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AIDS TESTING AND MEDICAL
INFORMATION
Connecticut
Legal Issues
HIV Confidentiality
The Connecticut General Assembly
established protections regarding the confidentiality of individuals
with HIV infection or AIDS in 1989. Below is the current language, which
was updated in 1997 and again in 1999.
Sec. 19a-581. Definitions.
As used in this chapter except where the context otherwise requires:
(1) "Department" means the department of
public health;
(2) "Commissioner" means the commissioner
of public health;
(3) "AIDS" means acquired immune deficiency
syndrome, as defined by the Centers for Disease Control of the United
States Public Health Service;
(4) "HIV infection" means infection with
the human immunodeficiency virus or any other related virus identified
as a probable causative agent of AIDS;
(5) "HIV-related illness" means any illness
that may result from or may be associated with HIV infection;
(6) "HIV-related test" means any laboratory
test or series of tests for any virus, antibody, antigen or etiologic
agent whatsoever thought to cause or indicate the presence of HIV
infection;
(7) "Protected individual" means a
person who has been counseled regarding HIV infection, is the subject of
an HIV-related test or who has been diagnosed as having HIV infection,
AIDS or HIV-related illness;
(8) "Confidential HIV-related information"
means any information pertaining to the protected individual or obtained
pursuant to a release of confidential HIV-related information,
concerning whether a person has been counseled regarding HIV infection,
has been the subject of an HIV-related test, or has HIV infection,
HIV-related illness or AIDS, or information which identifies or
reasonably could identify a person as having one or more of such
conditions, including information pertaining to such individual's
partners;
(9) "Release of confidential HIV-related
information" means a written authorization for disclosure of
confidential HIV-related information which is signed by the protected
individual or a person authorized to consent to health care for the
individual and which is dated and specifies to whom disclosure is
authorized, the purpose for such disclosure and the time period during
which the release is to be effective. A general authorization for the
release of medical or other information is not a release of
confidential HIV-related information, unless such authorization
specifically indicates its dual purpose as a general authorization and
an authorization for the release of confidential HIV-related information
and complies with the requirements of this subdivision;
(10) "Partner" means an identified spouse
or sex partner of the protected individual or a person identified as
having shared hypodermic needles or syringes with the protected
individual;
(11) "Health facility" means an
institution, as defined in section 19a-490, blood bank, blood
center, sperm bank, organ or tissue bank, clinical laboratory or
facility providing care or treatment to the mentally ill or persons with
mental retardation or a facility for the treatment of substance abuse;
(12) "Health care provider" means any
physician, dentist, nurse, provider of services for the mentally ill or
persons with mental retardation, or other person involved in providing
medical, nursing, counseling, or other health care, substance abuse or
mental health service, including such services associated with, or under
contract to, a health maintenance organization or medical services plan;
(13) "Significant risk of transmission"
means sexual activity that involves the transfer of one person s semen,
vaginal or cervical secretions to another person or sharing of needles
during intravenous drug use. The department may further define
significant risk of transmission in regulations adopted pursuant to
section 19a-589;
(14) "Significant exposure" means a
parenteral exposure such as a needlestick or cut, or mucous membrane
exposure such as a splash to the eye or mouth, to blood or a cutaneous
exposure involving large amounts of blood or prolonged contact with
blood, especially when the exposed skin is chapped, abraded, or
afflicted with dermatitis. The department may further define significant
exposure in regulations adopted pursuant to section 19a-589;
(15) "Exposure evaluation group" means at
least three impartial health care providers, at least one of whom shall
be a physician, designated by the chief administrator of a health
facility, correctional facility or other institution to determine if a
health care or other worker has been involved in a significant exposure.
No member of the group shall be directly involved in the exposure. The
department may further define exposure evaluation group in regulations
adopted pursuant to section 19a-589.
Sec. 19a-582. Informed consent for
testing. Exceptions. (a) Except as
required pursuant to section 19a-586 or by federal or state law, no
person shall order the performance of an HIV-related test without first
receiving written informed consent or oral informed consent which
has been documented in the medical record, of the subject of the test or
of a person authorized to consent to health care for such individual.
The laboratory shall report the test result to the person who orders the
performance of the test. Whenever practicable written consent shall be
obtained. A person ordering the performance of an HIV-related test shall
certify that informed consent has been received prior to ordering
testing by a licensed laboratory. No laboratory shall perform an
HIV-related test without a written certification that such
consent has been obtained, or without written certification that testing
without consent is being ordered pursuant to one of the exceptions in
subsection (e) of this section. The department of public health shall
develop recommended forms for health care providers for purposes of this
section. Such forms shall satisfy the requirement for a written consent
form but shall not fully satisfy the requirement for the
explanation pursuant to subsections (b) and (c) of this section. Any
form used pursuant to this section and all information conveyed
pursuant to subsections (c) and (d) of this section shall be written or
conveyed in a clear and coherent manner using plain language as
described in section 42-152. A person ordering the performance of an
HIV-related test shall not be held liable if a good faith effort is made
to convey the explanation required pursuant to subsections (b), (c) and
(d) of this section The department shall develop guidelines for meeting
the requirements of subsections (b), (c) and (d) of this section.
(b) Informed consent to an HIV-related test
shall include a statement provided to the subject of the test or
provided to a person authorized to consent to health care for the
subject which includes at least the following: (1) An explanation of the
test, including its purpose, the meaning of its results, and the
benefits of early diagnosis and medical intervention; (2) acknowledgment
that consent to an HIV test is not a precondition to receiving health
care but that refusal to consent may, in some circumstances, affect the
provider's ability to diagnose and treat the illness; (3) an explanation
of the procedures to be followed, including that the test is voluntary,
and a statement advising the subject on the availability of anonymous
testing; and (4) an explanation of the confidentiality protections
afforded confidential HIV-related information including the
circumstances under which and classes of persons to whom disclosure of
such information may be required, authorized or permitted by law. Such
explanation shall specifically acknowledge that known partners of the
protected individual may be warned of their potential risk of infection
without identifying the protected individual and that the law permits
the recording of HIV and AIDS-related information in medical charts and
records. Informed consent shall be obtained without undue inducement or
any element of compulsion, fraud, deceit, duress or other form of
constraint or coercion.
(c) Prior to obtaining informed consent, a
person ordering the performance of an HIV-related test shall provide the
subject of an HIV-related test, or to a person authorized to consent to
health care for the subject, an explanation of the nature of AIDS and
HIV-related illness and information about behaviors known to pose risks
for transmission of HIV infection.
(d) At the time of communicating the test
result to the subject of the test, a person ordering the performance of
an HIV-related test shall provide the subject of the test or the person
authorized to consent to health care for the subject with
counseling or referrals for counseling: (1) for coping with the
emotional consequences of learning the result; (2) regarding the
discrimination problems that disclosure of the result could cause; (3)
for behavior change to prevent transmission or contraction of HIV
infection; (4) to inform such person of available medical treatments;
(5) regarding the need of the test subject to notify his partners and,
as appropriate, provide assistance or referrals for assistance in
notifying partners. A health care provider or health facility shall not
withhold test results from the protected individual. The protected
individual may refuse to receive his test result but the person ordering
the performance of the test shall encourage him to receive the
result and to adopt behavior changes that will allow him to protect
himself and others from infection.
(e) The provisions of this section shall
not apply to the performance of an HIV-related test:
(1) By licensed medical personnel when the
subject is unable to grant or withhold consent and no other person is
available who is authorized to consent to health care for the
individual and the test results are needed for diagnostic purposes to
provide appropriate urgent care, except that in such cases the
counseling, referrals and notification of test results described in
subsection (d) of this section shall be provided as soon as practical;
(2) By a health care provider or health
facility in relation to the procuring, processing, distributing or use
of a human body or a human body part, including organs, tissues, eyes,
bones, arteries, blood, semen, or other body fluids, for use in medical
research or therapy, or for transplantation to individuals, provided if
the test results are communicated to the subject, the counseling,
referrals and notification of test results described in subsection (d)
of this section shall be provided;
(3) For the purpose of research if the
testing is performed in a manner by which the identity of the
test subject is not known and is unable to be retrieved by the
researcher;
(4) On a deceased person when such test is
conducted to determine the cause or circumstances of death or for
epidemiological purposes;
(5) In cases where a health care provider
or other person, including volunteer emergency medical services, fire
and public safety personnel, in the course of his occupational duties
has had a significant exposure, provided the following criteria are met:
(A) The worker is able to document significant exposure during
performance of his occupation, (B) the worker completes an incident
report within forty-eight hours of exposure identifying the parties to
the exposure, witnesses, time, place and nature of the event, (C)
the worker submits to a baseline HIV test within seventy-two hours of
the exposure and is negative on that test, (D) the patient's or person's
physician or, if the patient or person does not have a personal
physician or if the patient’s or person’s physician is unavailable,
another physician or health care provider has approached the patient or
person and sought voluntary consent and the patient or person has
refused to consent to testing, except in an exposure where the patient
or person is deceased, (E) an exposure evaluation group determines that
the criteria specified in subparagraphs (A), (B), (C), (D) and (F) of
this subdivision are met and that the worker has a significant exposure
to the blood of a patient or person and the patient or person, or the
patient's or person's legal guardian, refuses to grant informed consent
for an HIV test. If the patient or person is under the care or custody
of the health facility, correctional facility or other institution and a
sample of the patient's blood is available, said blood shall be tested.
If no sample of blood is available, and the patient is under the care or
custody of a health facility, correctional facility or other
institution, the patient shall have a blood sample drawn at the health
facility, correctional facility or other institution and tested. No
member of the exposure evaluation group who determines that a worker has
sustained a significant exposure and authorized the HIV testing of a
patient or other person, nor the health facility, correctional facility
or other institution, nor any person in a health facility or other
institution who relies in good faith on the group's determination and
performs that test shall have any liability as a result of his action
carried out pursuant to this section, unless such person acted in bad
faith. If the patient or person is not under the care or custody of a
health facility, correctional facility or other institution and a
physician not directly involved in the exposure certifies in writing
that the criteria specified in subparagraphs (A), (B), (C), (D) and (F)
of this subdivision are met and that a significant exposure has
occurred, the worker nay seek a court order for testing pursuant to
subdivision (8) of this subsection, (F) the worker would be able to take
meaningful immediate action, if results are known, which could not
otherwise be taken, as defined in regulations adopted pursuant to
section 19a-589, (G) the fact that an HIV test was given
as a result of an accidental exposure and the results of that test shall
not appear in a patient's or person's medical record unless such result
is relevant to the medical care the person is receiving at that time in
a health facility or correctional facility or other institution, (H) the
counseling described in subsection (d) of this section shall be provided
but the patient or person may choose not to be informed about the result
of the test, and (I) the cost of the HIV test shall be borne by
the employer of the potentially exposed
worker;
(6) In facilities operated by the
department of correction if the facility physician determines
that testing is needed for diagnostic purposes, to determine the need
for treatment or medical care specific to an HIV-related illness,
including prophylactic treatment of HIV infection to prevent further
progression of disease, provided no reasonable alternative exists that
will achieve the same goal;
(7) In facilities operated by the
department of correction if the facility physician and chief
administrator of the facility determine that the behavior of the inmate
poses a significant risk of transmission to another inmate or has
resulted in a significant exposure of another inmate of the facility and
no reasonable alternative exists that will achieve the same goal. No
involuntary testing shall take place pursuant to subdivisions (6) and
(7) of this subsection until reasonable effort has been made to secure
informed consent. When testing without consent takes place pursuant to
subdivisions (6) and (7) of this subsection, the counseling referrals
and notification of test results described in subsection (d) of this
section shall, nonetheless be provided;
(8) Under a court order which is issued in
compliance with the following provisions: (A) No court of this state
shall issue such order unless the court finds a clear and imminent
danger to the public health or the health of a person and that the
person has demonstrated a compelling need for the HIV-related test
result which cannot be accommodated by other means. In assessing
compelling need, the court shall weigh the need for a test result
against the privacy interests of the test subject and the public
interest which may be disserved by involuntary testing, (B) pleadings
pertaining to the request for an involuntary test shall substitute a
pseudonym for the true name of the subject to be tested. The disclosure
to the parties of the subject's true name shall be communicated
confidentially, in documents not filed with the court, (C) before
granting any such order, the court shall provide the individual on whom
a test result is being sought with notice and a reasonable opportunity
to participate in the proceeding if he is not already a party, (D) court
proceedings as to involuntary testing shall be conducted in camera
unless the subject of the test agrees to a hearing in open court or
unless the court determines that a public hearing is necessary to the
public interest and the proper administration of justice; or
(9) When the test is conducted by any life
or health insurer or health care center for purposes of assessing a
person’s fitness for insurance coverage offered by such insurer or
health care center.
(10) When the test is subsequent to a prior
confirmed test and the subsequent test is part of a series of repeated
testing for the purposes of medical monitoring and treatment, provided
(A) the patient has previously given informed consent and has been
counseled concerning medical treatments and behavioral changes necessary
to reduce HIV transmission, as required by this section, (B) the
patient, after consultation with the health care provider, has declined
reiteration of the specific informed consent, counseling and education
requirements of this section, and (C) a notation to that effect has been
entered into the patient’s medical record.
(f) Except as provided in subsection (e) of
this section, informed consent as described in this section shall
be obtained for each HIV test, or in the case where a sequence of tests
is required to confirm an initial positive result, for each sequence of
tests.
Sec l9a-583. Limitations on disclosure
of HIV-related information. (a) No
person who obtains confidential HIV-related information may disclose or
be compelled to disclose such information, except to the following:
(1) The protected individual, his legal
guardian or a person authorized to consent to health care for such
individual;
(2) Any person who secures a release of
confidential HIV-related information;
(3) A federal, state or local health
officer when such disclosure is mandated or authorized by federal or
state law;
(4) A health care provider or health
facility when knowledge of the HIV-related information is necessary to
provide appropriate care or treatment to the protected individual or a
child of the individual or when confidential HIV-related information is
already recorded in a medical chart or record and a health care provider
has access to such record for the purpose of providing medical care to
the protected individual;
(5) A medical examiner to assist in
determining the cause or circumstances of death;
(6) Health facility staff committees or
accreditation or oversight review organizations which are conducting
program monitoring, program evaluation or service reviews;
(7) A health care provider or other person
in cases where such provider or person in the course of his occupational
duties has had a significant exposure to HIV infection, provided the
following criteria are met: (A) The worker is able to document
significant exposure during performance of his occupation, (B) the
worker completes an incident report within forty-eight hours of
exposure, identifying the parties to the exposure, witnesses, time,
place and nature of the event, (C) the worker submits to a baseline HIV
test within seventy-two hours of the exposure and is negative on that
test for the presence of the AIDS virus, (D) the patient's or
person's physician or, if the patient or person does not have a personal
physician or if the patient’s or person’s physician is unavailable,
another physician or health care provider has approached the
patient or person and sought voluntary consent to disclosure and the
patient or person refuses to consent to disclosure, except in an
exposure where the patient or person is deceased, (E) the worker would
be able to take meaningful immediate action as defined in regulations
adopted pursuant to section 19a-589 which could not otherwise be taken,
(F) an exposure evaluation group determines that the criteria specified
in subparagraphs (A), (B), (C), (D), and (E) of this subdivision are met
and that a worker has a significant exposure to the blood of a patient
or person and the patient or person or the patient's or person's legal
guardian refuses to consent to release of the information. No member of
the exposure evaluation group who determines that a worker has sustained
a significant exposure and authorizes the disclosure of confidential
HIV-related information nor the health facility, correctional facility
or other institution nor any person in a health facility, correctional
facility or other institution who relies in good faith on the group’s
determination and discloses the result shall have any liability as a
result of his action carried out under this section, unless such
persons acted in bad faith. If the information is not held by a health
facility, correctional facility or other institution, a physician not
directly involved in the exposure has certified in writing that the
criteria specified in subparagraphs (A), (B), (C), (D) and (E) of this
subdivision are met and that a significant exposure has occurred;
(8) Employees of hospitals for mental
illness operated by the department of mental health if the infection
control committee of the hospital determines that the behavior of the
patient poses a significant risk of transmission to another patient of
the hospital. Disclosure shall only be allowed if it is likely to
prevent or reduce the risk of transmission and no reasonable
alternatives exist that will achieve the same goal and also preserve the
confidentiality of the information. Such "reasonable alternatives"
include counseling the patient concerning behaviors that pose a risk of
transmission and other efforts to prevent or address the behaviors that
pose a significant risk of transmission without disclosing the patient's
HIV status or other confidential HIV-related information. Disclosure
shall be limited to as few employees as possible and only to those
employees with a direct need to receive the information to achieve the
purpose authorized by this subdivision;
(9) Employees of facilities operated by the
department of correction to provide services related to HIV infection or
if the medical director and chief administrator of the facility
determine that the behavior of an inmate poses significant risk of
transmission to another inmate or has resulted in a significant exposure
of another inmate of the facility. Such a disclosure shall only be made
if it is specifically required to enable the inmate to receive such
services or is likely to prevent or reduce the risk of transmission and
no reasonable alternatives exist that will achieve the same goal and
also preserve the confidentiality of the information. Such "reasonable
alternatives" include counseling the inmate concerning behaviors that
pose a risk of transmission or other efforts to prevent or address the
behaviors that pose a significant risk of transmission without
disclosing the patient's HIV status or other confidential HIV-related
information. Disclosure shall be limited to as few employees as possible
and only to those employees with a direct need to receive the
information to achieve a purpose authorized by this subdivision;
(10) Any person allowed access to such
information by a court order which is issued in compliance with the
following provisions: (A) No court of this state shall issue such order
unless the court finds a clear and imminent danger to the public health
or the health of a person and that the person has demonstrated a
compelling need for the test results which cannot be accommodated by
other means. In assessing compelling need, the court shall weigh the
need for disclosure against the privacy interest of the test subject and
the public interest which may be disserved by disclosure which deters
future testing or which may lead to discrimination, (B) pleadings
pertaining to disclosure of confidential HIV-related information
shall substitute a pseudonym for the true name of the
subject of the test. The disclosure to the parties of the subject's true
name shall be communicated confidentially, in documents not filed with
the court, (C) before granting any such order, the court shall provide
the individual whose test result is in question with notice and a
reasonable opportunity to participate in the proceedings if he is not
already a party, (D) court proceedings as to disclosure of confidential
HIV-related information shall be conducted in camera unless the subject
of the test agrees to a hearing in open court or unless the court
determines that a public hearing is necessary to the public interest and
the proper administration of justice, (E) upon the issuance of an order
to disclose test results, the court shall impose appropriate safeguards
against unauthorized disclosure, which shall specify the persons who may
have access to the information, the purposes for which the information
shall be used, and appropriate prohibitions on future disclosure;
(11) Life and health insurers, government
payers and health care centers and their affiliates, reinsurers, and
contractors, except agents and brokers, in connection with underwriting
and claim activity for life, health, and disability benefits; and
(12) Any health care provider specifically
designated by the protected individual to receive such information
received by a life or health insurer or health care center pursuant to
an application for life, health or disability insurance.
(b) No person, except the protected
individual, his legal guardian or a person authorized to consent to
health care for such individual, to whom confidential HIV-related
information is disclosed may further disclose such information, except
as provided in this section and sections 19a-584 and l9a-585.
Sec. 19a-584. Disclosure of HIV-related
information by public health officers and physicians to partners of the
protected individual. (a) A public
health officer may inform or warn partners of an individual that they
may have been exposed to the HIV virus under the following conditions:
(1) The public health officer reasonably believes there is a significant
risk of transmission to the partner; (2) the public health officer has
counseled the protected individual regarding the need to notify the
partner and the public health officer reasonably believes the protected
individual will not inform the partner; (3) the public health officer
has informed the protected individual of his intent to make such
disclosure. The public health officer may also warn or inform a partner
at the request of a protected individual. When making such disclosure to
the partner the public health officer shall provide or make
referrals for the provision of the appropriate medical advice and
counseling for coping with the emotional consequences of learning the
information and for changing behavior to prevent transmission or
contraction of HIV infection. The public health officer shall not
disclose the identity of the protected individual or the identity of any
other partner. The public health officer, making a notification, shall
make such disclosure in person, except where circumstances reasonably
prevent doing so. The public health officer shall make a good faith
effort to notify the partner of the risk of HIV infection. The public
health officer shall have no obligation to warn or inform, identify or
locate any partner.
(b) A physician may warn or inform a known
partner of a protected individual if both the partner and the protected
individual are under the physician's care or the physician may disclose
confidential HIV-related information to a public health officer for the
purpose of informing or warning partners of the protected individual
that they may have been exposed to the HIV virus, under the following
conditions: (1) The physician reasonably believes there is a significant
risk of transmission to the partner; (2) the physician has counseled the
protected individual regarding the need to notify the partner and the
physician reasonably believes the protected individual will not inform
the partner; (3) the physician has informed the protected individual of
his intent to make such disclosure to the partner or public health
officer. The physician may also warn or inform a partner at the request
of a protected individual. When making such disclosure to the partner
the physician shall provide or make referrals for the provision of the
appropriate medical advice and counseling for coping with the emotional
consequences of learning the information and for changing behavior to
prevent transmission or contraction of HIV infection. The physician or
public health officer shall not disclose the identity of the
protected individual or the identity of any other partner. The public
health officer or physician making a notification shall make such
disclosure in person, except where circumstances reasonably prevent
doing so. Upon receiving such a request for assistance, the public
health officer shall make a good faith effort to notify said partner of
the risk of HIV infection. The physician or public health officer shall
have no obligation to warn or inform, identify or locate any partner.
The physician shall have no obligation to disclose information to a
public health officer for the purpose of warning or informing a partner.
(c) For purposes of this section, "public
health officer" means an employee of the department of public health
designated by the commissioner or if authorized by the commissioner, a
local health director, or his designee.
Sec. 19a-585. Requirements for
disclosure of HIV-related information.
(a) Whenever confidential HIV-related
information is disclosed it shall be accompanied by a statement in
writing, whenever possible, which includes the following or
substantially similar language: "This information has been disclosed to
you from records whose confidentiality is protected by state law. State
law prohibits you from making any further disclosure of it without the
specific written consent of the person to whom it pertains, or as
otherwise permitted by said law. A general authorization for the release
of medical or other information is not sufficient for this purpose." An
oral disclosure shall be accompanied or followed by such a notice within
ten days.
(b) Except for disclosures made to a
federal, state, or local health officer when such disclosure is mandated
or authorized by federal or state law or to persons reviewing
information or records in the ordinary course of ensuring that a health
facility is in compliance with applicable quality of care standards or
any other authorized program evaluation, program monitoring or service
review, a notation of all such disclosures shall be placed in the
medical record or with any record of an HIV-related test result of a
protected individual, who shall be informed of such disclosures upon
request; provided for disclosures made to governmental agents requiring
information necessary for payments to be made on behalf of patients or
clients pursuant to contract or law, such notation need only be entered
at the time the disclosure is first made.
(c) Nothing in this chapter shall limit a
person's or agency's responsibility to report, investigate or disclose
child protective services information pursuant to section 17a-101 and
regulations adopted pursuant to said section.
(d) The provisions of subsections (a) and
(b) of this section shall not be applicable to disclosures made pursuant
to subdivision (11) of subsection (a) of section 19a-583.
(e) Except as provided in subparagraph G)
of subdivision (5) of subsection (e) of section 19a-582, nothing in this
chapter shall prohibit the recording of HIV and AIDS-related information
in the medical chart or medical records of a protected individual or the
listing of AIDS, HIV-related illness or HIV infection in a certificate
of death or autopsy report. This chapter shall not be construed to
modify regulations relating to access to death certificates or autopsy
reports. This chapter shall not be construed to modify the provisions of
section 19a-25, or 19a-221.
Sec. 19a-586. Testing for insurance
purposes. (a) Any insurer that
requests an applicant for insurance coverage to take an HIV-related test
shall obtain the applicant’s written informed consent for such test
prior to conducting it.
(b) The insurance commissioner shall adopt
regulations, in consultation with the commissioner of public health and
in accordance with the provisions of chapter 54, which establish all
necessary requirements for the provision of informed consent pursuant to
the provisions of subsection (a) of this section. Such regulations shall
include, but not be limited to, requirements regarding (1) sufficient
notice at the time of application that the insured will be tested for
HIV infection and (2) an explanation of AIDS and HIV infection.
Sec. 19a-587. Disclosure by insurers.
Nothing in this chapter shall prohibit the disclosure by a life or
health insurer or health care center of a positive HIV-related test
result to an organization that assembles or collects information about
insurance applicants for the purposes of detecting fraud,
misrepresentation, or nondisclosure in connection with insurance
underwriting, provided such result is provided as a nonspecific blood
test result, within a general code category, which code is not
designated solely for HIV-related test results and provided the majority
of results included in the general code are not HIV-related and the code
does not otherwise allow members of the organization to reasonably
identify an applicant’s test result as an HIV-related test.
Sec. 19a-588. Notification of procedures
to certain municipal employees.
Each town shall notify its police, fire and emergency medical services
personnel of the procedures under subdivision (5) of subsection (e) of
section 19a-582 and subdivision (7) of subsection (a) of section 19a-583
pertaining to workers who have experienced a significant exposure.
Sec. 19a-589. Regulations.
The commissioner shall adopt such regulations, as he deems necessary, in
accordance with the provisions of chapter 54 to implement the provisions
of sections 19a-581 to 19a-585, inclusive.
Sec. 19a-590. Liability for violations.
Any person, except as otherwise provided in this chapter, who willfully
violates any provision of this chapter shall be liable in a private
cause of action for injuries suffered as a result of such violation.
Upon a finding that an individual has been injured as a result of such
violation, damages shall be assessed in the amount sufficient to
compensate said individual for such injury.
Sec. 19a-591. Definitions.
As used in sections 19a-591 to 19a-591c,
inclusive:
(1) "AIDS vaccine" means a vaccine which
has been developed by a manufacturer, is being tested and administered
at a research institution for purposes of determining whether it
provides immunity to acquired immune deficiency syndrome or is of
therapeutic benefit to persons or fetuses infected with the acquired
immune deficiency syndrome virus, and for which an investigational new
drug application is on file with the federal Food and Drug
Administration and is in effect.
(2) "Manufacturer" means any person who is
domiciled or has his principal place of business in this state and has
developed an AIDS vaccine.
(3) "Research institution" means a hospital
which is accredited by the Joint Commission on the Accreditation of
Healthcare Organizations, or a recognized medical school which operates,
or is affiliated with, or is operated by an accredited hospital.
(4) "Research subject" means a person who
is administered an AIDS vaccine, or a fetus of a person administered an
AIDS vaccine, or a child born to a person administered an AIDS vaccine.
(5) "Researcher" means a person employed by
or affiliated with a manufacturer or a research institution, who
participates in the development or testing or administration of an AIDS
vaccine, or who is involved in the diagnosis and treatment of a research
subject.
Sec. 19a-591a. Administration of AIDS
vaccine. A manufacturer, research
institution or researcher shall, prior to the administration of an AIDS
vaccine to a person, provide a written explanation of the immunity
provisions of section 19a-591b to such person and obtain such person’s
informed consent. A parent or legal guardian of a child may give
informed consent for such child. A copy of the informed consent shall be
maintained with such person’s medical records.
Sec. 19a-591b. Immunity from liability
for civil damages for personal injury to research subject. Exceptions.
A manufacturer, research institution or
researcher shall not be liable to a research subject for civil damages
for personal injury resulting from the administration of any AIDS
vaccine to such research subject, unless such injury was caused by the
gross negligence or reckless, willful or wanton misconduct of such
manufacturer, research institution or researcher or such manufacturer,
research institution or researcher has failed to comply with the
provisions of section 19a-591a. The immunity provided by this section
shall not apply to a manufacturer, research institution or researcher
who intentionally provided false information in connection with an
investigational new drug application.
Sec. 19a-591c. Research subjects.
No person shall be denied the opportunity to
be a research subject because of the inability to pay for medical
treatment.
Sec. 19a-592. Testing and treatment of
minor for HIV or AIDS. Confidentiality. Liability for costs.
(a) Any licensed physician may examine and
provide treatment for human immunodeficiency virus infection, or
acquired immune deficiency syndrome for a minor, only with the consent
of the parents or guardian of the minor unless the physician determines
that notification of the parents or guardian of the minor will result in
treatment being denied or the physician determines the minor will not
seek, pursue or continue treatment if the parents or guardian are
notified and the minor requests that his parents or guardian not be
notified. The physician shall fully document the reasons for the
determination to provide treatment without the consent or notification
of the parents or guardian of the minor and shall include such
documentation, signed by the minor, in the minor’s clinical record. The
fact of consultation, examination and treatment of a minor under the
provisions of this section shall be confidential and shall not be
divulged without the minor’s consent, including the sending of a bill
for the services to any person other than the minor until the physician
consults with the minor regarding the sending of a bill.
(b) A minor shall be personally liable for
all costs and expenses for services afforded him at his request under
this section.
Sec. 19a-593. Testing of pregnant women
and newborns. Notification and documentation requirements.
(a)
Each health care provider giving prenatal care to pregnant women in this
state shall inform her, or ascertain from the woman's medical record
that such information has already been provided to her, that HIV testing
is a part of routine prenatal care and shall inform her of the health
benefits to herself and her newborn of being tested for HIV infection.
Such information shall be conveyed along with the counseling required by
section 19a-582. The health care provider shall inform the patient that
HIV-related information is confidential pursuant to section 19a-583. If
the patient provides informed consent to an HIV-related test consistent
with section 19a- 582, the health care provider responsible for HIV
counseling under this section shall perform or arrange to have performed
an HIV-related test and document the test result in the medical record.
(b) If, during the current pregnancy, an HIV-related test has not been
documented in the patient's medical record at admission for delivery of
the baby, then the health care provider responsible for the patient's
care shall inform the pregnant woman as required under subsection (a) of
this section and shall also inform her of the health benefits to herself
and her newborn of being tested for HIV infection either before delivery
or within twenty-four hours after delivery and, in the absence of
specific written objection, shall cause such test to be administered.
(P.A. 95-269, S. 2; June Sp. Sess.
P.A. 99-2, S. 29.)
History: June Sp. Sess. P.A. 99-2
deleted existing provisions requiring obstetrician-gynecologists to
notify pregnant women of the availability of AIDS testing, added Subsec.
(a) re information on HIV testing, performance of HIV testing and
documentation of test results, and added Subsec. (b) re HIV information
and testing at admission for delivery.
See Sec. 19a-55 re newborn infant
health screening.
See Sec. 19a-90 re blood test of pregnant women.
Sec. 19a-593a. Limitation on causes of
action for HIV-related test. No
cause of action for civil assault, civil battery, invasion of privacy or
failure to obtain informed consent shall arise against any acute care
general hospital licensed under chapter 368v or any other health care
provider or person responsible for administering an HIV-related test, or
causing such test to be administered, as required by section 19a-55 or
19a-593, on the basis that such HIV-related test was administered
without the consent of the patient or the patient's parent or guardian.
Nothing in this section shall be construed to: (1) Relieve any person or
entity from liability for (A) negligence in administering such
HIV-related test, (B) negligence in the reporting or distribution of the
results of such HIV-related test, (C) negligence related to the
provision of any counseling about a patient's decision whether to obtain
treatment as a result of such HIV-related test, or (D) negligence in the
treatment of a patient; or (2) eliminate or limit any defense to any
cause of action that is or may be alleged against such hospital, health
care provider or person responsible for administering such HIV-related
test or causing such test to be
administered.
(June Sp. Sess. P.A. 01-4, S. 31,
58.)
History: June Sp. Sess. P.A. 01-4
effective July 1, 2001.
Sec. 19a-594. Pregnant women and newborn
testing public awareness programs and health care provider training.
(a) The Department of Public Health may
develop and implement a comprehensive training program designed to reach
all health care providers who are required by the provisions of sections
19a-90, 19a-555 and 19a- 593 to provide counseling or testing for HIV of
pregnant women or newborns. The training program may include instruction
on but not be limited to: The requirements of the provisions of sections
19a-90 and 19a-555; the requirements of this chapter; the benefits of
such HIV testing for pregnant women; the possible interventions to
prevent HIV transmission from a pregnant woman and her fetus or newborn;
the side effects of such interventions; appropriate protocols for the
counseling, testing and treatment of adolescents and their newborns; the
statutory confidentiality provisions that relate to adolescents;
resources available for health care, case management, counseling and
treatment for people with HIV and AIDS; and, the sanctions for violation
of the provisions of sections 19a-90 and 19a-555 and of this chapter.
(b) The Department of Public Health may develop educational materials
for women subject to the provisions of sections 19a-90, 19a-555 and
19a-593 and distribute such materials to any health care provider
subject to the provisions of sections 19a-90, 19a- 555 and 19a-593.
These materials shall be in plain language and shall be, whenever
possible, in the first language of the recipient of the materials. The
materials may include, but not be limited to: An explanation of the
provisions of sections 19a-90, 19a-555 and 19a-593; a description of the
provisions of this chapter; the appropriate confidentiality provisions
of the statute that refer to minors; a list of health care and support
services for people with HIV/AIDS; and a toll-free number to report any
violations of
the statutes by providers. Each health care
provider subject to the provisions of sections 19a-90, 19a-555 and
19a-593 shall give each woman who they counsel or test for HIV or whose
newborn they test for HIV a copy of such educational materials.
(c) Any health care provider who performs an HIV test on a newborn under
the provisions of sections 19a-90, 19a-555 and 19a-593 shall report the
results of such test to the mother of such newborn before the mother
leaves the hospital or within forty- eight hours of the birth of such
newborn whichever is sooner. Such provider shall refer any women whose
newborn tests positive for HIV to an HIV case manager and an appropriate
health care provider. Such provider shall also give the woman a list of
support services for people with HIV and AIDS.
(June Sp. Sess. P.A. 99-2, S. 17.)
Sec. 19a-594a. Referral of child to
state agency based on test result.
No child shall be referred to the Department of Children and Families
solely on the basis of a positive HIV test.
(June Sp. Sess. P.A. 99-2, S. 18.)
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