1-1 By: Hamric, et al. (Senate Sponsor - Zaffirini) H.B. No. 1345
1-2 (In the Senate - Received from the House May 4, 1995;
1-3 May 5, 1995, read first time and referred to Committee on Health
1-4 and Human Services; May 10, 1995, reported favorably by the
1-5 following vote: Yeas 9, Nays 0; May 10, 1995, sent to printer.)
1-6 A BILL TO BE ENTITLED
1-7 AN ACT
1-8 relating to tests for human immunodeficiency virus infection of
1-9 pregnant women or on delivery of a child.
1-10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11 SECTION 1. Section 81.090, Health and Safety Code, is
1-12 amended by amending Subsections (a), (c), and (d) and adding
1-13 Subsections (i), (j), (k), (l), (m), (n), and (o) to read as
1-14 follows:
1-15 (a) A physician or other person permitted by law to attend a
1-16 pregnant woman during gestation or at delivery of an infant shall:
1-17 (1) take or cause to be taken a sample of the woman's
1-18 blood at the first examination and visit;
1-19 (2) submit the sample to a laboratory approved under
1-20 this section for:
1-21 (A) a standard serologic test for syphilis
1-22 approved by the board; and
1-23 (B) a standard serologic test for HIV infection
1-24 approved by the board; and
1-25 (3) retain a report of each case for nine months and
1-26 deliver the report to any successor in the case.
1-27 (c) A physician or other person in attendance at a delivery
1-28 shall:
1-29 (1) take or cause to be taken a sample of blood from
1-30 the mother or from the umbilical cord of the infant within 24 hours
1-31 of delivery; and
1-32 (2) submit the sample to a laboratory approved under
1-33 this section for:
1-34 (A) a standard serologic test for syphilis
1-35 approved by the board; and
1-36 (B) a standard serologic test for HIV infection
1-37 approved by the board.
1-38 (d) A state, county, municipal, or private laboratory that
1-39 conducts standard serologic tests <for syphilis> on blood samples
1-40 submitted under this section must be approved by the department.
1-41 For the purpose of approving laboratories, the board shall adopt
1-42 rules establishing:
1-43 (1) minimum standards of proficiency for a laboratory
1-44 that conducts standard serologic tests;
1-45 (2) procedures for the inspection and monitoring of
1-46 laboratories conducting standard serologic tests;
1-47 (3) criteria for the issuance, suspension, and
1-48 revocation of laboratory proficiency certification to perform
1-49 standard serologic tests; and
1-50 (4) criteria for approval and disapproval of serologic
1-51 tests and procedures.
1-52 (i) Before conducting or causing to be conducted a standard
1-53 serologic test for HIV infection under this section, the physician
1-54 or other person shall advise the woman that the result of a test
1-55 taken under this section is confidential as provided by Subchapter
1-56 F, but that the test is not anonymous. The physician or other
1-57 person shall explain the difference between a confidential and an
1-58 anonymous test to the woman and that an anonymous test may be
1-59 available from another entity. The physician or other person shall
1-60 make the information available in another language, if needed, and
1-61 if resources permit. The information shall be provided by the
1-62 physician or another person, as needed, in a manner and in terms
1-63 understandable to a person who may be illiterate if resources
1-64 permit.
1-65 (j) The result of a standard test for HIV infection under
1-66 Subsection (a)(2)(B) or (c)(2)(B) is a test result for purposes of
1-67 Subchapter F.
1-68 (k) Before the blood sample is taken, the health care
2-1 provider shall distribute to the patient printed materials about
2-2 AIDS, HIV, and syphilis and shall verbally notify the patient that
2-3 an HIV test shall be performed if the patient does not object. If
2-4 the patient objects, the patient shall be referred to an anonymous
2-5 testing facility or instructed about anonymous testing methods.
2-6 The health care provider shall note on the medical records that the
2-7 distribution of printed materials was made and that verbal
2-8 notification was given. The materials shall be provided to the
2-9 health care provider by the Texas Department of Health and shall be
2-10 prepared and designed to inform the patients about:
2-11 (1) the incidence and mode of transmission of AIDS,
2-12 HIV, and syphilis;
2-13 (2) how being infected with HIV, AIDS, or syphilis
2-14 could affect the health of their child;
2-15 (3) the available cure for syphilis;
2-16 (4) the available treatment to prevent maternal-infant
2-17 HIV transmission; and
2-18 (5) methods to prevent the transmission of the HIV
2-19 virus and syphilis.
2-20 (l) A physician or other person may not conduct a standard
2-21 test for HIV infection under Subsection (a)(2)(B) or (c)(2)(B) if
2-22 the woman objects.
2-23 (m) If a screening test and a confirmatory test conducted
2-24 under this section show that the woman is or may be infected with
2-25 HIV, the physician or other person who submitted the sample for the
2-26 test shall provide or make available to the woman:
2-27 (1) information relating to treatment of HIV infection
2-28 and acquired immune deficiency syndrome, which must be in another
2-29 language, if needed, and must be presented, as necessary, in a
2-30 manner and in terms understandable to a person who may be
2-31 illiterate if resources permit; and
2-32 (2) counseling under Section 81.109.
2-33 (n) A physician or other person may comply with the
2-34 requirements of Subsection (m)(1) by referring the woman to an
2-35 entity that provides treatment for individuals infected with HIV or
2-36 with acquired immune deficiency syndrome.
2-37 (o) In this section, "HIV" has the meaning assigned by
2-38 Section 81.101.
2-39 SECTION 2. Section 81.102(a), Health and Safety Code, is
2-40 amended to read as follows:
2-41 (a) A person may not require another person to undergo a
2-42 medical procedure or test designed to determine or help determine
2-43 if a person has AIDS or HIV infection, antibodies to HIV, or
2-44 infection with any other probable causative agent of AIDS unless:
2-45 (1) the medical procedure or test is required under
2-46 Subsection (d), under Section 81.050, or under Article 21.31, Code
2-47 of Criminal Procedure;
2-48 (2) the medical procedure or test is required under
2-49 Section 81.090, and no objection has been made under Section
2-50 81.090(l);
2-51 (3) the medical procedure or test is authorized under
2-52 Article 21.21-4, Insurance Code;
2-53 (4) <(3)> a medical procedure is to be performed on
2-54 the person that could expose health care personnel to AIDS or HIV
2-55 infection, according to board guidelines defining the conditions
2-56 that constitute possible exposure to AIDS or HIV infection, and
2-57 there is sufficient time to receive the test result before the
2-58 procedure is conducted; or
2-59 (5) <(4)> the medical procedure or test is necessary:
2-60 (A) as a bona fide occupational qualification
2-61 and there is not a less discriminatory means of satisfying the
2-62 occupational qualification;
2-63 (B) to screen blood, blood products, body
2-64 fluids, organs, or tissues to determine suitability for donation;
2-65 (C) in relation to a particular person under
2-66 this chapter;
2-67 (D) to manage accidental exposure to blood or
2-68 other body fluids, but only if the test is conducted under written
2-69 infectious disease control protocols adopted by the health care
2-70 agency or facility;
3-1 (E) to test residents and clients of residential
3-2 facilities of the Texas Department of Mental Health and Mental
3-3 Retardation, but only if:
3-4 (i) the test result would change the
3-5 medical or social management of the person tested or others who
3-6 associated with that person; and
3-7 (ii) the test is conducted in accordance
3-8 with guidelines adopted by the residential facility or the Texas
3-9 Department of Mental Health and Mental Retardation and approved by
3-10 the department; or
3-11 (F) to test residents and clients of residential
3-12 facilities of the Texas Youth Commission, but only if:
3-13 (i) the test result would change the
3-14 medical or social management of the person tested or others who
3-15 associate with that person; and
3-16 (ii) the test is conducted in accordance
3-17 with guidelines adopted by the Texas Youth Commission.
3-18 SECTION 3. This Act takes effect September 1, 1995, and
3-19 applies only to a physician or other person attending a pregnant
3-20 woman during gestation or at delivery of an infant on or after
3-21 January 1, 1996.
3-22 SECTION 4. The importance of this legislation and the
3-23 crowded condition of the calendars in both houses create an
3-24 emergency and an imperative public necessity that the
3-25 constitutional rule requiring bills to be read on three several
3-26 days in each house be suspended, and this rule is hereby suspended.
3-27 * * * * *