California Legislature—2015–16 Regular Session

Assembly BillNo. 2179

Introduced by Assembly Member Gipson

February 18, 2016

An act to add Section 122440 to the Health and Safety Code, relating to public health.


AB 2179, as introduced, Gipson. Hepatitis C testing.

Existing law establishes the Office of AIDS in the State Department of Public Health and defines human immunodeficiency virus (HIV) as the etiologic agent of acquired immunodeficiency syndrome (AIDS). Existing law authorizes an HIV counselor who receives specified training and works in specified counseling and testing sites to perform HIV, hepatitis C virus (HCV), or combined HIV/HCV tests, including performing skin punctures for purposes of withdrawing blood for purposes of these tests, as specified.

This bill would authorize a hepatis C counselor, who meets specified requirements comparable to the requirements specified for an HIV counselor, to perform HCV tests in the manner described above with respect to HCV testing by an HIV counselor.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

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

P1    1


Section 122440 is added to the Health and Safety
, to read:

P2    1


(a) A hepatitis C counselor who meets the
2requirements of subdivision (e) may do all of the following:

3(1) Perform any hepatitis C virus (HCV) test that is classified
4as waived under the federal Clinical Laboratory Improvement Act
5(CLIA) (42 U.S.C. Sec. 263a et seq.) if all of the following
6conditions exist:

7(A) The performance of the HCV test meets the requirements
8of CLIA and, subject to subparagraph (B), Chapter 3 (commencing
9with Section 1200) of Division 2 of the Business and Professions

11(B) Notwithstanding Section 1246 of the Business and
12Professions Code, a hepatitis C counselor may perform skin
13punctures for the purpose of withdrawing blood for HCV testing,
14upon specific authorization from a licensed physician and surgeon,
15provided that the person meets both of the following requirements:

16(i) He or she works under the direction of a licensed physician
17and surgeon.

18(ii) He or she has been trained in both rapid test proficiency for
19skin puncture blood tests and oral swab tests and in universal
20infection control precautions, consistent with best infection control
21practices established by the Division of Occupational Safety and
22Health in the Department of Industrial Relations and the federal
23Centers for Disease Control and Prevention.

24(C) The person performing the HCV test meets the requirements
25for the performance of waived laboratory testing pursuant to
26subdivision (a) of Section 1206.5 of the Business and Professions
27Code. For purposes of this subdivision and subdivision (a) of
28Section 1206.5 of the Business and Professions Code, a hepatitis
29C counselor who meets the requirements of subdivision (e) shall
30be “other health care personnel providing direct patient care” as
31referred to in paragraph (13) of subdivision (a) of Section 1206.5
32of the Business and Professions Code.

33(D) The patient is informed that the preliminary result of the
34test is indicative of the likelihood of HCV exposure and that the
35result must be confirmed by an additional more specific test, or,
36if approved by the federal Centers for Disease Control and
37Prevention for that purpose, a second, different rapid HCV test.
38This subdivision does not allow a hepatitis C counselor to perform
39any HCV test that is not classified as waived under CLIA.

P3    1(2) Notwithstanding Section 1246.5 of the Business and
2Professions Code, order and report HCV test results from tests
3performed pursuant to paragraph (1) to patients without
4authorization from a licensed health care practitioner or his or her
5authorized representative. A patient who has indeterminate or
6positive test results from tests performed pursuant to paragraph
7(1) shall be referred to a licensed health care practitioner whose
8scope of practice includes the authority to refer a patient for
9laboratory testing for further evaluation.

10(b) A hepatitis C counselor shall not, unless also certified as a
11limited phlebotomist technician, perform a skin puncture pursuant
12to this section.

13(c) A hepatitis C counselor who meets the requirements of this
14section with respect to performing any HCV test that is classified
15as waived under CLIA may not perform any other test unless that
16person meets the statutory and regulatory requirements for
17performing that other test.

18(d) This section does not certify a hepatitis C counselor as a
19phlebotomy technician or a limited phlebotomy technician.
20Compliance with this section does not fulfill any requirements for
21certification as a phlebotomy technician or a limited phlebotomy
22technician, unless the hepatitis C counselor has otherwise satisfied
23the certification requirements imposed pursuant to Section 1246
24of the Business and Professions Code.

25(e) A hepatitis C counselor shall meet one of the following

27(1) Is trained by the Office of AIDS and working in an HIV
28counseling and testing site funded by the department through a
29local health jurisdiction, or its agents.

30(2) Is working in an HIV counseling and testing site that meets
31both of the following criteria:

32(A) Utilizes HIV counseling staff who are trained by the Office
33of AIDS or its agents to provide both HIV counseling and testing
34and hepatitis C counseling and testing.

35(B) Has a quality assurance plan approved by the local health
36department in the jurisdiction where the site is located and has
37HIV counseling and testing staff who comply with the quality
38assurance requirements specified in Section 1230 of Article 1 of
39Group 9 of Subchapter 1 of Chapter 2 of Division 1 of Title 17 of
40the California Code of Regulations.

P4    1(3) Is working at a site approved by the local health department
2to provide hepatitis C rapid testing and counseling, and has been
3trained using a curriculum approved by the local health department
4or the State Department of Public Health, which, at a minimum,
5provides training in universal precautions, safe working conditions,
6proper running and reading of hepatitis C rapid test kit technology,
7and providing accurate information to clients including the
8importance of confirmatory tests, linkages to medical care, and
9the prevention of hepatitis C transmission.