BILL NUMBER: AB 2280	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 6, 2006

INTRODUCED BY   Assembly Member Leno

                        FEBRUARY 22, 2006

   An act to add Section 120846 to the Health and Safety Code,
relating to public health.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2280, as amended, Leno  HIV counseling.
   Existing law provides for various programs relating to treatment
of persons with human immunodeficiency virus (HIV) and the acquired
immune deficiency syndrome (AIDS).
   This bill would require the State Department of Health Services,
no later than July 1, 2007, to develop a counseling model for all
persons who receive HIV testing at a  publicly funded clinic,
containing   clinic that receives state funding for HIV
testing. The bill would require that the department consider
including  specified components,  including 
 relating to  , among other things, risk assessment, data
collection,  and  prevention education  , and
additional counseling  .
   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.  (a) The Legislature finds and declares all of the
following:
   (1) Best practice models of human immunodeficiency virus (HIV)
counseling that grew out of early HIV testing have not kept pace with
the changes in the human immunodeficiency virus (HIV)/acquired
immune deficiency syndrome (AIDS) epidemic.
   (2) The availability of rapid HIV testing, in which a person can
get a preliminary reading of their HIV status in about 20 minutes,
has  illuminated weaknesses in   created
opportunities to   streamline  the current counseling
model.
   (3) The availability of treatment has turned HIV from a virtual
death sentence to a managed chronic medical condition.
   (4) Counseling of persons getting an HIV test has been focused on
educating people about HIV prevention techniques, collecting
epidemiological data, and referring people with a positive test
result to treatment  and partner notification counseling  .

   (5)  An increasing   A  number of test
subjects are persons at low risk for exposure to HIV, and 
serial testers are typically those persons   repeat
testers  who are tested on a regular basis.
   (6) The current counseling model employs the same  tactics
  process  regardless of whether the test subject
is at low or high risk of exposure and whether the test subject is a
first-time tester or is a  serial   repeat 
tester.
   (7) While any person who seeks an HIV test should be able to get
one, the limited resources available for testing demand that
confidential and anonymous testing clinics  be flexible in
terms of how counseling is delivered   have a range of
options for delivering counseling  .
   (b) It is the intent of the Legislature that a new HIV counseling
model be developed that allows clinics to increase the number of
persons seeking a HIV test to be able to be tested, and appropriately
reimburses clinics for the services provided to those persons.
  SEC. 2.  Section 120846 is added to the Health and Safety Code, to
read:
   120846.  (a) The department shall, no later than July 1, 2007,
develop a counseling model for all persons who receive HIV 
testing at a publicly funded clinic. The model shall include all of
the following components:   testing at a clinic that
receives state funding for HIV testing. The department shall consider
including each of the following components in the counseling model:

   (1) A brief risk-assessment mechanism developed by the department
that allows a clinic to ascertain whether a person seeking testing is
at low or high risk of exposure to HIV.  This mechanism
  The department may recommend when and how a clinic
should use this mechanism, but it  shall not be used to deny
testing to a subject who requests it.
   (2) A data collection form that  shall   may
 be self-administered by the test subject, and that includes
only questions that must be reported in accordance with existing
state and federal epidemiology report requirements. 
Consideration shall be given to reducing the length of the form and
its utility, including whether state or local resources exist to
analyze the data collected.  Additional questions may be added
only if new state or federal epidemiology reports are required.
 The form may   Local health agencies may add
questions only with the approval of the department. While the form
may be self-administered, it also may  be completed with the
assistance of a counselor at the request of the test subject.
   (3) A prevention education module that comprehensively covers all
pertinent information relative to methods by which a person can
protect himself or herself or his or her sexual or 
needle-sharing partners from exposure to HIV.  The module may be
administered individually or in small groups.  
needle-sharing partners from exposure to HIV.  Consideration may be
given to allowing clinics alternative methods of providing the
prevention education module, although no test subject shall be denied
the opportunity to receive prevention education   privately
and individually.  
   (b) The model shall give flexibility to clinics to determine the
extent of counseling provided to a test subject based on a test
subject's risk factors or frequency of HIV testing, except that every
person shall be subject subdivision (a).  
   (c) The model shall give flexibility to clinics to provide
counseling to couples or small groups, as appropriate. 

   (d) The model shall require additional counseling for a test
subject whose preliminary test result is positive. This additional
counseling shall include, as needed by the test subject, emotional
support, information on confirmatory testing, referral to care and
treating opportunities, and a review of methods to prevent exposing
others to HIV.  
   (4) Flexibility for clinics to determine the extent of counseling
provided to a test subject based on a test subject's risk factors or
frequency of HIV testing.  
   (5) Flexibility for clinics to provide counseling to couples or
small groups, as appropriate.  
   (6) Additional counseling for a test subject whose preliminary
test result is positive. This additional counseling may include, as
needed by the test subject, emotional support, information on
confirmatory testing, referral to care and treatment opportunities,
and a review of methods to prevent exposing others to HIV. 

   (e) 
    (b)  The department shall develop a reimbursement
schedule that accurately reflects the range of services provided
under this model. It is the intent of the Legislature that this new
model and reimbursement schedule be cost-neutral, except to the
extent that there is an increase in the volume of test subjects.