SENATE BILL REPORT
E2SSB 6221
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.
Senate Committee on Health Care & Corrections
Senate Hearing Date(s):January 14, 1988; January 18, 1988; February 1, 1988
Majority Report: That Substitute Senate Bill No. 6221 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.
Signed by Senators Deccio, Chairman; Johnson, Vice Chairman; Kreidler, Niemi, Smith, West, Wojahn.
Senate Staff:Don Sloma (786-7414)
February 2, 1988
Senate Committee on Ways & Means
Senate Hearing Date(s):February 8, 1988
Majority Report: That Second Substitute Senate Bill No. 6221 be substituted therefor, and the second substitute bill do pass.
Signed by Senators McDonald, Chairman; Craswell, Vice Chairman; Bauer, Bluechel, Cantu, Deccio, Fleming, Gaspard, Hayner, Johnson, Lee, Moore, Newhouse, Saling, Smith, Talmadge, Vognild, Warnke, Williams, Wojahn, Zimmerman.
Senate Staff:Jan Sharar (786-7715)
March 2, 1988
House Committe on Health Care
AS PASSED SENATE, FEBRUARY 15, 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:
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. 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, health care providers and school district employees 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 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.
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 with handicaps caused by AIDS or any other STD 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.
The existing penalties (misdemeanor) for exposing another to an STD is removed from law. However, the legislation makes it a class A felony to knowingly transmit the AIDS virus to another with the intent to do bodily harm.
Any other violation of the STD statute (Chapter 70.24 RCW) as amended is a gross misdemeanor.
Parents must be given the results of any HIV testing performed on their infants.
The Legislative Budget Committee is directed to develop a plan to assess implementation of the act and to study health cost reimbursement as related to AIDS.
Appropriations to DSHS, the LBC and through DSHS to the state Board of Health and regional AIDS service networks are provided.
All other state agencies affected are directed to execute their responsibilities under the act within available staffing and appropriations.
Antiquated sections of the 1919 STD statute are repealed.
Appropriation: $300,000 general fund-state to DSHS; $50,000 general fund-state to DSHS for Board of Health; $25,000 general fund-state to LBC; $4,500,000 general fund-state to DSHS for regional AIDS service networks; $200,000 general fund-state to University of Washington
Revenue: none
Fiscal Note: available
Senate Committee - Testified: HEALTH CARE & CORRECTIONS: FOR: Joanne Coker, Citizen; Sonnia Bean, Citizen; J'Non Rishan, Task Force for Public Health; Roger Butz, Safeco Ins.; Robb Mennaul, Wa. St. Hosp. Assn.; Betty Thornton, Home Care Assn. of Wa.; Nancy Sigafoos; Fundraiser, Olympia AIDS Task Force; Ian MacGowan, Northwest AIDS Foundation; Kevin Hughes; Pat Thibaudeau, Wa. Women United and Wa. Community Mental Health Center; Joan Brewster, Tacoma-Pierce Co. Health Dept.; Jan Secor, Pierce Co. AIDS Foundation; Mike Vandiver, W.A.S.P.C. Chief; Mark Judy, Gen. Hosp., Everette, Hosp. Foundation; Betty Thornton, Home Care Assn. of Wa.; Gary Edwards, W.A.S.P.C. Chief; Mary Erlich, W.S. Nurses; Bob Edie, U of W; Al Allen, Tacoma-Pierce Co. Health Dept.; Bud Nicola, Seattle-King Co. Health Dept.; Bill Lofferty, DSHS; Jim Holm, Wa. Privacy Lobby; Robert Ruhan, Northwest AIDS Foundation; Bea Kelleigh, Northwest AIDS Foundation; Jim Newton, Clallam Co. Sheriff's Dept.; Ed Gray, State Board of Health; Shirley Brundage, Bill of Rights; Cris Shardelman, Citizens for Sensible Legislation; Beverly Jacobsen, Statewide Steering Comm. on Adolescent Pregnancy Prevention; Jim Rabie, Wa. St. Law Enforcement Assoc.; Grady Moore, WFSE.
AGAINST: Sam Jacobs, ACLU; Jerry Sheehan, ACLU
Senate Committee - Testified: WAYS & MEANS: FOR: Bob Edie, University of Washington; Dwayne Slate, Washington State School Directors Association; Jackie McFadden, Washington State Association of Counties; J'Non Rishan, Task Force For Public Health
HOUSE AMENDMENTS:
Education materials used in common schools must emphasize avoiding substance abuse as well as practicing sexual abstinence outside lawful marriage as ways of controlling disease.
School districts may file and use locally developed curricula, pending state approval, if they believe the curricula is medically accurate.
Authorization to use HIV testing to verify insurance claims is limited to the state industrial insurance program.
Mandatory testing for those convicted of drug offenses is limited to those convicted of crimes involving hypodermic needles.
School employees are removed from the category of persons who can request HIV tests of persons to whose bodily fluids they have been exposed.
Due process protections are added for those ordered to be tested because their bodily fluids have been substantially exposed to others.
Voluntary counseling and testing is required for all persons arrested for prostitution and drug offenses.
Local public health officers must approve HIV testing of jail inmates using the same standards set forth for ordering such tests among the general public.
State Department of Corrections (DOC) HIV testing will be regulated by DOC with definitions of "possible risk" posed by behavior of inmates, to be developed in consultation with the State Board of Health. DOC administrators making these determinations must receive AIDS training.
Funds appropriated for regional AIDS service networks must be directed through lead counties, unless federally prohibited.
The funding formula for regional AIDS services networks is reworded technically, and is set to terminate in 1991. Funding may be used for case management services.
Materials authorized by regional AIDS services networks in the prevention or control of HIV infection shall not be considered drug paraphernalia.
The AIDS advisory committee is required to study related insurance issues and is set to terminate in 1991.
Chapter 49.60 RCW (the Human Rights Commission) is amended to include "actual or perceived HIV status" as a handicapping condition. The chapter bans discrimination on the basis of handicapping conditions.
The Human Rights Commission, in consultation with the State Board of Health, is to define "risk of transmission in the course of work" (relating to employment).
In notifying sexual partners of infected persons that they have been exposed to STDs, all efforts must be made to avoid disclosing the identity of the person who made the exposure.
Anonymous reporting of HIV test results is required of all laboratories.
Persons detained under the act may seek a five-day continuance of the hearing to review their detention, or a ten-day continuance where more than a 14-day detention has been requested. In such cases, the person requesting the continuance may be subject either to continued detention, or to a court order refraining them from specific behavior.
Minimum claims for civil action by persons aggrieved by a violation of this chapter are established.
Administering, exposing, or infecting a person with HIV with intent to do bodily harm is designated a Class B felony.
It is unlawful (a misdemeanor) for any person with an STD, other than HIV, who knows they are infected to have sexual intercourse with any other person, unless that person has been informed.
DSHS employees are immune from civil action for damages out of good faith performance of their duties under the act.
Studies and study plans to assess the impact of the act and to determine the costs of treating persons with AIDS and operating regional AIDS service networks are all deleted.
The requirement that parents be informed of the results of all HIV tests performed on their newborn infants is deleted.
All sections appropriating funds are deleted.
The requirement that the Higher Education Coordinating Board, the State Board for Community College Education, the Office of Superintendent of Public Instruction, and all other state and local entities use present resources to carry out their responsibilities under the act is deleted.