Subject: Health; hospitals; infection rates; disclosure
Statement of purpose: This bill proposes to require hospitals to report the rates of hospital-acquired infections to the commissioner of banking, insurance, securities, and health care administration.
AN ACT RELATING TO THE DISCLOSURE OF RATES OF HOSPITAL‑ACQUIRED INFECTIONS
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 18 V.S.A. § 9405b is amended to read:
§ 9405b. HOSPITAL COMMUNITY REPORTS
(a) The commissioner, in consultation with representatives from the public oversight commission, hospitals, and other groups of health care professionals shall adopt rules establishing a standard format for community reports, as well as the contents, which shall include:
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summary of the community needs assessment, including a description of strategic
initiatives discussed with or derived from the assessment; the one-year and
four-year capital expenditure plans; and the depreciation schedule for existing
(10) information on membership and governing body qualifications, a listing of the current governing body members, and means of obtaining a schedule of meetings of the hospital's governing body, including times scheduled for public participation; and
(11) a summary of the hospital’s rate of hospital-acquired infections as described in section 9405c of this subchapter.
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Sec. 2. 18 V.S.A. § 9405c is added to read:
§ 9405c. DISCLOSURE OF RATES OF HOSPITAL-ACQUIRED
(a) As used in this section, the following terms have the following definitions:
(1) “Advisory panel” means the infection control advisory panel created by subsection (d) of this section.
(2) “Hospital-acquired infection” means a localized or systemic condition that:
(A) results from adverse reaction to the presence of an infection agent or its toxins; and
(B) was not present or incubating at the time of a patient’s admission to the hospital.
(b) Individual hospitals shall collect data on rates of hospital-acquired infections for the specific clinical procedures determined by rule by the commissioner, including the following categories:
(1) surgical site infections;
(2) ventilator-associated pneumonia;
(3) central line-related bloodstream infections;
(4) urinary tract infections; and
(5) other categories as provided under subdivision (d) of this section.
(c) Hospitals shall submit quarterly reports on their rates of hospital‑acquired infections to the commissioner. Quarterly reports shall be submitted in a form and manner prescribed by rule by the commissioner in consultation with the advisory panel. Data in quarterly reports must cover a period ending not earlier than one month prior to submission of the report. Quarterly reports shall be made available to the public at each hospital and through the department. In addition, a summary of the quarterly reports shall be included in the hospital’s community report as required in subdivision 9405b(11) of this chapter.
(d) The commissioner shall appoint an advisory panel, including representatives from public and private hospitals, direct care nursing staff, physicians, epidemiologists with expertise in hospital-acquired infections, academic researchers, consumer organizations, health insurers, health maintenance organizations, organized labor, and purchasers of health insurance, such as employers. A majority of the members of the advisory panel shall represent interests other than hospitals. The advisory panel shall assist the commissioner in the development of all aspects of the department’s method for collecting, analyzing, and disclosing the information collected under this section, including collection methods and formatting and methods and means for release and dissemination.
(1) In developing the method for collecting and analyzing the infection rate data, the department and advisory panel shall consider existing methods and systems for data collection, such as the Centers for Disease Control's National Nosocomial Infection Surveillance Program, or its successor; however, the department's discretion to adopt a method shall not be limited or restricted to any existing method or system. The data collection and analysis methodology shall be disclosed to the public prior to any public disclosure of hospital-acquired infection rates.
(2) The department and the advisory panel shall evaluate on a regular basis the quality and accuracy of hospital information reported under this section and the data collection, analysis, and dissemination methods.
(3) The department may, after consultation with the advisory panel, require hospitals to collect data on rates of hospital-acquired infections in categories additional to those set forth in subsection (b) of this section.
(e) Beginning in 2007, the commissioner shall submit annually to the legislature a report summarizing the hospital quarterly reports and shall publish the annual report on its web site. The department may issue quarterly informational bulletins at its discretion, summarizing all or part of the information submitted in the hospital quarterly reports. All reports issued by the department shall be risk adjusted. The annual report shall compare the rates of risk-adjusted hospital-acquired infections collected under this section for each individual hospital in the state. The commissioner, in consultation with the advisory panel, shall make this comparison as easy to comprehend as possible. The report shall include also an executive summary written in plain language which shall include a discussion of findings, conclusions, and trends concerning the overall state of hospital-acquired infections in the state, including a comparison to prior years. The report may include policy recommendations, as appropriate. No hospital report or department disclosure may contain information identifying a patient, employee, or licensed health care professional in connection with a specific infection incident. The report shall be made available to any person upon request.
(f) It is the expressed intent of the general assembly that a patient’s right of confidentiality shall not be violated in any manner. Patient Social Security numbers and any other information that could be used to identify an individual patient shall not be released notwithstanding any other provision of law.
(g) A determination by the commissioner that a hospital has violated this section or rules adopted under this section may result in either of the following, or both:
(1) suspension or revocation of licensure under chapter 43 of this title.
(2) a civil penalty of up to $1,000.00 per day per violation for each day the hospital is in violation.
Sec. 3. 18 V.S.A. § 1905(19) is added to read:
(19) All hospitals shall comply with section 9405c of this title, relating to the disclosure of rates of hospital-acquired infections.
The Vermont General Assembly
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