Chapter 170

2007 -- H 6095 SUBSTITUTE B AS AMENDED

Enacted 07/02/07

A N A C T

RELATING TO HEALTH AND SAFETY -- PREVENTION AND SUPPRESSION OF CONTAGIOUS DISEASES

Introduced By: Representatives Naughton, Slater, Ginaitt, Dennigan, and Pacheco

Date Introduced: March 06, 2007

It is enacted by the General Assembly as follows:

     SECTION 1. Legislative intent. – (a) The general assembly hereby finds and declares that

HIV/AIDS is regarded to cause significant morbidity and mortality especially to the newborn.

(b) The state should follow the latest recommendations for maternal screening from the

U.S. Centers for Disease Control and Prevention.

(c) The general assembly acknowledges that: HIV/AIDS diagnosis and treatment during

pregnancy is of major public health concern, such that prenatal screening of the disease is in the

best interests of pregnant women, newborns and the public interest, and therefore screening for

HIV/AIDS should be included in the prenatal panel with a provision that the pregnant woman can

decline.

(d) In 2006 the HIV/AIDS testing rate for pregnant women in Rhode Island was only

fifty-three percent (53%) and of note New York, Illinois, and Connecticut have achieved testing

rates above ninety-five percent (95%) in pregnant women through comprehensive testing of

pregnant women and through rapid testing of newborns whose mothers are not tested.

(e) The general assembly therefore seeks to include prenatal HIV screening in routine

prenatal care.

     SECTION 2. 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

universally offer include HIV screening in these settings so as to promote earlier detection of HIV

with unrecognized or no identified risk factors. HIV should testing shall be included in the routine

panel of prenatal tests for all pregnant women unless testing is declined. 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) No person shall order the performance of an HIV-related test without first providing

the information and counseling set forth in subsection 23-13-19(c), informing the woman that she

has a right to decline testing, and obtaining the oral consent of the patient to be tested, or of a

person authorized to consent to health care for such individual, which consent and counseling

shall be documented in the patient's medical record.

(c) Prior to performing an HIV-related test, patients shall be provided pre-test counseling.

To allow greater flexibility for pre-test counseling by allowing client-specific counseling, a

physician or health care provider may tailor HIV counseling to best meet the needs of the

individual to be tested. Decisions concerning tailoring and the extent of pre-test counseling shall

be made on a case-by-case basis, but in no event shall a woman be tested for HIV pursuant to this

section without being provided with oral or written information that includes the following:

(1) an explanation of HIV infection;

(2) a description of the interventions that can reduce HIV transmission from mother to

infant;

(3) the meaning of positive and negative test results;

(4) an opportunity to ask questions.

The department of health shall provide appropriate health care providers with the written

information, in multiple languages, required in subsections (1), (2) and (3) herein.

(d) No physician or health care professional providing prenatal health services to a

pregnant woman shall perform an HIV test of any woman who has not given consent to testing.

(e) In the event that a pregnant woman tests positive for HIV/AIDS, the physician, health

care provider or counselor shall provide post-test counseling, which shall include information

about:

(1) the meaning of the test result;

(2) the possible need for additional testing;

(3) measures to prevent the transmission of HIV;

(4) measures to prevent perinatal HIV transmission; and

(5) the availability of, and referrals for, appropriate health care services, including

mental health care, and appropriate social and support services.

(f) All HIV testing pursuant to this section shall be kept confidential in accordance with

section 23-6-17.

(g) No physician or health care provider shall discriminate against a woman because she

is HIV positive or has declined to take an HIV test.

(b) (h) 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.

(c) (i) All persons tested under this section shall be counseled and tested in accordance

with regulations promulgated by the department of health.

     SECTION 3. This act shall take effect upon passage.

=======

LC02423/SUB B

=======