Rep. Mary E. Flowers

Filed: 3/22/2017

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 2800

2    AMENDMENT NO. ______. Amend House Bill 2800, AS AMENDED, by
3replacing everything after the enacting clause with the
4following:
 
5    "Section 5. The Perinatal HIV Prevention Act is amended by
6changing Sections 5, 10, 15, 30, and 35 as follows:
 
7    (410 ILCS 335/5)
8    Sec. 5. Definitions. In this Act:
9    "Birth center" means a facility licensed by the Department
10under paragraph (6) of Section 35 of the Alternative Health
11Care Delivery Act.
12    "Department" means the Department of Public Health.
13    "Health care professional" means a physician licensed to
14practice medicine in all its branches, a licensed physician
15assistant, or a licensed advanced practice nurse.
16    "Health care facility" or "facility" means any hospital,

 

 

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1birth center, or other institution that is licensed or
2otherwise authorized to deliver health care services.
3    "Health care services" means any prenatal medical care or
4labor or delivery services to a pregnant woman and her newborn
5infant, including hospitalization.
6    "Opt-out testing" means an approach in which an HIV test is
7offered to the patient, such that the patient is notified that
8HIV testing may occur unless the patient opts out by declining
9the test.
10    "Third trimester" means the 27th week of pregnancy through
11delivery.
12(Source: P.A. 99-173, eff. 7-29-15.)
 
13    (410 ILCS 335/10)
14    Sec. 10. HIV counseling and offer of HIV testing required.
15    (a) Every health care professional who provides health care
16services to a pregnant woman shall, unless she already has a
17negative HIV status has already been tested during the third
18trimester of the current pregnancy, or is already HIV-positive,
19provide the woman with HIV counseling, as described in subpart
20(d) of this Section, and shall test her for HIV on an opt-out
21basis unless she refuses. The counseling and testing or refusal
22of testing shall comply with the requirements for informed
23consent in the AIDS Confidentiality Act and be documented in
24the pregnant woman's medical record as required by the AIDS
25Confidentiality Act. A refusal may be verbal or in writing.

 

 

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1     A health care professional shall provide the first opt-out
2HIV testing counseling and recommend the testing as early in
3the woman's pregnancy as possible. The health care professional
4providing health care services to a pregnant woman in the third
5trimester shall perform a second round of opt-out HIV testing,
6ideally by the 36th week of pregnancy, unless the pregnant
7woman already has a negative HIV status from the third
8trimester of the current pregnancy, or is already HIV-positive.
9For women at continued risk of exposure to HIV infection in the
10judgment of the health care professional, a repeat test should
11be recommended late in pregnancy or at the time of labor and
12delivery. The counseling and testing or refusal of testing
13shall be documented in the woman's medical record.
14    (b) Every health care professional or facility that cares
15for a pregnant woman during labor or delivery shall, unless she
16has already has a negative HIV status from been tested during
17the third trimester of the current pregnancy, or is already
18HIV-positive, provide the woman with HIV counseling, as
19described in subpart (d) of this Section, and rapid opt-out HIV
20testing unless she refuses. The woman in labor or delivery may
21refuse the HIV test verbally or in writing. A refusal may be
22verbal or in writing. The counseling and testing or refusal of
23testing shall be documented in the laboring or delivering
24woman's medical record. The health care facility shall adopt a
25policy that provides that as soon as possible within medical
26standards after the infant's birth, the delivering mother's HIV

 

 

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1test result, if available, shall be noted in the newborn
2infant's medical record. It shall also be noted in the newborn
3infant's medical record if the mother's third trimester HIV
4test result is not available because she was not tested in the
5third trimester has not been tested or has declined testing.
6Any testing or test results shall be documented in accordance
7with the AIDS Confidentiality Act.
8    (c) Every health care professional or facility caring for a
9newborn infant shall, upon delivery or as soon as possible
10within medical standards after the infant's birth, provide
11counseling as described in subsection (d) of this Section to
12the parent or guardian of the infant and perform rapid HIV
13testing on the infant, when the HIV status of the infant's
14mother is unknown, or if the delivering woman did not undergo
15HIV testing in the third trimester of the current pregnancy.
16    (d) The counseling required under this Section must be
17provided in accordance with the AIDS Confidentiality Act and
18must include the following:
19        (1) For the health of the pregnant woman, the voluntary
20    nature of the testing, the benefits of HIV testing,
21    including the prevention of transmission, and the
22    requirement that HIV testing be performed unless she
23    refuses and the methods by which she can refuse.
24        (2) The benefit of HIV testing for herself and the
25    newborn infant, including interventions to prevent HIV
26    transmission.

 

 

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1        (3) The side effects of interventions to prevent HIV
2    transmission.
3        (4) The statutory confidentiality provisions that
4    relate to HIV and acquired immune deficiency syndrome
5    ("AIDS") testing.
6        (5) The requirement for mandatory testing of the
7    newborn if the mother's HIV status during the third
8    trimester of pregnancy is unknown and if the mother was not
9    rapidly tested for HIV at delivery at the time of delivery.
10        (6) An explanation of the test, including its purpose,
11    limitations, and the meaning of its results.
12        (7) An explanation of the procedures to be followed.
13        (8) The availability of additional or confirmatory
14    testing, if appropriate. Counseling may be provided in
15    writing, verbally, or by video, electronic, or other means.
16    The pregnant or delivering woman must be offered an
17    opportunity to ask questions about testing and to decline
18    testing for herself.
19    (e) All counseling and testing must be performed in
20accordance with the standards set forth in the AIDS
21Confidentiality Act, including the informed consent provisions
22of Sections 4, 7, and 8 of that Act, with the exception of the
23requirement of consent for testing of newborn infants.
24     Consent for testing of a newborn infant shall be presumed
25when a health care professional or health care facility seeks
26to perform a test on a newborn infant whose mother's HIV status

 

 

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1is not known either in the third trimester of pregnancy or at
2delivery, provided that the counseling required under
3subsection (d) of this Section and the AIDS Confidentiality Act
4has taken place.
5    (f) The Illinois Department of Public Health shall adopt
6necessary rules to implement this Act by July 1, 2008.
7(Source: P.A. 94-910, eff. 6-23-06; 95-702, eff. 6-1-08.)
 
8    (410 ILCS 335/15)
9    Sec. 15. Reporting.
10    (a) Health A health care facilities facility shall adopt a
11policy that provides that a report of a preliminarily
12HIV-positive woman identified by a rapid HIV test or and a
13report of a preliminarily HIV-exposed newborn infant
14identified by a rapid HIV test conducted during labor and
15delivery or after delivery shall be made to the Department's
16Perinatal HIV Hotline within 12 hours but not later than 24
17hours of the test result after birth. Section 15 of the AIDS
18Confidentiality Act applies to reporting under this Act, except
19that the immunities set forth in that Section do not apply in
20cases of willful or wanton misconduct.
21    (b) The Department shall adopt rules specifying the
22information required in reporting the preliminarily
23HIV-positive pregnant or post-partum woman and preliminarily
24HIV-exposed newborn infant and the method of reporting. In
25adopting the rules, the Department shall consider the need for

 

 

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1information, protections for the privacy and confidentiality
2of the infant and parents, the need to provide access to care
3and follow-up services to the infant, and procedures for
4destruction of records maintained by the Department if, through
5subsequent HIV testing, the pregnant or post-partum woman or
6newborn infant is found to be HIV-negative.
7    (c) The confidentiality provisions of the AIDS
8Confidentiality Act shall apply to the reports of cases of
9perinatal HIV made pursuant to this Section.
10    (d) Health care facilities shall monthly report aggregate
11statistics to the Department that include the number of
12pregnant or delivering infected women who presented with known
13HIV status; , the number of pregnant women rapidly tested for
14HIV in labor and delivery as either a first HIV test or a
15repeat third trimester HIV test; , the number of newborn infants
16rapidly tested for HIV-exposure because the HIV status of the
17delivering woman was unknown in the third trimester, or the
18delivering woman refused testing; , the number of preliminarily
19HIV-positive pregnant or delivering women and preliminarily
20HIV-exposed newborn infants identified; , the number of
21families referred to case management; , and other information
22the Department determines is necessary to measure progress
23under the provisions of this Act. Health care facilities must
24report the confirmatory test result when it becomes available
25for each preliminarily positive rapid HIV test performed on the
26pregnant or delivering woman and on a newborn.

 

 

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1    (e) The Department or its authorized representative shall
2provide case management services to the preliminarily positive
3pregnant or post-partum woman or the parent or guardian of the
4preliminarily positive newborn infant to ensure access to
5treatment and care and other services where the pregnant or
6post-partum woman or the as appropriate if the parent or
7guardian of the newborn infant has consented to the services.
8    (f) Every health care facility caring for a newborn infant
9whose mother had been diagnosed HIV positive prior to labor and
10delivery shall report a case of perinatal HIV exposure in
11accordance with the HIV/AIDS Registry Act, the Illinois
12Sexually Transmissible Disease Control Act, and rules to be
13developed by the Department. If after 18 months from the date
14that the report was submitted, a newborn infant is determined
15to not have HIV or AIDS, the Department shall remove the
16newborn infant's name from all reports, records, and files
17collected or created under this subsection (f).
18(Source: P.A. 94-910, eff. 6-23-06; 95-702, eff. 6-1-08.)
 
19    (410 ILCS 335/30)
20    Sec. 30. Objections of parent or guardian to test. The
21provisions of this Act requiring testing for HIV shall not
22apply when a parent or guardian of a child objects to HIV
23testing thereto on the grounds that the test conflicts with the
24parent's his or her religious tenets and practices. A written
25statement of the objection shall be presented to the physician

 

 

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1or other person whose duty it is to administer and report the
2tests under the provisions of this Act.
3(Source: P.A. 94-910, eff. 6-23-06.)
 
4    (410 ILCS 335/35)
5    Sec. 35. Department report. The Department of Public Health
6shall prepare an annual report for the Governor and the General
7Assembly on the implementation of this Act that includes
8information on the number of HIV-positive pregnant women who
9presented with known HIV status, the number of pregnant women
10rapidly tested for HIV in labor and delivery, the number of
11newborn infants rapidly tested for HIV exposure, the number of
12preliminarily HIV-positive pregnant women and preliminarily
13HIV-exposed newborn infants identified, the confirmatory test
14result for each preliminarily positive rapid HIV test performed
15on the woman and newborn, the number of families referred to
16case management, and other information the Department
17determines is necessary to measure progress under the
18provisions of this Act. The Department shall assess the needs
19of health care professionals and facilities for ongoing
20training in implementation of the provisions of this Act and
21make recommendations to improve the program.
22(Source: P.A. 94-910, eff. 6-23-06.)
 
23    Section 99. Effective date. This Act takes effect upon
24becoming law.".