Amended in Assembly March 28, 2016

California Legislature—2015–16 Regular Session

Assembly Bill No. 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.

LEGISLATIVE COUNSEL’S DIGEST

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:

SECTION 1.  

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

122440.  

(a) A hepatitis C counselor who meets the
requirements of subdivision begin delete (e) end delete begin insert (d) end insert may do all of the following:

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

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

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

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

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

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

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

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

begin delete

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

end delete begin delete

(c)

end delete

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

begin delete

(d)

end delete

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

begin delete

(e)

end delete

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

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

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

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

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

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