Revision: April 30, 2018, 2:56 p.m.
HB 407-FN - AS AMENDED BY THE HOUSE
9Jan2018... 2453h
21Mar2018... 2453h
21Mar2018... 0817h
2017 SESSION
17-0762
01/04
HOUSE BILL 407-FN
AN ACT requiring workers' compensation to cover prophylactic treatment for exposure.
SPONSORS: Rep. White, Graf. 13; Rep. Cahill, Rock. 17
COMMITTEE: Labor, Industrial and Rehabilitative Services
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This bill requires workers' compensation to cover prophylactic treatment for an identified occupational exposure pursuant to RSA 141-G.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
9Jan2018... 2453h
21Mar2018... 2453h
21Mar2018... 0817h 17-0762
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Seventeen
AN ACT requiring workers' compensation to cover prophylactic treatment for exposure.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraph; Workers' Compensation; Definitions. Amend RSA 281-A;2 by inserting after paragraph I-a the following new paragraph:
I-aa. "Airborne disease" means pathogenic microorganisms that may be discharged through respiratory secretions and can cause disease in humans through inhalation or contact with a mucous membrane. In this chapter these are defined as pertussis, meningococcal disease, and tuberculosis.
2 Workers' Compensation; Definitions. Amend RSA 281-A:2, I-d and I-e to read as follows:
I-d. "Bloodborne disease'' means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV), hepatitis C virus, and human immunodeficiency virus (HIV).
I-e. "Critical exposure'' means contact of an employee's ruptured or broken skin or mucous membrane with a person's blood or body fluids, other than tears, saliva, or perspiration, unless these are visibly contaminated with blood, of a magnitude that can result in transmission of bloodborne disease.
3 New Paragraph; Workers' Compensation; Definitions. Amend RSA 281-A:2 by inserting after paragraph V-b the following new paragraph:
V-c. “Emergency response/public safety worker” means call, volunteer, or regular firefighters; law enforcement officers certified under RSA 106-L; certified county corrections officers; and rescue or ambulance workers including ambulance service, emergency medical personnel, first responder service, and volunteer personnel.
4 Workers' Compensation; Definitions. Amend RSA 281-A:2, XIV-a to read as follows:
XIV-a. "Post-exposure prophylaxis" means preventive medical treatment started after an identified critical exposure or unprotected exposure in order to prevent infection and the development of disease, in accordance with standards promulgated by the Centers for Disease Control and Prevention, United States Department of Health and Human Services.
XIV-b. "Unprotected exposure'' includes instances of direct mouth-to-mouth resuscitation or the commingling of blood or other potentially infectious material of a source individual and an emergency response/public safety worker which is capable of transmitting a bloodborne or airborne disease.
XIV-c. "Rehabilitation provider'' as used in this chapter includes any person certified as a vocational rehabilitation provider under RSA 281-A:68 or RSA 281-A:69 and who operates for the purpose of assisting in the rehabilitation of disabled persons through an integrated program of medical and other services which are provided under competent professional supervision.
5 Workers' Compensation; Medical Hospital, and Remedial Care. Amend RSA 281-A:23, VI to read as follows:
VI. An employer subject to this chapter, or the employer's insurance carrier, may furnish or cause to be furnished, testing for the presence of a bloodborne disease when a critical exposure that arises out of and in the course of employment occurs. Such testing shall be provided without prejudice as to the issue of the causal relationship of any subsequently diagnosed bloodborne disease to the employee's work and without prejudice to the compensability of the bloodborne disease as an occupational disease or an accidental injury for the purposes of RSA 281-A. Notwithstanding the foregoing, any costs for testing associated with a testing order issued pursuant to RSA 141-G:11 shall be paid for by the employer's insurance carrier or third-party administrator. Such payment shall be provided without prejudice as to the issue of the causal relationship of any subsequently diagnosed disease or injury.
VI-a. All expenses associated with the medical evaluation and recommended post- exposure prophylaxis treatment for emergency response/public safety workers shall be paid by the employer’s insurance carrier or third-party administrator. Such medical evaluation and prophylaxis treatment shall be provided without prejudice as to the issue of the causal relationship of any subsequently diagnosed bloodborne disease or airborne disease to the emergency response/public safety worker’s work and without prejudice to the compensability of the bloodborne disease or airborne disease as an occupational disease or an accidental injury for the purposes of this chapter.
6 Effective Date. This act shall take effect January 1, 2019.
17-0762
Amended 4/30/18
HB 407-FN- FISCAL NOTE
AS AMENDED BY THE HOUSE (AMENDMENT #2018-0817h)
AN ACT requiring workers' compensation to cover prophylactic treatment for exposure.
FISCAL IMPACT: [ X ] State [ X ] County [ X ] Local [ ] None
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STATE: | FY 2018 | FY 2019 | FY 2020 | FY 2021 | |
Appropriation | $0 | $0 | $0 | $0 | |
Revenue | $0 | $0 | $0 | $0 | |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable | |
Funding Source: | [ X ] General [ ] Education [ X ] Highway [ X ] Other | ||||
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COUNTY: |
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Revenue | $0 | $0 | $0 | $0 | |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable | |
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LOCAL: |
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Revenue | $0 | $0 | $0 | $0 | |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable | |
METHODOLOGY:
The bill expands the scope of covered workers' compensation claims under RSA 281-A to include preventive treatment for emergency response/public safety workers exposed to certain defined airborne diseases (pertussis, meningococcal disease, and tuberculosis) and thus avoid the onset of such airborne diseases in exposed workers. The amendment clarifies the obligation of employers that self-fund workers' compensation through a third party administrator (TPA) to pay for the blood testing orders of a source individual issued under RSA 141-G:11. It also adds the hepatitis C virus to the list of defined bloodborne diseases under RSA 281-A.
The Department of Adminstrative Services indicates the state self-funds state employee workers' compensation claims and utilizes a TPA to administer benefits. The state employs public safety workers at multiple departments and expanding RSA 281-A to include coverage for preventive treatment related to airborne disease exposure may increase the number of covered claims and the amount of treatment costs paid through the workers' compensation system. Treatment costs may include medical examinations and post-prophylaxis medications (e.g. antimicrobial medications administered after an exposure to meningococcal disease). The number of future exposures, cost of treatments and medication costs are unknown. Expanding preventive treatments may reduce costs if it helps to avoid the onset of an airborne disease and related treatment costs. Some costs may simply shift from the self-funded employee health benefit plan to the self-funded workers' compensation plan. The fiscal impact is therefore indeterminable. The fiscal impact related to blood testing orders of a source individual under RSA 141-G:1 now applicable to TPAs is also indeterminable based on the unknown frequency and cost of such orders.
The Department of Labor assumes this bill will increase workers compensation rates paid by employers by an indeterminable amount. Consequently, state, county, and local expenditures will increase by an indeterminable amount due to their role as employers of emergency response/public safety workers and increased workers compensation related expenditures. The Department does not expect the bill would impact the staffing or operations of the Department. There would be no impact on state, county or local revenues.
The New Hampshire Municipal Association states there may be an increased cost for additional workers' compensation claims filed by municipal public safety workers which may be offset by a decrease in cost for long-term health cost for these same individuals. The fiscal impact on municipal worker's compensation rates is indeterminable.
The Insurance Department indicates there would be no fiscal impact to the Department.
The New Hampshire Association of Counties indicates an indeterminable fiscal impact to counties through their risk managers and impact to the risk pool.
AGENCIES CONTACTED:
Departments of Labor, Insurance, and Administrative Services, New Hampshire Association of Counties, and New Hampshire Municipal Association