Amended in Assembly March 28, 2016

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 amended, 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 subdivisionbegin delete (e)end deletebegin insert (d)end insert 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 inbegin delete bothend deletebegin insert eitherend insert rapid test
19proficiency for skin puncture blood testsbegin delete andend deletebegin insert orend insert oral swab tests
20and in universal infection control precautions, consistent with best
21infection control practices established by the Division of
22Occupational Safety and Health in the Department of Industrial
23Relations and the federal Centers for Disease Control and

25(C) The person performing the HCV test meets the requirements
26for the performance of waived laboratory testing pursuant to
27subdivision (a) of Section 1206.5 of the Business and Professions
28Code. For purposes of this subdivision and subdivision (a) of
29Section 1206.5 of the Business and Professions Code, a hepatitis
30C counselor who meets the requirements of subdivisionbegin delete (e)end deletebegin insert (d)end insert
31 shall be “other health care personnel providing direct patient care”
32as referred to in paragraph (13) of subdivision (a) of Section 1206.5
33of the Business and Professions Code.

34(D) The patient is informed that the preliminary result of the
35test is indicative of the likelihood of HCV exposure and that the
36result must be confirmed by an additional more specific test, or,
37if approved by the federal Centers for Disease Control and
38Prevention for that purpose, a second, different rapid HCV test.
39This subdivision does not allow a hepatitis C counselor to perform
40any 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 hasbegin insert anend insert indeterminate or
6positive testbegin delete resultsend deletebegin insert resultend insert from tests performed pursuant to
7paragraph (1) shall be referred to a licensed health care practitioner
8whose scope of practice includes the authority to refer a patient
9for laboratory testing for further evaluation.

begin delete

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

end delete
begin delete


end delete

14begin insert(b)end insert A hepatitis C counselor who meets the requirements of this
15section with respect to performing any HCV test that is classified
16as waived under CLIA may not perform any other test unless that
17person meets the statutory and regulatory requirements for
18performing that other test.

begin delete


end delete

20begin insert(c)end insert This section does not certify a hepatitis C counselor as a
21phlebotomy technician or a limited phlebotomy technician.
22Compliance with this section does not fulfill any requirements for
23certification as a phlebotomy technician or a limited phlebotomy
24technician, unless the hepatitis C counselor has otherwise satisfied
25the certification requirements imposed pursuant to Section 1246
26of the Business and Professions Code.

begin delete


end delete

28begin insert(d)end insert A hepatitis C counselor shall meet one of the following

30(1) Is trained by the Office of AIDS and working in an HIV
31counseling and testing site funded by the department through a
32local health jurisdiction, or its agents.

33(2) Is working in an HIV counseling and testing site that meets
34both of the following criteria:

35(A) Utilizes HIV counseling staff who are trained by the Office
36of AIDS or its agents to provide both HIV counseling and testing
37and hepatitis C counseling and testing.

38(B) Has a quality assurance plan approved by the local health
39department in the jurisdiction where the site is located and has
40HIV counseling and testing staff who comply with the quality
P4    1assurance requirements specified in Section 1230 of Article 1 of
2Group 9 of Subchapter 1 of Chapter 2 of Division 1 of Title 17 of
3the California Code of Regulations.

4(3) Is working at a site approved by the local health department
5to provide hepatitis C rapid testing and counseling, and has been
6trained using a curriculum approved by the local health department
7or the State Department of Public Health, which, at a minimum,
8provides training in universal precautions, safe working conditions,
9proper running and reading of hepatitis C rapid test kit technology,
10and providing accurate information to clients including the
11importance of confirmatory tests, linkages to medical care, and
12the prevention of hepatitis C transmission.