BILL ANALYSIS

C.S.H.B. 3377

By: Jones, Venton

Public Health

Committee Report (Substituted)

BACKGROUND AND PURPOSE

Currently, HIV testing is not part of the routine screening for sexually transmitted infections (STIs) unless a patient specifically requests a test. This burden on the patient creates unnecessary barriers to testing. According to the CDC, approximately 91 percent of new HIV cases in Texas are spread through sexual contact. Having HIV testing as a standard of practice with STI screenings would help identify people living with HIV as early as possible and reduce the transmission to other Texans. C.S.H.B. 3377 seeks to resolve this issue by changing HIV testing to an opt-out system, requiring a health care provider who conducts STI screening to submit a sample for an HIV diagnostic test unless that individual opts out and by requiring that an individual who receives a positive result be provided information on HIV health services and community support programs.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 2 of this bill.

ANALYSIS

C.S.H.B. 3377 amends the Health and Safety Code to require a health care provider who takes a sample of an individual's blood as part of a medical screening for a sexually transmitted infection to submit the sample for an HIV diagnostic test, regardless of whether an HIV test is part of a primary diagnosis, unless the individual opts out of the HIV test. The bill requires the health care provider, before taking the sample, to obtain the individual's consent for the HIV diagnostic test or inform the individual that the test will be performed unless the individual opts out of the test. The bill requires a health care provider who submits an individual's blood for an HIV diagnostic test to provide to each individual who receives a positive test result information on available HIV health services and referrals to community support programs.

C.S.H.B. 3377 requires the executive commissioner of the Health and Human Services Commission (HHSC), not later than January 1, 2024, to adopt rules to implement the bill's provisions and, in adopting the rules, to consider the most recent recommendations of the federal Centers for Disease Control and Prevention for HIV testing of adults and adolescents. The bill establishes that a health care provider is not required to comply with the bill's provisions until January 1, 2024.

C.S.H.B. 3377 establishes that implementation of a mandatory provision of this bill by HHSC is mandatory only if a specific appropriation is made for that purpose and that if HHSC does not implement a mandatory provision in a state fiscal year, HHSC, in its legislative budget request for the next state fiscal biennium, must certify that fact to the Legislative Budget Board and include a written estimate of the costs of implementing the provision in each year of that next state fiscal biennium. These provisions of the bill expire and any applicable duty of HHSC suspended by these provisions becomes mandatory on September 1, 2027.

EFFECTIVE DATE

September 1, 2023.

COMPARISON OF INTRODUCED AND SUBSTITUTE

While C.S.H.B. 3377 may differ from the introduced in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill.

The introduced requires a health care provider to obtain an individual's written consent for an HIV diagnostic test or verbally inform the individual that such a test will be performed. The substitute does not include the specification that the consent be written or that the information be provided verbally.

The substitute contains the following provisions absent from the introduced:

· a provision making implementation of a mandatory provision of the bill contingent on a specific appropriation for that provision;

· a requirement for HHSC to certify to the Legislative Budget Board that HHSC did not implement such a mandatory provision; and

· a provision establishing that any applicable suspended duty will become mandatory on September 1, 2027.