Text: HSB00044 Text: HSB00046 Text: HSB00000 - HSB00099 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
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 chapter141141A 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 chapter141141A 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 chapter141141A 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 section141.21141A.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 section141.21141A.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 section141.23141A.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 HIV 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 prevention and 6 19 control 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, and grants shall be 7 11 awarded to the maximum extent feasible to community-based 7 12 organizations. The prioritized schedule shall include public 7 13 and professional health education, testing and counseling, 7 14 contact counseling, and public information. 7 15 2. The department shall do all of the following: 7 16 a. Provide consultation to agencies and organizations 7 17 regarding appropriate policies for testing, education, 7 18 confidentiality, and infection control. 7 19 b. Conduct health information programs for the public 7 20 relating to HIV infection, including information about how the 7 21 infection is transmitted and how transmittal can be prevented. 7 22 The department shall prepare, for free distribution, printed 7 23 information relating to HIV infection and prevention. 7 24 c. Provide educational programs concerning HIV infection 7 25 in the workplace. 7 26 d. Develop and implement HIV education risk-reduction 7 27 programs for specific populations at high risk for infection. 7 28 e. Provide an informational brochure for patients who 7 29 provide samples for purposes of performing an HIV test which, 7 30 at a minimum, shall include a summary of the patient's rights 7 31 and responsibilities under the law. 7 32 f. In cooperation with the department of education, 7 33 develop and update a medically correct AIDS prevention 7 34 curriculum for use at the discretion of secondary and middle 7 35 schools. 8 1 3. The department shall, in cooperation with the 8 2 department of education and other agencies, organizations, 8 3 coalitions, and local health departments, develop and 8 4 implement a program of public and professional AIDS-related 8 5 education. 8 6 4. School districts shall provide to every elementary, 8 7 middle school, and secondary school student, with parental 8 8 consent, instruction concerning HIV infection and AIDS and its 8 9 prevention. 8 10 Sec. 8. NEW SECTION. 141A.4 TESTING AND COUNSELING. 8 11 1. HIV testing and counseling shall be offered to the 8 12 following: 8 13 a. All persons seeking treatment for a sexually 8 14 transmitted disease. 8 15 b. All persons seeking treatment for intravenous drug 8 16 abuse or having a history of intravenous drug abuse. 8 17 c. All persons who consider themselves at risk for the HIV 8 18 infection. 8 19 d. Male and female prostitutes. 8 20 2. A care provider attending a pregnant woman shall 8 21 provide education to the pregnant woman about HIV prevention, 8 22 risk reduction, and the treatment opportunities to reduce the 8 23 possible transmission of HIV to a fetus. A care provider 8 24 attending a pregnant woman shall offer to and strongly 8 25 encourage testing of a pregnant woman who reports one or more 8 26 recognized risk factors for HIV. A pregnant woman who 8 27 requests testing shall be tested regardless of the absence of 8 28 risk factors. 8 29 3. Counseling and testing shall be provided at alternative 8 30 testing and counseling sites and at sexually transmitted 8 31 disease clinics. The department shall assist local boards of 8 32 health in the development of programs which provide free 8 33 testing to the public. 8 34 Sec. 9. NEW SECTION. 141A.5 PARTNER NOTIFICATION PROGRAM 8 35 – HIV. 9 1 1. The department shall maintain a partner notification 9 2 program for persons known to have tested positive for the HIV 9 3 infection. 9 4 2. The department shall initiate the program at 9 5 alternative testing and counseling sites and at sexually 9 6 transmitted disease clinics. 9 7 3. In administering the program, the department shall 9 8 provide for the following: 9 9 a. A person who tests positive for the HIV infection shall 9 10 receive posttest counseling, during which time the person 9 11 shall be encouraged to refer for counseling and HIV testing 9 12 any person with whom the person has had sexual relations or 9 13 has shared intravenous equipment. 9 14 b. The physician or other health care provider attending 9 15 the person may provide to the department any relevant 9 16 information provided by the person regarding any person with 9 17 whom the tested person has had sexual relations or has shared 9 18 intravenous equipment. The department disease prevention 9 19 staff shall then conduct partner notification in the same 9 20 manner as that utilized for sexually transmitted diseases 9 21 consistent with the provisions of this chapter. 9 22 c. Devise a procedure, as a part of the partner 9 23 notification program, to provide for the notification of an 9 24 identifiable third party who is a sexual partner of or who 9 25 shares intravenous equipment with a person who has tested 9 26 positive for HIV, by the department or a physician, when all 9 27 of the following situations exist: 9 28 (1) A physician for the infected person is of the good 9 29 faith opinion that the nature of the continuing contact poses 9 30 an imminent danger of HIV infection transmission to the third 9 31 party. 9 32 (2) When the physician believes in good faith that the 9 33 infected person, despite strong encouragement, has not and 9 34 will not warn the third party and will not participate in the 9 35 voluntary partner notification program. 10 1 Notwithstanding subsection 4, the department or a physician 10 2 may reveal the identity of a person who has tested positive 10 3 for the HIV infection pursuant to this subsection only to the 10 4 extent necessary to protect a third party from the direct 10 5 threat of transmission. This subsection shall not be 10 6 interpreted to create a duty to warn third parties of the 10 7 danger of exposure to HIV through contact with a person who 10 8 tests positive for the HIV infection. 10 9 The department shall adopt rules pursuant to chapter 17A to 10 10 implement this paragraph "c". The rules shall provide a 10 11 detailed procedure by which the department or a physician may 10 12 directly notify an endangered third party. 10 13 4. In making contact the department shall not disclose the 10 14 identity of the person who provided the names of the persons 10 15 to be contacted and shall protect the confidentiality of 10 16 persons contacted. 10 17 5. The department may delegate its partner notification 10 18 duties under this section to local health authorities unless 10 19 the local authority refuses or neglects to conduct the contact 10 20 tracing program in a manner deemed to be effective by the 10 21 department. 10 22 6. In addition to the provisions for partner notification 10 23 provided under this section and notwithstanding any provision 10 24 to the contrary, a county medical examiner or deputy medical 10 25 examiner performing official duties pursuant to sections 10 26 331.801 through 331.805 or the state medical examiner or 10 27 deputy medical examiner performing official duties pursuant to 10 28 chapter 691, who determines through an investigation that a 10 29 deceased person was infected with HIV, may notify directly, or 10 30 request that the department notify, the immediate family of 10 31 the deceased or any person known to have had a significant 10 32 exposure from the deceased of the finding. 10 33 Sec. 10. NEW SECTION. 141A.6 AIDS-RELATED CONDITIONS – 10 34 SCREENING, TESTING, AND REPORTING. 10 35 1. Prior to obtaining a sample for the purpose of 11 1 performing a voluntary HIV-related test, a health care 11 2 provider shall supply the subject of the test with the 11 3 information set out in section 141A.7. Within seven days 11 4 after the testing of a person with a test result indicating 11 5 HIV infection which has been confirmed as positive according 11 6 to prevailing medical technology, the physician or other 11 7 health care provider at whose request the test was performed 11 8 shall make a report to the department on a form provided by 11 9 the department. 11 10 2. Within seven days of diagnosing a person as having an 11 11 AIDS-related condition, the diagnosing physician shall make a 11 12 report to the department on a form provided by the department. 11 13 3. Within seven days of the death of a person resulting 11 14 from an AIDS-related condition, the attending physician shall 11 15 make a report to the department on a form provided by the 11 16 department. 11 17 4. Within seven days of the testing of a person with a 11 18 test result indicating HIV infection which has been confirmed 11 19 as positive according to prevailing medical technology, the 11 20 director of a blood bank shall make a report to the department 11 21 on a form provided by the department. 11 22 5. Within seven days of the testing of a person with a 11 23 test result indicating HIV infection which has been confirmed 11 24 as positive according to prevailing medical technology, the 11 25 director of a clinical laboratory shall make a report to the 11 26 department on a form provided by the department. 11 27 6. The forms provided by the department shall require 11 28 inclusion of all of the following information: 11 29 a. The name of the patient. 11 30 b. The address of the patient. 11 31 c. The patient's date of birth. 11 32 d. The sex of the patient. 11 33 e. The race or ethnicity of the patient. 11 34 f. The patient's marital status. 11 35 g. The patient's telephone number. 12 1 h. The name and address of the laboratory or blood bank. 12 2 i. The date the test was found to be positive and the 12 3 collection date. 12 4 j. The name of the physician or health care provider who 12 5 performed the test. 12 6 k. If the patient is female, whether the patient is 12 7 pregnant. 12 8 Sec. 11. NEW SECTION. 141A.7 TESTING – APPLICATION FOR 12 9 SERVICES. 12 10 1. Prior to obtaining a sample for the purpose of 12 11 performing an HIV-related test, the subject of the test or the 12 12 subject's legal guardian, except when the provisions of 12 13 subsection 4 apply, shall be provided with preliminary 12 14 counseling which shall include but is not limited to the 12 15 following: 12 16 a. An explanation of the test, including the test's 12 17 purposes, potential uses, limitations, and the meaning of both 12 18 positive and negative results. 12 19 b. An explanation of the nature of AIDS and HIV and HIV- 12 20 related conditions, including the relationship between the 12 21 test results and the diseases. 12 22 c. An explanation of the procedures to be followed, 12 23 including the fact that the test is entirely voluntary and can 12 24 be performed anonymously if requested. 12 25 d. Information concerning behavioral patterns known to 12 26 expose a person to the possibility of contracting HIV and 12 27 methods for minimizing the risk of exposure. 12 28 2. A person seeking a HIV-related test shall have the 12 29 right to remain anonymous. A health care provider shall 12 30 provide for the anonymous administration of the test at the 12 31 subject's request or shall confidentially refer the subject to 12 32 a site which provides anonymous testing. However, if the 12 33 results of an HIV-related test are confirmed positive, the 12 34 subjects right to anonymity is terminated. 12 35 3. At any time that a subject is informed of test results, 13 1 counseling concerning the emotional and physical health 13 2 effects shall be initiated. If the test results are confirmed 13 3 positive, particular attention shall be given to explaining 13 4 the need for the precautions necessary to avoid transmitting 13 5 the virus. The subject shall be given information concerning 13 6 additional counseling. 13 7 4. Notwithstanding subsections 1 and 2, the provisions of 13 8 this section do not apply to any of the following: 13 9 a. The performance by a health care provider or health 13 10 facility of an HIV-related test when the health care provider 13 11 or health facility procures, processes, distributes, or uses a 13 12 human body part donated for a purpose specified under the 13 13 uniform anatomical gift Act, or semen provided prior to July 13 14 1, 1988, for the purpose of artificial insemination, or 13 15 donations of blood, and such test is necessary to ensure 13 16 medical acceptability of such gift or semen for the purposes 13 17 intended. 13 18 b. The performance of an HIV-related test by a health care 13 19 provider in medical situations when the subject of the test is 13 20 unable to grant or withhold consent, and the test results are 13 21 necessary for medical diagnostic purposes to provide 13 22 appropriate care or treatment, except that posttest counseling 13 23 shall be required when the test results are confirmed as 13 24 positive. 13 25 c. A person engaged in the business of insurance who is 13 26 subject to section 505.16. 13 27 d. The performance by a health care provider or health 13 28 facility of an HIV-related test when the subject of the test 13 29 is deceased and a documented significant exposure has 13 30 occurred. 13 31 5. A person may apply for voluntary treatment, 13 32 contraceptive services, or screening or treatment for HIV 13 33 infection and other sexually transmitted diseases directly to 13 34 a licensed physician and surgeon, an osteopathic physician and 13 35 surgeon, or a family planning clinic. Notwithstanding any 14 1 other provision of law, if the person who has personally made 14 2 application for services, screening, or treatment is a minor, 14 3 the fact that the minor sought services or is receiving 14 4 services, screening, or treatment shall not be reported or 14 5 disclosed, except for statistical purposes. Notwithstanding 14 6 any other provision of law, however, the minor shall be 14 7 informed prior to testing that, upon confirmation according to 14 8 prevailing medical technology of a positive HIV-related test 14 9 result, the minor's legal guardian is required to be informed 14 10 by the testing facility. Testing facilities where minors are 14 11 tested shall have available a program to assist minors and 14 12 legal guardians with the notification process which emphasizes 14 13 the need for family support and assists in making available 14 14 the resources necessary to accomplish that goal. However, a 14 15 testing facility which is precluded by federal statute, 14 16 regulation, or centers for disease control and prevention 14 17 guidelines from informing the legal guardian is exempt from 14 18 the notification requirement, but not from the requirement for 14 19 an assistance program. The minor shall give written consent 14 20 to these procedures and to receive the services, screening, or 14 21 treatment. Such consent is not subject to later disaffirmance 14 22 by reason of minority. 14 23 Sec. 12. NEW SECTION. 141A.8 CARE PROVIDER NOTIFICATION. 14 24 1. A hospital licensed under chapter 135B shall provide 14 25 notification to a care provider who renders assistance or 14 26 treatment to an individual, following submission of a 14 27 significant exposure report by the care provider to the 14 28 hospital and a diagnosis or confirmation by an attending 14 29 physician that the individual has HIV infection, and 14 30 determination that the exposure reported was a significant 14 31 exposure. The notification shall advise the care provider of 14 32 possible exposure to HIV infection. Notification shall be 14 33 made in accordance with both of the following: 14 34 a. The hospital informs the individual, when the 14 35 individual's condition permits, of the submission of a 15 1 significant exposure report. 15 2 b. The individual consents to serological testing by or 15 3 voluntarily discloses the individual's HIV status to the 15 4 hospital and consents to notification. 15 5 Notwithstanding paragraphs "a" and "b", notification shall 15 6 be made when the individual denies consent for or consent is 15 7 not reasonably obtainable for serological testing, and in the 15 8 course of admission, care, and treatment of the individual, 15 9 the individual is diagnosed or is confirmed as having HIV 15 10 infection. 15 11 2. The hospital shall notify the care provider involved in 15 12 attending or transporting an individual who submitted a 15 13 significant exposure report. This shall include a person who 15 14 renders direct emergency aid without compensation, or in the 15 15 case of an emergency care provider, the designated officer of 15 16 the emergency care provider service, who in turn shall notify 15 17 any emergency care providers. The identity of the designated 15 18 officer shall not be revealed to the individual. The 15 19 designated officer shall inform the hospital of those parties 15 20 who received the notification, and following receipt of this 15 21 information and upon request of the individual, the hospital 15 22 shall inform the individual of the parties to whom 15 23 notification was provided. 15 24 3. The hospital, upon request of the individual, shall 15 25 inform the individual of the persons to whom notification was 15 26 made. 15 27 4. The process for notification under this section shall 15 28 be initiated as soon as is reasonably possible. 15 29 5. A health care provider, with consent of the individual, 15 30 may provide the notification required of hospitals in this 15 31 section to care providers if an individual who has HIV 15 32 infection is delivered by a care provider to the office or 15 33 clinic of the health care provider for treatment. The 15 34 notification shall take place only upon submission of a 15 35 significant exposure report form by the care provider to the 16 1 health care provider and the determination by the health care 16 2 provider that a significant exposure has occurred. 16 3 6. This section does not require or permit, unless 16 4 otherwise provided, a hospital or health care provider to 16 5 administer a test for the express purpose of determining the 16 6 presence of HIV infection, except that testing may be 16 7 performed if the individual consents, and if the requirements 16 8 of section 141A.7 are satisfied. 16 9 7. When a care provider in the course of providing care 16 10 sustains a significant exposure on the premises of a hospital 16 11 or health facility, the individual to whom the care provider 16 12 was exposed is deemed to consent to a test to be administered 16 13 by the hospital or health care facility upon the written 16 14 request of the exposed care provider for the express purpose 16 15 of determining the presence of HIV infection in that 16 16 individual. The sample and test results shall only be 16 17 identified by the name of the exposed care provider on whose 16 18 behalf the test is administered and no reports otherwise 16 19 required by this chapter shall be made which identify the 16 20 individual tested. However, if the test results are positive, 16 21 the hospital or health care facility shall notify the 16 22 individual tested and ensure performance of counseling and 16 23 reporting requirements of this chapter in the same manner as 16 24 for an individual from whom actual consent was obtained. 16 25 8. A hospital or health care provider, or other person 16 26 participating in good faith in making a report under the 16 27 notification provisions of this section, under procedures 16 28 similar to this section for notification of its own employees 16 29 upon filing of a significant exposure report, or in failing to 16 30 make a report under this section, is immune from any 16 31 liability, civil or criminal, which might otherwise be 16 32 incurred or imposed. 16 33 9. Notifications made pursuant to this section shall not 16 34 disclose the identity of the individual who is diagnosed or 16 35 confirmed as having HIV infection unless the individual 17 1 provides a specific written release as provided in section 17 2 141A.8, subsection 1, paragraph "b". If the care provider 17 3 determines the identity of the individual, the identity of the 17 4 individual shall be confidential information and shall not be 17 5 disclosed by the care provider to any other person unless a 17 6 specific written release is obtained from the individual. 17 7 10. A hospital's duty to notify under this section is not 17 8 continuing but is limited to the diagnosis of HIV infection 17 9 made in the course of admission, care, and treatment following 17 10 the rendering of assistance or treatment of the individual 17 11 with the infection. 17 12 11. Notwithstanding subsection 10, if, following discharge 17 13 or completion of care or treatment, an individual for whom a 17 14 significant exposure report was submitted but which report did 17 15 not result in notification, wishes to provide information 17 16 regarding the individual's HIV infection status to the care 17 17 provider who submitted the report, the hospital shall provide 17 18 a procedure for notifying the care provider. 17 19 12. The employer of a care provider who submits a report 17 20 of significant exposure under this section sustained in the 17 21 course of employment shall pay the costs of HIV testing for 17 22 the individual and the costs of HIV testing and counseling for 17 23 the care provider. However, the department shall pay the 17 24 costs of HIV testing for the individual and the costs of HIV 17 25 testing and counseling for a care provider who renders direct 17 26 aid without compensation. 17 27 Sec. 13. NEW SECTION. 141A.9 CONFIDENTIALITY OF 17 28 INFORMATION. 17 29 Any information, including reports and records, obtained, 17 30 submitted, and maintained pursuant to this chapter is strictly 17 31 confidential medical information. The information shall not 17 32 be released, shared with an agency or institution, or made 17 33 public upon subpoena, search warrant, discovery proceedings, 17 34 or by any other means except as provided in this chapter. A 17 35 person shall not be compelled to disclose the identity of any 18 1 person upon whom an HIV-related test is performed, or the 18 2 results of the test in a manner which permits identification 18 3 of the subject of the test, except to persons entitled to that 18 4 information under this chapter. Information shall be made 18 5 available for release to the following individuals or under 18 6 the following circumstances: 18 7 1. To the subject of the test or the subject's legal 18 8 guardian subject to the provisions of section 141A.7, 18 9 subsection 3, when applicable. 18 10 2. To any person who secures a written release of test 18 11 results executed by the subject of the test or the subject's 18 12 legal guardian. 18 13 3. To an authorized agent or employee of a health facility 18 14 or health care provider, if the health facility or health care 18 15 provider ordered or participated in the testing or is 18 16 otherwise authorized to obtain the test results, the agent or 18 17 employee provides patient care or handles or processes 18 18 samples, and the agent or employee has a medical need to know 18 19 such information. 18 20 4. To a health care provider providing care to the subject 18 21 of the test when knowledge of the test results is necessary to 18 22 provide care or treatment. 18 23 5. To the department in accordance with reporting 18 24 requirements for an HIV-related condition. 18 25 6. To a health facility or health care provider which 18 26 procures, processes, distributes, or uses a human body part 18 27 from a deceased person with respect to medical information 18 28 regarding that person, or semen provided prior to July 1, 18 29 1988, for the purpose of artificial insemination. 18 30 7. Release may be made of medical or epidemiological 18 31 information for statistical purposes in a manner such that no 18 32 individual person can be identified. 18 33 8. Release may be made of medical or epidemiological 18 34 information to the extent necessary to enforce the provisions 18 35 of this chapter and related rules concerning the treatment, 19 1 control, and investigation of HIV infection by public health 19 2 officials. 19 3 9. Release may be made of medical or epidemiological 19 4 information to medical personnel to the extent necessary to 19 5 protect the health or life of the named party. 19 6 10. Release may be made of test results concerning a 19 7 patient pursuant to procedures established under section 19 8 141A.5, subsection 3, paragraph "c". 19 9 11. To a person allowed access to a record by a court 19 10 order which is issued in compliance with the following 19 11 provisions: 19 12 a. A court has found that the person seeking the test 19 13 results has demonstrated a compelling need for the test 19 14 results which need cannot be accommodated by other means. In 19 15 assessing compelling need, the court shall weigh the need for 19 16 disclosure against the privacy interest of the test subject 19 17 and the public interest which may be disserved by disclosure 19 18 due to its deterrent effect on future testing or due to its 19 19 effect in leading to discrimination. 19 20 b. Pleadings pertaining to disclosure of test results 19 21 shall substitute a pseudonym for the true name of the subject 19 22 of the test. The disclosure to the parties of the subject's 19 23 true name shall be communicated confidentially in documents 19 24 not filed with the court. 19 25 c. Before granting an order, the court shall provide the 19 26 person whose test results are in question with notice and a 19 27 reasonable opportunity to participate in the proceedings if 19 28 the person is not already a party. 19 29 d. Court proceedings as to disclosure of test results 19 30 shall be conducted in camera unless the subject of the test 19 31 agrees to a hearing in open court or unless the court 19 32 determines that a public hearing is necessary to the public 19 33 interest and the proper administration of justice. 19 34 e. Upon the issuance of an order to disclose test results, 19 35 the court shall impose appropriate safeguards against 20 1 unauthorized disclosure, which shall specify the persons who 20 2 may gain access to the information, the purposes for which the 20 3 information shall be used, and appropriate prohibitions on 20 4 future disclosure. 20 5 12. To an employer, if the test is authorized to be 20 6 required under any other provision of law. 20 7 13. To a convicted or alleged sexual assault offender; the 20 8 physician or other health care provider who orders the test of 20 9 a convicted or alleged offender; the victim; the parent, 20 10 guardian, or custodian of the victim if the victim is a minor; 20 11 the physician of the victim; the victim counselor or person 20 12 requested by the victim who is authorized to provide the 20 13 counseling required pursuant to section 141A.7; the victim's 20 14 spouse; persons with whom the victim has engaged in vaginal, 20 15 anal, or oral intercourse subsequent to the sexual assault; 20 16 members of the victim's family within the third degree of 20 17 consanguinity; and the county attorney who may use the results 20 18 as evidence in the prosecution of sexual assault under chapter 20 19 915, subchapter IV, or prosecution of the offense of criminal 20 20 transmission of HIV under chapter 709C. For the purposes of 20 21 this paragraph, "victim" means victim as defined section 20 22 915.40. 20 23 14. To employees of state correctional institutions 20 24 subject to the jurisdiction of the department of corrections, 20 25 employees of secure facilities for juveniles subject to the 20 26 department of human services, and employees of city and county 20 27 jails, if the employees have direct supervision over inmates 20 28 of those facilities or institutions in the exercise of the 20 29 duties prescribed pursuant to section 80.9, subsection 2, 20 30 paragraph "d". 20 31 15. To any person who secures a written release of test 20 32 results executed by a person authorized to provide consent to 20 33 performance of an HIV-related test pursuant to section 141A.7, 20 34 subsection 2, paragraph "d". 20 35 Sec. 14. NEW SECTION. 141A.10 IMMUNITIES. 21 1 1. A person making a report in good faith pursuant to this 21 2 chapter is immune from any liability, civil or criminal, which 21 3 might otherwise be incurred or imposed as a result of the 21 4 report. 21 5 2. A health care provider attending a person who tests 21 6 positive for the HIV infection has no duty to disclose to or 21 7 to warn third parties of the dangers of exposure to HIV 21 8 infection through contact with that person and is immune from 21 9 any liability, civil or criminal, for failure to disclose to 21 10 or warn third parties of the condition of that person. 21 11 Sec. 15. NEW SECTION. 141A.11 REMEDIES. 21 12 1. A person aggrieved by a violation of this chapter shall 21 13 have a right of civil action for damages in district court. 21 14 2. A care provider who intentionally or recklessly makes 21 15 an unauthorized disclosure under this chapter is subject to a 21 16 civil penalty of one thousand dollars. 21 17 3. A person who violates a confidentiality requirement of 21 18 section 141A.5 is guilty of an aggravated misdemeanor. 21 19 4. A civil action under this chapter is barred unless the 21 20 action is commenced within two years after the cause of action 21 21 accrues. 21 22 5. The attorney general may maintain a civil action to 21 23 enforce this chapter. 21 24 6. This chapter does not limit the rights of the subject 21 25 of an HIV-related test to recover damages or other relief 21 26 under any other applicable law. 21 27 7. This chapter shall not be construed to impose civil 21 28 liability or criminal sanction for disclosure of HIV-related 21 29 test results in accordance with any reporting requirement for 21 30 a diagnosed case of AIDS or a related condition by the 21 31 department or the centers for disease control and prevention 21 32 of the United States public health service. 21 33 Sec. 16. Section 321.186, unnumbered paragraph 4, Code 21 34 1999, is amended to read as follows: 21 35 A physician licensed under chapter 148, 150, or 150A, or an 22 1 optometrist licensed under chapter 154, may report to the 22 2 department the identity of a person who has been diagnosed as 22 3 having a physical or mental condition which would render the 22 4 person physically or mentally incompetent to operate a motor 22 5 vehicle in a safe manner. The physician or optometrist shall 22 6 make reasonable efforts to notify the person who is the 22 7 subject of the report, in writing. The written notification 22 8 shall state the nature of the disclosure and the reason for 22 9 the disclosure. A physician or optometrist making a report 22 10 under this section shall be immune from any liability, civil 22 11 or criminal, which might otherwise be incurred or imposed as a 22 12 result of the report. A physician or optometrist has no duty 22 13 to make a report or to warn third parties with regard to any 22 14 knowledge concerning a person's mental or physical competency 22 15 to operate a motor vehicle in a safe manner. Any report 22 16 received by the department from a physician or optometrist 22 17 under this section shall be kept confidential. Information 22 18 regulated by chapter141141A shall be subject to the 22 19 confidentiality provisions and remedies ofsections 141.23 and22 20141.24that chapter. 22 21 Sec. 17. Section 505.16, subsection 1, Code 1999, is 22 22 amended to read as follows: 22 23 1. A person engaged in the business of insurance shall not 22 24 require a test of an individual in connection with an 22 25 application for insurance for the presence of an antibody to 22 26 the human immunodeficiency virus unless the individual 22 27 provides a written release on a form approved by the insurance 22 28 commissioner. The form shall include information regarding 22 29 the purpose, content, use, and meaning of the test, disclosure 22 30 of test results including information explaining the effect of 22 31 releasing the information to a person engaged in the business 22 32 of insurance, the purpose for which the test results may be 22 33 used, and other information approved by the insurance 22 34 commissioner. The form shall also authorize the person 22 35 performing the test to provide the results of the test to the 23 1 insurance company subject to rules of confidentiality, 23 2 consistent with section141.23141A.9, approved by the 23 3 insurance commissioner. As used in this section, "a person 23 4 engaged in the business of insurance" includes hospital 23 5 service corporations organized under chapter 514 and health 23 6 maintenance organizations subject to chapter 514B. 23 7 Sec. 18. Section 904.515, Code 1999, is amended to read as 23 8 follows: 23 9 904.515 HUMAN IMMUNODEFICIENCY VIRUS-RELATED MATTERS – 23 10 EXEMPTION. 23 11 The provisions of chapter141141A relating to knowledge 23 12 and consent do not apply to persons committed to the custody 23 13 of the department. The department may provide for medically 23 14 acceptable procedures to inform employees, visitors, and 23 15 persons committed to the department of possible infection and 23 16 to protect them from possible infection. 23 17 Sec. 19. Section 915.40, subsection 3, paragraph c, Code 23 18 1999, is amended to read as follows: 23 19 c. The victim counselor or person requested by the victim 23 20 who is authorized to provide the counseling required pursuant 23 21 to section141.22141A.7. 23 22 Sec. 20. Section 915.42, subsection 4, paragraph a, Code 23 23 1999, is amended to read as follows: 23 24 a. Prior to the scheduling of a hearing, refer the victim 23 25 for counseling by a victim counselor or a person requested by 23 26 the victim who is authorized to provide the counseling 23 27 required pursuant to section141.22141A.7, regarding the 23 28 nature, reliability, and significance of the HIV-related test 23 29 and of the serologic status of the convicted offender. 23 30 Sec. 21. Section 915.43, subsections 1, 2, 4, and 5, Code 23 31 1999, are amended to read as follows: 23 32 1. The physician or other practitioner who orders the test 23 33 of a convicted or alleged offender for HIV under this 23 34 subchapter shall disclose the results of the test to the 23 35 convicted or alleged offender, and to the victim counselor or 24 1 a person requested by the victim who is authorized to provide 24 2 the counseling required pursuant to section141.22141A.7, who 24 3 shall disclose the results to the petitioner. 24 4 2. All testing under this chapter shall be accompanied by 24 5 pretest and posttest counseling as required under section 24 6141.22141A.7. 24 7 4. Results of a test performed under this subchapter, 24 8 except as provided in subsection 13, shall be disclosed only 24 9 to the physician or other practitioner who orders the test of 24 10 the convicted or alleged offender, the convicted or alleged 24 11 offender, the victim, the victim counselor or person requested 24 12 by the victim who is authorized to provide the counseling 24 13 required pursuant to section141.22141A.7, the physician of 24 14 the victim if requested by the victim, the parent, guardian, 24 15 or custodian of the victim, if the victim is a minor, and the 24 16 county attorney who filed the petition for HIV-related testing 24 17 under this chapter, who may use the results to file charges of 24 18 criminal transmission of HIV under chapter 709C. Results of a 24 19 test performed under this subchapter shall not be disclosed to 24 20 any other person without the written informed consent of the 24 21 convicted or alleged offender. A person to whom the results 24 22 of a test have been disclosed under this subchapter is subject 24 23 to the confidentiality provisions of section141.23141A.9, 24 24 and shall not disclose the results to another person except as 24 25 authorized by section141.23, subsection 1141A.9, subsection 24 26 12. 24 27 5. If testing is ordered under this subchapter, the court 24 28 shall also order periodic testing of the convicted offender 24 29 during the period of incarceration, probation, or parole or of 24 30 the alleged offender during a period of six months following 24 31 the initial test if the physician or other practitioner who 24 32 ordered the initial test of the convicted or alleged offender 24 33 certifies that, based upon prevailing scientific opinion 24 34 regarding the maximum period during which the results of an 24 35 HIV-related test may be negative for a person after being HIV- 25 1 infected, additional testing is necessary to determine whether 25 2 the convicted or alleged offender was HIV-infected at the time 25 3 the sexual assault or alleged sexual assault was perpetrated. 25 4 The results of the test conducted pursuant to this subsection 25 5 shall be released only to the physician or other practitioner 25 6 who orders the test of the convicted or alleged offender, the 25 7 convicted or alleged offender, the victim counselor or person 25 8 requested by the victim who is authorized to provide the 25 9 counseling required pursuant to section141.22141A.7, who 25 10 shall disclose the results to the petitioner, the physician of 25 11 the victim, if requested by the victim, and the county 25 12 attorney who may use the results as evidence in the 25 13 prosecution of the sexual assault or in the prosecution of the 25 14 offense of criminal transmission of HIV under chapter 709C. 25 15 Sec. 22. Chapter 141, Code 1999, is repealed. 25 16 EXPLANATION 25 17 This bill replaces the statute pertaining to acquired 25 18 immune deficiency syndrome (AIDS), which is currently divided 25 19 into subchapters, with a new chapter which combines the 25 20 subchapters and makes changes to the chapter. Existing Code 25 21 chapter 141 is repealed. 25 22 The bill combines all definitions used in the chapter into 25 23 one section. The bill provides a new definition of "care 25 24 provider" which encompasses any person providing health care 25 25 services of any kind, including emergency medical assistance 25 26 or treatment. The definition of "legal guardian" is expanded 25 27 to include an "attorney in fact". The definition of "ARC" or 25 28 "AIDS-related complex" is deleted. The definition of "sample" 25 29 is added to include any specimen obtained for the purposes of 25 30 conducting an HIV-related test. 25 31 The bill designates the Iowa department of public health as 25 32 the lead agency in the coordination and implementation of the 25 33 state's AIDS prevention and intervention plan. The bill also 25 34 authorizes the department to adopt rules to implement and 25 35 enforce the bill. The bill adds a provision authorizing the 26 1 department to coordinate efforts with local health officers to 26 2 investigate sources of HIV infection and to use every 26 3 appropriate means to prevent the spread of the disease. The 26 4 bill also includes language which allows the department to 26 5 continue to conduct epidemiological blinded and nonblinded 26 6 studies. 26 7 The bill assigns several duties to the department. These 26 8 duties include broad responsibilities for testing, education, 26 9 and disease control. The bill retains the requirement in 26 10 existing law that school districts, with parental consent, 26 11 provide education concerning HIV infection and prevention to 26 12 students. 26 13 The bill continues the requirement that testing and 26 14 counseling be offered for specified groups. In addition, the 26 15 bill requires that all pregnant women receive education about 26 16 testing and treatment opportunities to reduce the possible 26 17 transmission of HIV to a fetus. 26 18 The bill requires that the department maintain a partner 26 19 notification program for persons known to have tested positive 26 20 for HIV infection. Persons who test positive shall receive 26 21 posttest counseling and be encouraged to refer for counseling 26 22 and testing any person who may have sustained a significant 26 23 exposure from them. The section continues the provision that 26 24 a physician for an infected person may initiate partner 26 25 notification when the infected person will not participate and 26 26 will not warn an exposed third party. The bill deletes the 26 27 current provision that when a person who tests positive for 26 28 HIV infection will not participate in partner notification 26 29 prior to notification of a third party, the physician 26 30 proposing to cause the notification make reasonable efforts to 26 31 inform, in writing, the person who tested positive. 26 32 The bill provides for the performance of voluntary testing 26 33 and contains the reporting requirements for positive test 26 34 results. 26 35 The bill continues the provision of pretest counseling and 27 1 provides that a person seeking an HIV-related test shall have 27 2 the right to remain anonymous. However, a subject's right to 27 3 anonymity ends when the subject's test results are confirmed 27 4 positive. This section also provides that upon informing the 27 5 subject of test results, counseling is required to be 27 6 initiated and if the test results are positive, emphasis is to 27 7 be given to the need for precautions to prevent transmitting 27 8 the virus. This section also continues the provisions 27 9 granting exceptions to pretest counseling and provision of 27 10 information in instances of donation of body parts, patients 27 11 unable to give consent, insurance exams, and testing of 27 12 deceased persons involved in a documented significant exposure 27 13 incident. The provisions relating to minors are retained 27 14 which specifically authorize minors to apply for HIV-related 27 15 screening and treatment confidentially, provided that 27 16 confirmed positive HIV test results are to be reported to a 27 17 minor's legal guardian. 27 18 The bill provides a notification process under which care 27 19 providers who have suffered a significant exposure to an 27 20 individual in the course of providing assistance may obtain 27 21 information concerning that individual's HIV status. The bill 27 22 adds a provision that if a care provider in the course of 27 23 providing care on the premises of a hospital or health 27 24 facility sustains a significant exposure, the person to whom 27 25 the care provider was exposed is deemed to have consented to 27 26 an HIV-related test, upon the written request of the care 27 27 provider. The sample and test results are identified by the 27 28 name of the care provider and no report otherwise required is 27 29 to be made which identifies the subject of the test. If the 27 30 results are positive, the subject of the test is to be 27 31 informed and provided with counseling. 27 32 The bill provides for strict confidentiality of medical 27 33 information relating to a patient's HIV status. The bill 27 34 contains specific provisions relating to when that information 27 35 may be released and to whom. 28 1 The bill provides immunities for persons making reports 28 2 pursuant to the bill and provides that health care providers 28 3 have no duty to warn third parties regarding contact with a 28 4 person who has positive HIV test results. 28 5 The bill establishes civil and criminal remedies for 28 6 violations of confidentiality and other provisions of the 28 7 bill. The penalty for violation of a confidentiality 28 8 requirement relating to the partner notification program is 28 9 reduced from a class "D" felony (which carries a maximum 28 10 sentence of confinement of not more than 5 years and in 28 11 addition may include a fine of at least $500 but not more than 28 12 $7,500) to an aggravated misdemeanor (which carries a maximum 28 13 sentence of imprisonment not to exceed 2 years and a fine of 28 14 at least $500 but not more than $5,000). The bill contains 28 15 the specific penalty of a civil penalty of $1,000 for a care 28 16 provider who intentionally or recklessly makes an unauthorized 28 17 disclosure. 28 18 The bill eliminates the provisions for accreditation of HIV 28 19 testing laboratories. 28 20 The remainder of the bill makes conforming changes 28 21 necessitated by the enactment of new Code chapter 141A and the 28 22 repeal of the old Code chapter 141. 28 23 LSB 1785HC 78 28 24 pf/cf/24
Text: HSB00044 Text: HSB00046 Text: HSB00000 - HSB00099 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
© 1999 Cornell College and League of Women Voters of Iowa
Comments about this site or page?
webmaster@legis.iowa.gov.
Please remember that the person listed above does not vote on bills. Direct all comments concerning legislation to State Legislators.
Last update: Tue Feb 2 03:31:04 CST 1999
URL: /DOCS/GA/78GA/Legislation/HSB/00000/HSB00045/990201.html
jhf