AN ACT Relating to sexually transmissible diseases; amending RCW 9A.36.011; adding new sections to chapter 70.24 RCW; adding a new section to chapter 49.60 RCW; repealing RCW 70.24.010, 70.24.020, 70.24.030, 70.24.040, 70.24.050, 70.24.060, 70.24.070, 70.24.080, 70.24.090, 70.24.100, 70.24.110, and 70.24.120; making appropriations; and prescribing penalties.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. This chapter may be cited as the control and treatment of sexually transmissible disease act.

NEW SECTION. Sec. 2. The legislature finds and declares that sexually transmissible diseases constitute a serious and sometimes fatal threat to the public and individual health and welfare of the people of the state and to visitors to the state. The legislature finds that the incidence of sexually transmissible diseases is rising at an alarming rate and that these diseases result in significant social, health, and economic costs, including infant and maternal mortality, temporary and lifelong disability, and premature death. The legislature finds that sexually transmissible diseases, by their nature, involve sensitive issues of privacy, and it is the intent of the legislature that all programs designed to deal with these diseases afford patients privacy, confidentiality, and dignity. The legislature finds that medical knowledge and information about sexually transmissible diseases are rapidly changing. The legislature intends to provide a program that is sufficiently flexible to meet emerging needs, deals efficiently and effectively with reducing the incidence of sexually transmissible diseases, and provides patients with a secure knowledge that information they provide will remain private and confidential.

NEW SECTION. Sec. 3. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Acquired immunodeficiency syndrome" or "AIDS" means the syndrome characteristic of people infected with the human immune deficiency virus.

(2) "Human immunodeficiency virus" or "HIV" means all HIV and HIV-related viruses which damage the cellular branch of the human immune system and leave the infected person immunodeficient.

(3) "Asymptomatic HIV infection" means the absence of signs or symptoms of HIV infection in individuals who have tested positively for HIV infection.

(4) "AIDS-related complex" or "ARC" means clinical manifestations of HIV infection or clinical manifestations of HIV infection that meet the criteria established by the federal centers for disease control for classification of HIV infection.

(5) "Zidovudine and other drugs" means drugs available for treatment of various stages of infection with HIV.

(6) "Department" means the department of social and health services.

(7) "Sexually transmissible disease" means a bacterial, viral, fungal, or parasitic disease, determined by rule of the department to be sexually transmissible, to be a threat to the public health and welfare, and to be a disease for which a legitimate public interest will be served by providing for regulation and treatment. In considering which diseases are to be designated as sexually transmissible diseases, the department shall consider such diseases as chancroid, gonorrhea, granuloma inguinale, lymphogranuloma venereum, genital herpes simplex, chlamydia, nongonococcal urethritis (NGU), pelvic inflammatory disease (PID)/Acute Salpingitis, syphilis, AIDS, and HIV infection for designation, and shall consider the recommendations and classifications of the centers for disease control and other nationally recognized medical authorities. Not all diseases that are sexually transmissible need be designated for the purposes of this chapter.

NEW SECTION. Sec. 4. It is unlawful for any person who has chancroid, gonorrhea, granuloma inguinale, lymphogranuloma venereum, genital herpes simplex, chlamydia, nongonococcal urethritis (NGU), pelvic inflammatory disease (PID)/Acute Salpingitis, syphilis, or HIV infection, when such person knows he or she is infected with one or more of these diseases and when such person has been informed that he or she may communicate this disease to another person through sexual intercourse, to have sexual intercourse with any other person, unless such other person has been informed of the presence of the sexually transmissible disease.

NEW SECTION. Sec. 5. (1) Each person who makes a diagnosis of or treats a person with a sexually transmissible disease and each laboratory that performs a test for a sexually transmissible disease which concludes with a positive result shall report such facts as may be required by the department by rule, within a time period as specified by rule of the department, but in no case to exceed two weeks.

(2) The department shall adopt rules specifying the information required in and a minimum time period for reporting a sexually transmissible disease. In adopting such rules, the department shall consider the need for information, protections for the privacy and confidentiality of the patient, and the practical ability of persons and laboratories to report in a reasonable fashion. Rules pursuant to reporting of HIV infection shall be limited to physician reporting and shall include only physician diagnosed cases of AIDS and AIDS-related complex based upon diagnostic criteria from the centers for disease control of the United States public health service.

(3) Each person who violates the provisions of this section or the rules adopted under this section may be fined by the department up to five hundred dollars for each offense. The department shall report each violation of this section to the regulatory agency responsible for licensing each health care professional and each laboratory to which these provisions apply.

NEW SECTION. Sec. 6. (1) The department and its authorized representatives may interview, or cause to be interviewed, all persons infected or suspected of being infected with a sexually transmissible disease for the purpose of investigating the source and spread of the disease and for the purpose of ordering a person to submit to examination and treatment as necessary.

(2) All information gathered in the course of contact investigation shall be considered confidential. Such information is exempt from public disclosure.

(3) No person who is infected with a sexually transmissible disease, or suspected of an infection, who reveals the name or names of sexual contacts during the course of an investigation shall be held liable in a civil action for such revelation, unless the revelation is made falsely or with reckless disregard for the truth.

NEW SECTION. Sec. 7. (1) Subject to the provisions of subsection (3) of this section, the department and its authorized representatives may examine or cause to be examined persons suspected of being infected with or exposed to a sexually transmissible disease.

(2) Subject to the provisions of subsection (3) of this section, persons with a sexually transmissible disease shall report for complete treatment to a physician or shall submit to treatment at a county public health unit or other public facility, until the disease is noncommunicable.

(3) No person may be apprehended, examined, or treated for a sexually transmissible disease against his or her will, except upon the presentation of a warrant duly authorized by a court of competent jurisdiction. In requesting the issuance of such a warrant, the department shall show by a preponderance of evidence that a threat to the public's health or welfare exists unless such warrant is issued and shall show that all other reasonable means of obtaining compliance have been exhausted and that no other less-restrictive alternative is available.

NEW SECTION. Sec. 8. (1) Subject to the provisions of subsection (2) of this section, the department may order a person to be isolated or a place to be quarantined and made off limits to the public as a result of the probable spread of a sexually transmissible disease, until such time as the condition can be corrected or the threat to the public's health eliminated or reduced in such a manner that a substantial threat to the public's health no longer exists.

(2) No person may be ordered to be isolated, and no place may be ordered to be quarantined, except upon the order of a court of competent jurisdiction and upon proof:

(a) By the department by clear and convincing evidence that the public's health and welfare are significantly endangered by a person with a sexually transmissible disease or in a place where there is a significant amount of sexual activity likely to spread a sexually transmissible disease; and

(b) That all other reasonable means of correcting the problem have been exhausted and a less restrictive alternative exists.

(3) This section shall be considered supplemental to the existing authorities and powers of the department and shall not be construed to restrain or restrict the department in protecting the public health under other sections of law.

NEW SECTION. Sec. 9. (1) All information and records held by the department or its authorized representatives relating to known or suspected cases of sexually transmissible diseases shall be strictly confidential and shall not be released or made public by the department or its authorized representatives, or by a court or parties to a lawsuit upon revelation by subpoena, except that release may be made under the following circumstances:

(a) When made with the consent of all persons to which the information applies;

(b) When made for statistical purposes, and medical or epidemiologic information is summarized so that no person can be identified and no names are revealed;

(c) When made to medical personnel, appropriate state agencies, or courts of appropriate jurisdiction, to enforce this chapter and related rules; or

(d) When made in a medical emergency, but only to the extent necessary to protect the health or life of a named party.

(2) When disclosure is made pursuant to a subpoena, such information shall be sealed by the court from further disclosure, except as deemed necessary by the court to reach a decision, unless otherwise agreed to by all parties.

(3) No employee of the department or its authorized representatives shall be examined in a civil, criminal, special, or other proceeding as to the existence or contents of pertinent records of a person examined or treated for a sexually transmissible disease by the department or its authorized representatives, or of the existence or contents of such reports received from a private physician or private health facility, without the consent of the person examined and treated for such diseases, except in proceedings under sections 7 and 8 of this act.

NEW SECTION. Sec. 10. (1) The department, its authorized representatives, each physician licensed to practice medicine, each licensed health care professional who is acting pursuant to the scope of his or her license, and each public or private hospital, clinic, or other health facility may examine and provide treatment for sexually transmissible diseases to any minor, if the physician, health care professional, or facility is qualified to provide such treatment. The consent of the parents or guardians of a minor is not a prerequisite for an examination or treatment.

(2) The fact of consultation, examination, and treatment of a minor for a sexually transmissible disease is confidential and shall not be divulged in any direct or indirect manner, such as sending a bill for services rendered to a parent or guardian, except as provided in section 9 of this act.

NEW SECTION. Sec. 11. Every physician attending a pregnant woman in the state of Washington during gestation shall, in the case of each woman so attended, take or cause to be taken a sample of blood of such woman at the time of first examination, and submit such sample to an approved laboratory for a standard serological test for syphilis. If the pregnant woman first presents herself for examination after the fifth month of gestation the physician or other attendant shall in addition to the above, advise and urge the patient to secure a medical examination and blood test before the fifth month of any subsequent pregnancies.

NEW SECTION. Sec. 12. (1) The department or its authorized representatives may, at its discretion, enter any state, county, or municipal detention facility to interview, examine, and treat any prisoner for a sexually transmissible disease. Any such state, county, or municipal detention facility shall cooperate with the department or its authorized representatives to provide such space as is necessary for the examination and treatment of all prisoners suffering from or suspected of having a sexually transmissible disease.

(2) Nothing is this section shall be construed as relieving the department of corrections, counties, or municipalities of their primary responsibility for providing medical treatment for prisoners, including treatment for sexually transmissible diseases.

NEW SECTION. Sec. 13. The department may, within the level of funds authorized for this purpose, provide Zidovudine and other drugs to persons with AIDS who are not eligible for medicaid, the limited casualty program--medically indigent, or other federal, state, or private insurance programs which offer assistance in the payment for prescription drugs. To receive Zidovudine and other drugs under this section, the person must meet medical eligibility standards and not exceed financial eligibility standards set by the department.

NEW SECTION. Sec. 14. (1) Any person who violates section 3, 5, or 9 of this act is guilty of a gross misdemeanor.

(2) Any person who maliciously disseminates any false information or report concerning the existence of any sexually transmissible disease is guilty of a gross misdemeanor.

(3) Any person who violates the department's rules pertaining to sexually transmissible diseases may be punished by a fine of not less than one thousand dollars and not more than five thousand dollars for each violation. Any penalties enforced under this subsection shall be in addition to other penalties provided by this chapter.

NEW SECTION. Sec. 15. A new section is added to chapter 49.60 RCW to read as follows:

(1) Discriminatory practices otherwise prohibited under this chapter on the basis of race, color, creed, national origin, sex, marital status, age, or the presence of any sensory, mental, or physical handicap shall also be prohibited against individuals on the basis of actual or perceived HIV infection status.

(2) Subsection (1) of this section does not apply to RCW 49.60.030 (1)(e) or 49.60.178 if the discrimination is related solely to bona fide statistical differences in risk or exposure that have been actuarially substantiated.

Sec. 16. Section 4, chapter 257, Laws of 1986 and RCW 9A.36.011 are each amended to read as follows:

(1) A person is guilty of assault in the first degree if he or she, with intent to inflict great bodily harm:

(a) Assaults another with a firearm or any deadly weapon or by any force or means likely to produce great bodily harm or death; or

(b) Administers to or causes to be taken by another, poison or any other destructive or noxious substance; ((or))

(d) Transmits the AIDS virus to another.

(2) Assault in the first degree is a class A felony.

(3) "AIDS," as used in this section, is defined as provided in section 3 of this 1988 act.

NEW SECTION. Sec. 17. There is appropriated from the general fund to the department of social and health services for the biennium ending June 30, 1989, the sum of _______ dollars, or so much thereof as may be necessary, to establish a pilot project on the care of persons with AIDS. The pilot projects shall emphasize care outside of a hospital, such as hospice care, chore services, and in-home care.

NEW SECTION. Sec. 18. The legislature recognizes the critical need for developing central facilities for AIDS research and training. To this end, there is appropriated to the University of Washington from the general fund the sum of .......... dollars, or so much thereof as may be necessary, for the biennium ending June 30, 1989, to either construct or provide continued rental costs for a centralized clinical laboratory affiliated with the University of Washington. This facility shall develop:

(1) Outpatient and inpatient clinical research relating to AIDS, including training centers for health professionals in these areas. Clinical research shall pursue primary prevention of AIDS by behavioral intervention, chemotherapy, elimination of risk factors, and the development of an effective vaccine. The research shall also include a determination as to the most cost-effective means of health care delivery for AIDS patients. In addition, patients with AIDS shall be encouraged to enroll in experimental protocols in order to make promising new treatments available, contain costs, and maximize knowledge. Clinical training shall give primary care clinicians knowledge, skills, and experience needed to diagnose and manage the medical, dental, and psychological treatment of AIDS patients;

(2) A feasibility study with respect to establishing methadone treatment clinics in association with public health departments throughout the state. As part of the study, the laboratory shall consider the need for a needle exchange program, and consider changes to laws at the state and local levels which now categorize clean needles and syringes as drug paraphernalia and thus criminalize their possession or sale; and

(3) Health and safety guidelines for those laboratories conducting AIDS tests and research.

NEW SECTION. Sec. 19. There is appropriated from the general fund to the department of social and health services for the biennium ending June 30, 1989, the sum of .......... dollars, or so much thereof as may be necessary, to establish a comprehensive health education program in the common schools. This program shall introduce the concepts of infection, disease prevention, and healthy behavior in the early elementary grades. Basic knowledge of growth changes and human sexuality and understanding of the psychological and sociological aspects of human growth and development shall be increased as the student advances through the upper grade levels. Presentation of content shall reflect the appropriate level for students in each grade. "Age appropriate" content shall be reviewed by the office of the superintendent of public instruction to determine whether human sexuality is being taught early enough in a child's development.

NEW SECTION. Sec. 20. Sections 1 through 14 of this act are each added to chapter 70.24 RCW.

NEW SECTION. Sec. 21. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.

NEW SECTION. Sec. 22. The following acts or parts of acts are each repealed:

(1) Section 1, chapter 114, Laws of 1919 and RCW 70.24.010;

(2) Section 2, chapter 114, Laws of 1919, section 93, chapter 141, Laws of 1979 and RCW 70.24.020;

(3) Section 3, chapter 114, Laws of 1919 and RCW 70.24.030;

(4) Section 4, chapter 114, Laws of 1919 and RCW 70.24.040;

(5) Section 6, chapter 114, Laws of 1919 and RCW 70.24.050;

(6) Section 7, chapter 114, Laws of 1919, section 94, chapter 141, Laws of 1979 and RCW 70.24.060;

(7) Section 8, chapter 114, Laws of 1919 and RCW 70.24.070;

(8) Section 5, chapter 114, Laws of 1919 and RCW 70.24.080;

(9) Section 1, chapter 165, Laws of 1939 and RCW 70.24.090;

(10) Section 2, chapter 165, Laws of 1939, section 95, chapter 141, Laws of 1979 and RCW 70.24.100;

(11) Section 1, chapter 164, Laws of 1969 ex. sess. and RCW 70.24.110; and

(12) Section 1, chapter 59, Laws of 1977 and RCW 70.24.120.