[MCOH-EH] #ExtMail# Re: BBP exposures

[Hudson, T. Warner]

At UCLA we have 3 day dose packs of Isentress plus Truvada, the standard PEP regimen, we dispense from OH as do our EDs.  If the source is HIV positive or unknown then 28 days is prescribed and OH follow up for the 4-6 months.  We too have many HIV + sources often on drugs for resistant HIV so the exposed employee may be placed in Zerit, Rayataz, Lexiva or other more esoteric meds…we don’t have dose packs for those.

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health
UCLA Health System and Campus
Office 310.825.9146
Fax 310.206.4585
Pager 800.233.7231  ID 27132
E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Kathy.Dayvault at dekalbmedical.org
Sent: Monday, November 13, 2017 8:30 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Cc: MCOH-EH <mcoh-eh-bounces+kathy.dayvault=dekalbmedical.org at mylist.net>
Subject: Re: [MCOH-EH] #ExtMail# Re: BBP exposures

Hi Dr. Grubs,

The initial 3 doses is prescribed in the ED and is dispensed by our in house pharmacy, this most typically occurs over the weekend.

Obviously, there is no issue with being able to use the rest of the bottle.

We see a moderate to large number of HIV + patients in our ED who often end up being admitted.

Thanks,

Kathy

Kathy Dayvault, RN, BSN, MPH
 Manager, Occupational Health and Safety
 WorksWell Onsite
 Dekalb Medical  2701 North Decatur Road
 Decatur, GA 30033
ph: 404.501.4972 Fax:404-501-2045
kathy.dayvault at dekalbmedical.org<mailto:kathy.dayvault at dekalbmedical.org>




From:        "Grubbs, Scott" <Scott_Grubbs at bshsi.org<mailto:Scott_Grubbs at bshsi.org>>
To:        MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>,
Date:        11/10/2017 06:19 PM
Subject:        Re: [MCOH-EH] #ExtMail# Re:  BBP exposures
Sent by:        "MCOH-EH" <mcoh-eh-bounces+kathy.dayvault=dekalbmedical.org at mylist.net<mailto:mcoh-eh-bounces+kathy.dayvault=dekalbmedical.org at mylist.net>>
________________________________



Re Kathy Dayvault’s comments:
I am curious which meds you are using for HIV PEP.  We have been told that a three day supply of Truvada was not available, since once the 30 day bottle was opened the pills had to be used fairly quickly.    So, we have been writing for 30 day supplies even if just for a few days.  Have your local pharmacies figured a way around that?
Thanks!
Scott Grubbs, MD
WorkWell Occupational Health
Greenville, SC

From: MCOH-EH [mailto:mcoh-eh-bounces+scott_grubbs=bshsi.org at mylist.net] On Behalf Of Kathy.Dayvault at dekalbmedical.org<mailto:Kathy.Dayvault at dekalbmedical.org>
Sent: Thursday, October 12, 2017 10:45 AM
To: MCOH/EH
Cc: MCOH-EH
Subject: #ExtMail# Re: [MCOH-EH] BBP exposures

We provide initial care for BBF exposures for students and travelers - meaning we draw initial blood and would give three days of meds if indicated by a positive HIV source.

Follow up care, including continued blood draws and medications is under the direction of their WC or school liability insurance.

The involved person is directed to their WC provider/school for further direction.

For students, this is outlined in our contract with their school/college.

Thanks,

Kathy Dayvault, RN, BSN, MPH
Manager, Occupational Health and Safety
WorksWell Onsite
Dekalb Medical  2701 North Decatur Road
Decatur, GA 30033
ph: 404.501.4972 Fax:404-501-2045
kathy.dayvault at dekalbmedical.org<mailto:kathy.dayvault at dekalbmedical.org>




From:        "Morelli, Karen J" <kmorelli at emhs.org<mailto:kmorelli at emhs.org>>
To:        "'mcoh-eh at mylist.net'" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>,
Date:        10/12/2017 09:18 AM
Subject:        [MCOH-EH] BBP exposures
Sent by:        "MCOH-EH" <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>>
________________________________




I am wondering how other clinics bill for blood borne pathogen exposures.  Our company caters to member organization hospitals/practices as well as many outside our system clients.  Historically, we have billed the member organization for our services.  We would like to move to billing worker’s comp.  Getting the worker’s comp information on our members organizations is not an issue, however, we see many locums, travelers, etc. that would be covered by other worker’s comp carriers.  How do you go about gathering this information?  Do your facilities charge worker’s comp for BBP exposures?

Thank you for any guidance you may offer!
Karen

Karen Morelli RN, BSN, Clinical Manager
WorkHealth LLC
973-7382
kmorelli at emhs.org<mailto:kmorelli at emhs.org>
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