georgia- osha

GEORGIA- OSHA

Revised April 2017 1 OSHA

Table of Contents

Biomedical Waste

2

Post Exposure Process/ HIV Testing

10

Resources

20

Total Medical Compliance has created state-‐specific guidelines as a resource for our clients. This information is not intended as legal advice and may not cover all areas of compliance. TMC encourages clients to research and consult with your state agencies to remain up-‐to-‐date on any changes. Private sector workplaces must comply with federal occupational safety and health standards unless otherwise noted. BIOMEDICAL WASTE

GEORGIA- OSHA


RULES OF GEORGIA DEPARTMENT OF NATURAL RESOURCES ENVIRONMENTAL PROTECTION DIVISION CHAPTER 391-‐3-‐4 SOLID WASTE MANAGEMENT 391-‐3-‐4-‐.01 Definitions. Amended. (1) "Active Life" means the period of operation beginning with the initial receipt of solid waste and ending at completion of closure activities. (2) "Active Portion" means that part of a solid waste handling facility or landfill unit that has received or is receiving wastes and that has not been closed. (3) "Aquifer" means a geological formation, group of formations, or portion of a formation capable of yielding significant quantities of ground water to wells or springs. (4) "Affected County" means, in addition to the county in which a facility is or is proposed to be located, each county contiguous to the host county and each county and municipality within a county that has a written agreement with the facility to dispose of solid waste. (5) "Asbestos-‐Containing Waste" means any solid waste containing more than 1 percent, by weight, of naturally occurring hydrated mineral silicates separable into commercially used fibers, specifically the asbestiform varieties of serpentine, chrysotile, cummingtonite-‐grunerite, amosite, riebeckite, crocidolite, anthophyllite, tremolite, and actinolite, using the method specified in Appendix A, Subpart F, 40 CFR Part 763, Section 1. (6) "Baling" means a volume reduction technique whereby solid waste is compressed into bales. (7) "Biomedical Waste" means any solid waste which contains pathological waste, biological waste, cultures, and stocks of infectious agents and associated biologicals, contaminated animal carcasses (body parts, their bedding, and other waste from such animals), chemotherapy waste, discarded medical equipment and parts, not including expendable supplies and materials, which have not been decontaminated, as further defined in Rule 391-‐3-‐4-‐.15. (8) "Boiler" means a device as defined in Chapter 391-‐3-‐11, the Rules for Hazardous Waste Management. (9) "Certificate" means a document issued by a college or university of the University System of Georgia or other organization approved by the Director, stating that the operator has met the requirements of the Board for the specified operator classification of the certification program. (10) "Closure" means a procedure approved by the Division which provides for the cessation of waste receipt at a solid waste disposal site and for the securing of the site in preparation for post-‐ closure. (11) "Collector" means the person or persons as defined herein who, under agreements, verbal or written, with or without compensation does the work of collecting and/or transporting solid wastes, from industries, offices, retail outlets, businesses, institutions, and/or similar locations, or from residential dwellings, provided however, that this definition shall not include an individual collecting and/or transporting waste from his own single family dwelling unit. (12) "Commercial solid waste" means all types of solid waste generated by stores, offices, restaurants, warehouses, and other nonmanufacturing activities, excluding residential and industrial wastes. (13) "Composting" means that controlled biological decomposition of organic matter into a stable, odor free humus. (14) "Construction Demolition Waste" means waste building materials and rubble resulting from construction, remodeling, repair, and demolition operations on pavements, houses, commercial buildings and other structures. Such waste include, but are not limited to asbestos containing waste, wood, bricks, metal, concrete, wall board, paper, cardboard, inert waste landfill material, and other non-‐putrescible wastes which have a low potential for groundwater contamination.

GEORGIA- OSHA


(15) "Detected" means statistically significant evidence of contamination has been determined to exist by using methods specified in Rule 391-‐3-‐4-‐.14 (16) "Director" means the Director of Environmental Protection Division of the Department of Natural Resources. (17) " Disposal Facility" means any facility or location where the final disposition of solid waste occurs and includes, but is not limited to, landfilling and solid waste thermal treatment technology facilities. (18) "Division" means the Environmental Protection Division of the Department of Natural Resources. (19) "Existing MSWLF or landfill unit" means: (a) any municipal solid waste landfill or landfill unit that is receiving solid waste as of October 9, 1993, and meets either of the following two conditions: 1. disposed of over 100 tons per day (TPD) of solid waste between October 9, 1991, and October 9, 1992, (or other dates consistent with Federal standards and as may be approved by the Director), or; 2. is on the National Priorities List (NPL), as found in appendix B to 40 CFR, Part 300. (b) any municipal solid waste landfill or landfill unit that is receiving solid waste as of April 9, 1994, and meets the following two conditions: 1. disposed of 100 tons or less per day of solid waste between October 9, 1991, and October 9, 1992, and disposes of no more than an average of 100 TPD of solid waste each month between October 9, 1993, and April 9, 1994, (or other dates consistent with Federal standards and as may be approved by the Director), and; 2. is not on the National Priorities List (NPL), as found in appendix B to 40 CFR, part 300. (c) Waste placement in existing units must be consistent with past operating practices or modified practices to ensure good management. (20) "Generator" means any person in Georgia or in any other state who creates solid waste. (21) "Garbage" means food waste including waste accumulations of animal or vegetable matter used or intended for use as food, or that attends the preparation, use, cooking, dealing in or storing of meat, fish, fowl, fruit or vegetables. (22) "Groundwater" means water below the land surface in a zone of saturation. (23) "Hazardous Waste" means any solid waste which has been defined as hazardous waste in regulations promulgated by the Board of Natural Resources, Chapter 391-‐3 -‐11. (24) "Household waste" means any solid waste (including garbage, trash, and sanitary waste in septic tanks) derived from households (including single and multiple residences, hotels and motels, bunkhouses, ranger stations, crew quarters, campgrounds, picnic grounds, and day-‐use recreation areas). (25) "Host Local Government" means the host county or other local governmental jurisdiction within whose boundaries a municipal solid waste disposal facility is located. (26) "Industrial Furnace" means a device as defined in Chapter 391-‐3-‐11, the Rules for Hazardous Waste Management. (27) "Industrial Waste" means solid waste generated by manufacturing or industrial processes that is not a hazardous waste regulated under the Hazardous Waste Management Act and regulations promulgated by the Board of Natural Resources, Chapter 391-‐3-‐11. Such waste includes, but is not limited to, wastes resulting from the following manufacturing processes: Electric power generation; fertilizer/agricultural chemicals; food and related products/by-‐products; inorganic chemicals; iron and steel manufacturing; leather and leather products; nonferrous metals manufacturing/foundries; inorganic chemicals; plastics and resins manufacturing; pulp and paper industry; rubber and miscellaneous plastic products; stone, glass, clay, and concrete products; textile manufacturing; transportation equipment; and water treatment. This term does not include mining waste or oil or gas waste.

GEORGIA- OSHA


(28) "Inert Waste Landfill" means a disposal facility accepting only wastes that will not or are not likely to cause production of leachate of environmental concern. Such wastes are limited to earth and earth-‐like products, concrete, cured asphalt, rock, bricks, yard trimmings, stumps, limbs, and leaves. This definition excludes industrial and demolition waste not specifically listed above. (29) "Lateral expansion" means a horizontal expansion of the waste boundaries of an existing MSWLF unit or landfill unit. (30) "Leachate" means a liquid that has passed through or emerged from solid waste and contains soluble, suspended, or miscible materials removed from such wastes. (31) "Landfill Unit" means an area of land of which or an excavation in which solid waste is placed for permanent disposal and which is not a land application unit, surface impoundment, injection well, or compost pile. Permanent disposal requires the placement of daily, intermediate, and/or final earth, synthetic, or a combination of earth and synthetic cover over the solid waste. (32) "Leachate Collection System" means a system at a landfill for collection of the leachate which may percolate through the waste and into the soils surrounding the landfill. (33) "Liner" means a continuous layer of natural or man-‐made materials beneath or on the sides of a disposal site or disposal site cell which restricts the downward or lateral escape of solid waste constituents, or leachate. (34) "Liquid Waste" means any waste material that is determined to contain "free liquids" as defined by Method 9095 (paint Filter Liquids Test), as described in "Test Methods for the Evaluation of Solid Wastes, Physical/Chemical Methods" (EPA Pub. No. SW-‐846). (35) "Materials Recovery Facility" means a solid waste handling facility that provides for the extraction from solid waste of recoverable materials, materials suitable for use as a fuel or soil amendment, or any combination of such materials. (36) "Monofill" means a method of solid waste disposal that involves the landfilling of one waste type or wastes having very similar characteristics in a segregated trench or area which is physically separated from dissimilar or incompatible waste. (37) "Municipal Solid Waste" means any solid waste derived from households, including garbage, trash, and sanitary waste in septic tanks and means solid waste from single-‐ family and multifamily residences, hotels and motels, bunkhouses, campgrounds, picnic grounds, and day use recreation areas. The term includes yard trimmings and commercial solid waste, but does not include solid waste from mining, agricultural, or silvicultural operations or industrial processes or operations. (38) "Municipal Solid Waste Landfill (MSWLF) Unit" means a discrete area of land or an excavation that receives household waste, and that is not a land application unit, surface impoundment, injection well, or waste pile, as those terms are defined under 40 CFR Part 257.2. A MSWLF unit also may receive other types of solid waste, such as commercial solid waste, nonhazardous sludge, small quantity generator waste and industrial solid waste. Such a landfill may be publicly or privately owned. A MSWLF unit may be a new MSWLF unit, an existing MSWLF unit or a lateral expansion. (39) "Municipal Solid Waste Disposal Facility" means any facility or location where the final deposition of any amount of municipal solid waste occurs, whether or not mixed with or including commercial or industrial solid waste, and includes, but is not limited to, municipal solid waste landfills and solid waste thermal treatment technology facilities. (40) "Municipal Solid Waste Disposal Facility Operator" means the operator certified in accordance in accordance with Rule 391-‐3-‐4-‐.18 and stationed on the site who is in responsible charge of and has direct supervision of the daily field operations of a municipal solid waste disposal facility to ensure that the facility operates in compliance with the permit. (41) "Municipal Solid Waste Landfill" means a disposal facility where any amount of municipal solid waste, whether or not mixed with or including commercial waste, industrial waste, nonhazardous sludges, or small quantity generator hazardous wastes, is disposed of by means of placing an approved cover thereon.

GEORGIA- OSHA


(42) "New MSWLF Unit" means any municipal solid waste landfill unit that has not received waste prior to October 9, 1993. (43) "Open Burning" means the combustion of solid waste without: (a) Control of combustion air to maintain adequate temperature for efficient combustion; (b) Containment of the combustion reaction in an enclosed device to provide sufficient residence time and mixing for complete combustion; and (c) Control of the emission of the combustion products. (44) "Open Dump" means a disposal facility at which solid waste from one or more sources is left to decompose, burn or to otherwise create a threat to human health or the environment. (45) "Operating Records" means written records including, but not limited to, permit applications, monitoring reports, inspection reports, and other demonstrations of compliance with this Chapter, which records are kept on file at the facility or at an alternative location as approved by the Division. (46) "Operator" means the person(s) responsible for the overall operation of a facility or part of a facility. (47) "Owner" means the person(s) who owns a facility or part of a facility. (48) "Person" means the State of Georgia or any other state or any agency or institution thereof, and any municipality, county, political subdivision, public or private corporation, solid waste authority, special district empowered to engage in solid waste management activities, individual, partnership, association or other entity in Georgia or any other state. This term also includes any officer or governing or managing body of any municipality, political subdivision, solid waste authority, special district empowered to engage in solid waste activities, or public or private corporation in Georgia or any other state. This term also includes employees, departments, and agencies of the federal government. (49) "Post-‐closure" means a procedure approved by the Division to provide for long-‐term financial assurance, monitoring and maintenance of a solid waste disposal facility to protect human health and the environment. (50) "Private Industry Solid Waste Disposal Facility" means a disposal facility which is operated exclusively by and for a private solid waste generator for the purpose of accepting solid waste generated exclusively by said private solid waste generator. (51) "Processing Operation" means any method, system or other treatment designed to change the physical form or chemical content of solid waste and includes all aspects of its management (administration, personnel, land, equipment, buildings and other elements). (52) "Putrescible Wastes" means wastes that are capable of being quickly decomposed by microorganisms. Examples of putrescible wastes include but are not necessarily limited to kitchen wastes, animal manure, offal, hatchery and poultry processing plant wastes, dead animals, garbage and wastes which are contaminated by such wastes. (53) "Run-‐off' means any rainwater, leachate, or other liquid that drains over land from any part of a facility. (54) "Run-‐on" means any rainwater, leachate, or other liquid that drains over land onto any part of a facility. (55) "Recovered Materials" means those materials which have known use, reuse, or recycling potential; can be feasibly used, reused or recycled; and have been diverted or removed from the solid waste stream for sale, use, reuse, or recycling, whether or not requiring subsequent separation and processing. (56) Recovered Materials Processing Facility" means a facility engaged solely in the storage, processing, and resale or reuse of recovered materials. Such term shall not include a solid waste handling facility; provided, however, any solid waste generated by such facility shall be subject to all applicable laws and regulations relating to such solid waste.

GEORGIA- OSHA


(57) "Recycling" means any process by which materials which would otherwise become solid waste are collected, separated, or processed and reused or returned to use in the form of raw materials or products. (58) "Regional Landfill or Regional Solid Waste Disposal Facility" means a facility owned by a county, municipality, or special district empowered to engage in solid waste management activities, or any combination thereof, which serves two or more any combination of counties, municipalities, or special solid waste districts. (59) "Relevant Point of Compliance" is a vertical surface located at the hydraulically down-‐gradient limit of the waste management unit boundary that extends down into the uppermost aquifer underlying the facility. This point will be specified by the Director and shall be no more than 150 meters from the waste management unit boundary and shall be located on land owned by the owner of the landfill unit. The down-‐gradient monitoring system must be installed at this point, and monitoring conducted to ensure that the concentration values listed in Table 1 of Rule 391-‐3-‐ 4.07 will not be exceeded in the uppermost aquifer. (60) "Saturated Zone" means that part of the earth's curst in which all voids are filled with water. (61) "Scavenge" means the unpermitted removal of solids waste from a solid waste handling facility. (62) "Shredding" means the process by which solid waste is cut or tom into small pieces for final disposal of further processing. (63) "Significant Groundwater Recharge Areas" means any area as designated on Hydrologic Atlas 18 Most Significant Ground-‐Water Recharge Areas of Georgia, 1989, as published by the Georgia Geologic Survey, Environmental Protection Division, Georgia Department of Natural Resources, unless an applicant for a solid waste handling permit or other interested party can demonstrate to the satisfaction of the Director that an area designated on Hydrologic Atlas 18 is or is not, in fact, a significant groundwater recharge area. (64) "Sludge" means any solid, semi-‐solid, or liquid waste generated from a municipal, commercial, or industrial wastewater treatment plant, water supply treatment plant, or air pollution control facility exclusive of the treated effluent from a wastewater treatment plant. (65) "Solid Waste" means any garbage or refuse; sludge from a wastewater treatment plant, water supply treatment plant, or air pollution control facility; and other discarded material including solid, liquid, semisolid, or contained gaseous material resulting from industrial, commercial, mining, and agricultural operations and from community activities, but does not include recovered materials; solid or dissolved materials in domestic sewage; solid or dissolved materials in irrigation return flows or industrial discharges that are point sources subject to permit under 33 U.S.C. Section 1342; or source, special nuclear, or by-‐product material as defined by the federal Atomic Energy Act of 1954, as amended (68 Stat. 923). (66) "Solid Waste Handling" means the storage, collection, transportation, treatment, utilization, processing, or disposal of solid waste, or any combination of such activities. (67) "Solid Waste Handling Facility" means any facility, the primary purpose of which is the storage, collection, transportation, treatment, utilization, processing, or disposal, or any combination thereof, of solid waste. (68) "Solid Waste Handling Permit" means written authorization granted to a person by the Director to engage in solid waste handling. (69) "Solid Waste Management Act" or the "Act", wherever referred to in these Rules, means the Georgia Comprehensive Solid Waste Management Act, O.C.G.A. 12-‐8-‐20, et seq. (70) "Solid Waste Thermal Treatment Technology" means any solid waste handling facility, the purpose of which is to reduce the amount of solid waste to be disposed of through a process of combustion, with or without the process of waste to energy.

GEORGIA- OSHA


(71) "Tire" means a continuous solid or pneumatic rubber covering designed for encircling the wheel of a motor vehicle and which is neither attached to the motor vehicle nor a part of the motor vehicle as original equipment. (72) "Transfer Station" means a facility used to transfer solid waste from one transportation vehicle to another for transportation to a disposal facility or processing operation. (73) "Uppermost Aquifer" means the geologic formation nearest the natural ground surface that is an aquifer, as well as lower aquifers that are hydraulically interconnected with this aquifer within the solid waste handling facility's property boundary. (74) "Vertical Expansion" means the expansion of landfill beyond the approved maximum final elevations and within the approved waste management boundaries of the existing permit. (75) "Waste Management Unit Boundary" means a vertical surface located at the hydraulically down-‐gradient limit of the unit. This vertical surface extends down into the uppermost aquifer. (76) "Waste-‐to Energy Facility" means a solid waste handling facility that provides for the extraction and utilization of energy from municipal solid waste through a process of combustion. (77) "Yard Trimmings" means leaves, brush, grass, clippings, shrub and tree prunings, discarded Christmas trees, nursery and greenhouse vegetative residuals, and vegetative matter resulting from landscaping development and maintenance other than mining, agricultural, and silvacultural operations. 391-‐3-‐4-‐.15 BIOMEDICAL WASTE (1) All persons subject to regulation under Rule .15 shall, in addition to the requirements of Rule .15, handle biomedical waste in accordance with the provisions of O.C.G.A. 12-‐8-‐20, et seq., and the Rules for Solid Waste Management, Chapter 391-‐3-‐4 applicable to solid waste. (2) Biomedical waste shall mean and include the following: (a) Pathological waste, which means all recognizable human tissues and body parts except teeth which are removed during surgery, obstetrical procedures, autopsy, and laboratory procedures. (b) Biological waste, which means blood and blood products, exudates secretions, suctionings, and other body fluids which contains free liquids and cannot be or are not directly discarded into a municipal sewer system. (c) Cultures and stocks of infectious agents and associated biologicals including cultures from medical and pathological laboratories, cultures and stocks of infectious agents from research and industrial laboratories, wastes from the production of biologicals, discarded live and attenuated vaccines, and culture dishes and devices used to transfer, inoculate, and mix cultures. (d) Contaminated animal carcasses, body parts, their bedding, and other wastes from such animals which are infected with or which have been exposed to infectious agents, capable of causing disease in man. (e) Sharps, which means any discarded article that may cause punctures or cuts. Such waste includes, but is not limited to, items such as needles, IV tubing and syringes with needles attached, and scalpel blades. (f) Chemotherapy waste, which means any disposable material which has come in contact with cytotoxic/antineoplastic agents (agents toxic to cells) and/or antineoplastic agents (agents that inhibit or prevent the growth and spread of tumors or malignant cells) during the preparation, handling, and administration of such agents. Such waste includes, but is not limited to, masks, gloves, gowns, empty IV tubing bags and vials, and other contaminated materials. The above waste must first be classified as empty which means such quantity that it is not subject to other federal or state waste management regulations prior to being handled as biomedical waste. (g) Discarded medical equipment and parts, excluding expendable supplies and materials included in paragraphs (a) through (f) of this Rule, which have not been decontaminated, and that were in contact with infectious agents.

GEORGIA- OSHA


(3) Generation of Biomedical Waste. (a) Unless otherwise exempted, Rule 391-‐3-‐4-‐.15 shall apply to all persons generating or handling biomedical waste, including but not limited to: ambulatory service centers, blood banks, clinics, county health departments, dental offices, funeral homes, health maintenance organizations (HMOs), hospitals, laboratories, medical buildings, physicians offices, veterinary offices, research and manufacturing facilities, nursing homes, and biomedical waste transportation, storage, treatment, and disposal facilities. (b) Partial exemption: facilities which generate less than 100 pounds per month of biomedical waste shall be exempt from all provisions of Rule 391-‐3-‐4-‐.15 except that they shall comply fully with the provisions of Rule 391-‐3-‐4-‐.15(4)(a), (4)(b), (4)(b) 1., (4)(b) 2., (4)(c), (6)(c), and (7)(b). For purposes of this Rule, a facility is defined as one or more persons generating biomedical waste who share common waste management services including, but not limited to, bulk storage containers. (c) Total exemption: in no case shall a person be generator of biomedical waste if those wastes are generated from single-‐family residential premises or a single-‐family dwelling unit in the self-‐care and treatment of family members living in those premises or units and disposed of as residential solid waste. Home health care organizations or physicians treating patients in a home are not exempt unless otherwise exempted in (b) above. (d) All requirements of this Rule shall apply to persons or facilities who generate 100 pounds or more biomedical waste per month. (4) Storage and Containment of Biomedical Waste. (a) Containment of biomedical waste shall be a manner and location which affords protection from animals, rain and wind, does not provide a breeding place or a food source for insects and rodents, and minimizes exposure to the public. (b) Biomedical waste shall be segregated by separate containment from other waste at the point of origin. 1. Biomedical waste, except for sharps, shall be placed in containers which are impervious to moisture and have a strength sufficient to preclude ripping, tearing, or bursting under normal conditions of use. The containers shall be securely closed so as to prevent leakage or expulsion of solid or liquid wastes during storage, handling, or transport. 2. Sharps shall be contained for storage, transportation, treatment and subsequent disposal in leak-‐proof, rigid, puncture-‐resistant containers which are taped closed or tightly lidded to preclude loss of contents. (c) Rigid containers of discarded sharps and all other disposable containers used for containment of biological waste shall be red or orange in color or clearly identified with the universal biohazard symbol or clearly marked with the word "Biohazard". (d) Biomedical waste contained in disposable containers as prescribed above, shall be placed for storage, handling, or transport in disposable or reusable pails, cartons, boxes, drums, dumpsters, or portable bins. The containment system shall have a tight fitting cover and be kept clean and in good repair. The containers may be of any color and shall be conspicuously labeled with the universal biohazard symbol and the word "Biohazard" on the sides so as to be readily visible from any lateral direction when the container is upright. 1. Reusable containers used for shipment of biomedical waste shall be thoroughly washed and decontaminated each time they are emptied. 2. Reusable pails, drums, dumpsters or bins used for containment of biomedical waste shall not be used for other purposes except after being decontaminated by procedures as described in (4)(d) 1. above and after the universal biohazard symbol and word "Biohazard" are removed. (5) Transfer of Biomedical Waste to Off-‐Site Treatment or Disposal Facilities. (a) Any generator of biomedical waste shall transfer custody of the waste only to a collector who is operating under authority of these Rules.

GEORGIA- OSHA


(b) Biomedical waste shall not be transported in the same vehicle with other solid waste unless the biomedical waste is contained in a separate, fully enclosed leak-‐proof container within the vehicle compartment or unless all of the waste is to be treated as biomedical waste in accordance with the requirements of these Rules. (c) Biomedical waste shall be delivered for storage, including intermediate transfer, and treatment only to a facility or location for which there is a valid and appropriate operating permit as set forth in these Rules. (d) Surfaces of transport vehicles that have contacted spilled or leaked biomedical waste shall be decontaminated. (e) Equipment used to transport waste from the generator to the off-‐site treatment or disposal facility may not destroy the integrity of the container. (f) Vehicles used for the transport of biomedical waste shall not be used for transportation of food or food products. (6) Treatment of Biomedical Waste. (a) If treated in accordance with the following procedures, the waste shall no longer be considered biomedical waste and may be combined and handled with regular solid waste. Biomedical waste shall be treated by one of the following methods prior to disposal at a permitted waste disposal facility. 1. Incineration in the thermal treatment technology facility which provides complete combustion of waste to render it nonpathogenic. (i) Biomedical waste thermal treatment technology facilities shall be capable of maintaining a minimum temperature in the primary chamber sufficient to destroy infectious agents and procedure a residue essentially free of odors and unstable organic matter. If chemotherapy wastes are incinerated, the facility must be capable of maintaining a minimum of 1,800 degrees Fahrenheit in the secondary combustion chamber and a minimum residence time of two seconds. (ii) Atmospheric emissions shall be controlled so as not to exceed air quality standards of the Division. 2. Decontamination by heating with steam under pressure (autoclave) so as to render the biomedical waste noninfectious. (i) A recording thermometer shall be used during each complete cycle to ensure the attainment of a temperature of 121 degrees Centigrade (250 degrees Fahrenheit) for one-‐ half hour or longer in order to achieve decontamination of the entire load. (ii) Monitoring of the steam sterilization process shall be required in order to confirm the attainment of decontamination. (iii) Monitoring may be through the use of biological indicators or other methods as approved by the Director. Indicators used to ensure the attainment of the proper temperature during steam sterilization shall be placed at the point of the load where the rate of thermal penetration is at a minimum. 3. Other methods as may be approved by the Director. (b) Fluid or semisolid waste specified in (2)(b) of this Rule may be discharged to a sewage treatment system that provides secondary treatment of waste if approved by the agency responsible for the operation of the sewage treatment system. (c) Biomedical wastes consisting of recognizable human anatomical remains shall not be disposed of by landfilling. (d) Chemotherapy waste, as defined in (2)(f), shall be treated at a permitted thermal treatment technology facility or other facility approved by the Director. Steam decontamination may not be used for the treatment of chemotherapy waste. (e) All facilities treating regulated quantities of biomedical waste must, at a minimum, comply with the above criteria. Commercial biomedical waste treatment facilities may not construct or operate a biomedical waste treatment facility without first obtaining a solid waste handling permit under

GEORGIA- OSHA


these Rules. On-‐site biomedical waste treatment facilities are required to obtain a solid waste permit-‐by-‐Rule, and must comply with the provisions of paragraph (6)(a)-‐(d) of this Rule, in addition to Rule 391-‐3-‐4-‐.06. For purposes of this Rule, "Commercial biomedical waste treatment facility" means a facility which accepts over 25 percent of its biomedical waste from other, off-‐site, facilities, which are not owned by the facility owning the treatment or disposal facility, generally for a fee. (7) Disposal of Biomedical Waste. (a) Biomedical wastes treated in accordance with the provisions in Rule 391-‐3-‐4-‐.15(6) shall be properly disposed of at a facility permitted under the authority of these Rules unless otherwise approved by the Director. (b) Biomedical waste from generators of less than 100 pounds per month shall be properly disposed of at a municipal solid waste landfill or treatment facility permitted under authority of these Rules or other facilities approved by the Director. (c) The disposal of untreated biomedical waste, from generators of more than 100 pounds per month, by landfilling is prohibited. *A bill was submitted July 7, 2016 to change the current regulations but has not been passed yet. The link to the proposed amendment is: https://epd.georgia.gov/sites/epd.georgia.gov/files/Proposed%20Rule.pdf HIV TESTING/ POST-‐EXPOSURE REGULATIONS O.C.G.A. § 24-‐9-‐47 Georgia State Law § 24-‐9-‐47. Disclosure of AIDS Confidential Information (a) Any term used in this Code section and defined in Code Section 31-‐22-‐9.1 shall have the meaning provided for such term in Code Section 31-‐22-‐9.1. (b) Except as otherwise provided in this Code section: (1) No person or legal entity which receives AIDS confidential information pursuant to this Code section or which is responsible for recording, reporting, or maintaining AIDS confidential information shall: (A) Intentionally or knowingly disclose that information to another person or legal entity; or (B) Be compelled by subpoena, court order, or other judicial process to disclose that information to another person or legal entity; and (2) No person or legal entity which receives AIDS confidential information which that person or legal entity knows was disclosed in violation of paragraph (1) of this subsection shall: (A) Intentionally or knowingly disclose that information to another person or legal entity; or (B) Be compelled by subpoena, court order, or other judicial process to disclose that information to another person or legal entity. (c) AIDS confidential information may be disclosed to the person identified by that information or, if that person is a minor or incompetent person, to that person ́s parent or legal guardian. (d) AIDS confidential information may be disclosed to any person or legal entity designated to receive that information when that designation is made in writing by the person identified by that information or, if that person is a minor or incompetent person, by that person ́s parent or legal guardian. (e) AIDS confidential information may be disclosed to any agency or department of the federal government, this state, or any political subdivision of this state if that information is authorized or required by law to be reported to that agency or department. (f) The results of an HIV test may be disclosed to the person, or that person ́s designated representative, who ordered such tests of the body fluids or tissue of another person.

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(g) When the patient of a physician has been determined to be infected with HIV and that patient ́s physician reasonably believes that the spouse or sexual partner or any child of the patient, spouse, or sexual partner is a person at risk of being infected with HIV by that patient, the physician may disclose to that spouse, sexual partner, or child that the patient has been determined to be infected with HIV, after first attempting to notify the patient that such disclosure is going to be made. (h)(1) An administrator of an institution licensed as a hospital by the Department of Human Resources or a physician having a patient who has been determined to be infected with HIV may disclose to the Department of Human Resources: (A) The name and address of that patient; (B) That such patient has been determined to be infected with HIV; and (C) The name and address of any other person whom the disclosing physician or administrator reasonably believes to be a person at risk of being infected with HIV by that patient. (2) When mandatory and non-‐anonymous reporting of confirmed positive HIV tests to the Department of Human Resources is determined by that department to be reasonably necessary, that department shall establish by regulation a date on and after which such reporting shall be required. On and after the date so established, each health care provider, health care facility, or any other person or legal entity which orders an HIV test for another person shall report to the Department of Human Resources the name and address of any person thereby determined to be infected with HIV. No such report shall be made regarding any confirmed positive HIV test provided at any anonymous HIV test site operated by or on behalf of the Department of Human Resources. (3) The Department of Human Resources may disclose that a person has been reported, under paragraph (1) or (2) of this subsection, to have been determined to be infected with HIV to the board of health of the county in which that person resides or is located if reasonably necessary to protect the health and safety of that person or other persons who may have come in contact with the body fluids of the HIV infected person. The Department of Human Resources or county board of health to which information is disclosed pursuant to this paragraph or paragraph (1) or (2) of this subsection: (A) May contact any person named in such disclosure as having been determined to be an HIV infected person for the purpose of counseling that person and requesting therefrom the name of any other person who may be a person at risk of being infected with HIV by that HIV infected person; (B) May contact any other person reasonably believed to be a person at risk of being infected with HIV by that HIV infected person for the purposes of disclosing that such infected person has been determined to be infected with HIV and counseling such person to submit to an HIV test; and (C) Shall contact and provide counseling to the spouse of any HIV infected person whose name is thus disclosed if both persons are reasonably likely to have engaged in sexual intercourse or any other act determined by the department likely to have resulted in the transmission of HIV between such persons within the preceding seven years and if that spouse may be located and contacted without undue difficulty. (i) Any health care provider authorized to order an HIV test may disclose AIDS confidential information regarding a patient thereof if that disclosure is made to a health care provider or health care facility which has provided, is providing, or will provide any health care service to that patient and as a result of such provision of service that health care provider or facility: (1) Has personnel or patients who may be persons at risk of being infected with HIV by that patient, if that patient is an HIV infected person and such disclosure is reasonably necessary to protect any such personnel or patients from that risk; or (2) Has a legitimate need for that information in order to provide that health care service to that patient. (j) A health care provider or any other person or legal entity authorized but not required to disclose AIDS confidential information pursuant to this Code section shall have no duty to make such

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disclosure and shall not be liable to the patient or any other person or legal entity for failing to make such disclosure. A health care provider or any other person or legal entity which discloses information as authorized or required by this Code section or as authorized or required by law or rules or regulations made pursuant thereto shall have no civil or criminal liability therefor. (k) When any person or legal entity is authorized or required by this Code section or any other law to disclose AIDS confidential information to a person at risk of being infected with HIV and that person at risk is a minor or incompetent person, such disclosure may be made to any parent or legal guardian of the minor or incompetent person, to the minor or incompetent person, or to both the minor or incompetent person and any parent or legal guardian thereof. (l) When an institutional care facility is the site at which a person is at risk of being infected with HIV and as a result of that risk a disclosure of AIDS confidential information to any person at risk at that site is authorized or required under this Code section or any other law, such disclosure may be made to the person at risk or to that institutional care facility ́s chief administrative or executive officer, or such officer ́s designee, in which case that officer or designee is authorized to make such disclosure to the person at risk. (m) When a disclosure of AIDS confidential information is authorized or required by this Code section to be made to a physician, health care provider, or legal entity, that disclosure may be made to employees of that physician, health care provider, or legal entity who have been designated thereby to receive such information on behalf thereof. Those designated employees may thereafter disclose to and provide for the disclosure of that information among such other employees of that physician, health care provider, or legal entity, but such disclosures among those employees are only authorized when reasonably necessary in the ordinary course of business to carry out the purposes for which that disclosure is authorized or required to be made to that physician, health care provider, or legal entity. (n) Any disclosure of AIDS confidential information authorized or required by this Code section or any other law and any unauthorized disclosure of such information shall in no way destroy the confidential nature of that information except for the purpose for which the authorized or required disclosure is made. (o) Any person or legal entity which violates subsection (b) of this Code section shall be guilty of a misdemeanor. (p) Nothing in this Code section or any other law shall be construed to authorize the disclosure of AIDS confidential information if that disclosure is prohibited by federal law, or regulations promulgated thereunder, nor shall anything in this Code section or any other law be construed to prohibit the disclosure of information which would be AIDS confidential information except that such information does not permit the identification of any person. (q) A public safety agency or district attorney may obtain the results from an HIV test to which the person named in the request has submitted under Code Section 15-‐11-‐66.1, 17-‐10-‐15, 42-‐5-‐52.1, or 42-‐9-‐42.1, notwithstanding that the results may be contained in a sealed record. (r) Any person or legal entity required by an order of a court to disclose AIDS confidential information in the custody or control of such person or legal entity shall disclose that information as required by that order. (s) AIDS confidential information may be disclosed as medical information pursuant to Code Section 24-‐9-‐40, relating to the release of medical information, or pursuant to any other law which authorizes or requires the disclosure of medical information if: (1) The person identified by that information: (A) Has consented in writing to that disclosure; or (B) Has been notified of the request for disclosure of that information at least ten days prior to the time the disclosure is to be made and does not object to such disclosure prior to the time specified for that disclosure in that notice; or (2) A superior court in an in camera hearing finds by clear and convincing evidence a compelling

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need for the information which cannot be accommodated by other means. In assessing compelling need, the court shall weigh the public health, safety, or welfare needs or any other public or private need for the disclosure against the privacy interest of the person identified by the information and the public interest which may be disserved by disclosures which may deter voluntary HIV tests. If the court determines that disclosure of that information is authorized under this paragraph, the court shall order that disclosure and impose appropriate safeguards against any unauthorized disclosure. The records of that hearing otherwise shall be under seal. (t)(1) A superior court of this state may order a person or legal entity to disclose AIDS confidential information in its custody or control to: (A) A prosecutor in connection with a prosecution for the alleged commission of reckless conduct under subsection (c) of Code Section 16-‐5-‐60; (B) Any party in a civil cause of action; or (C) A public safety agency or the Department of Human Resources if that agency or department has an employee thereof who has, in the course of that employment, come in contact with the body fluids of the person identified by the AIDS confidential information sought in such a manner reasonably likely to cause that employee to become an HIV infected person and provided the disclosure is necessary for the health and safety of that employee, and for purposes of this subsection the term 'petitioner for disclosure' means any person or legal entity specified in subparagraph (A), (B), or (C) of this paragraph. (2) An order may be issued against a person or legal entity responsible for recording, reporting, or maintaining AIDS confidential information to compel the disclosure of that information if the petitioner for disclosure demonstrates by clear and convincing evidence a compelling need for the information which cannot be accommodated by other means. In assessing compelling need, the court shall weigh the public health, safety, or welfare needs or any other public or private need for the disclosure against the privacy interest of the person identified by the information and the public interest which may be disserved by disclosures which may deter voluntary HIV tests. (3) A petition seeking disclosure of AIDS confidential information under this subsection shall substitute a pseudonym for the true name of the person concerning whom the information is sought. The disclosure to the parties of that person ́s true name shall be communicated confidentially, in documents not filed with the court. (4) Before granting any order under this subsection, the court shall provide the person concerning whom the information is sought with notice and a reasonable opportunity to participate in the proceedings if that person is not already a party. (5) Court proceedings as to disclosure of AIDS confidential information under this subsection shall be conducted in camera unless the person concerning whom the information is sought agrees to a hearing in open court. (6) Upon the issuance of an order that a person or legal entity be required to disclose AIDS confidential information regarding a person named in that order, that person or entity so ordered shall disclose to the ordering court any such information which is in the control or custody of that person or entity and which relates to the person named in the order for the court to make an in camera inspection thereof. If the court determines from that inspection that the person named in the order is an HIV infected person, the court shall disclose to the petitioner for disclosure that determination and shall impose appropriate safeguards against unauthorized disclosure which shall specify the persons who may have access to the information, the purposes for which the information shall be used, and appropriate prohibitions on future disclosure. (7) The record of the proceedings under this subsection shall be sealed by the court. (8) An order may not be issued under this subsection against the Department of Human Resources, any county board of health, or any anonymous HIV test site operated by or on behalf of that department.

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(u) A health care provider, health care facility, or other person or legal entity who, in violation of this Code section, unintentionally discloses AIDS confidential information, notwithstanding the maintenance of procedures thereby which are reasonably adopted to avoid risk of such disclosure, shall not be civilly or criminally liable, unless such disclosure was due to gross negligence or wanton and willful misconduct. (v) AIDS confidential information may be disclosed when that disclosure is otherwise authorized or required by Code Section 42-‐1-‐6, if AIDS or HIV infection is the communicable disease at issue, or when that disclosure is otherwise authorized or required by any law which specifically refers to 'AIDS confidential information,' 'HIV test results,' or any similar language indicating a legislative intent to disclose information specifically relating to AIDS or HIV. (w) A health care provider who has received AIDS confidential information regarding a patient from the patient ́s health care provider directly or indirectly under the provisions of subsection (i) of this Code section may disclose that information to a health care provider which has provided, is providing, or will provide any health care service to that patient and as a result of that provision of service that health care provider: (1) Has personnel or patients who may be persons at risk of being infected with HIV by that patient, if that patient is an HIV infected person and such disclosure is reasonably necessary to protect any such personnel or patients from that risk; or (2) Has a legitimate need for that information in order to provide that health care service to that patient. (x) Neither the Department of Human Resources nor any county board of health shall disclose AIDS confidential information contained in its records unless such disclosure is authorized or required by this Code section or any other law, except that such information in those records shall not be a public record and shall not be subject to disclosure through subpoena, court order, or other judicial process. (y) The protection against disclosure provided by Code Section 24-‐9-‐40.1 shall be waived and AIDS confidential information may be disclosed to the extent that the person identified by such information, his heirs, successors, assigns, or a beneficiary of such person, including but not limited to an executor, administrator, or personal representative of such person ́s estate: (1) Files a claim or claims other entitlements under any insurance policy or benefit plan or is involved in any civil proceeding regarding such claim; (2) Places such person ́s care and treatment, the nature and extent of his injuries, the extent of his damages, his medical condition, or the reasons for his death at issue in any civil or criminal proceeding; or (3) Is involved in a dispute regarding coverage under any insurance policy or benefit plan. (z) AIDS confidential information may be collected, used, and disclosed by an insurer in accordance with the provisions of Chapter 39 of Title 33, relating to the collection, use, and disclosure of information gathered by insurance institutions. (aa) In connection with any civil or criminal action in which AIDS confidential information is disclosed as authorized or required by this Code section, the party to whom that information is thereby disclosed may subpoena any person to authenticate such AIDS confidential information, establish a chain of custody relating thereto, or otherwise testify regarding that information, including but not limited to testifying regarding any notifications to the patient regarding results of an HIV test. The provisions of this subsection shall apply as to records, personnel, or both of the Department of Human Resources or a county board of health notwithstanding Code Section 50-‐18-‐ 72, but only as to test results obtained by a prosecutor under subsection (q) of this Code section and to be used thereby in a prosecution for reckless conduct under subsection (c) of Code Section 16-‐5-‐ 60. (bb) AIDS confidential information may be disclosed as a part of any proceeding or procedure authorized or required pursuant to Chapter 3, 4, or 7 of Title 37, regarding a person who is alleged

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to be or who is mentally ill, mentally retarded, or alcoholic or drug dependent, or as a part of any proceeding or procedure authorized or required pursuant to Title 29, regarding the guardianship of a person or that person ́s estate, as follows: (1) Any person who files or transmits a petition or other document which discloses AIDS confidential information in connection with any such proceeding or procedure shall provide a cover page which contains only the type of proceeding or procedure, the court in which the proceeding or procedure is or will be pending, and the words 'CONFIDENTIAL INFORMATION' without in any way otherwise disclosing thereon the name of any individual or that such petition or other document specifically contains AIDS confidential information; (2) AIDS confidential information shall only be disclosed pursuant to this subsection after disclosure to and with the written consent of the person identified by that information, or that person ́s parent or guardian if that person is a minor or has previously been adjudicated as being incompetent, or by order of court obtained in accordance with subparagraph (C) of paragraph (3) of this subsection; (3) If any person files or transmits a petition or other document in connection with any such proceeding or procedure which discloses AIDS confidential information without obtaining consent as provided in paragraph (2) of this subsection, the court receiving such information shall either obtain written consent as set forth in that paragraph (2) for any further use or disclosure of such information or: (A) Return such petition or other document to the person who filed or transmitted same, with directions against further filing or transmittal of such information in connection with such proceeding or procedure except in compliance with this subsection; (B) Delete or expunge all references to such AIDS confidential information from the particular petition or other document; or (C)(i) If the court determines there is a compelling need for such information in connection with the particular proceeding or procedure, petition a superior court of competent jurisdiction for permission to obtain or disclose that information. If the person identified by the information is not yet represented by an attorney in the proceeding or procedure in connection with which the information is sought, the petitioning court shall appoint an attorney for such person. The petitioning court shall have both that person and that person ́s attorney personally served with notice of the petition and time and place of the superior court hearing thereon. Such hearing shall not be held sooner than 72 hours after service, unless the information is to be used in connection with an emergency guardianship proceeding under Chapter 5 of Title 29, in which event the hearing shall not be held sooner than 48 hours after service. (ii) The superior court in which a petition is filed pursuant to division (i) of this subparagraph shall hold an in camera hearing on such petition. The purpose of the hearing shall be to determine whether there is clear and convincing evidence of a compelling need for the AIDS confidential information sought in connection with the particular proceeding or procedure which cannot be accommodated by other means. In assessing compelling need, the superior court shall weigh the public health, safety, or welfare needs or any other public or private need for the disclosure against the privacy interest of the person identified by the information and the public interest which may be disserved by disclosures which may deter voluntary HIV tests. If the court determines that disclosure of that information is authorized under this subparagraph, the court shall order that disclosure and impose appropriate safeguards against any unauthorized disclosure. The records of that hearing otherwise shall be under seal; and (4) The court having jurisdiction over such proceeding or procedure, when it becomes apparent that AIDS confidential information will likely be or has been disclosed in connection with such proceeding or procedure, shall take such measures as the court determines appropriate to preserve the confidentiality of the disclosed information to the maximum extent possible. Such measures shall include, without being limited to, closing the proceeding or procedure to the public and

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sealing all or any part of the records of the proceeding or procedure containing AIDS confidential information. The records of any appeals taken from any such proceeding or procedure shall also be sealed. Furthermore, the court may consult with and obtain the advice of medical experts or other counsel or advisers as to the relevance and materiality of such information in such proceedings or procedures, so long as the identity of the person identified by such information is not thereby revealed. § 31-‐22-‐9.1 -‐ HIV tests -‐-‐ Who may perform test-‐ DEFINITIONS (a) As used in this Code section, the term: (1) "AIDS" means Acquired Immunodeficiency Syndrome or AIDS Related Complex within the reporting criteria of the department. (2) "AIDS confidential information" means information which discloses that a person: (A) Has been diagnosed as having AIDS; (B) Has been or is being treated for AIDS; (C) Has been determined to be infected with HIV; (D) Has submitted to an HIV test; (E) Has had a positive or negative result from an HIV test; (F) Has sought and received counseling regarding AIDS; or (G) Has been determined to be a person at risk of being infected with AIDS, and which permits the identification of that person. (3) "AIDS transmitting crime" means any of the following offenses specified in Title 16: (A) Rape; (B) Sodomy; (C) Aggravated sodomy; (D) Child molestation; (E) Aggravated child molestation; (F) Prostitution; (G) Solicitation of sodomy; (H) Incest; (I) Statutory rape; or (J) Any offense involving a violation of Article 2 of Chapter 13 of Title 16, regarding controlled substances, if that offense involves heroin, cocaine, derivatives of either, or any other controlled substance in Schedule I, II, III, IV, or V and that other substance is commonly intravenously injected, as determined by the regulations of the department. (4) "Body fluids" means blood, semen, or vaginal secretions. (5) "Confirmed positive HIV test" means the results of at least two separate types of HIV tests, both of which indicate the presence of HIV in the substance tested thereby. (6) "Counseling" means providing the person with information and explanations medically appropriate for that person which may include all or part of the following: accurate information regarding AIDS and HIV; an explanation of behaviors that reduce the risk of transmitting AIDS and HIV; an explanation of the confidentiality of information relating to AIDS diagnoses and HIV tests; an explanation of information regarding both social and medical implications of HIV tests; and disclosure of commonly recognized treatment or treatments for AIDS and HIV. The Department of Public Health shall develop brochures or other documents which meet the requirements of this paragraph and, upon delivery of such a brochure or document or of another brochure or document approved by the Department of Public Health to the person and referral of that person to the Department of Public Health for further information and explanations, counseling shall be deemed

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to have been provided within the meaning of this paragraph. (7) "Determined to be infected with HIV" means having a confirmed positive HIV test or having been clinically diagnosed as having AIDS. (8) "Health care facility" means any: (A) Institution or medical facility, as defined in Code Section 31-‐7-‐1; (B) Facility for mentally ill persons or persons with developmental disabilities, as such terms are defined in Code Section 37-‐1-‐1, or alcoholic or drug dependent persons, as defined in Code Section 37-‐7-‐1; (C) Medical, dental, osteopathic, or podiatric clinic; (D) Hospice, as defined in Code Section 31-‐7-‐172; (E) Clinical laboratory, as defined in Code Section 31-‐22-‐1; or (F) Administrative, clerical, or support personnel of any legal entity specified in subparagraphs (A) through (E) of this paragraph. (9) "Health care provider" means any of the following persons licensed or regulated by the state: (A) Physician or physician assistant; (B) Osteopath; (C) Podiatrist; (D) Midwife; (E) Dentist, dental technician, or dental hygienist; (F) Respiratory care professional, certified respiratory therapy technician, or registered respiratory therapist; (G) Registered nurse; (H) Licensed practical nurse; (I) Emergency medical technician, paramedic, or cardiac technician; (J) Clinical laboratory director, supervisor, technician, or technologist; (K) Funeral director or embalmer; (L) Member of a hospice team, as defined in Code Section 31-‐7-‐172; (M) Nursing home administrator; (N) Professional counselor, social worker, or marriage and family therapist; (O) Psychologist; (P) Administrative, clerical, or support personnel, whether or not they are licensed or regulated by the state, of any person specified in subparagraphs (A) through (O) of this paragraph; (Q) Trainee, student, or intern, whether or not they are licensed or regulated by the state, of any persons listed in subparagraphs (A) through (O) of this paragraph; or (R) First responder, as defined in Chapter 11 of this title, although such person is not licensed or regulated by the state. (10) "HIV" means any type of Human Immunodeficiency Virus, Human T-‐Cell Lymphotropic Virus Types III or IV, Lymphadenopathy Associated Virus Types I or II, AIDS Related Virus, or any other identified causative agent of AIDS. (11) "HIV infected person" means a person who has been determined to be infected with HIV, whether or not that person has AIDS, or who has been clinically diagnosed as having AIDS. (12) "HIV test" means any antibody, antigen, viral particle, viral culture, or other test to indicate the presence of HIV in the human body, which test has been approved for such purposes by the regulations of the department. (13) "Institutional care facility" means any: (A) Health care facility;

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(B) Child welfare agency, as defined in Code Section 49-‐5-‐12; (C) Group care facility, as defined in Code Section 49-‐5-‐3; (D) Penal institution; or (E) Military unit. (14) "Knowledge of being infected with HIV" means actual knowledge of: (A) A confirmed positive HIV test; or (B) A clinical diagnosis of AIDS. (15) "Law" means federal or state law. (16) "Legal entity" means a partnership, association, joint venture, trust, governmental entity, public or private corporation, health care facility, institutional care facility, or any other similar entity. (17) "Military unit" means the smallest organizational unit of the organized militia of the state, as defined in Code Section 38-‐2-‐2, or of any branch of the armed forces of the United States, which unit is commanded by a commissioned officer. (18) "Penal institution" means any jail, correctional institution, or similar facility for the detention of violators of state laws or local ordinances. (19) "Person" means a natural person. (20) "Person at risk of being infected with HIV" means any person who may have already come in contact with or who may in the future reasonably be expected to come in contact with the body fluids of an HIV infected person. (21) "Physician" means any person licensed to practice medicine under Chapter 34 of Title 43. (22) "Public safety agency" means that governmental unit which directly employs a public safety employee. (23) "Public safety employee" means an emergency medical technician, firefighter, law enforcement officer, or prison guard, as such terms are defined in Code Section 45-‐9-‐81, relating to indemnification of such personnel for death or disability. (b) Notwithstanding the provisions of Code Section 31-‐21-‐10 and Code Section 31-‐22-‐11, no person or legal entity, other than an insurer authorized to transact business in this state, shall submit for an HIV test any human body fluid or tissue to any person or legal entity except to: (1) A clinical laboratory licensed under this chapter; (2) A clinical laboratory exempt from licensure under Code Section 31-‐22-‐9; or (3) A clinical laboratory licensed as such pursuant to the laws of any other state. (c) No person or legal entity may sell or offer for sale any HIV test that permits any person or legal entity, including the person whose body fluids are to be tested, to perform that test other than a person or legal entity specified in paragraphs (1) through (3) of subsection (b) of this Code section. § 31-‐22-‐9.2 -‐ HIV tests -‐-‐ Report of positive results; notification; counseling; violations; exception for insurance coverage; exposure of health care provider (a) Any term used in this Code section and defined in Code Section 31-‐22-‐9.1 shall have the meaning provided for that term in Code Section 31-‐22-‐9.1. (b) Reserved. (c) Unless exempted under this Code section, each health care provider who orders an HIV test for any person shall do so only after notifying the person to be tested. Unless exempted under this subsection, the person to be tested shall have the opportunity to refuse the test. The provisions of this subsection shall not be required if the person is required to submit to an HIV test pursuant to Code Section 15-‐11-‐603, 17-‐10-‐15, 31-‐17-‐4.2, 31-‐17A-‐3, 42-‐5-‐52.1, or 42-‐9-‐42.1. The provisions of

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this subsection shall not be required if the person is a minor or incompetent and the parent or guardian thereof permits the test after compliance with this subsection. The provisions of this subsection shall not be required if the person is unconscious, temporarily incompetent, or comatose and the next of kin permits the test after compliance with this subsection. The provisions of this subsection shall not apply to emergency or life-‐threatening situations. The provisions of this subsection shall not apply if the physician ordering the test is of the opinion that the person to be tested is in such a medical or emotional state that disclosure of the test would be injurious to the person's health. The provisions of this subsection shall only be required prior to drawing the body fluids required for the HIV test and shall not be required for each test performed upon that fluid sample. (d) The health care provider ordering an HIV test shall provide medically appropriate counseling to the person tested with regard to the test results. Such medically appropriate counseling shall only be required when the last confirmatory test has been completed. (e) The criminal penalty provided in Code Section 31-‐22-‐13 shall not apply to a violation of subsection (c), (d), or (g) of this Code section. The statute of limitations for any action alleging a violation of this Code section shall be two years from the date of the alleged violation. (f) The provisions of this Code section shall not apply to situations in which an HIV test is ordered or required in connection with insurance coverage, provided that the person to be tested or the appropriate representative of that person has agreed to have the test administered under such procedures as may be established by the Commissioner of Insurance after consultation with the Department of Community Health. (g) Notwithstanding the other provisions of this Code section, when exposure of a health care provider to any body fluids of a patient occurs in such a manner as to create any risk that such provider might become an HIV infected person if the patient were an HIV infected person, according to current infectious disease guidelines of the Centers for Disease Control and Prevention or according to infectious disease standards of the health care facility where the exposure occurred, a health care provider otherwise authorized to order an HIV test shall be authorized to order any HIV test on such patient and obtain the results thereof: (1) If the patient or the patient's representative, if the patient is a minor, otherwise incompetent, or unconscious, does not refuse the test after being notified that the test is to be ordered and after having been provided an opportunity to refuse the test; or (2) If the patient or representative refuses the test, following compliance with paragraph (1) of this subsection, when at least one other health care provider who is otherwise authorized to order an HIV test concurs in writing to the testing, the patient is informed of the results of the test and is provided counseling with regard to those results, and the occurrence of that test is not made a part of the patient's medical records, where the test results are negative, without the patient's consent.

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RESOURCES AND REFERENCES http://law.justia.com/ https://epd.georgia.gov/sites/epd.georgia.gov/files/Proposed%20Rule.pdf CONTACT INFORMATION Georgia Composite Medical Board 2 Peachtree St, NW Atlanta, GA 30303 Phone: (404) 656-‐3913 Georgia Board of Dentistry 2 Peachtree Street, NW Atlanta, GA 30303 Phone: 404-‐651-‐8000

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