Amended in Senate August 1, 2016

Amended in Assembly May 31, 2016

Amended in Assembly April 21, 2016

Amended in Assembly April 12, 2016

California Legislature—2015–16 Regular Session

Assembly BillNo. 2439


Introduced by Assembly Member Nazarian

February 19, 2016


An act to add Section 120992 to the Health and Safety Code, relating to HIV testing.

LEGISLATIVE COUNSEL’S DIGEST

AB 2439, as amended, Nazarian. HIV testing.

Existing law requires that every patient who has blood drawn at a primary care clinic, as defined, and who has consented to the test to be offered an HIV test that is consistent with the United States Preventive Services Task Force recommendations for screening for HIV infection. Existing law specifies the manner in which the results of that test are provided.

This bill would create a pilot project, administered by the State Department of Public Health, to assess and make recommendations regarding the effectiveness of the routine offering of an HIV test in the emergency department of a hospital. The bill would require the department to select 4 hospitals, as provided, that have emergency departments to voluntarily participate in the pilot project. The bill would require the participating hospitals to offer an HIV test to any patient in the hospital emergency department, as provided, to collect specified information, and to report the information to the department. The pilot project would commence on March 1, 2017, and end on February 28, 2019. The bill would require the department, by July 1, 2019, to complete a report to the Legislature on the findings of the 4 hospitals in the pilot project and make recommendations about routine HIV testing in hospital emergency departments.

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

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

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SECTION 1.  

Section 120992 is added to the Health and Safety
2Code
, to read:

3

120992.  

(a) There is hereby created a pilot project, to be
4administered by the department, in order to assess and make
5recommendations regarding the effectiveness of the routine offering
6of an HIV test in the emergency department of a hospital.

7(b) The department shall select four hospitals that have
8emergency departments to voluntarily participate in the pilot
9project.

10(1) Two of the hospitals shall be selected from large urban areas.

11(2) One hospital shall be selected from a small urban or suburban
12area.

13(3) One hospital shall be selected from a rural area.

14(c) Each hospital in the pilot project shall offer an HIV test to
15any patient in the hospital emergency department who has
16consented to the HIV test pursuant to Section 120990. The
17emergency department shall comply with subdivision (h) of Section
18120990 and may choose to comply either by using emergency
19department or other hospital personnel or engaging the services
20of an HIV organization that has experience in prevention
21counseling for persons at risk for HIV.

22(d) begin insert(1)end insertbegin insertend insert A hospital in the pilot project shall not offer a test to
23any person who is being treated for a life-threatening emergency
24or who lacks the capacity to consent to an HIV test.

begin insert

25
(2) If an emergency department physician at a hospital in the
26pilot project determines that a patient is in significant pain or
27distress, including psychological distress, the hospital shall not
28offer an HIV test to the patient. Once an emergency department
29physician determines that the patient has stabilized and is no longer
P3    1in significant pain or distress, including psychological distress,
2the hospital shall offer an HIV test to the patient.

end insert

3(e) A hospital in the pilot project shall offer HIV tests to
4individualsbegin delete betweenend delete 15begin delete andend deletebegin insert toend insert 65 years of age, inclusive, pursuant
5to the United States Preventive Services Task Force
6recommendations.begin insert In order to protect the confidentiality and
7privacy interests of minors, the hospital shall not offer HIV tests
8to individuals 15 to 17 years of age, inclusive, in the presence of
9their parent or legal guardian.end insert

10(f) A hospital in the pilot project shall be authorized to charge
11a patient for the cost of the HIV testing.

12(g) A hospital in the pilot project shall be directed by the
13department to collect and report data on the following topics:

14(1) The frequency of HIV test offers.

15(2) The frequency of consent or nonconsent to an HIV test and
16any reasons given by the patient for the consent or the nonconsent.

17(3) The time taken to offer an HIV test and secure consent from
18a patient and the time taken to provide information and counseling
19pursuant to subdivision (h) of Section 120990.

20(4) The aggregate HIV positivity rate.

21(5) The frequency with which patients agree to participate in a
22session to receive information and counseling pursuant to
23subdivision (h) of Section 120990 and the reasons that patients
24give for refusing to participate.

25(6) The frequency of patients leaving the emergency department
26without receiving their test results.

27(h) A hospital in the pilot project shall provide information to
28the department regarding its practices and protocols for
29implementing the offer of an HIV test and the required followup
30to the test, as well as an assessment of the effectiveness of those
31practices and protocols.

32(i) (1) The pilot project shall commence on March 1, 2017, and
33end on February 28, 2019.

34(2) By July 1, 2019, the department shall complete a report to
35the Legislature on the findings of the four hospitals in the pilot
36project and make recommendations about routine HIV testing in
37hospital emergency departments. In preparing the report to the
38Legislature, the department shall solicit input from a broad range
39of HIV testing and hospital stakeholders.

P4    1(j) (1) The requirement for submitting a report imposed under
2paragraph (2) of subdivision (i) is inoperative on July 1, 2023,
3pursuant to Section 10231.5 of the Government Code.

4(2) A report submitted pursuant to paragraph (2) of subdivision
5(i) shall be submitted in compliance with Section 9795 of the
6Government Code.

7(k) For purposes of this section, “hospital” means a general
8acute care hospital as defined in subdivision (a) of Section 1250.

9(l) The department may seek or use private funding to cover the
10costs of administering the pilot project.



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