BILL ANALYSIS
AB 568
Page 1
`Date of Hearing: May 11, 2005
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Judy Chu, Chair
AB 568 (Garcia) - As Amended: April 25, 2005
Policy Committee: HealthVote:11-1
Urgency: No State Mandated Local Program:
Yes Reimbursable: Yes
SUMMARY
This bill requires any woman seeking an annual gynecological
examination or family planning appointment to be provided
information on HIV and AIDS and offered the option of being
tested for HIV. Specifically, this bill :
1)Requires 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, to be provided information on HIV and AIDS.
2)Requires the woman to be offered the option of being tested
onsite for HIV, if available, or provided referral information
to other testing locations.
3)Requires the HIV and AIDS information provided to include a
description of the modes of HIV and AIDS transmission, a
description of risk factors that may expose women to HIV and
AIDS, a description of the different HIV and AIDS tests
available, including blood or other bodily fluid test, and
information on whether or not testing may be covered by
medical insurance.
4)Requires the information sheet to include 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. This
signed information sheet must be maintained in the patient's
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medical record.
5)Requires, if the woman chooses to be tested for HIV, the
physician or health care professional attending the woman to
obtain a specimen from the woman and submit it to a licensed
clinical laboratory or to an approved public health laboratory
for a test to determine the presence of HIV.
FISCAL EFFECT
Indeterminate but significant on-going costs, likely in the
millions of dollars annually, depending upon how many women who
are offered the HIV test elect to be tested who would not
otherwise be tested. For Medi-Cal, DHS indicates it does not
have data on women who currently receive an HIV test as part of
their gynecological exam because it does not have a procedure
code for a gynecological exam. However, if half of the women in
CalPERS and Medi-Cal receive an annual gynecological exam, and
one-quarter of those women elect to receive an HIV test, costs
would be approximately $6.7 million total funds annually. The
cost of a confirmation test for a woman who tests positive for
HIV is approximately $25.
COMMENTS
1)Purpose . According to the author, current law does not
require a woman to be offered a HIV test as part of her annual
gynecological exam, or to be provided with information on the
subject. The CDC reported in 2003 that heterosexual women
accounted for 26% of all new HIV cases, with African American
and Hispanic women accounting for 83% 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 share needles or had sex with males. The author
contends that there are many reasons why fewer women seek
care, especially in communities where social and cultural
norms may discourage them from speaking out about their
sexuality.
2)Background . Existing law requires a licensed physician 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
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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.
3)Opposition . The American College of Obstetricians and
Gynecologists (ACOG) writes that it hesitates to put specifics
of the practice of medicine into law except under very limited
and specific circumstances, such as making HIV testing of
pregnant and delivering women routine. ACOG opposes the
mandated form as unnecessary, and it believes giving the form
at the registration for the visit will most likely lead to
more women asking to be tested when clinical indications would
otherwise indicate she did not need to be tested.
Analysis Prepared by : Scott Bain / APPR. / (916) 319-2081