Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO:
KRS
209.550,
209.552,
211.090,
211.180,
214.010,
216.510,
216.515,
216.530,
42 C.F.R.
483.80
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
209.554(1) requires the
Cabinet for Health and Family Services, Department for Public Health to
promulgate administrative regulations to implement provisions of
KRS
209.550 to
KRS
209.554 relating to immunization of residents
and employees of long-term care facilities against influenza and pneumococcal
disease. This administrative regulation establishes requirements for long-term
care facilities to request that residents and employees agree to be vaccinated
against influenza and pneumococcal disease, to provide vaccine for the
residents and employees or to make a referral for vaccination, to maintain
annual documentation of immunizations, and to report outbreaks of influenzalike
illnesses.
Section 1. Definitions.
(1) "Advisory Committee on Immunization
Practices" or "ACIP" means the United States Department of Health and Human
Services (HHS) Committee that makes national immunization recommendations to
the Secretary of HHS, the Assistant Secretary for Health, and the Director of
the Centers for Disease Control and Prevention (CDC).
(2) "Department" is defined by
KRS
209.550(2).
(3) "Employee" is defined by
KRS
209.550(4).
(4) "If vaccine is available" means that a
sufficient supply of vaccine has been produced by vaccine manufacturers and is
available for purchase and shipment.
(5) "Influenza" means an acute viral
infection of the respiratory tract:
(a)
Caused by an influenza virus;
(b)
Confirmed by:
1. Viral culture;
2. Polymerase chain reaction (PCR);
3. Nucleic acid detection testing;
or
4. Rapid influenza diagnostic
testing (RIDT); and
(c)
Characterized by the sudden onset of a group of signs and symptoms such as
fever, headache, myalgia, coryza, sore throat, and a dry cough.
(6) "Influenza-like illness" or
"ILI" means, in the absence of a known cause, other than influenza, an illness
in which a person experiences:
(a) Fever
greater than or equal to 100 degrees Fahrenheit or thirty seven and
eight-tenths (37.8) degrees Celsius, as confirmed through oral or equivalent
methods;
(b) Cough;
(c) Sore throat; or
(d) Cough and sore throat.
(7) "Influenza vaccine" means a
vaccine licensed by the Food and Drug Administration for the prevention of
influenza.
(8) "Immunize" means to
vaccinate.
(9) "Long-term care
facility" is defined by
KRS
209.550(6).
(10) "Medically indicated" means a vaccine is
recommended by the ACIP for a person:
(a) Who
has not been immunized against a disease; and
(b) For whom vaccination is recommended based
on:
1. The age of the person;
2. A preexisting medical condition that may
cause the person to be at risk; or
3. An occupation of the person that may put
others at risk of contracting the disease.
(11) "Outbreak" means two (2) or more cases
of influenza, or ILI, occurring in a single long-term care facility during a
seventy-two (72) hour period.
(12)
"Pneumococcal disease" means a bacterial infection usually involving the lungs
producing inflammation caused by Streptococcus pneumoniae, the bacteria
commonly referred to as "pneumococcus".
(13) "Pneumococcal vaccine" means a vaccine
licensed by the Food and Drug Administration for the prevention of
pneumococcus.
Section 2.
Vaccine Availability.
(1) If vaccine is
available, a long-term care facility shall:
(a) Obtain a sufficient quantity of influenza
and pneumococcal vaccine to immunize each employee and resident of a facility
for whom the vaccine is medically indicated; or
(b) Enter into an agreement with a local
health department or other health care provider to obtain or administer
influenza and pneumococcal vaccine to each employee and resident of a facility
for whom the vaccine is medically indicated and age-appropriate.
(2) A long-term care facility may
charge a third party, a resident, or an employee for the cost of the:
(a) Vaccine; and
(b) Administration of the vaccine.
Section 3. Immunization
Schedule for Residents.
(1) A long-term care
facility shall have an infection prevention and control plan in compliance with
42 C.F.R.
483.80.
(2) Influenza immunization shall be offered
to each resident in compliance with 42. C.F.R. 483.80(d)(1).
(3) Pneumococcal immunization shall be
offered to each resident in compliance with
42 C.F.R.
483.80(d)(2).
Section 4. Immunization for Employees.
(1) A long-term care facility shall request
that each employee agree to be vaccinated on an annual schedule against
influenza when the vaccine is:
(a)
Available;
(b) Medically indicated;
and
(c)
Age-appropriate.
(2) A
long-term care facility shall request that each employee agree to be vaccinated
against pneumococcal disease if the vaccine is:
(a) Available;
(b) Medically indicated; and
(c) Age-appropriate.
(3) If a long-term care facility is located
within a larger facility, such as a hospital, the provisions of this
administrative regulation shall apply to every employee of the larger facility
who may also work in the long-term care facility on a full-time, part-time, or
contractual basis.
Section
5. Health Records.
(1) A
long-term care facility shall maintain an immunization health record for each
employee and resident that shall document:
(a)
The immunization status of the employee or resident for influenza virus and
pneumococ-cal disease;
(b) The date
that the employee or resident received counseling on the risks and benefits of
the vaccines;
(c) The date the
employee or resident was requested to be immunized against influenza virus and
pneumococcal disease; and
(d) The
date the employee or resident was vaccinated against each disease.
(2) If after being advised of the
risks and benefits of the vaccine, an employee, resident, or legal guardian of
a resident refuses to be vaccinated, as provided in
KRS
209.552(5), a long-term care
facility shall document in the health record:
(a) The date each vaccine was
offered;
(b) Each vaccine that was
not administered; and
(c) The
reason each vaccine was refused.
Section 6. Reporting.
(1) Upon recognition of an outbreak of ILI, a
long-term care facility shall report the outbreak within twenty four (24)
hours, by telephone, facsimile, or e-mail to:
(a) The local health department having
jurisdiction; or
(b) The
department.
(2) Upon
receipt of a report of an outbreak from a long-term care facility, a local
health department shall:
(a) Immediately
notify the department; and
(b)
Assist the department in carrying out a public health response as
instructed.
(3) Within
one (1) week of reporting an outbreak of ILI, a long-term care facility shall
submit a completed EPID 200, Kentucky Reportable Disease Form, incorporated by
reference in
902
KAR 2:020, for each affected employee or resident to:
(a) The local health department having
jurisdiction; or
(b) The
department.
(4) Upon
notification of an outbreak of ILI, the local health department having
jurisdiction or the department shall contact the long-term care facility to
make recommendations for appropriate confirmation of the etiology of illness
and intervention.
(5) The
department shall maintain a database of confirmed occurrences of influenza
occurring in long-term care facilities.
(6) All long-term care facilities shall
report the seasonal immunization survey utilizing an electronic reporting
system provided by the department.
Section 7. Educational Literature. The
department shall provide each licensed long-term care facility with access to
the most current vaccine information statements for influenza and pneumococcal
disease as published by the CDC.
STATUTORY AUTHORITY:
KRS
209.554(1)