<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.52.01.06" title_num="10" subtitle_num="52" chapter_num="01" heading="Program Security.">
  <paragraph num="A.">
    <text>An OADPO program shall implement protocols for the safety and security of program locations, equipment, and staff.</text>
  </paragraph>
  <paragraph num="B.">
    <text>OADPO program staff shall:</text>
    <paragraph num="(1)">
      <text>Wear suitable clothing, including closed footwear, at all times;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Treat all body fluids as potentially infectious and follow infection control protocols at all times including:</text>
      <paragraph num="(a)">
        <text>Use of barriers including gloves;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Immediate washing of hands and other skin surfaces after contact with body fluids; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Careful handling and disposal of sharp instruments during and after use;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>When working off-site, have access to a communications system that allows staff to stay in contact with:</text>
      <paragraph num="(a)">
        <text>Other staff; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Emergency support;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Obtain consent of the owner or occupier of private property to enter the property to dispense or collect syringes or hypodermic needles; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Transport biohazardous waste to the disposal facility using a method that does not put any individuals at risk.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>OADPO programs shall:</text>
    <paragraph num="(1)">
      <text>Have a critical incident procedure that outlines processes and responsibilities of program staff for managing incidents including:</text>
      <paragraph num="(a)">
        <text>Participant aggression;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Threats of violence; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Other hazardous situations;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Have available the following safety equipment during program operations:</text>
      <paragraph num="(a)">
        <text>Puncture resistant utility gloves;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Bleach; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Forceps or tongs;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Have facilities that:</text>
      <paragraph num="(a)">
        <text>Have adequate lighting; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Are free from clutter; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Have a:</text>
      <paragraph num="(a)">
        <text>Contract with a licensed biohazardous waste disposal facility to receive biohazardous waste; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Written agreement that authorizes the OADPO program to drop off used syringes contained in a locked sharps container for safe disposal with a:</text>
        <paragraph num="(i)">
          <text>Hospital;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Doctor’s office;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Pharmacy;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Medical testing facility; or</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Other facility that already receives and safely disposes of hazardous waste.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>To prevent needlestick injuries, OADPO program participants, staff, volunteers, and any other individuals present at the facility in an occupational capacity shall:</text>
    <paragraph num="(1)">
      <text>Receive education on safety protocols for:</text>
      <paragraph num="(a)">
        <text>Carrying and handling:</text>
        <paragraph num="(i)">
          <text>Syringes;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Hypodermic needles; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Other sharps;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>The transport and disposal of biohazardous waste; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Infection control;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Refrain from touching, without safety equipment, used:</text>
      <paragraph num="(a)">
        <text>Hypodermic needles;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Syringes; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Injection supplies; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Be encouraged to wear clothing at all times that provides protection against needlestick injuries including:</text>
      <paragraph num="(a)">
        <text>Long pants; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Long-sleeved shirts.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Use of Sharps Containers.</text>
    <paragraph num="(1)">
      <text>Used hypodermic needles, syringes, and injection supplies collected by the program from participants shall be placed in sharps containers.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Sharps containers:</text>
      <paragraph num="(a)">
        <text>Shall be leak proof;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Shall be rigid;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Shall be puncture resistant;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Shall be labeled as containing sharps;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Shall be placed on a level, secure surface that is a safe distance between participants and staff or volunteers during syringe exchange transactions; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>May not be more than 75 percent full.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Participants shall:</text>
      <paragraph num="(a)">
        <text>Place into the sharps container all used:</text>
        <paragraph num="(i)">
          <text>Hypodermic needles;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Syringes; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Injection supplies;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>When possible, retrieve supplies that fall outside of the sharps container, including:</text>
        <paragraph num="(i)">
          <text>Hypodermic needles;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Syringes; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Injection supplies; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>When possible, cover supplies used by the participant including:</text>
        <paragraph num="(i)">
          <text>Hypodermic needles;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Syringes; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Injection supplies.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Needlestick Injuries.</text>
    <paragraph num="(1)">
      <text>OADPO programs shall implement protocols for handling needlestick injuries.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>OADPO programs shall designate at least one needlestick manager who shall:</text>
      <paragraph num="(a)">
        <text>Assist injured individuals present at the facility including:</text>
        <paragraph num="(i)">
          <text>Participants;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Staff;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Volunteers; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Any other individuals present in an occupational capacity;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Follow established procedures for accident or incident reporting; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Immediately notify the ranking supervisor of any needlestick injuries.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Participants, staff, volunteers, and any other individuals present at the facility in an occupational capacity shall:</text>
      <paragraph num="(a)">
        <text>Report a needlestick injury to the on-site needlestick manager immediately; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Visit the emergency room or a private physician within 24 hours of the occurrence.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Post-Exposure Management. OADPO programs shall implement protocols for post-exposure management including:</text>
    <paragraph num="(1)">
      <text>Testing; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Post-exposure prophylaxis.</text>
    </paragraph>
  </paragraph>
</regulation>