BILL NUMBER: AB 568 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 27, 2005
AMENDED IN ASSEMBLY APRIL 4, 2005
INTRODUCED BY Assembly Member Garcia
(Coauthors: Assembly Members Benoit, Berg, Bogh, Daucher, DeVore,
Emmerson, Haynes, Houston, Keene, La Suer, Lieber, Maze, Montanez,
Parra, Plescia, Sharon Runner, Spitzer, Tran, Villines, and Wyland)
(Coauthor: Senator Ducheny)
FEBRUARY 16, 2005
An act to add Section 121022 to the Health and Safety Code,
relating to HIV.
LEGISLATIVE COUNSEL'S DIGEST
AB 568, as amended, Garcia. Rapid HIV tests.
Existing law requires a licensed physician and surgeon or other
person engaged in the prenatal care of a pregnant woman or attending
the woman at the time of delivery to obtain or cause to be obtained a
blood specimen of the woman and to submit that blood specimen to a
laboratory for an HIV test. Prior to obtaining a blood specimen,
existing law requires the physician and surgeon or other person
engaged in the prenatal care of a pregnant woman or attending the
woman at the time of delivery to ensure that the woman is informed
that she has a right to accept or refuse the testing. Existing law
requires the acceptance of testing for HIV to be documented in
writing and signed by the patient.
Existing law authorizes the State Department of Health Services,
through its Office of AIDS and the authorized agents of the office,
to participate in a rapid human immunodeficiency virus (HIV) test
research program conducted with the federal Centers for Disease
Control and Prevention, involving innovative HIV testing and
counseling programs. Under the rapid HIV test research program,
existing law authorizes the department to perform and report clinical
test results using a rapid HIV test for diagnosis, prior to test
approval by the federal Food and Drug Administration (FDA). However,
existing law requires test performance and reporting to be done only
to the extent allowed under that device's investigational approval
by the FDA and pursuant to a California Health and Human Services
Agency Institutional Review Board-approved research protocol.
At the time of a woman's annual gynecological
examination, this bill would require the physician and surgeon or
other person performing the annual gynecological examination to offer
to test the woman for the presence of HIV through a blood specimen
or a rapid HIV test. The bill would require the acceptance of testing
for HIV to be documented in writing and signed by the patient. The
bill would prescribe procedures for the conduct of the HIV test.
After the results of the HIV test been received, the
This bill would require that any woman seeking an annual
gynecological examination or family planning appointment be provided
with information on HIV and AIDS, and would require that the woman be
offered the option of being tested onsite, if available, or referral
information to other testing locations. The bill would require
the physician and surgeon or other person
health care professional attending the woman at the time the
results are received to ensure that the woman receives information
and counseling, as appropriate, to explain the results and the
implications for the woman's health, including any followup care that
is indicated.
This bill would require a positive test result to be reported to
the local health officer as a reportable disease or condition. To the
extent this bill would expand the duties of local health officers,
it would impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1.
The Legislature finds and declares all of the following:
(a) The Centers for Disease Control and Prevention reported in
2003 that heterosexual women accounted for a staggering 26 percent of
all new HIV and AIDS cases with African American and Hispanic Women
accounting for 83 percent of these diagnoses. Heterosexual sex has
been the primary method of HIV exposure for women, with a growing
number becoming infected by male partners who participate in high
risk behavior, including sexual relations with multiple partners,
sexual relations with other males, needle users, or sharing needles.
(b) There are many reasons why fewer women seek care--especially
in communities where social and cultural norms may discourage women
from speaking out about their sexuality. In some cultures, the
promiscuous behavior of male partners is ignored, and in others,
seeking assistance brings fear of being stigmatized. As a result,
women fail to recognize the early symptoms of HIV and AIDS and do not
dare raise questions--even with their doctors.
(c) The current method of obtaining an HIV or AIDS test requires
women to be proactive or to seek treatment if they believe they may
have been exposed. This requires actively seeking out a testing site,
requesting an examination from an unfamiliar medical provider, and
in most cases, waiting anxiously for weeks for the results. In light
of this frightening threat to women's health, it is crucial all women
be provided with information about risk factors and be encouraged to
undergo testing during their normal office visits.
SECTION 1.
SEC. 2. Section 121022 is added to the Health and Safety
Code, to read:
121022.
(a) At the time of a woman's annual gynecological
examination, the physician and surgeon or other person performing the
annual gynecological examination shall offer to test the woman for
the presence of the human immunodeficiency virus (HIV) through a
blood specimen or a rapid HIV test as authorized pursuant to Section
120917.
(b) The physician and surgeon or other person performing the
annual gynecological examination shall ensure that the woman is
informed of the routine nature of the blood test, the purpose of the
testing, the risks and benefits of the test, the risk of transmission
of HIV, that approved treatments are known to decrease the risk of
transmission of HIV, and that the woman has a right to accept or
refuse this testing. The acceptance of testing for HIV shall be
documented in writing on the form developed by the department and the
Office of AIDS pursuant to Section 125092, or on a form that is
substantially equivalent in content, and signed by the patient. A
copy of this form shall be maintained in the medical record.
Any woman seeking an annual gynecological examination
or family planning appointment, at the time of signing in or
otherwise registering and completing any required forms or
documentation, shall be provided information on HIV and AIDS. In
addition, the woman shall be offered the option of being tested
onsite, if available, or provided referral information to other
testing locations. The information provided shall include, but shall
not be limited to, all of the following:
(1) A description of the modes of HIV and AIDS transmission.
(2) A description of risk factors that may expose women to HIV and
AIDS, including, but not limited to, partners who may not be
truthful about having sexual relations outside their monogamous
relationship, males having sex with other males or prostitutes, or
partners using intravenous drugs or sharing needles.
(3) A description of the different HIV and AIDS tests available,
including blood or other bodily fluid test.
(4) Information on whether or not testing may be covered by
medical insurance.
(b) The information sheet shall include:
(1) A clearly marked section in bold print with a place for the
patient's signature where they may accept or decline HIV and AIDS
testing.
(2) If testing is not available onsite, referral information shall
be provided.
(c) (1) If the woman chooses to be tested for HIV through a blood
test, the physician and surgeon or other person performing
the annual gynecological examination health care
professional attending the woman shall obtain a blood specimen
from the woman and submit it to a clinical laboratory licensed by the
department or to an approved public health laboratory for a test to
determine the presence of HIV, and the results shall be reported to
both of the following:
(A) A physician and surgeon or other person performing an
annual gynecological examination health care
professional who ordered the test, and who shall
subsequently inform the woman tested.
(B) A positive test result shall be reported to the local health
officer, with the information required and within the timeframes
established by the department, pursuant to Chapter 4 (commencing with
Section 2500) of Title 17 of the California Code of Regulations.
(2) If the woman chooses to be tested for HIV through a rapid HIV
test, the test shall be conducted only as authorized pursuant to
Section 120917.
(2) If the woman chooses a rapid HIV test, the woman shall be
informed that the preliminary result of the rapid HIV test is
indicative of the likelihood of HIV infection and that the result
must be confirmed by an additional more specific test, or, if
approved by the federal Food and Drug Administration for that
purpose, a second different rapid HIV test.
(d) After the results of the HIV test been received, the physician
and surgeon or other person attending the woman at the time the
results are received shall ensure that the woman receives information
and counseling, as appropriate, to explain the results and the
implications for the woman's health, including any followup care that
is indicated. If the woman tests positive for HIV antibodies, she
shall also receive, whenever possible, a referral to a provider,
provider group, or institution specializing in care for HIV positive
women. Health care providers are also strongly encouraged to seek
consultation with other providers specializing in the care of HIV
positive women.
(e) HIV information and counseling provided pursuant to
subdivision (d) shall include, but shall not be limited to, all of
the following:
(1) A description of the modes of HIV transmission.
(2) A discussion of risk-reduction behavior modifications
including methods to reduce the risk of transmission.
(3) If appropriate, referral information to other HIV prevention
and psychosocial services including anonymous and confidential test
sites approved by the Office of AIDS.
(f)
(e) Nothing in this section shall be construed to
require mandatory testing. Any documentation or disclosure of
HIV-related information shall be made in accordance with Chapter 7
(commencing with Section 120975) of Part 4 of Division 105 regarding
confidentiality and informed consent.
SEC. 2. SEC. 3.
If the Commission on State Mandates determines that this act
contains costs mandated by the state, reimbursement to local agencies
and school districts for those costs shall be made pursuant to Part
7 (commencing with Section 17500) of Division 4 of Title 2 of the
Government Code.