CHAPTER 2
HEPATITIS PROGRAMS
viral hepatitis program—vaccinations and testing
641—2.1(135) Definitions. For the purpose of these rules, the following definitions shall apply:
“Contracted agencies” means local health departments, clinics, and community-based organizations that are funded by the department to provide HCV testing and vaccination services.
“Department” means the Iowa department of public health.
“HCV” means the hepatitis C virus as defined by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.
“Viral hepatitis” means inflammation of the liver caused by one of several viruses: hepatitis A, B, C (formerly non-A, non-B), D and E.
641—2.2(135) Purpose. The purpose of the viral hepatitis program shall be to distribute information, offer HCV testing, and offer hepatitis A and B vaccinations to the citizens of this state who are at an increased risk of viral hepatitis exposure.
641—2.3(135) Exposure risks for hepatitis C virus. The following individuals are at increased risk of exposure to HCV as outlined by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.
	2.3(1) The following individuals are at high risk of infection:
	a. 	Injection drug users (IDUs);
	b. 	Recipients of clotting factors made before 1987; and
	c. 	Hemodialysis patients.
	2.3(2) The following individuals are at intermediate risk of infection:
	a. 	Recipients of blood or solid organs before 1992;
	b. 	Persons with undiagnosed liver problems; and
	c. 	Infants born to HCV-infected mothers.
	2.3(3) The following individuals are at low risk of infection:
	a. 	Health care/public safety workers;
	b. 	Persons having sex with multiple partners; and
	c. 	Persons having sex with an HCV-infected steady partner.
641—2.4(135) Information for public distribution. The department shall make available educational materials to the public on hepatitis C infection, how to avoid transmitting the virus, and where to seek counseling and testing services. The information shall be available on the department’s Web site at http://www.idph.state.ia.us/adper/hepatitis.asp and by mail to HIV/AIDS Hepatitis Program, Lucas State Office Building, 321 East 12th Street, Des Moines, Iowa 50319.
641—2.5(135) Hepatitis vaccination and testing program.
	2.5(1) When sufficient state and federal funds are available, the department will establish a vaccination and testing program. The program shall offer HCV testing and hepatitis A and B vaccinations through local health departments, clinics, and community-based organizations to high-risk individuals as defined in 2.5(2) and 2.5(3). Contracted agencies offering testing and vaccination services shall be required to provide integrated HIV, viral hepatitis, and sexually transmitted disease education; pretest and posttest counseling; and referral services.
	2.5(2) Contracted agencies shall offer HCV testing to the following high-risk individuals:
	a. 	Persons who have ever injected drugs;
	b. 	Injection drug users who share needles or other equipment;
	c. 	Persons who receive blood, blood products, or organ transplants prior to 1992; and
	d. 	Persons ever on long-term hemodialysis.
	2.5(3) Contracted agencies shall offer hepatitis A and B vaccinations to the following high-risk individuals:
	a. 	Injection and noninjection drug users;
	b. 	Men who have sex with men;
	c. 	Persons with a diagnosis of a recently acquired sexually transmitted disease (STD);
	d. 	HIV- or HCV-infected persons; and
	e. 	Sexual partners of persons infected with HIV, hepatitis A (HAV), or hepatitis B (HBV).
	2.5(4) Contracted agencies shall provide individuals presenting for counseling, testing, and referral services and testing positive for hepatitis C educational brochures explaining their potential risk of exposure.
	2.5(5) Contracted agencies shall provide individuals testing positive for HCV a referral list of health care providers to aid in seeking additional follow-up testing and other hepatitis-related services.
641—2.6 to 2.8 Reserved.
hepatitis c awareness program—veterans
641—2.9(135) Definitions. For the purpose of these rules, the following definitions shall apply:
“Department” means the Iowa department of public health.
“HCV” means the hepatitis C virus as defined by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.
“Veteran” means an individual meeting the definition contained in Iowa Code section 35.1.
641—2.10(135) Purpose. The purpose of the hepatitis C awareness program shall be to distribute information to veterans regarding the higher incidence of hepatitis C exposure and infection among veterans, the dangers presented by the disease, and contact information and referrals.
641—2.11(135) Awareness materials. The department shall provide hepatitis awareness materials to veterans through various educational media.
641—2.12(135) Awareness information. Information distributed by the department shall contain the following statements:
	2.12(1) HCV infection rates for veterans are estimated to be at least three times higher than the general population.
	2.12(2) Vietnam veterans experience a higher HCV infection rate than other veteran groups.
	2.12(3) Exposure to blood during combat and combat-related medical services poses a risk for HCV infection.
	2.12(4) Many veterans currently infected with HCV may have been exposed prior to the development of screening tests.
	2.12(5) Symptoms and liver complications associated with chronic hepatitis infection may not appear for decades after initial infection.
641—2.13(135) Resources for hepatitis follow-up and treatment. The department shall provide hepatitis resource information to veterans regarding medical follow-up and treatment options.
These rules are intended to implement Iowa Code sections 135.19 and 135.20.
[Filed 11/14/07, Notice 10/10/07—published 12/5/07, effective 1/9/08]