It is enacted by the General Assembly as follows:

SECTION 1. Sections 23-6-10, 23-6-11, 23-6-12, 23-6-13, 23-6-14, 23-6-15, 23-6-17, 23-6-18, 23-6-20, 23-6-22, 23-6-23 and 23-6-24 of the General Laws in Chapter 23-6 entitled "Prevention and Suppression of Contagious Diseases" are hereby amended to read as follows:

23-6-10. Purpose -- The purpose of sections 23-6-10 through 23-6-24 is to protect the public against transmission of the AIDS virus Human Immunodeficiency Virus (HIV), and to protect persons who are infected with the AIDS virus HIV from discrimination.

23-6-11. Definitions -- As used in sections 23-6-10 through 23-6-24:

(1) "AIDS" means the medical condition known as acquired immune deficiency syndrome, caused by infection of an individual by the human immunodeficiency virus (HIV).

(2) "AIDS HIV test" means any currently medically accepted diagnostic test for determining infection of an individual by the AIDS virus (HIV) HIV.

(3) "AIDS testing and notification form" "HIV Informed Consent Form" means a standardized form provided by the Rhode Island department of health. The form shall be developed by the department and shall contain the following information:

(i) The public health rationale for AIDS HIV testing;

(ii) The availability and cost of AIDS HIV testing and counseling;

(iii) That test results are confidential with certain exceptions;

(iv) A list of exceptions to confidentiality of test results;

(v) That the test is voluntary and that an informed consent form must be signed before testing;

(vi) That by signing this form the person is only acknowledging that the AIDS test and counseling have been offered.

(4) "Exposure evaluation group" means three (3) impartial health care providers designated to determine if a health care provider has been involved in a significant exposure. No member of the group shall be directly involved in the exposure.

(i) For inpatient services in a licensed health care facility hospital setting the group shall consist of the patient's attending physician or designee, the chief of service or designee and a staff nurse. For other non-inpatient exposures in a licensed health care facility, the third member of the exposure evaluation group shall be a representative from the employee health office. If the exposure involves the attending physician, another physician shall be designated by the chief of service.

(ii) In any other licensed health care facility or in a private office of a physician the group shall consist of three (3) physicians.

(5) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association., state or political subdivision or instrumentality of a state.

(6) "Physician" means a person licensed to practice allopathic or osteopathic medicine pursuant to the provisions of chapter 37 of title 5.

(7) "Services" means health care and social support services.

23-6-12. Testing -- Requirement for informed consent -- Unless otherwise excepted by the provisions of this chapter, no person may be tested for presence of the AIDS virus HIV, where the test result can be identified with a specific individual, unless he or she has given his or her informed consent by his or her signature or that of a parent, guardian, or agent on a written informed consent form specifically relating to such test after discussion of implications of the test with a qualified professional.

23-6-13. Informed consent form -- The written informed consent form shall include at least the following:

(1) The name and signature of the party(s) seeking and consenting to the AIDS HIV test;

(2) The name and nature of the test;

(3) The reasons for conducting the test;

(4) The fact that the test results shall remain confidential except as required by law; and

(5) Explanation of how test results will affect the tested person's ability to obtain services from the party requesting the test, or those for whom he or she is acting.

23-6-14. Exceptions -- Notwithstanding the provisions of sections 23-6-12 and 23-6-13, a physician or other health care provider may draw blood and secure a test for the presence of the AIDS virus HIV without informed consent under the following conditions:

(1) When the person to be tested is under one year of age;

(2) When the person to be tested is between one and thirteen (13) years of age and appears to be symptomatic for AIDS HIV;

(3) When the person to be tested is a minor under the care and authority of the department of children, youth, and families, and the director of that department certifies that an AIDS HIV test is necessary to secure health or human services for that person;

(4) When a person (the complainant) can document significant exposure to blood or other bodily fluids of another person (the individual to be tested), during performance of the complainant's occupation, providing:

(i) The complainant completes an incident report within forty-eight (48) hours of the exposure, identifying the parties to the exposure, witnesses, time, place, and nature of the event;

(ii) The complainant submits to a baseline AIDS HIV test and is negative on that test for the presence of the AIDS virus HIV, within seventy-two (72) hours of the exposure; and

(iii) There has been a significant percutaneous or mucus membrane exposure, i.e., needlestick; bite; splash over open wound, broken skin, or mucus membrane; by blood or bodily fluids of the person to be tested; of a type and in sufficient concentration to permit transmission of the AIDS virus HIV, if present in those fluids.

(5) In a licensed health care facility or in the private office of a physician in the event that an exposure evaluation group, as defined above, determines that a health care provider has a significant exposure to the blood and/or body fluids of a patient and the patient or the patient's guardian refuses to grant informed consent for an HIV test to determine whether the patient has the AIDS virus HIV, then, if a sample of the patient's blood is available, that blood shall be tested for the AIDS virus HIV:

(i) If a sample of the patient's blood is not otherwise available and the patient refuses to grant informed consent, then the health care worker may petition the superior court for a court order mandating that the test be performed.

(ii) Before a patient or a sample of the patient's blood is required to undergo an HIV test, the health care provider must submit to a baseline AIDS HIV test within seventy-two (72) hours of the exposure.

(iii) No member of the exposure evaluation group who determines that a health care worker has sustained a significant exposure and authorizes the HIV testing of a patient nor any person or health care facility who relies, in good faith, on the group's determination and performs the test shall have any liability as a result of their actions carried out under this chapter, unless those persons act in bad faith.

(6) In an emergency, where due to a grave medical or psychiatric condition, it is impossible to obtain consent from either the patient or the patient's parent, guardian, or agent.

(7) As permitted under sections 23-18.6-12, and 23-1-38 and 23-8-1.1.

(8) Mandatory testing for human immunodeficiency virus (HIV) conducted pursuant to sections 42-56-37, 11-34-10, and 21-28-4.20.

23-6-15. Reasonable effort to secure consent -- No involuntary testing for the AIDS virus HIV shall take place under any of the exceptions set forth in section 23-6-14 until reasonable efforts have been made to secure voluntary informed consent.

23-6-17. Confidentiality -- Disclosure of test results -- It shall be unlawful for any person to disclose to a third party the results of an individual's AIDS HIV test without the prior written consent of that individual, or in the case of a minor, the minor's parent, guardian, or agent on a form that specifically states that HIV test results may be released, except:

(1) A licensed laboratory or other health care facility which performs AIDS HIV tests shall report test results to a patient's licensed physician or other medical personnel who requested the test; and to the director of the department of health, pursuant to rules and regulations adopted for that purpose.

(2) A physician:

(i) May enter AIDS HIV test results in the medical record, as would be the case with any other diagnostic test;

(ii) May notify other health professionals directly involved in care of the individual testing positive on the AIDS HIV test, or to whom that individual is referred for treatment;

(iii) May notify persons exposed to blood or other body fluids of an individual who tests positive for AIDS HIV, pursuant to section 23-6-14(4) through (8) and section 23-17-31;

(iv) May notify the director of the department of children, youth, and families, pursuant to section 23-6-14(3); and

(v) May inform third parties with whom an AIDS-infected HIV-infected patient is in close and continuous contact, including but not limited to a spouse; if the nature of the contact, in the physician's opinion, poses a clear and present danger of AIDS HIV transmission to the third party; and if the physician has reason to believe that the patient, despite the physician's strong encouragement, has not and will not warn the third party, the procedure to be followed by the physician shall be established by the director of the department of health;

(3) As permitted in subsections (b)(1), (2), (5), (6), (8), (9), (10), (11), (12), (13), (14), and (15) of section 5-37.3-4 of the Confidentiality of Health Care Information Act, and section 40.1-5-26 of the Mental Health Law or as otherwise required by law.

(4) By a health care provider to appropriate persons entitled to receive notification of persons with infectious or communicable diseases pursuant to sections 23-5-9 and 23-28.36-3.

23-6-18. Protection of records -- Providers of health care, public health officials, and any other person who maintains records containing information on AIDS HIV test results of individuals shall be responsible for maintaining full confidentiality of these data, as provided in section 23-6-17, and shall take appropriate steps for their protection, including:

(1) Keeping records secure at all times and establishing adequate confidentiality safeguards for any such records electronically stored;

(2) Establishing and enforcing reasonable rules limiting access to these records; and

(3) Training persons who handle records in security objectives and technique.

23-6-20. Notification of disclosure -- In all cases when an individual's AIDS HIV test results are disclosed to a third party, other than a person involved in the care and treatment of the individual, and except as permitted in subsections (1), (2)(i), (2)(ii), (2)(iv), and (4) of section 23-6-17, the person so disclosing shall make reasonable efforts to inform that individual in advance of:

(1) The nature and purpose of the disclosure;

(2) The date of disclosure;

(3) The recipient of the disclosed information.

23-6-22. Discrimination prohibited -- No person, agency, organization, or corporate body may discriminate against a person on the basis of a positive AIDS HIV test result, or perception of same, in housing, employment, the granting of credit, public accommodation, or delivery of services, nor shall an AIDS HIV test be required as a condition of employment, except where nondiscrimination can be shown, on the testimony of competent medical authorities, to constitute a clear and present danger of AIDS virus HIV transmission to others.

23-6-23. Administrative relief -- Any person who believes that he or she has been unlawfully discriminated against in housing, employment, the granting of credit, public accommodations or delivery of services on the basis of a positive AIDS HIV test, or perception of same, may bring action for administrative relief before the Rhode Island human rights commission; and that commission may hear the matter and grant relief in such cases.

23-6-24. Insurance exemption -- (a) Life insurance.. - Sections 23-6-10 through 23-6-23 shall not apply to the offering or sale of life insurance in Rhode Island; provided, however, that any insurance company offering or selling life insurance within Rhode Island that requires an individual to be tested for infection with human immunodeficiency virus (HIV) or any other identified causative agent of AIDS HIV for purposes of determining insurability shall: (1) give that individual prior written notice of those requirements, and (2) proceed with that testing only upon the written authorization of the individual or in the event the individual is a minor, the individual's parent or guardian. Notwithstanding anything in sections 23-6-10 through 23-6-23 to the contrary, life insurance companies offering or selling life insurance in Rhode Island may otherwise obtain or disclose HIV test results in accordance with section 23-6-17(3). Nothing herein shall prohibit that company from collecting data for statistical purposes, so long as the insured is not identified. However, nothing herein shall be construed to permit that insurance company to cancel or refuse to renew a life insurance policy which by its terms has not lapsed on the basis of a positive AIDS HIV test result.

(b) Health benefits.. - (1) Health benefits shall include accident and sickness, including disability or health insurance, health benefit plans and/or policies, hospital, health, or medical service plans, or any health maintenance organization plan pursuant to title 27 or otherwise; the provisions of sections 23-6-10 through 23-6-23 shall apply to the offer or sale of health benefits in this state by any company regulated under the laws of this state, including, but not limited to, title 27 and chapter 62 of title 42 provided, however, sections 23-6-10 through 23-6-23 shall not apply to the following:

(i) Individual health benefit policies;

(ii) Small group health benefits plans, i.e., groups having fewer than twenty-five (25) employees eligible to participate in an employer sponsored plan, or, in the case of non-employer groups, a group having fewer than twenty-five (25) employees;

(iii) Late entrants into any group health benefits plan, regardless of the size of the group. A late entrant shall be defined as any individual who does not enroll into a health plan when first eligible thereunder but who later seeks coverage under the group plan;

(iv) Where an individual seeks to become eligible for an amount of group disability income benefit, which benefit would be in excess of the insurer's non-medical maximum as defined under the group plan.

(2) Any such company offering or selling health benefits in this state and regulated under the laws of this state that requires an individual to be tested for infection with HIV or any other identified causative agent of AIDS HIV as permitted in (i) to (iv) above for purposes of determining insurability shall: (i) give that individual prior written notice of those requirements, and (ii) proceed with that testing only upon the written authorization of the individual or in the event the individual is a minor, the individual's parent or guardian. Notwithstanding anything in this chapter to the contrary, companies offering or selling health benefits in this state may otherwise obtain or disclose HIV test results in accordance with section 23-6-17(c). Nothing herein shall prohibit that company from collecting data for statistical purposes so long as the insured's name is not identified.

(3) Nothing herein shall be construed to permit any company which offers or sells health benefits in this state to cancel or refuse to renew a health benefit, which has not by its terms lapsed, on the basis of a positive AIDS HIV test result.

(c) (1) There is hereby established a commission to develop and recommend to the legislature a risk pool plan under which all insurers issuing health insurance in the state shall participate and share a proportion of the risk and cost of insuring people with AIDS HIV.

(2) The commission shall consist of eleven (11) members; three (3) of whom shall be members of the house of representatives, not more than two (2) from the same political party, to be appointed by the speaker of the house; two (2) of whom shall be members of the senate, not more than one of whom shall be from the same political party, to be appointed by the majority leader; one of whom shall be the director of the department of health, or his or her designee; one of whom shall be the director of the department of business regulation, or his or her designee; two (2) of whom shall be representatives of the insurance community, to be appointed by the governor; and two (2) of whom shall be representatives of AIDS Project Rhode Island, project AIDS, to be appointed by the governor.

(3) The commission shall meet at the call of the speaker, and shall make its report to the legislature on or before February 1, 1989.

SECTION 2. Section 23-11-17 of the General Laws in Chapter 23-11 entitled "Sexually Transmitted Diseases" is hereby amended to read as follows:

23-11-17. Human immunodeficiency virus (HIV) testing -- (a) The physician or health care provider attending any person for a suspected sexually transmitted disease shall offer testing for human immunodeficiency virus (HIV). All testing pursuant to this section shall be performed in accordance with sections 23-6-17 and 23-6-18. The identity of the individuals tested under this section shall be maintained only at the site where the sample is drawn, and shall not be released except as otherwise provided by statute.

(b) Each person who is offered such a test and counseling shall be provided with an "AIDS testing and notification form" "Informed Consent Form" which he or she shall sign and date in acknowledgment of the offer. The department of health shall be responsible for costs associated with performing and reporting the results of the HIV tests, including the reasonable costs of pretest and post-test counseling. Such reasonable costs shall be negotiated and specified by contract.

(c) All persons tested under this section shall be provided pretest and post-test counseling in accordance with regulations adopted by the department of health; provided, however, that the counseling shall be in accordance with acceptable medical standards.

SECTION 3. Section 23-13-19 of the General Laws in Chapter 23-13 entitled "Maternal and Child Health Services for Children with Special Health Care Needs" is hereby amended to read as follows:

23-13-19. Human immunodeficiency virus (HIV) testing -- (a) Every physician or health care provider attending any person for prenatal care or family planning services shall offer testing for human immunodeficiency virus (HIV) unless deemed inappropriate by the physician. All testing pursuant to this section shall be performed in accordance with sections 23-6-12 and 23-6-13. The identity of the individuals tested under this section shall be maintained only at the site where the sample is drawn and shall not be released except as otherwise provided by statute. Each person who is offered such a test and counseling shall be provided with an "AIDS testing and notification form" "Informed Consent Form" which he or she shall sign and date in acknowledgment of that offer. The department of health shall be responsible for reasonable costs associated with performing and reporting the results of the HIV tests including the reasonable costs of pretest and post-test counseling. Such reasonable costs shall be negotiated and specified by contract.

(b) All persons tested under this section shall be provided pretest and post-test counseling in accordance with regulations adopted by the department of health; provided, however, that the counseling shall be in accordance with acceptable medical standards.

SECTION 4. Section 23-17-31 of the General Laws in Chapter 23-17 entitled "Licensing of Health Care Facilities" is hereby amended to read as follows:

23-17-31. Human immunodeficiency virus (HIV) testing -- Hospitals -- (a) Hospital patients in any hospital licensed under this chapter shall be offered testing for human immunodeficiency virus (HIV) unless excluded by regulations developed by the department of health, or unless the test is deemed inappropriate by a physician caring for the patient and so noted in the person's medical record. All testing pursuant to this section shall be performed in accordance with sections 23-6-12 and 23-6-13. The identity of the individuals tested under this section shall be maintained only at the hospital site where the sample is drawn, and shall not be released except as provided by statute. Each person who is offered such a test and counseling shall be provided with an "AIDS Testing and Notification Form" "Informed Consent Form" which he or she shall sign and date in acknowledgment of the offer.

(b) The department of health shall be responsible for reasonable costs associated with performing and reporting the results of the HIV tests.

(c) All persons tested under this section shall be provided pretest and post-test counseling, and the department of health shall define in regulation the nature and scope of the counseling; provided, however, that the counseling shall be in accordance with acceptable medical standards.

(d) The department of health will either provide or pay for all pretest and post-test counseling. It will negotiate with the hospitals concerning incremental costs associated with pretest and post-test counseling and will provide reasonable reimbursement of these costs or provide the services themselves in the case of post-test counseling.

SECTION 5. Section 40.1-24-20 of the General Laws in Chapter 40.1-24 entitled "Licensing of Facilities and Programs for People who are Mentally Ill and/or Mentally Retarded" is hereby amended to read as follows:

40.1-24-20. Human immunodeficiency virus (HIV) testing -- Facilities for drug abusers -- (a) Every physician or health care provider attending any person for any service offered at a facility for intravenous drug users, shall offer testing for human immunodeficiency virus (HIV) unless deemed inappropriate by the physician. All testing pursuant to this section shall be performed in accordance with sections 23-6-17 and 23-6-18, except where federal confidentiality laws may supercede. The identity of the individuals tested under this section shall be maintained only at the site where the sample is drawn, and shall not be released except as otherwise provided by statute.

(b) Each person who is offered a test and counseling shall be provided with an "AIDS testing and notification form" "Informed Consent Form" which he or she shall sign and date in acknowledgment of the offer.

(c) The department of health shall be responsible for reasonable costs associated with performing and reporting the results of the HIV tests, including the costs of pretest and post test counseling. The reasonable costs shall be negotiated and specified by contract.

(d) All persons tested under this section shall be provided pretest and post test counseling in accordance with regulations adopted by the department of health; provided, however, that the counseling shall be in accordance with acceptable medical standards.

SECTION 6. Section 42-56-37 of the General Laws in Chapter 42-56 entitled "Corrections Department" is hereby amended to read as follows:

42-56-37. Human Immunodeficiency Virus (HIV) testing -- (a) Every person who shall be committed to the adult correctional institution to answer for any criminal offense, after conviction, shall be required to be tested for Human Immunodeficiency Virus (HIV). No consent for this test shall be required from the person being tested, nor shall this test be subject to waiver. In addition, periodic testing for Human Immunodeficiency Virus (HIV) HIV, including testing at the time of release and when deemed appropriate by a physician, shall be required. No consent on the part of the person being tested shall be required.

(b) All inmates shall be provided appropriate pretest and post-test counseling in accordance with accepted medical standards. Inmates who develop AIDS or AIDS related complex shall be entitled to all reasonable medical treatment available for their illness. No inmate shall be punished, segregated or denied recreation privileges solely on the basis of a positive test result. However, the health care services division of the department of corrections shall, not later than September 1, 1998, adopt and put into effect reasonable rules and steps to protect the confidentiality of the HIV test results, in accordance with Section 23-6-17 and to prevent persons testing positive for Human Immunodeficiency Virus (HIV) HIV from infecting other inmates and/or correctional staff. If any person, including any member of the correctional staff at the State department of corrections, is assaulted or comes into contact with bodily fluid from an inmate or detainee, a department of corrections physician will incorporate accepted medical standards and determine whether the incident places the exposed person at risk for HIV or any other blood borne disease. This may involve drawing a serum sample on the source inmate or detainee in accordance with section23-6-14 and performing tests to determine the presence of blood borne infections such as HIV or hepatitis virus. The physician will immediately inform the exposed person of the medical assessment of risk, which will take into account the serostatus of the source inmate or detainee, and will provide for emergency medical care, according to accepted medical standards.

(c) The department of corrections shall institute a comprehensive AIDS HIV education and drug treatment program for inmates and staff at all of its facilities. The educational program for correctional staff shall be inservice, fully reimbursable to the employee, and mandatory and shall be given periodically in collaboration with the department of health. The department of corrections shall make easily accessible personal protective equipment for correctional personnel to be used in the event of administering cardiac or respiratory resuscitation.

SECTION 7. This act shall take effect upon passage.