BILL ANALYSIS H.B. 1345 By: Hamric 02-28-95 Committee Report (Amended) BACKGROUND Currently there is no cure for the human immunodeficiency virus (HIV). However, the Federal Drug Administration has approved the treatment of infected pregnant women with zidovudine (AZT). This medication reduces the chances of maternal-infant HIV transmission by two-thirds. In order to treat the child, however, an infected mother must first be diagnosed as HIV positive. Recent data have shown an increase in HIV among adolescents, minorities, and women. Heterosexual contact has surpassed intravenous drug use as the leading source of HIV infection in women. The rising occurrence of HIV in females has devastating implications for infants. Routine testing for the HIV virus during prenatal care visits may help stem the tide of this epidemic. Once the HIV virus is diagnosed in a pregnant woman, the AZT treatment may be administered. This medication has been proven to reduce the transmission of the HIV virus in babies born to HIV infected women by 66 percent. PURPOSE This legislation is meant to alert mothers who may otherwise be unaware they are at risk or are infected with HIV and to help ensure those infected are informed about treatments available to them and their babies. The U.S. Department of Health and Human Services has published guidelines for offering the AZT treatment to pregnant women. However, under H.B. 1345 neither this treatment nor HIV testing is mandatory. The mother will have the final decision to accept or reject AZT treatment after weighing the benefits and risks with her physician. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not grant any additional rulemaking authority to a state officer, institution, or agency. SECTION BY SECTION ANALYSIS SECTION 1: Amends Section 81.090 of the Health and Safety Code. Requires a physician or other care provider to distribute written information supplied by the Texas Department of Health about AIDS, HIV, and syphilis to a patient at an initial prenatal examination and at the time of birth. Also at these times, the health care provider is required to conduct an HIV test on the patient, unless she objects to the test. Such an objection will be noted in the woman's medical record. If both a screening test and confirmatory test are positive, Subsection (k) requires the health care provider to supply or make available information regarding treatment and counseling, as prescribed under Section 81.109, Health and Safety Code. Subsection (l) allows the provider to refer the patient to an entity that provides treatment for individuals infected with the HIV virus. SECTION 2: Amends Section 81.102(a), Health and Safety Code, to add HIV testing during pregnancy to a list of instances in which the HIV test may be required. SECTION 3: Effective date. This Act only applies to health care providers attending a pregnant woman after January 1, 1996. SECTION 4: Emergency clause. EXPLANATION OF AMENDMENTS The first of two amendments adopted clarifies wording in Section 1, making it explicit that both a screening test and a confirmatory test for HIV must show positive results before further action prescribed by the subsection is taken by the health care provider. The second amendment incorporates a new subsection (j) into Section 1 and reletters the remainder of the section. The new provision requires health care providers to distribute printed materials about AIDS, HIV, and syphilis before blood samples are taken for the tests required under this bill. The material is to be supplied by the Texas Department of Health and include information outlined in subsection (j), as amended. SUMMARY OF COMMITTEE ACTION H.B. 1345 was considered by the Public Health Committee in a public hearing on February 28, 1995. The following persons testified for the bill: Lenore Warden, representing self. Cliff Price, representing the Texas Pediatric Society. Carolyn Parker, representing Texas AIDS Network. Karen Haslund, representing self. Linda Traurig, representing Faith Home. The following person testified neutrally on the bill: Charles E. Bell, Texas Department of Health. The committee considered two amendments to the bill. Of the two amendments, both were adopted without objection. The bill was reported favorably as amended with the recommendation that it do pass and be printed, by a record vote of 6 Ayes, 0 Nays, 0 PNV, and 3 Absent.