Text: HSB00179 Text: HSB00181 Text: HSB00100 - HSB00199 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 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 4. School districts shall provide to every elementary, 8 5 middle school, and secondary school student, with parental 8 6 consent, instruction concerning HIV infection and AIDS and its 8 7 prevention. 8 8 Sec. 8. NEW SECTION. 141A.4 TESTING AND COUNSELING. 8 9 1. HIV testing and counseling shall be offered to the 8 10 following: 8 11 a. All persons seeking treatment for a sexually 8 12 transmitted disease. 8 13 b. All persons seeking treatment for intravenous drug 8 14 abuse or having a history of intravenous drug abuse. 8 15 c. All persons who consider themselves at risk for the HIV 8 16 infection. 8 17 d. Male and female prostitutes. 8 18 2. Pregnant women shall be provided information about HIV 8 19 prevention, risk reduction, and treatment opportunities to 8 20 reduce the possible transmission of HIV to a fetus. Pregnant 8 21 women who report one or more recognized risk factors for HIV 8 22 shall be strongly encouraged to undergo HIV-related testing. 8 23 A pregnant woman who requests testing shall be tested 8 24 regardless of the absence of risk factors. 8 25 Sec. 9. NEW SECTION. 141A.5 PARTNER NOTIFICATION PROGRAM 8 26 – HIV. 8 27 1. The department shall maintain a partner notification 8 28 program for persons known to have tested positive for the HIV 8 29 infection. 8 30 2. The department shall initiate the program at 8 31 alternative testing and counseling sites and at sexually 8 32 transmitted disease clinics. 8 33 3. In administering the program, the department shall 8 34 provide for the following: 8 35 a. A person who tests positive for the HIV infection shall 9 1 receive posttest counseling, during which time the person 9 2 shall be encouraged to refer for counseling and HIV testing 9 3 any person with whom the person has had sexual relations or 9 4 has shared intravenous equipment. 9 5 b. The physician or other health care provider attending 9 6 the person may provide to the department any relevant 9 7 information provided by the person regarding any person with 9 8 whom the tested person has had sexual relations or has shared 9 9 intravenous equipment. The department disease prevention 9 10 staff shall then conduct partner notification in the same 9 11 manner as that utilized for sexually transmitted diseases 9 12 consistent with the provisions of this chapter. 9 13 c. Devise a procedure, as a part of the partner 9 14 notification program, to provide for the notification of an 9 15 identifiable third party who is a sexual partner of or who 9 16 shares intravenous equipment with a person who has tested 9 17 positive for HIV, by the department or a physician, when all 9 18 of the following situations exist: 9 19 (1) A physician for the infected person is of the good 9 20 faith opinion that the nature of the continuing contact poses 9 21 an imminent danger of HIV infection transmission to the third 9 22 party. 9 23 (2) When the physician believes in good faith that the 9 24 infected person, despite strong encouragement, has not and 9 25 will not warn the third party and will not participate in the 9 26 voluntary partner notification program. 9 27 Notwithstanding subsection 4, the department or a physician 9 28 may reveal the identity of a person who has tested positive 9 29 for the HIV infection pursuant to this subsection only to the 9 30 extent necessary to protect a third party from the direct 9 31 threat of transmission. This subsection shall not be 9 32 interpreted to create a duty to warn third parties of the 9 33 danger of exposure to HIV through contact with a person who 9 34 tests positive for the HIV infection. 9 35 The department shall adopt rules pursuant to chapter 17A to 10 1 implement this paragraph "c". The rules shall provide a 10 2 detailed procedure by which the department or a physician may 10 3 directly notify an endangered third party. 10 4 4. In making contact the department shall not disclose the 10 5 identity of the person who provided the names of the persons 10 6 to be contacted and shall protect the confidentiality of 10 7 persons contacted. 10 8 5. The department may delegate its partner notification 10 9 duties under this section to local health authorities unless 10 10 the local authority refuses or neglects to conduct the contact 10 11 tracing program in a manner deemed to be effective by the 10 12 department. 10 13 6. In addition to the provisions for partner notification 10 14 provided under this section and notwithstanding any provision 10 15 to the contrary, a county medical examiner or deputy medical 10 16 examiner performing official duties pursuant to sections 10 17 331.801 through 331.805 or the state medical examiner or 10 18 deputy medical examiner performing official duties pursuant to 10 19 chapter 691, who determines through an investigation that a 10 20 deceased person was infected with HIV, may notify directly, or 10 21 request that the department notify, the immediate family of 10 22 the deceased or any person known to have had a significant 10 23 exposure from the deceased of the finding. 10 24 Sec. 10. NEW SECTION. 141A.6 AIDS-RELATED CONDITIONS – 10 25 SCREENING, TESTING, AND REPORTING. 10 26 1. Prior to obtaining a sample for the purpose of 10 27 performing a voluntary HIV-related test, a health care 10 28 provider shall inform the subject of the test that the test is 10 29 voluntary. Within seven days of the testing of a person with 10 30 a test result indicating HIV infection which has been 10 31 confirmed as positive according to prevailing medical 10 32 technology, the physician or other health care provider at 10 33 whose request the test was performed shall make a report to 10 34 the department on a form provided by the department. 10 35 2. Within seven days of diagnosing a person as having an 11 1 AIDS-related condition, the diagnosing physician shall make a 11 2 report to the department on a form provided by the department. 11 3 3. Within seven days of the death of a person resulting 11 4 from an AIDS-related condition, the attending physician shall 11 5 make a report to the department on a form provided by the 11 6 department. 11 7 4. Within seven days of the testing of a person with a 11 8 test result indicating HIV infection which has been confirmed 11 9 as positive according to prevailing medical technology, the 11 10 director of a blood bank shall make a report to the department 11 11 on a form provided by the department. 11 12 5. Within seven days of the testing of a person with a 11 13 test result indicating HIV infection which has been confirmed 11 14 as positive according to prevailing medical technology, the 11 15 director of a clinical laboratory shall make a report to the 11 16 department on a form provided by the department. 11 17 6. The forms provided by the department shall require 11 18 inclusion of all of the following information: 11 19 a. The name of the patient. 11 20 b. The address of the patient. 11 21 c. The patient's date of birth. 11 22 d. The gender of the patient. 11 23 e. The race or ethnicity of the patient. 11 24 f. The patient's marital status. 11 25 g. The patient's telephone number. 11 26 h. The name and address of the laboratory or blood bank. 11 27 i. The date the test was found to be positive and the 11 28 collection date. 11 29 j. The name of the physician or health care provider who 11 30 performed the test. 11 31 k. If the patient is female, whether the patient is 11 32 pregnant. 11 33 Sec. 11. NEW SECTION. 141A.7 TEST RESULTS – COUNSELING 11 34 – APPLICATION FOR SERVICES. 11 35 1. At any time that the subject of an HIV-related test is 12 1 informed of confirmed positive test results, counseling 12 2 concerning the emotional and physical health effects shall be 12 3 initiated. Particular attention shall be given to explaining 12 4 the need for the precautions necessary to avoid transmitting 12 5 the virus. The subject shall be given information concerning 12 6 additional 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 hospital 14 33 or health facility, the individual to whom the care provider 14 34 was exposed is deemed to consent to a test to be administered 14 35 by the hospital or health care facility upon the written 15 1 request of the exposed care provider for the express purpose 15 2 of determining the presence of HIV infection in that 15 3 individual. The sample and test results shall only be 15 4 identified by a number and no reports otherwise required by 15 5 this chapter shall be made which identify the individual 15 6 tested. However, if the test results are positive, the 15 7 hospital or health care facility shall notify the individual 15 8 tested and ensure performance of counseling and reporting 15 9 requirements of this chapter in the same manner as for an 15 10 individual from whom actual consent was obtained. 15 11 8. A hospital or health care provider, or other person 15 12 participating in good faith in making a report under the 15 13 notification provisions of this section, under procedures 15 14 similar to this section for notification of its own employees 15 15 upon filing of a significant exposure report, or in failing to 15 16 make a report under this section, is immune from any 15 17 liability, civil or criminal, which might otherwise be 15 18 incurred or imposed. 15 19 9. Notifications made pursuant to this section shall not 15 20 disclose the identity of the individual who is diagnosed or 15 21 confirmed as having HIV infection unless the individual 15 22 provides a specific written release as provided in subsection 15 23 1, paragraph "b". If the care provider determines the 15 24 identity of the individual, the identity of the individual 15 25 shall be confidential information and shall not be disclosed 15 26 by the care provider to any other person unless a specific 15 27 written release is obtained from the individual. 15 28 10. A hospital's duty to notify under this section is not 15 29 continuing but is limited to the diagnosis of HIV infection 15 30 made in the course of admission, care, and treatment following 15 31 the rendering of assistance or treatment of the individual 15 32 with the infection. 15 33 11. Notwithstanding subsection 10, if, following discharge 15 34 or completion of care or treatment, an individual for whom a 15 35 significant exposure report was submitted but which report did 16 1 not result in notification, wishes to provide information 16 2 regarding the individual's HIV infection status to the care 16 3 provider who submitted the report, the hospital shall provide 16 4 a procedure for notifying the care provider. 16 5 12. The employer of a care provider who submits a report 16 6 of significant exposure under this section sustained in the 16 7 course of employment shall pay the costs of HIV testing for 16 8 the individual and the costs of HIV testing and counseling for 16 9 the care provider. However, the department shall pay the 16 10 costs of HIV testing for the individual and the costs of HIV 16 11 testing and counseling for a care provider who renders direct 16 12 aid without compensation. 16 13 Sec. 13. NEW SECTION. 141A.9 CONFIDENTIALITY OF 16 14 INFORMATION. 16 15 Any information, including reports and records, obtained, 16 16 submitted, and maintained pursuant to this chapter is strictly 16 17 confidential medical information. The information shall not 16 18 be released, shared with an agency or institution, or made 16 19 public upon subpoena, search warrant, discovery proceedings, 16 20 or by any other means except as provided in this chapter. A 16 21 person shall not be compelled to disclose the identity of any 16 22 person upon whom an HIV-related test is performed, or the 16 23 results of the test in a manner which permits identification 16 24 of the subject of the test, except to persons entitled to that 16 25 information under this chapter. Information shall be made 16 26 available for release to the following individuals or under 16 27 the following circumstances: 16 28 1. To the subject of the test or the subject's legal 16 29 guardian subject to the provisions of section 141A.7, 16 30 subsection 3, when applicable. 16 31 2. To any person who secures a written release of test 16 32 results executed by the subject of the test or the subject's 16 33 legal guardian. 16 34 3. To an authorized agent or employee of a health facility 16 35 or health care provider, if the health facility or health care 17 1 provider ordered or participated in the testing or is 17 2 otherwise authorized to obtain the test results, the agent or 17 3 employee provides patient care or handles or processes 17 4 samples, and the agent or employee has a medical need to know 17 5 such information. 17 6 4. To a health care provider providing care to the subject 17 7 of the test when knowledge of the test results is necessary to 17 8 provide care or treatment. 17 9 5. To the department in accordance with reporting 17 10 requirements for an HIV-related condition. 17 11 6. To a health facility or health care provider which 17 12 procures, processes, distributes, or uses a human body part 17 13 from a deceased person with respect to medical information 17 14 regarding that person, or semen provided prior to July 1, 17 15 1988, for the purpose of artificial insemination. 17 16 7. Release may be made of medical or epidemiological 17 17 information for statistical purposes in a manner such that no 17 18 individual person can be identified. 17 19 8. Release may be made of medical or epidemiological 17 20 information to the extent necessary to enforce the provisions 17 21 of this chapter and related rules concerning the treatment, 17 22 control, and investigation of HIV infection by public health 17 23 officials. 17 24 9. Release may be made of medical or epidemiological 17 25 information to medical personnel to the extent necessary to 17 26 protect the health or life of the named party. 17 27 10. Release may be made of test results concerning a 17 28 patient pursuant to procedures established under section 17 29 141A.5, subsection 3, paragraph "c". 17 30 11. To a person allowed access to a record by a court 17 31 order which is issued in compliance with the following 17 32 provisions: 17 33 a. A court has found that the person seeking the test 17 34 results has demonstrated a compelling need for the test 17 35 results which need cannot be accommodated by other means. In 18 1 assessing compelling need, the court shall weigh the need for 18 2 disclosure against the privacy interest of the test subject 18 3 and the public interest which may be disserved by disclosure 18 4 due to its deterrent effect on future testing or due to its 18 5 effect in leading to discrimination. 18 6 b. Pleadings pertaining to disclosure of test results 18 7 shall substitute a pseudonym for the true name of the subject 18 8 of the test. The disclosure to the parties of the subject's 18 9 true name shall be communicated confidentially in documents 18 10 not filed with the court. 18 11 c. Before granting an order, the court shall provide the 18 12 person whose test results are in question with notice and a 18 13 reasonable opportunity to participate in the proceedings if 18 14 the person is not already a party. 18 15 d. Court proceedings as to disclosure of test results 18 16 shall be conducted in camera unless the subject of the test 18 17 agrees to a hearing in open court or unless the court 18 18 determines that a public hearing is necessary to the public 18 19 interest and the proper administration of justice. 18 20 e. Upon the issuance of an order to disclose test results, 18 21 the court shall impose appropriate safeguards against 18 22 unauthorized disclosure, which shall specify the persons who 18 23 may gain access to the information, the purposes for which the 18 24 information shall be used, and appropriate prohibitions on 18 25 future disclosure. 18 26 12. To an employer, if the test is authorized to be 18 27 required under any other provision of law. 18 28 13. To a convicted or alleged sexual assault offender; the 18 29 physician or other health care provider who orders the test of 18 30 a convicted or alleged offender; the victim; the parent, 18 31 guardian, or custodian of the victim if the victim is a minor; 18 32 the physician of the victim; the victim counselor or person 18 33 requested by the victim to provide counseling regarding the 18 34 HIV-related test and results; the victim's spouse; persons 18 35 with whom the victim has engaged in vaginal, anal, or oral 19 1 intercourse subsequent to the sexual assault; members of the 19 2 victim's family within the third degree of consanguinity; and 19 3 the county attorney who may use the results as evidence in the 19 4 prosecution of sexual assault under chapter 915, subchapter 19 5 IV, or prosecution of the offense of criminal transmission of 19 6 HIV under chapter 709C. For the purposes of this paragraph, 19 7 "victim" means victim as defined section 915.40. 19 8 14. To employees of state correctional institutions 19 9 subject to the jurisdiction of the department of corrections, 19 10 employees of secure facilities for juveniles subject to the 19 11 department of human services, and employees of city and county 19 12 jails, if the employees have direct supervision over inmates 19 13 of those facilities or institutions in the exercise of the 19 14 duties prescribed pursuant to section 80.9, subsection 2, 19 15 paragraph "d". 19 16 Sec. 14. NEW SECTION. 141A.10 IMMUNITIES. 19 17 1. A person making a report in good faith pursuant to this 19 18 chapter is immune from any liability, civil or criminal, which 19 19 might otherwise be incurred or imposed as a result of the 19 20 report. 19 21 2. A health care provider attending a person who tests 19 22 positive for the HIV infection has no duty to disclose to or 19 23 to warn third parties of the dangers of exposure to HIV 19 24 infection through contact with that person and is immune from 19 25 any liability, civil or criminal, for failure to disclose to 19 26 or warn third parties of the condition of that person. 19 27 Sec. 15. NEW SECTION. 141A.11 REMEDIES. 19 28 1. A person aggrieved by a violation of this chapter shall 19 29 have a right of civil action for damages in district court. 19 30 2. A care provider who intentionally or recklessly makes 19 31 an unauthorized disclosure under this chapter is subject to a 19 32 civil penalty of one thousand dollars. 19 33 3. A person who violates a confidentiality requirement of 19 34 section 141A.5 is guilty of an aggravated misdemeanor. 19 35 4. A civil action under this chapter is barred unless the 20 1 action is commenced within two years after the cause of action 20 2 accrues. 20 3 5. The attorney general may maintain a civil action to 20 4 enforce this chapter. 20 5 6. This chapter does not limit the rights of the subject 20 6 of an HIV-related test to recover damages or other relief 20 7 under any other applicable law. 20 8 7. This chapter shall not be construed to impose civil 20 9 liability or criminal sanction for disclosure of HIV-related 20 10 test results in accordance with any reporting requirement for 20 11 a diagnosed case of AIDS or a related condition by the 20 12 department or the centers for disease control and prevention 20 13 of the United States public health service. 20 14 Sec. 16. Section 321.186, unnumbered paragraph 4, Code 20 15 1999, is amended to read as follows: 20 16 A physician licensed under chapter 148, 150, or 150A, or an 20 17 optometrist licensed under chapter 154, may report to the 20 18 department the identity of a person who has been diagnosed as 20 19 having a physical or mental condition which would render the 20 20 person physically or mentally incompetent to operate a motor 20 21 vehicle in a safe manner. The physician or optometrist shall 20 22 make reasonable efforts to notify the person who is the 20 23 subject of the report, in writing. The written notification 20 24 shall state the nature of the disclosure and the reason for 20 25 the disclosure. A physician or optometrist making a report 20 26 under this section shall be immune from any liability, civil 20 27 or criminal, which might otherwise be incurred or imposed as a 20 28 result of the report. A physician or optometrist has no duty 20 29 to make a report or to warn third parties with regard to any 20 30 knowledge concerning a person's mental or physical competency 20 31 to operate a motor vehicle in a safe manner. Any report 20 32 received by the department from a physician or optometrist 20 33 under this section shall be kept confidential. Information 20 34 regulated by chapter141141A shall be subject to the 20 35 confidentiality provisions and remedies ofsections 141.23 and21 1141.24that chapter. 21 2 Sec. 17. Section 505.16, subsection 1, Code 1999, is 21 3 amended to read as follows: 21 4 1. A person engaged in the business of insurance shall not 21 5 require a test of an individual in connection with an 21 6 application for insurance for the presence of an antibody to 21 7 the human immunodeficiency virus unless the individual 21 8 provides a written release on a form approved by the insurance 21 9 commissioner. The form shall include information regarding 21 10 the purpose, content, use, and meaning of the test, disclosure 21 11 of test results including information explaining the effect of 21 12 releasing the information to a person engaged in the business 21 13 of insurance, the purpose for which the test results may be 21 14 used, and other information approved by the insurance 21 15 commissioner. The form shall also authorize the person 21 16 performing the test to provide the results of the test to the 21 17 insurance company subject to rules of confidentiality, 21 18 consistent with section141.23141A.9, approved by the 21 19 insurance commissioner. As used in this section, "a person 21 20 engaged in the business of insurance" includes hospital 21 21 service corporations organized under chapter 514 and health 21 22 maintenance organizations subject to chapter 514B. 21 23 Sec. 18. Section 904.515, Code 1999, is amended to read as 21 24 follows: 21 25 904.515 HUMAN IMMUNODEFICIENCY VIRUS-RELATED MATTERS – 21 26 EXEMPTION. 21 27 The provisions of chapter141141A relating to knowledge 21 28 and consent do not apply to persons committed to the custody 21 29 of the department. The department may provide for medically 21 30 acceptable procedures to inform employees, visitors, and 21 31 persons committed to the department of possible infection and 21 32 to protect them from possible infection. 21 33 Sec. 19. Section 915.40, subsection 3, paragraph c, Code 21 34 1999, is amended to read as follows: 21 35 c. The victim counselor or person requested by the victim 22 1who is authorizedto providethecounselingrequired pursuant22 2to section 141.22regarding the HIV-related test and results. 22 3 Sec. 20. Section 915.42, subsection 4, paragraph a, Code 22 4 1999, is amended to read as follows: 22 5 a. Prior to the scheduling of a hearing, refer the victim 22 6 for counseling by a victim counselor or a person requested by 22 7 the victimwho is authorizedto providethecounseling 22 8required pursuant to section 141.22,regarding the nature, 22 9 reliability, and significance of the HIV-related test and of 22 10 the serologic status of the convicted offender. 22 11 Sec. 21. Section 915.43, subsections 1, 2, 4, and 5, Code 22 12 1999, are amended to read as follows: 22 13 1. The physician or other practitioner who orders the test 22 14 of a convicted or alleged offender for HIV under this 22 15 subchapter shall disclose the results of the test to the 22 16 convicted or alleged offender, and to the victim counselor or 22 17 a person requested by the victimwho is authorizedto provide 22 18thecounselingrequired pursuant to section 141.22,regarding 22 19 the HIV-related test and results who shall disclose the 22 20 results to the petitioner. 22 21 2. All testing under this chapter shall be accompanied by 22 22 pretest and posttest counselingas required under section22 23141.22. 22 24 4. Results of a test performed under this subchapter, 22 25 except as provided in subsection 13, shall be disclosed only 22 26 to the physician or other practitioner who orders the test of 22 27 the convicted or alleged offender, the convicted or alleged 22 28 offender, the victim, the victim counselor or person requested 22 29 by the victimwho is authorizedto providethecounseling 22 30required pursuant to section 141.22regarding the HIV-related 22 31 test and results, the physician of the victim if requested by 22 32 the victim, the parent, guardian, or custodian of the victim, 22 33 if the victim is a minor, and the county attorney who filed 22 34 the petition for HIV-related testing under this chapter, who 22 35 may use the results to file charges of criminal transmission 23 1 of HIV under chapter 709C. Results of a test performed under 23 2 this subchapter shall not be disclosed to any other person 23 3 without the written informed consent of the convicted or 23 4 alleged offender. A person to whom the results of a test have 23 5 been disclosed under this subchapter is subject to the 23 6 confidentiality provisions of section141.23141A.9, and shall 23 7 not disclose the results to another person except as 23 8 authorized by section141.23, subsection 1141A.9, subsection 23 9 13. 23 10 5. If testing is ordered under this subchapter, the court 23 11 shall also order periodic testing of the convicted offender 23 12 during the period of incarceration, probation, or parole or of 23 13 the alleged offender during a period of six months following 23 14 the initial test if the physician or other practitioner who 23 15 ordered the initial test of the convicted or alleged offender 23 16 certifies that, based upon prevailing scientific opinion 23 17 regarding the maximum period during which the results of an 23 18 HIV-related test may be negative for a person after being HIV- 23 19 infected, additional testing is necessary to determine whether 23 20 the convicted or alleged offender was HIV-infected at the time 23 21 the sexual assault or alleged sexual assault was perpetrated. 23 22 The results of the test conducted pursuant to this subsection 23 23 shall be released only to the physician or other practitioner 23 24 who orders the test of the convicted or alleged offender, the 23 25 convicted or alleged offender, the victim counselor or person 23 26 requested by the victimwho is authorizedto provide the 23 27 counselingrequired pursuant to section 141.22,regarding the 23 28 HIV-related test and results who shall disclose the results to 23 29 the petitioner, the physician of the victim, if requested by 23 30 the victim, and the county attorney who may use the results as 23 31 evidence in the prosecution of the sexual assault or in the 23 32 prosecution of the offense of criminal transmission of HIV 23 33 under chapter 709C. 23 34 Sec. 22. Chapter 141, Code 1999, is repealed. 23 35 EXPLANATION 24 1 This bill replaces the statute pertaining to acquired 24 2 immune deficiency syndrome (AIDS), which is currently divided 24 3 into subchapters, with a new chapter which combines the 24 4 subchapters and makes changes to the chapter. Existing Code 24 5 chapter 141 is repealed. 24 6 The bill combines all definitions used in the chapter into 24 7 one section. The bill provides a new definition of "care 24 8 provider" which encompasses any person providing health care 24 9 services of any kind, including emergency medical assistance 24 10 or treatment. The definition of "legal guardian" is expanded 24 11 to include an "attorney in fact". The definition of "ARC" or 24 12 "AIDS-related complex" is deleted. The definition of "sample" 24 13 is added to include any specimen obtained for the purposes of 24 14 conducting an HIV-related test. 24 15 The bill designates the Iowa department of public health as 24 16 the lead agency in the coordination and implementation of the 24 17 state's AIDS prevention and intervention plan. The bill also 24 18 authorizes the department to adopt rules to implement and 24 19 enforce the bill. The bill continues the authorization for 24 20 the department to coordinate efforts with local health 24 21 officers to investigate sources of HIV infection and to use 24 22 every appropriate means to prevent the spread of the disease. 24 23 The bill also continues authorization for the department to 24 24 conduct epidemiological blinded and nonblinded studies. 24 25 The bill assigns several duties to the department. These 24 26 duties include broad responsibilities for testing, education, 24 27 and disease control. The bill retains the requirement in 24 28 existing law that school districts, with parental consent, 24 29 provide education concerning HIV infection and prevention to 24 30 students. 24 31 The bill continues the requirement that testing and 24 32 counseling be offered for specified groups. In addition, the 24 33 bill requires that all pregnant women receive information 24 34 about testing and treatment opportunities to reduce the 24 35 possible transmission of HIV to a fetus, requires that all 25 1 pregnant women with risk factors for HIV be strongly 25 2 encouraged to be tested, and requires that upon request a 25 3 pregnant woman be tested regardless of the absence of risk 25 4 factors. 25 5 The bill requires that the department maintain a partner 25 6 notification program for persons known to have tested positive 25 7 for HIV infection. Persons who test positive shall receive 25 8 posttest counseling and be encouraged to refer for counseling 25 9 and testing any person who may have sustained a significant 25 10 exposure from them. The section continues the provision that 25 11 a physician for an infected person may initiate partner 25 12 notification when the infected person will not participate and 25 13 will not warn an exposed third party. The bill deletes the 25 14 current provision that when a person who tests positive for 25 15 HIV infection will not participate in partner notification 25 16 prior to notification of a third party, the physician 25 17 proposing to cause the notification make reasonable efforts to 25 18 inform, in writing, the person who tested positive. 25 19 The bill provides for the performance of voluntary testing, 25 20 eliminates anonymous testing, and contains the reporting 25 21 requirements for positive test results. 25 22 The bill eliminates the provision of pretest counseling. 25 23 The bill provides that upon informing the subject of positive 25 24 test results, counseling is required to be initiated with 25 25 emphasis given to the need for precautions to prevent 25 26 transmitting the virus. The bill continues the provisions 25 27 granting exceptions to counseling in instances of donation of 25 28 body parts, patients unable to give consent, insurance exams, 25 29 and testing of deceased persons involved in a documented 25 30 significant exposure incident. The provisions relating to 25 31 minors are amended to eliminate the provision that if a person 25 32 who personally applies for services, screening, or treatment 25 33 is a minor, the fact that the minor sought services or is 25 34 receiving services, screening, or treatment is not to be 25 35 reported or disclosed except for statistical purposes. The 26 1 bill retains the provision that confirmed positive HIV test 26 2 results are to be reported to a minor's legal guardian. 26 3 The bill provides a notification process under which care 26 4 providers who have suffered a significant exposure to an 26 5 individual in the course of providing assistance may obtain 26 6 information concerning that individual's HIV status. The bill 26 7 adds a provision that if a care provider in the course of 26 8 providing care on the premises of a hospital or health 26 9 facility sustains a significant exposure, the person to whom 26 10 the care provider was exposed is deemed to have consented to 26 11 an HIV-related test, upon the written request of the care 26 12 provider. The sample and test results are only identified by 26 13 a number and no report otherwise required is to be made which 26 14 identifies the subject of the test. If the results are 26 15 positive, the subject of the test is to be informed and 26 16 provided with counseling. 26 17 The bill provides for strict confidentiality of medical 26 18 information relating to a patient's HIV status. The bill 26 19 contains specific provisions relating to when that information 26 20 may be released and to whom. 26 21 The bill provides immunities for persons making reports 26 22 pursuant to the bill and provides that health care providers 26 23 have no duty to warn third parties regarding contact with a 26 24 person who has positive HIV test results. 26 25 The bill establishes civil and criminal remedies for 26 26 violations of confidentiality and other provisions of the 26 27 bill. The penalty for violation of a confidentiality 26 28 requirement relating to the partner notification program is 26 29 reduced from a class "D" felony (which carries a maximum 26 30 sentence of confinement of not more than 5 years and in 26 31 addition may include a fine of at least $500 but not more than 26 32 $7,500) to an aggravated misdemeanor (which carries a maximum 26 33 sentence of imprisonment not to exceed 2 years and a fine of 26 34 at least $500 but not more than $5,000). The bill contains 26 35 the specific civil penalty of $1,000 for a care provider who 27 1 intentionally or recklessly makes an unauthorized disclosure. 27 2 The bill eliminates the provisions for accreditation of HIV 27 3 testing laboratories. 27 4 The remainder of the bill makes conforming changes 27 5 necessitated by the enactment of new Code chapter 141A and the 27 6 repeal of Code chapter 141. 27 7 LSB 2694HC 78 27 8 pf/cf/24
Text: HSB00179 Text: HSB00181 Text: HSB00100 - HSB00199 Text: HSB Index Bills and Amendments: General Index Bill History: General Index
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