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NO. 17. AN ACT RELATING TO CONFIDENTIALITY OF HIV REPORTING.

(H.451)

It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1. FINDINGS

The General Assembly finds that:

(1) Improved monitoring of the incidents of human immunodeficiency virus (HIV) infection will enhance state and local efforts to plan for future health care and social service needs, to develop HIV prevention strategies and to create resources to fight the spread of HIV infection.

(2) Effective HIV public health prevention strategies are dependent, in large part, on voluntary individual testing. A system that protects the confidentiality of individuals promotes participation in any testing program, enhances education and increases the distribution of information about preventing the spread of HIV.

(3) A system of HIV reporting that uses the individual's name is a major deterrent for a person's willingness to be tested or to seek medical care for HIV. This deterrent is even higher for those people at the highest risk for HIV infection. Therefore, a system that reports individual HIV cases using a unique identifier, rather than the participant's name, promotes prevention and the accumulation of important data.

(4) Providing anonymous HIV antibody testing increases the number of individuals who seek HIV testing by guaranteeing the privacy of test results. A successful and useful HIV surveillance system must ensure continued funding, anonymity and accessibility of HIV testing sites.

Sec. 2. 18 V.S.A. § 1001 is amended to read:

§ 1001. REPORTS TO COMMISSIONER OF HEALTH

(a) When a physician, health care provider, administrator of a hospital, health care facility, health maintenance organization or managed care organization, or the administrator's designee, town health officer, nurse practitioner, nurse, physician's assistant or school health official has reason to believe that a person is sick or has died of a diagnosed or suspected disease, identified by the department of health as a reportable disease and dangerous to the public health or if a laboratory director has evidence of such sickness or disease, he or she shall transmit within 24 hours a report thereof and identify the name and address of the patient and the name of the patient's physician to the commissioner of health or designee, except in the case of the human immunodeficiency virus (HIV) which shall be reported only by a unique identifier code. The commissioner with the approval of the secretary of human services shall by regulation establish a list of those diseases dangerous to the public health that shall be reportable. All information collected pursuant to this section and in support of investigations and studies undertaken by the commissioner for the purpose of determining the nature or cause of any disease outbreak shall be privileged and confidential. The health department shall, by rule, require that any person required to report under this section has in place a procedure that ensures confidentiality.

(b) Public health records that relate to the human immunodeficiency virus (HIV) or to acquired immune deficiency syndrome (AIDS) that contain any personally identifying information, or any information that may indirectly identify a person and was developed or acquired by state or local public health agencies shall be confidential and shall not be disclosed, except for public health purposes as provided by law or pursuant to a written authorization voluntarily executed by the individual subject of the public health record, or the individual's guardian or conservator.

(c) A disclosure made pursuant to subsection (b) of this section shall include only the information necessary for the purpose for which the disclosure is made. The disclosure shall be made only on agreement that the information shall remain confidential and shall not be further disclosed without additional written authorization by the individual subject as required by subsection (b) of this section.

(d) A confidential public health record shall not be:

(1) Disclosed or discoverable in any civil, criminal, administrative or other proceeding.

(2) Used to determine issues relating to employment or insurance for any individual.

(e) Any person who willfully or maliciously discloses the content of any confidential public health record without written authorization or as authorized by law or in violation of subsections (b), (c) or (e) shall be subject to a civil penalty of not less than $10,000.00 and not more than $25,000.00, and costs and attorney fees as determined by the court.

Sec. 3. HIV REPORTING SYSTEM; RULES; DEPARTMENT OF HEALTH

(a) As soon as practicable, but no later than January 1, 2000, the department of health shall design and implement a uniform statewide system for reporting HIV, using a unique identifier code that prohibits reporting the name or any other personally identifying information of any individual infected with HIV to state or local public health agencies. "Personally identifying information" means any information codes or characteristics from which an individual's identity may be determined, including complete Social Security numbers and drivers license numbers. The system shall be designed to protect the confidentiality of individuals, maintain the security of all health records that relate to HIV and efficiently and productively evaluate collected data to strengthen public health efforts to treat and prevent HIV infection.

(b) The department shall consult with persons infected with HIV, representatives of communities most affected by and at risk for HIV infection, health care and support service providers, local health officers, experts in HIV epidemiology and other interested and appropriate persons to develop and design this reporting system and any related rules adopted. The department shall adopt rules to implement this system and those rules shall, at a minimum, include the following:

(1) Criteria by which an HIV surveillance system will be evaluated. Criteria developed shall include analysis of impact of case-based surveillance of the willingness of individuals to seek testing and medical care for HIV.

(2) The use of data derived from case reporting which will be used, at a minimum, to conduct epidemiological analyses, evaluate the effectiveness of HIV prevention activities, assist in allocating resources and plan for future service needs.

(c) The department shall make ongoing improvements to the system of surveillance of the HIV epidemic. These improvements shall include, as appropriate, examination and development of additional utilization of noncase reporting surveillance methods that include population-based seroprevalence studies, sentinel and random serosurveys and behavioral surveillance studies.

(d) The department shall conduct training for health care providers, local health department employees, laboratory employees and members of affected communities in order to promote understanding of and compliance with the HIV reporting system.

Approved: May 10, 1999