BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 422
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          SENATE THIRD READING
          SB 422 (Wright)
          As Amended April 25, 2011
          Majority vote

           SENATE VOTE  :39-1  
           
           HEALTH              19-0        JUDICIARY           9-0         
           
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          |Ayes:|Monning, Logue, Ammiano,  |Ayes:|Feuer, Wagner, Atkins,    |
          |     |Atkins, Bonilla, Eng,     |     |Dickinson, Beth Gaines,   |
          |     |Garrick, Gordon, Hayashi, |     |Huber, Jones, Monning,    |
          |     |Roger Hern�ndez,          |     |Wieckowski                |
          |     |Bonnie Lowenthal,         |     |                          |
          |     |Mansoor, Mitchell,        |     |                          |
          |     |Nestande, Pan,            |     |                          |
          |     |V. Manuel P�rez, Silva,   |     |                          |
          |     |Smyth, Williams           |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           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.









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           FISCAL EFFECT  :  None

           COMMENTS  :  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 or 
          her, can it be possible for an experienced public health partner 
          services specialist to communicate with the patient to encourage 
          him or 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.

          The Federal Centers for Disease Control and Prevention (CDC) 
          estimates that more than one million people are living with HIV 
          in the United States (U.S.).  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 








                                                                  SB 422
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          for 31% of annual new HIV infections and 28% of people living 
          with HIV.  Women account 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.

          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.


           Analysis Prepared by  :    Melanie Moreno / HEALTH / (916) 
          319-2097 


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