HOUSE BILL REPORT

E2SSB 6221

As Amended by the House

BYSenate Committee on Ways & Means (originally sponsored by Senators Deccio, Kreidler, Johnson, Niemi, Smith, Wojahn, Zimmerman, Hayner, Vognild and Talmadge)

Modifying provisions relating to sexually transmissible diseases.

House Committe on Health Care

Majority Report:  Do pass with amendments.  (11)

      Signed by Representatives Braddock, Chair; Day, Vice Chair; Bristow, Brooks, Bumgarner, Cantwell, Lewis, Lux, D. Sommers, Sprenkle and Vekich.

House Staff:Bill Hagens (786-7131)

AS PASSED HOUSE MARCH 1, 1988

BACKGROUND:

Acquired immunodeficiency syndrome (AIDS) is a fatal disease transmitted by sexual contact and certain exposures to infected blood.  The syndrome is characterized by a number of "opportunistic infections" which appear in persons from several weeks to several years after they have been infected with the human immunodeficiency virus (HIV) -- the cause of AIDS.  Some 3 to 5 percent of those infected with HIV have developed AIDS during each year after they were infected.

Nationally, it is estimated that between 1 and 1-1/2 million persons may be infected with HIV.  The number of AIDS cases is approaching 50,000.

In the state of Washington, as of January 28, 1988, there were 735 persons diagnosed with AIDS, with estimates of 15,000 to 19,000 persons with HIV.  Although Washington ranks 19th in population nationally, it ranks 12th in number of AIDS cases.  It is estimated that by the end of 1991 the number of AIDS cases will approach 5,000 in Washington.  The number with HIV will be some 30,000.

While at present over 75 percent of the AIDS cases are in the Seattle-King County area, the epidemic is rapidly spreading to other parts of the state.  Two years ago, only four counties reported any AIDS cases.  Presently, 27 counties have reported at least one case.

Due to the newness of the disease, there is no state policy on AIDS.  Services are mostly limited to the Seattle-King County area.  There is no state policy on AIDS education for students, health workers, private and public employees.  Further the state laws dealing with sexually transmitted diseases have not been significantly amended in modern times and do not meet contemporary standards.

SUMMARY:

BILL AS AMENDED:  A list of currently known sexually transmitted diseases (STD) including AIDS and HIV are added to statute.  The Board of Health is authorized to add other STDs to the definition, when appropriate.

Information directed to the public regarding STDs shall give emphasis to the importance of sexual abstinence, sexual fidelity and the avoidance of substance abuse in controlling disease.

All publicly funded materials regarding STDs directed to children in the common schools must emphasize sexual abstinence outside lawful marriage.

The Center for Voluntary Action is given the additional related responsibility of providing information about agencies and individuals working in the prevention and treatment of AIDS.

A state policy on AIDS education in common schools is established.  It stresses that AIDS is a serious life threatening disease, that preventing the disease involves sexual abstinence and avoidance of substance abuse, and that an active role of parents and locally elected school board officials in the development is crucial to AIDS prevention.  Each school district is required to develop an AIDS prevention education program in consultation with educators, parents, and other community members.  The Superintendent of Public Instruction (SPI) shall provide model curriculum which shall be reviewed by the DSHS office on AIDS for medical accuracy.  The office on AIDS shall approve any locally developed curricula for medical accuracy in consultation with local public health officers.  School districts are permitted to file curricula with the office on AIDS and use it until it is approved or disapproved.  AIDS education shall be offered annually--5th through 12th grades.  Parents shall be given reasonable opportunities to review the material before it is presented to their children.  A student may be exempted from the AIDS education, upon the written request of the parents, if the parents have reviewed the material.

The governing entities of colleges, universities, and vocational schools are required to make AIDS information available to new students.

An office on AIDS is established within the Department of Social and Health Services (DSHS), which shall coordinate AIDS related activities and administer all state and federal AIDS related funding.

The Department of Licensing (DOL), DSHS, all health professional boards, SPI and units of local government are directed to establish training and education requirements for the professionals they certify and/or license.

AIDS testing and counseling is defined.  Persons convicted of sex offenses, persons convicted of crimes involving the use of hypodermic needles or other objects used for injecting controlled substances into the human body, and those convicted of promoting, soliciting, or performing acts of prostitution shall be tested and counseled upon sentencing.  Law enforcement officers, fire fighters, and health care providers may request testing and counseling of those to whose bodily fluids they have been substantially exposed.  If local public health officers find the exposure to be substantial, they must perform the tests.  Jail and prison administrators are given the authority to test an inmate if his or her behavior poses a risk to the public safety or to other inmates.

The Secretary of Corrections is directed to report to the Legislature by January 1, 1989 on the need for an AIDS-related segregation policy for state corrections facilities.

Health care professionals attending pregnant women must assure that AIDS counseling has been provided, and all persons in state certified drug treatment programs must be counseled.

Six Regional AIDS service networks covering the state and conforming in boundaries to DSHS regions are to be established by October 1, 1988.  The most populace county in each region is designated as the lead county.  Lead counties, in consultation with other counties, are responsible for coordinating a comprehensive range of AIDS education, counseling, testing and other services in each region.

Seventy-five percent of the appropriation to the regional AIDS service networks will be allocated for counseling, testing, education, notification of sexual partners of infected persons, planning and coordination, to be allocated on a per capita basis. Twenty-five percent of the appropriation for the regional networks will be allocated for intervention strategies with high risk groups and a needs assessment for persons with AIDS based on regional plans.  The formula is terminated on July 1, 1991.  DSHS shall propose a future funding formula.

The act clarifies that AIDS prevention programs are not in violation of the paraphernalia law.

The University of Washington may establish a center for AIDS education, and it shall be linked to the networks and the office on AIDS.

The governor shall appoint an advisory committee to assist the Secretary of DSHS in the implementation of AIDS programs.  The committee will terminate July 1, 1991.

Records regarding testing, counseling or treatment for STDs are confidential with limited exceptions. Local public health officers shall interview persons with STDs to determine their sexual partners and shall contact partners, pursuant to Board of Health rules.

Explicit provisions are made to protect persons who are perceived to have or actually have HIV from discrimination.  An exception is made for insurers where bona fide statistical differences in risk or exposure have been substantiated.

Employers who follow the provisions of the act and who adhere to regulations and guidelines regarding protecting the public and other employees from exposure in the workplace are exempt from civil or criminal liability.

Public health officers are given authority to address persons whose behavior is identified as a danger to public health. They may take as many of the following steps as necessary, in a serial fashion, to address the problem when the person in question does not wish to comply voluntarily:  1) order a person to submit to medical examination or testing or seek counseling, treatment, etc.; 2) order a person to cease and desist from specific behaviors or adhere to restrictions; or 3) detain a person for up to 90 days in an appropriate facility designated by the Board of Health.  Throughout the involuntary aspects of this procedure the person will be provided a full range of due process rights, including notice, counsel, and a jury trial if detained in excess of 14 days.

It is made a class B felony to knowingly transmit or expose the HIV virus to another with the intent to do bodily harm.  Transmitting of other STDs is maintained as a gross misdemeanor.

AMENDED BILL COMPARED TO SECOND SUBSTITUTE:  School employees are removed from category of persons who can directly request HIV testing.

Regional AIDS service networks are required to offer volunteer testing and counseling services to persons arrested for prostitution and drug offenses.

The Department of Corrections is required to define "possible risk" for testing purposes in consultation with the Board of Health.

A termination date is placed on the advisory committee.

Discrimination protections are extended to persons who are perceived to have or actually have HIV infection.

HIV testing laboratories are required to report anonymous HIV prevalence rates to the department.

Standards for civil damages are established.

Paraphernalia law application is clarified.

Criminal penalties for transmitting or exposing HIV is reduced from a class A to a class B felony.

Budgetary and studies provisions are deleted.

Fiscal Note:      Available.

House Committee ‑ Testified For:    Senator Alex Deccio, Sponsor; Jule Sugarman, Secretary of DSHS; Dr. W.E. Lafferty, DSHS; Robb Menaul, Washington State Hospital Association; Ken Bertrand, Group Health Cooperative of Puget Sound; Joanne Coker; Bob Fisher, Washington Education Association; Therese Peterson, Tacoma School District; H. Hunter Hansfield, Seattle-King County Health Department; Ann Olson, Parent Teachers Association; Robert Rohan, Northwest AIDS Foundation; Susie Tracy, Washington State Medical Association; Tom Milne, Washington State Association of Local Public Health Officials; Dr. Al Allen, Tacoma Pierce County Health Department; Bud Nicola, Seattle-King County Health Department; Ward Hinds, Snohomish County Health Department; Bill Gladden, Washington State Human Rights Commission; Mary Tennyson, Washington State Human Rights Commission; Carmen Rockwell, U.S. Department of Health & Human Services Office of Civil Rights; Bobbe Bridge, Washington Privacy Lobby; Pat Thibaudeau, Washington Women United.

House Committee - Testified Against:      Jerry Sheehan, ACLU; Su Docekal, Radical Women; George Bakan, Freedom Day Committee.

House Committee - Testimony For:    AIDS is a very deadly disease and a comprehensive state policy is needed.

House Committee - Testimony Against:      The detention and mandatory testing provisions are unnecessary because such actions have not been proven effective in controlling disease.