Rep. Sara Feigenholtz

Filed: 3/12/2014

 

 


 

 


 
09800HB5925ham001LRB098 20292 RPM 56528 a

1
AMENDMENT TO HOUSE BILL 5925

2    AMENDMENT NO. ______. Amend House Bill 5925 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Clinical Laboratory and Blood Bank
5Act is amended by adding Sections 2-134, 2-135, 2-136, and
62-137 and by changing Section 7-102 as follows:
 
7    (210 ILCS 25/2-134 new)
8    Sec. 2-134. Health care operations. "Health care
9operations" has the meaning ascribed to it under HIPAA, as
10specified in 45 CFR 164.501.
 
11    (210 ILCS 25/2-135 new)
12    Sec. 2-135. HIPAA. "HIPAA" means the Health Insurance
13Portability and Accountability Act of 1996, Public Law 104-191,
14as amended by the Health Information and Technology for
15Economic and Clinical Health Act of 2009, Public Law 111-05,

 

 

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1and any subsequent amendments thereto and any regulations
2promulgated thereunder.
 
3    (210 ILCS 25/2-136 new)
4    Sec. 2-136. Payment. "Payment" has the meaning ascribed to
5it under HIPAA, as specified in 45 CFR 164.501.
 
6    (210 ILCS 25/2-137 new)
7    Sec. 2-137. Treatment. "Treatment" has the meaning
8ascribed to it under HIPAA, as specified in 45 CFR 164.501.
 
9    (210 ILCS 25/7-102)  (from Ch. 111 1/2, par. 627-102)
10    Sec. 7-102. Reports of test results.
11    (a) Clinical laboratory test results may be reported or
12transmitted to:
13        (1) the licensed physician or other authorized person
14    who requested the test, their designee, or both;
15        (2) any health care provider who is providing treatment
16    to the patient;
17        (3) an electronic health information exchange for the
18    purposes of transmitting, using, or disclosing clinical
19    laboratory test results in any manner required or permitted
20    by HIPAA. The result of a test shall be reported directly
21    to the licensed physician or other authorized person who
22    requested it.
23    (b) No interpretation, diagnosis, or prognosis or

 

 

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1suggested treatment shall appear on the laboratory report form,
2except that a report made by a physician licensed to practice
3medicine in Illinois, a dentist licensed in Illinois, or an
4optometrist licensed in Illinois may include such information.
5    (c) Nothing in this Act prohibits the sharing of
6information as authorized in Section 2.1 of the Department of
7Public Health Act.
8(Source: P.A. 98-185, eff. 1-1-14.)
 
9    Section 10. The AIDS Confidentiality Act is amended by
10changing Sections 2, 3, 9, 10, and 16 and by adding Sections
119.1, 9.2, 9.3, 9.4, 9.4a, 9.6, 9.7, 9.8, 9.9, and 9.10 as
12follows:
 
13    (410 ILCS 305/2)  (from Ch. 111 1/2, par. 7302)
14    Sec. 2. The General Assembly finds that:
15    (1) The use of tests designed to reveal a condition
16indicative of Human Immunodeficiency Virus (HIV) infection can
17be a valuable tool in protecting the public health.
18    (2) Despite existing laws, regulations and professional
19standards which require or promote the informed, voluntary and
20confidential use of tests designed to reveal HIV infection,
21many members of the public are deterred from seeking such
22testing because they misunderstand the nature of the test or
23fear that test results or other health information that reveals
24their HIV status will be disclosed without their consent.

 

 

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1    (3) The public health will be served by facilitating
2informed, voluntary and confidential use of tests designed to
3reveal HIV infection and appropriately protecting the health
4information privacy of patients who are HIV-positive.
5    (4) The public health will also be served by expanding the
6availability of informed, voluntary, and confidential HIV
7testing and treatment and making HIV testing a routine part of
8general medical care, as recommended by the United States
9Centers for Disease Control and Prevention.
10    (5) The use of electronic health record systems and the
11exchange of electronic patient records, both paper and
12electronic, through secure means, including through secure
13health information exchanges, should be encouraged to improve
14patient health care and care coordination, facilitate public
15health reporting, and control health care costs, among other
16purposes.
17    (6) Limiting the use or disclosure of, and requests for,
18protected health information to the minimum necessary to
19accomplish an intended purpose, when being transmitted by or on
20behalf of a covered entity under HIPAA, is a key component of
21health information privacy. The disclosure of HIV-related
22information, when allowed by this Act, shall be performed in
23accordance with the minimum necessary standard when required
24under HIPAA.
25(Source: P.A. 95-7, eff. 6-1-08.)
 

 

 

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1    (410 ILCS 305/3)  (from Ch. 111 1/2, par. 7303)
2    Sec. 3. When used in this Act:
3    (a) "AIDS" means acquired immunodeficiency syndrome.
4    (b) "Authority" means the Illinois Health Information
5Exchange Authority established pursuant to the Illinois Health
6Information Exchange and Technology Act.
7    (c) "Business associate" has the meaning ascribed to it
8under HIPAA, as specified in 45 CFR 160.103.
9    (d) "Covered entity" has the meaning ascribed to it under
10HIPAA, as specified in 45 CFR 160.103.
11    (e) "De-identified information" means health information
12that is not individually identifiable as described under HIPAA,
13as specified in 45 CFR 164.514(b).
14    (f) (a) "Department" means the Illinois Department of
15Public Health or its designated agents.
16    (g) "Disclosure" has the meaning ascribed to it under
17HIPAA, as specified in 45 CFR 160.103.
18    (h) "Health care operations" has the meaning ascribed to it
19under HIPAA, as specified in 45 CFR 164.501.
20    (i) "Health care professional" means (i) a licensed
21physician, (ii) a physician assistant to whom the physician
22assistant's supervising physician has delegated the provision
23of AIDS and HIV-related health services, (iii) an advanced
24practice registered nurse who has a written collaborative
25agreement with a collaborating physician which authorizes the
26provision of AIDS and HIV-related health services, (iv) a

 

 

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1licensed dentist, (v) a licensed podiatric physician, or (vi)
2an individual certified to provide HIV testing and counseling
3by a state or local public health department.
4    (j) "Health care provider" has the meaning ascribed to it
5under HIPAA, as specified in 45 CFR 160.103.
6    (b) "AIDS" means acquired immunodeficiency syndrome.
7    (c) "HIV" means the Human Immunodeficiency Virus or any
8other identified causative agent of AIDS.
9    (d) "Informed consent" means a written or verbal agreement
10by the subject of a test or the subject's legally authorized
11representative without undue inducement or any element of
12force, fraud, deceit, duress or other form of constraint or
13coercion, which entails at least the following pre-test
14information:
15        (1) a fair explanation of the test, including its
16    purpose, potential uses, limitations and the meaning of its
17    results; and
18        (2) a fair explanation of the procedures to be
19    followed, including the voluntary nature of the test, the
20    right to withdraw consent to the testing process at any
21    time, the right to anonymity to the extent provided by law
22    with respect to participation in the test and disclosure of
23    test results, and the right to confidential treatment of
24    information identifying the subject of the test and the
25    results of the test, to the extent provided by law.
26    Pre-test information may be provided in writing, verbally,

 

 

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1or by video, electronic, or other means. The subject must be
2offered an opportunity to ask questions about the HIV test and
3decline testing. Nothing in this Act shall prohibit a health
4care provider from combining a form used to obtain informed
5consent for HIV testing with forms used to obtain written
6consent for general medical care or any other medical test or
7procedure provided that the forms make it clear that the
8subject may consent to general medical care, tests, or medical
9procedures without being required to consent to HIV testing and
10clearly explain how the subject may opt-out of HIV testing.
11    (k) (e) "Health facility" means a hospital, nursing home,
12blood bank, blood center, sperm bank, or other health care
13institution, including any "health facility" as that term is
14defined in the Illinois Finance Authority Act.
15    (l) "Health information exchange" or "HIE" means a health
16information exchange or health information organization that
17oversees and governs the electronic exchange of health
18information that (i) is established pursuant to the Illinois
19Health Information Exchange and Technology Act, or any
20subsequent amendments thereto, and any administrative rules
21adopted thereunder; (ii) has established a data sharing
22arrangement with the Authority; or (iii) as of August 16, 2013,
23was designated by the Authority Board as a member of, or was
24represented on, the Authority Board's Regional Health
25Information Exchange Workgroup. In certain circumstances, in
26accordance with HIPAA, an HIE will be a business associate.

 

 

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1    (m) "Health oversight agency" has the meaning ascribed to
2it under HIPAA, as specified in 45 CFR 164.501.
3    (n) "HIPAA" means the Health Insurance Portability and
4Accountability Act of 1996, Public Law 104-191, as amended by
5the Health Information Technology for Economic and Clinical
6Health Act of 2009, Public Law 111-05, and any subsequent
7amendments thereto and any regulations promulgated thereunder.
8    (o) "HIV" means the human immunodeficiency virus.
9    (p) "HIV-related information" means the identity of a
10person upon whom an HIV test is performed, the results of an
11HIV test, as well as diagnosis, treatment, and prescription
12information that reveals a patient is HIV-positive, including
13such information contained in a limited data set. "HIV-related
14information" does not include information that has been
15de-identified in accordance with HIPAA.
16    (q) "Informed consent" means a written or verbal agreement
17by the subject of a test or the subject's legally authorized
18representative without undue inducement or any element of
19force, fraud, deceit, duress, or other form of constraint or
20coercion, which entails at least the following pre-test
21information:
22        (1) a fair explanation of the test, including its
23    purpose, potential uses, limitations, and the meaning of
24    its results;
25        (2) a fair explanation of the procedures to be
26    followed, including the voluntary nature of the test, the

 

 

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1    right to withdraw consent to the testing process at any
2    time, the right to anonymity to the extent provided by law
3    with respect to participation in the test and disclosure of
4    test results, and the right to confidential treatment of
5    information identifying the subject of the test and the
6    results of the test, to the extent provided by law; and
7        (3) where the entity providing the test is a
8    participant in an HIE, a fair explanation that the results
9    of the patient's HIV test will be accessible through an HIE
10    and meaningful disclosure of the patient's opt-out right
11    under Section 9.6 of this Act.
12    Pre-test information may be provided in writing, verbally,
13or by video, electronic, or other means. The subject must be
14offered an opportunity to ask questions about the HIV test and
15decline testing. Nothing in this Act shall prohibit a health
16care provider from combining a form used to obtain informed
17consent for HIV testing with forms used to obtain written
18consent for general medical care or any other medical test or
19procedure provided that the forms make it clear that the
20subject may consent to general medical care, tests, or medical
21procedures without being required to consent to HIV testing and
22clearly explain how the subject may opt out of HIV testing.
23    (r) "Limited data set" has the meaning ascribed to it under
24HIPAA, as described in 45 CFR 164.512(e)(2).
25    (s) "Minimum necessary" means the HIPAA standard for using,
26disclosing, and requesting protected health information found

 

 

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1in 45 CFR 154.502(b) and 164.514(d).
2    (t) "Organized health care arrangement" has the meaning
3ascribed to it under HIPAA, as specified in 45 CFR 160.103.
4    (u) "Patient safety activities" has the meaning ascribed to
5it under 42 CFR 3.20.
6    (v) "Payment" has the meaning ascribed to it under HIPAA,
7as specified in 45 CFR 164.501.
8    (w) "Person" includes any natural person, partnership,
9association, joint venture, trust, governmental entity, public
10or private corporation, health facility, or other legal entity.
11    (x) "Protected health information" has the meaning
12ascribed to it under HIPAA, as specified in 45 CFR 160.103.
13    (y) "Research" has the meaning ascribed to it under HIPAA,
14as specified in 45 CFR 164.501.
15    (z) "State agency" means an instrumentality of the State of
16Illinois and any instrumentality of another state that,
17pursuant to applicable law or a written undertaking with an
18instrumentality of the State of Illinois, is bound to protect
19the privacy of HIV-related information of Illinois persons.
20    (f) "Health care provider" means any health care
21professional, nurse, paramedic, psychologist or other person
22providing medical, nursing, psychological, or other health
23care services of any kind.
24    (f-5) "Health care professional" means (i) a licensed
25physician, (ii) a physician assistant to whom the physician
26assistant's supervising physician has delegated the provision

 

 

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1of AIDS and HIV-related health services, (iii) an advanced
2practice registered nurse who has a written collaborative
3agreement with a collaborating physician which authorizes the
4provision of AIDS and HIV-related health services, (iv) a
5licensed dentist, (v) a licensed podiatric physician, or (vi)
6an individual certified to provide HIV testing and counseling
7by a state or local public health department.
8    (aa) (g) "Test" or "HIV test" means a test to determine the
9presence of the antibody or antigen to HIV, or of HIV
10infection.
11    (bb) "Treatment" has the meaning ascribed to it under
12HIPAA, as specified in 45 CFR 164.501.
13    (cc) "Use" has the meaning ascribed to it under HIPAA, as
14specified in 45 CFR 160.103, where context dictates.
15    (h) "Person" includes any natural person, partnership,
16association, joint venture, trust, governmental entity, public
17or private corporation, health facility or other legal entity.
18(Source: P.A. 98-214, eff. 8-9-13.)
 
19    (410 ILCS 305/9)  (from Ch. 111 1/2, par. 7309)
20    Sec. 9. (1) No person may disclose or be compelled to
21disclose HIV-related information the identity of any person
22upon whom a test is performed, or the results of such a test in
23a manner which permits identification of the subject of the
24test, except to the following persons:
25    (a) The subject of an HIV the test or the subject's legally

 

 

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1authorized representative. A physician may notify the spouse of
2the test subject, if the test result is positive and has been
3confirmed pursuant to rules adopted by the Department, provided
4that the physician has first sought unsuccessfully to persuade
5the patient to notify the spouse or that, a reasonable time
6after the patient has agreed to make the notification, the
7physician has reason to believe that the patient has not
8provided the notification. This paragraph shall not create a
9duty or obligation under which a physician must notify the
10spouse of the test results, nor shall such duty or obligation
11be implied. No civil liability or criminal sanction under this
12Act shall be imposed for any disclosure or non-disclosure of a
13test result to a spouse by a physician acting in good faith
14under this paragraph. For the purpose of any proceedings, civil
15or criminal, the good faith of any physician acting under this
16paragraph shall be presumed.
17    (b) Any person designated in a legally effective
18authorization for release of the HIV-related information test
19results executed by the subject of the HIV-related information
20test or the subject's legally authorized representative.
21    (c) An authorized agent or employee of a health facility or
22health care provider if the health facility or health care
23provider itself is authorized to obtain the test results, the
24agent or employee provides patient care or handles or processes
25specimens of body fluids or tissues, and the agent or employee
26has a need to know such information.

 

 

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1    (d) The Department and local health authorities serving a
2population of over 1,000,000 residents or other local health
3authorities as designated by the Department, in accordance with
4rules for reporting, preventing, and controlling the spread of
5disease and the conduct of public health surveillance, public
6health investigations, and public health interventions, as
7otherwise provided by State law. The Department, local health
8authorities, and authorized representatives shall not disclose
9HIV test results and HIV-related information and records held
10by them relating to known or suspected cases of AIDS or HIV
11infection, publicly or in any action of any kind in any court
12or before any tribunal, board, or agency. HIV test results and
13HIV-related information AIDS and HIV infection data shall be
14protected from disclosure in accordance with the provisions of
15Sections 8-2101 through 8-2105 of the Code of Civil Procedure.
16    (e) A health facility, or health care provider, or health
17care professional which procures, processes, distributes or
18uses: (i) a human body part from a deceased person with respect
19to medical information regarding that person; or (ii) semen
20provided prior to the effective date of this Act for the
21purpose of artificial insemination.
22    (f) Health facility staff committees for the purposes of
23conducting program monitoring, program evaluation or service
24reviews.
25    (f-5) A court in accordance with the provisions of Section
2612-5.01 of the Criminal Code of 2012.

 

 

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1    (g) (Blank).
2    (h) Any health care provider or employee of a health
3facility, and any firefighter or EMT-A, EMT-P, or EMT-I,
4involved in an accidental direct skin or mucous membrane
5contact with the blood or bodily fluids of an individual which
6is of a nature that may transmit HIV, as determined by a
7physician in his medical judgment.
8    (i) Any law enforcement officer, as defined in subsection
9(c) of Section 7, involved in the line of duty in a direct skin
10or mucous membrane contact with the blood or bodily fluids of
11an individual which is of a nature that may transmit HIV, as
12determined by a physician in his medical judgment.
13    (j) A temporary caretaker of a child taken into temporary
14protective custody by the Department of Children and Family
15Services pursuant to Section 5 of the Abused and Neglected
16Child Reporting Act, as now or hereafter amended.
17    (k) In the case of a minor under 18 years of age whose test
18result is positive and has been confirmed pursuant to rules
19adopted by the Department, the health care professional
20provider who ordered the test shall make a reasonable effort to
21notify the minor's parent or legal guardian if, in the
22professional judgment of the health care professional
23provider, notification would be in the best interest of the
24child and the health care professional provider has first
25sought unsuccessfully to persuade the minor to notify the
26parent or legal guardian or a reasonable time after the minor

 

 

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1has agreed to notify the parent or legal guardian, the health
2care professional provider has reason to believe that the minor
3has not made the notification. This subsection shall not create
4a duty or obligation under which a health care professional
5provider must notify the minor's parent or legal guardian of
6the test results, nor shall a duty or obligation be implied. No
7civil liability or criminal sanction under this Act shall be
8imposed for any notification or non-notification of a minor's
9test result by a health care professional provider acting in
10good faith under this subsection. For the purpose of any
11proceeding, civil or criminal, the good faith of any health
12care professional provider acting under this subsection shall
13be presumed.
14    (2) All information and records held by a State agency,
15local health authority, or health oversight agency pertaining
16to HIV-related information shall be strictly confidential and
17exempt from copying and inspection under the Freedom of
18Information Act. The information and records shall not be
19released or made public by the State agency, local health
20authority, or health oversight agency, shall not be admissible
21as evidence nor discoverable in any action of any kind in any
22court or before any tribunal, board, agency, or person, and
23shall be treated in the same manner as the information and
24those records subject to the provisions of Part 21 of Article
25VIII of the Code of Civil Procedure, except under the following
26circumstances:

 

 

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1        (A) when made with the written consent of all persons
2    to whom the information pertains; or
3        (B) when authorized by Section 5-4-3 of the Unified
4    Code of Corrections.
5    Disclosure shall be limited to those who have a need to
6know the information, and no additional disclosures may be
7made.
8(Source: P.A. 96-328, eff. 8-11-09; 97-1046, eff. 8-21-12;
997-1150, eff. 1-25-13.)
 
10    (410 ILCS 305/9.1 new)
11    Sec. 9.1. Uses and disclosures for treatment, payment, and
12health care operations. Notwithstanding Sections 9 and 10 of
13this Act, a covered entity may, without a patient's consent:
14        (1) use or disclose HIV-related information for its own
15    treatment, payment, or health care operations;
16        (2) disclose HIV-related information for treatment
17    activities of a health care provider;
18        (3) disclose HIV-related information to another
19    covered entity or health care provider for the payment
20    activities of the entity that receives the information;
21        (4) disclose HIV-related information to another
22    covered entity for health care operations activities of the
23    entity that receives the information, if each entity has or
24    had a relationship with the individual who is the subject
25    of the HIV-related information being requested, the

 

 

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1    HIV-related information pertains to such relationship, and
2    the disclosure is for the purpose of (A) conducting quality
3    assessment and improvement activities, including outcomes
4    evaluation and development of clinical guidelines,
5    provided that the obtaining of generalizable knowledge is
6    not the primary purpose of any studies resulting from such
7    activities; patient safety activities; population-based
8    activities relating to improving health or reducing health
9    care costs, protocol development, case management, and
10    care coordination, contacting of health care providers and
11    patients with information about treatment alternatives;
12    and related functions that do not include treatment; (B)
13    reviewing the competence or qualifications of health care
14    professionals, evaluating practitioner and provider
15    performance, health plan performance, conducting training
16    programs in which students, trainees, or practitioners in
17    areas of health care learn under supervision to practice or
18    improve their skills as health care providers, training of
19    non-health care professionals, accreditation,
20    certification, licensing, or credentialing activities; or
21    (C) health care fraud and abuse detection or compliance;
22    and
23        (5) disclose HIV-related information to other
24    participants in an organized health care arrangement in
25    which the covered entity is also a participant for any
26    health care operations activities of the organized health

 

 

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1    care arrangement.
 
2    (410 ILCS 305/9.2 new)
3    Sec. 9.2. Uses and disclosures for health oversight
4activities.
5    (a) Notwithstanding Sections 9 and 10 of this Act, a
6covered entity may disclose HIV-related information, without a
7patient's consent, to a health oversight agency for health
8oversight activities authorized by law, including audits,
9civil, administrative, or criminal investigations;
10inspections; licensure or disciplinary actions; civil
11administrative or criminal proceedings or actions; or other
12activities necessary for appropriate oversight of (i) the
13health care system; (ii) government benefit programs for which
14health information is relevant to beneficiary eligibility;
15(iii) entities subject to government regulatory programs for
16which health information is necessary for determining
17compliance with program standards; or (iv) entities subject to
18civil rights laws for which health information is necessary for
19determining compliance.
20    (b) For purposes of the disclosures permitted by this
21Section, a health oversight activity does not include an
22investigation or other activity in which the individual is the
23subject of the investigation or activity and such investigation
24or other activity does not arise out of and is not directly
25related to (i) the receipt of health care; (ii) a claim for

 

 

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1public benefits related to health; or (iii) qualification for,
2or receipt of, public benefits or services when a patient's
3health is integral to the claim for public benefits or
4services, except that, if a health oversight activity or
5investigation is conducted in conjunction with an oversight
6activity or investigation relating to a claim for public
7benefits not related to health, the joint activity or
8investigation is considered a health oversight activity for
9purposes of this Section.
10    (c) If a covered entity is also a health oversight agency,
11the covered entity may use HIV-related information for health
12oversight activities permitted by this Section.
 
13    (410 ILCS 305/9.3 new)
14    Sec. 9.3. Business associates.
15    (a) Notwithstanding Sections 9 and 10 of this Act, a
16covered entity may, without a patient's consent, disclose a
17patient's HIV-related information to a business associate and
18may allow a business associate to create, receive, maintain, or
19transmit protected health information on its behalf, if the
20covered entity obtains, through a written contract or other
21written agreement or arrangement that meets the applicable
22requirements of 45 CFR 164.504(e), satisfactory assurance that
23the business associate will appropriately safeguard the
24information. A covered entity is not required to obtain such
25satisfactory assurances from a business associate that is a

 

 

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1subcontractor.
2    (b) A business associate may disclose protected health
3information to a business associate that is a subcontractor and
4may allow the subcontractor to create, receive, maintain, or
5transmit protected health information on its behalf, if the
6business associate obtains satisfactory assurances, in
7accordance with 45 CFR 164.504(e)(1)(i), that the
8subcontractor will appropriately safeguard the information.
 
9    (410 ILCS 305/9.4 new)
10    Sec. 9.4. Use and disclosure of information to an HIE.
11Notwithstanding the provisions of Section 9 and 10 of this Act,
12a covered entity may, without a patient's consent, disclose the
13identity of any patient upon whom a test is performed and such
14patient's HIV-related information from a patient's record to an
15HIE if the disclosure is a required or permitted disclosure to
16a business associate or is a disclosure otherwise required or
17permitted under this Act. An HIE may, without a patient's
18consent, use or disclose such information to the extent it is
19allowed to use or disclose such information as a business
20associate in compliance with 45 CFR 164.502(e) or for such
21other purposes as are specifically allowed under this Act.
 
22    (410 ILCS 305/9.4a new)
23    Sec. 9.4a. Other disclosures. Nothing in this Act shall be
24construed (1) to limit the use of an HIE to facilitate

 

 

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1disclosures permitted by this Act or (2) to allow for the
2disclosure of information from a patient's record to law
3enforcement or for law enforcement purposes.
 
4    (410 ILCS 305/9.6 new)
5    Sec. 9.6. HIE opt out. Section 9.6 of the Mental Health and
6Developmental Disabilities Confidentiality Act is incorporated
7herein by reference. In addition to the requirements set out in
8Section 9.6 of the Mental Health and Developmental Disabilities
9Confidentiality Act, at the time of a patient's first encounter
10for HIV-related care with a health care provider, health care
11professional, or health facility that participates in an HIE,
12or, in the event of a medical emergency that makes it
13impossible, as soon thereafter as is practicable, the patient
14shall receive meaningful disclosure regarding the HIE in which
15the health care provider, health care professional, or health
16facility participates and shall be afforded an opportunity to
17opt out of disclosure of the patient's health information
18through the HIE.
 
19    (410 ILCS 305/9.7 new)
20    Sec. 9.7. Record locator service to support HIE. Section
219.9 of the Mental Health and Developmental Disabilities and
22Confidentiality Act is herein incorporated by reference.
 
23    (410 ILCS 305/9.8 new)

 

 

09800HB5925ham001- 22 -LRB098 20292 RPM 56528 a

1    Sec. 9.8. Disclosure of limited data sets and de-identified
2information. Notwithstanding the provisions of Section 9 and 10
3of this Act:
4        (1) a covered entity may, without a patient's consent,
5    create, use, and disclose a limited data set using
6    HIV-related information from a patient's record or
7    disclose HIV-related information from a patient's record
8    to a business associate for the purpose of establishing a
9    limited data set; the creation, use, and disclosure of such
10    a limited data set must comply with the requirements set
11    forth under HIPAA;
12        (2) a covered entity may, without a patient's consent,
13    create, use, and disclose de-identified information using
14    information from a patient's record that is subject to this
15    Act or disclose HIV-related information from a patient's
16    record to a business associate for the purpose
17    de-identifying the information; the creation, use, and
18    disclosure of such de-identified data must comply with the
19    requirements set forth under HIPAA. A covered entity or a
20    business associate may disclose information that is
21    de-identified; and
22        (3) the recipient of de-identified information shall
23    not re-identify de-identified information using any public
24    or private data source.
 
25    (410 ILCS 305/9.9 new)

 

 

09800HB5925ham001- 23 -LRB098 20292 RPM 56528 a

1    Sec. 9.9. Research. HIV-related information may be
2disclosed for research in accordance with the requirements set
3forth under HIPAA.
 
4    (410 ILCS 305/9.10 new)
5    Sec. 9.10. Minimum necessary. When using and disclosing
6HIV-related information under this Act, a covered entity shall
7do so in accordance with the minimum necessary standard under
8HIPAA.
 
9    (410 ILCS 305/10)  (from Ch. 111 1/2, par. 7310)
10    Sec. 10. No person to whom the results of a test have been
11disclosed may disclose the test results to another person
12except as authorized under this Act by Section 9.
13(Source: P.A. 85-677; 85-679.)
 
14    (410 ILCS 305/16)  (from Ch. 111 1/2, par. 7316)
15    Sec. 16. The Department shall promulgate rules and
16regulations concerning implementation and enforcement of this
17Act, except to the extent that this Act delegates to the
18Authority the promulgation or adoption of any rules,
19regulations, standards, or contractual obligations. The rules
20and regulations promulgated by the Department pursuant to this
21Act may include procedures for taking appropriate action with
22regard to health care facilities or health care providers which
23violate this Act or the regulations promulgated hereunder. The

 

 

09800HB5925ham001- 24 -LRB098 20292 RPM 56528 a

1provisions of The Illinois Administrative Procedure Act shall
2apply to all administrative rules and procedures of the
3Department pursuant to this Act, except that in case of
4conflict between The Illinois Administrative Procedure Act and
5this Act, the provisions of this Act shall control. The
6Department shall conduct training, technical assistance, and
7outreach activities, as needed, to implement routine HIV
8testing in healthcare medical settings.
9(Source: P.A. 95-7, eff. 6-1-08.)
 
10    Section 15. The Genetic Information Privacy Act is amended
11by changing Sections 5, 10, 20, 25, 30, 35, and 40 and by
12adding Sections 31, 31.1, 31.2, 31.3, 31.4, 31.5, 31.6, 31.7,
1331.8, and 31.9 as follows:
 
14    (410 ILCS 513/5)
15    Sec. 5. Legislative findings; intent. The General Assembly
16finds that:
17        (1) The use of genetic testing can be valuable to an
18    individual.
19        (2) Despite existing laws, regulations, and
20    professional standards which require or promote voluntary
21    and confidential use of genetic testing information, many
22    members of the public are deterred from seeking genetic
23    testing because of fear that test results will be disclosed
24    without consent in a manner not permitted by law or will be

 

 

09800HB5925ham001- 25 -LRB098 20292 RPM 56528 a

1    used in a discriminatory manner.
2        (3) The public health will be served by facilitating
3    voluntary and confidential nondiscriminatory use of
4    genetic testing information.
5        (4) The use of electronic health record systems and the
6    exchange of patient records, both paper and electronic,
7    through secure means, including through secure health
8    information exchanges, should be encouraged to improve
9    patient health care and care coordination, facilitate
10    public health reporting, and control health care costs,
11    among other purposes.
12        (5) Limiting the use or disclosure of, and requests
13    for, protected health information to the minimum necessary
14    to accomplish an intended purpose, when being transmitted
15    by or on behalf of a covered entity under HIPAA, is a key
16    component of health information privacy. The disclosure of
17    genetic information, when allowed by this Act, shall be
18    performed in accordance with the minimum necessary
19    standard when required under HIPAA.
20(Source: P.A. 90-25, eff. 1-1-98.)
 
21    (410 ILCS 513/10)
22    Sec. 10. Definitions. As used in this Act:
23    "Authority" means the Illinois Health Information Exchange
24Authority established pursuant to the Illinois Health
25Information Exchange and Technology Act.

 

 

09800HB5925ham001- 26 -LRB098 20292 RPM 56528 a

1    "Business associate" has the meaning ascribed to it under
2HIPAA, as specified in 45 CFR 160.103.
3    "Covered entity" has the meaning ascribed to it under
4HIPAA, as specified in 45 CFR 160.103.
5    "De-identified information" means health information that
6is not individually identifiable as described under HIPAA, as
7specified in 45 CFR 164.514(b).
8    "Disclosure" has the meaning ascribed to it under HIPAA, as
9specified in 45 CFR 160.103.
10    "Employer" means the State of Illinois, any unit of local
11government, and any board, commission, department,
12institution, or school district, any party to a public
13contract, any joint apprenticeship or training committee
14within the State, and every other person employing employees
15within the State.
16    "Employment agency" means both public and private
17employment agencies and any person, labor organization, or
18labor union having a hiring hall or hiring office regularly
19undertaking, with or without compensation, to procure
20opportunities to work, or to procure, recruit, refer, or place
21employees.
22    "Family member" means, with respect to an individual, (i)
23the spouse of the individual; (ii) a dependent child of the
24individual, including a child who is born to or placed for
25adoption with the individual; (iii) any other person qualifying
26as a covered dependent under a managed care plan; and (iv) all

 

 

09800HB5925ham001- 27 -LRB098 20292 RPM 56528 a

1other individuals related by blood or law to the individual or
2the spouse or child described in subsections (i) through (iii)
3of this definition.
4    "Genetic information" has the meaning ascribed to it under
5HIPAA, as specified in 45 CFR 160.103. means, with respect to
6any individual, information about (i) the individual's genetic
7tests; (ii) the genetic tests of a family member of the
8individual; and (iii) the manifestation or possible
9manifestation of a disease or disorder in a family member of
10the individual. Genetic information does not include
11information about the sex or age of any individual.
12    "Genetic monitoring" means the periodic examination of
13employees to evaluate acquired modifications to their genetic
14material, such as chromosomal damage or evidence of increased
15occurrence of mutations that may have developed in the course
16of employment due to exposure to toxic substances in the
17workplace in order to identify, evaluate, and respond to
18effects of or control adverse environmental exposures in the
19workplace.
20    "Genetic services" has the meaning ascribed to it under
21HIPAA, as specified in 45 CFR 160.103 means a genetic test,
22genetic counseling, including obtaining, interpreting, or
23assessing genetic information, or genetic education.
24    "Genetic testing" and "genetic test" have the meaning
25ascribed to "genetic test" under HIPAA, as specified in 45 CFR
26160.103. mean a test or analysis of human genes, gene products,

 

 

09800HB5925ham001- 28 -LRB098 20292 RPM 56528 a

1DNA, RNA, chromosomes, proteins, or metabolites that detect
2genotypes, mutations, chromosomal changes, abnormalities, or
3deficiencies, including carrier status, that (i) are linked to
4physical or mental disorders or impairments, (ii) indicate a
5susceptibility to illness, disease, impairment, or other
6disorders, whether physical or mental, or (iii) demonstrate
7genetic or chromosomal damage due to environmental factors.
8Genetic testing and genetic tests do not include routine
9physical measurements; chemical, blood and urine analyses that
10are widely accepted and in use in clinical practice; tests for
11use of drugs; tests for the presence of the human
12immunodeficiency virus; analyses of proteins or metabolites
13that do not detect genotypes, mutations, chromosomal changes,
14abnormalities, or deficiencies; or analyses of proteins or
15metabolites that are directly related to a manifested disease,
16disorder, or pathological condition that could reasonably be
17detected by a health care professional with appropriate
18training and expertise in the field of medicine involved.
19    "Health care operations" has the meaning ascribed to it
20under HIPAA, as specified in 45 CFR 164.501.
21    "Health care professional" means (i) a licensed physician,
22(ii) a physician assistant to whom the physician assistant's
23supervising physician has delegated the provision of genetic
24testing or genetic counseling-related services, (iii) an
25advanced practice registered nurse who has a written
26collaborative agreement with a collaborating physician which

 

 

09800HB5925ham001- 29 -LRB098 20292 RPM 56528 a

1authorizes the provision of genetic testing or genetic
2counseling-related health services, (iv) a licensed dentist,
3(v) a licensed podiatrist, (vi) a licensed genetic counselor,
4or (vii) an individual certified to provide genetic testing by
5a state or local public health department.
6    "Health care provider" has the meaning ascribed to it under
7HIPAA, as specified in 45 CFR 160.103.
8    "Health facility" means a hospital, blood bank, blood
9center, sperm bank, or other health care institution, including
10any "health facility" as that term is defined in the Illinois
11Finance Authority Act.
12    "Health information exchange" or "HIE" means a health
13information exchange or health information organization that
14exchanges health information electronically that (i) is
15established pursuant to the Illinois Health Information
16Exchange and Technology Act, or any subsequent amendments
17thereto, and any administrative rules promulgated thereunder;
18(ii) has established a data sharing arrangement with the
19Authority; or (iii) as of August 16, 2013, was designated by
20the Authority Board as a member of, or was represented on, the
21Authority Board's Regional Health Information Exchange
22Workgroup. In certain circumstances, in accordance with HIPAA,
23an HIE will be a business associate.
24    "Health oversight agency" has the meaning ascribed to it
25under HIPAA, as specified in 45 CFR 164.501.
26    "HIPAA" means the Health Insurance Portability and

 

 

09800HB5925ham001- 30 -LRB098 20292 RPM 56528 a

1Accountability Act of 1996, Public Law 104-191, as amended by
2the Health Information Technology for Economic and Clinical
3Health Act of 2009, Public Law 111-05, and any subsequent
4amendments thereto and any regulations promulgated thereunder.
5    "Insurer" means (i) an entity that is subject to the
6jurisdiction of the Director of Insurance transacts an
7insurance business and (ii) a managed care plan.
8    "Labor organization" includes any organization, labor
9union, craft union, or any voluntary unincorporated
10association designed to further the cause of the rights of
11union labor that is constituted for the purpose, in whole or in
12part, of collective bargaining or of dealing with employers
13concerning grievances, terms or conditions of employment, or
14apprenticeships or applications for apprenticeships, or of
15other mutual aid or protection in connection with employment,
16including apprenticeships or applications for apprenticeships.
17    "Licensing agency" means a board, commission, committee,
18council, department, or officers, except a judicial officer, in
19this State or any political subdivision authorized to grant,
20deny, renew, revoke, suspend, annul, withdraw, or amend a
21license or certificate of registration.
22    "Limited data set" has the meaning ascribed to it under
23HIPAA, as described in 45 CFR 164.512(e)(2).
24    "Labor organization" includes any organization, labor
25union, craft union, or any voluntary unincorporated
26association designed to further the cause of the rights of

 

 

09800HB5925ham001- 31 -LRB098 20292 RPM 56528 a

1union labor that is constituted for the purpose, in whole or in
2part, of collective bargaining or of dealing with employers
3concerning grievances, terms or conditions of employment, or
4apprenticeships or applications for apprenticeships, or of
5other mutual aid or protection in connection with employment,
6including apprenticeships or applications for apprenticeships.
7    "Managed care plan" means a plan that establishes,
8operates, or maintains a network of health care providers that
9have entered into agreements with the plan to provide health
10care services to enrollees where the plan has the ultimate and
11direct contractual obligation to the enrollee to arrange for
12the provision of or pay for services through:
13        (1) organizational arrangements for ongoing quality
14    assurance, utilization review programs, or dispute
15    resolution; or
16        (2) financial incentives for persons enrolled in the
17    plan to use the participating providers and procedures
18    covered by the plan.
19    A managed care plan may be established or operated by any
20entity including a licensed insurance company, hospital or
21medical service plan, health maintenance organization, limited
22health service organization, preferred provider organization,
23third party administrator, or an employer or employee
24organization.
25    "Minimum necessary" means HIPAA's standard for using,
26disclosing, and requesting protected health information found

 

 

09800HB5925ham001- 32 -LRB098 20292 RPM 56528 a

1in 45 CFR 164.502(b) and 164.514(d).
2    "Nontherapeutic purpose" means a purpose that is not
3intended to improve or preserve the life or health of the
4individual whom the information concerns.
5    "Organized health care arrangement" has the meaning
6ascribed to it under HIPAA, as specified in 45 CFR 160.103.
7    "Patient safety activities" has the meaning ascribed to it
8under 42 CFR 3.20.
9    "Payment" has the meaning ascribed to it under HIPAA, as
10specified in 45 CFR 164.501.
11    "Person" includes any natural person, partnership,
12association, joint venture, trust, governmental entity, public
13or private corporation, health facility, or other legal entity.
14    "Protected health information" has the meaning ascribed to
15it under HIPAA, as specified in 45 CFR 164.103.
16    "Research" has the meaning ascribed to it under HIPAA, as
17specified in 45 CFR 164.501.
18    "State agency" means an instrumentality of the State of
19Illinois and any instrumentality of another state which
20pursuant to applicable law or a written undertaking with an
21instrumentality of the State of Illinois is bound to protect
22the privacy of genetic information of Illinois persons.
23    "Treatment" has the meaning ascribed to it under HIPAA, as
24specified in 45 CFR 164.501.
25    "Use" has the meaning ascribed to it under HIPAA, as
26specified in 45 CFR 160.103, where context dictates.

 

 

09800HB5925ham001- 33 -LRB098 20292 RPM 56528 a

1(Source: P.A. 95-927, eff. 1-1-09.)
 
2    (410 ILCS 513/20)
3    Sec. 20. Use of genetic testing information for insurance
4purposes.
5    (a) An insurer may not seek information derived from
6genetic testing for use in connection with a policy of accident
7and health insurance. Except as provided in subsection (c) (b),
8an insurer that receives information derived from genetic
9testing, regardless of the source of that information, may not
10use the information for a nontherapeutic purpose as it relates
11to a policy of accident and health insurance.
12    (b) An insurer shall not use or disclose protected health
13information that is genetic information for underwriting
14purposes. For purposes of this Section, "underwriting
15purposes" means, with respect to an insurer:
16        (1) rules for, or determination of, eligibility
17    (including enrollment and continued eligibility) for, or
18    determination of, benefits under the plan, coverage, or
19    policy (including changes in deductibles or other
20    cost-sharing mechanisms in return for activities such as
21    completing a health risk assessment or participating in a
22    wellness program);
23        (2) the computation of premium or contribution amounts
24    under the plan, coverage, or policy (including discounts,
25    rebates, payments in kind, or other premium differential

 

 

09800HB5925ham001- 34 -LRB098 20292 RPM 56528 a

1    mechanisms in return for activities, such as completing a
2    health risk assessment or participating in a wellness
3    program);
4        (3) the application of any pre-existing condition
5    exclusion under the plan, coverage, or policy; and
6        (4) other activities related to the creation, renewal,
7    or replacement of a contract of health insurance or health
8    benefits.
9    "Underwriting purposes" does not include determinations of
10medical appropriateness where an individual seeks a benefit
11under the plan, coverage, or policy.
12    This subsection (b) does not apply to insurers that are
13issuing a long-term care policy, excluding a nursing home fixed
14indemnity plan.
15    (c) (b) An insurer may consider the results of genetic
16testing in connection with a policy of accident and health
17insurance if the individual voluntarily submits the results and
18the results are favorable to the individual.
19    (d) (c) An insurer that possesses information derived from
20genetic testing may not release the information to a third
21party, except as specified in this Act Section 30.
22(Source: P.A. 92-430, eff. 8-17-01.)
 
23    (410 ILCS 513/25)
24    Sec. 25. Use of genetic testing information by employers.
25    (a) An employer, employment agency, labor organization,

 

 

09800HB5925ham001- 35 -LRB098 20292 RPM 56528 a

1and licensing agency shall treat genetic testing and genetic
2information in such a manner that is consistent with the
3requirements of federal law, including but not limited to the
4Genetic Information Nondiscrimination Act of 2008, the
5Americans with Disabilities Act, Title VII of the Civil Rights
6Act of 1964, the Family and Medical Leave Act of 1993, the
7Occupational Safety and Health Act of 1970, the Federal Mine
8Safety and Health Act of 1977, or the Atomic Energy Act of
91954.
10    (b) An employer may release genetic testing information
11only in accordance with Sections 15 and 30 of this Act.
12    (c) An employer, employment agency, labor organization,
13and licensing agency shall not directly or indirectly do any of
14the following:
15        (1) solicit, request, require or purchase genetic
16    testing or genetic information of a person or a family
17    member of the person, or administer a genetic test to a
18    person or a family member of the person as a condition of
19    employment, preemployment application, labor organization
20    membership, or licensure;
21        (2) affect the terms, conditions, or privileges of
22    employment, preemployment application, labor organization
23    membership, or licensure, or terminate the employment,
24    labor organization membership, or licensure of any person
25    because of genetic testing or genetic information with
26    respect to the employee or family member, or information

 

 

09800HB5925ham001- 36 -LRB098 20292 RPM 56528 a

1    about a request for or the receipt of genetic testing by
2    such employee or family member of such employee;
3        (3) limit, segregate, or classify employees in any way
4    that would deprive or tend to deprive any employee of
5    employment opportunities or otherwise adversely affect the
6    status of the employee as an employee because of genetic
7    testing or genetic information with respect to the employee
8    or a family member, or information about a request for or
9    the receipt of genetic testing or genetic information by
10    such employee or family member of such employee; and
11        (4) retaliate through discharge or in any other manner
12    against any person alleging a violation of this Act or
13    participating in any manner in a proceeding under this Act.
14    (d) An agreement between a person and an employer,
15prospective employer, employment agency, labor organization,
16or licensing agency, or its employees, agents, or members
17offering the person employment, labor organization membership,
18licensure, or any pay or benefit in return for taking a genetic
19test is prohibited.
20    (e) An employer shall not use genetic information or
21genetic testing in furtherance of a workplace wellness program
22benefiting employees unless (1) health or genetic services are
23offered by the employer, (2) the employee provides written
24authorization and informed consent in accordance with Section
2530 of this Act, (3) only the employee or family member if the
26family member is receiving genetic services and the licensed

 

 

09800HB5925ham001- 37 -LRB098 20292 RPM 56528 a

1health care professional or licensed genetic counselor
2involved in providing such services receive individually
3identifiable information concerning the results of such
4services, and (4) any individually identifiable information is
5only available for purposes of such services and shall not be
6disclosed to the employer except in aggregate terms that do not
7disclose the identity of specific employees.
8    (f) Nothing in this Act shall be construed to prohibit
9genetic testing of an employee who requests a genetic test and
10who provides written authorization and informed consent, in
11accordance with Section 30 of this Act, from taking a genetic
12test for the purpose of initiating a workers' compensation
13claim under the Workers' Compensation Act.
14    (g) A purchase of commercially and publicly available
15documents, including newspapers, magazines, periodicals, and
16books but not including medical databases or court records or
17inadvertently requesting family medical history by an
18employer, employment agency, labor organization, and licensing
19agency does not violate this Act.
20    (h) Nothing in this Act shall be construed to prohibit an
21employer that conducts DNA analysis for law enforcement
22purposes as a forensic laboratory and that includes such
23analysis in the Combined DNA Index System pursuant to the
24federal Violent Crime Control and Law Enforcement Act of 1994
25from requesting or requiring genetic testing or genetic
26information of such employer's employees, but only to the

 

 

09800HB5925ham001- 38 -LRB098 20292 RPM 56528 a

1extent that such genetic testing or genetic information is used
2for analysis of DNA identification markers for quality control
3to detect sample contamination.
4    (i) Nothing in this Act shall be construed to prohibit an
5employer from requesting or requiring genetic information to be
6used for genetic monitoring of the biological effects of toxic
7substances in the workplace, but only if (1) the employer
8provides written notice of the genetic monitoring to the
9employee; (2) the employee provides written authorization and
10informed consent under Section 30 of this Act or the genetic
11monitoring is required by federal or State law; (3) the
12employee is informed of individual monitoring results; (4) the
13monitoring is in compliance with any federal genetic monitoring
14regulations or State genetic monitoring regulations under the
15authority of the federal Occupational Safety and Health Act of
161970; and (5) the employer, excluding any health care provider,
17licensed health care professional, or health facility licensed
18genetic counselor that is involved in the genetic monitoring
19program, receives the results of the monitoring only in
20aggregate terms that do not disclose the identity of specific
21employees.
22    (j) Despite lawful acquisition of genetic testing or
23genetic information under subsections (e) through (i) of this
24Section, an employer, employment agency, labor organization,
25and licensing agency still may not use or disclose the genetic
26test or genetic information in violation of this Act.

 

 

09800HB5925ham001- 39 -LRB098 20292 RPM 56528 a

1    (k) Except as provided in subsections (e), (f), (h), and
2(i) of this Section, a person shall not knowingly sell to or
3interpret for an employer, employment agency, labor
4organization, or licensing agency, or its employees, agents, or
5members, a genetic test of an employee, labor organization
6member, or license holder, or of a prospective employee,
7member, or license holder.
8(Source: P.A. 95-927, eff. 1-1-09.)
 
9    (410 ILCS 513/30)
10    Sec. 30. Disclosure of person tested and test results.
11    (a) No person may disclose or be compelled to disclose the
12identity of any person upon whom a genetic test is performed or
13the results of a genetic test in a manner that permits
14identification of the subject of the test, except to the
15following persons:
16        (1) The subject of the test or the subject's legally
17    authorized representative. This paragraph does not create
18    a duty or obligation under which a health care provider
19    must notify the subject's spouse or legal guardian of the
20    test results, and no such duty or obligation shall be
21    implied. No civil liability or criminal sanction under this
22    Act shall be imposed for any disclosure or nondisclosure of
23    a test result to a spouse by a physician acting in good
24    faith under this paragraph. For the purpose of any
25    proceedings, civil or criminal, the good faith of any

 

 

09800HB5925ham001- 40 -LRB098 20292 RPM 56528 a

1    physician acting under this paragraph shall be presumed.
2        (2) Any person designated in a specific written legally
3    effective authorization for release release of the test
4    results executed by the subject of the test or the
5    subject's legally authorized representative.
6        (3) An authorized agent or employee of a health
7    facility or health care provider if the health facility or
8    health care provider itself is authorized to obtain the
9    test results, the agent or employee provides patient care,
10    and the agent or employee has a need to know the
11    information in order to conduct the tests or provide care
12    or treatment.
13        (4) A health facility, or health care provider, or
14    health care professional that procures, processes,
15    distributes, or uses:
16            (A) a human body part from a deceased person with
17        respect to medical information regarding that person;
18        or
19            (B) semen provided prior to the effective date of
20        this Act for the purpose of artificial insemination.
21        (5) Health facility staff committees for the purposes
22    of conducting program monitoring, program evaluation, or
23    service reviews.
24        (6) In the case of a minor under 18 years of age, the
25    health care provider, health care professional, or health
26    facility who ordered the test shall make a reasonable

 

 

09800HB5925ham001- 41 -LRB098 20292 RPM 56528 a

1    effort to notify the minor's parent or legal guardian if,
2    in the professional judgment of the health care provider,
3    health care professional, or health facility, notification
4    would be in the best interest of the minor and the health
5    care provider, health care professional, or health
6    facility has first sought unsuccessfully to persuade the
7    minor to notify the parent or legal guardian or after a
8    reasonable time after the minor has agreed to notify the
9    parent or legal guardian, the health care provider, health
10    care professional, or health facility has reason to believe
11    that the minor has not made the notification. This
12    paragraph shall not create a duty or obligation under which
13    a health care provider, health care professional, or health
14    facility must notify the minor's parent or legal guardian
15    of the test results, nor shall a duty or obligation be
16    implied. No civil liability or criminal sanction under this
17    Act shall be imposed for any notification or
18    non-notification of a minor's test result by a health care
19    provider, health care professional, or health facility
20    acting in good faith under this paragraph. For the purpose
21    of any proceeding, civil or criminal, the good faith of any
22    health care provider, health care professional, or health
23    facility acting under this paragraph shall be presumed.
24    (b) (7) All information and records held by a State agency,
25or local health authority, or health oversight agency
26pertaining to genetic information shall be strictly

 

 

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1confidential and exempt from copying and inspection under the
2Freedom of Information Act. The information and records shall
3not be released or made public by the State agency, or local
4health authority, or health oversight agency and shall not be
5admissible as evidence nor discoverable in any action of any
6kind in any court or before any tribunal, board, agency, or
7person and shall be treated in the same manner as the
8information and those records subject to the provisions of Part
921 of Article VIII of the Code of Civil Procedure except under
10the following circumstances:
11            (A) when made with the written consent of all
12        persons to whom the information pertains;
13            (B) when authorized by Section 5-4-3 of the Unified
14        Code of Corrections;
15            (C) when made for the sole purpose of implementing
16        the Newborn Metabolic Screening Act and rules; or
17            (D) when made under the authorization of the
18        Illinois Parentage Act of 1984.
19    Disclosure shall be limited to those who have a need to
20know the information, and no additional disclosures may be
21made.
22    (c) (b) Disclosure by an insurer in accordance with the
23requirements of the Article XL of the Illinois Insurance Code
24shall be deemed compliance with this Section.
25(Source: P.A. 96-328, eff. 8-11-09.)
 

 

 

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1    (410 ILCS 513/31 new)
2    Sec. 31. Uses and disclosures for treatment, payment, and
3health care operations. Notwithstanding Sections 30 and 35 of
4this Act, a covered entity may, without a patient's consent:
5    (1) use or disclose genetic information for its own
6treatment, payment, or health care operations;
7    (2) disclose genetic information for treatment activities
8of a health care provider;
9    (3) disclose genetic information to another covered entity
10or health care provider for the payment activities of the
11entity that receives the information;
12    (4) disclose genetic information to another covered entity
13for health care operations activities of the entity that
14receives the information, if each entity has or had a
15relationship with the individual who is the subject of the
16genetic information being requested, the genetic information
17pertains to such relationship, and the disclosure is for the
18purpose of (A) conducting quality assessment and improvement
19activities, including outcomes evaluation and development of
20clinical guidelines, provided that the obtaining of
21generalizable knowledge is not the primary purpose of any
22studies resulting from such activities; patient safety
23activities; population-based activities relating to improving
24health or reducing health care costs, protocol development,
25case management, and care coordination, contacting of health
26care providers and patients with information about treatment

 

 

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1alternatives; and related functions that do not include
2treatment; (B) reviewing the competence or qualifications of
3health care professionals, evaluating practitioner and
4provider performance, health plan performance, conducting
5training programs in which students, trainees, or
6practitioners in areas of health care learn under supervision
7to practice or improve their skills as health care providers,
8training of non-health care professionals, accreditation,
9certification, licensing, or credentialing activities; or (C)
10health care fraud and abuse detection or compliance; and
11    (5) disclose genetic information to other participants in
12an organized health care arrangement in which the covered
13entity is also a participant for any health care operations
14activities of the organized health care arrangement.
 
15    (410 ILCS 513/31.1 new)
16    Sec. 31.1. Uses and disclosures for health oversight
17activities.
18    (a) Notwithstanding Sections 30 and 35 of this Act, a
19covered entity may disclose genetic information, without a
20patient's consent, to a health oversight agency for health
21oversight activities authorized by law, including audits,
22civil, administrative, or criminal investigations;
23inspections; licensure or disciplinary actions; civil
24administrative or criminal proceedings or actions; or other
25activities necessary for appropriate oversight of (i) the

 

 

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1health care system; (ii) government benefit programs for which
2health information is relevant to beneficiary eligibility;
3(iii) entities subject to government regulatory programs for
4which health information is necessary for determining
5compliance with program standards; or (iv) entities subject to
6civil rights laws for which health information is necessary for
7determining compliance.
8    (b) For purposes of the disclosures permitted by this
9Section, a health oversight activity does not include an
10investigation or other activity in which the individual is the
11subject of the investigation or activity and such investigation
12or other activity does not arise out of and is not directly
13related to (i) the receipt of health care; (ii) a claim for
14public benefits related to health; or (iii) qualification for,
15or receipt of, public benefits or services when a patient's
16health is integral to the claim for public benefits or
17services, except that, if a health oversight activity or
18investigation is conducted in conjunction with an oversight
19activity or investigation relating to a claim for public
20benefits not related to health, the joint activity or
21investigation is considered a health oversight activity for
22purposes of this Section.
23    (c) If a covered entity is also a health oversight agency,
24the covered entity may use genetic information for health
25oversight activities permitted by this Section.
 

 

 

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1    (410 ILCS 513/31.2 new)
2    Sec. 31.2. Uses and disclosures for public health
3activities. Notwithstanding Sections 30 and 35 of this Act,
4genetic information may be disclosed without a patient's
5consent for public health activities and purposes to the
6Department, when the Department is authorized by law to collect
7or receive such information for the purpose of preventing or
8controlling disease, injury, or disability, including, but not
9limited to, the reporting of disease, injury, vital events such
10as birth or death, and the conduct of public health
11surveillance, public health investigations, and public health
12interventions.
 
13    (410 ILCS 513/31.3 new)
14    Sec. 31.3. Business associates.
15    (a) Notwithstanding Sections 30 and 35 of this Act, a
16covered entity may, without a patient's consent, disclose a
17patient's genetic information to a business associate and may
18allow a business associate to create, receive, maintain, or
19transmit protected health information on its behalf, if the
20covered entity obtains, through a written contract or other
21written agreement or arrangement that meets the applicable
22requirements of 45 CFR 164.504(e), satisfactory assurance that
23the business associate will appropriately safeguard the
24information. A covered entity is not required to obtain such
25satisfactory assurances from a business associate that is a

 

 

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1subcontractor.
2    (b) A business associate may disclose protected health
3information to a business associate that is a subcontractor and
4may allow the subcontractor to create, receive, maintain, or
5transmit protected health information on its behalf, if the
6business associate obtains satisfactory assurances, in
7accordance with 45 CFR 164.504(e)(1)(i), that the
8subcontractor will appropriately safeguard the information.
 
9    (410 ILCS 513/31.4 new)
10    Sec. 31.4. Record locator service to support HIE. Section
119.9 of the Mental Health and Developmental Disabilities
12Confidentiality Act is herein incorporated by reference.
 
13    (410 ILCS 513/31.5 new)
14    Sec. 31.5. Use and disclosure of information to an HIE.
15Notwithstanding the provisions of Section 30 and 35 of this
16Act, a covered entity may, without a patient's consent,
17disclose the identity of any patient upon whom a test is
18performed and such patient's genetic information from a
19patient's record to a HIE if the disclosure is a required or
20permitted disclosure to a business associate or is a disclosure
21otherwise required or permitted under this Act. An HIE may,
22without a patient's consent, use or disclose such information
23to the extent it is allowed to use or disclose such information
24as a business associate in compliance with 45 CFR 164.502(e) or

 

 

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1for such other purposes as are specifically allowed under this
2Act.
 
3    (410 ILCS 513/31.6 new)
4    Sec. 31.6. Other disclosures. Nothing in this Act shall be
5construed (1) to limit the use of an HIE to facilitate
6disclosures permitted by this Act or (2) to allow for the
7disclosure of information from a patient's record to law
8enforcement or for law enforcement purposes.
 
9    (410 ILCS 513/31.7 new)
10    Sec. 31.7. Establishment and disclosure of limited data
11sets and de-identified information.
12    (a) A covered entity may, without a genetic information
13test subject's consent, create, use, and disclose a limited
14data set using information subject to this Act or disclose
15information subject to this Act to a business associate for the
16purpose of establishing a limited data set. The creation, use,
17and disclosure of such a limited data set must comply with the
18requirements set forth under HIPAA.
19    (b) A covered entity may, without a genetic information
20test subject's consent, create, use, and disclose
21de-identified information using information subject to this
22Act or disclose information subject to this Act to a business
23associate for the purpose of de-identifying the information.
24The creation, use, and disclosure of such de-identified

 

 

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1information must comply with the requirements set forth under
2HIPAA. A covered entity or a business associate may disclose
3information that is de-identified in accordance with HIPAA.
4    (c) The recipient of de-identified information shall not
5re-identify de-identified information using any public or
6private data source.
 
7    (410 ILCS 513/31.8 new)
8    Sec. 31.8. HIE opt out. Section 9.6 of the Mental Health
9and Developmental Disabilities Confidentiality Act is
10incorporated herein by reference. In addition to the
11requirements set out in Section 9.6 of the Mental Health and
12Developmental Disabilities Confidentiality Act, at the time of
13a patient's first encounter for genetic testing with a health
14care provider, health care professional, or health facility
15that participates in an HIE, or, in the event of a medical
16emergency that makes it impossible, as soon thereafter as is
17practicable, the patient shall receive meaningful disclosure
18regarding the HIE in which the health care provider, health
19care professional, or health facility participates and shall be
20afforded an opportunity to opt out of disclosure of the
21patient's health information through the HIE.
 
22    (410 ILCS 513/31.9 new)
23    Sec. 31.9. Research. Genetic information may be disclosed
24for research, in accordance with the requirements set forth

 

 

09800HB5925ham001- 50 -LRB098 20292 RPM 56528 a

1under HIPAA.
 
2    (410 ILCS 513/35)
3    Sec. 35. Disclosure by person to whom results have been
4disclosed. No person to whom the results of a test have been
5disclosed may disclose the test results to another person
6except as authorized under this Act by Section 30.
7(Source: P.A. 90-25, eff. 1-1-98.)
 
8    (410 ILCS 513/40)
9    Sec. 40. Right of action.
10    (a) Any person aggrieved by a violation of this Act shall
11have a right of action in a State circuit court or as a
12supplemental claim in a federal district court against an
13offending party. A prevailing party may recover for each
14violation:
15        (1) Against any party who negligently violates a
16    provision of this Act, liquidated damages of $2,500 or
17    actual damages, whichever is greater.
18        (2) Against any party who intentionally or recklessly
19    violates a provision of this Act, liquidated damages of
20    $15,000 or actual damages, whichever is greater.
21        (3) Reasonable attorney's fees and costs, including
22    expert witness fees and other litigation expenses.
23        (4) Such other relief, including an injunction, as the
24    State or federal court may deem appropriate.

 

 

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1    (b) Article XL of the Illinois Insurance Code shall provide
2the exclusive remedy for violations of Section 30 by insurers.
3    (c) Notwithstanding any provisions of the law to the
4contrary, any person alleging a violation of subsection (a) of
5Section 15, subsection (b) of Section 25, Section 30, Section
631, or Section 35 of this Act shall have a right of action in a
7State circuit court or as a supplemental claim in a federal
8district court to seek a preliminary injunction preventing the
9release or disclosure of genetic testing or genetic information
10pending the final resolution of any action under this Act.
11(Source: P.A. 95-927, eff. 1-1-09.)
 
12    Section 20. The Unified Code of Corrections is amended by
13changing Sections 3-8-2 and 3-10-2 as follows:
 
14    (730 ILCS 5/3-8-2)  (from Ch. 38, par. 1003-8-2)
15    Sec. 3-8-2. Social Evaluation; physical examination;
16HIV/AIDS.
17    (a) A social evaluation shall be made of a committed
18person's medical, psychological, educational and vocational
19condition and history, including the use of alcohol and other
20drugs, the circumstances of his offense, and such other
21information as the Department may determine. The committed
22person shall be assigned to an institution or facility in so
23far as practicable in accordance with the social evaluation.
24Recommendations shall be made for medical, dental,

 

 

09800HB5925ham001- 52 -LRB098 20292 RPM 56528 a

1psychiatric, psychological and social service treatment.
2    (b) A record of the social evaluation shall be entered in
3the committed person's master record file and shall be
4forwarded to the institution or facility to which the person is
5assigned.
6    (c) Upon admission to a correctional institution each
7committed person shall be given a physical examination. If he
8is suspected of having a communicable disease that in the
9judgment of the Department medical personnel requires medical
10isolation, the committed person shall remain in medical
11isolation until it is no longer deemed medically necessary.
12    (d) Upon arrival at a reception and classification center
13or an inmate's final destination, the Department must provide
14the committed person with appropriate information in writing,
15verbally, by video or other electronic means concerning HIV and
16AIDS. The Department shall develop the informational materials
17in consultation with the Department of Public Health. At the
18same time, the Department also must offer the committed person
19the option of being tested, with no copayment, for infection
20with human immunodeficiency virus (HIV). Pre-test information
21shall be provided to the committed person and informed consent
22obtained as required in subsection (q) (d) of Section 3 and
23Section 5 of the AIDS Confidentiality Act. The Department may
24conduct opt-out HIV testing as defined in Section 4 of the AIDS
25Confidentiality Act. If the Department conducts opt-out HIV
26testing, the Department shall place signs in English, Spanish

 

 

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1and other languages as needed in multiple, highly visible
2locations in the area where HIV testing is conducted informing
3inmates that they will be tested for HIV unless they refuse,
4and refusal or acceptance of testing shall be documented in the
5inmate's medical record. The Department shall follow
6procedures established by the Department of Public Health to
7conduct HIV testing and testing to confirm positive HIV test
8results. All testing must be conducted by medical personnel,
9but pre-test and other information may be provided by committed
10persons who have received appropriate training. The
11Department, in conjunction with the Department of Public
12Health, shall develop a plan that complies with the AIDS
13Confidentiality Act to deliver confidentially all positive or
14negative HIV test results to inmates or former inmates. Nothing
15in this Section shall require the Department to offer HIV
16testing to an inmate who is known to be infected with HIV, or
17who has been tested for HIV within the previous 180 days and
18whose documented HIV test result is available to the Department
19electronically. The testing provided under this subsection (d)
20shall consist of a test approved by the Illinois Department of
21Public Health to determine the presence of HIV infection, based
22upon recommendations of the United States Centers for Disease
23Control and Prevention. If the test result is positive, a
24reliable supplemental test based upon recommendations of the
25United States Centers for Disease Control and Prevention shall
26be administered.

 

 

09800HB5925ham001- 54 -LRB098 20292 RPM 56528 a

1(Source: P.A. 97-244, eff. 8-4-11; 97-323, eff. 8-12-11;
297-813, eff. 7-13-12.)
 
3    (730 ILCS 5/3-10-2)  (from Ch. 38, par. 1003-10-2)
4    Sec. 3-10-2. Examination of Persons Committed to the
5Department of Juvenile Justice.
6    (a) A person committed to the Department of Juvenile
7Justice shall be examined in regard to his medical,
8psychological, social, educational and vocational condition
9and history, including the use of alcohol and other drugs, the
10circumstances of his offense and any other information as the
11Department of Juvenile Justice may determine.
12    (a-5) Upon admission of a person committed to the
13Department of Juvenile Justice, the Department of Juvenile
14Justice must provide the person with appropriate information
15concerning HIV and AIDS in writing, verbally, or by video or
16other electronic means. The Department of Juvenile Justice
17shall develop the informational materials in consultation with
18the Department of Public Health. At the same time, the
19Department of Juvenile Justice also must offer the person the
20option of being tested, at no charge to the person, for
21infection with human immunodeficiency virus (HIV). Pre-test
22information shall be provided to the committed person and
23informed consent obtained as required in subsection (q) (d) of
24Section 3 and Section 5 of the AIDS Confidentiality Act. The
25Department of Juvenile Justice may conduct opt-out HIV testing

 

 

09800HB5925ham001- 55 -LRB098 20292 RPM 56528 a

1as defined in Section 4 of the AIDS Confidentiality Act. If the
2Department conducts opt-out HIV testing, the Department shall
3place signs in English, Spanish and other languages as needed
4in multiple, highly visible locations in the area where HIV
5testing is conducted informing inmates that they will be tested
6for HIV unless they refuse, and refusal or acceptance of
7testing shall be documented in the inmate's medical record. The
8Department shall follow procedures established by the
9Department of Public Health to conduct HIV testing and testing
10to confirm positive HIV test results. All testing must be
11conducted by medical personnel, but pre-test and other
12information may be provided by committed persons who have
13received appropriate training. The Department, in conjunction
14with the Department of Public Health, shall develop a plan that
15complies with the AIDS Confidentiality Act to deliver
16confidentially all positive or negative HIV test results to
17inmates or former inmates. Nothing in this Section shall
18require the Department to offer HIV testing to an inmate who is
19known to be infected with HIV, or who has been tested for HIV
20within the previous 180 days and whose documented HIV test
21result is available to the Department electronically. The
22testing provided under this subsection (a-5) shall consist of a
23test approved by the Illinois Department of Public Health to
24determine the presence of HIV infection, based upon
25recommendations of the United States Centers for Disease
26Control and Prevention. If the test result is positive, a

 

 

09800HB5925ham001- 56 -LRB098 20292 RPM 56528 a

1reliable supplemental test based upon recommendations of the
2United States Centers for Disease Control and Prevention shall
3be administered.
4    Also upon admission of a person committed to the Department
5of Juvenile Justice, the Department of Juvenile Justice must
6inform the person of the Department's obligation to provide the
7person with medical care.
8    (b) Based on its examination, the Department of Juvenile
9Justice may exercise the following powers in developing a
10treatment program of any person committed to the Department of
11Juvenile Justice:
12        (1) Require participation by him in vocational,
13    physical, educational and corrective training and
14    activities to return him to the community.
15        (2) Place him in any institution or facility of the
16    Department of Juvenile Justice.
17        (3) Order replacement or referral to the Parole and
18    Pardon Board as often as it deems desirable. The Department
19    of Juvenile Justice shall refer the person to the Parole
20    and Pardon Board as required under Section 3-3-4.
21        (4) Enter into agreements with the Secretary of Human
22    Services and the Director of Children and Family Services,
23    with courts having probation officers, and with private
24    agencies or institutions for separate care or special
25    treatment of persons subject to the control of the
26    Department of Juvenile Justice.

 

 

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1    (c) The Department of Juvenile Justice shall make periodic
2reexamination of all persons under the control of the
3Department of Juvenile Justice to determine whether existing
4orders in individual cases should be modified or continued.
5This examination shall be made with respect to every person at
6least once annually.
7    (d) A record of the treatment decision including any
8modification thereof and the reason therefor, shall be part of
9the committed person's master record file.
10    (e) The Department of Juvenile Justice shall by certified
11mail, return receipt requested, notify the parent, guardian or
12nearest relative of any person committed to the Department of
13Juvenile Justice of his physical location and any change
14thereof.
15(Source: P.A. 97-244, eff. 8-4-11; 97-323, eff. 8-12-11;
1697-813, eff. 7-13-12.)
 
17    Section 25. The County Jail Act is amended by changing
18Section 17.10 as follows:
 
19    (730 ILCS 125/17.10)
20    Sec. 17.10. Requirements in connection with HIV/AIDS.
21    (a) In each county other than Cook, during the medical
22admissions exam, the warden of the jail, a correctional officer
23at the jail, or a member of the jail medical staff must provide
24the prisoner with appropriate written information concerning

 

 

09800HB5925ham001- 58 -LRB098 20292 RPM 56528 a

1human immunodeficiency virus (HIV) and acquired
2immunodeficiency syndrome (AIDS). The Department of Public
3Health and community-based organizations certified to provide
4HIV/AIDS testing must provide these informational materials to
5the warden at no cost to the county. The warden, a correctional
6officer, or a member of the jail medical staff must inform the
7prisoner of the option of being tested for infection with HIV
8by a certified local community-based agency or other available
9medical provider at no charge to the prisoner.
10    (b) In Cook County, during the medical admissions exam, an
11employee of the Cook County Health & Hospitals System must
12provide the prisoner with appropriate information in writing,
13verbally or by video or other electronic means concerning human
14immunodeficiency virus (HIV) and acquired immunodeficiency
15syndrome (AIDS) and must also provide the prisoner with option
16of testing for infection with HIV or any other identified
17causative agent of AIDS, as well as counseling in connection
18with such testing. The Cook County Health & Hospitals System
19may provide the inmate with opt-out human immunodeficiency
20virus (HIV) testing, as defined in Section 4 of the AIDS
21Confidentiality Act, unless the inmate refuses. If opt-out HIV
22testing is conducted, the Cook County Health & Hospitals System
23shall place signs in English, Spanish, and other languages as
24needed in multiple, highly visible locations in the area where
25HIV testing is conducted informing inmates that they will be
26tested for HIV unless they refuse, and refusal or acceptance of

 

 

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1testing shall be documented in the inmate's medical record.
2Pre-test information shall be provided to the inmate and
3informed consent obtained from the inmate as required in
4subsection (q) (d) of Section 3 and Section 5 of the AIDS
5Confidentiality Act. The Cook County Health & Hospitals System
6shall follow procedures established by the Department of Public
7Health to conduct HIV testing and testing to confirm positive
8HIV test results. All aspects of HIV testing shall comply with
9the requirements of the AIDS Confidentiality Act, including
10delivery of test results, as determined by the Cook County
11Health & Hospitals System in consultation with the Illinois
12Department of Public Health. Nothing in this Section shall
13require the Cook County Health & Hospitals System to offer HIV
14testing to inmates who are known to be infected with HIV. The
15Department of Public Health and community-based organizations
16certified to provide HIV/AIDS testing may provide these
17informational materials to the Bureau at no cost to the county.
18The testing provided under this subsection (b) shall consist of
19a test approved by the Illinois Department of Public Health to
20determine the presence of HIV infection, based upon
21recommendations of the United States Centers for Disease
22Control and Prevention. If the test result is positive, a
23reliable supplemental test based upon recommendations of the
24United States Centers for Disease Control and Prevention shall
25be administered.
26    (c) In each county, the warden of the jail must make

 

 

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1appropriate written information concerning HIV/AIDS available
2to every visitor to the jail. This information must include
3information concerning persons or entities to contact for local
4counseling and testing. The Department of Public Health and
5community-based organizations certified to provide HIV/AIDS
6testing must provide these informational materials to the
7warden at no cost to the office of the county sheriff.
8    (d) Implementation of this Section is subject to
9appropriation.
10(Source: P.A. 97-244, eff. 8-4-11; 97-323, eff. 8-12-11;
1197-813, eff. 7-13-12.)".