By Hamric, et al. H.B. No. 1345
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to tests for human immunodeficiency virus infection of
1-3 pregnant women or on delivery of a child.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 81.090, Health and Safety Code, is
1-6 amended by amending Subsections (a), (c), and (d) and adding
1-7 Subsections (i), (j), (k), (l), (m), (n), and (o) to read as
1-8 follows:
1-9 (a) A physician or other person permitted by law to attend a
1-10 pregnant woman during gestation or at delivery of an infant shall:
1-11 (1) take or cause to be taken a sample of the woman's
1-12 blood at the first examination and visit;
1-13 (2) submit the sample to a laboratory approved under
1-14 this section for:
1-15 (A) a standard serologic test for syphilis
1-16 approved by the board; and
1-17 (B) a standard serologic test for HIV infection
1-18 approved by the board; and
1-19 (3) retain a report of each case for nine months and
1-20 deliver the report to any successor in the case.
1-21 (c) A physician or other person in attendance at a delivery
1-22 shall:
1-23 (1) take or cause to be taken a sample of blood from
1-24 the mother or from the umbilical cord of the infant within 24 hours
2-1 of delivery; and
2-2 (2) submit the sample to a laboratory approved under
2-3 this section for:
2-4 (A) a standard serologic test for syphilis
2-5 approved by the board; and
2-6 (B) a standard serologic test for HIV infection
2-7 approved by the board.
2-8 (d) A state, county, municipal, or private laboratory that
2-9 conducts standard serologic tests <for syphilis> on blood samples
2-10 submitted under this section must be approved by the department.
2-11 For the purpose of approving laboratories, the board shall adopt
2-12 rules establishing:
2-13 (1) minimum standards of proficiency for a laboratory
2-14 that conducts standard serologic tests;
2-15 (2) procedures for the inspection and monitoring of
2-16 laboratories conducting standard serologic tests;
2-17 (3) criteria for the issuance, suspension, and
2-18 revocation of laboratory proficiency certification to perform
2-19 standard serologic tests; and
2-20 (4) criteria for approval and disapproval of serologic
2-21 tests and procedures.
2-22 (i) Before conducting or causing to be conducted a standard
2-23 serologic test for HIV infection under this section, the physician
2-24 or other person shall advise the woman that the result of a test
2-25 taken under this section is confidential as provided by Subchapter
2-26 F, but that the test is not anonymous. The physician or other
2-27 person shall explain the difference between a confidential and an
3-1 anonymous test to the woman and that an anonymous test may be
3-2 available from another entity. The physician or other person shall
3-3 make the information available in another language, if needed, and
3-4 if resources permit. The information shall be provided by the
3-5 physician or another person, as needed, in a manner and in terms
3-6 understandable to a person who may be illiterate if resources
3-7 permit.
3-8 (j) The result of a standard test for HIV infection under
3-9 Subsection (a)(2)(B) or (c)(2)(B) is a test result for purposes of
3-10 Subchapter F.
3-11 (k) Before the blood sample is taken, the health care
3-12 provider shall distribute to the patient printed materials about
3-13 AIDS, HIV, and syphilis and shall verbally notify the patient that
3-14 an HIV test shall be performed if the patient does not object. If
3-15 the patient objects, the patient shall be referred to an anonymous
3-16 testing facility or instructed about anonymous testing methods.
3-17 The health care provider shall note on the medical records that the
3-18 distribution of printed materials was made and that verbal
3-19 notification was given. The materials shall be provided to the
3-20 health care provider by the Texas Department of Health and shall be
3-21 prepared and designed to inform the patients about:
3-22 (1) the incidence and mode of transmission of AIDS,
3-23 HIV, and syphilis;
3-24 (2) how being infected with HIV, AIDS, or syphilis
3-25 could affect the health of their child;
3-26 (3) the available cure for syphilis;
3-27 (4) the available treatment to prevent maternal-infant
4-1 HIV transmission; and
4-2 (5) methods to prevent the transmission of the HIV
4-3 virus and syphilis.
4-4 (l) A physician or other person may not conduct a standard
4-5 test for HIV infection under Subsection (a)(2)(B) or (c)(2)(B) if
4-6 the woman objects.
4-7 (m) If a screening test and a confirmatory test conducted
4-8 under this section show that the woman is or may be infected with
4-9 HIV, the physician or other person who submitted the sample for the
4-10 test shall provide or make available to the woman:
4-11 (1) information relating to treatment of HIV infection
4-12 and acquired immune deficiency syndrome, which must be in another
4-13 language, if needed, and must be presented, as necessary, in a
4-14 manner and in terms understandable to a person who may be
4-15 illiterate if resources permit; and
4-16 (2) counseling under Section 81.109.
4-17 (n) A physician or other person may comply with the
4-18 requirements of Subsection (m)(1) by referring the woman to an
4-19 entity that provides treatment for individuals infected with HIV or
4-20 with acquired immune deficiency syndrome.
4-21 (o) In this section, "HIV" has the meaning assigned by
4-22 Section 81.101.
4-23 SECTION 2. Section 81.102(a), Health and Safety Code, is
4-24 amended to read as follows:
4-25 (a) A person may not require another person to undergo a
4-26 medical procedure or test designed to determine or help determine
4-27 if a person has AIDS or HIV infection, antibodies to HIV, or
5-1 infection with any other probable causative agent of AIDS unless:
5-2 (1) the medical procedure or test is required under
5-3 Subsection (d), under Section 81.050, or under Article 21.31, Code
5-4 of Criminal Procedure;
5-5 (2) the medical procedure or test is required under
5-6 Section 81.090, and no objection has been made under Section
5-7 81.090(l);
5-8 (3) the medical procedure or test is authorized under
5-9 Article 21.21-4, Insurance Code;
5-10 (4) <(3)> a medical procedure is to be performed on
5-11 the person that could expose health care personnel to AIDS or HIV
5-12 infection, according to board guidelines defining the conditions
5-13 that constitute possible exposure to AIDS or HIV infection, and
5-14 there is sufficient time to receive the test result before the
5-15 procedure is conducted; or
5-16 (5) <(4)> the medical procedure or test is necessary:
5-17 (A) as a bona fide occupational qualification
5-18 and there is not a less discriminatory means of satisfying the
5-19 occupational qualification;
5-20 (B) to screen blood, blood products, body
5-21 fluids, organs, or tissues to determine suitability for donation;
5-22 (C) in relation to a particular person under
5-23 this chapter;
5-24 (D) to manage accidental exposure to blood or
5-25 other body fluids, but only if the test is conducted under written
5-26 infectious disease control protocols adopted by the health care
5-27 agency or facility;
6-1 (E) to test residents and clients of residential
6-2 facilities of the Texas Department of Mental Health and Mental
6-3 Retardation, but only if:
6-4 (i) the test result would change the
6-5 medical or social management of the person tested or others who
6-6 associated with that person; and
6-7 (ii) the test is conducted in accordance
6-8 with guidelines adopted by the residential facility or the Texas
6-9 Department of Mental Health and Mental Retardation and approved by
6-10 the department; or
6-11 (F) to test residents and clients of residential
6-12 facilities of the Texas Youth Commission, but only if:
6-13 (i) the test result would change the
6-14 medical or social management of the person tested or others who
6-15 associate with that person; and
6-16 (ii) the test is conducted in accordance
6-17 with guidelines adopted by the Texas Youth Commission.
6-18 SECTION 3. This Act takes effect September 1, 1995, and
6-19 applies only to a physician or other person attending a pregnant
6-20 woman during gestation or at delivery of an infant on or after
6-21 January 1, 1996.
6-22 SECTION 4. The importance of this legislation and the
6-23 crowded condition of the calendars in both houses create an
6-24 emergency and an imperative public necessity that the
6-25 constitutional rule requiring bills to be read on three several
6-26 days in each house be suspended, and this rule is hereby suspended.