House Bill hb1289er
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    2002 Legislature                     HB 1289, Second Engrossed
  1
  2         An act relating to the testing of inmates for
  3         HIV; creating s. 945.355, F.S.; defining the
  4         term "HIV test"; requiring the Department of
  5         Corrections to perform an HIV test before an
  6         inmate is released if the inmate's HIV status
  7         is unknown; providing certain exceptions;
  8         requiring that the Department of Corrections
  9         notify the Department of Health and the county
10         health department where the inmate plans to
11         reside following release if the inmate is HIV
12         positive; requiring the department to provide
13         special transitional assistance to an inmate
14         who is HIV positive; requiring the department
15         to report to the Legislature; amending s.
16         945.10, F.S.; requiring that certain medical
17         records be released to the Department of Health
18         and the county health department where an
19         inmate who is HIV positive plans to reside;
20         reenacting s. 945.10(1)(a), F.S., relating to
21         mental health, medical, or substance abuse
22         records of an inmate; amending s. 381.004,
23         F.S.; providing that informed consent is not
24         required for an HIV test of an inmate prior to
25         the inmate's release; amending s. 944.704,
26         F.S.; providing additional duties for the
27         department with respect to transition
28         assistance for inmates who are HIV positive;
29         limiting liability; providing an appropriation;
30         providing an effective date.
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    2002 Legislature                     HB 1289, Second Engrossed
  1         WHEREAS, HIV and AIDS infections are one of the state's
  2  most critical challenges, with Florida having the third
  3  highest number of AIDS cases in the nation and the second
  4  highest number of pediatric AIDS cases, and
  5         WHEREAS, the prevalence of HIV and AIDS cases in the
  6  state's prisons exceeds the prevalence of HIV and AIDS in the
  7  general population, and
  8         WHEREAS, between 1989 and 1997, death due to AIDS
  9  accounted for over half of inmate deaths in the state's
10  prisons, and
11         WHEREAS, recent advances in treatment for HIV and AIDS
12  can potentially reduce the number of opportunistic infections
13  and associated medical costs and delay the onset of death due
14  to the disease, and
15         WHEREAS, referral to appropriate medical and social
16  services upon the release of an inmate can play a crucial role
17  in the treatment, care, and secondary prevention efforts, NOW
18  THEREFORE,
19
20  Be It Enacted by the Legislature of the State of Florida:
21
22         Section 1.  Section 945.355, Florida Statutes, is
23  created to read:
24         945.355  HIV testing of inmates prior to release.--
25         (1)  As used in this section, the term "HIV test" means
26  a test ordered to determine the presence of the antibody or
27  antigen to human immunodeficiency virus or the presence of
28  human immunodeficiency virus infection.
29         (2)  If an inmate's HIV status is unknown to the
30  department, the department shall, pursuant to s. 381.004(3),
31  perform an HIV test on the inmate not less than 60 days prior
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    2002 Legislature                     HB 1289, Second Engrossed
  1  to the inmate's presumptive release date from prison by reason
  2  of parole, accumulation of gain-time credits, or expiration of
  3  sentence. An inmate who is known to the department to be HIV
  4  positive or who has been tested within the previous year and
  5  does not request retesting need not be tested under this
  6  section, but is subject to subsections (4) and (5). However,
  7  an inmate who is released due to an emergency is exempt from
  8  the provisions of this section.
  9         (3)  The department shall record the results of the HIV
10  test in the inmate's medical record.
11         (4)  Pursuant to ss. 381.004(3) and 945.10, the
12  department shall notify the Department of Health and the
13  county health department where the inmate plans to reside
14  regarding an inmate who is known to be HIV positive or has
15  received an HIV positive test result under this section prior
16  to the release of that inmate.
17         (5)  Prior to the release of an inmate who is known to
18  be HIV positive or who has received a positive HIV test result
19  under this section, the department shall provide special
20  transitional assistance to the inmate, which must include:
21         (a)  Education on preventing the transmission of HIV to
22  others and on the importance of receiving follow-up care and
23  treatment.
24         (b)  A written, individualized discharge plan that
25  includes referrals to and contacts with the county health
26  department and local HIV primary care services in the area
27  where the inmate plans to reside.
28         (c)  A 30-day supply of all HIV/AIDS-related
29  medications that the inmate is taking prior to release under
30  the protocols of the Department of Corrections and the
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    2002 Legislature                     HB 1289, Second Engrossed
  1  treatment guidelines of the United States Department of Health
  2  and Human Services.
  3         Section 2.  By March 1, 2003, the Department of
  4  Corrections shall submit a report to the Legislature
  5  concerning the department's implementation of section 945.355,
  6  Florida Statutes. At a minimum, the report must include the
  7  total number of inmates tested under the program, the number
  8  of inmates who tested positive for HIV, the number of inmates
  9  who received special transitional assistance, and the number
10  of inmates who received medication in accordance with
11  protocols of the Department of Corrections and the treatment
12  guidelines of the United States Department of Health and Human
13  Services.
14         Section 3.  Paragraph (a) of subsection (1) of section
15  945.10, Florida Statutes, is reenacted, and subsection (2) of
16  that section is amended to read:
17         945.10  Confidential information.--
18         (1)  Except as otherwise provided by law or in this
19  section, the following records and information of the
20  Department of Corrections are confidential and exempt from the
21  provisions of s. 119.07(1) and s. 24(a), Art. I of the State
22  Constitution:
23         (a)  Mental health, medical, or substance abuse records
24  of an inmate or an offender.
25         (2)  The records and information specified in
26  paragraphs (1)(a)-(h) (1)(b)-(h) may be released as follows
27  unless expressly prohibited by federal law:
28         (a)  Information specified in paragraphs (1)(b), (d),
29  and (f) to the Office of the Governor, the Legislature, the
30  Parole Commission, the Department of Children and Family
31  Services, a private correctional facility or program that
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    2002 Legislature                     HB 1289, Second Engrossed
  1  operates under a contract, the Department of Legal Affairs, a
  2  state attorney, the court, or a law enforcement agency. A
  3  request for records or information pursuant to this paragraph
  4  need not be in writing.
  5         (b)  Information specified in paragraphs (1)(c), (e),
  6  and (h) to the Office of the Governor, the Legislature, the
  7  Parole Commission, the Department of Children and Family
  8  Services, a private correctional facility or program that
  9  operates under contract, the Department of Legal Affairs, a
10  state attorney, the court, or a law enforcement agency. A
11  request for records or information pursuant to this paragraph
12  must be in writing and a statement provided demonstrating a
13  need for the records or information.
14         (c)  Information specified in paragraph (1)(b) to an
15  attorney representing an inmate under sentence of death,
16  except those portions of the records containing a victim's
17  statement or address, or the statement or address of a
18  relative of the victim. A request for records of information
19  pursuant to this paragraph must be in writing and a statement
20  provided demonstrating a need for the records or information.
21         (d)  Information specified in paragraph (1)(b) to a
22  public defender representing a defendant, except those
23  portions of the records containing a victim's statement or
24  address, or the statement or address of a relative of the
25  victim. A request for records or information pursuant to this
26  paragraph need not be in writing.
27         (e)  Information specified in paragraph (1)(b) to state
28  or local governmental agencies. A request for records or
29  information pursuant to this paragraph must be in writing and
30  a statement provided demonstrating a need for the records or
31  information.
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    2002 Legislature                     HB 1289, Second Engrossed
  1         (f)  Information specified in paragraph (1)(b) to a
  2  person conducting legitimate research. A request for records
  3  and information pursuant to this paragraph must be in writing,
  4  the person requesting the records or information must sign a
  5  confidentiality agreement, and the department must approve the
  6  request in writing.
  7         (g)  Information specified in paragraph (1)(a) to the
  8  Department of Health and the county health department where an
  9  inmate plans to reside if he or she has tested positive for
10  the presence of the antibody or antigen to human
11  immunodeficiency virus infection.
12
13  Records and information released under this subsection remain
14  confidential and exempt from the provisions of s. 119.07(1)
15  and s. 24(a), Art. I of the State Constitution when held by
16  the receiving person or entity.
17         Section 4.  Paragraph (h) of subsection (3) of section
18  381.004, Florida Statutes, is amended to read:
19         381.004  HIV testing.--
20         (3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED
21  CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--
22         (h)  Notwithstanding the provisions of paragraph (a),
23  informed consent is not required:
24         1.  When testing for sexually transmissible diseases is
25  required by state or federal law, or by rule including the
26  following situations:
27         a.  HIV testing pursuant to s. 796.08 of persons
28  convicted of prostitution or of procuring another to commit
29  prostitution.
30
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    2002 Legislature                     HB 1289, Second Engrossed
  1         b.  HIV testing of inmates pursuant to s. 945.355 prior
  2  to their release from prison by reason of parole, accumulation
  3  of gain-time credits, or expiration of sentence.
  4         c.b.  Testing for HIV by a medical examiner in
  5  accordance with s. 406.11.
  6         2.  Those exceptions provided for blood, plasma,
  7  organs, skin, semen, or other human tissue pursuant to s.
  8  381.0041.
  9         3.  For the performance of an HIV-related test by
10  licensed medical personnel in bona fide medical emergencies
11  when the test results are necessary for medical diagnostic
12  purposes to provide appropriate emergency care or treatment to
13  the person being tested and the patient is unable to consent,
14  as supported by documentation in the medical record.
15  Notification of test results in accordance with paragraph (c)
16  is required.
17         4.  For the performance of an HIV-related test by
18  licensed medical personnel for medical diagnosis of acute
19  illness where, in the opinion of the attending physician,
20  obtaining informed consent would be detrimental to the
21  patient, as supported by documentation in the medical record,
22  and the test results are necessary for medical diagnostic
23  purposes to provide appropriate care or treatment to the
24  person being tested. Notification of test results in
25  accordance with paragraph (c) is required if it would not be
26  detrimental to the patient.  This subparagraph does not
27  authorize the routine testing of patients for HIV infection
28  without informed consent.
29         5.  When HIV testing is performed as part of an autopsy
30  for which consent was obtained pursuant to s. 872.04.
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    2002 Legislature                     HB 1289, Second Engrossed
  1         6.  For the performance of an HIV test upon a defendant
  2  pursuant to the victim's request in a prosecution for any type
  3  of sexual battery where a blood sample is taken from the
  4  defendant voluntarily, pursuant to court order for any
  5  purpose, or pursuant to the provisions of s. 775.0877, s.
  6  951.27, or s. 960.003; however, the results of any HIV test
  7  performed shall be disclosed solely to the victim and the
  8  defendant, except as provided in ss. 775.0877, 951.27, and
  9  960.003.
10         7.  When an HIV test is mandated by court order.
11         8.  For epidemiological research pursuant to s.
12  381.0032, for research consistent with institutional review
13  boards created by 45 C.F.R. part 46, or for the performance of
14  an HIV-related test for the purpose of research, if the
15  testing is performed in a manner by which the identity of the
16  test subject is not known and may not be retrieved by the
17  researcher.
18         9.  When human tissue is collected lawfully without the
19  consent of the donor for corneal removal as authorized by s.
20  765.5185 or enucleation of the eyes as authorized by s.
21  765.519.
22         10.  For the performance of an HIV test upon an
23  individual who comes into contact with medical personnel in
24  such a way that a significant exposure has occurred during the
25  course of employment or within the scope of practice and where
26  a blood sample is available that was taken from that
27  individual voluntarily by medical personnel for other
28  purposes.  The term "medical personnel" includes a licensed or
29  certified health care professional; an employee of a health
30  care professional or health care facility; employees of a
31  laboratory licensed under chapter 483; personnel of a blood
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  1  bank or plasma center; a medical student or other student who
  2  is receiving training as a health care professional at a
  3  health care facility; and a paramedic or emergency medical
  4  technician certified by the department to perform life-support
  5  procedures under s. 401.23.
  6         a.  Prior to performance of an HIV test on a
  7  voluntarily obtained blood sample, the individual from whom
  8  the blood was obtained shall be requested to consent to the
  9  performance of the test and to the release of the results.
10  The individual's refusal to consent and all information
11  concerning the performance of an HIV test and any HIV test
12  result shall be documented only in the medical personnel's
13  record unless the individual gives written consent to entering
14  this information on the individual's medical record.
15         b.  Reasonable attempts to locate the individual and to
16  obtain consent shall be made, and all attempts must be
17  documented. If the individual cannot be found, an HIV test may
18  be conducted on the available blood sample. If the individual
19  does not voluntarily consent to the performance of an HIV
20  test, the individual shall be informed that an HIV test will
21  be performed, and counseling shall be furnished as provided in
22  this section.  However, HIV testing shall be conducted only
23  after a licensed physician documents, in the medical record of
24  the medical personnel, that there has been a significant
25  exposure and that, in the physician's medical judgment, the
26  information is medically necessary to determine the course of
27  treatment for the medical personnel.
28         c.  Costs of any HIV test of a blood sample performed
29  with or without the consent of the individual, as provided in
30  this subparagraph, shall be borne by the medical personnel or
31  the employer of the medical personnel. However, costs of
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  1  testing or treatment not directly related to the initial HIV
  2  tests or costs of subsequent testing or treatment shall not be
  3  borne by the medical personnel or the employer of the medical
  4  personnel.
  5         d.  In order to utilize the provisions of this
  6  subparagraph, the medical personnel must either be tested for
  7  HIV pursuant to this section or provide the results of an HIV
  8  test taken within 6 months prior to the significant exposure
  9  if such test results are negative.
10         e.  A person who receives the results of an HIV test
11  pursuant to this subparagraph shall maintain the
12  confidentiality of the information received and of the persons
13  tested.  Such confidential information is exempt from s.
14  119.07(1).
15         f.  If the source of the exposure will not voluntarily
16  submit to HIV testing and a blood sample is not available, the
17  medical personnel or the employer of such person acting on
18  behalf of the employee may seek a court order directing the
19  source of the exposure to submit to HIV testing.  A sworn
20  statement by a physician licensed under chapter 458 or chapter
21  459 that a significant exposure has occurred and that, in the
22  physician's medical judgment, testing is medically necessary
23  to determine the course of treatment constitutes probable
24  cause for the issuance of an order by the court.  The results
25  of the test shall be released to the source of the exposure
26  and to the person who experienced the exposure.
27         11.  For the performance of an HIV test upon an
28  individual who comes into contact with medical personnel in
29  such a way that a significant exposure has occurred during the
30  course of employment or within the scope of practice of the
31  medical personnel while the medical personnel provides
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  1  emergency medical treatment to the individual; or who comes
  2  into contact with nonmedical personnel in such a way that a
  3  significant exposure has occurred while the nonmedical
  4  personnel provides emergency medical assistance during a
  5  medical emergency.  For the purposes of this subparagraph, a
  6  medical emergency means an emergency medical condition outside
  7  of a hospital or health care facility that provides physician
  8  care. The test may be performed only during the course of
  9  treatment for the medical emergency.
10         a.  An individual who is capable of providing consent
11  shall be requested to consent to an HIV test prior to the
12  testing. The individual's refusal to consent, and all
13  information concerning the performance of an HIV test and its
14  result, shall be documented only in the medical personnel's
15  record unless the individual gives written consent to entering
16  this information on the individual's medical record.
17         b.  HIV testing shall be conducted only after a
18  licensed physician documents, in the medical record of the
19  medical personnel or nonmedical personnel, that there has been
20  a significant exposure and that, in the physician's medical
21  judgment, the information is medically necessary to determine
22  the course of treatment for the medical personnel or
23  nonmedical personnel.
24         c.  Costs of any HIV test performed with or without the
25  consent of the individual, as provided in this subparagraph,
26  shall be borne by the medical personnel or the employer of the
27  medical personnel or nonmedical personnel. However, costs of
28  testing or treatment not directly related to the initial HIV
29  tests or costs of subsequent testing or treatment shall not be
30  borne by the medical personnel or the employer of the medical
31  personnel or nonmedical personnel.
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  1         d.  In order to utilize the provisions of this
  2  subparagraph, the medical personnel or nonmedical personnel
  3  shall be tested for HIV pursuant to this section or shall
  4  provide the results of an HIV test taken within 6 months prior
  5  to the significant exposure if such test results are negative.
  6         e.  A person who receives the results of an HIV test
  7  pursuant to this subparagraph shall maintain the
  8  confidentiality of the information received and of the persons
  9  tested.  Such confidential information is exempt from s.
10  119.07(1).
11         f.  If the source of the exposure will not voluntarily
12  submit to HIV testing and a blood sample was not obtained
13  during treatment for the medical emergency, the medical
14  personnel, the employer of the medical personnel acting on
15  behalf of the employee, or the nonmedical personnel may seek a
16  court order directing the source of the exposure to submit to
17  HIV testing.  A sworn statement by a physician licensed under
18  chapter 458 or chapter 459 that a significant exposure has
19  occurred and that, in the physician's medical judgment,
20  testing is medically necessary to determine the course of
21  treatment constitutes probable cause for the issuance of an
22  order by the court.  The results of the test shall be released
23  to the source of the exposure and to the person who
24  experienced the exposure.
25         12.  For the performance of an HIV test by the medical
26  examiner or attending physician upon an individual who expired
27  or could not be resuscitated while receiving emergency medical
28  assistance or care and who was the source of a significant
29  exposure to medical or nonmedical personnel providing such
30  assistance or care.
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    2002 Legislature                     HB 1289, Second Engrossed
  1         a.  HIV testing may be conducted only after a licensed
  2  physician documents in the medical record of the medical
  3  personnel or nonmedical personnel that there has been a
  4  significant exposure and that, in the physician's medical
  5  judgment, the information is medically necessary to determine
  6  the course of treatment for the medical personnel or
  7  nonmedical personnel.
  8         b.  Costs of any HIV test performed under this
  9  subparagraph may not be charged to the deceased or to the
10  family of the deceased person.
11         c.  For the provisions of this subparagraph to be
12  applicable, the medical personnel or nonmedical personnel must
13  be tested for HIV under this section or must provide the
14  results of an HIV test taken within 6 months before the
15  significant exposure if such test results are negative.
16         d.  A person who receives the results of an HIV test
17  pursuant to this subparagraph shall comply with paragraph (e).
18         13.  For the performance of an HIV-related test
19  medically indicated by licensed medical personnel for medical
20  diagnosis of a hospitalized infant as necessary to provide
21  appropriate care and treatment of the infant when, after a
22  reasonable attempt, a parent cannot be contacted to provide
23  consent. The medical records of the infant shall reflect the
24  reason consent of the parent was not initially obtained.  Test
25  results shall be provided to the parent when the parent is
26  located.
27         14.  For the performance of HIV testing conducted to
28  monitor the clinical progress of a patient previously
29  diagnosed to be HIV positive.
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    2002 Legislature                     HB 1289, Second Engrossed
  1         15.  For the performance of repeated HIV testing
  2  conducted to monitor possible conversion from a significant
  3  exposure.
  4         Section 5.  Section 944.704, Florida Statutes, is
  5  amended to read:
  6         944.704  Staff who provide transition assistance;
  7  duties.--The department shall provide a transition assistance
  8  specialist at each of the major institutions whose duties
  9  include, but are not limited to:
10         (1)  Coordinating delivery of transition assistance
11  program services at the institution and at the community
12  correctional centers authorized pursuant to s. 945.091(1)(b).
13         (2)  Assisting in the development of each inmate's
14  postrelease plan.
15         (3)  Obtaining job placement information.
16         (4)  Providing a written medical-discharge plan and
17  referral to a county health department.
18         (5)  For an inmate who is known to be HIV positive,
19  providing a 30-day supply of all HIV/AIDS-related medication
20  that the inmate is taking prior to release, if required under
21  protocols of the Department of Corrections and treatment
22  guidelines of the United States Department of Health and Human
23  Services.
24         (6)(4)  Facilitating placement in a private transition
25  housing program, if requested by any eligible inmate. If an
26  inmate who is nearing his or her date of release requests
27  placement in a contracted substance abuse transition housing
28  program, the transition assistance specialist shall inform the
29  inmate of program availability and assess the inmate's need
30  and suitability for transition housing assistance. If an
31  inmate is approved for placement, the specialist shall assist
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  1  the inmate and coordinate the release of the inmate with the
  2  selected program. If an inmate requests and is approved for
  3  placement in a contracted faith-based substance abuse
  4  transition housing program, the specialist must consult with
  5  the chaplain prior to such placement. In selecting inmates who
  6  are nearing their date of release for placement in a
  7  faith-based program, the department shall ensure that an
  8  inmate's faith orientation, or lack thereof, will not be
  9  considered in determining admission to the program and that
10  the program does not attempt to convert an inmate toward a
11  particular faith or religious preference.
12         (7)(5)  Providing a photo identification card to all
13  inmates prior to their release.
14
15  The transition assistance specialist may not be a correctional
16  officer or correctional probation officer as defined in s.
17  943.10.
18         Section 6.  Notwithstanding any provision of the
19  Florida Statutes providing for a waiver of sovereign immunity,
20  neither the state, its agencies, subdivisions nor employees of
21  the state, its agencies, or subdivisions shall be liable to
22  any person for negligently causing death or personal injury
23  arising out of complying with section 944.355, Florida
24  Statutes.
25         Section 7.  The sum of $793,244 is appropriated from
26  the General Revenue Fund to the Department of Corrections for
27  the 2002-2003 fiscal year for the purpose of implementing the
28  provisions of this act.
29         Section 8.  This act shall take effect July 1, 2002.
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