Amended in Senate August 18, 2014

Amended in Assembly May 6, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 1898

Introduced by Assembly Member Brown

February 19, 2014

An act to amend Section 121025 of the Health and Safety Code, relating to public health.

LEGISLATIVE COUNSEL’S DIGEST

AB 1898, as amended, Brown. Public health records: reporting: HIV/AIDS.

Existing law, with specified exceptions, prohibits the disclosure of public health records containing personally identifiable information relating to human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) that were developed or acquired by a state or local public health agency. Existing law authorizes disclosure of these public health records if otherwise provided by law for public health purposes, pursuant to a written authorization by the person who is the subject of the record, or when the confidential information is necessary to carry out the duties of the public health agency or researcher in the investigation, control, or surveillance of disease. Existing law requires these authorized disclosures to include only the information necessary for the purpose of that disclosure and to be made upon the agreement that the information will be kept confidential and will not be further disclosed without written authorization.

Existing law provides exceptions to the above-described requirements on the disclosure of information regarding public health records relating to HIV or AIDS, and authorizes specified disclosures of that information for the purpose of enhancing the completeness of HIV/AIDS, tuberculosis, and sexually transmitted disease coinfection reporting to the federal Centers for Disease Control and Prevention (CDC), including authorizing local public agency tuberculosis control staff to disclose the information to certain state public health agency staff who may further disclose the information to the CDC, as specified.

This bill would require any disclosure authorized under these provisions to include only the information necessary for the purpose of that disclosure and to be made upon the agreement that the information will be kept begin delete confidential and will not be further disclosed without written authorization. end delete begin insert confidential. This bill would prohibit specified disclosures from being made without written authorization. end insert The bill would include hepatitis B, hepatitis C, and meningococcal infection for HIV/AIDS coinfection reporting to the CDC. The bill would additionally authorize begin insert , for purposes of the investigation, control, or surveillance of HIV and its coinfection with hepatitis B, hepatitis C, and meningococcal infection, end insert local public health agency communicable disease staff to further disclose the information to state public health agency begin delete staff for the purpose of the investigation, control, or surveillance of HIV and coinfection with hepatitis B, hepatitis C, and meningococcal infection. end delete begin insert staff, who may further disclose the information to the CDC, as specified. end insert

Existing law authorizes local public health agency sexually transmitted disease control and tuberculosis control staff to disclose the HIV/AIDS-related information to state or local public health agency sexually transmitted disease control and tuberculosis control staff, the HIV-positive person, or his or her health care provider, for the purpose of facilitating appropriate medical care and treatment of persons coinfected with HIV, tuberculosis, syphilis, gonorrhea, or chlamydia.

This bill would additionally authorize any local public health agency sexually transmitted disease control, communicable disease control, and tuberculosis staff to further disclose that information to state or local public health agency sexually transmitted disease control, communicable disease control, and tuberculosis staff for the purpose of facilitating appropriate medical care and treatment of persons coinfected with HIV, hepatitis B, hepatitis C, or meningococcal infection, as specified.

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

Section 121025 of the Health and Safety Code
is amended to read:

121025.  

(a) Public health records relating to human
immunodeficiency virus (HIV) or acquired immunodeficiency
syndrome (AIDS), containing personally identifying information,
that were developed or acquired by a state or local public health
agency, or an agent of that agency, shall be confidential and shall
not be disclosed, except as otherwise provided by law for public
health purposes or pursuant to a written authorization by the person
who is the subject of the record or by his or her guardian or
conservator.

(b) In accordance with subdivision (g) of Section 121022, a
state or local public health agency, or an agent of that agency, may
disclose personally identifying information in public health records,
as described in subdivision (a), to other local, state, or federal
public health agencies or to corroborating medical researchers,
when the confidential information is necessary to carry out the
duties of the agency or researcher in the investigation, control, or
surveillance of disease, as determined by the state or local public
health agency.

begin insert

(c) Any disclosures authorized by subdivision (a), (b), or this
subdivision shall include only the information necessary for the
purpose of that disclosure and shall be made only upon the
agreement that the information will be kept confidential as
described in subdivision (a). Except as provided in paragraphs
(1) to (3), inclusive, or as otherwise provided by law, any
disclosure authorized by subdivision (a) or (b) shall not be made
without written authorization as described in subdivision (a). Any
unauthorized further disclosure shall be subject to the penalties
described in subdivision (e).

end insert begin delete

(c) (1) 

end delete

begin insert (1) end insert begin insert   end insert Notwithstanding any other law, the following disclosures
shall be authorized for the purpose of enhancing the completeness
of reporting to the federal Centers for Disease Control and
Prevention (CDC) of HIV/AIDS and coinfection with tuberculosis,
syphilis, gonorrhea, chlamydia, hepatitis B, hepatitis C, and
meningococcal infection:

(A) The local public health agency HIV surveillance staff may
further disclose the information to the health care provider who
provides HIV care to the HIV-positive person who is the subject
of the record for the purpose of assisting in compliance with
subdivision (a) of Section 121022.

(B) Local public health agency tuberculosis control staff may
further disclose the information to state public health agency
tuberculosis control staff, who may further disclose the information,
without disclosing patient identifying information, to the CDC, to
the extent the information is requested by the CDC and permitted
by subdivision (b), for purposes of the investigation, control, or
surveillance of HIV and tuberculosis coinfections.

(C) Local public health agency sexually transmitted disease
control staff may further disclose the information to state public
health agency sexually transmitted disease control staff, who may
further disclose the information, without disclosing patient
identifying information, to the CDC, to the extent it is requested
by the CDC and permitted by subdivision (b), for the purposes of
the investigation, control, or surveillance of HIV and syphilis,
gonorrhea, or chlamydia coinfection.

(D)  begin delete Local end delete begin insert For purposes of the investigation, control, or
surveillance of HIV and its coinfection with hepatitis B, hepatitis
C, and meningococcal infection, local end insert public health agency
communicable disease staff may further disclose the information
to state public health agency begin delete staff for the purposes of the
investigation, control, or surveillance of HIV and coinfection with
hepatitis B, hepatitis C, and meningococcal infection. end delete begin insert staff, who
may further disclose the information, without disclosing patient
identifying information, to the CDC to the extent the information
is requested by the CDC and permitted by subdivision (b). end insert

(2) Notwithstanding any other law, the following disclosures
shall be authorized for the purpose of facilitating appropriate
HIV/AIDS medical care and treatment:

(A) State public health agency HIV surveillance staff, AIDS
Drug Assistance Program staff, and care services staff may further
disclose the information to local public health agency staff, who
may further disclose the information to the HIV-positive person
who is the subject of the record, or the health care provider who
provides his or her HIV care, for the purpose of proactively offering
and coordinating care and treatment services to him or her.

(B) AIDS Drug Assistance Program staff and care services staff
in the State Department of Public Health may further disclose the
information directly to the HIV-positive person who is the subject
of the record or the health care provider who provides his or her
HIV care, for the purpose of proactively offering and coordinating
care and treatment services to him or her.

(C) Local public health agency staff may further disclose
acquired or developed information to the HIV-positive person who
is the subject of the record or the health care provider who provides
his or her HIV care for the purpose of proactively offering and
coordinating care and treatment services to him or her.

(3) Notwithstanding any other law, for the purpose of facilitating
appropriate medical care and treatment of persons coinfected with
HIV and tuberculosis, syphilis, gonorrhea, chlamydia, hepatitis B,
hepatitis C, or meningococcal infection, local public health agency
sexually transmitted disease control, communicable disease control,
and tuberculosis control staff may further disclose the information
to state or local public health agency sexually transmitted disease
control, communicable disease control, and tuberculosis control
staff, the HIV-positive person who is the subject of the record, or
the health care provider who provides his or her HIV, tuberculosis,
hepatitis B, hepatitis C, meningococcal infection, and sexually
transmitted disease begin delete control end delete care.

(4) For the purposes of paragraphs (2) and (3), “staff” shall not
include nongovernmental entities, but shall include state and local
contracted employees who work within state and local public health
departments.

(d) A confidential public health record, as defined in subdivision
(c) of Section 121035, shall not be disclosed, discoverable, or
compelled to be produced in any civil, criminal, administrative,
or other proceeding.

(e) (1) A person who negligently discloses the content of a
confidential public health record, as defined in subdivision (c) of
Section 121035, to a third party, except pursuant to a written
authorization, as described in subdivision (a), or as otherwise
authorized by law, shall be subject to a civil penalty in an amount
not to exceed five thousand dollars ($5,000), plus court costs, as
determined by the court. The penalty and costs shall be paid to the
person whose record was disclosed.

(2) A person who willfully or maliciously discloses the content
of any confidential public health record, as defined in subdivision
(c) of Section 121035, to a third party, except pursuant to a written
authorization, or as otherwise authorized by law, shall be subject
to a civil penalty in an amount not less than five thousand dollars
($5,000) and not more than twenty-five thousand dollars ($25,000),
plus court costs, as determined by the court. The penalty and costs
shall be paid to the person whose confidential public health record
was disclosed.

(3) A person who willfully, maliciously, or negligently discloses
the content of a confidential public health record, as defined in
subdivision (c) of Section 121035, to a third party, except pursuant
to a written authorization, or as otherwise authorized by law, that
results in economic, bodily, or psychological harm to the person
whose confidential public health record was disclosed, is guilty
of a misdemeanor, punishable by imprisonment in a county jail
for a period not to exceed one year, or a fine of not to exceed
twenty-five thousand dollars ($25,000), or both, plus court costs,
as determined by the court. The penalty and costs shall be paid to
the person whose confidential public health record was disclosed.

(4) A person who commits an act described in paragraph (1),
(2), or (3), shall be liable to the person whose confidential public
health record was disclosed for all actual damages for economic,
bodily, or psychological harm that is a proximate result of the act.

(5) Each violation of this section is a separate and actionable
offense.

(6) This section does not limit or expand the right of an injured
person whose confidential public health record was disclosed to
recover damages under any other applicable law.

(f) In the event that a confidential public health record, as
defined in subdivision (c) of Section 121035, is disclosed, the
information shall not be used to determine employability, or
insurability of a person.

begin delete

(g) Any disclosure authorized by subdivision (a), (b), or (c)
shall include only the information necessary for the purpose of
that disclosure and shall be made only upon the agreement that
the information (1) will be kept confidential and (2) will not be
further disclosed without written authorization, as described in
subdivision (a). Any unauthorized further disclosure will be subject
to the penalties described in subdivision (e).

end delete