HOUSE BILL REPORT
HB 1527
BYRepresentatives Braddock, Brooks, Sprenkle, Moyer, Ebersole, Zellinsky, Valle, Wineberry, Crane, Ballard, Heavey, R. King, Dellwo, Ferguson, Sayan and Silver
Revising provisions relating to sexually transmissible diseases.
House Committe on Health Care
Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. (11)
Signed by Representatives Braddock, Chair; Day, Vice Chair; Bristow, Brooks, Bumgarner, Cantwell, Lewis, Lux, D. Sommers, Sprenkle and Vekich.
House Staff:Bill Hagens (786-7131)
Rereferred House Committee on Ways & Means/Appropriations
Majority Report: The second substitute bill be substituted therefor and the second substitute bill do pass. (20)
Signed by Representatives Locke, Chair; Belcher, Braddock, Brekke, Butterfield, Ebersole, Fuhrman, Grant, Grimm, Hine, Holland, McLean, Nealey, Peery, Silver, H. Sommers, Spanel, Sprenkle, Wang and B. Williams.
House Staff: David Knutson (786-7136)
AS REPORTED BY COMMITTEE ON WAYS & MEANS/APPROPRIATIONS
FEBRUARY 6, 1988
BACKGROUND:
Acquired immunodeficiency syndrome (AIDS) is a world-wide and national health problem without parallel in modern times. Nationally, the number of AIDS cases is approaching 50,000. Further, it is estimated that between 1 and 1-1/2 million persons may have human immunodeficiency virus HIV--the cause of AIDS.
In the state of Washington, as of January 28, 1988, there were 735 persons diagnosed with AIDS, with estimates of 12,000 to 15,000 persons infected with HIV. Although Washington ranks number 19 in population nationally, it ranks 12 in number of AIDS cases. It is estimated that by the end of 1991 the number of AIDS cases will approach 5,000.
While at present over 75% 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 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, or private and public employees. Further, state laws dealing of sexually transmitted diseases (STDs) have not been significantly amended in modern times and do not meet contemporary standards.
SUMMARY:
SUBSTITUTE BILL: Contemporary definitions of AIDS, HIV and STDs are added to statute. The board of health is authorized to add other STDs to the definition, when appropriate.
Information directed to the public, especially school students, regarding STDs shall give emphasis to the importance of sexual abstinence and the avoidance of substance abuse in controlling disease.
The center for voluntary action is given the additional related responsibility of assisting in the prevention and spreading 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 curriculum development is crucial to AIDS prevention. Each school district is required to develop an AIDS prevention education program in consultation with teachers, parents, and other community members. The superintendent for public instruction SPI shall provide model curriculum. The office on AIDS shall review the material for accuracy. 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 requirement, upon the written request of a parent, if the parent has reviewed the material before hand.
The governing entities of colleges, universities, and vocational schools are required to provide new students with AIDS education.
An office on AIDS is established within the Department of Social and Health Services (DSHS), which shall have the major coordination function for AIDS activities.
Health professionals certified and/or licensed by the Department of Licensing (DOL) or DSHS, educational employees, certain state and local government employees shall receive appropriate AIDS education.
AIDS testing and counseling is defined. Persons convicted of sex offenses; promoting, soliciting, or performing acts of prostitution; and certain drug offenses shall be tested and counseled upon conviction. Voluntary testing and counseling shall be offered to persons arrested of these crimes.
Jail and prison administrators are given the authority to test and counsel an inmate if the inmate's behavior poses a risk to the public safety or to other inmates.
Six to eight Regional AIDS service networks are created on a phased-in basis--3 networks by July 1, 1989 and 3 to 5 networks by July 1, 1991. These entities are designated the official regional AIDS offices and shall have the responsibility of coordinating a comprehensive range of AIDS services. The University of Washington shall establish a center for AIDS treatment and 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.
Explicit provisions are made to protect persons with AIDS or HIV from discrimination.
Health officers are given authority to address persons with STDs whose behavior is identified as a danger to public health. A health officer 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, testing, counseling, or treatment; 2) order a person to cease and desist from specific behaviors and/or impose 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.
Provisions are established to permit law enforcement officials, fire fighters, health care providers, or health care facility staff persons exposed to the bodily fluid of another person in the course of employment to request testing and counseling of the person in question. The health officer may order such testing and counseling, if deemed appropriate. If the person in question does not wish to comply with the request, the involuntary provisions of the chapter can be used.
Health care information is safeguarded against misuse and may be released only in limited circumstances under the protection of confidentiality.
Local health officers are given the authority to interview identified persons for the purposes of tracing STD contacts.
Civil remedies and criminal sanctions are established for violation of this chapter.
The legislative budget committee is directed to study health care cost reimbursement as related to AIDS.
Antiquated sections of the 1919 STD statute are repealed.
SUBSTITUTE BILL COMPARED TO ORIGINAL: The role of parents and community leader in the development of school AIDS curriculum is strengthened. Mandatory AIDS education grades are changed from annually 9th through 12th to annually 5th through 12th.
A section prohibiting condom confiscation by law enforcement is deleted.
Mandatory testing provisions are expanded to include not only sex offenders and prostitutes, but also those promoting and soliciting prostitution and intravenous drug offenders. Voluntary counseling and testing services are explicitly extended to person arrested for prostitution and drug related crimes.
Due process provisions are strengthened for involuntary procedures.
AIDS training for health professionals, educators, and other public employees is made mandatory instead of advisory.
Pursuant to the appropriate procedures, mandatory testing and counseling are permitted of persons whose bodily fluids come in contact with law enforcement officers, fire fighters, and health workers.
A Legislative Budget Committee assessment plan is replaced with two studies on cost reimbursement.
CHANGES PROPOSED BY COMMITTEE ON WAYS & MEANS/APPROPRIATIONS: Local Health officer approval is required prior to jail-based testing. State health officer approval is required prior to Department of Corrections institution-based testing. The privacy of individuals infected with HIV is protected. Educational requirements for grades 5-12 are clarified. The board of health is directed to cooperate with appropriate agencies in developing rules. Organizational issues related to AIDS service delivery are clarified. A more severe penalty for persons who violate the provisions of the act for a second time in a twelve month period is provided.
Fiscal Note: Requested February 3, 1988.
House Committee ‑ Testified For: (Health Care) Chase Riveland, Department of Licensing; Gary Moore, Washington Federation of State Employees; Mike Vandiver, Washington Association of Sheriffs and Police Chiefs; Dr. Bill Lafferty, DSHS; Sam Jacobs, ACLU; Beverly Jacobson, Statewide Steering Committee on Adolescent Pregnancy Prevention, Pregnancy and Parenting; Al Allen, Tacoma-Pierce County Health Department; Bud Nicola, Seattle-King County Health Department; Robert Rohan, Northwest AIDS Foundation; Bea Kelleigh, Northwest AIDS Foundation; Gary Edwards, Washington State Association of Sheriffs and Police Chiefs; Jim Rabie, Washington State Law Enforcement Association; Jim Newton, Clallam County Sheriffs Department; Dr. Ed Gray, State Board of Health; Chris Shardelman, Citizens for Sensible Legislation; Mary Erlich, Washington State Nurses; Rob Menaul, Washington State Hospital Association; Bill Collins, Washington State Correctional Association; Susie Tracy, Washington State Medical Association; John Beare, M.D., DSHS; Joan Brewster, Tacoma-Pierce County Health Department; Maggie Reich; Sonnia Bean; Pat Tividall, Washington Women United, Washington Community Mental Health.
(Ways & Means/Appropriations) Dr. Atwood, Yakima Health Department; Dr. Allen, Tacoma-Pierce Health Department; Dr. Hansfield, Seattle-King Health Department; Jule Sugarman, Department of Social and Health Services; Michelle Radosevich, Washington Education Association; Pat Thibadeau, Washington Women United; and others.
House Committee - Testified Against: (Health Care) J'Non Rishan, Task Force for Public Health; Jerry Sheehan, ACLU.
(Ways & Means/Appropriations) None Presented.
House Committee - Testimony For: (Health Care) AIDS is a very deadly disease and a comprehensive state policy is needed.
(Ways & Means/Appropriations) There is an immediate need to mobilize public health forces to address the problem of AIDS. Increased education, testing, and counseling services are necessary to deal with the current situation.
House Committee - Testimony Against: (Health Care) The detention and mandatory testing provisions are unnecessary because such actions have not been proven effective in controlling disease. The bill is excessive in protecting the rights of the high risk population.
(Ways & Means/Appropriations) None Presented.