Senate Bill 2096

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    Florida Senate - 1998                                  SB 2096

    By Senator Burt





    16-1231-98

  1                      A bill to be entitled

  2         An act relating to human immunodeficiency virus

  3         testing; amending s. 381.004, F.S.; providing

  4         for disclosure of HIV test results to the

  5         patient's health care providers; requiring HIV

  6         testing of certain health care facility

  7         patients; providing that health care providers

  8         receiving HIV test results must maintain their

  9         confidentiality; amending s. 395.3025, F.S.;

10         providing for inclusion of results of required

11         HIV tests in patient records; providing an

12         effective date.

13

14  Be It Enacted by the Legislature of the State of Florida:

15

16         Section 1.  Section 381.004, Florida Statutes, is

17  amended to read:

18         381.004  Testing for human immunodeficiency virus.--

19         (1)  LEGISLATIVE INTENT.--The Legislature finds that

20  the use of tests designed to reveal a condition indicative of

21  human immunodeficiency virus infection can be a valuable tool

22  in protecting the public health.  The Legislature finds that

23  despite existing laws, regulations, and professional standards

24  which require or promote the informed, voluntary, and

25  confidential use of tests designed to reveal human

26  immunodeficiency virus infection, many members of the public

27  are deterred from seeking such testing because they

28  misunderstand the nature of the test or fear that test results

29  will be disclosed without their consent.  The Legislature

30  finds that the public health will be served by facilitating

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  1  informed, voluntary, and confidential use of tests designed to

  2  detect human immunodeficiency virus infection.

  3         (2)  DEFINITIONS.--As used in this section:

  4         (a)  "HIV test" means a test ordered after July 6,

  5  1988, to determine the presence of the antibody or antigen to

  6  human immunodeficiency virus or the presence of human

  7  immunodeficiency virus infection.

  8         (b)  "HIV test result" means a laboratory report of a

  9  human immunodeficiency virus test result entered into a

10  medical record on or after July 6, 1988, or any report or

11  notation in a medical record of a laboratory report of a human

12  immunodeficiency virus test.  As used in this section, the

13  term "HIV test result" does not include test results reported

14  to a health care provider by a patient.

15         (c)  "Significant exposure" means:

16         1.  Exposure to blood or body fluids through

17  needlestick, instruments, or sharps;

18         2.  Exposure of mucous membranes to visible blood or

19  body fluids, to which universal precautions apply according to

20  the National Centers for Disease Control and Prevention,

21  including, without limitations, the following body fluids:

22         a.  Blood.

23         b.  Semen.

24         c.  Vaginal secretions.

25         d.  Cerebro-spinal fluid (CSF).

26         e.  Synovial fluid.

27         f.  Pleural fluid.

28         g.  Peritoneal fluid.

29         h.  Pericardial fluid.

30         i.  Amniotic fluid.

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  1         j.  Laboratory specimens that contain HIV (e.g.,

  2  suspensions of concentrated virus); or

  3         3.  Exposure of skin to visible blood or body fluids,

  4  especially when the exposed skin is chapped, abraded, or

  5  afflicted with dermatitis or the contact is prolonged or

  6  involving an extensive area.

  7         (d)  "Test subject" or "subject of the test" means the

  8  person upon whom an HIV test is performed, or the person who

  9  has legal authority to make health care decisions for the test

10  subject.

11         (3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED

12  CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--

13         (a)  No person in this state shall perform a test

14  designed to identify the human immunodeficiency virus, or its

15  antigen or antibody, without first obtaining the informed

16  consent of the person upon whom the test is being performed,

17  except as specified in paragraph (i).  Informed consent shall

18  be preceded by an explanation of the right to confidential

19  treatment of information identifying the subject of the test

20  and the results of the test to the extent provided by law.

21  Consent need not be in writing provided there is documentation

22  in the medical record that the test has been explained and the

23  consent has been obtained.

24         (b)  Except as provided in paragraph (i), informed

25  consent must be obtained from a legal guardian or other person

26  authorized by law when the person:

27         1.  Is not competent or is otherwise unable to make an

28  informed judgment; or

29         2.  Has not reached the age of majority, except as

30  provided in s. 384.30.

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  1         (c)  Except as provided in paragraph (i), no person

  2  shall order a test without making available to the person

  3  tested, prior to the test, information regarding measures for

  4  the prevention of, exposure to, and transmission of human

  5  immunodeficiency virus. At the time an HIV test is ordered,

  6  the person ordering the test shall schedule a return visit

  7  with the test subject for the purpose of disclosing the test

  8  results and conducting posttest counseling as described in

  9  paragraph (e).

10         (d)  No test result shall be determined as positive,

11  and no positive test result shall be revealed to any person,

12  without corroborating or confirmatory tests being conducted.

13  However, preliminary test results may be released to licensed

14  physicians or the medical personnel subject to the significant

15  exposure for purposes of subparagraphs (i)10. and 11.  Except

16  as provided in this section, test results are confidential and

17  exempt from the provisions of s. 119.07(1).

18         (e)  Except as otherwise provided, no test result shall

19  be revealed to the person upon whom the test was performed

20  without affording that person the immediate opportunity for

21  individual, face-to-face counseling about:

22         1.  The meaning of the test results;

23         2.  The possible need for additional testing;

24         3.  Measures for the prevention of the transmission of

25  the human immunodeficiency virus infection;

26         4.  The availability in the geographic area of any

27  appropriate health care services, including mental health

28  care, and appropriate social and support services;

29         5.  The benefits of locating and counseling any

30  individual by whom the infected individual may have been

31  exposed to the human immunodeficiency virus infection and any

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  1  individual whom the infected individual may have exposed to

  2  such human immunodeficiency virus infection; and

  3         6.  The availability, if any, of the services of public

  4  health authorities with respect to locating and counseling any

  5  individual described in subparagraph 5.

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  7  Telephonic posttest counseling shall be permitted when

  8  reporting the HIV test results of a home access HIV test that

  9  is approved by the United States Food and Drug Administration

10  and analyzed by a laboratory certified under the federal

11  Clinical Laboratory Improvement Amendments of 1988 or licensed

12  under part I of chapter 483.

13         (f)  Except as provided in this section, the identity

14  of any person upon whom a test has been performed and test

15  results are confidential and exempt from the provisions of s.

16  119.07(1).  No person who has obtained or has knowledge of a

17  test result pursuant to this section may disclose or be

18  compelled to disclose the identity of any person upon whom a

19  test is performed, or the results of such a test in a manner

20  which permits identification of the subject of the test,

21  except to the following persons:

22         1.  The subject of the test or the subject's legally

23  authorized representative.

24         2.  Any person, including third-party payors,

25  designated in a legally effective release of the test results

26  executed prior to or after the test by the subject of the test

27  or the subject's legally authorized representative. The test

28  subject may in writing authorize the disclosure of the test

29  subject's HIV test results to third party payors, who need not

30  be specifically identified, and to other persons to whom the

31  test subject subsequently issues a general release of medical

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  1  information.  A general release without such prior written

  2  authorization is not sufficient to release HIV test results.

  3         3.  An authorized agent or employee of a health

  4  facility or health care provider if the health facility or

  5  health care provider itself is authorized to obtain the test

  6  results, the agent or employee participates in the

  7  administration or provision of patient care or handles or

  8  processes specimens of body fluids or tissues, and the agent

  9  or employee has a need to know such information.  The

10  department shall adopt a rule defining which persons have a

11  need to know pursuant to this subparagraph.

12         4.  Health care providers consulting between themselves

13  or with health care facilities to determine diagnosis and

14  treatment. For purposes of this subparagraph, health care

15  providers shall include licensed health care professionals

16  employed by or associated with state, county, or municipal

17  detention facilities when such health care professionals are

18  acting exclusively for the purpose of providing diagnoses or

19  treatment of persons in the custody of such facilities.

20         5.  The department, in accordance with rules for

21  reporting and controlling the spread of disease, as otherwise

22  provided by state law.

23         6.  A health facility or health care provider which

24  procures, processes, distributes, or uses:

25         a.  A human body part from a deceased person, with

26  respect to medical information regarding that person; or

27         b.  Semen provided prior to July 6, 1988, for the

28  purpose of artificial insemination.

29         7.  Health facility staff committees, for the purposes

30  of conducting program monitoring, program evaluation, or

31  service reviews pursuant to chapters 395 and 766.

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  1         8.  Authorized medical or epidemiological researchers

  2  who may not further disclose any identifying characteristics

  3  or information.

  4         9.  A person allowed access by a court order which is

  5  issued in compliance with the following provisions:

  6         a.  No court of this state shall issue such order

  7  unless the court finds that the person seeking the test

  8  results has demonstrated a compelling need for the test

  9  results which cannot be accommodated by other means.  In

10  assessing compelling need, the court shall weigh the need for

11  disclosure against the privacy interest of the test subject

12  and the public interest which may be disserved by disclosure

13  which deters blood, organ, and semen donation and future human

14  immunodeficiency virus-related testing or which may lead to

15  discrimination.  This paragraph shall not apply to blood bank

16  donor records.

17         b.  Pleadings pertaining to disclosure of test results

18  shall substitute a pseudonym for the true name of the subject

19  of the test.  The disclosure to the parties of the subject's

20  true name shall be communicated confidentially in documents

21  not filed with the court.

22         c.  Before granting any such order, the court shall

23  provide the individual whose test result is in question with

24  notice and a reasonable opportunity to participate in the

25  proceedings if he or she is not already a party.

26         d.  Court proceedings as to disclosure of test results

27  shall be conducted in camera, unless the subject of the test

28  agrees to a hearing in open court or unless the court

29  determines that a public hearing is necessary to the public

30  interest and the proper administration of justice.

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  1         e.  Upon the issuance of an order to disclose test

  2  results, the court shall impose appropriate safeguards against

  3  unauthorized disclosure which shall specify the persons who

  4  may have access to the information, the purposes for which the

  5  information shall be used, and appropriate prohibitions on

  6  future disclosure.

  7         10.  A person allowed access by order of a judge of

  8  compensation claims of the Division of Workers' Compensation

  9  of the Department of Labor and Employment Security.  A judge

10  of compensation claims shall not issue such order unless he or

11  she finds that the person seeking the test results has

12  demonstrated a compelling need for the test results which

13  cannot be accommodated by other means.

14         11.  Those employees of the department or of

15  child-placing or child-caring agencies or of family foster

16  homes, licensed pursuant to s. 409.175, who are directly

17  involved in the placement, care, control, or custody of such

18  test subject and who have a need to know such information;

19  adoptive parents of such test subject; or any adult custodian,

20  any adult relative, or any person responsible for the child's

21  welfare, if the test subject was not tested under subparagraph

22  (b)2. and if a reasonable attempt has been made to locate and

23  inform the legal guardian of a test result. The department

24  shall adopt a rule to implement this subparagraph.

25         12.  Medical personnel who have been subject to a

26  significant exposure during the course of medical practice or

27  in the performance of professional duties, or individuals who

28  are the subject of the significant exposure as provided in

29  subparagraphs (i)10. and 11.

30         13.  Health care providers involved in the patient's

31  care.

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  1         (g)  Except as provided in this section, the identity

  2  of a person upon whom a test has been performed is

  3  confidential and exempt from the provisions of s. 119.07(1).

  4  No person to whom the results of a test have been disclosed

  5  may disclose the test results to another person except as

  6  authorized by this subsection and by ss. 951.27 and 960.003.

  7  Whenever disclosure is made pursuant to this subsection, it

  8  shall be accompanied by a statement in writing which includes

  9  the following or substantially similar language: "This

10  information has been disclosed to you from records whose

11  confidentiality is protected by state law.  State law

12  prohibits you from making any further disclosure of such

13  information without the specific written consent of the person

14  to whom such information pertains, or as otherwise permitted

15  by state law.  A general authorization for the release of

16  medical or other information is NOT sufficient for this

17  purpose." An oral disclosure shall be accompanied by oral

18  notice and followed by a written notice within 10 days, except

19  that this notice shall not be required for disclosures made

20  pursuant to subparagraphs (f)3. and 4.

21         (h)  Human immunodeficiency virus test results

22  contained in the medical records of a hospital licensed under

23  chapter 395 may be released in accordance with s. 395.3025

24  without being subject to the requirements of subparagraph

25  (f)2., subparagraph (f)9., or paragraph (g); provided the

26  hospital has obtained written informed consent for the HIV

27  test in accordance with provisions of this section.

28         (i)  Notwithstanding the provisions of paragraph (a),

29  informed consent is not required:

30

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  1         1.  When testing for sexually transmissible diseases is

  2  required by state or federal law, or by rule including the

  3  following situations:

  4         a.  HIV testing pursuant to s. 796.08 of persons

  5  convicted of prostitution or of procuring another to commit

  6  prostitution.

  7         b.  Testing for HIV by a medical examiner in accordance

  8  with s. 406.11.

  9         2.  Those exceptions provided for blood, plasma,

10  organs, skin, semen, or other human tissue pursuant to s.

11  381.0041.

12         3.  For the performance of an HIV-related test by

13  licensed medical personnel in bona fide medical emergencies

14  when the test results are necessary for medical diagnostic

15  purposes to provide appropriate emergency care or treatment to

16  the person being tested and the patient is unable to consent,

17  as supported by documentation in the medical record. Posttest

18  counseling is required.

19         4.  For the performance of an HIV-related test by

20  licensed medical personnel for medical diagnosis of acute

21  illness where, in the opinion of the attending physician,

22  obtaining informed consent would be detrimental to the

23  patient, as supported by documentation in the medical record,

24  and the test results are necessary for medical diagnostic

25  purposes to provide appropriate care or treatment to the

26  person being tested. Posttest counseling is required if it

27  would not be detrimental to the patient.  This subparagraph

28  does not authorize the routine testing of patients for HIV

29  infection without informed consent.

30         5.  When HIV testing is performed as part of an autopsy

31  for which consent was obtained pursuant to s. 872.04.

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  1         6.  For the performance of an HIV test upon a defendant

  2  pursuant to the victim's request in a prosecution for any type

  3  of sexual battery where a blood sample is taken from the

  4  defendant voluntarily, pursuant to court order for any

  5  purpose, or pursuant to the provisions of s. 775.0877, s.

  6  951.27, or s. 960.003; however, the results of any HIV test

  7  performed shall be disclosed solely to the victim and the

  8  defendant, except as provided in ss. 775.0877, 951.27, and

  9  960.003.

10         7.  When an HIV test is mandated by court order.

11         8.  For epidemiological research pursuant to s.

12  381.0032, for research consistent with institutional review

13  boards created by 45 C.F.R. part 46, or for the performance of

14  an HIV-related test for the purpose of research, if the

15  testing is performed in a manner by which the identity of the

16  test subject is not known and may not be retrieved by the

17  researcher.

18         9.  When human tissue is collected lawfully without the

19  consent of the donor for corneal removal as authorized by s.

20  732.9185 or enucleation of the eyes as authorized by s.

21  732.919.

22         10.  For the performance of an HIV test upon an

23  individual who comes into contact with medical personnel in

24  such a way that a significant exposure has occurred during the

25  course of employment or within the scope of practice and where

26  a blood sample is taken from that individual voluntarily by

27  medical personnel for other purposes.  "Medical personnel"

28  includes a licensed or certified health care professional; an

29  employee of a health care professional, health care facility,

30  or blood bank; and a paramedic or emergency medical technician

31  as defined in s. 401.23.

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  1         a.  Prior to performance of an HIV test on a

  2  voluntarily obtained blood sample, the individual from whom

  3  the blood was obtained shall be requested to consent to the

  4  performance of the test and to the release of the results.

  5  The individual's refusal to consent and all information

  6  concerning the performance of an HIV test and any HIV test

  7  result shall be documented only in the medical personnel's

  8  record unless the individual gives written consent to entering

  9  this information on the individual's medical record.

10         b.  Reasonable attempts to locate the individual and to

11  obtain consent shall be made and all attempts must be

12  documented. If the individual cannot be found, an HIV test may

13  be conducted on the available blood sample. If the individual

14  does not voluntarily consent to the performance of an HIV

15  test, the individual shall be informed that an HIV test will

16  be performed, and counseling shall be furnished as provided in

17  this section.  However, HIV testing shall be conducted only

18  after a licensed physician documents, in the medical record of

19  the medical personnel, that there has been a significant

20  exposure and that, in the physician's medical judgment, the

21  information is medically necessary to determine the course of

22  treatment for the medical personnel.

23         c.  Costs of any HIV test of a blood sample performed

24  with or without the consent of the individual, as provided in

25  this subparagraph, shall be borne by the medical personnel or

26  the employer of the medical personnel. However, costs of

27  testing or treatment not directly related to the initial HIV

28  tests or costs of subsequent testing or treatment shall not be

29  borne by the medical personnel or the employer of the medical

30  personnel.

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  1         d.  In order to utilize the provisions of this

  2  subparagraph, the medical personnel must either be tested for

  3  HIV pursuant to this section or provide the results of an HIV

  4  test taken within 6 months prior to the significant exposure

  5  if such test results are negative.

  6         e.  A person who receives the results of an HIV test

  7  pursuant to this subparagraph shall maintain the

  8  confidentiality of the information received and of the persons

  9  tested.  Such confidential information is exempt from s.

10  119.07(1).

11         11.  For the performance of an HIV test upon an

12  individual who comes into contact with medical personnel in

13  such a way that a significant exposure has occurred during the

14  course of employment or within the scope of practice of the

15  medical personnel while the medical personnel provides

16  emergency medical treatment to the individual; or who comes

17  into contact with nonmedical personnel in such a way that a

18  significant exposure has occurred while the nonmedical

19  personnel provides emergency medical assistance during a

20  medical emergency.  For the purposes of this subparagraph, a

21  medical emergency means an emergency medical condition outside

22  of a hospital or health care facility that provides physician

23  care. The test may be performed only during the course of

24  treatment for the medical emergency.

25         a.  An individual who is capable of providing consent

26  shall be requested to consent to an HIV test prior to the

27  testing. The individual's refusal to consent, and all

28  information concerning the performance of an HIV test and its

29  result, shall be documented only in the medical personnel's

30  record unless the individual gives written consent to entering

31  this information on the individual's medical record.

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  1         b.  HIV testing shall be conducted only after a

  2  licensed physician documents, in the medical record of the

  3  medical personnel or nonmedical personnel, that there has been

  4  a significant exposure and that, in the physician's medical

  5  judgment, the information is medically necessary to determine

  6  the course of treatment for the medical personnel or

  7  nonmedical personnel.

  8         c.  Costs of any HIV test performed with or without the

  9  consent of the individual, as provided in this subparagraph,

10  shall be borne by the medical personnel or the employer of the

11  medical personnel or nonmedical personnel.  However, costs of

12  testing or treatment not directly related to the initial HIV

13  tests or costs of subsequent testing or treatment shall not be

14  borne by the medical personnel or the employer of the medical

15  personnel or nonmedical personnel.

16         d.  In order to utilize the provisions of this

17  subparagraph, the medical personnel or nonmedical personnel

18  shall be tested for HIV pursuant to this section or shall

19  provide the results of an HIV test taken within 6 months prior

20  to the significant exposure if such test results are negative.

21         e.  A person who receives the results of an HIV test

22  pursuant to this subparagraph shall maintain the

23  confidentiality of the information received and of the persons

24  tested.  Such confidential information is exempt from s.

25  119.07(1).

26         12.  For the performance of an HIV-related test

27  medically indicated by licensed medical personnel for medical

28  diagnosis of a hospitalized infant as necessary to provide

29  appropriate care and treatment of the infant when, after a

30  reasonable attempt, a parent cannot be contacted to provide

31  consent. The medical records of the infant shall reflect the

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  1  reason consent of the parent was not initially obtained.  Test

  2  results and posttest counseling shall be provided to the

  3  parent when the parent is located.

  4         13.  For the performance of an HIV test on any patient

  5  entering a health care facility licensed under chapter 395 for

  6  treatment involving an invasive procedure, whether the

  7  treatment is performed in an emergency room or on an

  8  outpatient or inpatient basis.  Each such patient shall be

  9  tested for HIV, and the test results shall be made available

10  to the health care providers involved in the patient's care,

11  notwithstanding any other provision of this section.  Each

12  person who receives the results of an HIV test performed under

13  this subparagraph shall maintain the confidentiality of the

14  information and the identity of the person tested.  Such

15  confidential information is exempt from s. 119.07(1).

16         (4)  COUNTY HEALTH DEPARTMENT NETWORK OF VOLUNTARY

17  HUMAN IMMUNODEFICIENCY VIRUS TESTING PROGRAMS.--

18         (a)  The Department of Health shall establish a network

19  of voluntary human immunodeficiency virus testing programs in

20  every county in the state. These programs shall be conducted

21  in each county health department established under the

22  provisions of part I of chapter 154. Additional programs may

23  be contracted to other private providers to the extent that

24  finances permit and local circumstances dictate.

25         (b)  Each county health department shall have the

26  ability to provide counseling and testing for human

27  immunodeficiency virus to each patient who receives services

28  and shall offer such testing on a voluntary basis to each

29  patient who presents himself or herself for services in a

30  public health program designated by the State Health Officer

31  by rule.

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  1         (c)  Each county health department shall provide a

  2  program of counseling and testing for human immunodeficiency

  3  virus infection, on both an anonymous and confidential basis.

  4  Counseling provided to a patient tested on both an anonymous

  5  and confidential basis shall include informing the patient of

  6  the availability of partner-notification services, the

  7  benefits of such services, and the confidentiality protections

  8  available as part of such services. The Department of Health

  9  or its designated agent shall continue to provide for

10  anonymous testing through an alternative testing site program

11  with sites throughout all areas of the state. Each county

12  health department shall maintain a list of anonymous testing

13  sites.  The list shall include the locations, phone numbers,

14  and hours of operation of the sites and shall be disseminated

15  to all persons and programs offering human immunodeficiency

16  virus testing within the service area of the county health

17  department, including physicians licensed under chapter 458 or

18  chapter 459. Except as provided in this section, the identity

19  of a person upon whom a test has been performed and test

20  results are confidential and exempt from the provisions of s.

21  119.07(1).

22         (d)  The result of a serologic test conducted under the

23  auspices of the Department of Health shall not be used to

24  determine if a person may be insured for disability, health,

25  or life insurance or to screen or determine suitability for,

26  or to discharge a person from, employment.  Any person who

27  violates the provisions of this subsection is guilty of a

28  misdemeanor of the first degree, punishable as provided in s.

29  775.082 or s. 775.083.

30         (5)  HUMAN IMMUNODEFICIENCY VIRUS TESTING REQUIREMENTS;

31  REGISTRATION WITH THE DEPARTMENT OF HEALTH; EXEMPTIONS FROM

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  1  REGISTRATION.--No county health department and no other person

  2  in this state shall conduct or hold themselves out to the

  3  public as conducting a testing program for acquired immune

  4  deficiency syndrome, acquired immune deficiency syndrome

  5  related complex, or human immunodeficiency virus status

  6  without first registering with the Department of Health,

  7  complying with all other applicable provisions of state law,

  8  and meeting the following requirements:

  9         (a)  The program must be directed by a person with a

10  minimum number of contact hours of experience in the

11  counseling of persons with acquired immune deficiency

12  syndrome, acquired immune deficiency syndrome related complex,

13  or human immunodeficiency virus infection, as established by

14  the Department of Health by rule.

15         (b)  The program must have all medical care supervised

16  by a physician licensed under the provisions of chapter 458 or

17  chapter 459.

18         (c)  The program shall have all laboratory procedures

19  performed in a laboratory licensed under the provisions of

20  chapter 483.

21         (d)  The program must meet all the informed consent

22  criteria contained in subsection (3).

23         (e)  The program must provide pretest counseling on the

24  meaning of a test for human immunodeficiency virus, including

25  medical indications for the test; the possibility of false

26  positive or false negative results; the potential need for

27  confirmatory testing; the potential social, medical, and

28  economic consequences of a positive test result; and the need

29  to eliminate high-risk behavior.

30         (f)  The program must provide supplemental

31  corroborative testing on all positive test results before the

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  1  results of any positive test are provided to the patient.

  2  Except as provided in this section, the identity of any person

  3  upon whom a test has been performed and test results are

  4  confidential and exempt from the provisions of s. 119.07(1).

  5         (g)  The program must provide face-to-face posttest

  6  counseling on the meaning of the test results; the possible

  7  need for additional testing; the social, medical, and economic

  8  consequences of a positive test result; and the need to

  9  eliminate behavior which might spread the disease to others.

10         (h)  Each person providing posttest counseling to a

11  patient with a positive test result shall receive specialized

12  training, to be specified by rule of the department, about the

13  special needs of persons with positive results, including

14  recognition of possible suicidal behavior, and shall refer the

15  patient for further health and social services as appropriate.

16         (i)  When services are provided for a charge during

17  pretest counseling, testing, supplemental testing, and

18  posttest counseling, the program must provide a complete list

19  of all such charges to the patient and the Department of

20  Health.

21         (j)  Nothing in this subsection shall be construed to

22  require a facility licensed under chapter 483 or a person

23  licensed under the provisions of chapter 457, chapter 458,

24  chapter 459, chapter 460, chapter 461, chapter 466, or chapter

25  467 to register with the Department of Health if he or she

26  does not advertise or hold himself or herself out to the

27  public as conducting testing programs for human

28  immunodeficiency virus infection or specializing in such

29  testing.

30         (6)  PENALTIES.--

31

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  1         (a)  Any violation of this section by a facility or

  2  licensed health care provider shall be a ground for

  3  disciplinary action contained in the facility's or

  4  professional's respective licensing chapter.

  5         (b)  Any person who violates the confidentiality

  6  provisions of this section and s. 951.27 commits a misdemeanor

  7  of the first degree, punishable as provided in s. 775.082 or

  8  s. 775.083.

  9         (7)  EXEMPTIONS.--Except as provided in paragraph

10  (4)(d) and ss. 627.429 and 641.3007, insurers and others

11  participating in activities related to the insurance

12  application and underwriting process shall be exempt from this

13  section.

14         (8)  MODEL PROTOCOL FOR COUNSELING AND TESTING FOR

15  HUMAN IMMUNODEFICIENCY VIRUS.--The Department of Health shall

16  develop a model protocol consistent with the provisions of

17  this section for counseling and testing persons for the human

18  immunodeficiency virus.

19         (9)  FEES.--

20         (a)  Each person or private organization registered as

21  an AIDS or HIV testing site shall pay the department a fee

22  which shall be set by rule of the department.

23         (b)  Fees established pursuant to paragraph (a) shall

24  be an amount sufficient to meet all costs incurred by the

25  department in carrying out its registration, data collection,

26  complaint monitoring, and administrative responsibilities

27  under this section, for all private AIDS or HIV testing sites,

28  but shall not exceed $100.

29         (c)  No other fees shall be charged by other

30  governmental agencies for these purposes.

31

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  1         (10)  RULES.--The Department of Health may adopt such

  2  rules as are necessary to implement this section.

  3         (11)  TESTING AS A CONDITION OF TREATMENT OR

  4  ADMISSION.--

  5         (a)  It is unlawful for any facility the operation of

  6  which, or for any person engaged in an occupation the practice

  7  of which, requires a license by the Agency for Health Care

  8  Administration, the Department of Health, or the Department of

  9  Business and Professional Regulation, to require any person to

10  take or submit to a human immunodeficiency virus-related test

11  as a condition of admission to any such facility or as a

12  condition of purchasing or obtaining any service or product

13  for which the license is required. This subsection shall not

14  be construed to prohibit any physician in good faith from

15  declining to provide a particular treatment requested by a

16  patient if the appropriateness of that treatment can only be

17  determined through a human immunodeficiency virus-related

18  test.

19         (b)  The Agency for Health Care Administration, the

20  Department of Health, and the Department of Business and

21  Professional Regulation shall adopt rules implementing this

22  subsection.

23         (c)  Any violation of this subsection or the rules

24  implementing it shall be punishable as provided in subsection

25  (6).

26         Section 2.  Subsection (10) is added to section

27  395.3025, Florida Statutes, to read:

28         395.3025  Patient and personnel records; copies;

29  examination.--

30         (10)  Patient records shall include a notation of any

31  infectious diseases, including the result of HIV testing

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  1  conducted pursuant to s. 381.004(3)(i)13., and shall be made

  2  available to the health care providers involved in the

  3  patient's care so that appropriate treatment can be provided

  4  and that protection can be offered to the health care

  5  providers.

  6         Section 3.  This act shall take effect July 1, 1998.

  7

  8            *****************************************

  9                          SENATE SUMMARY

10    Requires HIV testing of persons entering a health care
      facility licensed under ch. 395, F.S., for treatment
11    involving an invasive procedure.  Health care providers
      of patients are entitled to know HIV test results, but
12    they may not breach requirements of confidentiality.

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