BILL NUMBER: AB 1663
VETOED DATE: 09/29/1998
To the Members of the California Assembly:
I am returning Assembly Bill No. 1663 without my signature.
This bill would enact a statewide public health reporting system for
Human Immunodeficiency Virus (HIV) using a unique identifier method
that does not report the name or any other identifying information
about the person infected. This bill would also increase civil
penalties for violating existing confidentiality laws related to
Acquired Immunodeficiency Syndrome (AIDS) and HIV public records.
California is one of only nine states that does not track HIV
infection. California law, however, does require that persons with
AIDS, and approximately 80 other diseases, be reported by name to the
Local Health Officer.
Tracking the HIV/AIDS epidemic using only AIDS case data tells us
where the epidemic was ten years ago, but not what is currently
happening or where the epidemic is headed. The new AIDS drugs are
delaying the onset of AIDS and thus delaying AIDS case-based
epidemiological information. In contrast, HIV infection reporting
would provide far more timely information about where and how new
infections are occurring so that education and prevention efforts can
be effectively targeted at high-risk p opulations and communities.
Furthermore, HIV reporting would give a much better estimate of the
population in need of care and treatment services, especially for
those who have yet to develop AIDS.
Public health officials and physicians are divided on the best way to
report HIV infection. The author and supporters of this measure
argue that reporting HIV test results by name will deter individuals
from seeking testing or medical care. However, The National Centers
for Disease Control (CDC) found that HIV name based reporting systems
resulted in less than a 2 percent decline in the number of those
seeking HIV testing.
Concerns over confidentiality and discrimination should not be used
to justify an inadequate reporting system. Existing law ensures
confidentiality and protects those with HIV or AIDS from
discrimination. Health & Safety Code Section 120980 provides that
the result of an HIV test may not be disclosed to any third party
absent written authorization. The California Fair Employment and
Housing Act and regulations prohibit discrimination in employment or
housing. The Unruh Civil Rights Act proh ibits discrimination by
business establishments and discrimination in the use of public
accommodations. Most importantly, Health & Safety Code Assembly Bill
1663 Page 2
Section 120980 prohibits using the results of an HIV test for
determining an individual's eligibility for employment. Thus, any
further concerns over privacy and discrimination do not warrant
designing a reporting system that does not adequately provide for
partner notification. Irrational concerns over privacy should not
interfere with what must be our highest priority, interrupting the
chain of HIV transmission.
Thirty states are successfully using a name based HIV reporting
system while only two states, Maryland and Texas, use a unique
identifier based system similar to this bill. The CDC found that the
Maryland and Texas systems had so many inaccurate and incomplete
reports that it was difficult to obtain useful data and to trace and
notify partners of possible HIV infection. As a result of these
significant defects, Texas is abandoning its unique identifier based
system in favor of a name based HI V reporting system.
California is now experiencing a dramatic increase in HIV infections
among lower-income and minority women. These are preventable
infections resulting from partner contact and intravenous drug use.
We know, from our experience with the 80 other reportable,
communicable diseases, that we can minimize the exposure and deaths
resulting from this terrifying disease. We must not ignore the
experience of 30 other states and implement an inadequate HIV
reporting system that, in the end, will result in tragic
consequences.
Cordially,
PETE WILSON