Amended in Assembly March 16, 2016

California Legislature—2015–16 Regular Session

Assembly Bill No. 2640

Introduced by Assembly Member Gipson

February 19, 2016

An act to amend Section begin delete 122405 end delete begin insert 120990 end insert of the Health and Safety Code, relating to public health.

LEGISLATIVE COUNSEL’S DIGEST

AB 2640, as amended, Gipson. Public health: begin delete hepatitis C. end delete begin insert HIV. end insert

begin insert

Existing law requires a medical care provider or person administering a test for HIV to, after receiving results indicating no infection for a patient who is at high risk for HIV infection, advise the patient of the need for periodic retesting and explain the limitations of current testing technology and the current window period for verification of results.

end insert begin insert

This bill would additionally require a medical care provider or person administering a test for HIV to inform people who test negative for HIV infection and are at high risk for HIV infection of the effectiveness and safety of all federal Food and Drug Administration-approved methods that prevent or reduce the risk of contracting HIV, including preexposure prophylaxis and postexposure prophylaxis.

end insert begin delete

Existing law, the Hepatitis C Education, Screening, and Treatment Act, sets forth provisions pertaining to education and outreach related to hepatitis C, as specified. Existing law sets forth the intent of the Legislature with regard to these provisions.

end delete begin delete

This bill would make technical, nonsubstantive changes to these provisions.

end delete

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

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

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 120990 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

120990.  

(a) Prior to ordering a test that identifies infection of
a patient with HIV, a medical care provider shall inform the patient
that the test is planned, provide information about the test, inform
the patient that there are numerous treatment options available for
a patient who tests positive for HIV and that a person who tests
negative for HIV should continue to be routinely tested, and advise
the patient that he or she has the right to decline the test. If a patient
declines the test, the medical care provider shall note that fact in
the patient’s medical file.

(b) Subdivision (a) does not apply when a person independently
requests an HIV test from a medical care provider.

(c) Except as provided in subdivision (a), a person shall not
administer a test for HIV infection unless the person being tested
or his or her parent, guardian, conservator, or other person specified
in Section 121020 has provided informed consent for the
performance of the test. Informed consent may be provided orally
or in writing, but the person administering the test shall maintain
documentation of consent, whether obtained orally or in writing,
in the client’s medical record. This consent requirement does not
apply to a test performed at an alternative site pursuant to Section
120890 or 120895. This section does not authorize a person to
administer a test for HIV unless that person is otherwise lawfully
permitted to administer an HIV test.

(d) Subdivision (c) shall not apply when a person independently
requests an HIV test from an HIV counseling and testing site that
employs a trained HIV counselor, pursuant to Section 120917,
provided that the person is provided with information required
pursuant to subdivision (a) and his or her independent request for
an HIV test is documented by the person administering the test.

(e) Nothing in this section shall preclude a medical examiner
or other physician from ordering or performing a test to detect
HIV on a cadaver when an autopsy is performed or body parts are
donated pursuant to the Uniform Anatomical Gift Act (Chapter
3.5 (commencing with Section 7150) of Part 1 of Division 7).

(f) (1) The requirements of subdivision (c) do not apply when
blood is tested as part of a scientific investigation conducted either
by a medical researcher operating under the approval of an
institutional review board or by the department, in accordance with
a protocol for unlinked testing.

(2) For purposes of this subdivision, “unlinked testing” means
blood samples that are obtained anonymously, or that have the
name or identifying information of the individual who provided
the sample removed in a manner that prevents the test results from
ever being linked to the particular individual who participated in
the research or study.

(g) Nothing in this section permits a person to unlawfully
disclose an individual’s HIV status, or to otherwise violate
provisions of Section 54 of the Civil Code, the Americans With
Disabilities Act of 1990 (Public Law 101-336), or the California
Fair Employment and Housing Act (Part 2.8 (commencing with
Section 12900) of Division 3 of Title 2 of the Government Code),
which prohibit discrimination against individuals who are living
with HIV, who test positive for HIV, or who are presumed to be
HIV-positive.

(h) After the results of a test performed pursuant to this section
have been received, the medical care provider or the person who
administers the test shall ensure that the patient receives timely
information and counseling, as appropriate, to explain the results
and the implications for the patient’s health. If the patient tests
positive for HIV infection, the medical provider or the person who
administers the test shall inform the patient that there are numerous
treatment options available and identify followup testing and care
that may be recommended, including contact information for
medical and psychological services. If the patient tests negative
for HIV infection and is known to be at high risk for HIV infection,
the medical provider or the person who administers the test shall
advise the patient of the need for periodic retesting, explain the
limitations of current testing technology and the current window
period for verification of results, begin insert provide information about the
effectiveness and safety of all federal Food and Drug
Administration-approved methods that prevent or reduce the risk
of contracting HIV, including preexposure prophylaxis and
postexposure prophylaxis, consistent with guidance of the federal
Centers for Disease Control and Prevention, end insert and may offer
prevention counseling or a referral to prevention counseling.

(i) This section shall not apply to a clinical laboratory.

begin delete

SECTION 1.  

Section 122405 of the Health and Safety Code
is amended to read:

122405.  

The Legislature hereby finds and declares the
following:

(a)  Hepatitis C is classified as a silent killer, where no
recognizable signs or symptoms occur until severe liver damage
has occurred.

(b)  Hepatitis C has been characterized by the World Health
Organization as a disease of primary concern to humanity.

(c)  Studies indicate that 1.8 percent of the population, nearly
4 million Americans, carry the virus HCV that causes hepatitis C.
In California, as many as 500,000 individuals may be carriers and
could develop the debilitating and potentially deadly liver disease
associated with hepatitis C in their lifetime. An expert panel,
convened in March by the National Institutes of Health (NIH),
estimated that 30,000 acute new infections occur each year in the
United States, and only 25 to 30 percent of those are diagnosed.
Current data sources indicate that 8,000 to 10,000 Americans die
from hepatitis C each year.

(d)  Studies also indicate that 39.4 percent of male inmates and
54.5 percent of female inmates in California correctional facilities
have hepatitis C, 26 times higher than the general population. Upon
their release from prison, these inmates present a significant health
risk to the general population of California.

(e)  It is the intent of the Legislature to study the adequacy of
the health care delivery system as it pertains to hepatitis C.

(f)  It is the intent of the Legislature to urge the department to
make funds available to community-based nonprofit organizations
for education and outreach with respect to the hepatitis C virus.

end delete