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Occupational Exposures in Corrections

Summary, Status, Action You Can Take and Read More
Updated: April 20, 2004

Summary: More fear than risk surrounds this issue. There has never been a documented case of inmate-to-corrections employee HIV transmission. Upon review of existing statutes, the Minnesota Department of Health concluded there was ”no public health need to include corrections workers in the EMS statute.”

An individual who experiences a significant exposure to HIV in an occupational setting, as determined in consultation with an experienced infectious disease physician, can virtually eliminate risk of HIV infection through post exposure prophylactic treatment. The treatment should start as soon as possible, but certainly within 72 hours. It involves taking HIV anti-viral drugs for a period of two to four weeks. Initiating and continuing treatment are actions that should be taken, regardless of the HIV status of the other person involved in the exposure.

For Hepatitis A & B, the best response if prevention. Vaccines exist to prevent infections. There is no post-exposure prevention treatment for Hepatitis C and also no urgency for immediate treatment if an infection occurs. The response that provides the only certain and reliable information for an exposed individual is to be monitored for symptoms of acute infections and to get tested. The status of the other person involved in the exposure provides no reliable infection information.

In 1998 and 1999, the Minnesota Department of Health convened a study process that resulted in enactment of completely redrafted EMS and correctional workers blood borne pathogens laws in 2000. There is currently a process in place for ensuring timely responses to prevent infections and provide care for exposed workers.

Addressing only one form of risk – inmate-to-employee transmission, does not create a safe workplace in correctional settings. It requires universal precautions addressing employee-to-inmate transmission, employee-to-employee transmission or inmate-to-inmate transmission, even though these scenarios are as likely. It requires an ongoing program of workplace education to counter misinformation and fear about exposure risk. It requires access to health care to manage disease and infection risk. The best policy for creating safer workplace requires a comprehensive approach that is not achieved through a forced testing plan.

Sharing of medical information needs to be carefully managing in any workplace setting. Attention needs to be paid to both the release of formal records as well as informally inferred information. This is particularly when it comes to something like HIV in the corrections setting where it is too easy for the information to be misused; subjecting inmates and others to discrimination, maltreatment and violence because of his/her presumed or actual HIV status.

Status: Current language in the House Omnibus Crime Prevention bill [HF2028] would allow forced HIV testing of inmates, allowing wardens to override or circumvent the existing court-order process for getting an inmate's blood sample in cases of significant occupational exposures by correctional workers. Correctional workers continue to push for changes despite the fact there has never been a documented case of HIV infection through occupational exposure. MAP opposes the proposed change that would affect a law enacted in 2000 after a two-year Department of Health study. MAP is working with the union representatives to address the concerns of corrections workers while ensuring that sound public health procedures remain in place. Complicating the legislative situation is the fact stand-alone bills including the language that was put into the House Omnibus Crime Prevention bill could also come up for votes in the House [HF2339] or Senate [SF2640]. See Take Action above for more on what you can do, and the MAP Bill Tracker for more information.

OCCUPATIONAL EXPOSURE TO BLOODBORN PATHOGENS IN CORRECTIONAL FACILITIES
HF2028 – HOUSE OMNIBUS CRIME PREVENTION BILL

150.3 Sec. 5. Minnesota Statutes 2002, section 241.336, is
150.4 amended by adding a subdivision to read:
150.5 Subd. 3. [PROCEDURES WITHOUT CONSENT; EXPEDITED PROCESS;
150.6 INMATE NOTICE.] (a) An inmate in a correctional facility is
150.7 subject to the collection and testing of a blood sample if a
150.8 significant exposure occurs. In the absence of affirmative
150.9 consent and cooperation in the collection of a blood sample, the
150.10 head of a correctional facility may order an inmate to provide a
150.11 blood sample for testing for bloodborne pathogens if the
150.12 requirements of this subdivision are met.
150.13 (b) The head of a correctional facility must not order the
150.14 taking of a blood sample under this subdivision unless one or
150.15 more affidavits have been executed attesting that:
150.16 (1) the correctional facility followed the procedures in
150.17 sections 241.33 to 241.342 and attempted to obtain bloodborne
150.18 pathogen test results according to those sections;
150.19 (2) a licensed physician knowledgeable about the most
150.20 current recommendations of the United States Public Health
150.21 Service has determined that a significant exposure has occurred
150.22 to the corrections employee under section 241.341; and
150.23 (3) a physician has documented that the corrections
150.24 employee has provided a blood sample and consented to testing
150.25 for bloodborne pathogens, and bloodborne pathogen test results
150.26 are needed for beginning, continuing, modifying, or
150.27 discontinuing medical treatment for the corrections employee
150.28 under section 241.341.
150.29 (c) The head of the correctional facility may order the
150.30 inmate to provide a blood sample for bloodborne pathogen testing
150.31 if, based on the affidavits submitted under paragraph (b) or
150.32 other available evidence:
150.33 (1) there is probable cause to believe the corrections
150.34 employee has experienced a significant exposure to the inmate;
150.35 (2) the correctional facility imposes appropriate
150.36 safeguards against unauthorized disclosure, limits uses of
151.1 samples to those authorized by section 241.338, limits access to
151.2 the test results to the inmate and to persons who have a direct
151.3 need for the test results, and establishes a protocol for the
151.4 destruction of test results after they are no longer needed;
151.5 (3) a physician for the corrections employee needs the test
151.6 results for beginning, continuing, modifying, or discontinuing
151.7 medical treatment for the corrections employee; and
151.8 (4) the head of the correctional facility finds that the
151.9 interests of the corrections employee and the state in obtaining
151.10 the test results outweigh the interests of the inmate. In that
151.11 analysis, the head of the correctional facility may consider the
151.12 corrections employee's interests, including health, safety,
151.13 productivity, resumption of normal work and nonwork activities,
151.14 and peace of mind against the interests of the inmate, including
151.15 privacy, health, and safety. The head of the correctional
151.16 facility may also consider the interests of the state and
151.17 public, including economic, productivity, and safety interests.
151.18 (d) Facilities shall cooperate with petitioners in
151.19 providing any necessary affidavits to the extent that facility
151.20 staff can attest under oath to the facts in the affidavits.
151.21 (e) The commissioner of corrections and the director of
151.22 each local correctional facility must provide written notice to
151.23 each inmate through the inmate handbook, or a comparable
151.24 document, that an inmate may be subject to a blood draw without
151.25 a hearing if the inmate causes bodily fluids to come into
151.26 contact with employees of the Department of Corrections or
151.27 employees of local correctional facilities.
151.28 [EFFECTIVE DATE.] This section is effective the day
151.29 following final enactment.

S.F No. 2640, 1st Engrossment: 83rd Legislative Session (2003-2004)

Posted on Mar 31, 2004
1.1 A bill for an act
1.2 relating to correctional officer safety; establishing
1.3 an expedited process for the nonconsensual collection
1.4 of a blood sample from an inmate when a corrections
1.5 employee is significantly exposed to the potential
1.6 transfer of a bloodborne pathogen; amending Minnesota
1.7 Statutes 2002, section 241.336, by adding a
1.8 subdivision.
1.9 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.10 Section 1. Minnesota Statutes 2002, section 241.336, is
1.11 amended by adding a subdivision to read:
1.12 Subd. 3. [PROCEDURES WITHOUT CONSENT; EXPEDITED
1.13 PROCESS.] (a) As used in this subdivision, "qualified physician"
1.14 means a person who:
1.15 (1) is a licensed physician employed by or under contract
1.16 with the correctional facility to provide services to employees
1.17 and inmates; and
1.18 (2) is an infectious disease specialist or consults with an
1.19 infectious disease specialist or a hospital infectious disease
1.20 officer.
1.21 (b) An inmate in a correctional facility is subject to the
1.22 release of medical information related to bloodborne pathogen
1.23 infections or the collection and testing of a blood sample if a
1.24 significant exposure occurs as determined by procedures in
1.25 section 241.331, subdivision 2, clause (1). In the absence of
1.26 affirmative consent and cooperation in the release of medical
1.27 information or collection of a blood sample, the head of a
2.1 correctional facility, having reported to and consulted with the
2.2 state epidemiologist, may order an inmate to provide release of
2.3 medical information related to bloodborne pathogen infections or
2.4 a blood sample for testing for bloodborne pathogens if:
2.5 (1) the correctional facility followed the procedures in
2.6 sections 241.33 to 241.336, subdivision 1, and 241.337 to
2.7 241.342 and attempted to obtain bloodborne pathogen test results
2.8 according to those sections;
2.9 (2) a qualified physician has determined that a significant
2.10 exposure has occurred to the corrections employee under section
2.11 241.341;
2.12 (3) a qualified physician has documented that the
2.13 corrections employee has received vaccinations for preventing
2.14 bloodborne pathogens, provided a blood sample, and consented to
2.15 testing for bloodborne pathogens, and that bloodborne pathogen
2.16 test results are needed for beginning, continuing, modifying, or
2.17 discontinuing medical treatment for the corrections employee
2.18 under section 241.341;
2.19 (4) the head of the correctional facility has received
2.20 affidavits from qualified physicians, treating the corrections
2.21 worker and the inmate, attesting that a significant exposure has
2.22 occurred to the corrections employee under section 241.341;
2.23 (5) the correctional facility imposes appropriate
2.24 safeguards against unauthorized disclosure and use of medical
2.25 information or samples consistent with those established in
2.26 sections 241.331 to 241.34;
2.27 (6) a qualified physician for the corrections employee
2.28 needs the test results for beginning, continuing, modifying, or
2.29 discontinuing medical treatment for the corrections employee;
2.30 and
2.31 (7) the head of the correctional facility finds a
2.32 compelling need for the medical information or test results.
2.33 In assessing whether a compelling need exists under clause
2.34 (7), the head of the correctional facility shall weigh the
2.35 officer's need for the exchange of medical information or blood
2.36 collection and test results against the interests of the inmate,
3.1 including, but not limited to, privacy, health, safety, or
3.2 economic interests. The head of the correctional facility shall
3.3 also consider whether release of medical information or
3.4 involuntary blood collection and testing would serve or harm
3.5 public health interests.
3.6 (c) Each state and local correctional facility shall adopt
3.7 a plan for implementing by July 1, 2006, policies and procedures
3.8 for:
3.9 (1) the education and treatment of corrections employees
3.10 and inmates that are consistent with those established by the
3.11 Department of Corrections;
3.12 (2) ensuring that corrections employees and inmates are
3.13 routinely offered and are provided voluntary vaccinations to
3.14 prevent bloodborne pathogen infections;
3.15 (3) ensuring that corrections employees and inmates are
3.16 routinely offered and are provided with voluntary postexposure
3.17 prophylactic treatments for bloodborne pathogen infections in
3.18 accordance with the most current guidelines of the United States
3.19 Public Health Service; and
3.20 (4) ensuring voluntary access to treatment for bloodborne
3.21 pathogen infections in accordance with the most current
3.22 guidelines of the United States Public Health Service for
3.23 corrections workers or inmates who are determined to have a
3.24 bloodborne pathogen infection through procedures established in
3.25 sections 241.331 to 241.34.
3.26 (d) The commissioner of corrections and the director of
3.27 each local correctional facility shall provide written notice to
3.28 each inmate through the inmate handbook, or a comparable
3.29 document, of the provisions of this subdivision.
3.30 [EFFECTIVE DATE.] This section is effective the day
3.31 following final enactment.

Action You Can Take:
1. Keep informed. Check the current issue of the MAP Advocate to find out what's happening.

2. Write a letter. Send a letter to the editor of your local paper or send and email to a friend.

3. Contact your legislators. Send an email or make a phone call to your State Senator and State Representative.

Read More:
MAP Advocate
MAP Action Agenda
MAP Facts

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