LSL C.S.H.B. 164 75(R) BILL ANALYSIS PUBLIC HEALTH C.S.H.B. 164 By: Maxey 3-12-97 Committee Report (Substituted) BACKGROUND The 74th Legislature passed HB 1345, relating to the voluntary testing of HIV in pregnant women. The legislation required that a health care professional test a woman for HIV, if she does not object, during her pregnancy or at the time of her delivery. The manner in which Chapter 81.090 of the Health and Safety Code was written, however, does not take into account whether or not a woman has been tested prior to delivery. If she has, the second test at birth is redundant and costly. In addition, the principal impetus for HB 1345 was federal research which demonstrated that taking the drug AZT during pregnancy could reduce the risk of perinatal HIV transmission in infected women by two-thirds. However, the medication is most effective if taken well in advance of delivery or during the actual delivery. An HIV test taken at the time of birth does not offer the chance to provide AZT therapy that could prevent infection in the newborn. PURPOSE CSHB 164 will prevent the unnecessary testing of HIV in pregnant women at delivery. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Sec. 81.090, Health and Safety Code, as follows: Subsection (a)(2)(B) adds a reference to Subsection (g) to this section regarding laboratories approved for a standard serologic test for HIV infection approved by the board. Subsection (c) makes conforming changes. Subsection (g) is added to stipulate that a physician or other person is not required to submit a sample for a standard HIV test under Subsection (a) if the first examination and visit occurs at the time of delivery. Subsections (j) and (l) make conforming changes. SECTION 2. Emergency clause. Effective upon passage. COMPARISON OF ORIGINAL TO SUBSTITUTE The original bill required a health professional to test a woman for HIV infection at delivery unless previously tested. CSHB 164 establishes that a physician is not required to test a woman at delivery. This change was made because even if the woman is tested immediately prior to delivery, the results will not be available until two to three days after she has given birth. The medical treatment to reduce the risk of transmission of HIV cannot prevent the transmission of the disease after delivery.