Article 1 in general 35 1 101. Local contributions; disposition
25 204. Wyoming colorectal cancer early detection and prevention program
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- 35 25 205. Breast and cervical cancer programs.
- 35 25 206. Pain management.
- 35 25 301. Diabetes care planning; reports to the legislature.
- 35 26 101. Automated external defibrillators; definitions.
- 35 26 102. Possession of automated external defibrillator.
- 35 26 103. Limited liability for use of automated external defibrillator.
- 35 27 101. Definitions.
- 35 27 102. Public health nursing infant home visitation subprogram created; eligibility.
- 35 27 103. Program evaluation and statistical information.
- 35 27 104. Program funding.
- 35 28 101. Definitions.
- 35 28 102. Establishment of a safety program.
35 25 204. Wyoming colorectal cancer early detection and prevention program. (a) Subject to the availability of appropriations, the department shall undertake a colorectal cancer screening and prevention program for those who qualify as specified in subsection (c) of this section. (b) Initially the screening and prevention program funded under this program shall consist of colonoscopies which shall consist of both the examination of the colon and rectum and the removal and pathological examination of polyps in accordance with the normal standards of care for colonoscopies. After July 1, 2008, the department may, by rule and regulation, authorize other forms of screening to participate in the program provided these other forms of screening are evidence based and are shown by the evidence to be as effective or as cost effective as traditional colonoscopies. (c) Starting July 1, 2007 Wyoming residents with incomes at or below two hundred and fifty percent (250%) of the federal poverty level shall be eligible to participate in this program and this shall remain the standard if the biennial budget bill does not establish a different standard and unless a different standard is established pursuant to subsection (d) of this section. (d) Eligibility for the program set forth in this section shall be limited to individuals who are Wyoming residents and have been so for at least one (1) year immediately prior to screening. The eligibility shall be for one (1) colonoscopy every ten (10) years, counting any done before the effective date of this act or before the individual became a Wyoming resident. However, the department on a case-by-case basis may authorize follow-up screening when medically indicated based on national evidence based guidelines. Eligibility shall be restricted to individuals who are at least fifty (50) years old and who have not become eligible for the federal Medicare program. In the event that analysis shows spending in the program will exceed the budget available, the department shall institute a waiting list. (e) The department shall provide vouchers to eligible persons for reimbursement for a colonoscopy at the rate paid under the Wyoming Medical Assistance and Services Act for colonoscopies, including polyp removal. The person receiving a voucher under this subsection shall pay all other costs of the colonoscopy. When the funds appropriated for this program are expended, the department shall cease issuing vouchers under this section. (f) The department shall develop an internet based application process for determining individual eligibility. The result of a successful application may be a voucher that the individual may present to a provider the department has contracted with or may be an online statement of eligibility that the providers can access or both. The department may use city or county health departments, other public health offices, providers, advocacy groups and any other appropriate governmental or private entities to assist individuals in completing the application process. 35 25 205. Breast and cervical cancer programs. (a) The breast and cervical cancer program within the department is authorized to obtain private and federal grant funds and to seek appropriations for: (i) Education, outreach and breast and cervical cancer screenings for those unable to afford them; (ii) Continuation of the existing pilot outreach program for the medically underserved population in the Big Horn Basin and expansion of that program to other areas of the state; and (iii) Implementation of the program known as the native sisters program for outreach to members of the Shoshone and Arapaho Tribes, provided that any grants or contracts entered into pursuant to this paragraph shall contain any restrictions necessary to comply with Article 16, Section 6 of the Wyoming Constitution. 35 25 206. Pain management. (a) The department may establish an acute and chronic pain management advisory committee consisting of the following members: (i) One (1) employee of the department appointed by the director who will serve as the chairman of the committee; (ii) One (1) member appointed by the board of medicine; (iii) One (1) member appointed by the board of nursing; (iv) One (1) member appointed by the board of pharmacy; and (v) One (1) member of the public who has experience in pain management appointed by the director. (b) The members of the pain management advisory committee shall serve at the pleasure of the director of the department and shall meet at least two (2) times each year. The travel expenses of the members of the pain management committee as described in subsection (a) of this section shall be paid by their respective departments or boards. The department shall pay the per diem and travel expenses of the member of the public appointed pursuant to paragraph (v) of subsection (a) of this section and shall provide administrative support for the operation of the committee. (c) The committee shall perform the following functions: (i) Research issues associated with acute and chronic pain management including those issues assigned to the committee by the director of the department; (ii) Offer recommendations to the director of the department, other state agencies and licensing boards of health care professionals regarding policies and programs that would manage acute and chronic pain more effectively or efficiently; and (iii) Make recommendations regarding legislation to the director of the department. ARTICLE 3 DIABETES CARE PLANNING 35 25 301. Diabetes care planning; reports to the legislature. (a) The department of health shall develop a plan to reduce the incidence of diabetes in Wyoming, improve diabetes care, and control complications associated with diabetes. The plan shall include identification of goals and benchmarks. The department shall submit the plan to the joint labor, health and social services interim committee by October 1, 2014. (b) The department of health shall track for statistical and trending analysis the following: (i) The prevalence of all types of diabetes in the state and the financial impact that diabetes is having on the state. Items included in this assessment shall include the number of individuals with diabetes, the number of individuals with diabetes and family members impacted by prevention and diabetes control programs implemented by the department, the financial toll or impact diabetes and its complications place on the Medicaid program and the financial toll or impact diabetes and its complications place on the Medicaid program in comparison to other chronic diseases and conditions; (ii) An assessment of the benefits of implemented programs and activities aimed at controlling diabetes and preventing the disease; (iii) A description of the level of coordination existing between the department, other agencies and Shoshone and Arapaho tribes on activities, programmatic activities and messaging on managing, treating or preventing all forms of diabetes and its complications; (iv) Detailed action plans for battling diabetes with a range of actionable items for consideration by the legislature. The plans shall identify proposed action steps to reduce the impact of diabetes, prediabetes and related diabetes complications. The plan shall also identify expected outcomes of the action steps proposed in the following biennium while also establishing benchmarks for controlling and preventing relevant forms of diabetes; and (v) The impact of gestational diabetes on the Medicaid population, including an analysis of cost implications, the number of pregnant women screened and diagnosed and patient outcome measures and recommended strategies to reduce the impact of the condition and to improve outcomes for this population; (vi) The development of a detailed budget blueprint identifying needs, costs and resources required to implement the plan developed pursuant to this section. The blueprint shall include a budget range for all options presented in the plan for consideration by the legislature. CHAPTER 26 AUTOMATED EXTERNAL DEFIBRILLATORS 35 26 101. Automated external defibrillators; definitions. (a) As used in this article: (i) "Automated external defibrillator (AED)" means a medical device heart monitor and defibrillator that: (A) Has received approval of its premarket notification filed pursuant to U.S. Code, title 21, section 360(k) from the U.S. Food and Drug Administration; (B) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, and is capable of determining, without intervention by an operator, whether defibrillation should be performed; and (C) Upon determining that defibrillation should be performed, automatically charges and delivers, or requests delivery of, an electrical impulse to an individual's heart. 35 26 102. Possession of automated external defibrillator. (a) In order to ensure public health and safety, all persons who possess an AED shall: (i) Obtain appropriate training in cardiopulmonary resuscitation (CPR) and in the use of an AED by the American Heart Association, American Red Cross or by another nationally recognized, or Wyoming department of health recognized, course in CPR and AED use and maintains currency through refresher training every two (2) years; and (ii) Ensure that the AED is maintained and tested according to the manufacturer's guidelines. (iii) Repealed by Laws 2005, ch. 89, § 2. (b) Any person or entity in possession of an AED shall notify an agent of the emergency communications center and the local ambulance service of the existence, location and type of AED. 35 26 103. Limited liability for use of automated external defibrillator. (a) Any person who uses or attempts to use an automated external defibrillator device on a victim of a perceived medical emergency, any prescribing physician who authorizes the purchase of the AED and any individual who provides training in cardiopulmonary resuscitation (CPR) in the use of an AED shall be immune from civil liability for any harm resulting from the use or attempted use of such device, unless the harm involved was caused by willful or criminal misconduct, gross negligence, reckless misconduct or a conscious, flagrant indifference to the safety of the victim who was harmed. (b) Any person responsible for the site where the AED is located shall be immune from civil liability for any personal injury that results from any act or omission of acts that do not amount to willful or wanton misconduct or gross negligence if that person complies with the requirements of W.S. 35 26 102. (c) Any clinical use of the AED shall be reported to the licensed physician. CHAPTER 27 PUBLIC HEALTH NURSES INFANT HOME VISITATION SERVICES 35 27 101. Definitions. (a) As used in this act: (i) "Department" means the Wyoming department of health; (ii) "TANF" means the federal temporary assistance to needy families program authorized by Pub. L. 104-193; (iii) "Program" means the public health nursing infant home visitation subprogram created by this act; (iv) "This act" means W.S. 35 27 101 through 35 27 104. 35 27 102. Public health nursing infant home visitation subprogram created; eligibility. (a) There is created the public health nursing infant home visitation subprogram. (b) Pregnant women, or families with infants, are eligible for services of the program if: (i) The delivery of the newborn or the prenatal care is paid for, or is eligible to be paid for, under the Wyoming Medical Assistance and Services Act or the woman is eligible for services under the women's, infants' and children's supplemental food program; (ii) The mother is confined to a county jail, the Wyoming women's center or any other correctional facility in the state, or is on probation or parole as a result of a conviction of a criminal offense; (iii) The mother has a mental illness or substance abuse problem and is an inpatient at the Wyoming state hospital, a psychiatric hospital or an inpatient treatment facility, or is referred for services by a community mental health center; or (iv) The mother is a victim of domestic abuse. (c) The services provided under the program shall ordinarily be available only until the infant has attained twenty-four (24) months of age, but may be extended by the public health nurse to an older age in cases of special need. (d) The program shall: (i) To the extent practical and needed, provide prenatal contacts and follow-up contacts with each eligible pregnant woman. If another agency or program is actually performing adequate prenatal contacts, the program created under this act shall defer to that agency or program, or develop an agreement on a county by county or region by region basis as to which program will provide the contacts to avoid duplication; (ii) To the extent needed where there were prenatal contacts, and to the extent practical where adequate contact was not made with the eligible mother prior to delivery, as soon as practical after the mother and infant return to their home, conduct a welcome home visit for the infant in the family home. During the welcome home visit, the public health nurse may, as appropriate: (A) Provide information in written, audio or video format on the care and nurturing of infants; (B) Provide information on recommended immunizations; (C) Provide available supplies and equipment useful in the caring for infants. The public health nurses may accept donations of such supplies and equipment; and (D) Assess the infant and the infant's circumstances in accordance with departmental instructions and protocols and, as needed, plan follow-up visits and services and refer the mother to other community or governmental resources, programs and providers. (e) The department shall: (i) Establish home visitation subprograms within available resources and shall initially use the following implementation priorities in case of shortage of resources: (A) First time pregnant women under the age of twenty (20) years who are eligible for assistance under the Wyoming Medical Assistance and Services Act or the women's, infants' and children's supplemental food program; (B) Any pregnant woman or family in need of the services of the program who is referred by an attending physician; (C) First time births to women who, regardless of age, are eligible for assistance under the Wyoming Medical Assistance and Services Act or the women's, infants' and children's supplemental food program; (D) Premature births; (E) Victims of domestic abuse; (F) Pregnant women or mothers with a mental illness or substance abuse problem; (G) Pregnant women or mothers confined to a county jail, the Wyoming women's center or any other correctional facility in the state, or on probation or parole as a result of a conviction for a criminal offense; and (H) Subsequent pregnancies and births where the woman or family is eligible for assistance under the Wyoming Medical Assistance and Services Act or the women's, infants' and children's supplemental food program. (ii) Modify the priority list required under paragraph (i) of this subsection as needed; (iii) Develop or specify protocols for public health nurses to use in the program; (iv) Provide training for the nurses conducting the visits; and (v) Where a county or municipal health department or health district exists, contract with the governing body of that department or district: (A) For the provision of the program's services; or (B) To provide the public health nurses to conduct the program. (f) The department may subcontract with providers of research based, nonnurse models for home visiting services, as appropriate and indicated by client assessment, to secure the most effective services available for the eligible populations. (g) The public health nurses responsible for each county shall jointly for that county develop a list of programs, resources and providers to whom referrals may be made and the types of referrals that may be made to each entity. The lists shall be reviewed at least annually with the county health officer, the manager of the department of family services field office serving the county, the preschool developmental disability program serving the county and the county or municipal human services agency or coordinator, if any. (h) Any physician providing prenatal care or delivering a baby where the care or delivery is eligible for reimbursement under the Wyoming Medical Assistance and Services Act may, unless contraindicated, refer the expectant mother or the infant to the public health nurse serving the county for placement in the program. Physicians may refer other pregnant women, infants or families to the program as medically needed. The referrals shall begin once the program is operational within the county. 35 27 103. Program evaluation and statistical information. (a) It shall be the goal of the program in each county to provide appropriate nursing contact to all eligible women. The department shall statistically track, in order to provide trending reports as needed, the number of known eligible births, the number receiving appropriate contacts, the number of women needing follow up services and the number who did not receive follow up services broken down by cause as follows: (i) The number who refused service; (ii) The number who did not receive follow-up services due to lack of resources; (iii) The number who did not receive services for other reasons, which reasons may be specified to the extent useful. (b) If the report required under subsection (a) of this section shows that appropriate contacts were not made for ninety-five percent (95%) of the eligible births, or less than seventy-five percent (75%) of the women needing follow-up services received them, the department shall provide a written explanation of the reasons why the goals and objectives of the program under this section were not met. (c) The department shall collect statistics to the extent practical to permit evaluation of the success of the program in achieving the reduction: (i) In abuse of the infants; (ii) Of subsequent out of wedlock pregnancies by the visited mothers; (iii) In problems resulting from substance abuse; (iv) In number of arrests among mothers under the program; (v) In the use of tobacco products by mothers under the program; (vi) In violent and anti-social behavior by infants under the program once they reach adolescence and young adulthood, as measured by arrests and convictions. 35 27 104. Program funding. The department shall report to the legislature any reduction in federal temporary assistance to needy families (TANF) program funds which results in the need for additional state funds to administer W.S. 35 27 101 through 35 27 104. The provisions of W.S. 35 27 101 through 35 27 104 shall not be effective one hundred eighty (180) days after the adjournment of the legislative session next following the submission of the report, unless the legislature appropriates the additional funds required. CHAPTER 28 PUBLIC POOL AND SPA HEALTH AND SAFETY 35 28 101. Definitions. (a) As used in this act: (i) "Bathhouse" means a structure that contains dressing rooms, showers and toilet facilities for use with an adjacent public pool; (ii) "Department" means the Wyoming department of agriculture; (iii) "Director" means the director of the Wyoming department of agriculture or his duly authorized representative; (iv) "Imminent health hazard" means a significant threat or danger to health when there is evidence sufficient to show that a product, practice, circumstance or event creates a situation that requires immediate correction or cessation of operation to prevent injury based on: (A) The number of potential injuries; and (B) The nature, severity and duration of the anticipated injury. (v) "Local health department" means a health department established by a county, municipality or district pursuant to W.S. 35 1 301 et seq.; (vi) "Person" means municipalities, recreation districts, counties, state agencies, individuals, corporations, partnerships, enterprises or associations; (vii) "Pool" means an artificial structure containing water used for swimming, bathing, diving, surfing, wading or a similar use and operated by an owner, lessee, operator, licensee or concessionaire regardless of whether a fee is charged for use; (viii) "Public pool" means a pool that is open to the public or a segment of the public; (ix) "Regulatory authority" means the authority which issued the license or adopted the rule or regulation being enforced including the department of agriculture or local health department; (x) "Spa" means a bathing facility including, but not limited to, a hot tub or whirlpool designed for recreational or therapeutic use and not designed to be drained, cleaned and refilled for each use. Spas are designed to provide a means of agitation, which may include, but is not limited to, hydro jet circulation, hot water, cold water, mineral baths, air induction systems or any combination thereof; (xi) "Swimming pool" means a body of water, other than a natural swimming area, maintained exclusively for swimming, recreative bathing or wading, and includes appurtenances used in connection with the swimming pool; (xii) "Waterborne disease outbreak" means the occurrence of two (2) or more cases of a similar illness resulting from the ingestion of water from a common water source; (xiii) "Waterborne illnesses" means illnesses caused by microorganisms, including, but not limited to, cryptosporidium, giardia, pseudomonas, E. coli 0157:H7 and shigella and spread by accidentally swallowing water that has been contaminated with fecal matter; (xiv) "This act" means W.S. 35 28 101 through 35 28 110. 35 28 102. Establishment of a safety program. (a) The director shall establish and maintain a public pool and spa health and safety program. The director shall carry out provisions of the public pool and spa health and safety program and shall be assisted by the department of health. A local department of health, if established according to law, may establish and maintain its own local public pool and spa health and safety program so long as the program meets the requirements of this act and regulations adopted pursuant to this act. The director or his designee shall: (i) Gather health and safety information related to public pools and spas and disseminate the information to the public, public pool or spa industry and local departments of health which have implemented a health and safety program; (ii) On a voluntary basis, provide health and safety training for the pool and spa industry in this state, and work with other state, local and federal agencies to coordinate public health and safety educational efforts; (iii) Regulate the health and safety of public pools and spas. In any area which does not have a local public health and safety program established pursuant to law, the department shall issue licenses, conduct inspections and hold hearings to enforce any legal provision or rule adopted under this act; (iv) Maintain a statewide database of public pool and spa license and inspection results; (v) Work with federal, state and local agencies to coordinate public health and safety efforts and activities related to public pools and spas and coordinate with all other agencies to maintain consistency in inspection and enforcement activities; (vi) Establish health and safety priorities related to public pools and spas for this state; (vii) Provide laboratory support if needed for the analysis of water samples used to support inspection activities and to monitor health and safety; (viii) Provide support for local health and safety programs related to public pool and spa programs as authorized by the legislature; (ix) Take appropriate action against any person holding a public pool and spa license for the purpose of protecting the public health and preventing the transmission of infectious disease. (b) The director of the department of health or his designee shall: (i) Investigate all possible waterborne illnesses and outbreaks and request assistance from the department of agriculture and local health departments as necessary; (ii) Provide support for local health and safety programs related to public pool and spa programs as authorized by the legislature; (iii) Provide laboratory support for water inspection and accompanying monitoring activities for the health and safety of a public swimming pool or spa. (c) Duties of a local health department shall include: (i) Issuing licenses, conducting inspections, holding hearings and taking enforcement actions as necessary to carry out the provisions of the health and safety program related to public pools and spas; (ii) Coordinating activities with the department of agriculture in order to provide for statewide consistency; and (iii) Reporting to the department of health any waterborne outbreak of illness and assisting the department of health in any outbreak investigations if requested. (d) A local jurisdiction may provide laboratory support for water inspection and accompanying monitoring activities for the health and safety of a public swimming pool or spa. 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