Rep. Mary E. Flowers

Filed: 3/7/2017

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 2800

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

 

 

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1otherwise authorized to deliver health care services.
2    "Health care services" means any prenatal medical care or
3labor or delivery services to a pregnant woman and her newborn
4infant, including hospitalization.
5    "Opt-out testing" means an approach in which an HIV test is
6offered to the patient, such that the patient is notified that
7HIV testing may occur unless the patient opts out by declining
8the test.
9    "Third trimester" means the 27th week of pregnancy through
10delivery.
11(Source: P.A. 99-173, eff. 7-29-15.)
 
12    (410 ILCS 335/10)
13    Sec. 10. HIV counseling and offer of HIV testing required.
14    (a) Every health care professional who provides health care
15services to a pregnant woman shall, unless she already has a
16documented negative HIV status has already been tested during
17the third trimester of the current pregnancy, or is already
18documented to be HIV-positive, provide the woman with HIV
19counseling, as described in subpart (d) of this Section, and
20shall test her for HIV on an opt-out basis unless she refuses.
21The counseling and testing or refusal of testing shall comply
22with the requirements for informed consent in the AIDS
23Confidentiality Act and be documented in the pregnant woman's
24medical record as required by the AIDS Confidentiality Act. A
25refusal 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 documented negative HIV status from the
8third trimester of the current pregnancy, or is already
9documented to be HIV-positive. For women at continued risk of
10exposure to HIV infection in the judgment of the health care
11professional, a repeat test should be recommended late in
12pregnancy or at the time of labor and delivery. The counseling
13and testing or refusal of testing shall be documented in the
14woman's medical record.
15    (b) Every health care professional or facility that cares
16for a pregnant woman during labor or delivery shall, unless she
17has already has a documented negative HIV status from been
18tested during the third trimester of the current pregnancy, or
19is already documented to be HIV-positive, provide the woman
20with HIV counseling, as described in subpart (d) of this
21Section, and rapid opt-out HIV testing unless she refuses. The
22woman in labor or delivery may refuse the HIV test verbally or
23in writing. A refusal may be verbal or in writing. The
24counseling and testing or refusal of testing shall be
25documented in the laboring or delivering woman's medical
26record. The health care facility shall adopt a policy that

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1    Section 99. Effective date. This Act takes effect upon
2becoming law.".