General Assembly: 78 (1999 Regular GA) - Chapter 181 - Acquired immune deficiency syndrome — miscellaneous provisions


Published: 1999-05-26

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453 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION CH. 181

CHAPTER 181 ACQUIRED IMMUNE DEFICIENCY SYNDROME- MISCELLANEOUS PROVISIONS

S.F. 248

AN ACT relating to acquired immune deficiency syndrome, providing penalties, and providing for a repeal.

Be It Enacted by the General Assembly ofthe State of Iowa:

Section 1. Section 80.9, subsection 2, paragraph d, Code 1999, is amended to read as follows:

d. To collect and classify, and keep at all times available, complete information useful for the detection of crime, and the identification and apprehension of criminals. Such informa- tion shall be available for all peace officers within the state, under such regulations as the commissioner may prescribe. The provisions of chapter -l# 141A do not apply to the entry of human immunodeficiency virus-related information by criminal or juvenile justice agen- cies, as defined in section 692.1, into the Iowa criminal justice information system or the national crime information center system. The provisions of chapter -l# 141A also do not apply to the transmission of the same information from either or both information systems to criminal or juvenile justice agencies. The provisions of chapter -l# 141A also do not apply to the transmission of the same information from either or both information systems to employees of state correctional institutions subject to the jurisdiction of the department of corrections, employees of secure facilities for juveniles subject to the jurisdiction of the department of human services, and employees of city and county jails, if those employees have direct physical supervision over inmates of those facilities or institutions. Human immunodeficiency virus-related information shall not be transmitted over the police radio broadcasting system under chapter 693 or any other radio-based communications system. An employee of an agency receiving human immunodeficiency virus-related information under this section who communicates the information to another employee who does not have direct physical supervision over inmates, other than to a supervisor of an employee who has direct physical supervision over inmates for the purpose of conveying the informa- tion to such an employee, or who communicates the information to any person not em- ployed by the agency or uses the information outside the agency is guilty of a class "D" felony. The commissioner shall adopt rules regarding the transmission of human immuno- deficiency virus-related information including provisions for maintaining confidentiality of the information. The rules shall include a requirement that persons receiving informa- tion from the Iowa criminal justice information system or the national crime information center system receive training regarding confidentiality standards applicable to the infor- mation received from the system. The commissioner shall develop and establish, in coop- eration with the department of corrections and the Iowa department of public health, train- ing programs and program criteria for persons receiving human immunodeficiency virus-related information through the Iowa criminal justice information system or the na- tional crime information center system.

Sec. 2. Section 139B.1, subsection 1, paragraph a, Code 1999, is amended to read as follows:

a. "Contagious or infectious disease" means hepatitis in any form, meningococcal dis- ease, tuberculosis, and any other disease with the exception of AIDS or HIV infection as defined in section -l-4l-:U 141A.l, determined to be life-threatening to a person exposed to the disease as established by rules adopted by the department based upon a determination by the state epidemiologist and in accordance with guidelines of the centers for disease prevention and control* of the United States department of health and human services.

• Centers for disease control and prevention probably intended

454 CH. 181 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION ----------------------------------------~-------------------------

Sec. 3. Section 139C.1, subsection 6, Code 1999, is amended to read as follows: 6. "HIV" means HIV as defined in section~ 141A.1.

Sec. 4. Section 139C.2, subsection 7, Code 1999, is amended to read as follows: 7. Information relating to the HIV status of a health care provider is confidential and

subject to the provisions of section~ 141A.9. A person who intentionally or recklessly makes an unauthorized disclosure of such information is subject to a civil penalty of one thousand dollars. The attorney general or the attorney general's designee may maintain a civil action to enforce this section. Proceedings maintained under this section shall provide for the anonymity of the individual and all documentation shall be maintained in a confi- dential manner. Information relating to the HBV status of a health care provider is confi- dential and shall not be accessible to the public. Information regulated by this section, however, may be disclosed to members of the expert review panel established by the depart- ment or a panel established by hospital protocol under this section. The information may also be disclosed to the appropriate examining board by filing a report as required by this section. The examining board shall consider the report a complaint subject to the confiden- tiality provisions of section 272C.6. A licensee, upon the filing of a formal charge or notice of hearing by the examining board based on such a complaint, may seek a protective order from the board.

Sec. 5. NEW SECTION. 141A.1 DEFINITIONS. As used in this chapter, unless the context otherwise requires: 1. "AIDS" means acquired immune deficiency syndrome as defined by the centers for

disease control and prevention of the United States department of health and human ser- vices.

2. "AIDS-related conditions" means the human immunodeficiency virus, or any other condition resulting from the human immunodeficiency virus infection.

3. "Blinded epidemiological studies" means studies in which specimens which were col- lected for other purposes are selected according to established criteria, are permanently stripped of personal identifiers, and are then tested.

4. "Blood bank" means a facility for the collection, processing, or storage of human blood or blood derivatives, including blood plasma, or from which or by means of which human blood or blood derivatives are distributed or otherwise made available.

5. "Care provider" means any emergency care provider, health care provider, or any other person providing health care services of any kind.

6. "Department" means the Iowa department of public health. 7. "Emergency care provider" means a person who is trained and authorized by federal or

state law to provide emergency medical assistance or treatment, for compensation or in a voluntary capacity, including but not limited to all of the following:

(1) An emergency medical care provider as defined in section 14 7 A.1. (2) A health care provider. (3) A fire fighter. (4) A peace officer. "Emergency care provider" also includes a person who renders emergency aid without

compensation. 8. "Good faith" means objectively reasonable and not in violation of clearly established

statutory rights or other rights of a person which a reasonable person would know or should have known.

9. "Health care provider" means a person licensed or certified under chapter 148, 148C, 150, 150A, 152, or 153 to provide professional health care service to a person during the person's medical care, treatment, or confinement.

10. "Health facility" means a hospital, health care facility, clinic, blood bank, blood cen- ter, sperm bank, laboratory organ transplant center and procurement agency, or other health care institution.

455 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION CH. 181

11. "HIV" means the human immunodeficiency virus identified as the causative agent of AIDS.

12. "HIV-related test" means a diagnostic test conducted by a laboratory approved pursu- ant to the federal Clinical Laboratory Improvements Act for determining the presence of HIV.

13. "Infectious bodily fluids" means bodily fluids capable of transmitting HIV infection as determined by the centers for disease control and prevention of the United States depart- ment of health and human services and adopted by rule of the department.

14. "Legal guardian" means a person appointed by a court pursuant to chapter 633 or an attorney in fact as defined in section 144B.l. In the case of a minor, "legal guardian" also means a parent or other person responsible for the care of the minor.

15. "Nonblinded epidemiological studies" means studies in which specimens are col- lected for the express purpose of testing for the HIV infection and persons included in the nonblinded study are selected according to established criteria.

16. "Release of test results" means a written authorization for disclosure of HIV-related test results which is signed and dated, and which specifies to whom disclosure is authorized and the time period during which the release is to be effective.

17. "Sample" means a human specimen obtained for the purpose of conducting an HIV-related test.

18. "Significant exposure" means the risk of contracting HIV infection by means of expo- sure to a person's infectious bodily fluids in a manner capable of transmitting HIV infection as determined by the centers for disease control and prevention of the United States depart- ment of health and human services and adopted by rule of the department.

Sec. 6. NEW SECTION. 141A.2 LEAD AGENCY. 1. The department is designated as the lead agency in the coordination and implementa-

tion of the state comprehensive AIDS-related conditions prevention and intervention plan. 2. The department shall adopt rules pursuant to chapter 17 A to implement and enforce

this chapter. The rules may include procedures for taking appropriate action with regard to health facilities or health care providers which violate this chapter or the rules adopted pursuant to this chapter.

3. The department shall adopt rules pursuant to chapter 17 A which require that if a health care provider attending a person prior to the person's death determines that the person suffered from or was suspected of suffering from a contagious or infectious disease, the health care provider shall place with the remains written notification of the condition for the information of any person handling the body of the deceased person subsequent to the person's death. For purposes of this subsection, "contagious or infectious disease" means hepatitis in any form, meningococcal disease, tuberculosis, and any other disease including AIDS or HIV infection, determined to be life-threatening to a person exposed to the disease as established by rules adopted by the department based upon a determination by the state epidemiologist and in accordance with guidelines of the centers for disease control and prevention of the United States department of health and human services.

4. The department, in cooperation with the department of public safety, and persons who represent those who attend dead bodies shall establish for all care providers, including paramedics, ambulance personnel, physicians, nurses, hospital personnel, first responders, peace officers, and fire fighters, who provide care services to a person, and for all persons who attend dead bodies, protocol and procedures for the use of universal precautions to prevent the transmission of contagious and infectious diseases.

5. The department shall coordinate efforts with local health officers to investigate sources of HIV infection and use every appropriate means to prevent the spread of the infection.

6. The department, with the approval of the state board of health, may conduct epidemio- logical blinded and nonblinded studies to determine the incidence and prevalence of the HIV infection. Initiation of any new epidemiological studies shall be contingent upon the

CH. 181 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION 456

receipt of funding sufficient to cover all the costs associated with the studies. The informed consent, reporting, and counseling requirements of this chapter shall not apply to blinded studies.

Sec. 7. NEW SECTION. 141A.3 DUTIES OF THE DEPARTMENT. 1. All federal and state moneys appropriated to the department for AIDS-related activities

shall be allocated in accordance with a prioritized schedule developed by rule of the depart- ment, and grants shall be awarded to the maximum extent feasible to community-based organizations.

2. The department shall do all of the following: a. Provide consultation to agencies and organizations regarding appropriate policies for

testing, education, confidentiality, and infection control. b. Conduct health information programs for the public relating to HIV infection, includ-

ing information about how the infection is transmitted and how transmittal can be pre- vented. The department shall prepare, for free distribution, printed information relating to HIV infection and prevention.

c. Provide educational programs concerning HIV infection in the workplace. d. Develop and implement HIV education risk-reduction programs for specific popula-

tions at high risk for infection. e. Provide an informational brochure for patients who provide samples for purposes of

performing an HIV test which, at a minimum, shall include a summary of the patient's rights and responsibilities under the law.

f. In cooperation with the department of education, develop and update a medically cor- rect AIDS prevention curriculum for use at the discretion of secondary and middle schools.

3. The department shall, in cooperation with the department of education and other agen- cies, organizations, coalitions, and local health departments, develop and implement a program of public and professional AIDS-related education.

Sec. 8. NEW SECTION. 141A.4 TESTING AND COUNSELING. 1. HIV testing and counseling shall be offered to the following: a. All persons seeking treatment for a sexually transmitted disease. b. All persons seeking treatment for injecting drug abuse or having a history of injecting

drug abuse. c. All persons who consider themselves at risk for the HIV infection. d. Male and female prostitutes. 2. Pregnant women shall be provided information about HIV prevention, risk reduction,

and treatment opportunities to reduce the possible transmission of HIV to a fetus. Pregnant women who report one or more recognized risk factors for HIV shall be strongly encouraged to undergo HIV-related testing. A pregnant woman who requests testing shall be tested regardless of the absence of risk factors.

Sec. 9. NEW SECTION. 141A.5 PARTNER NOTIFICATION PROGRAM- HIV. 1. The department shall maintain a partner notification program for persons known to

have tested positive for the HIV infection. 2. The department shall initiate the program at alternative testing and counseling sites

and at sexually transmitted disease clinics. 3. In administering the program, the department shall provide for the following: a. A person who tests positive for the HIV infection shall receive posttest counseling,

during which time the person shall be encouraged to refer for counseling and HIV testing any person with whom the person has had sexual relations or has shared drug injecting equipment.

b. The physician or other health care provider attending the person may provide to the department any relevant information provided by the person regarding any person with whom the tested person has had sexual relations or has shared drug injecting equipment.

457 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION CH. 181

The department disease prevention staff shall then conduct partner notification in the same manner as that utilized for sexually transmitted diseases consistent with the provisions of this chapter.

c. Devise a procedure, as a part of the partner notification program, to provide for the notification of an identifiable third party who is a sexual partner of or who shares drug injecting equipment with a person who has tested positive for HIV, by the department or a physician, when all of the following situations exist:

(1) A physician for the infected person is of the good faith opinion that the nature of the continuing contact poses an imminent danger of HIV infection transmission to the third party.

(2) When the physician believes in good faith that the infected person, despite strong encouragement, has not and will not warn the third party and will not participate in the voluntary partner notification program.

Notwithstanding subsection 4, the department or a physician may reveal the identity of a person who has tested positive for the HIV infection pursuant to this subsection only to the extent necessary to protect a third party from the direct threat of transmission. This subsec- tion shall not be interpreted to create a duty to warn third parties of the danger of exposure to HIV through contact with a person who tests positive for the HIV infection.

The department shall adopt rules pursuant to chapter 17 A to implement this paragraph "c". The rules shall provide a detailed procedure by which the department or a physician may directly notify an endangered third party.

4. In making contact the department shall not disclose the identity of the person who provided the names of the persons to be contacted and shall protect the confidentiality of persons contacted.

5. The department may delegate its partner notification duties under this section to local health authorities unless the local authority refuses or neglects to conduct the contact trac- ing program in a manner deemed to be effective by the department.

6. In addition to the provisions for partner notification provided under this section and notwithstanding any provision to the contrary, a county medical examiner or deputy medi- cal examiner performing official duties pursuant to sections 331.801 through 331.805 or the state medical examiner or deputy medical examiner performing official duties pursuant to chapter 691, who determines through an investigation that a deceased person was infected with HIV, may notify directly, or request that the department notify, the immediate family of the deceased or any person known to have had a significant exposure from the deceased of the finding.

Sec.10. NEWSECTION. 141A6 AIDS-RELATED CONDITIONS-SCREENING, TEST- ING, AND REPORTING.

1. Prior to obtaining a sample for the purpose of performing a voluntary HIV -related test, a health care provider shall inform the subject of the test that the test is voluntary. Within seven days of the receipt of a test result indicating HIV infection which has been confirmed as positive according to prevailing medical technology, the physician or other health care provider at whose request the test was performed shall make a report to the department on a form provided by the department.

2. Within seven days of diagnosing a person as having an AIDS-related condition, the diagnosing physician shall make a report to the department on a form provided by the department.

3. Within seven days of the death of a person resulting from an AIDS-related condition, the attending physician shall make a report to the department on a form provided by the department.

4. Within seven days of the receipt of a test result indicating HIV infection which has been confirmed as positive according to prevailing medical technology, the director of a blood bank shall make a report to the department on a form provided by the department.

CH. 181 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION 458

5. Within seven days of the receipt of a test result indicating HIV infection which has been confirmed as positive according to prevailing medical technology, the director of a clinica11aboratory shall make a report to the department on a form provided by the depart- ment.

6. The forms provided by the department shall require inclusion of all of the following information:

a. The name of the patient. b. The address of the patient. c. The patient's date of birth. d. The gender of the patient. e. The race or ethnicity of the patient. f. The patient's marital status. g. The patient's telephone number. h. The name and address of the laboratory or blood bank. i. The date the test was found to be positive and the collection date. j. The name of the physician or health care provider who performed the test. k If the patient is female, whether the patient is pregnant.

Sec. 11. NEWSECTION. 141A.7 TESTRESULTS-COUNSELING-APPLICATION FOR SERVICES.

1. Prior to undergoing an HIV-related test, information shall be available to the subject of the test concerning testing and any means of obtaining additional information regarding HIV infection and risk reduction. At any time that the subject of an HIV-related test is informed of confirmed positive test results, counseling concerning the emotional and physi- cal health effects shall be initiated. Particular attention shall be given to explaining the need for the precautions necessary to avoid transmitting the virus. The subject shall be given information concerning additional counseling.

2. Notwithstanding subsection 1, the provisions of this section do not apply to any of the following:

a. The performance by a health care provider or health facility of an HIV-related test when the health care provider or health facility procures, processes, distributes, or uses a human body part donated for a purpose specified under the uniform anatomical gift Act, or semen provided prior to July 1, 1988, for the purpose of artificial insemination, or donations of blood, and such test is necessary to ensure medical acceptability of such gift or semen for the purposes intended.

b. A person engaged in the business of insurance who is subject to section 505.16. c. The performance by a health care provider or health facility of an HIV-related test when

the subject of the test is deceased and a documented significant exposure has occurred. 3. A person may apply for voluntary treatment, contraceptive services, or screening or

treatment for HIV infection and other sexually transmitted diseases directly to a licensed physician and surgeon, an osteopathic physician and surgeon, or a family planning clinic. Notwithstanding any other provision of law, however, a minor shall be informed prior to testing that, upon confirmation according to prevailing medical technology of a positive HIV-related test result, the minor's legal guardian is required to be informed by the testing facility. Testing facilities where minors are tested shall have available a program to assist minors and legal guardians with the notification process which emphasizes the need for family support and assists in making available the resources necessary to accomplish that goal. However, a testing facility which is precluded by federal statute, regulation, or centers for disease control and prevention guidelines from informing the legal guardian is exempt from the notification requirement. The minor shall give written consent to these procedures and to receive the services, screening, or treatment. Such consent is not subject to later disaffirmance by reason of minority.

459 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION CH. 181

Sec. 12. NEW SECTION. 141A.8 CARE PROVIDER NOTIFICATION. 1. A hospital licensed under chapter 135B shall provide notification to a care provider

who renders assistance or treatment to an individual, following submission of a significant exposure report by the care provider to the hospital and a diagnosis or confirmation by an attending physician that the individual has HIV infection, and determination that the expo- sure reported was a significant exposure. The notification shall advise the care provider of possible exposure to HIV infection. Notification shall be made in accordance with both of the following:

a. The hospital informs the individual, when the individual's condition permits, of the submission of a significant exposure report.

b. The individual consents to serological testing by or voluntarily discloses the individual's HIV status to the hospital and consents to notification.

Notwithstanding paragraphs "a" and "b", notification shall be made when the individual denies consent for or consent is not reasonably obtainable for serological testing, and in the course of admission, care, and treatment of the individual, the individual is diagnosed or is confirmed as having HIV infection.

2. The hospital shall notify the care provider involved in attending or transporting an individual who submitted a significant exposure report. This shall include a person who renders direct emergency aid without compensation, or in the case of an emergency care provider, the designated officer of the emergency care provider service, who in turn shall notify any emergency care providers. The identity of the designated officer shall not be revealed to the individual. The designated officer shall inform the hospital of those parties who received the notification, and following receipt of this information and upon request of the individual, the hospital shall inform the individual of the parties to whom notification was provided.

3. The hospital, upon request of the individual, shall inform the individual of the persons to whom notification was made.

4. The process for notification under this section shall be initiated as soon as is reason- ably possible.

5. A health care provider, with consent of the individual, may provide the notification required of hospitals in this section to care providers if an individual who has HIV infection is delivered by a care provider to the office or clinic of the health care provider for treatment. The notification shall take place only upon submission of a significant exposure report form by the care provider to the health care provider and the determination by the health care provider that a significant exposure has occurred.

6. This section does not require or permit, unless otherwise provided, a hospital or health care provider to administer a test for the express purpose of determining the presence of HIV infection, except that testing may be performed if the individual consents, and if the require- ments of this section are satisfied.

7. When a care provider in the course of providing care sustains a significant exposure on the premises of a health care facility or while engaged in rendering aid or providing trans- portation to an individual in circumstances which lead to the individual's presence at a health care facility, the individual to whom the care provider was exposed is deemed to consent to a test to be administered by the health care facility upon the written request of the exposed care provider for the express purpose of determining the presence of HIV infection in that individual. The sample and test results shall only be identified by a number and no reports otherwise required by this chapter shall be made which identify the individual tested. However, if the test results are positive, the health care facility shall notify the individual tested and ensure performance of counseling and reporting requirements of this chapter in the same manner as for an individual from whom actual consent was obtained.

8. A hospital or health care provider, or other person participating in good faith in mak- ing a report under the notification provisions of this section, under procedures similar to this section for notification of its own employees upon filing of a significant exposure

CH. 181 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION 460

report, or in failing to make a report under this section, is immune from any liability, civil or criminal, which might otherwise be incurred or imposed.

9. Notifications made pursuant to this section shall not disclose the identity of the indi- vidual who is diagnosed or confirmed as having HIV infection unless the individual pro- vides a specific written release as provided in subsection 1, paragraph "b". If the care pro- vider determines the identity of the individual, the identity of the individual shall be confi- dential information and shall not be disclosed by the care provider to any other person unless a specific written release is obtained from the individual.

10. A hospital's duty to notify under this section is not continuing but is limited to the diagnosis of HIV infection made in the course of admission, care, and treatment following the rendering of assistance or treatment of the individual with the infection.

11. Notwithstanding subsection 10, if, following discharge or completion of care or treat- ment, an individual for whom a significant exposure report was submitted but which report did not result in notification, wishes to provide information regarding the individual's HIV infection status to the care provider who submitted the report, the hospital shall provide a procedure for notifying the care provider.

12. The employer of a care provider who submits a report of significant exposure under this section sustained in the course of employment shall pay the costs of HIV testing for the individual and the costs of HIV testing and counseling for the care provider. However, the department shall pay the costs of HIV testing for the individual and the costs of HIV testing and counseling for a care provider who renders direct aid without compensation.

Sec. 13. NEW SECTION. 141A.9 CONFIDENTIALITY OF INFORMATION. Any information, including reports and records, obtained, submitted, and maintained

pursuant to this chapter is strictly confidential medical information. The information shall not be released, shared with an agency or institution, or made public upon subpoena, search warrant, discovery proceedings, or by any other means except as provided in this chapter. A person shall not be compelled to disclose the identity of any person upon whom an HIV-related test is performed, or the results of the test in a manner which permits identifica- tion of the subject of the test, except to persons entitled to that information under this chapter. Information shall be made available for release to the following individuals or under the following circumstances:

1. To the subject of the test or the subject's legal guardian subject to the provisions of section 141A. 7, subsection 3, when applicable.

2. To any person who secures a written release of test results executed by the subject of the test or the subject's legal guardian.

3. To an authorized agent or employee of a health facility or health care provider, if the health facility or health care provider ordered or participated in the testing or is otherwise authorized to obtain the test results, the agent or employee provides patient care or handles or processes samples, and the agent or employee has a medical need to know such infor- mation.

4. To a health care provider providing care to the subject of the test when knowledge of the test results is necessary to provide care or treatment.

5. To the department in accordance with reporting requirements for an HIV-related condition.

6. To a health facility or health care provider which procures, processes, distributes, or uses a human body part from a deceased person with respect to medical information regard- ing that person, or semen provided prior to July 1, 1988, for the purpose of artificial insemi- nation.

7. Release may be made of medical or epidemiological information for statistical pur- poses in a manner such that no individual person can be identified.

8. Release may be made of medical or epidemiological information to the extent neces- sary to enforce the provisions of this chapter and related rules concerning the treatment, control, and investigation of HIV infection by public health officials.

461 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION CH. 181

9. Release may be made of medical or epidemiological information to medical personnel to the extent necessary to protect the health or life of the named party.

10. Release may be made of test results concerning a patient pursuant to procedures established under section 141A.5, subsection 3, paragraph "c".

11. To a person allowed access to a record by a court order which is issued in compliance with the following provisions:

a. A court has found that the person seeking the test results has demonstrated a compel- ling need for the test results which need cannot be accommodated by other means. In assessing compelling need, the court shall weigh the need for disclosure against the privacy interest of the test subject and the public interest which may be disserved by disclosure due to its deterrent effect on future testing or due to its effect in leading to discrimination.

b. Pleadings pertaining to disclosure of test results shall substitute a pseudonym for the true name of the subject of the test. The disclosure to the parties of the subject's true name shall be communicated confidentially in documents not filed with the court.

c. Before granting an order, the court shall provide the person whose test results are in question with notice and a reasonable opportunity to participate in the proceedings if the person is not already a party.

d. Court proceedings as to disclosure of test results shall be conducted in camera unless the subject of the test agrees to a hearing in open court or unless the court determines that a public hearing is necessary to the public interest and the proper administration of justice.

e. Upon the issuance of an order to disclose test results, the court shall impose appropri- ate safeguards against unauthorized disclosure, which shall specify the persons who may gain access to the information, the purposes for which the information shall be used, and appropriate prohibitions on future disclosure.

12. To an employer, if the test is authorized to be required under any other provision of law.

13. To a convicted or alleged sexual assault offender; the physician or other health care provider who orders the test of a convicted or alleged offender; the victim; the parent, guard- ian, or custodian of the victim if the victim is a minor; the physician of the victim; the victim counselor or person requested by the victim to provide counseling regarding the HIV-related test and results; the victim's spouse; persons with whom the victim has engaged in vaginal, anal, or oral intercourse subsequent to the sexual assault; members of the victim's family within the third degree of consanguinity; and the county attorney who may use the results as evidence in the prosecution of sexual assault under chapter 915, subchapter IV, or pros- ecution of the offense of criminal transmission of HIV under chapter 709C. For the purposes of this paragraph, "victim" means victim as defined section 915.40.

14. To employees of state correctional institutions subject to the jurisdiction of the depart- ment of corrections, employees of secure facilities for juveniles subject to the department of human services, and employees of city and county jails, if the employees have direct super- vision over inmates of those facilities or institutions in the exercise of the duties prescribed pursuant to section 80.9, subsection 2, paragraph "d".

Sec. 14. NEWSECTION. 141A.10 IMMUNITIES. 1. A person making a report in good faith pursuant to this chapter is immune from any

liability, civil or criminal, which might otherwise be incurred or imposed as a result of the report.

2. A health care provider attending a person who tests positive for the HIV infection has no duty to disclose to or to warn third parties of the dangers of exposure to HIV infection through contact with that person and is immune from any liability, civil or criminal, for failure to disclose to or warn third parties of the condition of that person.

Sec. 15. NEWSECTION. 141A.ll REMEDIES. 1. A person aggrieved by a violation of this chapter shall have a right of civil action for

damages in district court.

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2. A care provider who intentionally or recklessly makes an unauthorized disclosure under this chapter is subject to a civil penalty of one thousand dollars.

3. A person who violates a confidentiality requirement of section 141A.5 is guilty of an aggravated misdemeanor.

4. A civil action under this chapter is barred unless the action is commenced within two years after the cause of action accrues.

5. The attorney general may maintain a civil action to enforce this chapter. 6. This chapter does not limit the rights of the subject of an HIV-related test to recover

damages or other relief under any other applicable law. 7. This chapter shall not be construed to impose civil liability or criminal sanction for

disclosure of HIV-related test results in accordance with any reporting requirement for a diagnosed case of AIDS or a related condition by the department or the centers for disease control and prevention of the United States public health service.

Sec. 16. Section 321.186, unnumbered paragraph 4, Code 1999, is amended to read as follows:

A physician licensed under chapter 148, 150, or 150A, or an optometrist licensed under chapter 154, may report to the department the identity of a person who has been diagnosed as having a physical or mental condition which would render the person physically or mentally incompetent to operate a motor vehicle in a safe manner. The physician or optom- etrist shall make reasonable efforts to notify the person who is the subject of the report, in writing. The written notification shall state the nature of the disclosure and the reason for the disclosure. A physician or optometrist making a report under this section shall be immune from any liability, civil or criminal, which might otherwise be incurred or imposed as a result of the report. A physician or optometrist has no duty to make a report or to warn third parties with regard to any knowledge concerning a person's mental or physical com- petency to operate a motor vehicle in a safe manner. Any report received by the department from a physician or optometrist under this section shall be kept confidential. Information regulated by chapter -l-4+ 141A shall be subject to the confidentiality provisions and rem- edies of seetions 141.26 and 141.24 that chapter.

Sec. 17. Section 505.16, subsection 1, Code 1999, is amended to read as follows: 1. A person engaged in the business of insurance shall not require a test of an individual

in connection with an application for insurance for the presence of an antibody to the human immunodeficiency virus unless the individual provides a written release on a form approved by the insurance commissioner. The form shall include information regarding the purpose, content, use, and meaning of the test, disclosure of test results including informa- tion explaining the effect of releasing the information to a person engaged in the business of insurance, the purpose for which the test results may be used, and other information ap- proved by the insurance commissioner. The form shall also authorize the person perform- ing the test to provide the results of the test to the insurance company subject to rules of confidentiality, consistent with section~ 141A.9, approved by the insurance commis- sioner. As used in this section, "a person engaged in the business of insurance" includes hospital service corporations organized under chapter 514 and health maintenance organi- zations subject to chapter 514B.

Sec. 18. Section 904.515, Code 1999, is amended to read as follows: 904.515 HUMAN IMMUNODEFICIENCYVIRUS-RELATED MATTERS- EXEMPTION. The provisions of chapter -l-4+ 141A relating to knowledge and consent do not apply to

persons committed to the custody of the department. The department may provide for medi- cally acceptable procedures to inform employees, visitors, and persons committed to the department of possible infection and to protect them from possible infection.

Sec. 19. Section 915.40, subsection 3, paragraph c, Code 1999, is amended to read as follows:

463 LAWS OF THE SEVENTY-EIGHTH G.A., 1999 SESSION CH. 181

c. The victim counselor or person requested by the victim who is authorized to provide the counseling required pursuant to seetion 141.22 regarding the HlV-related test and results.

Sec. 20. Section 915.42, subsection 4, paragraph a, Code 1999, is amended to read as follows:

a. Prior to the scheduling of a hearing, refer the victim for counseling by a victim counse- lor or a person requested by the victim who is authorized to provide the counseling required pursuant to section 141.22, regarding the nature, reliability, and significance of the HlV-related test and of the serologic status of the convicted offender.

Sec. 21. Section 915.43, subsections 1, 2, 4, and 5, Code 1999, are amended to read as follows:

1. The physician or other practitioner who orders the test of a convicted or alleged of- fender for HlV under this subchapter shall disclose the results of the test to the convicted or alleged offender, and to the victim counselor or a person requested by the victim whe-is authorized to provide the counseling required pursuant to section 141.22, regarding the HlV-related test and results who shall disclose the results to the petitioner.

2. All testing under this chapter shall be accompanied by pretest and posttest counseling as required under section~ 141A.7.

4. Results of a test performed under this subchapter, except as provided in subsection 13, shall be disclosed only to the physician or other practitioner who orders the test of the convicted or alleged offender, the convicted or alleged offender, the victim, the victim coun- selor or person requested by the victim who is authorized to provide the counseling required pursuant to section 141.22 regarding the HlV-related test and results, the physician ofthe victim if requested by the victim, the parent, guardian, or custodian of the victim, if the victim is a minor, and the county attorney who filed the petition for HlV-related testing under this chapter, who may use the results to file charges of criminal transmission of HlV under chapter 709C. Results of a test performed under this subchapter shall not be disclosed to any other person without the written informed consent of the convicted or alleged offender. A person to whom the results of a test have been disclosed under this subchapter is subject to the confidentiality provisions of section~ 141A.9, and shall not disclose the results to another person except as authorized by section 141.23, subsection 1 141A.9. subsection 13.

5. If testing is ordered under this subchapter, the court shall also order periodic testing of the convicted offender during the period of incarceration, probation, or parole or of the alleged offender during a period of six months following the initial test if the physician or other practitioner who ordered the initial test of the convicted or alleged offender certifies that, based upon prevailing scientific opinion regarding the maximum period during which the results of an HlV-related test may be negative for a person after being HlV-infected, additional testing is necessary to determine whether the convicted or alleged offender was HlV-infected at the time the sexual assault or alleged sexual assault was perpetrated. The results of the test conducted pursuant to this subsection shall be released only to the physi- cian or other practitioner who orders the test of the convicted or alleged offender, the con- victed or alleged offender, the victim counselor or person requested by the victim whe-is authorized to provide the counseling required pursuant to section 141.22, regarding the HlV-related test and results who shall disclose the results to the petitioner, the physician of the victim, if requested by the victim, and the county attorney who may use the results as evidence in the prosecution of the sexual assault or in the prosecution of the offense of criminal transmission of HlV under chapter 709C.

Sec. 22. Chapter 141, Code 1999, is repealed.

Approved May 26, 1999