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Tennessee

All citations are to "Tenn. Code Ann." unless otherwise noted.

http://www.law.tulane.edu/

DEFINITIONS

(1) "Bloodborne pathogen" is defined at § 41-51-102.

(2) "Emergency response employees" is defined at § 68-140-520.

(3) "Health care facility is defined at § 68-11-210.

(4) "HIV" is defined at §§ 39-13-521, 39-13-109 and 39-13-516.

(5) "HIV test" is defined at § 39-13-521.

(6) "Intimate contact with another" and "intravenous or intramuscular drug paraphernalia" are defined at § 39-13-109.

(7) "Residential HIV supportive living facility," "residential hospice," and "HIV resident" are defined at § 68-11-201.

(8) "Sexually transmitted disease" and "test," as it pertains to sexually transmitted disease, are defined at § 68-10-112.

CRIMINAL LAW

(1) Exposure of another to HIV (see Definitions (4)) is a criminal offense. A person commits the offense when the person is infected with HIV and knowingly engages in the following activities: intimate contact with another (see Definitions (6)); transfer, donation, or provision of blood, semen, organs, or other potentially infectious body fluids or body parts for transfusion, transplantation, insemination, or other administration to another in any manner; or dispensing, delivery, exchange, sale or transfer to another of any nonsterile intravenous or intramuscular drug paraphernalia (see Definitions (6)). It is an affirmative defense that the person exposed to HIV knew that the infected person was infected with HIV, knew that the action could result in infection with HIV, and gave advance consent to the action with such knowledge. The defense must be proven by a preponderance of the evidence. Actual transmission of HIV is not required in order for a person to have committed the offense. Criminal exposure of another to HIV is a class C felony. § 39-13-109.

(2) A person commits aggravated prostitution when the person, knowing themselves to be infected with HIV, engages in sexual activity as a business, is an inmate in a house of prostitution, or loiters in a public place for the purpose of being hired to engage in sexual activity. Infection with HIV is not required in order for the offense to occur. Aggravated prostitution is a class C felony. § 39-13-516.

(3) Any person infected with a sexually transmitted disease (STD) (see Definitions (8) who exposes another to infection violates the Health, Safety and Environmental Protection Code. § 68-10-107. This violation is a Class C felony. § 68-10-111.

(4) Health officers or any other persons who fail to perform their duty under the provisions of the Health, Safety and Environmental Protection Code regarding STDs are guilty of a class C felony. Each violation is a separate offense. § 68-10-111.

(5) Any person quarantined or isolated (see Social & Medical Services (1), (2), (7), (8)) for continuing to pose a direct threat of significant risk to the health and safety of the public regarding the transmission of HIV who intentionally escapes commits a class E felony. § 39-13-108.

(6) It is unlawful for a person to be or attempt to be a blood donor (see Testing & Reporting (9)), except when deemed necessary for medical research, if the person has knowingly received a confirmed positive result from a human t lymphotrophic virus type III (HTLV-III) antibody test or is suffering from a confirmed case of AIDS. § 68-32-104.

(7) It is the duty of the warden of the Tennessee State Penitentiary upon reception of any convict to have the convict undergo HIV testing (see Definitions (5)), with or without the inmates’ consent, through a licensed medical laboratory, unless the inmate has been tested before reception. If the inmate has not undergone testing before reception, he or she shall also undergo a confirmatory test and be referred to appropriate counseling when necessary. The results of any HIV test ordered is not a public record and is available only to the person tested, the attending physician of the person tested, the Department of Health, and the Department of Correction. This provision only applies of inmates who are less than twenty-one years of age. § 41-21-107.

(8) Correctional institutions must inform employees, contract employees, or visitors of the infectious disease status of an inmate, including an inmate’s HIV status, if such person has potentially been exposed to an infectious disease by the inmate. After the report of an exposure incident, a superintendent, director, or warden of a correction institution, county or municipal jail, or workhouse shall test the inmate or inmates, with or without the inmate’s consent, to determine the bloodborne pathogen infectivity (see Definitions (1)). The results of the test shall be disclosed to each correctional employee, law enforcement officer, or visitor who was involved in the exposure incident and who reasonably believes that that person may have been exposed to a serious or life-threatening disease or pathogen. This law does not authorize the release of confidential information to members of the public. Any person informed of the results of any inmate’s test shall treat the information received as confidential. § 41-51-102.

Social & Medical Services (4), (7), (8), (9)

Testing & Reporting (1), (4), (6), (7), (11)

EDUCATION

(1) All material, including information pertaining to the prevention of AIDS or other sexually transmitted diseases (STDs) (see Definitions (8)), which is written, published, distributed, or used by any public entity, or is paid for, in whole or in part, with any public monies, and which is directed at children in grades kindergarten through twelve, shall place primary emphasis on abstinence from premarital intimacy and on the avoidance of drug abuse in controlling the spread of AIDS. Adoption of any program of AIDS education shall not be required in any local education agency until adopted by the local Board of Education. § 49-6-1008.

(2) A locally devised program of family life instruction shall be implemented in any county in which the pregnancy rate exceeds 19.5 pregnancies per 1,000 females aged fifteen through seventeen. The program shall include a component which specifically addresses the nature and prevention of AIDS and other STDs. § 49-6-1301. The State Board of Education plan for family life instruction shall also include an AIDS education component. The plan shall be suitable for adoption by any local education agency which fails to develop a family life instruction program based on the prevalence of teen pregnancy. § 49-6-1302.

(3) It is the duty and responsibility of the Public School Nurse Program to provide local education agencies with information, advice, and technical assistance for student and parental instruction on topics related to health and wellness, including STDs. § 68-1-1202.

(4) It is the duty and responsibility of the executive director of the Public School Nurse Program to: 1) Assist local education agencies in the development, implementation and coordination of student health policies with regard to first aid emergencies, medications, acute illnesses and infection control; 2) Provide local education agencies with information, advice and technical assistance pertaining to student and parental instruction on topics related to health and wellness, including, but not limited to, sexually transmitted disease and infection control; 3) Assist local education agencies in the provision of student health services, including, but not limited to, medical screening, acute care, counseling for students with chronic diseases, and counseling for students who are engaging in, or who may be at risk of engaging in, behavioral patters which jeopardize physical or mental health and well-being. § 68-1-1202.

Miscellaneous (5)

Testing & Reporting (10), (12)

EMPLOYMENT

Social & Medical Services (4), (5)

Testing & Reporting (8)

HOUSING

(1) No cause of action shall arise against an owner or a real estate licensee for failure to disclose that the occupant of real property was afflicted with HIV or another disease which has been determined by medical evidence to be highly unlikely to be transmitted through occupancy. § 66-5-207.

INSURANCE

(1) Upon assignment of benefits of a health, accident or sickness insurance policy to a hospital, residential HIV supportive living facility (see Definitions (7)), and other health care agencies or the doctor or dentist for health care services rendered, by the insured under the policy, the health care agency or doctor or dentist shall be paid the benefits under such policy to the extent of the assignment within thirty days from the time the insurance company has received a final billing statement from such health care agency, doctor or dentist; provided, that the insurance company has received information necessary to determine the extent of liability, if any. It is the duty of the insurance company to request the information required for payment of such benefits within fifteen days after receiving claim for benefits under such policy. If any portion of the claim is under dispute, the insurer shall within such thirty day period pay the amount of the claim that is not is dispute and notify the health care provider in writing of the reason(s) for the dispute of the amount in dispute. An audit on the premise of the health care provider shall be scheduled if the dispute is due to the need for verification of services rendered and cannot otherwise be resolved by the insurer and health care provider. The insurer shall pay the amount determined to be due under the audit within thirty days of the date of the audit. If any portion of an assigned claim remains unpaid sixty days after the billing statement is received by the insurance company, interest charges may be added to the unpaid portion of the claim. Failure of the insurer to comply with these provisions may be reported to the commissioner. § 69-11-219.

RESEARCH

Criminal Law (6)

SOCIAL & MEDICAL SERVICES

(1) The Department of Health is empowered and directed to make such rules for the control of sexually transmitted diseases (STDs) (see Definitions (8)) as it may deem advisable, including the reporting, isolation and quarantine of infected persons. § 68-10-109.

(2) The Department of Health is authorized to quarantine or isolate within a secure facility, as may be necessary, any person when such person clearly and convincingly demonstrates willful and knowing disregard for the health and safety of others regarding the transmission of HIV and continues to pose a direct threat of significant risk to the health and safety of the public. § 39-13-108. In establishing isolation or quarantine, the municipal or county health officer having jurisdiction shall designate and define the limits of the area of quarantine, and no person other than the attending physician or nurse shall enter or leave without the permission of the health officer. § 68-10-105. No one but a state, municipal, district, or county health officer or authorized representative shall establish or terminate quarantine of persons infected with an STD. The decision to establish or terminate quarantine shall be made based on available medical and epidemiological information concerning the STD diagnosis, modes of transmission, available treatment, and the necessity of the protection of the public health. § 68-10-106. County legislative bodies, city officials, or other boards of the incorporated towns and cities are empowered to provide suitable places for the detention of persons who may be subject to isolation or quarantine. Such legislative bodies and governing boards are authorized, on behalf of their counties, cities, and towns, to incur the necessary expense to enforce the quarantine laws. § 68-10-108.

(3) One of the duties of the Black Health Care Commission is to study the many problems which jeopardize the health of Tennessee’s Black community, including, but not limited to, such persistent interdisciplinary problems as AIDS. § 3-15-404.

(4) The superintendent, warden, or director of any correctional institution or county or municipal jail or workhouse shall provide training in universal precaution for bloodborne pathogens for all employees at risk of potential occupational exposure to bloodborne pathogens, including HIV. In order to increase awareness of the need for precaution, the superintendent, director or warden may periodically warn employees at risk that a portion of the inmate population is likely to be infected with a bloodborne pathogen. § 41-51-101.

(5) A professional nurse who is employed by a primary health care center that receives fifty percent or more of its family planning funds from funds distributed by the Department of Health has the authority to issue drugs for STDs that are approved by the Department of Health. § 63-7-124.

(6) Every physician or other person treating persons infected with an STD has the duty to give the person under treatment printed instructions containing information recommended by the Department of Health. § 68-10-103.

(7) State, district, county and municipal health officers or their authorized deputies, within their respective jurisdictions, are directed and empowered to make examinations of persons reasonably suspected of being infected with a communicable STD. Health officers or their deputies shall require such persons, when found to be infected, to report for treatment and to continue treatment until noninfectious or until an infectious relapse shall not occur. When, in the judgment of the Health Officer, it is necessary to protect the public health, the officer shall isolate or quarantine persons infected with an STD, provided that the person suspected of being infected may have present at the time of examination a physician of the person’s own choosing. The loitering about or residing at a house of prostitution or other place where lewdness is practiced shall be sufficient to cause a person to be suspected of being infected with an STD. It is the duty of all health officers to investigate the sources of STD infection and to cooperate with officers whose duty it is to enforce laws directed against lewdness, prostitution, and the spread of STDs. § 68-10-104.

(8) Whenever, in the judgment of the municipal, district or county health officer, there is reasonable clinical or epidemiological evidence to suspect that any person or persons are infected with an STD and the person or person refuses to be examined, the health officer or health officer’s authorized deputy may go before a magistrate or judge of a court of general sessions and swear out a warrant of arrest for the person or persons. The magistrate or judge is not bound to issue the warrant unless and until there is a showing of reasonable cause on the basis of sound clinical and epidemiological evidence. If reasonable cause is shown for the arrest and examination of the person or persons, the magistrate or judge shall direct that an examination be made of the person or persons to determine whether or not they are infected. If, after a full hearing, the court is of the opinion that the person examined is infected with an STD, the court may commit the person to an isolation hospital maintained by the state or local government for the purpose of detaining or treating such persons, who shall remain under treatment until the disease, in the opinion of the health officer, is no longer communicable or no longer in a stage in which infectious relapse may occur. § 68-10-110.

(9) Any state, district or municipal health officer or any physician may diagnose and treat minors infected with STDs without the knowledge or consent of the minors’ parents and without incurring civil or criminal liability in connection therewith, except for negligence. § 68-10-104.

Criminal Law (1), (4)

Insurance (1)

Education (2), (3)

Testing & Reporting (1), (3), (4), (5), (8), (9)

TESTING & REPORTING

(1) When a person is initially arrested for rape, aggravated rape, statutory rape, or rape of a child, that person shall undergo HIV testing immediately. A licensed medical laboratory shall perform such test at the expense of the arrestee. The arrestee shall obtain a confirmatory test when necessary. The arrestee shall be referred to appropriate counseling. The licensed medical laboratory shall report the test results immediately to the victim. The result of the HIV test (see Definitions (5)) is not a public record and shall be available only to the following: the victim; a parent or guardian of a minor or incapacitated victim; the attending physician of the person tested and of the victim; the Department of Health; the Department of Corrections; the person tested; and the district attorney general prosecuting the case. If the arrestee is convicted, the court shall review the HIV test results prior to sentencing. The court may consider as an enhancement factor at the time of sentencing that the defendant has tested positive for HIV. § 39-13-521.

(2) Actual transmission of HIV is not necessary in order for the court to consider the defendant’s HIV infection as an enhancement factor. Upon the conviction of the defendant for prostitution, the court shall order the convicted person to submit to an HIV test. The defendant shall return a certified copy of the results of all tests to the court, which shall examine the results in camera and seal the record. The district attorney general may view the record for the sole purpose of determining whether there is probable cause to prosecute for aggravated prostitution. The district attorney general must file a written, signed request stating the reason the court should grant permission to view the record. If the test result is positive, the district attorney general may use the results in a prosecution for aggravated prostitution. § 39-13-521.

(3) Whenever any physician, surgeon, or practitioner of medicine knows or suspects that any person whom such physician has been called to visit, or who has been brought to see such physician for examination, is infected or suspected of being infected with a communicable disease including AIDS, such physician shall immediately notify the health authorities of the town or county where the diseased person is found. In the event of the death of such person, the physician shall also notify the person to whom the body is delivered, at the time of delivery, of the known or suspected communicable disease, so that the necessary precautions can be taken in the handling, preparation, and disposition of the body. § 68-5-102.

(4) Every physician or other person who diagnoses, treats, or prescribes for a case of a sexually transmitted disease (STD) (see Definitions (8)) and every superintendent or manager of a clinic, hospital, laboratory, or penal institution in which there is a case of a STD shall report the case immediately to those persons or agents designated as recipients of such reports by the Commissioner of Health. Reporting of STDs other than those designated as reportable in the Health Department regulations is not required. § 68-10-101.

(5) An attending physician or other person shall notify the municipal or county health officer of the name and address of any person who has an STD and is known or reasonably suspected to conduct themselves so as to expose others to infection. § 68-10-102.

(6) All records and information held by the Health Department or a local health department relating to known or suspected cases of STDs shall be strictly confidential. Such information shall not be released or made public under subpoena, court order, discovery, search warrant, or otherwise, except that release may be made under the following circumstances: for statistical purposes, in a form that does not allow identification of individuals; with the consent of all persons identified in the information released; to enforce provisions governing control and treatment of STDs, with release being made to medical personnel, appropriate state agencies or county and district courts; in a medical emergency, to protect the health or life of the patient; for a minor not more than thirteen years of age, with only the name, age, address, and the STD treated being reported, and for a court proceeding involving child abuse, with any information regarding the minor disclosed in camera; and during a legal proceeding if the evidence is material, relevant, and reasonably calculated to be admissible, the probative value exceeds the interest in confidentiality, the merits of the litigation cannot be fairly resolved without disclosure, and the evidence is necessary to avoid substantial injustice to the party seeking it. § 68-10-113. Except as provided above, no state or local health department officer shall be examined in a civil, criminal, special, or other proceeding as to the existence or contents of records of a person treated for an STD by a state or local health department or as to the existence or contents of such reports received from a private physician or private health facility. § 68-10-114.

(7) If during the course of transporting or processing a person charged with the commission of a criminal offense, a law enforcement officer is exposed to the blood or other body fluid of such arrested person in any manner that presents a significant risk of transmission of HIV, then the exposed officer has the right to request that such arrested person be tested for the presence of HIV. § 68-10-116.

(8) All licensed acute care hospitals, birthing centers, and ambulatory surgical treatment centers in Tennessee shall adopt, at the institutions’ discretion, appropriate policies regarding the testing of patients and staff for HIV and any other identified causative agents of AIDS. Acting in consultation with the Department of Health, the following state entities shall promulgate rules requiring the facilities and persons, regulated by such state entities, to adopt and utilize universal precautions for the prevention of HIV: the Board of Licensing of Health Care Facilities; the Board of Registration in Podiatry; the Board of Dentistry; the Board of Medical Examiners; the Board of Nursing; the Board of Optometry; the Board of Osteopathic Examination; the Board of Occupational and Physical Therapy Examiners; and the Board of Medical Examiners’ Committee on Physician Assistants. In the event that an employee of a health care facility, a student studying at the facility, or other health care provider is exposed to the blood or other body fluid of a patient, such facility may require that patients’ blood be tested for the presence of HIV and Hepatitis B. Such testing shall be performed at no charge to the patient. The results of the testing shall be confidential. § 68-11-222.

(9) All facilities collecting fresh human blood or plasma directly from an individual donor shall have such blood or plasma tested for the potential presence of HIV. Any blood shown to be potentially contaminated by HIV shall not be used for transfusions or for any other purposes which might pose a threat of transmission of the virus. Any person who contracts AIDS from any contaminated blood or blood product shall have a cause of action for damages, including all medical expenses, against any facility supplying untested blood, if the person can establish that the person received any untested blood or blood product derived therefrom. No cause of action shall arise in those emergency situations where the attending physician determines that failure to transfuse will be life threatening to the patient. § 68-32-102.

(10) A provider of health care services who assume responsibility for the prenatal care of a pregnant woman during gestation shall counsel each pregnant woman in the provider’s care, as early as possible in the course of the pregnancy, with written materials or videos that explain and provide information on HIV and the medical treatment of HIV. The Department of Health shall make available the educational and counseling materials required for the counseling of pregnant women to providers responsible for the counseling. After the pregnant woman has received counseling and information, she shall sign a form indicating that she has been informed and indicating her consent or refusal to HIV testing (see Definitions (5)). Unless the pregnant woman has refused testing, the health care provider shall arrange for the pregnant woman to be tested for HIV as early as possible. A pregnant woman who presents herself for delivery and who has not been tested for HIV during the course of pregnancy shall be given counseling and information as soon as may be medically appropriate and, unless she refuses in writing after receiving counseling and information, shall be tested for HIV as soon as may be medically appropriate. All HIV testing performed shall be done in a confidential manner and the test results may be disclosed only as provided by law. If the HIV test results are positive, the health care provider shall arrange for a counselor to be present when the health care provider discloses the results to the woman tested. The counselor shall explain the test results, counsel the woman to obtain appropriate medical treatment for her and her baby, make available information concerning the available medical intervention to prevent the onset of illness in the mother and to prevent transmission of HIV to her children, and arrange for additional counseling. §§ 68-5-701 to 68-5-703. Each health care provider treating pregnant women shall report to the Department of Health on a monthly basis the total number of women under such provider’s care who were tested for HIV and the total number of such women who tested positive. The Department of Health shall, each month, compile the reports and publish the total number of women tested and total number of women testing positive in the previous month for the entire state and for each county. § 68-5-704.

(11) If in the course of performing normal, authorized professional job duties, a paramedic, emergency response employee (see Definitions (2)), fire fighters, first response workers, emergency medical technician, or volunteer making an authorized emergency response believes that such member may have been exposed to potentially life-threatening airborne or bloodborne diseases, including HIV, such person has the right to request in writing that the individual who may have exposed such person be evaluated to determine the presence of such disease or diseases. Such requests shall be made to the designated exposure control officer of the responding agency or county medical examiner who shall conduct the evaluation. This evaluation shall include all medical records pertaining to the individual who is the subject of the evaluation. This information shall be used solely for the purpose of performing the evaluation and shall be otherwise confidential. The responding agency shall pay for any costs related to the evaluation. This evaluation shall be conducted pursuant to public necessity rules. Any agency, individual, or facility providing any assistance or information necessary for completing such evaluation shall not incur any civil or criminal liability as a result of providing such assistance or information consistent with the rules. § 68-10-117.

(12) A local government or any licensed ambulance service may utilized one or more of its employees licensed as an EMT-P as its designated officer or officers for exposure control to perform infection control procedures necessary for prevention, exposure control and post-exposure evaluation on persons employed by that local government or licensed ambulance service as emergency response employees (see Definitions (2)). Infection control procedures shall include immunization, informational and educational programs, and post-exposure evaluation of an emergency response employee exposed to potentially life-threatening airborne or bloodborne disease, including, but not limited to HIV. This post-exposure evaluation shall consist of ascertaining information relative to the events regarding the perceived exposure, as wall as assessing the degree or significance of the exposure for the purpose of informing the medical director. The medical director shall determine the potential public health risk and recommend the immediate course of action pertaining to the medical care of the emergency response employee and any potential public health risk relative thereto. Further evaluation, treatment and follow-up of the emergency response employee’s condition shall be performed at a licensed hospital or physician’s office. § 68-140-520.

Criminal Law (6), (7), (8)

Social & Medical Services (1)

Miscellaneous (1)

MISCELLANEOUS

(1) A person who has a reasonable belief that a person has knowingly exposed another to HIV may inform the potential victim without incurring any liability. § 68-10-115.

(2) The Department of Health has the power to license health care facilities, including residential HIV supportive living facilities (see Definitions (7)). It has the power to review all licensed facilities. § 68-11-202. It is unlawful for such facilities to operate without a license. The Department of Health may initiate proceeding for injunctive or other form of relief, including penalties, against facilities operating without a license or violations of the law or terms and conditions of the licenses. §§ 68-11-204, 68-11-213. Federally operated health care facilities are exempt from the licensing requirement. § 68-11-204. The provisions governing application for license and the licensing fees are found at §§ 68-11-206 and 68-11-216 respectively.

(3) Every licensed hospital, residential HIV supportive living facility (see Definitions (7)), and other health care facilities (see Definitions (3)), shall be inspected at least once each year by a duly appointed representative of the Department of Health. § 68-11-210.

(4) The Board for Licensing Health Care Facilities has the duty and power to adopt such rules and regulations pertaining to the operation and management of hospitals, residential HIV supportive living facilities (see Definitions (7)), and other medical care facilities, and to rescind, amend or modify such rules and regulations, as are necessary in the public interest and particularly the establishment and maintenance of standards of hospitalization required for the efficient care of patients or medical care facilities, including residential HIV supportive living facilities (see Definitions (7)). The board may waive any of the rules and regulations pertaining to any covered health care facility, where such waiver would not have a detrimental effect on the health, safety and welfare of the public. The board shall prescribe the minimum standards as to equipment and provision for the care of patients of medical care facilities, including residential HIV supportive living facilities (see Definitions (7)), in order to operate lawfully as such. Persons who wish to serve as chief administrator of a licensed residential HIV supportive living facility (see Definitions (7)) or other residential or institutional home, shall first by the board as a residential/institutional home administrator. § 68-11-209.

(5) An owner or lessee of a motor vehicle, who is a resident of this state, upon complying with state motor vehicle laws relating to registration and licensing of motor vehicles, and paying the fees applicable, shall be issued a supporter of AIDS Response Knoxville (ARK) new specialty earmarked license plate for a motor vehicle. This new specialty earmarked plates shall be designed in consultation with the board of directors of ARK and the commissioner of safety; provided, that such plates shall bear a logo of a "red ribbon", the symbol of HIV education, service and support groups, as part of such plates’ approved design. The funds derived from the sale of such plate, less the expense the state has incurred in designing and manufacturing the plate, shall be deposited in a special fund in the general fund to be used exclusively to support HIV-AIDS prevention, education, information, services and support programs administered or approved by ARK. This money shall be deposited in a general fund reserve to be allocated by the general appropriations act which shall be known as the HIV-AIDS prevention, education, service and support endowment fund. The Commissioner of Health shall make grants to ARK for such programs from the moneys available in this fund. § 55-4-279.

 

 

 

 

 

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