Text: HF00680                           Text: HF00682
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Bills and Amendments: General Index     Bill History: General Index



House File 681

Partial Bill History

Bill Text

PAG LIN
  1  1    Section 1.  Section 80.9, subsection 2, paragraph d, Code
  1  2 1999, is amended to read as follows:
  1  3    d.  To collect and classify, and keep at all times
  1  4 available, complete information useful for the detection of
  1  5 crime, and the identification and apprehension of criminals.
  1  6 Such information shall be available for all peace officers
  1  7 within the state, under such regulations as the commissioner
  1  8 may prescribe.  The provisions of chapter 141 141A do not
  1  9 apply to the entry of human immunodeficiency virus-related
  1 10 information by criminal or juvenile justice agencies, as
  1 11 defined in section 692.1, into the Iowa criminal justice
  1 12 information system or the national crime information center
  1 13 system.  The provisions of chapter 141 141A also do not apply
  1 14 to the transmission of the same information from either or
  1 15 both information systems to criminal or juvenile justice
  1 16 agencies.  The provisions of chapter 141 141A also do not
  1 17 apply to the transmission of the same information from either
  1 18 or both information systems to employees of state correctional
  1 19 institutions subject to the jurisdiction of the department of
  1 20 corrections, employees of secure facilities for juveniles
  1 21 subject to the jurisdiction of the department of human
  1 22 services, and employees of city and county jails, if those
  1 23 employees have direct physical supervision over inmates of
  1 24 those facilities or institutions.  Human immunodeficiency
  1 25 virus-related information shall not be transmitted over the
  1 26 police radio broadcasting system under chapter 693 or any
  1 27 other radio-based communications system.  An employee of an
  1 28 agency receiving human immunodeficiency virus-related
  1 29 information under this section who communicates the
  1 30 information to another employee who does not have direct
  1 31 physical supervision over inmates, other than to a supervisor
  1 32 of an employee who has direct physical supervision over
  1 33 inmates for the purpose of conveying the information to such
  1 34 an employee, or who communicates the information to any person
  1 35 not employed by the agency or uses the information outside the
  2  1 agency is guilty of a class "D" felony.  The commissioner
  2  2 shall adopt rules regarding the transmission of human
  2  3 immunodeficiency virus-related information including
  2  4 provisions for maintaining confidentiality of the information.
  2  5 The rules shall include a requirement that persons receiving
  2  6 information from the Iowa criminal justice information system
  2  7 or the national crime information center system receive
  2  8 training regarding confidentiality standards applicable to the
  2  9 information received from the system.  The commissioner shall
  2 10 develop and establish, in cooperation with the department of
  2 11 corrections and the Iowa department of public health, training
  2 12 programs and program criteria for persons receiving human
  2 13 immunodeficiency virus-related information through the Iowa
  2 14 criminal justice information system or the national crime
  2 15 information center system.
  2 16    Sec. 2.  Section 139B.1, subsection 1, paragraph a, Code
  2 17 1999, is amended to read as follows:
  2 18    a.  "Contagious or infectious disease" means hepatitis in
  2 19 any form, meningococcal disease, tuberculosis, and any other
  2 20 disease with the exception of AIDS or HIV infection as defined
  2 21 in section 141.21 141A.1, determined to be life-threatening to
  2 22 a person exposed to the disease as established by rules
  2 23 adopted by the department based upon a determination by the
  2 24 state epidemiologist and in accordance with guidelines of the
  2 25 centers for disease prevention and control of the United
  2 26 States department of health and human services.
  2 27    Sec. 3.  Section 139C.1, subsection 6, Code 1999, is
  2 28 amended to read as follows:
  2 29    6.  "HIV" means HIV as defined in section 141.21 141A.1.
  2 30    Sec. 4.  Section 139C.2, subsection 7, Code 1999, is
  2 31 amended to read as follows:
  2 32    7.  Information relating to the HIV status of a health care
  2 33 provider is confidential and subject to the provisions of
  2 34 section 141.23 141A.9.  A person who intentionally or
  2 35 recklessly makes an unauthorized disclosure of such
  3  1 information is subject to a civil penalty of one thousand
  3  2 dollars.  The attorney general or the attorney general's
  3  3 designee may maintain a civil action to enforce this section.
  3  4 Proceedings maintained under this section shall provide for
  3  5 the anonymity of the individual and all documentation shall be
  3  6 maintained in a confidential manner.  Information relating to
  3  7 the HBV status of a health care provider is confidential and
  3  8 shall not be accessible to the public.  Information regulated
  3  9 by this section, however, may be disclosed to members of the
  3 10 expert review panel established by the department or a panel
  3 11 established by hospital protocol under this section.  The
  3 12 information may also be disclosed to the appropriate examining
  3 13 board by filing a report as required by this section.  The
  3 14 examining board shall consider the report a complaint subject
  3 15 to the confidentiality provisions of section 272C.6.  A
  3 16 licensee, upon the filing of a formal charge or notice of
  3 17 hearing by the examining board based on such a complaint, may
  3 18 seek a protective order from the board.
  3 19    Sec. 5.  NEW SECTION.  141A.1  DEFINITIONS.
  3 20    As used in this chapter, unless the context otherwise
  3 21 requires:
  3 22    1.  "AIDS" means acquired immune deficiency syndrome as
  3 23 defined by the centers for disease control and prevention of
  3 24 the United States department of health and human services.
  3 25    2.  "AIDS-related conditions" means the human
  3 26 immunodeficiency virus, or any other condition resulting from
  3 27 the human immunodeficiency virus infection.
  3 28    3.  "Blinded epidemiological studies" means studies in
  3 29 which specimens which were collected for other purposes are
  3 30 selected according to established criteria, are permanently
  3 31 stripped of personal identifiers, and are then tested.
  3 32    4.  "Blood bank" means a facility for the collection,
  3 33 processing, or storage of human blood or blood derivatives,
  3 34 including blood plasma, or from which or by means of which
  3 35 human blood or blood derivatives are distributed or otherwise
  4  1 made available.
  4  2    5.  "Care provider" means any emergency care provider,
  4  3 health care provider, or any other person providing health
  4  4 care services of any kind.
  4  5    6.  "Department" means the Iowa department of public
  4  6 health.
  4  7    7.  "Emergency care provider" means a person who is trained
  4  8 and authorized by federal or state law to provide emergency
  4  9 medical assistance or treatment, for compensation or in a
  4 10 voluntary capacity, including but not limited to all of the
  4 11 following:
  4 12    (1)  An emergency medical care provider as defined in
  4 13 section 147A.1.
  4 14    (2)  A health care provider.
  4 15    (3)  A fire fighter.
  4 16    (4)  A peace officer.
  4 17    "Emergency care provider" also includes a person who
  4 18 renders emergency aid without compensation.
  4 19    8.  "Good faith" means objectively reasonable and not in
  4 20 violation of clearly established statutory rights or other
  4 21 rights of a person which a reasonable person would know or
  4 22 should have known.
  4 23    9.  "Health care provider" means a person licensed or
  4 24 certified under chapter 148, 148C, 150, 150A, 152, or 153 to
  4 25 provide professional health care service to a person during
  4 26 the person's medical care, treatment, or confinement.
  4 27    10.  "Health facility" means a hospital, health care
  4 28 facility, clinic, blood bank, blood center, sperm bank,
  4 29 laboratory organ transplant center and procurement agency, or
  4 30 other health care institution.
  4 31    11.  "HIV" means the human immunodeficiency virus
  4 32 identified as the causative agent of AIDS.
  4 33    12.  "HIV-related test" means a diagnostic test conducted
  4 34 by a laboratory approved pursuant to the federal Clinical
  4 35 Laboratory Improvements Act for determining the presence of
  5  1 HIV.
  5  2    13.  "Infectious bodily fluids" means bodily fluids capable
  5  3 of transmitting HIV infection as determined by the centers for
  5  4 disease control and prevention of the United States department
  5  5 of health and human services and adopted by rule of the
  5  6 department.
  5  7    14.  "Legal guardian" means a person appointed by a court
  5  8 pursuant to chapter 633 or an attorney in fact as defined in
  5  9 section 144B.1.  In the case of a minor, "legal guardian" also
  5 10 means a parent or other person responsible for the care of the
  5 11 minor.
  5 12    15.  "Nonblinded epidemiological studies" means studies in
  5 13 which specimens are collected for the express purpose of
  5 14 testing for the HIV infection and persons included in the
  5 15 nonblinded study are selected according to established
  5 16 criteria.
  5 17    16.  "Release of test results" means a written
  5 18 authorization for disclosure of HIV-related test results which
  5 19 is signed and dated, and which specifies to whom disclosure is
  5 20 authorized and the time period during which the release is to
  5 21 be effective.
  5 22    17.  "Sample" means a human specimen obtained for the
  5 23 purpose of conducting an HIV-related test.
  5 24    18.  "Significant exposure" means the risk of contracting
  5 25 HIV infection by means of exposure to a person's infectious
  5 26 bodily fluids in a manner capable of transmitting HIV
  5 27 infection as determined by the centers for disease control and
  5 28 prevention of the United States department of health and human
  5 29 services and adopted by rule of the department.
  5 30    Sec. 6.  NEW SECTION.  141A.2  LEAD AGENCY.
  5 31    1.  The department is designated as the lead agency in the
  5 32 coordination and implementation of the state comprehensive
  5 33 AIDS-related conditions prevention and intervention plan.
  5 34    2.  The department shall adopt rules pursuant to chapter
  5 35 17A to implement and enforce this chapter.  The rules may
  6  1 include procedures for taking appropriate action with regard
  6  2 to health facilities or health care providers which violate
  6  3 this chapter or the rules adopted pursuant to this chapter.
  6  4    3.  The department shall adopt rules pursuant to chapter
  6  5 17A which require that if a health care provider attending a
  6  6 person prior to the person's death determines that the person
  6  7 suffered from or was suspected of suffering from a contagious
  6  8 or infectious disease, the health care provider shall place
  6  9 with the remains written notification of the condition for the
  6 10 information of any person handling the body of the deceased
  6 11 person subsequent to the person's death.  For purposes of this
  6 12 subsection, "contagious or infectious disease" means hepatitis
  6 13 in any form, meningococcal disease, tuberculosis, and any
  6 14 other disease including AIDS or HIV infection, determined to
  6 15 be life-threatening to a person exposed to the disease as
  6 16 established by rules adopted by the department based upon a
  6 17 determination by the state epidemiologist and in accordance
  6 18 with guidelines of the centers for disease control and
  6 19 prevention of the United States department of health and human
  6 20 services.
  6 21    4.  The department, in cooperation with the department of
  6 22 public safety and persons who represent those who attend dead
  6 23 bodies, shall establish for all care providers, including
  6 24 paramedics, ambulance personnel, physicians, nurses, hospital
  6 25 personnel, first responders, peace officers, and fire
  6 26 fighters, who provide care services to a person, and for all
  6 27 persons who attend dead bodies, protocol and procedures for
  6 28 the use of universal precautions to prevent the transmission
  6 29 of contagious and infectious diseases.
  6 30    5.  The department shall coordinate efforts with local
  6 31 health officers to investigate sources of HIV infection and
  6 32 use every appropriate means to prevent the spread of the
  6 33 infection.
  6 34    6.  The department, with the approval of the state board of
  6 35 health, may conduct epidemiological blinded and nonblinded
  7  1 studies to determine the incidence and prevalence of the HIV
  7  2 infection.  Initiation of any new epidemiological studies
  7  3 shall be contingent upon the receipt of funding sufficient to
  7  4 cover all the costs associated with the studies.  The informed
  7  5 consent, reporting, and counseling requirements of this
  7  6 chapter shall not apply to blinded studies.
  7  7    Sec. 7.  NEW SECTION.  141A.3  DUTIES OF THE DEPARTMENT.
  7  8    1.  All federal and state moneys appropriated to the
  7  9 department for AIDS-related activities shall be allocated in
  7 10 accordance with a prioritized schedule developed by rule of
  7 11 the department, and grants shall be awarded to the maximum
  7 12 extent feasible to community-based organizations.
  7 13    2.  The department shall do all of the following:
  7 14    a.  Provide consultation to agencies and organizations
  7 15 regarding appropriate policies for testing, education,
  7 16 confidentiality, and infection control.
  7 17    b.  Conduct health information programs for the public
  7 18 relating to HIV infection, including information about how the
  7 19 infection is transmitted and how transmittal can be prevented.
  7 20 The department shall prepare, for free distribution, printed
  7 21 information relating to HIV infection and prevention.
  7 22    c.  Provide educational programs concerning HIV infection
  7 23 in the workplace.
  7 24    d.  Develop and implement HIV education risk-reduction
  7 25 programs for specific populations at high risk for infection.
  7 26    e.  Provide an informational brochure for patients who
  7 27 provide samples for purposes of performing an HIV test which,
  7 28 at a minimum, shall include a summary of the patient's rights
  7 29 and responsibilities under the law.
  7 30    f.  In cooperation with the department of education,
  7 31 develop and update a medically correct AIDS prevention
  7 32 curriculum for use at the discretion of secondary and middle
  7 33 schools.
  7 34    3.  The department shall, in cooperation with the
  7 35 department of education and other agencies, organizations,
  8  1 coalitions, and local health departments, develop and
  8  2 implement a program of public and professional AIDS-related
  8  3 education.
  8  4    Sec. 8.  NEW SECTION.  141A.4  TESTING AND COUNSELING.
  8  5    1.  HIV testing and counseling shall be offered to the
  8  6 following:
  8  7    a.  All persons seeking treatment for a sexually
  8  8 transmitted disease.
  8  9    b.  All persons seeking treatment for injecting drug abuse
  8 10 or having a history of injecting drug abuse.
  8 11    c.  All persons who consider themselves at risk for the HIV
  8 12 infection.
  8 13    d.  Male and female prostitutes.
  8 14    2.  Pregnant women shall be provided information about HIV
  8 15 prevention, risk reduction, and treatment opportunities to
  8 16 reduce the possible transmission of HIV to a fetus.  Pregnant
  8 17 women who report one or more recognized risk factors for HIV
  8 18 shall be strongly encouraged to undergo HIV-related testing.
  8 19 A pregnant woman who requests testing shall be tested
  8 20 regardless of the absence of risk factors.
  8 21    Sec. 9.  NEW SECTION.  141A.5  PARTNER NOTIFICATION PROGRAM
  8 22 – HIV.
  8 23    1.  The department shall maintain a partner notification
  8 24 program for persons known to have tested positive for the HIV
  8 25 infection.
  8 26    2.  The department shall initiate the program at
  8 27 alternative testing and counseling sites and at sexually
  8 28 transmitted disease clinics.
  8 29    3.  In administering the program, the department shall
  8 30 provide for the following:
  8 31    a.  A person who tests positive for the HIV infection shall
  8 32 receive posttest counseling, during which time the person
  8 33 shall be encouraged to refer for counseling and HIV testing
  8 34 any person with whom the person has had sexual relations or
  8 35 has shared drug injecting equipment.
  9  1    b.  The physician or other health care provider attending
  9  2 the person may provide to the department any relevant
  9  3 information provided by the person regarding any person with
  9  4 whom the tested person has had sexual relations or has shared
  9  5 drug injecting equipment.  The department disease prevention
  9  6 staff shall then conduct partner notification in the same
  9  7 manner as that utilized for sexually transmitted diseases
  9  8 consistent with the provisions of this chapter.
  9  9    c.  Devise a procedure, as a part of the partner
  9 10 notification program, to provide for the notification of an
  9 11 identifiable third party who is a sexual partner of or who
  9 12 shares drug injecting equipment with a person who has tested
  9 13 positive for HIV, by the department or a physician, when all
  9 14 of the following situations exist:
  9 15    (1)  A physician for the infected person is of the good
  9 16 faith opinion that the nature of the continuing contact poses
  9 17 an imminent danger of HIV infection transmission to the third
  9 18 party.
  9 19    (2)  When the physician believes in good faith that the
  9 20 infected person, despite strong encouragement, has not and
  9 21 will not warn the third party and will not participate in the
  9 22 voluntary partner notification program.
  9 23    Notwithstanding subsection 4, the department or a physician
  9 24 may reveal the identity of a person who has tested positive
  9 25 for the HIV infection pursuant to this subsection only to the
  9 26 extent necessary to protect a third party from the direct
  9 27 threat of transmission.  This subsection shall not be
  9 28 interpreted to create a duty to warn third parties of the
  9 29 danger of exposure to HIV through contact with a person who
  9 30 tests positive for the HIV infection.
  9 31    The department shall adopt rules pursuant to chapter 17A to
  9 32 implement this paragraph "c".  The rules shall provide a
  9 33 detailed procedure by which the department or a physician may
  9 34 directly notify an endangered third party.
  9 35    4.  In making contact, the department shall not disclose
 10  1 the identity of the person who provided the names of the
 10  2 persons to be contacted and shall protect the confidentiality
 10  3 of persons contacted.
 10  4    5.  The department may delegate its partner notification
 10  5 duties under this section to local health authorities unless
 10  6 the local health authority refuses or neglects to conduct the
 10  7 contact tracing program in a manner deemed to be effective by
 10  8 the department.
 10  9    6.  In addition to the provisions for partner notification
 10 10 provided under this section and notwithstanding any provision
 10 11 to the contrary, a county medical examiner or deputy medical
 10 12 examiner performing official duties pursuant to sections
 10 13 331.801 through 331.805 or the state medical examiner or
 10 14 deputy medical examiner performing official duties pursuant to
 10 15 chapter 691, who determines through an investigation that a
 10 16 deceased person was infected with HIV, may notify directly, or
 10 17 request that the department notify, the immediate family of
 10 18 the deceased or any person known to have had a significant
 10 19 exposure from the deceased of the finding.
 10 20    Sec. 10.  NEW SECTION.  141A.6  AIDS-RELATED CONDITIONS –
 10 21 SCREENING, TESTING, AND REPORTING.
 10 22    1.  Prior to obtaining a sample for the purpose of
 10 23 performing a voluntary HIV-related test, a health care
 10 24 provider shall inform the subject of the test that the test is
 10 25 voluntary.  Within seven days of the receipt of a test result
 10 26 indicating HIV infection which has been confirmed as positive
 10 27 according to prevailing medical technology, the physician or
 10 28 other health care provider at whose request the test was
 10 29 performed shall make a report to the department on a form
 10 30 provided by the department.
 10 31    2.  Within seven days of diagnosing a person as having an
 10 32 AIDS-related condition, the diagnosing physician shall make a
 10 33 report to the department on a form provided by the department.
 10 34    3.  Within seven days of the death of a person resulting
 10 35 from an AIDS-related condition, the attending physician shall
 11  1 make a report to the department on a form provided by the
 11  2 department.
 11  3    4.  Within seven days of the receipt of a test result
 11  4 indicating HIV infection which has been confirmed as positive
 11  5 according to prevailing medical technology, the director of a
 11  6 blood bank shall make a report to the department on a form
 11  7 provided by the department.
 11  8    5.  Within seven days of the receipt of a test result
 11  9 indicating HIV infection which has been confirmed as positive
 11 10 according to prevailing medical technology, the director of a
 11 11 clinical laboratory shall make a report to the department on a
 11 12 form provided by the department.
 11 13    6.  The forms provided by the department shall require
 11 14 inclusion of all of the following information:
 11 15    a.  The name of the patient.
 11 16    b.  The address of the patient.
 11 17    c.  The patient's date of birth.
 11 18    d.  The gender of the patient.
 11 19    e.  The race or ethnicity of the patient.
 11 20    f.  The patient's marital status.
 11 21    g.  The patient's telephone number.
 11 22    h.  The name and address of the laboratory or blood bank.
 11 23    i.  The date the test was found to be positive and the
 11 24 collection date.
 11 25    j.  The name of the physician or health care provider who
 11 26 performed the test.
 11 27    k.  If the patient is female, whether the patient is
 11 28 pregnant.
 11 29    Sec. 11.  NEW SECTION.  141A.7  TEST RESULTS – COUNSELING
 11 30 – APPLICATION FOR SERVICES.
 11 31    1.  Prior to undergoing an HIV-related test, information
 11 32 shall be available to the subject of the test concerning
 11 33 testing and any means of obtaining additional information
 11 34 regarding HIV infection and risk reduction.  At any time that
 11 35 the subject of an HIV-related test is informed of confirmed
 12  1 positive test results, counseling concerning the emotional and
 12  2 physical health effects shall be initiated.  Particular
 12  3 attention shall be given to explaining the need for the
 12  4 precautions necessary to avoid transmitting the virus.  The
 12  5 subject shall be given information concerning additional
 12  6 counseling.
 12  7    2.  Notwithstanding subsection 1, the provisions of this
 12  8 section do not apply to any of the following:
 12  9    a.  The performance by a health care provider or health
 12 10 facility of an HIV-related test when the health care provider
 12 11 or health facility procures, processes, distributes, or uses a
 12 12 human body part donated for a purpose specified under the
 12 13 uniform anatomical gift Act, or semen provided prior to July
 12 14 1, 1988, for the purpose of artificial insemination, or
 12 15 donations of blood, and such test is necessary to ensure
 12 16 medical acceptability of such gift or semen for the purposes
 12 17 intended.
 12 18    b.  A person engaged in the business of insurance who is
 12 19 subject to section 505.16.
 12 20    c.  The performance by a health care provider or health
 12 21 facility of an HIV-related test when the subject of the test
 12 22 is deceased and a documented significant exposure has
 12 23 occurred.
 12 24    3.  A person may apply for voluntary treatment,
 12 25 contraceptive services, or screening or treatment for HIV
 12 26 infection and other sexually transmitted diseases directly to
 12 27 a licensed physician and surgeon, an osteopathic physician and
 12 28 surgeon, or a family planning clinic.  Notwithstanding any
 12 29 other provision of law, however, a minor shall be informed
 12 30 prior to testing that, upon confirmation according to
 12 31 prevailing medical technology of a positive HIV-related test
 12 32 result, the minor's legal guardian is required to be informed
 12 33 by the testing facility.  Testing facilities where minors are
 12 34 tested shall have available a program to assist minors and
 12 35 legal guardians with the notification process which emphasizes
 13  1 the need for family support and assists in making available
 13  2 the resources necessary to accomplish that goal.  However, a
 13  3 testing facility which is precluded by federal statute,
 13  4 regulation, or centers for disease control and prevention
 13  5 guidelines from informing the legal guardian is exempt from
 13  6 the notification requirement.  The minor shall give written
 13  7 consent to these procedures and to receive the services,
 13  8 screening, or treatment.  Such consent is not subject to later
 13  9 disaffirmance by reason of minority.
 13 10    Sec. 12.  NEW SECTION.  141A.8  CARE PROVIDER NOTIFICATION.
 13 11    1.  A hospital licensed under chapter 135B shall provide
 13 12 notification to a care provider who renders assistance or
 13 13 treatment to an individual, following submission of a
 13 14 significant exposure report by the care provider to the
 13 15 hospital and a diagnosis or confirmation by an attending
 13 16 physician that the individual has HIV infection, and
 13 17 determination that the exposure reported was a significant
 13 18 exposure.  The notification shall advise the care provider of
 13 19 possible exposure to HIV infection.  Notification shall be
 13 20 made in accordance with both of the following:
 13 21    a.  The hospital informs the individual, when the
 13 22 individual's condition permits, of the submission of a
 13 23 significant exposure report.
 13 24    b.  The individual consents to serological testing by or
 13 25 voluntarily discloses the individual's HIV status to the
 13 26 hospital and consents to notification.
 13 27    Notwithstanding paragraphs "a" and "b", notification shall
 13 28 be made when the individual denies consent for or consent is
 13 29 not reasonably obtainable for serological testing, and in the
 13 30 course of admission, care, and treatment of the individual,
 13 31 the individual is diagnosed or is confirmed as having HIV
 13 32 infection.
 13 33    2.  The hospital shall notify the care provider involved in
 13 34 attending or transporting an individual who submitted a
 13 35 significant exposure report.  This shall include a person who
 14  1 renders direct emergency aid without compensation, or in the
 14  2 case of an emergency care provider, the designated officer of
 14  3 the emergency care provider service, who in turn shall notify
 14  4 any emergency care providers.  The identity of the designated
 14  5 officer shall not be revealed to the individual.  The
 14  6 designated officer shall inform the hospital of those parties
 14  7 who received the notification, and following receipt of this
 14  8 information and upon request of the individual, the hospital
 14  9 shall inform the individual of the parties to whom
 14 10 notification was provided.
 14 11    3.  The hospital, upon request of the individual, shall
 14 12 inform the individual of the persons to whom notification was
 14 13 made.
 14 14    4.  The process for notification under this section shall
 14 15 be initiated as soon as is reasonably possible.
 14 16    5.  A health care provider, with consent of the individual,
 14 17 may provide the notification required of hospitals in this
 14 18 section to care providers if an individual who has HIV
 14 19 infection is delivered by a care provider to the office or
 14 20 clinic of the health care provider for treatment.  The
 14 21 notification shall take place only upon submission of a
 14 22 significant exposure report form by the care provider to the
 14 23 health care provider and the determination by the health care
 14 24 provider that a significant exposure has occurred.
 14 25    6.  This section does not require or permit, unless
 14 26 otherwise provided, a hospital or health care provider to
 14 27 administer a test for the express purpose of determining the
 14 28 presence of HIV infection, except that testing may be
 14 29 performed if the individual consents, and if the requirements
 14 30 of this section are satisfied.
 14 31    7.  When a care provider in the course of providing care
 14 32 sustains a significant exposure on the premises of a health
 14 33 care facility or while engaged in rendering aid or providing
 14 34 transportation to an individual in circumstances which lead to
 14 35 the individual's presence at a health care facility, the
 15  1 individual to whom the care provider was exposed is deemed to
 15  2 consent to a test to be administered by the health care
 15  3 facility upon the written request of the exposed care provider
 15  4 for the express purpose of determining the presence of HIV
 15  5 infection in that individual.  The sample and test results
 15  6 shall only be identified by a number and no reports otherwise
 15  7 required by this chapter shall be made which identify the
 15  8 individual tested.  However, if the test results are positive,
 15  9 the health care facility shall notify the individual tested
 15 10 and ensure performance of counseling and reporting
 15 11 requirements of this chapter in the same manner as for an
 15 12 individual from whom actual consent was obtained.
 15 13    8.  A hospital or health care provider, or other person
 15 14 participating in good faith in making a report under the
 15 15 notification provisions of this section, under procedures
 15 16 similar to this section for notification of its own employees
 15 17 upon filing of a significant exposure report, or in failing to
 15 18 make a report under this section, is immune from any
 15 19 liability, civil or criminal, which might otherwise be
 15 20 incurred or imposed.
 15 21    9.  Notifications made pursuant to this section shall not
 15 22 disclose the identity of the individual who is diagnosed or
 15 23 confirmed as having HIV infection unless the individual
 15 24 provides a specific written release as provided in subsection
 15 25 1, paragraph "b".  If the care provider determines the
 15 26 identity of the individual, the identity of the individual
 15 27 shall be confidential information and shall not be disclosed
 15 28 by the care provider to any other person unless a specific
 15 29 written release is obtained from the individual.
 15 30    10.  A hospital's duty to notify under this section is not
 15 31 continuing but is limited to the diagnosis of HIV infection
 15 32 made in the course of admission, care, and treatment following
 15 33 the rendering of assistance or treatment of the individual
 15 34 with the infection.
 15 35    11.  Notwithstanding subsection 10, if, following discharge
 16  1 or completion of care or treatment, an individual for whom a
 16  2 significant exposure report was submitted but which report did
 16  3 not result in notification, wishes to provide information
 16  4 regarding the individual's HIV infection status to the care
 16  5 provider who submitted the report, the hospital shall provide
 16  6 a procedure for notifying the care provider.
 16  7    12.  The employer of a care provider who submits a report
 16  8 of significant exposure under this section sustained in the
 16  9 course of employment shall pay the costs of HIV testing for
 16 10 the individual and the costs of HIV testing and counseling for
 16 11 the care provider.  However, the department shall pay the
 16 12 costs of HIV testing for the individual and the costs of HIV
 16 13 testing and counseling for a care provider who renders direct
 16 14 aid without compensation.
 16 15    Sec. 13.  NEW SECTION.  141A.9  CONFIDENTIALITY OF
 16 16 INFORMATION.
 16 17    Any information, including reports and records, obtained,
 16 18 submitted, and maintained pursuant to this chapter is strictly
 16 19 confidential medical information.  The information shall not
 16 20 be released, shared with an agency or institution, or made
 16 21 public upon subpoena, search warrant, discovery proceedings,
 16 22 or by any other means except as provided in this chapter.  A
 16 23 person shall not be compelled to disclose the identity of any
 16 24 person upon whom an HIV-related test is performed, or the
 16 25 results of the test in a manner which permits identification
 16 26 of the subject of the test, except to persons entitled to that
 16 27 information under this chapter.  Information shall be made
 16 28 available for release to the following individuals or under
 16 29 the following circumstances:
 16 30    1.  To the subject of the test or the subject's legal
 16 31 guardian subject to the provisions of section 141A.7,
 16 32 subsection 3, when applicable.
 16 33    2.  To any person who secures a written release of test
 16 34 results executed by the subject of the test or the subject's
 16 35 legal guardian.
 17  1    3.  To an authorized agent or employee of a health facility
 17  2 or health care provider, if the health facility or health care
 17  3 provider ordered or participated in the testing or is
 17  4 otherwise authorized to obtain the test results, the agent or
 17  5 employee provides patient care or handles or processes
 17  6 samples, and the agent or employee has a medical need to know
 17  7 such information.
 17  8    4.  To a health care provider providing care to the subject
 17  9 of the test when knowledge of the test results is necessary to
 17 10 provide care or treatment.
 17 11    5.  To the department in accordance with reporting
 17 12 requirements for an HIV-related condition.
 17 13    6.  To a health facility or health care provider which
 17 14 procures, processes, distributes, or uses a human body part
 17 15 from a deceased person with respect to medical information
 17 16 regarding that person, or semen provided prior to July 1,
 17 17 1988, for the purpose of artificial insemination.
 17 18    7.  Release may be made of medical or epidemiological
 17 19 information for statistical purposes in a manner such that no
 17 20 individual person can be identified.
 17 21    8.  Release may be made of medical or epidemiological
 17 22 information to the extent necessary to enforce the provisions
 17 23 of this chapter and related rules concerning the treatment,
 17 24 control, and investigation of HIV infection by public health
 17 25 officials.
 17 26    9.  Release may be made of medical or epidemiological
 17 27 information to medical personnel to the extent necessary to
 17 28 protect the health or life of the named party.
 17 29    10.  Release may be made of test results concerning a
 17 30 patient pursuant to procedures established under section
 17 31 141A.5, subsection 3, paragraph "c".
 17 32    11.  To a person allowed access to a record by a court
 17 33 order which is issued in compliance with the following
 17 34 provisions:
 17 35    a.  A court has found that the person seeking the test
 18  1 results has demonstrated a compelling need for the test
 18  2 results which need cannot be accommodated by other means.  In
 18  3 assessing compelling need, the court shall weigh the need for
 18  4 disclosure against the privacy interest of the test subject
 18  5 and the public interest which may be disserved by disclosure
 18  6 due to its deterrent effect on future testing or due to its
 18  7 effect in leading to discrimination.
 18  8    b.  Pleadings pertaining to disclosure of test results
 18  9 shall substitute a pseudonym for the true name of the subject
 18 10 of the test.  The disclosure to the parties of the subject's
 18 11 true name shall be communicated confidentially in documents
 18 12 not filed with the court.
 18 13    c.  Before granting an order, the court shall provide the
 18 14 person whose test results are in question with notice and a
 18 15 reasonable opportunity to participate in the proceedings if
 18 16 the person is not already a party.
 18 17    d.  Court proceedings as to disclosure of test results
 18 18 shall be conducted in camera unless the subject of the test
 18 19 agrees to a hearing in open court or unless the court
 18 20 determines that a public hearing is necessary to the public
 18 21 interest and the proper administration of justice.
 18 22    e.  Upon the issuance of an order to disclose test results,
 18 23 the court shall impose appropriate safeguards against
 18 24 unauthorized disclosure, which shall specify the persons who
 18 25 may gain access to the information, the purposes for which the
 18 26 information shall be used, and appropriate prohibitions on
 18 27 future disclosure.
 18 28    12.  To an employer, if the test is authorized to be
 18 29 required under any other provision of law.
 18 30    13.  To a convicted or alleged sexual assault offender; the
 18 31 physician or other health care provider who orders the test of
 18 32 a convicted or alleged offender; the victim; the parent,
 18 33 guardian, or custodian of the victim if the victim is a minor;
 18 34 the physician of the victim; the victim counselor or person
 18 35 requested by the victim to provide counseling regarding the
 19  1 HIV-related test and results; the victim's spouse; persons
 19  2 with whom the victim has engaged in vaginal, anal, or oral
 19  3 intercourse subsequent to the sexual assault; members of the
 19  4 victim's family within the third degree of consanguinity; and
 19  5 the county attorney who may use the results as evidence in the
 19  6 prosecution of sexual assault under chapter 915, subchapter
 19  7 IV, or prosecution of the offense of criminal transmission of
 19  8 HIV under chapter 709C.  For the purposes of this paragraph,
 19  9 "victim" means victim as defined section 915.40.
 19 10    14.  To employees of state correctional institutions
 19 11 subject to the jurisdiction of the department of corrections,
 19 12 employees of secure facilities for juveniles subject to the
 19 13 department of human services, and employees of city and county
 19 14 jails, if the employees have direct supervision over inmates
 19 15 of those facilities or institutions in the exercise of the
 19 16 duties prescribed pursuant to section 80.9, subsection 2,
 19 17 paragraph "d".
 19 18    Sec. 14.  NEW SECTION.  141A.10  IMMUNITIES.
 19 19    1.  A person making a report in good faith pursuant to this
 19 20 chapter is immune from any liability, civil or criminal, which
 19 21 might otherwise be incurred or imposed as a result of the
 19 22 report.
 19 23    2.  A health care provider attending a person who tests
 19 24 positive for the HIV infection has no duty to disclose to or
 19 25 to warn third parties of the dangers of exposure to HIV
 19 26 infection through contact with that person and is immune from
 19 27 any liability, civil or criminal, for failure to disclose to
 19 28 or warn third parties of the condition of that person.
 19 29    Sec. 15.  NEW SECTION.  141A.11  REMEDIES.
 19 30    1.  A person aggrieved by a violation of this chapter shall
 19 31 have a right of civil action for damages in district court.
 19 32    2.  A care provider who intentionally or recklessly makes
 19 33 an unauthorized disclosure under this chapter is subject to a
 19 34 civil penalty of one thousand dollars.
 19 35    3.  A person who violates a confidentiality requirement of
 20  1 section 141A.5 is guilty of an aggravated misdemeanor.
 20  2    4.  A civil action under this chapter is barred unless the
 20  3 action is commenced within two years after the cause of action
 20  4 accrues.
 20  5    5.  The attorney general may maintain a civil action to
 20  6 enforce this chapter.
 20  7    6.  This chapter does not limit the rights of the subject
 20  8 of an HIV-related test to recover damages or other relief
 20  9 under any other applicable law.
 20 10    7.  This chapter shall not be construed to impose civil
 20 11 liability or criminal sanctions for disclosure of HIV-related
 20 12 test results in accordance with any reporting requirement for
 20 13 a diagnosed case of AIDS or a related condition by the
 20 14 department or the centers for disease control and prevention
 20 15 of the United States public health service.
 20 16    Sec. 16.  Section 321.186, unnumbered paragraph 4, Code
 20 17 1999, is amended to read as follows:
 20 18    A physician licensed under chapter 148, 150, or 150A, or an
 20 19 optometrist licensed under chapter 154, may report to the
 20 20 department the identity of a person who has been diagnosed as
 20 21 having a physical or mental condition which would render the
 20 22 person physically or mentally incompetent to operate a motor
 20 23 vehicle in a safe manner.  The physician or optometrist shall
 20 24 make reasonable efforts to notify the person who is the
 20 25 subject of the report, in writing.  The written notification
 20 26 shall state the nature of the disclosure and the reason for
 20 27 the disclosure.  A physician or optometrist making a report
 20 28 under this section shall be immune from any liability, civil
 20 29 or criminal, which might otherwise be incurred or imposed as a
 20 30 result of the report.  A physician or optometrist has no duty
 20 31 to make a report or to warn third parties with regard to any
 20 32 knowledge concerning a person's mental or physical competency
 20 33 to operate a motor vehicle in a safe manner.  Any report
 20 34 received by the department from a physician or optometrist
 20 35 under this section shall be kept confidential.  Information
 21  1 regulated by chapter 141 141A shall be subject to the
 21  2 confidentiality provisions and remedies of sections 141.23 and
 21  3 141.24 that chapter.
 21  4    Sec. 17.  Section 505.16, subsection 1, Code 1999, is
 21  5 amended to read as follows:
 21  6    1.  A person engaged in the business of insurance shall not
 21  7 require a test of an individual in connection with an
 21  8 application for insurance for the presence of an antibody to
 21  9 the human immunodeficiency virus unless the individual
 21 10 provides a written release on a form approved by the insurance
 21 11 commissioner.  The form shall include information regarding
 21 12 the purpose, content, use, and meaning of the test, disclosure
 21 13 of test results including information explaining the effect of
 21 14 releasing the information to a person engaged in the business
 21 15 of insurance, the purpose for which the test results may be
 21 16 used, and other information approved by the insurance
 21 17 commissioner.  The form shall also authorize the person
 21 18 performing the test to provide the results of the test to the
 21 19 insurance company subject to rules of confidentiality,
 21 20 consistent with section 141.23 141A.9, approved by the
 21 21 insurance commissioner.  As used in this section, "a person
 21 22 engaged in the business of insurance" includes hospital
 21 23 service corporations organized under chapter 514 and health
 21 24 maintenance organizations subject to chapter 514B.
 21 25    Sec. 18.  Section 904.515, Code 1999, is amended to read as
 21 26 follows:
 21 27    904.515  HUMAN IMMUNODEFICIENCY VIRUS-RELATED MATTERS –
 21 28 EXEMPTION.
 21 29    The provisions of chapter 141 141A relating to knowledge
 21 30 and consent do not apply to persons committed to the custody
 21 31 of the department.  The department may provide for medically
 21 32 acceptable procedures to inform employees, visitors, and
 21 33 persons committed to the department of possible infection and
 21 34 to protect them from possible infection.
 21 35    Sec. 19.  Section 915.40, subsection 3, paragraph c, Code
 22  1 1999, is amended to read as follows:
 22  2    c.  The victim counselor or person requested by the victim
 22  3 who is authorized to provide the counseling required pursuant
 22  4 to section 141.22 regarding the HIV-related test and results.
 22  5    Sec. 20.  Section 915.42, subsection 4, paragraph a, Code
 22  6 1999, is amended to read as follows:
 22  7    a.  Prior to the scheduling of a hearing, refer the victim
 22  8 for counseling by a victim counselor or a person requested by
 22  9 the victim who is authorized to provide the counseling
 22 10 required pursuant to section 141.22, regarding the nature,
 22 11 reliability, and significance of the HIV-related test and of
 22 12 the serologic status of the convicted offender.
 22 13    Sec. 21.  Section 915.43, subsections 1, 2, 4, and 5, Code
 22 14 1999, are amended to read as follows:
 22 15    1.  The physician or other practitioner who orders the test
 22 16 of a convicted or alleged offender for HIV under this
 22 17 subchapter shall disclose the results of the test to the
 22 18 convicted or alleged offender, and to the victim counselor or
 22 19 a person requested by the victim who is authorized to provide
 22 20 the counseling required pursuant to section 141.22, regarding
 22 21 the HIV-related test and results who shall disclose the
 22 22 results to the petitioner.
 22 23    2.  All testing under this chapter shall be accompanied by
 22 24 pretest and posttest counseling as required under section
 22 25 141.22 141A.7.
 22 26    4.  Results of a test performed under this subchapter,
 22 27 except as provided in subsection 13, shall be disclosed only
 22 28 to the physician or other practitioner who orders the test of
 22 29 the convicted or alleged offender, the convicted or alleged
 22 30 offender, the victim, the victim counselor or person requested
 22 31 by the victim who is authorized to provide the counseling
 22 32 required pursuant to section 141.22 regarding the HIV-related
 22 33 test and results, the physician of the victim if requested by
 22 34 the victim, the parent, guardian, or custodian of the victim,
 22 35 if the victim is a minor, and the county attorney who filed
 23  1 the petition for HIV-related testing under this chapter, who
 23  2 may use the results to file charges of criminal transmission
 23  3 of HIV under chapter 709C.  Results of a test performed under
 23  4 this subchapter shall not be disclosed to any other person
 23  5 without the written informed consent of the convicted or
 23  6 alleged offender.  A person to whom the results of a test have
 23  7 been disclosed under this subchapter is subject to the
 23  8 confidentiality provisions of section 141.23 141A.9, and shall
 23  9 not disclose the results to another person except as
 23 10 authorized by section 141.23, subsection 1 141A.9, subsection
 23 11 13.
 23 12    5.  If testing is ordered under this subchapter, the court
 23 13 shall also order periodic testing of the convicted offender
 23 14 during the period of incarceration, probation, or parole or of
 23 15 the alleged offender during a period of six months following
 23 16 the initial test if the physician or other practitioner who
 23 17 ordered the initial test of the convicted or alleged offender
 23 18 certifies that, based upon prevailing scientific opinion
 23 19 regarding the maximum period during which the results of an
 23 20 HIV-related test may be negative for a person after being HIV-
 23 21 infected, additional testing is necessary to determine whether
 23 22 the convicted or alleged offender was HIV-infected at the time
 23 23 the sexual assault or alleged sexual assault was perpetrated.
 23 24 The results of the test conducted pursuant to this subsection
 23 25 shall be released only to the physician or other practitioner
 23 26 who orders the test of the convicted or alleged offender, the
 23 27 convicted or alleged offender, the victim counselor or person
 23 28 requested by the victim who is authorized to provide the
 23 29 counseling required pursuant to section 141.22, regarding the
 23 30 HIV-related test and results who shall disclose the results to
 23 31 the petitioner, the physician of the victim, if requested by
 23 32 the victim, and the county attorney who may use the results as
 23 33 evidence in the prosecution of the sexual assault or in the
 23 34 prosecution of the offense of criminal transmission of HIV
 23 35 under chapter 709C.
 24  1    Sec. 22.  Chapter 141, Code 1999, is repealed.  
 24  2                           EXPLANATION 
 24  3    This bill replaces the statute pertaining to acquired
 24  4 immune deficiency syndrome (AIDS), which is currently divided
 24  5 into subchapters, with a new chapter which combines the
 24  6 subchapters and makes changes to the chapter.  Existing Code
 24  7 chapter 141 is repealed.
 24  8    The bill combines all definitions used in the chapter into
 24  9 one section.  The bill provides a new definition of "care
 24 10 provider" which encompasses any person providing health care
 24 11 services of any kind, including emergency medical assistance
 24 12 or treatment.  The definition of "legal guardian" is expanded
 24 13 to include an "attorney in fact".  The definition of "ARC" or
 24 14 "AIDS-related complex" is deleted.  The definition of "sample"
 24 15 is added to include any specimen obtained for the purposes of
 24 16 conducting an HIV-related test.
 24 17    The bill designates the Iowa department of public health as
 24 18 the lead agency in the coordination and implementation of the
 24 19 state's AIDS prevention and intervention plan.  The bill also
 24 20 authorizes the department to adopt rules to implement and
 24 21 enforce the bill.  The bill continues the authorization for
 24 22 the department to coordinate efforts with local health
 24 23 officers to investigate sources of HIV infection and to use
 24 24 every appropriate means to prevent the spread of the disease.
 24 25 The bill also continues authorization for the department to
 24 26 conduct epidemiological blinded and nonblinded studies.
 24 27    The bill assigns several duties to the department.  These
 24 28 duties include broad responsibilities for testing, education,
 24 29 and disease control.
 24 30    The bill continues the requirement that testing and
 24 31 counseling be offered for specified groups.  In addition, the
 24 32 bill requires that all pregnant women receive information
 24 33 about testing and treatment opportunities to reduce the
 24 34 possible transmission of HIV to a fetus, requires that all
 24 35 pregnant women with risk factors for HIV be strongly
 25  1 encouraged to be tested, and requires that upon request a
 25  2 pregnant woman be tested regardless of the absence of risk
 25  3 factors.
 25  4    The bill requires that the department maintain a partner
 25  5 notification program for persons known to have tested positive
 25  6 for HIV infection.  Persons who test positive shall receive
 25  7 posttest counseling and are encouraged to refer for counseling
 25  8 and testing any person who may have sustained a significant
 25  9 exposure from them.  The section continues the provision that
 25 10 a physician for an infected person may initiate partner
 25 11 notification when the infected person will not participate and
 25 12 will not warn an exposed third party.  The bill deletes the
 25 13 current provision that when a person who tests positive for
 25 14 HIV infection will not participate in partner notification
 25 15 prior to notification of a third party, the physician
 25 16 proposing to cause the notification make reasonable efforts to
 25 17 inform, in writing, the person who tested positive.
 25 18    The bill provides for the performance of voluntary testing,
 25 19 eliminates anonymous testing, and contains the reporting
 25 20 requirements for positive test results.
 25 21    The bill provides that prior to undergoing an HIV-related
 25 22 test, information shall be available to the subject of the
 25 23 test concerning testing and any means of obtaining additional
 25 24 information regarding HIV infection and risk reduction.  The
 25 25 bill provides that upon informing the subject of positive test
 25 26 results, counseling is required to be initiated with emphasis
 25 27 given to the need for precautions to prevent transmitting the
 25 28 virus.  The bill continues the provisions granting exceptions
 25 29 to counseling in instances of donation of body parts, patients
 25 30 unable to give consent, insurance exams, and testing of
 25 31 deceased persons involved in a documented significant exposure
 25 32 incident.  The provisions relating to minors are amended to
 25 33 eliminate the provision that if a person who personally
 25 34 applies for services, screening, or treatment is a minor, the
 25 35 fact that the minor sought services or is receiving services,
 26  1 screening, or treatment is not to be reported or disclosed
 26  2 except for statistical purposes.  The bill retains the
 26  3 provision that confirmed positive HIV test results are to be
 26  4 reported to a minor's legal guardian.
 26  5    The bill provides a notification process under which care
 26  6 providers who have suffered a significant exposure to an
 26  7 individual in the course of providing assistance may obtain
 26  8 information concerning that individual's HIV status.  The bill
 26  9 adds a provision that if a care provider in the course of
 26 10 providing care on the premises of a health care facility or in
 26 11 rendering aid or providing transportation to an individual in
 26 12 circumstances which lead to the individual's presence at the
 26 13 health care facility, sustains a significant exposure, the
 26 14 person to whom the care provider was exposed is deemed to have
 26 15 consented to an HIV-related test, upon the written request of
 26 16 the care provider.  The sample and test results are only
 26 17 identified by a number and no report otherwise required is to
 26 18 be made which identifies the individual tested.  If the
 26 19 results are positive, the individual tested is to be informed
 26 20 and provided with counseling.
 26 21    The bill provides for strict confidentiality of medical
 26 22 information relating to a patient's HIV status.  The bill
 26 23 contains specific provisions relating to when that information
 26 24 may be released and to whom.
 26 25    The bill provides immunity for persons making reports
 26 26 pursuant to the bill and provides that health care providers
 26 27 have no duty to warn third parties regarding contact with a
 26 28 person who has positive HIV test results.
 26 29    The bill establishes civil and criminal remedies for
 26 30 violations of confidentiality and other provisions of the
 26 31 bill.  The penalty for violation of a confidentiality
 26 32 requirement relating to the partner notification program is
 26 33 reduced from a class "D" felony (which carries a maximum
 26 34 sentence of confinement of not more than 5 years and in
 26 35 addition may include a fine of at least $500 but not more than
 27  1 $7,500) to an aggravated misdemeanor (which carries a maximum
 27  2 sentence of imprisonment not to exceed 2 years and a fine of
 27  3 at least $500 but not more than $5,000).  The bill contains
 27  4 the specific civil penalty of $1,000 for a care provider who
 27  5 intentionally or recklessly makes an unauthorized disclosure.
 27  6    The bill eliminates the provisions for accreditation of HIV
 27  7 testing laboratories.
 27  8    The remainder of the bill makes conforming changes
 27  9 necessitated by the enactment of new Code chapter 141A and the
 27 10 repeal of Code chapter 141.  
 27 11 LSB 2694HV 78
 27 12 pf/cf/24.1
     

Text: HF00680                           Text: HF00682
Text: HF00600 - HF00699                 Text: HF Index
Bills and Amendments: General Index     Bill History: General Index

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