AN ACT Relating to sexually transmissible diseases; amending RCW 43.150.050, 28A.05.010, 70.24.050, 70.24.070, 70.24.080, 70.24.110, and 70.24.120; adding a new section to chapter 28A.05 RCW; adding a new section to chapter 28B.10 RCW; adding a new section to chapter 28B.50 RCW; adding a new section to chapter 28C.04 RCW; adding new sections to chapter 49.60 RCW; adding new sections to chapter 70.24 RCW; creating new sections; repealing RCW 70.24.010, 70.24.020, 70.24.030, 70.24.040, and 70.24.060; prescribing penalties; providing an effective date; and declaring an emergency.

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

PART I

DEFINITIONS

NEW SECTION. Sec. 101. A new section is added to chapter 70.24 RCW to read as follows:

Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter:

(1) "Acquired immunodeficiency syndrome" or "AIDS" means the clinical syndrome of HIV-related illness as defined by the board of health by rule.

(2) "Board" means the state board of health.

(3) "Health care provider" means any person who is a member of a profession under RCW 18.130.040 or other person providing medical, nursing, psychological, or other health care services regulated by the department of licensing or the department of social and health services.

(4) "Health care facility" means a hospital, nursing home, neuropsychiatric or mental health facility, home health agencies, hospices, child care agency, adult family home, group care facility, family foster home, clinic, blood bank, blood center, sperm bank, laboratory, or other social service or health care institution regulated or operated by the department of social and health services.

(5) "HIV-related conditions" means any medical condition resulting from infection with HIV including, but not limited to, seropositivity for HIV.

(6) "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.

(7) "Test for a sexually transmitted disease" means a test approved by the board in rule.

(8) "Legal guardian" means a person appointed by a court to assume legal authority for another who has been found incompetent or, in the case of a minor, a person who has legal custody of the child.

(9) "Local health officer" means the officer directing the county health department or his or her designee.

(10) "Person" includes any natural person, partnership, association, joint venture, trust, public or private corporation, or health facility.

(11) "Release of test results" means a written authorization for disclosure of any sexually transmitted disease test result which is signed, dated, and which specifies to whom disclosure is authorized and the time period during which the release is to be effective. (12) "Sexually transmitted disease" means a bacterial, viral, fungal, or parasitic disease, determined by the board in rule to be sexually transmitted, 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. The board shall designate chancroid, gonorrhea, granuloma inguinale, lymphogranuloma venereum, genital herpes simplex, chlamydia, nongonnoccal urethritis (NGU), genital human papilloma virus infection, syphillis, acquired immunodeficiency syndrome (AIDS), and human immunodeficiency virus (HIV) infection as sexually transmitted diseases, and shall consider the recommendations and classifications of the centers for disease control and other nationally recognized medical authorities in designating other diseases as sexually transmitted. (13) "State health officer" means the secretary of social and health services or an officer appointed by the secretary.

PART II

SEXUAL ABSTINENCE AND AVOIDANCE OF SUBSTANCE ABUSE

NEW SECTION. Sec. 201. A new section is added to chapter 70.24 RCW to read as follows:

Information directed to the general public, especially the common schools, and providing education regarding any sexually transmitted disease that is written, published, distributed, or used by any public entity, and all such information paid for, in whole or in part, with any public moneys shall give emphasis to the importance of sexual abstinence and avoidance of substance abuse in controlling disease.

PART III

CENTER FOR VOLUNTARY ACTION

Sec. 301. Section 5, chapter 11, Laws of 1982 1st ex. sess. and RCW 43.150.050 are each amended to read as follows:

The center, working in cooperation with individuals, local groups, and organizations throughout the state, may undertake any program or activity for which funds are available which furthers the goals of this chapter. These programs and activities may include, but are not limited to:

(1) Providing information about programs, activities, and resources of value to volunteers and to organizations operating or planning volunteer programs;

(2) Sponsoring recognition events for outstanding individuals and organizations;

(3) Facilitating the involvement of business, industry, government, and labor in community service and betterment;

(4) Organizing, or assisting in the organization of, training workshops and conferences;

(5) Publishing schedules of significant events, lists of published materials, accounts of successful programs and programming techniques, and other information concerning the field of volunteerism, and distributing this information broadly;

(6) Reviewing the laws and rules of the state of Washington, and proposed changes therein, to determine their impact on the success of volunteer activities and programs, and recommending such changes as seem appropriate to ensure the achievement of the goals of this chapter;

(7) Providing information about and assistance to agencies and individuals who are working to prevent the spread of the human immunodeficiency virus, as defined in chapter 70.24 RCW, and to agencies and individuals who are working to provide health and social services to persons with acquired immunodeficiency syndrome, as defined in chapter 70.24 RCW.

PART IV

AIDS EDUCATION IN THE COMMON SCHOOLS

NEW SECTION. Sec. 401. The legislature finds that the public schools provide a unique and appropriate setting for educating young people about the pathology and prevention of acquired immunodeficiency syndrome (AIDS). The legislature recognizes that schools and communities vary throughout the state and that locally elected school directors should have a significant role in establishing a program of AIDS education in their districts.

NEW SECTION. Sec. 402. A new section is added to chapter 28A.05 RCW to read as follows:

(1) The life-threatening dangers of acquired immunodeficiency syndrome (AIDS) and its prevention shall be taught in the public schools of this state. AIDS prevention education shall be limited to the discussion of the life-threatening dangers of the disease, its spread, and prevention. Students shall receive such education at least once annually beginning at least with the fifth grade.

(2) Each district board of directors shall adopt an AIDS prevention education program which is developed in consultation with teachers, administrators, parents, and other community members including, but not limited to, persons from medical, public health, and mental health organizations and agencies so long as the curriculum and materials developed for use in the AIDS education program is approved for medical accuracy by the office on AIDS established in section 702 of this act within the department of social and health services.

(3) Model curriculum and other resources available from the superintendent of public instruction through the state clearinghouse for educational information may be reviewed by the school district board of directors, in addition to materials designed locally, in developing the district's AIDS education program.

(4) Each school district shall, at least one month before teaching AIDS prevention education in any classroom, conduct at least one presentation during weekend and evening hours for the parents and guardians of students concerning the curriculum and materials that will be used for such education. The parents and guardians shall be notified by the school district of the presentation and that the curriculum and materials are available for inspection. No student may be required to participate in AIDS prevention education if the student's parent or guardian, having attended one of the district presentations, objects in writing to the participation.

(5) The office of the superintendent of public instruction with the assistance of the department of social and health services shall update AIDS education curriculum material as newly discovered medical facts make it necessary.

(6) The curriculum for AIDS prevention education shall be designed to teach students which behaviors place a person dangerously at risk of infection with the human immunodeficiency virus (HIV) and methods to avoid such risk including, at least:

(a) The dangers of drug abuse, especially that involving the use of hypodermic needles; and

(b) The dangers of sexual intercourse, with or without condoms.

(7) The program of AIDS prevention education shall stress the life-threatening dangers of contracting AIDS and shall stress that abstinence from sexual activity is the only certain means for the prevention of the spread or contraction of the AIDS virus through sexual contact. It shall also teach that condoms and other artificial means of birth control are not a certain means of preventing the spread of the AIDS virus and reliance on condoms puts a person at risk for exposure to the disease.

Sec. 403. Section 28A.05.010, chapter 223, Laws of 1969 ex. sess. as last amended by section 1, chapter 232, Laws of 1987 and RCW 28A.05.010 are each amended to read as follows:

All common schools shall give instruction in reading, penmanship, orthography, written and mental arithmetic, geography, the history of the United States, English grammar, physiology and hygiene with special reference to the effects of alcoholic stimulants and narcotics on the human system, science with special reference to the environment, and such other studies as may be prescribed by rule or regulation of the state board of education. All teachers shall stress the importance of the cultivation of manners, the fundamental principles of honesty, honor, industry and economy, the minimum requisites for good health including the beneficial effect of physical exercise and methods to prevent infection with human immunodeficiency virus, and the worth of kindness to all living creatures and the land. The prevention of child abuse may be offered as part of the curriculum in the common schools.

NEW SECTION. Sec. 404. Sections 402 and 403 of this act shall take effect July 1, 1988.

PART V

AIDS EDUCATION IN COLLEGES, UNIVERSITIES, AND VOCATIONAL SCHOOLS

NEW SECTION. Sec. 501. A new section is added to chapter 28B.10 RCW to read as follows:

The governing board of each state four-year institution of higher education shall provide education to all newly matriculated students on methods of transmission of the human immunodeficiency virus and prevention of acquired immunodeficiency syndrome. The curricula and materials shall be reviewed for medical accuracy by the department of social and health services.

NEW SECTION. Sec. 502. A new section is added to chapter 28B.50 RCW to read as follows:

The state board for community college education shall provide education to all newly matriculated students on methods of transmission of the human immunodeficiency virus and prevention of acquired immunodeficiency syndrome. The curricula and materials shall be reviewed for medical accuracy by the department of social and health services.

NEW SECTION. Sec. 503. A new section is added to chapter 28C.04 RCW to read as follows:

Each publicly operated vocational school shall provide education to all newly matriculated students on methods of transmission of the human immunodeficiency virus and prevention of acquired immunodeficiency syndrome. The curricula and materials shall be reviewed for medical accuracy by the department of social and health services.

PART VI

AIDS TRAINING FOR EMPLOYEES

NEW SECTION. Sec. 601. The number of acquired immunodeficiency syndrome (AIDS) cases in the state may reach five thousand by 1991. This makes it necessary to provide our state's workforce with the resources and knowledge to deal with the epidemic. To ensure that accurate information is available to the state's work force, a clearinghouse for all technically correct educational materials related to AIDS should be created.

NEW SECTION. Sec. 602. There is established in the department of social and health services an office on AIDS, which shall be administratively placed within the public health subentity of the department. This office shall be the repository and clearinghouse for all education and training material related to the treatment, transmission, and prevention of AIDS. The office on AIDS shall have the responsibility for coordinating all publicly funded education and service activities related to AIDS. The University of Washington shall provide the office on AIDS with appropriate training and educational materials necessary to carry out its duties. The office on AIDS shall assist state agencies with information necessary to carry out the purposes of this chapter. The department shall work with state and county agencies and specific employee and professional groups to provide information appropriate to their needs, and shall make educational materials available to private employers and encourage them to distribute this information to their employees.

NEW SECTION. Sec. 603. The department of social and health services shall adopt rules that recommend appropriate education and training for licensed and certified emergency medical personnel under chapter 18.73 RCW on the prevention, transmission, and treatment of AIDS. The department shall require appropriate education or training as a condition of license issuance or renewal.

NEW SECTION. Sec. 604. Each disciplining authority under chapter 18.130 RCW shall adopt rules that require appropriate education and training for licensees on the prevention, transmission, and treatment of AIDS. The disciplining authorities shall work with the office on AIDS under section 602 of this act to develop the training and educational material necessary for health professionals.

NEW SECTION. Sec. 605. The state board of pharmacy shall adopt rules that require appropriate education and training for licensees on the prevention, transmission, and treatment of AIDS. The board shall work with the office on AIDS under section 602 of this act to develop the training and educational material necessary for health professionals.

NEW SECTION. Sec. 606. The superintendent of public instruction shall adopt rules that require appropriate education and training for public school employees on the prevention, transmission, and treatment of AIDS. The superintendent of public instruction shall work with the office on AIDS under section 602 of this act to develop the educational and training material necessary for school employees.

NEW SECTION. Sec. 607. The state personnel board, the higher education personnel board, and each unit of local government shall determine whether any employees under their jurisdiction have a substantial likelihood of exposure in the course of their employment to the human immunodeficiency virus. If so, the agency or unit of government shall adopt rules requiring for appropriate training and education for the employees on the prevention, transmission, and treatment of AIDS. The rules shall specifically provide for such training and education for law enforcement, correctional, and health care workers. The state personnel board, the higher education personnel board, and each unit of local government shall work with the office on AIDS under section 602 of this act to develop the educational and training material necessary for employees.

NEW SECTION. Sec. 608. The department of social and health services shall adopt rules requiring appropriate education and training of employees of state licensed or certified health care facilities. The education and training shall be on the prevention, transmission, and treatment of AIDS and shall not be required for employees who are covered by comparable rules adopted under other sections of this chapter.

NEW SECTION. Sec. 609. Sections 602 through 608 of this act are each added to chapter 70.24 RCW.

PART VII

COUNSELING AND TESTING

NEW SECTION. Sec. 701. Unless the context clearly requires otherwise, the definitions in this section apply throughout this chapter.

(1) "Pretest counseling" means counseling aimed at helping the individual understand ways to reduce the risk of HIV infection, the nature and purpose of the tests, the significance of the results, and the potential dangers of the disease, and to assess the individual's ability to cope with the results.

(2) "Posttest counseling" means further counseling following testing usually directed toward increasing the individual's understanding of the human immunodeficiency virus infection, changing the individual's behavior, and, if necessary, encouraging the individual to notify persons with whom there has been contact capable of spreading HIV.

(3) "AIDS counseling" means counseling directed toward increasing the individual's understanding of acquired immunodeficiency syndrome and changing the individual's behavior.

(4) "HIV testing" means a test indicative of infection with the human immunodeficiency virus as specified by the board of health by rule.

NEW SECTION. Sec. 702. No person may undergo HIV testing without the person's consent except:

(1) Pursuant to RCW 7.70.065 for incompetent persons;

(2) In seroprevalence studies where neither the persons whose blood is being tested know the test results nor the persons conducting the tests know who is undergoing testing; or

(3) As otherwise expressly authorized by this chapter.

NEW SECTION. Sec. 703. (1) Local health departments authorized under this chapter shall conduct or cause to be conducted pretest counseling, HIV testing, and posttest counseling of all persons:

(a) Convicted of a sexual offense under chapter 9A.44 RCW;

(b) Convicted of prostitution offenses under chapter 9A.88 RCW; or

(c) Convicted of drug offenses under RCW 69.50.401: PROVIDED, That the court determines at the time of conviction that the related drug offense is one associated with the use of the hypodermic needles.

(2) Such testing shall be conducted as soon as possible after conviction and shall be so ordered by the judge.

(3) This section applies only to offenses committed after the effective date of this section.

NEW SECTION. Sec. 704. Local health departments, in cooperation with the regional AIDS services networks, shall make available voluntary testing and counseling services to all persons arrested for prostitution offenses under chapter 9A.88 RCW and drug offenses under chapter 69.50 RCW. Services shall include educational materials that outline the seriousness of AIDS and encourage voluntary participation.

NEW SECTION. Sec. 705. (1) Every health care practitioner attending: (a) A pregnant woman, if appropriate; and (b) a person seeking treatment of a sexually transmitted disease, shall insure that AIDS counseling of the patient is conducted.

(2) AIDS counseling shall be provided to each person in a drug treatment program under chapter 69.54 RCW.

NEW SECTION. Sec. 706. Jail administrators, with the approval of the local health officer, may order pretest counseling, HIV testing, and posttest counseling for persons detained in the jail if the local health officer determines that actual or threatened behavior presents a possible risk to the staff, general public, or other persons. Approval of the local health officer shall be based on the provisions of section 911(3) of this act. The administrator shall establish, pursuant to RCW 70.48.071, a procedure to document the possible risk which is the basis for the HIV testing. Documentation of the behavior, or threat thereof, shall be reviewed with the person to try to assure that the person understands the basis for testing.

NEW SECTION. Sec. 707. (1) Department of corrections facility administrators may order pretest counseling, HIV testing, and posttest counseling for inmates if the state health officer determines that actual or threatened behavior presents a possible risk to the staff, general public, or other inmates. Approval of the state health officer shall be based on the provisions of section 911(3) of this act. The department of corrections shall establish a procedure to document the possible risk which is the basis for the HIV testing. Documentation of the behavior, or threat thereof, shall be reviewed with the inmate.

(2) Chapter 34.04 RCW does not apply to the procedure developed by the department of corrections pursuant to this section. This section shall not be construed as requiring any hearing process except as may be required under existing federal constitutional law.

(3) Section 703 of this act does not apply to the department of corrections or to inmates in its custody or subject to its jurisdiction.

NEW SECTION. Sec. 708. The board of health shall adopt rules establishing minimum standards for pretest counseling, HIV testing, posttest counseling, and AIDS counseling. In adopting rules under this section, the board shall use infection control and education available from appropriate agencies.

NEW SECTION. Sec. 709. Sections 701 through 708 of this act are each added to chapter 70.24 RCW.

PART VIII

REGIONAL AIDS SERVICE NETWORKS

NEW SECTION. Sec. 801. A new section is added to chapter 70.24 RCW to read as follows:

The department of social and health services shall establish a state-wide system of regional acquired immunodeficiency syndrome (AIDS) service networks as follows:

(1) The secretary of social and health services shall direct that all state or federal funds, including those from federal Title XIX for services or other activities authorized in this chapter, shall be allocated to the office on AIDS established in section 602 of this act. The secretary shall further direct that all funds for services and activities specified in subsection (3) of this section shall, without exception, be provided to lead counties through contractual agreements based on plans developed as provided in subsection (2) of this section. The department of social and health services shall deny funding allocations to lead counties only if the denial is based upon documented incidents of nonfeasance, misfeasance, or malfeasance. However, the department shall give written notice and thirty days for corrective action in incidents of misfeasance or nonfeasance before funding may be denied. The department shall designate six AIDS service network regions encompassing the state. In doing so, the department shall use the boundaries of the regional structures in place for the community services administration on January 1, 1988.

(2) The department shall request that a lead county within each region, which shall be the county with the largest population, prepare, through a cooperative effort of local health departments within the region, a regional organizational and service plan which meets the requirements set forth in subsection (3) of this section. Efforts should be made to use existing plans, where appropriate. The plan should place emphasis on contracting with existing hospitals, major voluntary organizations, or health care organizations within a region that have in the past provided quality services similar to those mentioned in subsection (3) of this section and that have demonstrated an interest in providing any of the components listed in subsection (3) of this section. If any of the counties within a region do not participate, it shall be the lead county's responsibility to develop the part of the plan for the nonparticipating county or counties. If all of the counties within a region do not participate, the department shall assume the responsibility.

(3) The regional AIDS service network plan shall include the following components:

(a) A designated single administrative or coordinating agency;

(b) A complement of services to include:

(i) Voluntary and anonymous counseling and testing;

(ii) Mandatory testing and/or counseling services for certain individuals, as required by law;

(iii) Notification of sexual partners of infected persons, as required by law;

(iv) Education for the general public, health professionals, and high-risk groups;

(v) Intervention strategies to reduce the infection of the human immunodeficiency virus among high-risk groups, possibly including needle sterilization and methadone maintenance;

(vi) Related community outreach services for runaway youth;

(vii) The provision of related health and social services;

(viii) Strategies for the development of volunteer networks;

(ix) Strategies for the coordination of related agencies within the network; and

(x) Other necessary information, including needs particular to the region;

(i) Case management services; and

(ii) A community-based continuum-of-care model encompassing both medical, mental health, and social services with the goal of maintaining persons with AIDS in a home-like setting, to the extent possible, in the least-expensive manner; and

(d) Budget, caseload, and staffing projections.

(4) Efforts shall be made by both the counties and the department to use existing service delivery systems, where possible, in developing the networks.

(5) The University of Washington health science programs, in cooperation with the department, shall establish a center for AIDS treatment and education, which shall be linked to the networks. The center for AIDS treatment and education is not intended to engage in state-funded research related to HIV infection, AIDS, or HIV-related conditions. Its duties shall include providing the office on AIDS, established by section 602 of this act, with the appropriate educational materials necessary to carry out that office's duties.

(6) The department shall implement this section, consistent with available funds by July 1, 1989, by establishing three regional AIDS service networks and by establishing the AIDS center for treatment and education. At least one of the regional service networks shall include a class AA county and at least one shall be in the eastern region of the state. By July 1, 1991, the department shall establish at least three, but no more than five, additional regional service networks.

(7) The regional AIDS services networks shall be the official state regional agencies for AIDS information education and coordination of services. The state health officer, as designated by the secretary of social and health services, shall make adequate efforts to publicize the existence and functions of the networks.

(8) If the department is not able to establish a network by an agreement solely with counties, it may contract with nonprofit agencies for any or all of the designated network responsibilities.

(9) The department, in establishing the networks, shall study mechanisms that could lead to reduced costs and/or increased access to services. The methods shall include capitation.

(10) The department shall reflect in its departmental biennial budget request the funds necessary to implement this section.

(11) The department shall submit an implementation plan to the appropriate committees of the legislature by December 15, 1988.

NEW SECTION. Sec. 802. The department of social and health services shall study the need for community residential care for persons with AIDS, including facility size, staffing, and related community health and social services, and report its finding to the appropriate committees of the legislature by December 15, 1988.

NEW SECTION. Sec. 803. A new section is added to chapter 70.24 RCW to read as follows:

To assist the secretary of social and health services in the development and implementation of AIDS programs, the governor shall appoint an AIDS advisory committee.

PART IX

CONTROL OF SEXUALLY TRANSMITTED DISEASES

NEW SECTION. Sec. 901. The legislature declares that sexually transmitted diseases constitute a serious and sometimes fatal threat to the public and individual health and welfare of the people of the state. The legislature finds that the incidence of sexually transmitted 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 further finds that sexually transmitted 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 also finds that medical knowledge and information about sexually transmitted diseases are rapidly changing. It is therefore the intent of the legislature to provide a program that is sufficiently flexible to meet emerging needs, deals efficiently and effectively with reducing the incidence of sexually transmitted diseases, and provides patients with a secure knowledge that information they provide will remain private and confidential.

NEW SECTION. Sec. 902. A new section is added to chapter 49.60 RCW to read as follows:

(1) Sensory, mental, or physical handicap shall include actual or perceived HIV infection status of an individual.

(2) Subsection (1) of this section shall not apply to transactions with insurance entities, health service contractors, or health maintenance organizations subject to RCW 49.60.030 (1)(e) or 49.60.178 to prohibit fair discrimination on the basis of actual HIV infection status when bona fide statistical differences in risk or exposure have been substantiated.

(3) For the purposes of this chapter, "HIV" means the human immunodeficiency virus, and includes all HIV and HIV-related viruses which damage the cellular branch of the human immune system and leave the infected person immunodeficient.

NEW SECTION. Sec. 903. A new section is added to chapter 49.60 RCW to read as follows:

(1) No person may require an individual to take an HIV test, as defined in chapter 70.24 RCW, as a condition of hiring, promotion, or continued employment unless the absence of HIV infection is a bona fide occupational qualification for the job in question.

(2) No person may discharge or fail or refuse to hire any individual, or segregate or classify any individual in any way which would deprive or tend to deprive that individual of employment opportunities or adversely affect his or her status as an employee, or otherwise discriminate against any individual with respect to compensation, terms, conditions, or privileges of employment on the basis of the results of an HIV test unless the absence of HIV infection is a bona fide occupational qualification of the job in question.

(3) A person who asserts that a bona fide occupational qualification exists for HIV testing shall have the burden of proving that:

(a) The HIV test is necessary to ascertain whether an employee is currently able to perform in a reasonable manner the duties of the particular job or whether an employee will present a significant risk of transmitting HIV infection to other persons in the course of work activities; and

(b) There exists no means of reasonable accommodation short of requiring the test.

NEW SECTION. Sec. 904. A new section is added to chapter 70.24 RCW to read as follows:

(1) No person may disclose or be compelled to disclose the identity of any person who has investigated, considered, or requested a test or treatment for a sexually transmitted disease.

(2) No person may disclose or be compelled to disclose the identity of any person upon whom a test for a sexually transmitted disease is performed, or the results of such a test or any information relating to diagnosis of or treatment for a sexually transmitted disease in a manner which permits identification of the subject of the test, diagnosis, or treatment except to the following persons:

(a) The subject of the test or the subject's legal representative for health care decisions in accordance with RCW 7.70.065, with the exception of the legal representative of a minor child over fourteen years of age and otherwise competent;

(b) Any person who secures a specific release of test results executed by the subject of the test or the subject's legal representative for health care decisions in accordance with RCW 7.70.065, with the exception of the legal representative of a minor child over fourteen years of age and otherwise competent;

(c) The state health officer, a local health officer, or the centers for disease control of the United States public health service in accordance with reporting requirements for a diagnosed case of sexually transmitted disease;

(d) A health facility or health care provider that procures, processes, distributes, or uses: (i) A human body part, tissue, or blood from a deceased person with respect to medical information regarding that person; or (ii) semen, including that provided prior to the effective date of this section, for the purpose of artificial insemination;

(e) Any state or local health officer conducting an investigation pursuant to section 911 of this act, provided that such record was obtained by means of court ordered HIV testing pursuant to section 703 or 911 of this act;

(f) A person allowed access to the record by a court order granted after application showing good cause therefor. In assessing good cause, the court shall weigh the public interest and the need for disclosure against the injury to the patient, to the physician-patient relationship, and to the treatment services. Upon the granting of the order, the court, in determining the extent to which any disclosure of all or any part of the record of any such test is necessary, shall impose appropriate safeguards against unauthorized disclosure. An order authorizing disclosure shall: (i) Limit disclosure to those parts of the patient's record deemed essential to fulfill the objective for which the order was granted; (ii) limit disclosure to those persons whose need for information is the basis for the order; and (iii) include any other appropriate measures to keep disclosure to a minimum for the protection of the patient, the physician-patient relationship, and the treatment services, including but not limited to the written statement set forth in subsection (4) of this section;

(g) Officials and employees of the department of corrections as authorized by this chapter;

(h) Persons who, because of their behavioral interaction with the infected individual, have been placed at risk for acquisition of a sexually transmitted disease as provided in section 906 of this act: PROVIDED, That the exposed person is believed to be unaware that a risk of disease exposure existed: PROVIDED, FURTHER, That all available means to inform the exposed individual short of disclosure of the identity of the infected person have been exhausted; and

(i) A law enforcement officer, fire fighter, health care provider, or health care facility staff person who has requested a test of a person whose bodily fluids he or she has been exposed to, pursuant to section 703 of this act, if a state or local health officer performs the test.

(3) No person to whom the results of a test for a sexually transmitted disease have been disclosed pursuant to subsection (2) of this section may disclose the test results to another person except as authorized by that subsection.

(4) Whenever disclosure is made pursuant to this section, it shall be accompanied by a statement in writing which includes the following or substantially similar language: "This information has been disclosed to you from records whose confidentiality is protected by state law. State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by state law. A general authorization for the release of medical or other information is NOT sufficient for this purpose." An oral disclosure shall be accompanied or followed by such a notice within ten days.

NEW SECTION. Sec. 905. A new section is added to chapter 70.24 RCW to read as follows:

The board shall establish reporting requirements for sexually transmitted diseases in rule. Reporting under this section may be required for such sexually transmitted diseases included under this chapter as the board finds appropriate.

NEW SECTION. Sec. 906. A new section is added to chapter 70.24 RCW to read as follows:

(1) The board shall adopt rules authorizing interviews and the board and local health officers and their authorized representatives may interview, or cause to be interviewed, all persons infected with a sexually transmitted disease and all persons who, in accordance with standards adopted by the board in rule, are reasonably believed to be infected with such diseases for the purpose of investigating the source and spread of the diseases and for the purpose of ordering a person to submit to examination, counseling, or treatment as necessary for the protection of the public health and safety, subject to section 911 of this act.

(2) State and local health officers shall investigate identified partners of persons infected with sexually transmitted diseases in accordance with procedures prescribed by the board.

(3) All information gathered in the course of contact investigation pursuant to this section shall be considered confidential.

(4) No person contacted under this section or reasonably believed to be infected with a sexually transmitted disease 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 with a knowing or reckless disregard for the truth.

(5) Any person who knowingly or maliciously disseminates any false information or report concerning the existence of any sexually transmitted disease under this section is guilty of a gross misdemeanor punishable as provided under RCW 9A.20.021.

(6) Any information obtained by the superintendent or administrator, or such person's designee, in conducting an investigation under this section, may be used as necessary for disease prevention or control, for protection of the safety and security of the staff, other inmates, or the general public, or for the orderly operation of the institution, notwithstanding subsection (3) of this section.

NEW SECTION. Sec. 907. A new section is added to chapter 70.24 RCW to read as follows:

(1) Notwithstanding any other provision of this chapter, information regarding an offender's sexually transmitted disease status shall be made available by health care providers to a department of corrections superintendent or administrator as necessary for disease prevention or control and for protection of the safety and security of the staff, offenders, and the public. The information may be submitted to transporting officers and receiving facilities, including facilities that are not under the department of correction's jurisdiction.

(2) Information regarding an offender's sexually transmitted disease status is confidential and may be disclosed by the superintendent or administrator only as necessary for disease prevention or control and for protection of the safety and security of the staff, offenders, and the public. Unauthorized disclosure of this information to any person may result in disciplinary action, in addition to any other penalties as may be prescribed by law.

Sec. 908. Section 6, chapter 114, Laws of 1919 and RCW 70.24.050 are each amended to read as follows:

Diagnosis of a sexually transmitted disease in every instance must be confirmed by laboratory tests or examinations in a laboratory approved or conducted in accordance with procedures and such other requirements as may be established by the ((~~state~~)) board ((~~of health, before any person shall be isolated or committed to quarantine and before any person committed to quarantine shall be discharged therefrom~~)). Laboratories testing for HIV shall report anonymous HIV prevalence results to the department for health statistics purposes in a manner established by the board.

NEW SECTION. Sec. 909. A new section is added to chapter 70.24 RCW to read as follows:

(1) Information regarding the sexually transmitted disease status of a person detained in a jail may be made available by health care providers to the jail administrator as necessary for disease prevention or control and for protection of the safety and security of the staff, offenders, and the public. The information may be submitted to transporting officers and receiving facilities.

(2) Information regarding a person's sexually transmitted disease status is confidential and may be disclosed to jail staff by the jail administrator only as necessary for disease prevention or control and for protection of the safety and security of the staff, offenders, and the public. Unauthorized disclosure of this information to any person may result in disciplinary action, in addition to any other penalties as may be prescribed by law.

Sec. 910. Section 8, chapter 114, Laws of 1919 and RCW 70.24.070 are each amended to read as follows:

For the purpose of carrying out ((~~the provisions of~~)) this ((~~act~~)) chapter, the ((~~state~~)) board ((~~of health~~)) shall have the power and authority((, from time to time, to divide the state into such number of quarantine districts consisting of one or more counties or parts of counties or municipalities as it shall deem expedient, and to establish at such place or places as it shall deem necessary quarantine stations and clinics)) to designate facilities for the detention and treatment of persons found to be infected with a sexually transmitted disease and to ((~~establish~~)) designate any such ((~~quarantine station and clinic in connection with any county or city jail, or~~)) facility in any hospital or other public or private institution, other than a jail or correctional facility, having, or which may be provided with, such necessary detention, segregation, isolation, clinic and hospital facilities as may be required and prescribed by the board, and to enter into arrangements for the conduct of such ((~~quarantine stations and clinics~~)) facilities with the public officials or persons, associations, or corporations in charge of or maintaining and operating such institutions.

NEW SECTION. Sec. 911. A new section is added to chapter 70.24 RCW to read as follows:

(1) Subject to the provisions of this chapter, the state and local health officers or their authorized representatives may examine and counsel or cause to be examined and counseled persons reasonably believed to be infected with or to have been exposed to a sexually transmitted disease.

(2) Orders or restrictive measures directed to persons with a sexually transmitted disease shall be used as the last resort when other measures to protect the public health have failed, including all reasonable efforts, which shall be documented, to obtain the voluntary cooperation of the person who may be subject to such an order. The orders and measures shall be applied serially with the least intrusive measures used first. The burden of proof shall be on the state or local health officer to show that specified grounds exist for the issuance of the orders or restrictive measures and that the terms and conditions imposed are no more restrictive than necessary to protect the public health.

(3) When the state or local health officer within his or her respective jurisdiction knows or has reason to believe, because of direct medical knowledge or reliable testimony of others in a position to have direct knowledge of a person's behavior, that a person has a sexually transmitted disease and is engaging in specified conduct, as determined by the board by rule based upon generally accepted standards of medical and public health science, that endangers the public health, he or she shall conduct an investigation in accordance with procedures prescribed by the board to evaluate the specific facts alleged, if any, and the reliability and credibility of the person or persons providing such information and, if satisfied that the allegations are true, he or she may issue an order according to the following priority to:

(a) Order a person to submit to a medical examination or testing, seek counseling, or obtain medical treatment for curable diseases, or any combination of these, within a period of time determined by the health officer, not to exceed fourteen days.

(b) Direct a person to cease and desist from specified conduct which endangers the health of others by imposing such restrictions upon the person as are necessary to prevent the specified conduct that endangers the health of others only if the health officer has determined that clear and convincing evidence exists to believe that such person has been ordered to report for counseling as provided in (a) of this subsection and continues to demonstrate behavior which endangers the health of others. Any restriction shall be in writing, setting forth the name of the person to be restricted and the initial period of time, not to exceed three months, during which the order shall remain effective, the terms of the restrictions, and such other conditions as may be necessary to protect the public health. Restrictions shall be imposed in the least-restrictive manner necessary to protect the public health.

(4) A law enforcement officer, fire fighter, health care provider, or health care facility staff person exposed to another person's bodily fluids in the course of his or her employment may request that a state or local health officer order pretest counseling, HIV testing, and posttest counseling for the person whose bodily fluids he or she has been exposed to. If the health officer determines such request falls within the provisions of subsection (3) of this section, the health officer shall order the counseling and testing. If the person who is the subject of an order pursuant to this subsection refuses to comply, the provisions of subsection (5) of this section shall apply.

(5) (a) Upon the issuance of any order by the state or local health officer pursuant to subsection (3) of this section, such health officer shall give written notice promptly, personally, and confidentially to the person who is the subject of the order stating the grounds and provisions of the order, including the factual bases therefor, the evidence relied upon for proof of infection and dangerous behavior, and the likelihood of repetition of such behaviors in the absence of such an order, and notifying the person who is the subject of the order that, if he or she contests the order, he or she may appear at a judicial hearing on the enforceability of the order within seventy-two hours of the receipt of the order, to be held in superior court. He or she may have an attorney appear on his or her behalf in the hearing at public expense, if necessary. The hearing shall be held within seventy-two hours of receipt of the notice, unless the person subject to the order agrees to comply. If the person contests the order, no invasive medical procedures shall be carried out prior to a hearing being held pursuant to this subsection. If the person does not contest the order within seventy-two hours of receiving it, and the person does not comply with the order within the time period specified for compliance with the order, the state or local health officer may request a warrant be issued by the superior court to insure appearance at the hearing. The hearing shall be within seventy-two hours of the expiration date of the time specified for compliance with the original order. The burden of proof shall be on the health officer to show by clear and convincing evidence that the specified grounds exist for the issuance of the order and for the need for compliance and that the terms and conditions imposed therein are no more restrictive than necessary to protect the public health. Upon conclusion of the hearing, the court shall issue appropriate orders affirming, modifying, or dismissing the order.

(b) If the superior court dismisses the order of the public health officer, the fact that the order was issued shall be expunged from the records of the board or local department of health.

(6) Any hearing conducted pursuant to this section shall be closed and confidential unless a public hearing is requested by the person who is the subject of the order, in which case the hearing will be conducted in open court. Unless in open hearing, any transcripts or records relating thereto shall also be confidential and may be sealed by the order of the court.

NEW SECTION. Sec. 912. A new section is added to chapter 70.24 RCW to read as follows:

(1) When the procedures of section 911 of this act have been exhausted and the state or local health officer, within his or her respective jurisdiction, knows or has reason to believe, because of medical information, that a person has a sexually transmitted disease and that the person continues to engage in behaviors that present an imminent danger to the public health as defined in by the board in rule based upon generally accepted standards of medical and public health science, the health officer may bring an action in superior court to detain the person in a facility designated by the board for a period of time necessary to accomplish a program of counseling and education, excluding any coercive techniques or procedures, designed to get the person to adopt nondangerous behavior. In no case may the period exceed ninety days under each order. The board shall establish, by rule, standards for counseling and education under this subsection. The health officer shall request the prosecuting attorney to file such action in superior court. During that period, reasonable efforts will be made in a noncoercive manner to get the person to adopt nondangerous behavior.

(2) If an action is filed as outlined in subsection (1) of this section, the superior court, upon the petition of the prosecuting attorney, shall issue other appropriate court orders including, but not limited to, an order to take the person into custody immediately, for a period not to exceed seventy-two hours, and place him or her in a facility designated or approved by the board. The person who is the subject of the order shall be given written notice of the order promptly, personally, and confidentially stating the grounds and provisions of the order, including the factual bases therefor, the evidence relied upon for proof of infection and dangerous behavior, and the likelihood of repetition of such behaviors in the absence of such an order, and notifying the person that if he or she refuses to comply with the order he or she may appear at a hearing to review the order and that he or she may have an attorney appear on his or her behalf in the hearing at public expense, if necessary. If the person contests testing or treatment, no invasive medical procedures shall be carried out prior to a hearing being held pursuant to subsection (3) of this section.

(3) The hearing shall be conducted by the court no later than forty-eight hours after the receipt of the order unless a continuance is sought by the person who is the subject of the order, which continuance shall be granted upon showing of good cause for the delay. The person has a right to be present at the hearing and may have an attorney appear on his or her behalf in the hearing, at public expense if necessary. If the order includes detention for a period of fourteen days or longer, the person shall also have the right to a trial by jury upon request. Upon conclusion of the hearing, the court shall issue appropriate orders.

(4) The burden of proof shall be on the state or local health officer to show by clear and convincing evidence that grounds exist for the issuance of any court order pursuant to subsection (2) or (3) of this section. If the superior court dismisses the order, the fact that the order was issued shall be expunged from the records of the board or local department of health.

(5) Any hearing conducted by the superior court pursuant to subsection (2) or (3) of this section shall be closed and confidential unless a public hearing is requested by the person who is the subject of the order, in which case the hearing will be conducted in open court. Unless in open hearing, any transcripts or records relating thereto shall also be confidential and may be sealed by order of the court.

(6) Any order entered by the superior court pursuant to subsection (1) or (2) of this section shall impose terms and conditions no more restrictive than necessary to protect the public health.

Sec. 913. Section 5, chapter 114, Laws of 1919 and RCW 70.24.080 are each amended to read as follows:

Any person who shall violate any of the provisions of this ((~~act~~)) chapter or any lawful rule ((~~or regulation made~~)) adopted by the ((~~state~~)) board ((~~of health~~)) pursuant to the authority herein granted, or who shall fail or refuse to obey any lawful order issued by any state, county or municipal health officer, pursuant to the authority granted in this ((~~act~~)) chapter, shall be deemed guilty of a gross misdemeanor punishable as provided under RCW 9A.20.021.

Sec. 914. Section 1, chapter 164, Laws of 1969 ex. sess. and RCW 70.24.110 are each amended to read as follows:

A minor fourteen years of age or older who may have come in contact with any ((~~venereal~~)) sexually transmitted disease or suspected ((~~venereal~~)) sexually transmitted disease may give consent to the furnishing of hospital, medical and surgical care related to the diagnosis or treatment of such disease. Such consent shall not be subject to disaffirmance because of minority. The consent of the parent, parents, or legal guardian of such minor shall not be necessary to authorize hospital, medical and surgical care related to such disease and such parent, parents, or legal guardian shall not be liable for payment for any care rendered pursuant to this section.

Sec. 915. Section 1, chapter 59, Laws of 1977 and RCW 70.24.120 are each amended to read as follows:

((~~Venereal~~)) Sexually transmitted disease case investigators, upon specific authorization from a ((~~doctor~~)) physician, are hereby authorized to perform venipuncture or skin puncture on a person for the sole purpose of withdrawing blood for use in ((~~venereal~~)) sexually transmitted disease tests.

The term "((~~venereal~~)) sexually transmitted disease case investigator" shall mean only those persons who:

(1) Are employed by public health authorities; and

(2) Have been trained by a ((~~doctor~~)) physician in proper procedures to be employed when withdrawing blood in accordance with training requirements established by the department of social and health services; and

(3) Possess a statement signed by the instructing ((~~doctor~~)) physician that the training required by subsection (2) of this section has been successfully completed.

The term "((~~doctor~~)) physician" means any person licensed under the provisions of chapters 18.57 or 18.71 RCW.

NEW SECTION. Sec. 916. A new section is added to chapter 70.24 RCW to read as follows:

(1) Any person aggrieved by a violation of this chapter shall have a right of action in superior court and may recover for each violation:

(a) Against any person who negligently violates a provision of this chapter, one thousand dollars, or actual damages, whichever is greater, for each violation.

(b) Against any person who intentionally or recklessly violates a provision of this chapter, two thousand dollars, or actual damages, whichever is greater, for each violation.

(d) Such other relief, including an injunction, as the court may deem appropriate.

(2) Any action under this chapter is barred unless the action is commenced within three years after the cause of action accrues.

(3) The attorney general may maintain a civil action to enforce this chapter in which the court may order any relief authorized under subsection (1) of this section.

(4) Nothing in this chapter limits the rights of the subject of a test for a sexually transmitted disease to recover damages or other relief under any other applicable law.

(5) Nothing in this chapter may be construed to impose civil liability or criminal sanction for disclosure of a test result for a sexually transmitted disease in accordance with any reporting requirement for a diagnosed case of sexually transmitted disease by the department or the centers for disease control of the United States public health service.

NEW SECTION. Sec. 917. A new section is added to chapter 70.24 RCW to read as follows:

The board shall adopt such rules as are necessary to implement and enforce this chapter. Rules may also be adopted by the department of social and health services or the department of licensing for the purposes of this chapter. The rules may include procedures for taking appropriate action, in addition to any other penalty under this chapter, with regard to health care facilities or health care providers which violate this chapter or the rules adopted under this chapter. The rules shall prescribe stringent safeguards to protect the confidentiality of the persons and records subject to this chapter. The procedures set forth in chapter 34.04 RCW apply to the administration of this chapter, except that in case of conflict between chapter 34.04 RCW and this chapter, the provisions of this chapter shall control.

NEW SECTION. Sec. 918. A new section is added to chapter 70.24 RCW to read as follows:

It shall be a gross misdemeanor punishable as provided under RCW 9A.20.021 for anyone infected with a sexually transmitted disease knowingly, intentionally, and maliciously, to infect another person. Any person who violates the provisions of this section for a second time in a twelve-month period shall be guilty of a class C felony.

NEW SECTION. Sec. 919. A new section is added to chapter 70.24 RCW to read as follows:

Nothing in this chapter may be construed to require additional funding of programs to treat communicable disease established as of the effective date of this section.

NEW SECTION. Sec. 920. A new section is added to chapter 70.24 RCW to read as follows:

Members of the state board of health and local boards of health, health officers, and employees of local health departments are immune from civil action for damages arising out of the good faith performance of their duties as prescribed by this chapter, unless such performance constitutes gross negligence.

NEW SECTION. Sec. 921. A new section is added to chapter 70.24 RCW to read as follows:

Nothing in this chapter is intended to create a state-mandated liberty interest of any nature for offenders or inmates confined in department of corrections facilities or subject to the jurisdiction of the department of corrections.

NEW SECTION. Sec. 922. 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; and

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

PART X

LEGISLATIVE STUDIES

NEW SECTION. Sec. 1001. (1) The legislative budget committee shall conduct two studies to recommend what system of state reimbursement most accurately reflects the additional costs involved in treating AIDS patients. The committee shall report to the legislature on the first study by November 15, 1988.

(2) A second study to recommend what state system of reimbursement most accurately reflects the costs of regional AIDS service networks will commence in 1990. The committee shall report to the legislature on the second study by November 15, 1990.

(3) Both studies shall include input from the division of medical assistance and major provider groups.

PART XI

MISCELLANEOUS

NEW SECTION. Sec. 1101. 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. 1102. Except as otherwise specifically provided, this act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect immediately.