BILL ANALYSIS �
SB 422
Page 1
Date of Hearing: June 21, 2011
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
SB 422 (Wright) - As Amended: April 25, 2011
SENATE VOTE : 39-1
SUBJECT : Reporting of certain communicable diseases.
SUMMARY : Revises existing law that permits the sharing of
information related to a positive HIV test between a physician,
a local health officer, and the HIV-positive person's sexual
partner, spouse, and/or persons with whom hypodermic needles
have been shared. Specifically, this bill :
1)Includes the "designated staff of the local public health
agency for HIV partner services" among the people to whom a
physician, who has a confirmed positive test for HIV of an
individual, may disclose that information without criminal or
civil liability.
2)Permits disclosure of identifying information of a person who
tests positive for HIV with the written consent of the
individual, as specified.
3)Exempts from civil and criminal liability a local health
officer and the designated local public health agency staff
for HIV partner services who alert the other specified people
about a positive HIV result.
4)Makes technical, conforming changes.
EXISTING LAW exempts a physician who has the results for a
confirmed positive test for HIV from civil and criminal
liability for disclosing that information to specified people,
including the local health officer, and requires that no
identifying information be disclosed, except as specified.
Permits the local health officer to notify the other specified
people for appropriate care and followup.
FISCAL EFFECT : None
COMMENTS :
SB 422
Page 2
1)PURPOSE OF THIS BILL . According to the author, there is a
need to specify a legal process for a physician to identify an
HIV-infected patient to designated local public health staff,
so that the patient can be interviewed for information about
exposed partners. Current law can be interpreted as
absolutely prohibiting a physician from identifying a patient
to local public health for partner services. Only if the
local public health staff know who the patient is and how to
reach him/her, can it be possible for an experienced public
health partner services specialist to communicate with the
patient to encourage him/her to identify all possible exposed
persons and how the public health specialist can help to
contact them. The author states that this bill would make it
easier to achieve effective partner notification and better
empower California's local public health departments to help
to prevent the spread of HIV. The author states that public
health staff would not feel constrained about contacting,
alerting, and referring those exposed partners for testing and
counseling to help prevent more HIV infections, or to provide
care if they are already infected. Additionally, the author
asserts there were be less pressure to prematurely expunge
information related to the partners from public health
records.
2)Background . The Federal Centers for Disease Control and
Prevention (CDC) estimates that more than one million people
are living with HIV in the United States. Despite increases
in the total number of people living with HIV in the U.S. in
recent years, the annual number of new HIV infections has
remained relatively stable. However, new infections continue
at far too high a level, with an estimated 56,300 Americans
becoming infected with HIV each year. More than 18,000 people
with AIDS still die each year in the U.S. Gay, bisexual, and
other men who have sex with men (MSM) are strongly affected
and represent the majority of persons who have died. Through
2007, more than 576,000 people with AIDS in the U.S. have died
since the epidemic began. Among racial/ethnic groups, African
Americans face the most severe burden of HIV/AIDS in the
nation. While blacks represent approximately 12% of the U.S.
population, they account for 46% of people living with HIV in
the U.S., as well as 45% of new infections each year. MSM
account for 53% of all new HIV infections in the U.S. each
year, and 48% of people living with HIV. Individuals infected
through heterosexual contact account for 31% of annual new HIV
infections and 28% of people living with HIV. Women account
SB 422
Page 3
for 27% of annual new HIV infections and 25% of those living
with HIV. Finally, injection drug users represent 12% of
annual new HIV infections and 19% of those living with HIV.
3)SUPPORT . Beyond AIDS writes that this bill will connect the
dots to improve current law by empowering necessary public
health communication for the prevention and control of the
spread of HIV infections. The California Medical Association
writes that it is very important that physicians are able to
communicate with the appropriate personnel to help control the
transmission of HIV. The California Academy of Preventive
Medicine states that by facilitating communication and
disclosure among health departments, health care providers,
and patients, this bill can result in more complete and
accurate surveillance to track who is being infected with HIV,
so that preventive efforts can be targeted to the people at
risk. The Infectious Disease Association of California writes
that when providing information about suspected contacts to a
local health officer, an HIV positive patient cannot be
identified to allow the health department staff to interview
him or her in order to get information that they do not have
time and techniques to collect, and that this bill will help
assure such communication is possible.
4)PREVIOUS LEGISLATION . AB 2541 (Portantino and Fletcher),
Chapter 470, Statutes of 2010, deletes the HIV exemption from
authorized electronic reporting and explicitly provides
disclosure authority to state and local public health
personnel for the purpose of providing complete information
regarding sexually transmitted disease surveillance to the
federal government.
AB 2658 (Horton), Chapter 449, Statutes of 2008 requires
laboratories to submit all cases of "reportable diseases and
conditions" electronically, within one year of the
establishment of the new state electronic laboratory reporting
system. However, AB 2658 exempted HIV reports from this
requirement to allow the Department of public Health
sufficient time to ensure the new system's data architecture
is in line with HIV-specific reporting requirements and that
the system would meet federal standards for HIV reporting.
SB 699 (Soto), Chapter 20, Statutes of 2006, requires health
care providers and laboratories to report HIV cases by the
patient's name rather than code in order to comply with
federal funding requirements.
SB 422
Page 4
5)DOUBLE REFERRED . This bill is double referred. Should it
pass out of this committee, it will be referred to the
Assembly Committee on Judiciary.
REGISTERED SUPPORT / OPPOSITION :
Support
Beyond AIDS (sponsor)
California Academy of Preventive Medicine
California Medical Association
Infectious Disease Association of California
3 individuals
Opposition
None on file.
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097