HB1759 95TH GENERAL ASSEMBLY

LRB095 09579 KBJ 29779 b

95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB1759

Introduced 2/23/2007, by Rep. Mary E. Flowers

SYNOPSIS AS INTRODUCED:

410 ILCS 335/10

Amends the Perinatal HIV Prevention Act. Provides that every health care professional who provides health care services to a pregnant woman shall provide the woman with HIV counseling and perform (instead of recommend) HIV testing in accordance with the Centers for Disease Control and Prevention's Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings, unless she has already received an HIV test during pregnancy or she refuses in writing to take the test. Provides that every health care professional who provides health care services to a pregnant women, prior to providing an HIV test, must provide the pregnant woman with oral or written information and inform the woman of her right to refuse the test, and, upon request, provide the woman with the necessary forms to register her refusal. Provides that every health care professional who provides health care services to a pregnant woman shall not perform HIV testing on that woman after she has refused the test in writing, unless she withdraws her refusal in writing. Provides that for women at continued risk of exposure to HIV infection in the judgment of the health care professional, a repeat test should be provided (instead of recommended) late in pregnancy or at the time of labor and delivery, unless the woman refuses to the test in writing. Provides that the provision of pre-test information or refusal of testing shall be documented in the woman's medical record. Provides that any testing, provision of pre-test information, and prenatal information must be in accordance with the Centers for Disease Control and Prevention recommendations. Makes other changes.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning public health.

WHEREAS, The majority of children who are infected with human immunodeficiency virus (HIV) acquire the virus from their mothers during pregnancy; and

WHEREAS, More than one million Americans are infected with HIV, and 40,000 new cases of HIV occur each year; and

WHEREAS, More than one-quarter of persons with HIV do not know they are infected and contribute to up to 70% of new cases of HIV each year; and

WHEREAS, Pregnant women, particularly women of color, are at high risk for acquiring HIV, but often do not know they carry the risk of transmitting the virus to their newborns; and

WHEREAS, More than 99% of mother-to-newborn transmissions of HIV can be prevented if a pregnant woman is tested for HIV and treated with medications before the birth of her child; and

WHEREAS, National recommendations for preventing mother-to-newborn HIV infection from authorities, including the Institute of Medicine, the Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the Presidential Advisory Council on HIV/AIDS, and the National Congress of Black Women, indicate that the most effective way to prevent mother-to-newborn HIV transmission is through routine prenatal testing of all pregnant women with the right to refuse; and

WHEREAS, Nearly 300 babies have been born with HIV in Illinois since 1994 since it was demonstrated that prenatal HIV testing and treatment can prevent mother-to-newborn HIV infection; and

WHEREAS, The earlier in a pregnancy a woman is identified as having HIV, the greater the opportunity to provide her with more effective care for herself and prevent transmission of HIV to her newborn; therefore

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Perinatal HIV Prevention Act is amended by changing Section 10 as follows:

(410 ILCS 335/10)

Sec. 10. HIV counseling and offer of HIV testing required.

(a) Every health care professional who provides health care services to a pregnant woman shall provide the woman with HIV counseling and perform recommend HIV testing in accordance with the Centers for Disease Control and Prevention's Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings (September 22, 2006), unless she has already received an HIV test during pregnancy or she refuses in writing to take the test. Every health care professional who provides health care services to a pregnant woman must test the woman for HIV as early in the woman's pregnancy as possible, unless she has already received an HIV test during pregnancy or objects in writing to the test. Every health care professional who provides health care services to a pregnant women, prior to providing an HIV test, must provide the pregnant woman with oral or written information included in subsection (d) and inform the woman of her right to refuse the test, and, upon request, provide the woman with the necessary forms to register her refusal. Every health care professional who provides health care services to a pregnant woman shall not perform HIV testing on that woman after she has refused the test in writing, unless she withdraws her refusal in writing. HIV testing shall be provided with the woman's consent. A health care professional shall provide the counseling and recommend the testing as early in the woman's pregnancy as possible. For women at continued risk of exposure to HIV infection in the judgment of the health care professional, a repeat test should be provided recommended late in pregnancy or at the time of labor and delivery, unless the woman refuses to the test in writing. The health care professional shall inform the pregnant woman that, should she refuse HIV testing during pregnancy, her newborn infant will be tested for HIV. The provision of pre-test information and any written refusal relating to testing counseling and recommendation of testing shall be documented in the woman's medical record.

(b) Every health care professional or facility that cares for a pregnant woman during labor or delivery shall provide the woman with HIV counseling and recommend HIV testing, unless she refuses in writing to the testing. HIV testing shall be provided with the woman's consent. No counseling or offer of testing is required if already provided during the woman's pregnancy. The provision of pre-test information or refusal of testing counseling and offer of testing shall be documented in the woman's medical record. The health care facility shall adopt a policy that provides that as soon as possible within medical standards after the infant's birth, the mother's HIV test result, if available, shall be noted in the newborn infant's medical record. It shall also be noted in the newborn infant's medical record if the mother's HIV test result is not available because she has not been tested or has refused declined testing. Any testing or test results shall be documented in accordance with the Centers for Disease Control and Prevention's Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings (September 22, 2006) AIDS Confidentiality Act.

(c) Every health care professional or facility caring for a newborn infant shall, upon delivery or as soon as possible within medical standards after the infant's birth, provide pre-test information counseling to the parent or guardian of the infant and perform rapid HIV testing on the infant, when the HIV status of the infant's mother is unknown.

(d) The pre-test information counseling required under this Section must be provided in accordance with the Centers for Disease Control and Prevention's Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings (September 22, 2006) AIDS Confidentiality Act and must include the following:

(1) For the health of the pregnant woman, the voluntary nature of the testing (the right to refuse HIV testing) and the benefits of HIV testing, including the prevention of transmission.

(2) The benefit of HIV testing for the newborn infant, including interventions to prevent HIV transmission.

(3) The side effects of interventions to prevent HIV transmission.

(4) The statutory confidentiality provisions that relate to HIV and acquired immune deficiency syndrome ("AIDS") testing.

(e) All prenatal information counseling and testing must be performed in accordance with the standards set forth in the Centers for Disease Control and Prevention's Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings (September 22, 2006) AIDS Confidentiality Act, including the written informed consent provisions of Sections 4, 7, and 8 of that Act, with the exception of the requirement of consent for testing of newborn infants. No additional process or written documentation of informed consent beyond what is required for other routine prenatal tests is required for HIV testing. Consent for testing of a newborn infant shall be presumed when a health care professional or health care facility seeks to perform a test on a newborn infant whose mother's HIV status is not known, provided that the provision of the pre-test information counseling required under subsection (d) has taken place.

(f) The Illinois Department of Public Health shall adopt necessary rules to implement this Act.

(Source: P.A. 93-566, eff. 8-20-03; 94-910, eff. 6-23-06.)