Purpose and Reason:
The Rhode Island Department of Health (“RIDOH”; “The Department”) is proposing to amend “Immunization, Testing, and Health Screening for Health Care Workers” [216-RICR-20-15-7] to update references, revise tuberculosis testing requirements, and update COVID-19 protocols and infection control.
Proposed Amendments Include
§ 7.1
- Added “and during” to the purpose statement to indicate that screening and testing would occur prior to and also during employment.
- Added “The Rhode Island Department of Health (RIDOH) recommends vaccination for all healthcare workers as a means of reducing the spread of illness and lessening the effects of these illnesses.”
§ 7.2 – Updated regulatory authority citations
§ 7.3 –
- Updated incorporated materials:
- (C) – Replaced CDC guidelines for tuberculosis to 2019 version
- (D) – Updated OSHA blood borne pathogen standards to cite the 2019 version
- Added a reference for “Recommendations of the Advisory Committee on Immunization Practices for Use of a Hepatitis B Vaccine with a Novel Adjuvant.”
§ 7.4
- (A) – Definitions
- (8) – Removed “and stations, as defined in R.I. Gen. Laws § 23-16.2-2” from the definition of healthcare facility, as it is no longer applicable.
- (9) – Removed “that can be transmitted from person to person” from definition of healthcare worker.
- (11) – Removed definition of “Period in which flu is widespread.”
- (13) – Added “licensed” and removed “registered nurse” and “licensed practical nurse” from the definition of practitioner.
- (15) –
- Added “for COVID vaccination” and “within a reasonable timeframe after it becomes available, in consultation with institutional employee health programs.”
- Removed “including any booster dose(s)”
§ 7.5
- (D)
- Replaced “Transient employees or outside contractors” with “Persons”
- Replaced “employment” with “their work.”
- Removed “that can be transmitted from person to person”
- (E) – Replaced “prescribe” with “require.”
- (F) – Replaced “discovering” with “diagnosing.”
- (H) – Added “without any waiting period.”
- (I) – Removed entire subsection
§ 7.6
- (A)
- Changed “each” to “all”
- Removed “involved in direct patient contact”
- (C) – Removed “non-employee, contracted”
- (D) – Replaced “attending patients” with “work.”
§ 7.6.1
- (A) –
- Reworded medical exemption requirement for clarity and to include that a practitioner must provide a valid medical exemption.
- Added “For Hepatitis B, Influenza, and COVID vaccines, the option to decline exists, see §§ 7.6.1(A)(4), (5), and (6) of this Part below.”
- (1)(a)(2) – Added “past” to requirement of laboratory evidence and replaced “laboratory” with “titer.”
- (2)(a)((3)) – Added option to cite a provider verification of a history of herpes zoster as an alternative to a varicella vaccine.
- (4) – Hepatitis B section was moved to subsection 4.
- §§ (c)(2) and (3) were removed and § (c)(1) was revised to cite the newly incorporated reference.
- (5)
- Removed “Annual Seasonal” from the Influenza header.
- Section was updated and reorganized for clarity. New text was added.
- (5)(g) – Added “annually” to reporting requirements
- (5)(g)((4)) and ((5)) – Removed the requirement to report the number of workers who decline the vaccine for personal reasons.
- (5) – Moved this section to § 7.6.2
- (6) – Added this section as an updated and expanded version of the former § 7.6.1(B).
§ 7.6.2
- (A) – Revised requirements for pre-employment testing including replacing PPD tests with TST and BAMT with IGRA.
- (6) – Revised wording for unusual circumstances that do not meet the criteria as listed.
- (B) – Reworded and added to section from previous version to update requirements for TB testing.
§ 7.7
- (B) – Removed “With such documentation, each healthcare facility shall additionally maintain documentary proof of COVID-19 vaccination. Documentation of status and proof of vaccination, including month, day, and year of vaccine administration shall be made available to the Department upon request.”
- (C) – Added “and testing.”
§§ 7.8 and 7.9 – Removed sections covering Vaccination Refusal and Violations
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Comment(s) Received*