What it means to you: Public awareness of healthcare-associated infections is mounting, as is support for state-mandated reporting. In addition, recent MRSA outbreaks led to a flurry of MRSA-based state legislation requiring screenings or prevention plans. That means healthcare facilities across the country are under the microscope—and so are staff members. Many hospitals that aren’t required to report rates are already working proactively to reduce HAI rates, regardless of legislation. Just because you don’t have to report your rates today doesn’t mean you won’t have to in the future. In fact, federal legislation might not be far behind. Several infection control bills are new or pending, including the Healthy Hospitals Act of 2007, the Community and Healthcare-Associated Infections Reduction Act, the MRSA Infection Prevention and Patient Protection Act and the MRSA Research and Study Act.

The scoop: Nearly half of all U.S. states have passed legislation requiring some form of public reporting of healthcare-acquired infection rates. View this map to find out what lawmakers are proposing in your state. Another seven states whose legislatures are currently in session are still considering laws. You can keep tabs on their progress here. Other states of note include:

· West Virginia, which just passed legislation in March 2008. The state will begin requiring reports from hospitals in July 2009 and publish its first public report in January 2011. The bill includes a provision to fine hospitals that fail to report rates.

· In California, a bill that requires hospitals to conduct MRSA screenings and self-report HAI rates has passed the Senate and now faces the Assembly in June. In 2004, Gov. Schwarzenegger vetoed a bill that required HAI reporting by hospitals, and instead backed a 2006 bill that mandated infection control policy development by hospitals. In this San Francisco Chronicle article, the author of California’s new bill, SB 1058, says: "Just as we have access to car safety ratings, we ought to have access to hospital safety ratings. The public has the right to know."

· Despite the increased media frenzy surrounding MRSA outbreaks in the U.S., only three states have passed MRSA-specific legislation—Connecticut, Maryland and Tennessee.

· Two states (Nebraska and Nevada) require that infection rates be reported—but only confidentially to state agencies. Arkansas encourages its facilities to report their rates voluntarily.