[MCOH-EH] HIV testing after occupational exposure in Arizona - new law

[Orford, Robert R., M.D.]

Arizona has passed legislation regulating HIV testing after occupational exposures. The Arizona Medical Association published the summary below earlier today. The bill itself is available at http://www.azleg.gov/legtext/51leg/2r/laws/0222.pdf. This will make it easier overall for testing to be done on patients after an employee is exposed. However, the law does require the exposed employee's written consent for the testing of the source patient's blood to be done. It also does allow a patient to refuse to submit to a blood test specifically for HIV testing after an exposure has occurred, but it does not require the patient to provide a specific consent if blood has already been drawn for other reasons (which is usually the case).

Bob Orford,
Scottsdale, AZ
Coalition works to improve HIV testing, consent

[http://upload.wikimedia.org/wikipedia/commons/7/76/HIV_Rapid_Test_being_administered.jpg]During this session, ArMA worked diligently with hospitals, ED physicians, law enforcement and other first responders to create a procedure allowing those significantly exposed to HIV to seek and receive information necessary for them to make informed decisions on care after an exposure. SB1276 was sponsored by Senator Kimberly Yee. As might be expected, it took several stakeholder meetings to hammer out the clinical and legal concerns as well as to obtain the input and agreement of the HIV-positive community. The result is the first significant change in consent since the early 1990s and it recognizes that medicine's approach and treatment of HIV has changed dramatically within that time. Following are the basic provisions of the bill:

  *   HIV-related testing requested by a health care provider or first responder who has had an occupational significant exposure risk to a patient's blood or bodily fluid, may be performed under a general consent to receive treatment, except in an emergency when consent can be implied.
  *   Testing may only be conducted on receipt of a written request from a health care provider or first responder who documents the occurrence and information regarding the nature of the occupational significant exposure risk and the report is reviewed and confirmed by a health care provider who is both licensed pursuant to Title 32, Chapters 13, 15 or 17 and competent to determine a significant exposure risk.
  *   Maintains that a patient may not be forced to provide a blood sample.
  *   Stipulates that when an HIV-related test is ordered, a health care provider must provide the patient with the test results and information
  *   that explains HIV infection and the meaning of a positive or negative test result and indicates that the patient may ask questions.
  *   Allows a medical or alternative medical examiner to provide a blood sample from a deceased person for the purpose of HIV-related testing and provides the medical or alternative medical examiner is not required to perform an HIV-related test for an occupational significant exposure risk.
  *   Permits a person who obtains communicable disease related information to disclose that information when a health care provider or first responder who has had an occupational significant exposure risk to the protected person's blood or bodily fluid if the health care provider or first responder provides a written request that documents the occurrence and information regarding the nature of the occupational significant exposure risk and the report is reviewed and confirmed by a health care provider who is both licensed pursuant to Title 32, Chapters 13, 15 or 17 and competent to determine a significant exposure risk.
  *   Requires a health care provider who releases communicable disease information to provide education and counseling to the person who had the occupational significant exposure.
  *   Defines first responder and occupational significant exposure risk.

Near the end of the session, the bill passed with ArMA's support and was signed by the Governor.





Robert R. Orford, MD,CM

Division of Preventive, Occupational, and Aerospace Medicine
Mayo Clinic Scottsdale
13400 East Shea Blvd.,
Scottsdale, AZ, 85259

Phone (480) 301-7379
FAX (480) 301-7569

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://mylist.net/archives/mcoh-eh/attachments/20140510/e14c51c0/attachment-0001.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.jpg
Type: image/jpeg
Size: 1602583 bytes
Desc: image001.jpg
URL: <http://mylist.net/archives/mcoh-eh/attachments/20140510/e14c51c0/attachment-0002.jpg>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image002.jpg
Type: image/jpeg
Size: 5727 bytes
Desc: image002.jpg
URL: <http://mylist.net/archives/mcoh-eh/attachments/20140510/e14c51c0/attachment-0003.jpg>