LEGISLATION ON HEALTHCARE-ASSOCIATED INFECTIONS

States with legislation passed:

25 state laws require public reporting of hospital-acquired infection rates.

2 state laws require confidential reporting of infection rates to state agencies (NE, NV).

2 state law permits voluntary public reporting of infection information (AR, AZ).

5 states have study laws on public reporting (AK, GA, IN, NM, NC).

16 states and D.C. have no laws on public reporting of hospital infections.  Only 3 states (MT, ND, WY) have not entertained any legislation on the matter.

LAWS REQUIRING PUBLIC REPORTING OF INFECTION RATES

California (2008)

To read the law, go to:

http://info.sen.ca.gov/pub/07-08/bill/sen/sb_1051-100/sb_1058_bill_20080225_amended_sen_v98.pdf

Beginning Januarly 2011, annual reports will provide facility-specific hospital infection rates for for: MRSA; Vancomycin-resistant enterococcal bloodstream infections, and the number of inpatient days; central-line associated bloodstream infections, and the total number of days patients have central lines; surgical-site infections; and C. difficile. 

The laws include screening of high-risk patients for MRSA, and follow-up screening for the prevention of the spread of both hospital-acquired and community-acquired MRSA.  Additionally, those patients who are screened as positive for MRSA must be told of the results, and precautions must be taken to prevent the spread of MRSA in the hospital.  Positive-tested patients must be given information on how to treat it and prevent the transmission of MRSA.  The laws also call for improved oversight by the licensing agency, as well as training on prevention of infections for healthcare workers in hospitals.

For more information, go to: www.dhs.ca.gov

Colorado (2006)

To read the law, go to http://www.leg.state.co.us/2003a/inetcbill.nsf/fsbillcont/8B5A1642447EFBD987256C5A006271E6?Open&file=1045_enr.pdf

The law requires hospitals, ambulatory surgical centers and dialysis centers to report incidents of hospital-acquired infections to the CDC for analysis, which in turn will be used by Colorado’s department of health to publicize information on infection rates at individual sites.  The first report, which was issued in January 2008, includes infection rates for cardiac and orthopedic surgical site infections, and central-line bloodstream infections.    

For the reports, go to: www.cdphe.state.co.us/hf/PatientSafety/HFAI/index.html

Connecticut (2006)

To read the law, go to: 

http://www.cga.ct.gov/2006/ACT/PA/2006PA-00142-R00SB-00160-PA.htm

The law requires hospitals to report infections to the state’s health department. A committee, which includes consumer representatives, will advise the department on specifics regarding the types of outcome and process measures to be collected, as well as how these are to be collected and reported.  The department will then make hospital-specific infection information available to the public.  Quality reports are available on Connecticut’s Department of Health website.

For more information, go to: http://www.ct.gov/dph/cwp/view.asp?a=3136&q=417318

Delaware (2007)

To read the law, go to:

http://delcode.delaware.gov/title16/c010a/index.shtml

The law requires hospitals to report on infection rates through the state’s department of health.  Hospitals are to report infections to the CDC on a quarterly basis. The first report is to be issued by June 30, 2009; quarterly updates will be available to the public at each hospital and by the department of health.  The law also requires correctional facilities to report hospital-acquired infections related to specific procedures.

For more information, go to: www.dhss.delaware.gov/dhss

Florida (2004)

This law has the Agency for Health Care Administration take the lead in collecting and reporting on hospital-acquired infections.  Florida was the first state to publish a hospital-specific report on hospital infections, which was released in November 2005. 

For more information, go to: http://www.doh.state.fl.us/Disease_ctrl/epi/Epi_Updates/Epi_Weekly/11-04-05.htm

Illinois (2003/amended in 2005)

Recent amendments to the 2003 law require reporting of central-line infections, surgical site infections and ventilator-associated pneumonia in the critical-care units of hospitals.  An annual report is due on December 31 of each year.  Though the first report was to be issued in 2007, it never materialized.   

For more information, go to: idph.state.il.us

Maryland (2006)

This law requires the healthcare commission to include hospital-acquired infection information in the current reporting system on the quality of care in hospitals, which includes comparative data on individual hospitals in the state. 

For more information, go to: www.dhmh.state.md.us

Massachusetts (2008)

Requires hospitals to report infection rates and prohibits payment for some hospital- acquired conditions by state agencies.

For more information, go to: www.mass.gov/?pageID=eohhs2agencylanding&L=4&L0=Home&L1=Government&L2=Departments+and+Divisions&L3=Department+of+Public+Health&sid=Eeohhs2

Minnesota (2007)

Requires hospitals to report hospital-acquired infection measures stipulated by the National Quality Forum.   The first report is expected in January 2009.

For more information, go to: https://www.revisor.leg.state.mn.us/statutes/?id=144.585   

Missouri (2004)

Requires hospitals to report risk-adjusted rates for surgical-site infections, ventilator-associated pneumonia and central-line bloodstream infections.  Two reports are currently available on the department of health website: one on bloodstream infections and surgical infections for total hip replacements, and the other on CABG and abdominal hysterectomies.   

For more information, go to: http://www.dhss.mo.gov/HAI/

New Jersey (2007)

Hospital infection rates are to be reported to the Department of Health and Senior Services.  The reports include hospital quality indicators, which are to be selected by the Commissioner of Health in consultation with the Quality Improvement Advisory Committee. 

For more information, go to: http://www.state.nj.us/health/hais/index.shtml

New York (2005)

For the law on reporting, go to: Public Health Consolidated Laws: 

Article 28, Section 2819

http://public.leginfo.state.ny.us/menugetf.cgi?COMMONQUERY=LAWS

This public reporting law, which was adopted by the National Conference of Insurance Legislators (NCOIL), as a model act was developed by the state’s hospital associations and with consumer organizations, including the Committee to Reduce Infection Deaths. The first report, released in June 2008, provided aggregate statewide data and hospital-level data without naming the hospital. 

A subsequent report, to be published in May 2009, will include data on central-line and surgical-site infection rates in intensive-care units at individual hospitals.  Ventilator-associated pneumonia rates in critical care units are expected in later reports.  The law also allows the health department to require additional reporting, as deemed necessary by advisory committee.  MRSA and C. diff are not required by law and have not been included by the advisory committee.  RID urges patients to contact their local state lawmakers to insist on disclosure of MRSA and C. diff rates as well.

For more information, go to: http://www.nyhealth.gov/nysdoh/hospital/reports/hospital_acquired_infections

New Hampshire (2006)

This law requires hospitals to report the rate of central-line related bloodstream infections, ventilator-associated pneumonia and surgical-site infections.  The department of health has the authority to add other measures to these reports in the future. The first report has been delayed and is not expected until 2009.   

For more information, go to: www.dhhs.state.nh.us/DHHS/DHHS_SITE/default.htm

Ohio (2006)

The law establishes a council that is to consult with consumers, nurses, and infection control professionals on reporting infection rates.  The law requires various price and performance data to be collected from hospitals beginning in 2007, and to be reported to the public within 90 days of getting the information from the hospitals. 

For more information, go to:

http://www.odh.ohio.gov/search/odhsearch.aspx?cx=005573049444910625664%3Aqpjdmnnabcy&cof=FORID%3A11&ie=UTF-8&q=hospital+infections&x=16&y=8#1220

Oklahoma (2006)

This law gives an advisory council formed by the Commissioner of Health the right to approve the reporting of new facility-specific quality indicators, including certain hospital-infection related indices and incidences.

For more information, go to: http://www.ok.gov/health/Disease,_Prevention,_Preparedness/Acute_Disease_Service/Seasonal_Disease_Topics/Staph_and_MRSA/

Oregon

The law requires the Office of Health Policy and Research (OHPR) to implement hospital infection reporting, but does not specify which infections are to be reported.  The first public report is to be available by January 2010.

For more information, go to:  www.oregon.gov/DHS/ph/

Pennsylvania (2004/amended in 2007) 

PA has published the most comprehensive reports on hospital infections, including central-line infections, surgical-site infections, ventilator-associated pneumonia and catheter-associated urinary-tract infections. 

For the reports, go to:  http://www.phc4.com  

Click “Reports” in the subheading, then “Hospital Infections”.

Rhode Island (2008)

The laws require the department of health to compare infection rates among the state’s hospitals.  An advisory committee is to develop the reporting system and determine which infection rates are to be reported.  The law allows for reporting on the four major types of hospital-acquired infections (surgical site infections, ventilator associated pneumonia, central-line bloodstream infections, and urinary tract infections), but allows for the advisory committee to recommend additional reporting.  Surgical infection reporting must include post-discharge surveillance.  The state may also report measures that indicate hospitals’ compliance with infection-prevention practices.  The first public report is expected January 2010 on the department of health’s website; individual hospitals must also make their data available.

For more information, go to: www.health.state.ri.us

South Carolina (2006)

This state’s first annual report was issued in August 2008 and can be found at http://www.scdhec.gov/health/disease/hai/reports.htm.  Click on the hospital of your choice for the report, which includes rates for surgical-site infections and central-line bloodstream infections.   

Tennessee (2006)

This law calls only for the reporting of central-line bloodstream infections in intensive-care units.  A task force will develop an infection reporting system, and may recommend additional reporting measures.  RID urges patients to contact their state lawmakers to insist upon the inclusion of MRSA and C. diff rates, as well as catheter and surgical-site infection rates.  

For more information, go to: http://health.state.tn.us/mrsa/index.htm

Texas (2007)

This law on hospital reporting requires hospitals and ambulatory surgical centers to reports surgical-site infections and central-line bloodstream infections in intensive-care units. It also requires reporting for pediatric and adolescent hospitals/units.  The first report was to be issued June 2008, but the state failed to fund the initiative, which has delayed its implementation.   

For more information, go to: www.dshs.state.tx.us

Virginia (2005)

The law went into effect in July 2008, and requires acute care hospitals to report nosocomial infection rates through the CDC National Health Safety Network.  No specifics on how a reporting system is to be developed or when the reports will be made public.

For more information, go to:  www.vdh.state.va.us

Vermont (2006)

The first reports were issued in 2006, but did not include comparative data on hospital infection rates.  Subsequent reports include hospital-specific infection rates for surgical site infections and central-line bloodstream infections.  The reports may be accessed at www.vthospitalreportcards.info 

Washington (2007)

The law requires infection rate disclosure in stages, beginning with central-line infections in July 2008, then ventilator-associated pneumonia in January 2009, and finally surgical site infections in January 2010.  The first report is to be published on the website of the department of health in December 2009.   

For more information, go to: http://www.doh.wa.gov/hsqa/fsl/crs/pdf/S&C-08-04.pdf 

West Virginia (2008)

The first report on hospital infections is expected in January 2011.  Hospitals may be fined for failure to disclose infection rates.  Though the law doesn’t specify the infections to be reported, an advisory committee working in conjunction with the West Virginia Healthcare Authority, is to develop a reporting system and decide how information is to be reported to the public. 

For more information, go to:  www.wvdhhr.org

VOLUNTARY OR NON-PUBLIC HOSPITAL INFECTION REPORTING

Arizona (2006)  Non-legislative initiative by the state calls for voluntary reporting of hospital infections to the state health department.

Arkansas (2007)  The law requires health facilities to collect data on healthcare-associated infections for surgical-site infections and central-line bloodstream infections in intensive care units.  Facilities may voluntarily submit quarterly reports to the state’s Department of Health and Human Services, which is summarized for the legislature and then presented to the public on the DOHHS website. 

Nebraska (2005)  Though it is mandatory to gather information on the numbers of hospital infection, the information is held only by state agencies and is not shared with the public. 

Nevada (2005)  Though it is mandatory to gather information on the numbers of hospital infection, the information is held only by state agencies and is not shared with the public. 

STATES WITH STUDIES ON HAI REPORTING

Alaska (2006) A task force has been put together to make recommendations on how hospitals should disclose their infection rates.  No report has been disclosed yet.

Georgia (2006) A state commission is studying hospital safety standards and best practices, as well as the cause and incidence of infections.  No report has been disclosed yet.   

Indiana (2005 and 2007) The 2007 law requires the state department of health to collect, analyze and disseminate findings on patient safety.  The law makes it voluntary for certain persons to submit information to the agency, and makes the reports and certain other information confidential and privileged.   The 2005 act establishes the medical informatics commission, which is to conduct a study on health care information and which is to develop health care quality indicators on various patient safety issues, including healthcare-associated infection rates. 

New Mexico (2007)  A state task force is initiating a pilot program for reporting hospital-acquired infections. The results of the pilot program, which is launched in six hospitals, will be used to determine the best methods for reporting infections.

North Carolina (2007) This law establishes an advisory commission for the purpose of preparing state agencies, hospitals, and the public for the reporting and public disclosure of hospital-acquired infection incidence rates, but is not yet required.

STATES WITH NO PUBLIC HAI LEGISLATION

Alabama – bill died in session

Georgia – bill died in session

Hawaii -- bill died in session

Idaho – bill died in session

Iowa – law on correctional facility infection incidence only; no public reporting of HAI

Kansas – bill died in session

Kentucky – bill pending

Louisiana – bill died in session

Maine – an annual report is submitted to the legislature on statewide efforts to prevent hospital-acquired infections, which are then to be made available to the public.

Michigan – bill died in session.

Mississippi – bill died in session

Montana – has yet to entertain a bill on any of these issues

North Dakota – has yet to entertain a bill on any of these issues

South Dakota – bill died in session

Wisconsin – bill died in session

Wyoming – has yet to entertain a bill on any of these issues

District of Columbia – bill died in session