Amended in Senate August 15, 2016

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 Bill No. 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, begin delete as provided, end delete begin insert or fewer under specified circumstances, end insert 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 begin delete July end delete begin insert December end insert 1, 2019, to complete a report to the Legislature on the findings of the begin delete 4 end delete hospitals in the pilot project and make recommendations about routine HIV testing in hospital emergency departments.

begin insert

This bill would require that these provisions be implemented only to the extent that the department identifies available funding for the purposes of these provisions.

end insert

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

120992.  

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

(b) The department shall select four hospitals that have
emergency departments to voluntarily participate in the pilot
project. begin insert The department may select fewer hospitals if an insufficient
number of hospitals express willingness to voluntarily participate. end insert

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

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

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

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

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

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

(e) A hospital in the pilot project shall offer HIV tests to
individuals 15 to 65 years of age, inclusive, pursuant to the United
States Preventive Services Task Force recommendations. In order
to protect the confidentiality and privacy interests of minors, the
hospital shall not offer HIV tests to individuals 15 to 17 years of
age, inclusive, in the presence of their parent or legal guardian.

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

(g) A hospital in the pilot project shall be directed by the
begin delete department end delete begin insert department, in a form, manner, and timeframe
determined by the department, end insert to collect and report data on the
following topics:

(1) The frequency of HIV test offers.

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

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

(4) The aggregate HIV positivity rate.

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

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

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

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

(2) By begin delete July end delete begin insert December end insert 1, 2019, the department shall complete
a report to the Legislature on the findings of the begin delete four end delete hospitals in
the pilot project and make recommendations about routine HIV
testing in hospital emergency departments. In preparing the report
to the Legislature, the department shall solicit input from a broad
range of HIV testing and hospital stakeholders.

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

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

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

(l)  begin insert This section shall be implemented only to the extent that the
department identifies available funding for the purposes of this
section. end insert The department may seek or use private funding to cover
the costs of administering the pilot project.