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Senate File 248

Partial Bill History

Bill Text

PAG LIN
  1  1                                         SENATE FILE 248
  1  2 
  1  3                             AN ACT
  1  4 RELATING TO ACQUIRED IMMUNE DEFICIENCY SYNDROME, PROVIDING
  1  5    PENALTIES, AND PROVIDING FOR A REPEAL.  
  1  6 
  1  7 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  1  8 
  1  9    Section 1.  Section 80.9, subsection 2, paragraph d, Code
  1 10 1999, is amended to read as follows:
  1 11    d.  To collect and classify, and keep at all times
  1 12 available, complete information useful for the detection of
  1 13 crime, and the identification and apprehension of criminals.
  1 14 Such information shall be available for all peace officers
  1 15 within the state, under such regulations as the commissioner
  1 16 may prescribe.  The provisions of chapter 141 141A do not
  1 17 apply to the entry of human immunodeficiency virus-related
  1 18 information by criminal or juvenile justice agencies, as
  1 19 defined in section 692.1, into the Iowa criminal justice
  1 20 information system or the national crime information center
  1 21 system.  The provisions of chapter 141 141A also do not apply
  1 22 to the transmission of the same information from either or
  1 23 both information systems to criminal or juvenile justice
  1 24 agencies.  The provisions of chapter 141 141A also do not
  1 25 apply to the transmission of the same information from either
  1 26 or both information systems to employees of state correctional
  1 27 institutions subject to the jurisdiction of the department of
  1 28 corrections, employees of secure facilities for juveniles
  1 29 subject to the jurisdiction of the department of human
  1 30 services, and employees of city and county jails, if those
  1 31 employees have direct physical supervision over inmates of
  1 32 those facilities or institutions.  Human immunodeficiency
  1 33 virus-related information shall not be transmitted over the
  1 34 police radio broadcasting system under chapter 693 or any
  1 35 other radio-based communications system.  An employee of an
  2  1 agency receiving human immunodeficiency virus-related
  2  2 information under this section who communicates the
  2  3 information to another employee who does not have direct
  2  4 physical supervision over inmates, other than to a supervisor
  2  5 of an employee who has direct physical supervision over
  2  6 inmates for the purpose of conveying the information to such
  2  7 an employee, or who communicates the information to any person
  2  8 not employed by the agency or uses the information outside the
  2  9 agency is guilty of a class "D" felony.  The commissioner
  2 10 shall adopt rules regarding the transmission of human
  2 11 immunodeficiency virus-related information including
  2 12 provisions for maintaining confidentiality of the information.
  2 13 The rules shall include a requirement that persons receiving
  2 14 information from the Iowa criminal justice information system
  2 15 or the national crime information center system receive
  2 16 training regarding confidentiality standards applicable to the
  2 17 information received from the system.  The commissioner shall
  2 18 develop and establish, in cooperation with the department of
  2 19 corrections and the Iowa department of public health, training
  2 20 programs and program criteria for persons receiving human
  2 21 immunodeficiency virus-related information through the Iowa
  2 22 criminal justice information system or the national crime
  2 23 information center system.
  2 24    Sec. 2.  Section 139B.1, subsection 1, paragraph a, Code
  2 25 1999, is amended to read as follows:
  2 26    a.  "Contagious or infectious disease" means hepatitis in
  2 27 any form, meningococcal disease, tuberculosis, and any other
  2 28 disease with the exception of AIDS or HIV infection as defined
  2 29 in section 141.21 141A.1, determined to be life-threatening to
  2 30 a person exposed to the disease as established by rules
  2 31 adopted by the department based upon a determination by the
  2 32 state epidemiologist and in accordance with guidelines of the
  2 33 centers for disease prevention and control of the United
  2 34 States department of health and human services.
  2 35    Sec. 3.  Section 139C.1, subsection 6, Code 1999, is
  3  1 amended to read as follows:
  3  2    6.  "HIV" means HIV as defined in section 141.21 141A.1.
  3  3    Sec. 4.  Section 139C.2, subsection 7, Code 1999, is
  3  4 amended to read as follows:
  3  5    7.  Information relating to the HIV status of a health care
  3  6 provider is confidential and subject to the provisions of
  3  7 section 141.23 141A.9.  A person who intentionally or
  3  8 recklessly makes an unauthorized disclosure of such
  3  9 information is subject to a civil penalty of one thousand
  3 10 dollars.  The attorney general or the attorney general's
  3 11 designee may maintain a civil action to enforce this section.
  3 12 Proceedings maintained under this section shall provide for
  3 13 the anonymity of the individual and all documentation shall be
  3 14 maintained in a confidential manner.  Information relating to
  3 15 the HBV status of a health care provider is confidential and
  3 16 shall not be accessible to the public.  Information regulated
  3 17 by this section, however, may be disclosed to members of the
  3 18 expert review panel established by the department or a panel
  3 19 established by hospital protocol under this section.  The
  3 20 information may also be disclosed to the appropriate examining
  3 21 board by filing a report as required by this section.  The
  3 22 examining board shall consider the report a complaint subject
  3 23 to the confidentiality provisions of section 272C.6.  A
  3 24 licensee, upon the filing of a formal charge or notice of
  3 25 hearing by the examining board based on such a complaint, may
  3 26 seek a protective order from the board.
  3 27    Sec. 5.  NEW SECTION.  141A.1  DEFINITIONS.
  3 28    As used in this chapter, unless the context otherwise
  3 29 requires:
  3 30    1.  "AIDS" means acquired immune deficiency syndrome as
  3 31 defined by the centers for disease control and prevention of
  3 32 the United States department of health and human services.
  3 33    2.  "AIDS-related conditions" means the human
  3 34 immunodeficiency virus, or any other condition resulting from
  3 35 the human immunodeficiency virus infection.
  4  1    3.  "Blinded epidemiological studies" means studies in
  4  2 which specimens which were collected for other purposes are
  4  3 selected according to established criteria, are permanently
  4  4 stripped of personal identifiers, and are then tested.
  4  5    4.  "Blood bank" means a facility for the collection,
  4  6 processing, or storage of human blood or blood derivatives,
  4  7 including blood plasma, or from which or by means of which
  4  8 human blood or blood derivatives are distributed or otherwise
  4  9 made available.
  4 10    5.  "Care provider" means any emergency care provider,
  4 11 health care provider, or any other person providing health
  4 12 care services of any kind.
  4 13    6.  "Department" means the Iowa department of public
  4 14 health.
  4 15    7.  "Emergency care provider" means a person who is trained
  4 16 and authorized by federal or state law to provide emergency
  4 17 medical assistance or treatment, for compensation or in a
  4 18 voluntary capacity, including but not limited to all of the
  4 19 following:
  4 20    (1)  An emergency medical care provider as defined in
  4 21 section 147A.1.
  4 22    (2)  A health care provider.
  4 23    (3)  A fire fighter.
  4 24    (4)  A peace officer.
  4 25    "Emergency care provider" also includes a person who
  4 26 renders emergency aid without compensation.
  4 27    8.  "Good faith" means objectively reasonable and not in
  4 28 violation of clearly established statutory rights or other
  4 29 rights of a person which a reasonable person would know or
  4 30 should have known.
  4 31    9.  "Health care provider" means a person licensed or
  4 32 certified under chapter 148, 148C, 150, 150A, 152, or 153 to
  4 33 provide professional health care service to a person during
  4 34 the person's medical care, treatment, or confinement.
  4 35    10.  "Health facility" means a hospital, health care
  5  1 facility, clinic, blood bank, blood center, sperm bank,
  5  2 laboratory organ transplant center and procurement agency, or
  5  3 other health care institution.
  5  4    11.  "HIV" means the human immunodeficiency virus
  5  5 identified as the causative agent of AIDS.
  5  6    12.  "HIV-related test" means a diagnostic test conducted
  5  7 by a laboratory approved pursuant to the federal Clinical
  5  8 Laboratory Improvements Act for determining the presence of
  5  9 HIV.
  5 10    13.  "Infectious bodily fluids" means bodily fluids capable
  5 11 of transmitting HIV infection as determined by the centers for
  5 12 disease control and prevention of the United States department
  5 13 of health and human services and adopted by rule of the
  5 14 department.
  5 15    14.  "Legal guardian" means a person appointed by a court
  5 16 pursuant to chapter 633 or an attorney in fact as defined in
  5 17 section 144B.1.  In the case of a minor, "legal guardian" also
  5 18 means a parent or other person responsible for the care of the
  5 19 minor.
  5 20    15.  "Nonblinded epidemiological studies" means studies in
  5 21 which specimens are collected for the express purpose of
  5 22 testing for the HIV infection and persons included in the
  5 23 nonblinded study are selected according to established
  5 24 criteria.
  5 25    16.  "Release of test results" means a written
  5 26 authorization for disclosure of HIV-related test results which
  5 27 is signed and dated, and which specifies to whom disclosure is
  5 28 authorized and the time period during which the release is to
  5 29 be effective.
  5 30    17.  "Sample" means a human specimen obtained for the
  5 31 purpose of conducting an HIV-related test.
  5 32    18.  "Significant exposure" means the risk of contracting
  5 33 HIV infection by means of exposure to a person's infectious
  5 34 bodily fluids in a manner capable of transmitting HIV
  5 35 infection as determined by the centers for disease control and
  6  1 prevention of the United States department of health and human
  6  2 services and adopted by rule of the department.
  6  3    Sec. 6.  NEW SECTION.  141A.2  LEAD AGENCY.
  6  4    1.  The department is designated as the lead agency in the
  6  5 coordination and implementation of the state comprehensive
  6  6 AIDS-related conditions prevention and intervention plan.
  6  7    2.  The department shall adopt rules pursuant to chapter
  6  8 17A to implement and enforce this chapter.  The rules may
  6  9 include procedures for taking appropriate action with regard
  6 10 to health facilities or health care providers which violate
  6 11 this chapter or the rules adopted pursuant to this chapter.
  6 12    3.  The department shall adopt rules pursuant to chapter
  6 13 17A which require that if a health care provider attending a
  6 14 person prior to the person's death determines that the person
  6 15 suffered from or was suspected of suffering from a contagious
  6 16 or infectious disease, the health care provider shall place
  6 17 with the remains written notification of the condition for the
  6 18 information of any person handling the body of the deceased
  6 19 person subsequent to the person's death.  For purposes of this
  6 20 subsection, "contagious or infectious disease" means hepatitis
  6 21 in any form, meningococcal disease, tuberculosis, and any
  6 22 other disease including AIDS or HIV infection, determined to
  6 23 be life-threatening to a person exposed to the disease as
  6 24 established by rules adopted by the department based upon a
  6 25 determination by the state epidemiologist and in accordance
  6 26 with guidelines of the centers for disease control and
  6 27 prevention of the United States department of health and human
  6 28 services.
  6 29    4.  The department, in cooperation with the department of
  6 30 public safety, and persons who represent those who attend dead
  6 31 bodies shall establish for all care providers, including
  6 32 paramedics, ambulance personnel, physicians, nurses, hospital
  6 33 personnel, first responders, peace officers, and fire
  6 34 fighters, who provide care services to a person, and for all
  6 35 persons who attend dead bodies, protocol and procedures for
  7  1 the use of universal precautions to prevent the transmission
  7  2 of contagious and infectious diseases.
  7  3    5.  The department shall coordinate efforts with local
  7  4 health officers to investigate sources of HIV infection and
  7  5 use every appropriate means to prevent the spread of the
  7  6 infection.
  7  7    6.  The department, with the approval of the state board of
  7  8 health, may conduct epidemiological blinded and nonblinded
  7  9 studies to determine the incidence and prevalence of the HIV
  7 10 infection.  Initiation of any new epidemiological studies
  7 11 shall be contingent upon the receipt of funding sufficient to
  7 12 cover all the costs associated with the studies.  The informed
  7 13 consent, reporting, and counseling requirements of this
  7 14 chapter shall not apply to blinded studies.
  7 15    Sec. 7.  NEW SECTION.  141A.3  DUTIES OF THE DEPARTMENT.
  7 16    1.  All federal and state moneys appropriated to the
  7 17 department for AIDS-related activities shall be allocated in
  7 18 accordance with a prioritized schedule developed by rule of
  7 19 the department, and grants shall be awarded to the maximum
  7 20 extent feasible to community-based organizations.
  7 21    2.  The department shall do all of the following:
  7 22    a.  Provide consultation to agencies and organizations
  7 23 regarding appropriate policies for testing, education,
  7 24 confidentiality, and infection control.
  7 25    b.  Conduct health information programs for the public
  7 26 relating to HIV infection, including information about how the
  7 27 infection is transmitted and how transmittal can be prevented.
  7 28 The department shall prepare, for free distribution, printed
  7 29 information relating to HIV infection and prevention.
  7 30    c.  Provide educational programs concerning HIV infection
  7 31 in the workplace.
  7 32    d.  Develop and implement HIV education risk-reduction
  7 33 programs for specific populations at high risk for infection.
  7 34    e.  Provide an informational brochure for patients who
  7 35 provide samples for purposes of performing an HIV test which,
  8  1 at a minimum, shall include a summary of the patient's rights
  8  2 and responsibilities under the law.
  8  3    f.  In cooperation with the department of education,
  8  4 develop and update a medically correct AIDS prevention
  8  5 curriculum for use at the discretion of secondary and middle
  8  6 schools.
  8  7    3.  The department shall, in cooperation with the
  8  8 department of education and other agencies, organizations,
  8  9 coalitions, and local health departments, develop and
  8 10 implement a program of public and professional AIDS-related
  8 11 education.
  8 12    Sec. 8.  NEW SECTION.  141A.4  TESTING AND COUNSELING.
  8 13    1.  HIV testing and counseling shall be offered to the
  8 14 following:
  8 15    a.  All persons seeking treatment for a sexually
  8 16 transmitted disease.
  8 17    b.  All persons seeking treatment for injecting drug abuse
  8 18 or having a history of injecting drug abuse.
  8 19    c.  All persons who consider themselves at risk for the HIV
  8 20 infection.
  8 21    d.  Male and female prostitutes.
  8 22    2.  Pregnant women shall be provided information about HIV
  8 23 prevention, risk reduction, and treatment opportunities to
  8 24 reduce the possible transmission of HIV to a fetus.  Pregnant
  8 25 women who report one or more recognized risk factors for HIV
  8 26 shall be strongly encouraged to undergo HIV-related testing.
  8 27 A pregnant woman who requests testing shall be tested
  8 28 regardless of the absence of risk factors.
  8 29    Sec. 9.  NEW SECTION.  141A.5  PARTNER NOTIFICATION PROGRAM
  8 30 – HIV.
  8 31    1.  The department shall maintain a partner notification
  8 32 program for persons known to have tested positive for the HIV
  8 33 infection.
  8 34    2.  The department shall initiate the program at
  8 35 alternative testing and counseling sites and at sexually
  9  1 transmitted disease clinics.
  9  2    3.  In administering the program, the department shall
  9  3 provide for the following:
  9  4    a.  A person who tests positive for the HIV infection shall
  9  5 receive posttest counseling, during which time the person
  9  6 shall be encouraged to refer for counseling and HIV testing
  9  7 any person with whom the person has had sexual relations or
  9  8 has shared drug injecting equipment.
  9  9    b.  The physician or other health care provider attending
  9 10 the person may provide to the department any relevant
  9 11 information provided by the person regarding any person with
  9 12 whom the tested person has had sexual relations or has shared
  9 13 drug injecting equipment.  The department disease prevention
  9 14 staff shall then conduct partner notification in the same
  9 15 manner as that utilized for sexually transmitted diseases
  9 16 consistent with the provisions of this chapter.
  9 17    c.  Devise a procedure, as a part of the partner
  9 18 notification program, to provide for the notification of an
  9 19 identifiable third party who is a sexual partner of or who
  9 20 shares drug injecting equipment with a person who has tested
  9 21 positive for HIV, by the department or a physician, when all
  9 22 of the following situations exist:
  9 23    (1)  A physician for the infected person is of the good
  9 24 faith opinion that the nature of the continuing contact poses
  9 25 an imminent danger of HIV infection transmission to the third
  9 26 party.
  9 27    (2)  When the physician believes in good faith that the
  9 28 infected person, despite strong encouragement, has not and
  9 29 will not warn the third party and will not participate in the
  9 30 voluntary partner notification program.
  9 31    Notwithstanding subsection 4, the department or a physician
  9 32 may reveal the identity of a person who has tested positive
  9 33 for the HIV infection pursuant to this subsection only to the
  9 34 extent necessary to protect a third party from the direct
  9 35 threat of transmission.  This subsection shall not be
 10  1 interpreted to create a duty to warn third parties of the
 10  2 danger of exposure to HIV through contact with a person who
 10  3 tests positive for the HIV infection.
 10  4    The department shall adopt rules pursuant to chapter 17A to
 10  5 implement this paragraph "c".  The rules shall provide a
 10  6 detailed procedure by which the department or a physician may
 10  7 directly notify an endangered third party.
 10  8    4.  In making contact the department shall not disclose the
 10  9 identity of the person who provided the names of the persons
 10 10 to be contacted and shall protect the confidentiality of
 10 11 persons contacted.
 10 12    5.  The department may delegate its partner notification
 10 13 duties under this section to local health authorities unless
 10 14 the local authority refuses or neglects to conduct the contact
 10 15 tracing program in a manner deemed to be effective by the
 10 16 department.
 10 17    6.  In addition to the provisions for partner notification
 10 18 provided under this section and notwithstanding any provision
 10 19 to the contrary, a county medical examiner or deputy medical
 10 20 examiner performing official duties pursuant to sections
 10 21 331.801 through 331.805 or the state medical examiner or
 10 22 deputy medical examiner performing official duties pursuant to
 10 23 chapter 691, who determines through an investigation that a
 10 24 deceased person was infected with HIV, may notify directly, or
 10 25 request that the department notify, the immediate family of
 10 26 the deceased or any person known to have had a significant
 10 27 exposure from the deceased of the finding.
 10 28    Sec. 10.  NEW SECTION.  141A.6  AIDS-RELATED CONDITIONS –
 10 29 SCREENING, TESTING, AND REPORTING.
 10 30    1.  Prior to obtaining a sample for the purpose of
 10 31 performing a voluntary HIV-related test, a health care
 10 32 provider shall inform the subject of the test that the test is
 10 33 voluntary.  Within seven days of the receipt of a test result
 10 34 indicating HIV infection which has been confirmed as positive
 10 35 according to prevailing medical technology, the physician or
 11  1 other health care provider at whose request the test was
 11  2 performed shall make a report to the department on a form
 11  3 provided by the department.
 11  4    2.  Within seven days of diagnosing a person as having an
 11  5 AIDS-related condition, the diagnosing physician shall make a
 11  6 report to the department on a form provided by the department.
 11  7    3.  Within seven days of the death of a person resulting
 11  8 from an AIDS-related condition, the attending physician shall
 11  9 make a report to the department on a form provided by the
 11 10 department.
 11 11    4.  Within seven days of the receipt of a test result
 11 12 indicating HIV infection which has been confirmed as positive
 11 13 according to prevailing medical technology, the director of a
 11 14 blood bank shall make a report to the department on a form
 11 15 provided by the department.
 11 16    5.  Within seven days of the receipt of a test result
 11 17 indicating HIV infection which has been confirmed as positive
 11 18 according to prevailing medical technology, the director of a
 11 19 clinical laboratory shall make a report to the department on a
 11 20 form provided by the department.
 11 21    6.  The forms provided by the department shall require
 11 22 inclusion of all of the following information:
 11 23    a.  The name of the patient.
 11 24    b.  The address of the patient.
 11 25    c.  The patient's date of birth.
 11 26    d.  The gender of the patient.
 11 27    e.  The race or ethnicity of the patient.
 11 28    f.  The patient's marital status.
 11 29    g.  The patient's telephone number.
 11 30    h.  The name and address of the laboratory or blood bank.
 11 31    i.  The date the test was found to be positive and the
 11 32 collection date.
 11 33    j.  The name of the physician or health care provider who
 11 34 performed the test.
 11 35    k.  If the patient is female, whether the patient is
 12  1 pregnant.
 12  2    Sec. 11.  NEW SECTION.  141A.7  TEST RESULTS – COUNSELING
 12  3 – APPLICATION FOR SERVICES.
 12  4    1.  Prior to undergoing an HIV-related test, information
 12  5 shall be available to the subject of the test concerning
 12  6 testing and any means of obtaining additional information
 12  7 regarding HIV infection and risk reduction.  At any time that
 12  8 the subject of an HIV-related test is informed of confirmed
 12  9 positive test results, counseling concerning the emotional and
 12 10 physical health effects shall be initiated.  Particular
 12 11 attention shall be given to explaining the need for the
 12 12 precautions necessary to avoid transmitting the virus.  The
 12 13 subject shall be given information concerning additional
 12 14 counseling.
 12 15    2.  Notwithstanding subsection 1, the provisions of this
 12 16 section do not apply to any of the following:
 12 17    a.  The performance by a health care provider or health
 12 18 facility of an HIV-related test when the health care provider
 12 19 or health facility procures, processes, distributes, or uses a
 12 20 human body part donated for a purpose specified under the
 12 21 uniform anatomical gift Act, or semen provided prior to July
 12 22 1, 1988, for the purpose of artificial insemination, or
 12 23 donations of blood, and such test is necessary to ensure
 12 24 medical acceptability of such gift or semen for the purposes
 12 25 intended.
 12 26    b.  A person engaged in the business of insurance who is
 12 27 subject to section 505.16.
 12 28    c.  The performance by a health care provider or health
 12 29 facility of an HIV-related test when the subject of the test
 12 30 is deceased and a documented significant exposure has
 12 31 occurred.
 12 32    3.  A person may apply for voluntary treatment,
 12 33 contraceptive services, or screening or treatment for HIV
 12 34 infection and other sexually transmitted diseases directly to
 12 35 a licensed physician and surgeon, an osteopathic physician and
 13  1 surgeon, or a family planning clinic.  Notwithstanding any
 13  2 other provision of law, however, a minor shall be informed
 13  3 prior to testing that, upon confirmation according to
 13  4 prevailing medical technology of a positive HIV-related test
 13  5 result, the minor's legal guardian is required to be informed
 13  6 by the testing facility.  Testing facilities where minors are
 13  7 tested shall have available a program to assist minors and
 13  8 legal guardians with the notification process which emphasizes
 13  9 the need for family support and assists in making available
 13 10 the resources necessary to accomplish that goal.  However, a
 13 11 testing facility which is precluded by federal statute,
 13 12 regulation, or centers for disease control and prevention
 13 13 guidelines from informing the legal guardian is exempt from
 13 14 the notification requirement.  The minor shall give written
 13 15 consent to these procedures and to receive the services,
 13 16 screening, or treatment.  Such consent is not subject to later
 13 17 disaffirmance by reason of minority.
 13 18    Sec. 12.  NEW SECTION.  141A.8  CARE PROVIDER NOTIFICATION.
 13 19    1.  A hospital licensed under chapter 135B shall provide
 13 20 notification to a care provider who renders assistance or
 13 21 treatment to an individual, following submission of a
 13 22 significant exposure report by the care provider to the
 13 23 hospital and a diagnosis or confirmation by an attending
 13 24 physician that the individual has HIV infection, and
 13 25 determination that the exposure reported was a significant
 13 26 exposure.  The notification shall advise the care provider of
 13 27 possible exposure to HIV infection.  Notification shall be
 13 28 made in accordance with both of the following:
 13 29    a.  The hospital informs the individual, when the
 13 30 individual's condition permits, of the submission of a
 13 31 significant exposure report.
 13 32    b.  The individual consents to serological testing by or
 13 33 voluntarily discloses the individual's HIV status to the
 13 34 hospital and consents to notification.
 13 35    Notwithstanding paragraphs "a" and "b", notification shall
 14  1 be made when the individual denies consent for or consent is
 14  2 not reasonably obtainable for serological testing, and in the
 14  3 course of admission, care, and treatment of the individual,
 14  4 the individual is diagnosed or is confirmed as having HIV
 14  5 infection.
 14  6    2.  The hospital shall notify the care provider involved in
 14  7 attending or transporting an individual who submitted a
 14  8 significant exposure report.  This shall include a person who
 14  9 renders direct emergency aid without compensation, or in the
 14 10 case of an emergency care provider, the designated officer of
 14 11 the emergency care provider service, who in turn shall notify
 14 12 any emergency care providers.  The identity of the designated
 14 13 officer shall not be revealed to the individual.  The
 14 14 designated officer shall inform the hospital of those parties
 14 15 who received the notification, and following receipt of this
 14 16 information and upon request of the individual, the hospital
 14 17 shall inform the individual of the parties to whom
 14 18 notification was provided.
 14 19    3.  The hospital, upon request of the individual, shall
 14 20 inform the individual of the persons to whom notification was
 14 21 made.
 14 22    4.  The process for notification under this section shall
 14 23 be initiated as soon as is reasonably possible.
 14 24    5.  A health care provider, with consent of the individual,
 14 25 may provide the notification required of hospitals in this
 14 26 section to care providers if an individual who has HIV
 14 27 infection is delivered by a care provider to the office or
 14 28 clinic of the health care provider for treatment.  The
 14 29 notification shall take place only upon submission of a
 14 30 significant exposure report form by the care provider to the
 14 31 health care provider and the determination by the health care
 14 32 provider that a significant exposure has occurred.
 14 33    6.  This section does not require or permit, unless
 14 34 otherwise provided, a hospital or health care provider to
 14 35 administer a test for the express purpose of determining the
 15  1 presence of HIV infection, except that testing may be
 15  2 performed if the individual consents, and if the requirements
 15  3 of this section are satisfied.
 15  4    7.  When a care provider in the course of providing care
 15  5 sustains a significant exposure on the premises of a health
 15  6 care facility or while engaged in rendering aid or providing
 15  7 transportation to an individual in circumstances which lead to
 15  8 the individual's presence at a health care facility, the
 15  9 individual to whom the care provider was exposed is deemed to
 15 10 consent to a test to be administered by the health care
 15 11 facility upon the written request of the exposed care provider
 15 12 for the express purpose of determining the presence of HIV
 15 13 infection in that individual.  The sample and test results
 15 14 shall only be identified by a number and no reports otherwise
 15 15 required by this chapter shall be made which identify the
 15 16 individual tested.  However, if the test results are positive,
 15 17 the health care facility shall notify the individual tested
 15 18 and ensure performance of counseling and reporting
 15 19 requirements of this chapter in the same manner as for an
 15 20 individual from whom actual consent was obtained.
 15 21    8.  A hospital or health care provider, or other person
 15 22 participating in good faith in making a report under the
 15 23 notification provisions of this section, under procedures
 15 24 similar to this section for notification of its own employees
 15 25 upon filing of a significant exposure report, or in failing to
 15 26 make a report under this section, is immune from any
 15 27 liability, civil or criminal, which might otherwise be
 15 28 incurred or imposed.
 15 29    9.  Notifications made pursuant to this section shall not
 15 30 disclose the identity of the individual who is diagnosed or
 15 31 confirmed as having HIV infection unless the individual
 15 32 provides a specific written release as provided in subsection
 15 33 1, paragraph "b".  If the care provider determines the
 15 34 identity of the individual, the identity of the individual
 15 35 shall be confidential information and shall not be disclosed
 16  1 by the care provider to any other person unless a specific
 16  2 written release is obtained from the individual.
 16  3    10.  A hospital's duty to notify under this section is not
 16  4 continuing but is limited to the diagnosis of HIV infection
 16  5 made in the course of admission, care, and treatment following
 16  6 the rendering of assistance or treatment of the individual
 16  7 with the infection.
 16  8    11.  Notwithstanding subsection 10, if, following discharge
 16  9 or completion of care or treatment, an individual for whom a
 16 10 significant exposure report was submitted but which report did
 16 11 not result in notification, wishes to provide information
 16 12 regarding the individual's HIV infection status to the care
 16 13 provider who submitted the report, the hospital shall provide
 16 14 a procedure for notifying the care provider.
 16 15    12.  The employer of a care provider who submits a report
 16 16 of significant exposure under this section sustained in the
 16 17 course of employment shall pay the costs of HIV testing for
 16 18 the individual and the costs of HIV testing and counseling for
 16 19 the care provider.  However, the department shall pay the
 16 20 costs of HIV testing for the individual and the costs of HIV
 16 21 testing and counseling for a care provider who renders direct
 16 22 aid without compensation.
 16 23    Sec. 13.  NEW SECTION.  141A.9  CONFIDENTIALITY OF
 16 24 INFORMATION.
 16 25    Any information, including reports and records, obtained,
 16 26 submitted, and maintained pursuant to this chapter is strictly
 16 27 confidential medical information.  The information shall not
 16 28 be released, shared with an agency or institution, or made
 16 29 public upon subpoena, search warrant, discovery proceedings,
 16 30 or by any other means except as provided in this chapter.  A
 16 31 person shall not be compelled to disclose the identity of any
 16 32 person upon whom an HIV-related test is performed, or the
 16 33 results of the test in a manner which permits identification
 16 34 of the subject of the test, except to persons entitled to that
 16 35 information under this chapter.  Information shall be made
 17  1 available for release to the following individuals or under
 17  2 the following circumstances:
 17  3    1.  To the subject of the test or the subject's legal
 17  4 guardian subject to the provisions of section 141A.7,
 17  5 subsection 3, when applicable.
 17  6    2.  To any person who secures a written release of test
 17  7 results executed by the subject of the test or the subject's
 17  8 legal guardian.
 17  9    3.  To an authorized agent or employee of a health facility
 17 10 or health care provider, if the health facility or health care
 17 11 provider ordered or participated in the testing or is
 17 12 otherwise authorized to obtain the test results, the agent or
 17 13 employee provides patient care or handles or processes
 17 14 samples, and the agent or employee has a medical need to know
 17 15 such information.
 17 16    4.  To a health care provider providing care to the subject
 17 17 of the test when knowledge of the test results is necessary to
 17 18 provide care or treatment.
 17 19    5.  To the department in accordance with reporting
 17 20 requirements for an HIV-related condition.
 17 21    6.  To a health facility or health care provider which
 17 22 procures, processes, distributes, or uses a human body part
 17 23 from a deceased person with respect to medical information
 17 24 regarding that person, or semen provided prior to July 1,
 17 25 1988, for the purpose of artificial insemination.
 17 26    7.  Release may be made of medical or epidemiological
 17 27 information for statistical purposes in a manner such that no
 17 28 individual person can be identified.
 17 29    8.  Release may be made of medical or epidemiological
 17 30 information to the extent necessary to enforce the provisions
 17 31 of this chapter and related rules concerning the treatment,
 17 32 control, and investigation of HIV infection by public health
 17 33 officials.
 17 34    9.  Release may be made of medical or epidemiological
 17 35 information to medical personnel to the extent necessary to
 18  1 protect the health or life of the named party.
 18  2    10.  Release may be made of test results concerning a
 18  3 patient pursuant to procedures established under section
 18  4 141A.5, subsection 3, paragraph "c".
 18  5    11.  To a person allowed access to a record by a court
 18  6 order which is issued in compliance with the following
 18  7 provisions:
 18  8    a.  A court has found that the person seeking the test
 18  9 results has demonstrated a compelling need for the test
 18 10 results which need cannot be accommodated by other means.  In
 18 11 assessing compelling need, the court shall weigh the need for
 18 12 disclosure against the privacy interest of the test subject
 18 13 and the public interest which may be disserved by disclosure
 18 14 due to its deterrent effect on future testing or due to its
 18 15 effect in leading to discrimination.
 18 16    b.  Pleadings pertaining to disclosure of test results
 18 17 shall substitute a pseudonym for the true name of the subject
 18 18 of the test.  The disclosure to the parties of the subject's
 18 19 true name shall be communicated confidentially in documents
 18 20 not filed with the court.
 18 21    c.  Before granting an order, the court shall provide the
 18 22 person whose test results are in question with notice and a
 18 23 reasonable opportunity to participate in the proceedings if
 18 24 the person is not already a party.
 18 25    d.  Court proceedings as to disclosure of test results
 18 26 shall be conducted in camera unless the subject of the test
 18 27 agrees to a hearing in open court or unless the court
 18 28 determines that a public hearing is necessary to the public
 18 29 interest and the proper administration of justice.
 18 30    e.  Upon the issuance of an order to disclose test results,
 18 31 the court shall impose appropriate safeguards against
 18 32 unauthorized disclosure, which shall specify the persons who
 18 33 may gain access to the information, the purposes for which the
 18 34 information shall be used, and appropriate prohibitions on
 18 35 future disclosure.
 19  1    12.  To an employer, if the test is authorized to be
 19  2 required under any other provision of law.
 19  3    13.  To a convicted or alleged sexual assault offender; the
 19  4 physician or other health care provider who orders the test of
 19  5 a convicted or alleged offender; the victim; the parent,
 19  6 guardian, or custodian of the victim if the victim is a minor;
 19  7 the physician of the victim; the victim counselor or person
 19  8 requested by the victim to provide counseling regarding the
 19  9 HIV-related test and results; the victim's spouse; persons
 19 10 with whom the victim has engaged in vaginal, anal, or oral
 19 11 intercourse subsequent to the sexual assault; members of the
 19 12 victim's family within the third degree of consanguinity; and
 19 13 the county attorney who may use the results as evidence in the
 19 14 prosecution of sexual assault under chapter 915, subchapter
 19 15 IV, or prosecution of the offense of criminal transmission of
 19 16 HIV under chapter 709C.  For the purposes of this paragraph,
 19 17 "victim" means victim as defined section 915.40.
 19 18    14.  To employees of state correctional institutions
 19 19 subject to the jurisdiction of the department of corrections,
 19 20 employees of secure facilities for juveniles subject to the
 19 21 department of human services, and employees of city and county
 19 22 jails, if the employees have direct supervision over inmates
 19 23 of those facilities or institutions in the exercise of the
 19 24 duties prescribed pursuant to section 80.9, subsection 2,
 19 25 paragraph "d".
 19 26    Sec. 14.  NEW SECTION.  141A.10  IMMUNITIES.
 19 27    1.  A person making a report in good faith pursuant to this
 19 28 chapter is immune from any liability, civil or criminal, which
 19 29 might otherwise be incurred or imposed as a result of the
 19 30 report.
 19 31    2.  A health care provider attending a person who tests
 19 32 positive for the HIV infection has no duty to disclose to or
 19 33 to warn third parties of the dangers of exposure to HIV
 19 34 infection through contact with that person and is immune from
 19 35 any liability, civil or criminal, for failure to disclose to
 20  1 or warn third parties of the condition of that person.
 20  2    Sec. 15.  NEW SECTION.  141A.11  REMEDIES.
 20  3    1.  A person aggrieved by a violation of this chapter shall
 20  4 have a right of civil action for damages in district court.
 20  5    2.  A care provider who intentionally or recklessly makes
 20  6 an unauthorized disclosure under this chapter is subject to a
 20  7 civil penalty of one thousand dollars.
 20  8    3.  A person who violates a confidentiality requirement of
 20  9 section 141A.5 is guilty of an aggravated misdemeanor.
 20 10    4.  A civil action under this chapter is barred unless the
 20 11 action is commenced within two years after the cause of action
 20 12 accrues.
 20 13    5.  The attorney general may maintain a civil action to
 20 14 enforce this chapter.
 20 15    6.  This chapter does not limit the rights of the subject
 20 16 of an HIV-related test to recover damages or other relief
 20 17 under any other applicable law.
 20 18    7.  This chapter shall not be construed to impose civil
 20 19 liability or criminal sanction for disclosure of HIV-related
 20 20 test results in accordance with any reporting requirement for
 20 21 a diagnosed case of AIDS or a related condition by the
 20 22 department or the centers for disease control and prevention
 20 23 of the United States public health service.
 20 24    Sec. 16.  Section 321.186, unnumbered paragraph 4, Code
 20 25 1999, is amended to read as follows:
 20 26    A physician licensed under chapter 148, 150, or 150A, or an
 20 27 optometrist licensed under chapter 154, may report to the
 20 28 department the identity of a person who has been diagnosed as
 20 29 having a physical or mental condition which would render the
 20 30 person physically or mentally incompetent to operate a motor
 20 31 vehicle in a safe manner.  The physician or optometrist shall
 20 32 make reasonable efforts to notify the person who is the
 20 33 subject of the report, in writing.  The written notification
 20 34 shall state the nature of the disclosure and the reason for
 20 35 the disclosure.  A physician or optometrist making a report
 21  1 under this section shall be immune from any liability, civil
 21  2 or criminal, which might otherwise be incurred or imposed as a
 21  3 result of the report.  A physician or optometrist has no duty
 21  4 to make a report or to warn third parties with regard to any
 21  5 knowledge concerning a person's mental or physical competency
 21  6 to operate a motor vehicle in a safe manner.  Any report
 21  7 received by the department from a physician or optometrist
 21  8 under this section shall be kept confidential.  Information
 21  9 regulated by chapter 141 141A shall be subject to the
 21 10 confidentiality provisions and remedies of sections 141.23 and
 21 11 141.24 that chapter.
 21 12    Sec. 17.  Section 505.16, subsection 1, Code 1999, is
 21 13 amended to read as follows:
 21 14    1.  A person engaged in the business of insurance shall not
 21 15 require a test of an individual in connection with an
 21 16 application for insurance for the presence of an antibody to
 21 17 the human immunodeficiency virus unless the individual
 21 18 provides a written release on a form approved by the insurance
 21 19 commissioner.  The form shall include information regarding
 21 20 the purpose, content, use, and meaning of the test, disclosure
 21 21 of test results including information explaining the effect of
 21 22 releasing the information to a person engaged in the business
 21 23 of insurance, the purpose for which the test results may be
 21 24 used, and other information approved by the insurance
 21 25 commissioner.  The form shall also authorize the person
 21 26 performing the test to provide the results of the test to the
 21 27 insurance company subject to rules of confidentiality,
 21 28 consistent with section 141.23 141A.9, approved by the
 21 29 insurance commissioner.  As used in this section, "a person
 21 30 engaged in the business of insurance" includes hospital
 21 31 service corporations organized under chapter 514 and health
 21 32 maintenance organizations subject to chapter 514B.
 21 33    Sec. 18.  Section 904.515, Code 1999, is amended to read as
 21 34 follows:
 21 35    904.515  HUMAN IMMUNODEFICIENCY VIRUS-RELATED MATTERS –
 22  1 EXEMPTION.
 22  2    The provisions of chapter 141 141A relating to knowledge
 22  3 and consent do not apply to persons committed to the custody
 22  4 of the department.  The department may provide for medically
 22  5 acceptable procedures to inform employees, visitors, and
 22  6 persons committed to the department of possible infection and
 22  7 to protect them from possible infection.
 22  8    Sec. 19.  Section 915.40, subsection 3, paragraph c, Code
 22  9 1999, is amended to read as follows:
 22 10    c.  The victim counselor or person requested by the victim
 22 11 who is authorized to provide the counseling required pursuant
 22 12 to section 141.22 regarding the HIV-related test and results.
 22 13    Sec. 20.  Section 915.42, subsection 4, paragraph a, Code
 22 14 1999, is amended to read as follows:
 22 15    a.  Prior to the scheduling of a hearing, refer the victim
 22 16 for counseling by a victim counselor or a person requested by
 22 17 the victim who is authorized to provide the counseling
 22 18 required pursuant to section 141.22, regarding the nature,
 22 19 reliability, and significance of the HIV-related test and of
 22 20 the serologic status of the convicted offender.
 22 21    Sec. 21.  Section 915.43, subsections 1, 2, 4, and 5, Code
 22 22 1999, are amended to read as follows:
 22 23    1.  The physician or other practitioner who orders the test
 22 24 of a convicted or alleged offender for HIV under this
 22 25 subchapter shall disclose the results of the test to the
 22 26 convicted or alleged offender, and to the victim counselor or
 22 27 a person requested by the victim who is authorized to provide
 22 28 the counseling required pursuant to section 141.22, regarding
 22 29 the HIV-related test and results who shall disclose the
 22 30 results to the petitioner.
 22 31    2.  All testing under this chapter shall be accompanied by
 22 32 pretest and posttest counseling as required under section
 22 33 141.22 141A.7.
 22 34    4.  Results of a test performed under this subchapter,
 22 35 except as provided in subsection 13, shall be disclosed only
 23  1 to the physician or other practitioner who orders the test of
 23  2 the convicted or alleged offender, the convicted or alleged
 23  3 offender, the victim, the victim counselor or person requested
 23  4 by the victim who is authorized to provide the counseling
 23  5 required pursuant to section 141.22 regarding the HIV-related
 23  6 test and results, the physician of the victim if requested by
 23  7 the victim, the parent, guardian, or custodian of the victim,
 23  8 if the victim is a minor, and the county attorney who filed
 23  9 the petition for HIV-related testing under this chapter, who
 23 10 may use the results to file charges of criminal transmission
 23 11 of HIV under chapter 709C.  Results of a test performed under
 23 12 this subchapter shall not be disclosed to any other person
 23 13 without the written informed consent of the convicted or
 23 14 alleged offender.  A person to whom the results of a test have
 23 15 been disclosed under this subchapter is subject to the
 23 16 confidentiality provisions of section 141.23 141A.9, and shall
 23 17 not disclose the results to another person except as
 23 18 authorized by section 141.23, subsection 1 141A.9, subsection
 23 19 13.
 23 20    5.  If testing is ordered under this subchapter, the court
 23 21 shall also order periodic testing of the convicted offender
 23 22 during the period of incarceration, probation, or parole or of
 23 23 the alleged offender during a period of six months following
 23 24 the initial test if the physician or other practitioner who
 23 25 ordered the initial test of the convicted or alleged offender
 23 26 certifies that, based upon prevailing scientific opinion
 23 27 regarding the maximum period during which the results of an
 23 28 HIV-related test may be negative for a person after being HIV-
 23 29 infected, additional testing is necessary to determine whether
 23 30 the convicted or alleged offender was HIV-infected at the time
 23 31 the sexual assault or alleged sexual assault was perpetrated.
 23 32 The results of the test conducted pursuant to this subsection
 23 33 shall be released only to the physician or other practitioner
 23 34 who orders the test of the convicted or alleged offender, the
 23 35 convicted or alleged offender, the victim counselor or person
 24  1 requested by the victim who is authorized to provide the
 24  2 counseling required pursuant to section 141.22, regarding the
 24  3 HIV-related test and results who shall disclose the results to
 24  4 the petitioner, the physician of the victim, if requested by
 24  5 the victim, and the county attorney who may use the results as
 24  6 evidence in the prosecution of the sexual assault or in the
 24  7 prosecution of the offense of criminal transmission of HIV
 24  8 under chapter 709C.
 24  9    Sec. 22.  Chapter 141, Code 1999, is repealed.  
 24 10 
 24 11 
 24 12                                                             
 24 13                               MARY E. KRAMER
 24 14                               President of the Senate
 24 15 
 24 16 
 24 17                                                             
 24 18                               RON J. CORBETT
 24 19                               Speaker of the House
 24 20 
 24 21    I hereby certify that this bill originated in the Senate and
 24 22 is known as Senate File 248, Seventy-eighth General Assembly.
 24 23 
 24 24 
 24 25                                                             
 24 26                               MICHAEL E. MARSHALL
 24 27                               Secretary of the Senate
 24 28 Approved                , 1999
 24 29 
 24 30 
 24 31                               
 24 32 THOMAS J. VILSACK
 24 33 Governor
     
Text: SF00247                           Text: SF00249
Text: SF00200 - SF00299                 Text: SF Index
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