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AIDS TESTING
AND MEDICAL INFORMATION
Legal Issues
http://www.dph.state.ct.us/BCH/AIDS/legal.htm
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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