Chapter 599
2006 -- H 7773 SUBSTITUTE A AS AMENDED
Enacted 07/14/06
A N A C T
RELATING
TO CRIMINAL OFFENSES
Introduced
By: Representatives Handy, Gallison, and Ehrhardt
Date
Introduced: February 28, 2006
It is enacted by the General Assembly as
follows:
SECTION 1. Section
11-34-10 of the General Laws in Chapter 11-34 entitled
"Prostitution and Lewdness" is hereby
amended to read as follows:
11-34-10.
Human Immunodeficiency Virus (HIV). -- (a) Any person convicted of a
violation of any provisions of this chapter
shall be required to be tested for Human
Immunodeficiency Virus (HIV). No consent for the
testing shall be required.
(b) 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 department of health shall
maintain sites for providing both anonymous and
confidential HIV testing, and HIV counseling and
referral. Each site, funded by the department of
health, shall offer free testing, counseling and
referral for indigent parties and other individuals
without health insurance, offer a sliding scale
for payment for all other individuals and, in the
case of confidential testing, screen for ability
to pay through a third-party insurer. In the case of
nonfunded sites for HIV testing, organizations
and/or institutions performing the test shall offer
free testing, counseling and referral for
indigent parties and other individuals without health
insurance.
(c) All persons
tested under this section shall be provided pretest pre-test and
post-test
counseling by individuals trained by the
department of health, as an HIV testing counselor, in
accordance with regulations adopted promulgated
by the department of health; provided, that the
counseling shall be in accordance with
acceptable medical standards.
(d) All persons
who are tested under this section, who are determined to be intravenous
drug abusers, injecting drug users, shall be
referred to appropriate sources of drug substance
abuse treatment by the department of health HIV
testing counselor and/or the attending
practitioner as follows:
(1) Those persons
who test positive for HIV infection shall be given priority for those
outpatient substance abuse treatment
programs which that are sponsored or supported by the
department of health. appropriate state
agency responsible for these services.
(2) Those persons
who are injecting drug users and test negative for HIV infection shall
be referred, by the HIV testing counselor
and/or attending practitioner, to the appropriate division
state agency responsible for these services in the department of
health for earliest possible
evaluation and treatment.
SECTION 2. Section
21-28-4.20 of the General Laws in Chapter 21-28 entitled "Uniform
Controlled Substances Act" is hereby
amended to read as follows:
21-28-4.20.
Human Immunodeficiency Virus (HIV) -- Testing. -- (a) Any person
convicted of possession of any controlled
substance that has been administered with a
hypodermic instrument associated with
intravenous drug use, retractable hypodermic syringe,
needle, or any similar instrument adapted for
the administration of drugs shall be required to be
tested for human immunodeficiency virus (HIV).
No consent for the testing shall be required.
(b) 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 pre-test and post-test
counseling. The department of health shall
maintain sites for providing both anonymous and
confidential HIV testing, and HIV counseling and
referral. Each site, funded by the department of
health, shall offer free testing, counseling and
referral for indigent parties and other individuals
without health insurance, offer a sliding scale
for payment for all other individuals and, in the
case of confidential testing, screen for ability
to pay through a third-party insurer. In the case of
nonfunded sites for HIV testing, organizations
and/or institutions performing the test shall offer
free testing, counseling and referral for
indigent parties and other individuals without health
insurance.
(c) All persons
tested under this section shall be provided pre-test and post-test
counseling by individuals trained by the
department of health in accordance with regulations
adopted promulgated by the department of health;
provided, that this counseling shall be in
accordance with acceptable medical standards.
(d) All persons
who are tested under this section, who are determined to be intravenous
drug abusers, convicted of possession of any
controlled substance that has been administered with
a hypodermic instrument, retractable hypodermic
syringe, needle, or any similar instrument
adopted for the administration of drugs shall be referred by
the HIV testing counselor and/or
attending practitioner to appropriate sources
of drug treatment by the department of health as
follows:
(1) Those persons
who test positive for HIV infection shall be given priority for those
outpatient treatment programs which are sponsored
or supported by the department of health a
state agency;
(2) Those persons
who test negative for HIV infection shall be referred to the appropriate
division in the department of health for
earliest possible evaluation and treatment.
SECTION 3.
Sections 23-6-11, 23-6-12, 23-6-14, 23-6-17, 23-6-18, 23-6-20, 23-6-25 and
23-6-26 of the General Laws in Chapter 23-6
entitled "Prevention and Suppression of Contagious
Diseases" are hereby amended to read as
follows:
23-6-11.
Definitions. -- As used in sections 23-6-10 -- 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) (i)
"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.
(ii) 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.
(iii) In any
other licensed health care facility or in a private office of a physician the
group shall consist of three (3) physicians.
(3) (2)
"HIV" means the human immunodeficiency virus, the pathogenic organism
responsible for the acquired immunodeficiency
syndrome (AIDS).
(4) (3)
"HIV informed "Informed consent form" means a standardized
form provided by
the Rhode Island department of health to
those individuals offered HIV testing. The form shall be
developed by the department and shall contain
the following information:
(i) The public
health rationale for HIV testing and information describing the nature of
the HIV disease;
(ii) The
availability and cost of 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 HIV
test
and counseling have been offered and/or that
he or she has declined (opted-out) the offer to be
tested. ; and
(vii)
Notwithstanding the provisions of subsections (v) and (vi) above, in the event
an
individual consents to anonymous testing, the
HIV testing counselor and/or attending practitioner
ordering the test shall receive only verbal
confirmation from the client that the client understands
all applicable information contained within the
informed consent form.
(5) (4)
"HIV test" means any currently medically accepted diagnostic test for
determining infection of an individual by HIV.
(6) (5)
"Person" means any individual, firm, partnership, corporation,
company,
association, or joint stock association, state
or political subdivision or instrumentality of a state.
(7) (6)
"Physician" means a person licensed to practice allopathic or
osteopathic
medicine pursuant to the provisions of chapter
37 of title 5.
(8) (7)
"Services" means health care and social support services.
(8)
"Occupational health representative" is an individual, within a
health care facility,
trained to respond to occupational, particularly
blood borne, exposures.
23-6-12.
Testing. – (a) Recommendations regarding HIV testing shall reference
the most
current guidelines issued by the Centers for
Disease Control and Prevention (CDC) pertaining to
HIV Counseling, Testing and Referral of Adults,
Adolescents and Pregnant Women; provided,
however, those guidelines shall be interpreted
by the department of health so as to best serve the
clients and patients seeking HIV testing, and
shall in no event be interpreted or implemented in a
manner inconsistent with the minimum informed
consent standards of this Title or other
protections of state law. The recommendations shall
emphasize that: (1) HIV screening is
recommended in all health care settings, after
the patient is informed, in accordance with this
chapter's informed consent standards, that HIV
testing will be done unless the patient declines;
(2) persons at high- risk for HIV infection
should be screened for HIV at least annually, in
accordance with this chapter's informed consent
standards; and (3) only verbal informed consent
is required for anonymous testing.
(b) Unless
otherwise excepted by the provisions of this chapter, no person may be tested
for the presence of 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 the test after discussion of
implications of the test with a qualified
professional. A physician or health care provider
attending to any person who may be at risk for
HIV infection shall routinely offer the HIV test to
those patients. All testing pursuant to this
section shall be performed in accordance with sections
23-6-17 (confidentiality) and 23-6-18
(protection of the medical record) and this chapter's
informed consent standards.
(c) In the
event an individual consents to anonymous testing and tests positive for HIV,
the HIV testing counselor shall discuss with the
client options regarding referrals and reporting of
this positive screening, including the necessity
of accessing a physician.
(d) In addition
to, and separate from, the requirement of subdivision 23-6-26(b)(4), all
HIV CD4 T-lymphocyte test results and all HIV
viral load detection test results, detectable and
nondetectable, shall be reported to the department
of health through a department designed
reporting system that uses a nonname based code
and contains no patient identifying information.
These reports may be used by the department to
improve the clinical progress of patients through
contact with their physicians, and to use the
aggregate information collected to develop and
improve prevention programs and create better
access to care.
23-6-14.
Exceptions. -- Notwithstanding the provisions of sections 23-6-12
and 23-6-13,
a A physician or other health care
provider may draw blood and secure a test sample for the
presence of 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 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
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 the 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 HIV test and is negative on that test for the
presence of 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
HIV if present in those fluids. ; and
(iv) If a
sample of the patient's blood is not otherwise available and the patient
refuses to
grant informed consent, then the complainant may
petition the superior court for a court order
mandating that the test be performed.
(5) (i) In a
licensed health care facility or in the private office of a physician in the
event
that an occupational health representative or
physician, registered nurse practitioner, physician
assistant, or nurse-midwife not directly
involved in the
exposure evaluation group, as defined in
section 23-6-11(2), determines that a
health care provider, other than one in a supervisory
position to the person making the determination
had 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 HIV, then, if a sample of the
patient's blood is available, that blood shall
be tested for HIV.
(ii) 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.
(iii) 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 HIV test within seventy-two (72) hours of
the exposure.
(iv) No member
of the exposure evaluation group person 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
acts in good faith on the group's determination and
recommends performs the test be performed,
shall have any liability as a result of their actions
carried out under this chapter, unless those
persons are proven to have act acted in bad faith.
(6) In an
emergency, where due to a grave medical or psychiatric condition, it is
impossible to obtain consent from the patient or
the patient's parent, guardian, or agent.
(7) As permitted
under sections 23-18.6-12 (organ transplant), 23-1-38 (sperm
donation)
and 23-8-1.1 (person under eighteen (18)
years may give consent for testing for communicable
diseases).
(8) Mandatory
testing for human immunodeficiency virus (HIV) conducted pursuant to
sections 42-56-37 (testing at ACI),
11-34-10 (prostitution) , and 21-28-4.20 (IDU and needles).
23-6-17.
Confidentiality. – (a) It is unlawful for any person to disclose
to a third party
the results of an individual's 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 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 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 the care of the individual
testing positive on the 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 HIV, pursuant to section 23-6-14(4)
through (8) (exceptions) and section 23-17-31
(testing of hospitalized patients);
(iv) May notify
the director of the department of children, youth, and families, pursuant
to section 23-6-14(3) (testing of a minor to
secure services); and
(v) May inform
third parties with whom an HIV-infected patient is in close and
continuous exposure related contact,
including but not limited to a spouse and/or partner, if the
nature of the contact, in the physician's
opinion, poses a clear and present danger of 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 inform the third party that they
may have been exposed to HIV; 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 (confidentiality
of health care information) and section 40.1-5-26
(disclosure of confidential information under
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 (report of
infectious disease upon death) and 23-28.36-3 (notification
to EMT, firefighter, police officer of
infectious disease).
(b) Facilities
and other health care providers subject to this section will have
documentation that each person with access to
any confidential information understands and
acknowledges that the information may not be
disclosed except as provided herein. The director
shall establish protocols for collecting,
maintaining and transferring the information (and
ultimately destroying the information) to ensure
the integrity of the transfer, and, if possible, the
director may suspend any transfer, even to CDC,
if he or she is not confident that the transfer is
secure.
23-6-18.
Protection of records. – (a) Providers of health care, public
health officials, and
any other person who maintains records containing
information on HIV test results of individuals
are 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 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.
(b) The
department shall evaluate reports of HIV/AIDS for completeness and potential
referrals for service. All case reports shall be
kept in a confidential and secure setting. An
HIV/AIDS policy and protocol for security shall
be developed and implemented by the
department for this purpose.
(1) The
department shall evaluate its procedures for HIV/AIDS reporting on a
continuous basis for timeliness, completeness of
reporting, and security of confidential
information.
(2) The
department's protocol shall be in accordance with the recommendations of the
December 10, 1999 Morbidity and Mortality Weekly
Report Recommendations and Reports,
"CDC Guidelines for National Human Immunodeficiency
Virus Case Surveillance, including
monitoring for Human Immunodeficiency Virus
infection and Acquired Immunodeficiency
Syndrome" document, or its successor
document, that pertains to patient records and
confidentiality; provided, however, that in no
event shall the protocol be less protective than that
required by state law.
(3) All reports
and notifications made pursuant to this section shall be confidential and
protected from release except under the
provisions of this law. Any person aggrieved by a
violation of this section shall have a right of
action in the superior court and may recover for each
violation:
(i) Against any
person who negligently violates a provision of this section, damages of
one thousand dollars ($1,000) or actual damages,
whichever is greater.
(ii) Against
any person who intentionally or recklessly violates a provision of this
section,
damages of five thousand dollars ($5,000) or
actual damages, whichever is greater.
(iii) Reasonable
attorneys' fees;
(iv) Such other
relief, including an injunction, as the court may deem appropriate; and
(v) Any action
under this section is barred unless the action is commenced within three
(3) years after the cause of action accrues. A
cause of action shall accrue when the injured party
becomes aware of an unauthorized disclosure.
23-6-20.
Notification of disclosure. -- In all cases when an individual's 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 by
subsections (1), (2)(i), (2)(ii), (2)(iv), and or (4) of
section 23-6-17 (permitted disclosures re:
confidentiality), and permitted by and disclosed in
accordance with the federal health insurance
portability and accountability act of 1996 (Public
law 104-191) enacted on August 21, 1996 and as
thereafter amended,
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.
23-6-25.
Alternative test sites. -- The department of health shall maintain
alternative
sites for providing free, voluntary, anonymous
HIV testing, counseling, and referral on a
continuing basis and at sites that, may be
designated by the director of the department of health.
The department of health shall maintain sites
for providing both anonymous and confidential HIV
testing, and HIV counseling and referral. Each
site, funded by the department of health, shall
offer free testing, counseling and referral for
indigent parties and other individuals without health
insurance, offer a sliding scale for payment for
all other individuals and, in the case of
confidential testing, screen for ability to pay
through a third-party insurer. In the case of
nonfunded sites for HIV testing, organizations
and/or institutions performing the test shall offer
free testing, counseling and referral for
indigent parties and other individuals without health
insurance.
23-6-26.
Laboratory analysis for HIV. -- (a) HIV/AIDS is regarded to cause
significant
morbidity and mortality, can be screened, diagnosed
and treated, and is of major public health
concern, such that surveillance of the disease
occurrence is in the public interest, and therefore
shall be designated as notifiable and reportable
by name.
(b) Under this
provision the following shall be reported:
(1) A diagnosis
of HIV, according to the U.S. Centers for Disease Control and Prevention
case definition of HIV.
(2) A diagnosis
of AIDS, according to the U.S. Centers for Disease Control and
Prevention case definition of AIDS.
(3) A positive
ELIZA result of any HIV test and/or other FDA approved test indicative of
the presence of HIV.
(4) CD4
T-lymphocyte test results <200 mg/dl and or fourteen percent (14%).
(5) A perinatal
exposure of a newborn to HIV indicated by two positive PCR tests; <18
months; and/or other U.S. Food and Drug
Administration approved tests that indicate the
presence of HIV in pediatric cases.
(6) Other U.S.
Food and Drug Administration approved tests indicative of the presence of
HIV/AIDS, as approved by the department.
(a) (c)
All biological samples or specimens taken from Rhode Island residents for the
purpose of performing laboratory analysis for
the detection of antibody to human
immunodeficiency virus (HIV), by or under the
direction or order of any physician licensed to
practice medicine in this state, or on order
of any duly licensed health care provider shall be sent
to the Rhode Island department of health
laboratory for analysis. Specimens analyzed for the sole
purpose of assuring the safety of the blood
supply or for strictly research purposes may be tested
for HIV antibody in other licensed laboratories. This provision shall
not apply to those HIV tests
performed in a hospital laboratory. Hospitals
shall forward all positive HIV test results to the
department of health. The department of
health laboratory shall conduct all confirmatory testing
for HIV/AIDS; exceptions, for alternative
testing methods, may be granted through written
approval by the department of health.
(b) (d)
No Except in the case of anonymous testing, a physician or
laboratory or duly
licensed health care provider providing samples or
specimens for HIV-testing, or results of HIV
tests to the department, shall include the name
of the patient. or any other information which
would identify the person tested.
(e) Any HIV
cases reported in the previous code based system, shall remain in a code
based data set. The department of health shall
only use and require HIV name case reports
submitted after the enactment of this law.
(f) In addition to, and
separate from, the requirement of subdivision 23-6-26(b)(4), all
HIV CD4 T-lymphocyte test results and all
HIV viral load detection test results, detectable and
nondetectable, shall be reported to
the department of health through a department designed
reporting system that uses a nonname
based code and contains no patient identifying information.
These reports may be used by the
department to improve the clinical progress of patients through
contact with their physicians, and to
use the aggregate information collected to develop and
improve prevention programs and create
better access to care.
SECTION 4. Chapter
23-6 of the General Laws entitled "Prevention and Suppression of
Contagious Diseases" is hereby amended by
adding thereto the following section:
23-6-27.
Reporting of HIV/AIDS and perinatal exposure of newborns. – (a) The
following persons shall report information
required by this section to the department's HIV/AIDS
surveillance team:
(1) a
physician/health care provider who diagnoses or treats HIV/AIDS;
(2) The
administrator of a health care facility as defined in Rhode Island general laws
chapter 23-17 who diagnoses or treats HIV/AIDS;
or
(3) the
administrator of a prison in which there is an HIV/AIDS infected person or
perinatal exposure to HIV/AIDS.
Reports provided
under this section shall specify the infected person's name, as well as all
information required on the official department
HIV Case Report Form.
(b) Any high
managerial agent who is responsible for the administration of a clinical or
hospital laboratory, blood bank, mobile unit, or
other facility in which a laboratory examination
of any specimen derived from a human body yields
serological, or other evidence of HIV/AIDS,
including perinatal exposure to HIV/AIDS shall
notify the department in a timely manner as
stipulated in the rules promulgated by the
department. Reports provided under this section shall
specify the name as well as all information
indicated on the official department HIV Case Report
Form.
(c) Reports as
required by this section shall only be made if confirmed with a Western
Blot or other FDA approved confirmatory test.
(1) All
facilities obtaining blood from human donors for the purpose of transfusion or
manufacture of blood products shall report
HIV/AIDS consistent with this section.
(2) Any
laboratory that processes specimens shall permit the department to examine the
records of said laboratory, facility, or office
in order to evaluate compliance with this section.
(d) Perinatal
HIV/AIDS exposure reporting shall be made to the department regardless of
confirmatory testing.
(e) Reports
required by this section shall be mailed within forty-eight (48) hours of
diagnosis or treatment, to the department using
a designated envelope that shall be provided by
the department's HIV/AIDS Surveillance Team. Any
other reporting method shall be approved in
advance by the department.
(f) Nothing in
this section shall preclude the performance of anonymous HIV/AIDS
testing.
SECTION 5. Sections
23-11-17 and 23-11-19 of the General Laws in Chapter 23-11
entitled "Sexually Transmitted
Diseases" are 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 (confidentiality)
and 23-6-18 (protection of the medical
record) and the informed consent standards
contained in chapter 6 of title 23. 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 tested and counseling
counseled shall first be
provided with an "informed consent
form" as provided by subsection 23-6-11(3), and shall
specifically be given the opportunity to decline
or opt-out of testing, which he or she shall sign
and date in acknowledgment of his/her
election to be tested. the offer. The department of health is
responsible for costs associated with performing
and reporting the results of the HIV tests,
including the reasonable costs of pretest and
post-test counseling. Those reasonable costs shall be
negotiated and specified by contract.
(b) In the
event an individual consents to anonymous testing and tests positive for HIV,
the HIV testing counselor shall provide the
client an informed consent form as provided by
subsection 23-6-11(3). If an individual is
tested anonymously and is found positive on the initial
screening test or during a post-test
consultation, the counselor shall discuss, with the client,
options regarding referrals and reporting of
this positive screening, including the necessity of
accessing a physician. The department of health
shall maintain sites for providing both
anonymous and confidential HIV testing, and HIV
counseling and referral. Each site, funded by
the department of health, shall offer free
testing, counseling and referral for indigent parties and
other individuals without health insurance,
offer a sliding scale for payment for all other
individuals and, in the case of confidential
testing, screen, for ability to pay through a third-party
insurer. In the case of nonfunded sites for HIV
testing, organizations and/or institutions
performing the test shall offer free testing,
counseling and referral for indigent parties and other
individuals without health insurance.
(c) All persons
tested under this section shall be provided pretest and post-test
counseling counseled and tested in
accordance with regulations adopted promulgated by the
department of health; provided, however, that
the counseling shall be in accordance with
acceptable medical standards. , and no
test results shall be given by any means (e.g. phone, mail,
e-mail, fax, etc.) other than in person . Counselors for HIV counseling,
testing and referral must
undergo training given by the department of
health to become a qualified professional counselor.
23-11-19.
Exchange of hypodermic needles and syringes. -- (a) The director of the
department of health shall maintain a program
offering the free exchange of new hypodermic
needles and syringes for used hypodermic needles
and syringes as a means to prevent the
transmission of human immunodeficiency virus
(HIV) or viral hepatitis among intravenous
injecting drug users eighteen (18) years of age or older.
Any site used in the program shall be
approved by the director of health and shall make available
educational materials, HIV
counseling and testing, and referral services
targeted to the education of HIV/AIDS and viral
hepatitis transmission as well as information and
referrals pertaining to and drug substance abuse
prevention and treatment. Any individual(s)
who either administers or participates in the program
shall be immune from criminal prosecution for
violating the provisions of section 21-28.5-
1(a)(11) [deleted] unless the individual(s) is
found to have in his or her possession hypodermic
needles and syringes that are not a part of the
exchange program.
(b) Any program
of needle and syringe exchange must be implemented pursuant to the
provisions of this section and shall incorporate
an on-going evaluation plan to determine the
impact of the needle exchange program on the
participants and the community in the efforts to
lower the HIV rate among injecting users
including successful referrals to substance abuse
treatment.
SECTION 6. 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 a human
immunodeficiency virus (HIV) test and counseling shall be
provided with an "informed consent
form" which he or she shall sign and date in
acknowledgment of that offer. The department of
health is 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. Those
reasonable costs shall be negotiated and specified
by contract.
Every physician
or health care provider attending any person for prenatal care or family
planning services shall universally offer HIV
screening in these settings so as to promote earlier
detection of HIV with unrecognized or no
identified risk factors. HIV should be included in the
routine panel of prenatal tests for all pregnant
women. Repeat testing in the third trimester is
recommended if determined by the physician. Each
person who is offered testing and counseling
shall first be provided with an "informed
consent form" as provided by subsection 23-6-11(3),
which he/she shall sign and date, and shall
specifically be given the opportunity to decline or opt-
out of the testing. All testing pursuant to this
section shall be performed in accordance with
sections 23-6-12 and 23-6-13.
(b) In the
event an individual consents to anonymous testing and tests positive for HIV,
the HIV testing counselor shall discuss with the
client options regarding referrals and reporting of
this positive screening, including the necessity
of accessing a physician. The department of health
shall maintain sites for providing both
anonymous and confidential HIV testing, and HIV
counseling and referral. Each site, funded by
the department of health, shall offer free testing,
counseling and referral for indigent parties and
other individuals without health insurance, offer a
sliding scale for payment for all other
individuals and, in the case of confidential testing, screen
for ability to pay through a third-party
insurer. In the case of nonfunded sites for HIV testing,
organizations and/or institutions performing the
test shall offer free testing, counseling and
referral for indigent parties and other
individuals without health insurance.
(b) (c)
All persons tested under this section shall be counseled and tested provided
pretest and post-test counseling in accordance with
regulations adopted promulgated by the
department of health.; provided,
however, that the counseling shall be in accordance with
acceptable medical standards.
SECTION 7. Section
23-17-31.1 of the General Laws in Chapter 23-17 entitled
"Licensing of Health Care Facilities"
is hereby amended to read as follows:
23-17-31.1. Human
immunodeficiency virus (HIV) testing -- Facilities for drug
abusers. – Human
immunodeficiency virus (HIV) testing – Facilities for drug users. -- (a)
Every physician or health care provider
attending any person for any service offered at a facility
for intravenous injecting 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 (confidentiality)
and 23-6-18 (protection of
records), except where federal confidentiality laws may
supersede. 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
the statute.
(b) Each
person who is offered a test and counseling shall be provided with an
"AIDS
testing and notification form" which he or
she shall sign and date in acknowledgement of the
offer.
Each person
tested and counseled shall first be provided an "informed consent
form" as
provided by subsection 23-6-11(3), which he/she
shall sign and date, and shall specifically be
given the opportunity to decline or opt-out of
the testing.
(c) In the
event an individual consents to anonymous testing and tests positive for HIV,
the HIV testing counselor shall discuss, with
the client, options regarding referrals and reporting
of this positive screening, including the
necessity of accessing a physician.
(c) (d)
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. The department
of health shall maintain sites for providing
both anonymous and confidential HIV testing, and
HIV counseling and referral. Each site, funded by
the department of health, shall offer free
testing, counseling and referral for indigent
parties and other individuals without health insurance,
offer a sliding scale for payment for all other
individuals and, in the case of confidential testing,
screen for ability to pay through a third-party
insurer. In the case of nonfunded sites for HIV
testing, organizations and/or institutions
performing the test shall offer free testing, counseling
and referral for indigent parties and other
individuals without health insurance.
(d) (e)
All persons tested under this section shall be provided pretest and
post-test
counseling counseled and tested in
accordance with regulations adopted by the department of
health. The counseling shall be in accordance
with acceptable medical standards.
SECTION 8.
Sections 23-28.36-2 and 23-28.36-3 of the General Laws in Chapter 23-
28.36 entitled "Notification of Fire
Fighters, Police Officers and Emergency Medical Technicians
After Exposure to infectious diseases" are
hereby amended to read as follows:
23-28.36-2.
Definitions. -- The following terms when used in this chapter shall
have the
following meanings herein ascribed:
(1)
"Contagious disease" means an infectious disease.
(2)
"Disability" means a condition of physical incapacity to perform any
assigned duty or
duties in the fire department or emergency
medical service.
(3)
"Emergency medical technician" means a person licensed pursuant to
chapter 4.1 of
this title to provide emergency medical
services.
(4) "Fire
department" means service groups (paid or volunteer) that are organized
and
trained for the prevention and control of loss
of life and property from fire or other emergency.
(5) "Fire
fighter" means an individual who is assigned to fire fighting activity and
is
required to respond to alarms and perform
emergency action at the location of a fire, hazardous
materials, or other emergency incident.
(6)
"Infectious disease" means interruption, cessation, or disorder of
body functions,
systems, or organs transmissible by association
with the sick or their secretions or excretions,
excluding the common cold. Infectious disease
includes, but is not limited to, human
immunodeficiency virus (HIV), hepatitis B virus
(HBV), and hepatitis C virus (HCV).
(7)
"Licensed facility" means a hospital, nursing home, medical
clinic, dialysis center,
physician's office operatory, or the
like, as may be licensed by the province state to provide
medical care.
(8) "Police
officer" means any permanently employed city or town police officer, state
police officer, committing squad member, or
other permanent law enforcement officer as defined
in section 12-7-21; provided, however, this
shall not include the highest ranking officer of any of
the departments.
(9) "Strike
force member" means any member of the statewide strike force of the
department of attorney general.
23-28.36-3.
Notification of infectious diseases. -- (a) Notwithstanding the
provisions of
sections 40.1-5-26 (disclosure of
confidential information and records under mental health law)
and 5-37.3-4 (confidentiality of health care
information), if, while treating, investigating, or
transporting an ill or injured person to a
licensed facility, a fire fighter, police officer, strike force
member or emergency medical technician comes
into contact with is occupationally exposed (e.g.
blood borne exposure) to a person who is
subsequently diagnosed as having an infectious disease,
and the exposure is sufficient to create the
risk of transmission of the disease, the licensed facility
receiving that person shall notify the highest
ranking officer of the treating, investigating, or
transporting individual's department of health
of the exposure to that person which officer shall
then notify the exposed individual. Further, any
city or town police department notified of
infectious diseases pursuant to the provisions
of this section shall, within forty-eight (48) hours,
notify any strike force member who was exposed
to the infected person.
(b) The
notification shall be made within forty-eight (48) hours, or sooner, of
confirmation of the patient's diagnosis.
(c) The notified
employee shall contact the licensed health care facility to determine the
infectious disease to which he or she has been
exposed, and to receive the appropriate medical
direction for dealing with the infectious
disease.
(d) Notification made
pursuant to this section shall be conducted in a manner which will
protect the confidentiality of the patient, fire
fighter, police officer, or emergency technician.
SECTION 9. 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 Developmentally
Disabled" is hereby amended to read as
follows:
40.1-24-20. Human
immunodeficiency virus (HIV) testing -- Facilities for drug
abusers. – Human immunodeficiency
virus (HIV) testing – Facilities for drug users. -- (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 (confidentiality)
and 23-6-18 (protection of medical records)
and the informed consent standards contained in
chapter 6 of title 23,
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
"informed
consent form" which he or she shall sign
and date in acknowledgment of the offer.
Each person
tested and counseled shall first be provided with an "informed consent
form"
as provided by subsection 23-6-11(3), which
he/she shall sign and date, and shall specifically be
given the opportunity to decline or opt-out of
the testing.
(c) In the
event an individual consents to anonymous testing and tests positive for HIV,
the HIV testing counselor shall discuss with the
client options regarding referrals and reporting of
this positive screening, including the necessity
of accessing a physician.
(d) The
department of health shall assist providers with performing and reporting the
results of the HIV tests.
(c) (e)
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.
The department
of health shall maintain sites for providing both anonymous and
confidential HIV testing, and HIV counseling and
referral. Each site, funded by the department of
health, shall offer free testing, counseling and
referral for indigent parties and other individuals
without health insurance, offer a sliding scale
for payment for all other individuals and, in the
case of confidential testing, screen for ability
to pay through a third-party insurer. In the case of
nonfunded sites for HIV testing, organizations
and/or institutions performing the test shall offer
free testing, counseling and referral for indigent
parties and other individuals without health
insurance.
(d) (f)
All persons tested under this section shall be provided pretest and post
test
counseling counseled and tested in
accordance with regulations adopted promulgated by the
department of health.; provided,
however, that the counseling shall be in accordance with
acceptable medical standards.
SECTION 10. This
act shall take effect upon passage.
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LC01565/SUB
A
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