97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
SB1944

 

Introduced 2/10/2011, by Sen. William Delgado

 

SYNOPSIS AS INTRODUCED:
 
New Act

    Creates the Prenatal and Neonatal Congenital Toxoplasmosis Prevention and Treatment Act. Sets forth definitions. Provides that health care professionals shall provide counseling for Toxoplasmosis and testing for T. gondii when providing care to a pregnant woman during her pregnancy, unless the woman has been diagnosed prior to the pregnancy or she refuses, and during her delivery, unless she has already been determined to be IgG positive and chronically infected or she refuses. Sets forth circumstances under which every health care professional or facility caring for a newborn infant shall provide counseling and perform Toxoplasmosis testing. Sets forth subject matter requirements for the counseling required under the Act. Provides that consent for testing of a newborn infant shall be presumed when a health care professional or facility seeks to perform a test on a newborn infant whose mother's Toxoplasmosis status is unknown, provided that mandated counseling has taken place. Provides that the Department of Public Health shall adopt necessary rules to implement the Act. Effective immediately.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Prenatal and Neonatal Congenital Toxoplasmosis Prevention and
6Treatment Act.
 
7    Section 5. Definitions. In this Act:
8    "Acute Acquired Toxoplasmosis" means the disease caused by
9recent acquisition of T. gondii.
10    "Congenital Toxoplasmosis" means an infection of a fetus or
11newborn infant with T. gondii. This infection occurs when a
12mother acquires T. gondii for the first time during pregnancy
13or when an immunologically compromised mother has a chronic
14infection and she transmits the infection to the fetus or
15newborn infant. Such infection may cause brain and eye damage
16in the fetus or infant.
17    "Department" means the Department of Public Health.
18    "Health care facility" or "facility" means any hospital or
19other institution that is licensed or otherwise authorized to
20deliver health care services.
21    "Health care professional" means a physician licensed to
22practice medicine in all its branches, a physician assistant
23who has been delegated the provision of health services by his

 

 

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1or her supervising physician, or an advanced practice
2registered nurse who has written collaborative agreements with
3a collaborating physician that authorizes the provision of
4health services.
5    "Health care services" means any prenatal medical care or
6labor delivery services to a pregnant woman and her newborn
7infant, including hospitalization.
8    "IgG" means Immunoglobulin G. A T. gondii specific IgG
9antibody means that the person is infected with Toxoplasma
10gondii.
11    "IgM" means Immunoglobulin M. A T. gondii specific IgM is
12an antibody that detects recent or acute infection with
13Toxoplasma gondii, this antibody can be present for years.
14Other specialized tests can detect whether an infection is very
15recent.
16    "Toxoplasma gondii", "T. gondii", or "Toxoplasma" means an
17apicomplexan parasite that can cause disease.
18    "Toxoplasmosis" means the disease caused by Toxoplasma
19gondii.
20    "U.S. Taxoplasmosis Reference Laboratory" means the Palo
21Alto Toxoplasma Serology Laboratory in Palo Alto, California.
22The Palo Alto Laboratory serves as the reference laboratory for
23the U.S. Centers for Disease Control and Prevention (CDC) and
24Food and Drug Administration (FDA). The Palo Alto Laboratory
25performs serologic tests that cannot be reliably completed at
26commercial laboratories.
 

 

 

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1    Section 10. Toxoplasmosis counseling and offer of
2Toxoplasmosis testing required.
3    (a) Every health care professional who provides health care
4services to a pregnant woman shall, unless the woman has been
5diagnosed with Toxoplasma infection though serologic testing
6prior to the current pregnancy, provide the woman with
7Toxoplasmosis counseling and shall test her for T. gondii
8unless she refuses. The counseling and testing or refusal of
9testing shall be documented in the woman's medical record. A
10refusal may be verbal or in writing. A health care professional
11shall provide the counseling and recommend the testing as early
12in the woman's pregnancy as possible. For women who are
13negative for antibodies to T. gondii, IgG testing shall
14continue throughout pregnancy at an interval of once per month.
15At any time during pregnancy, if a woman who was previously
16negative has a positive IgG to T. gondii, then the woman shall
17be screened for IgM specific for T. gondii. If the IgM is
18positive, then a sample shall be sent to the U.S. Toxoplasmosis
19Reference Laboratory in Palo Alto, California for confirmation
20and to determine a likely date of acquisition. Expert advice
21will be sought for any woman who seroconverts or who is acutely
22infected so that treatment for her fetus or infant can be
23offered without delay to protect the baby from brain and eye
24disease due to Toxoplasma gondii.
25    (b) Every health care professional during labor or delivery

 

 

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1shall, unless the woman receiving care has already been
2determined to be IgG positive and chronically infected prior to
3or during the current pregnancy, provide the woman with
4Toxoplasmosis counseling and Toxoplasmosis testing, unless the
5woman refuses. A refusal may be verbal or in writing. The
6counseling and testing or refusal of testing shall be
7documented in the woman's medical record. The health care
8facility shall adopt a policy that provides that as soon as
9possible within medical standards after the infant's birth, the
10mother's Toxoplasmosis test result, if available, shall be
11noted in the newborn infant's medical record. It shall also be
12noted in the newborn infant's medical record if the mother's
13Toxoplasmosis test result is not available because she has not
14been tested or has declined testing. Any testing or test
15results shall be documented in accordance with current
16standards of patient confidentiality.
17    (c) Every health care professional or facility caring for a
18newborn infant shall, upon delivery or as soon as possible
19within medical standards after the infant's birth, provide
20counseling to the parent or guardian of the infant and perform
21Toxoplasmosis testing on the infant when the Toxoplasmosis
22status of the infant's mother is negative in the best
23prepregnancy test or unknown or when there is evidence of acute
24acquired gestational T. gondii infection.
25    (d) Every health care professional or facility caring for a
26mother at one month postpartum shall provide counseling and

 

 

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1perform Toxoplasmosis testing when her Toxoplasmosis status is
2negative or unknown.
3    (e) If the mother is not tested as described in subsection
4(d) of this Section, then every health care professional or
5facility caring for a newborn infant at one month of age shall
6provide counseling to the parent or guardian of the infant and
7perform Toxoplasmosis testing on the infant when the
8Toxoplasmosis status of the infant's mother is negative or
9unknown.
10    (f) The counseling required under this Section must be
11provided in accordance with the federal Health Insurance
12Portability and Accountability Act and must include all of the
13following:
14        (1) For the health of the pregnant woman, the voluntary
15    nature of the testing, the benefits of Toxoplasmosis
16    testing, including prevention of acquisition and
17    treatment, and the requirement that Toxoplasmosis testing
18    be performed unless she refuses and the methods by which
19    she can refuse.
20        (2) The benefit of Toxoplasmosis testing for herself
21    and the newborn infant, including interventions and
22    treatment to prevent Toxoplasmosis.
23        (3) The side effects of interventions to prevent and
24    treat Toxoplasmosis.
25        (4) The requirement for mandatory testing of the
26    newborn if the mother's Toxoplasmosis status is unknown at

 

 

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1    the time of delivery.
2        (5) An explanation of the test, including its purpose,
3    limitations, and the meaning of its results.
4        (6) An explanation of the procedures to be followed.
5        (7) The availability of additional or confirmatory
6    testing, if appropriate.
7    Counseling may be provided in writing, verbally, or by
8video, electronic, or other means. The woman must be offered an
9opportunity to ask questions about testing and to decline
10testing for herself.
11    (g) Consent for testing of a newborn infant shall be
12presumed when a health care professional or health care
13facility seeks to perform a test on a newborn infant whose
14mother's Toxoplasmosis status is unknown, provided that
15mandated counseling has taken place.
16    (h) The Department of Public Health shall adopt necessary
17rules to implement this Act.
 
18    Section 99. Effective date. This Act takes effect upon
19becoming law.