Bill Amendment: IL HB2800 | 2017-2018 | 100th General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: PERINATAL HIV PREVENTION

Status: 2017-08-22 - Public Act . . . . . . . . . 100-0265 [HB2800 Detail]

Download: Illinois-2017-HB2800-House_Amendment_003.html

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Rep. Mary E. Flowers

Filed: 3/22/2017

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AMENDMENT TO HOUSE BILL 2800
AMENDMENT NO. ______. Amend House Bill 2800, AS AMENDED, by
replacing everything after the enacting clause with the
following:
"Section 5. The Perinatal HIV Prevention Act is amended by
changing Sections 5, 10, 15, 30, and 35 as follows:
(410 ILCS 335/5)
Sec. 5. Definitions. In this Act:
"Birth center" means a facility licensed by the Department
under paragraph (6) of Section 35 of the Alternative Health
Care Delivery Act.
"Department" means the Department of Public Health.
"Health care professional" means a physician licensed to
practice medicine in all its branches, a licensed physician
assistant, or a licensed advanced practice nurse.
"Health care facility" or "facility" means any hospital,

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birth center, or other institution that is licensed or
otherwise authorized to deliver health care services.
"Health care services" means any prenatal medical care or
labor or delivery services to a pregnant woman and her newborn
infant, including hospitalization.
"Opt-out testing" means an approach in which an HIV test is
offered to the patient, such that the patient is notified that
HIV testing may occur unless the patient opts out by declining
the test.
"Third trimester" means the 27th week of pregnancy through
delivery.
(Source: P.A. 99-173, eff. 7-29-15.)
(410 ILCS 335/10)
Sec. 10. HIV counseling and offer of HIV testing required.
(a) Every health care professional who provides health care
services to a pregnant woman shall, unless she already has a
negative HIV status has already been tested during the third
trimester of the current pregnancy, or is already HIV-positive,
provide the woman with HIV counseling, as described in subpart
(d) of this Section, and shall test her for HIV on an opt-out
basis unless she refuses. The counseling and testing or refusal
of testing shall comply with the requirements for informed
consent in the AIDS Confidentiality Act and be documented in
the pregnant woman's medical record as required by the AIDS
Confidentiality Act. A refusal may be verbal or in writing.

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A health care professional shall provide the first opt-out
HIV testing counseling and recommend the testing as early in
the woman's pregnancy as possible. The health care professional
providing health care services to a pregnant woman in the third
trimester shall perform a second round of opt-out HIV testing,
ideally by the 36th week of pregnancy, unless the pregnant
woman already has a negative HIV status from the third
trimester of the current pregnancy, or is already HIV-positive.
For women at continued risk of exposure to HIV infection in the
judgment of the health care professional, a repeat test should
be recommended late in pregnancy or at the time of labor and
delivery. The counseling and testing or refusal of testing
shall be documented in the woman's medical record.
(b) Every health care professional or facility that cares
for a pregnant woman during labor or delivery shall, unless she
has already has a negative HIV status from been tested during
the third trimester of the current pregnancy, or is already
HIV-positive, provide the woman with HIV counseling, as
described in subpart (d) of this Section, and rapid opt-out HIV
testing unless she refuses. The woman in labor or delivery may
refuse the HIV test verbally or in writing. A refusal may be
verbal or in writing. The counseling and testing or refusal of
testing shall be documented in the laboring or delivering
woman's medical record. The health care facility shall adopt a
policy that provides that as soon as possible within medical
standards after the infant's birth, the delivering mother's HIV

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test result, if available, shall be noted in the newborn
infant's medical record. It shall also be noted in the newborn
infant's medical record if the mother's third trimester HIV
test result is not available because she was not tested in the
third trimester has not been tested or has declined testing.
Any testing or test results shall be documented in accordance
with the AIDS Confidentiality Act.
(c) Every health care professional or facility caring for a
newborn infant shall, upon delivery or as soon as possible
within medical standards after the infant's birth, provide
counseling as described in subsection (d) of this Section to
the parent or guardian of the infant and perform rapid HIV
testing on the infant, when the HIV status of the infant's
mother is unknown, or if the delivering woman did not undergo
HIV testing in the third trimester of the current pregnancy.
(d) The counseling required under this Section must be
provided in accordance with the AIDS Confidentiality Act and
must include the following:
(1) For the health of the pregnant woman, the voluntary
nature of the testing, the benefits of HIV testing,
including the prevention of transmission, and the
requirement that HIV testing be performed unless she
refuses and the methods by which she can refuse.
(2) The benefit of HIV testing for herself and the
newborn infant, including interventions to prevent HIV
transmission.

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(3) The side effects of interventions to prevent HIV
transmission.
(4) The statutory confidentiality provisions that
relate to HIV and acquired immune deficiency syndrome
("AIDS") testing.
(5) The requirement for mandatory testing of the
newborn if the mother's HIV status during the third
trimester of pregnancy is unknown and if the mother was not
rapidly tested for HIV at delivery at the time of delivery.
(6) An explanation of the test, including its purpose,
limitations, and the meaning of its results.
(7) An explanation of the procedures to be followed.
(8) The availability of additional or confirmatory
testing, if appropriate. Counseling may be provided in
writing, verbally, or by video, electronic, or other means.
The pregnant or delivering woman must be offered an
opportunity to ask questions about testing and to decline
testing for herself.
(e) All counseling and testing must be performed in
accordance with the standards set forth in the AIDS
Confidentiality Act, including the informed consent provisions
of Sections 4, 7, and 8 of that Act, with the exception of the
requirement of consent for testing of newborn infants.
Consent for testing of a newborn infant shall be presumed
when a health care professional or health care facility seeks
to perform a test on a newborn infant whose mother's HIV status

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is not known either in the third trimester of pregnancy or at
delivery, provided that the counseling required under
subsection (d) of this Section and the AIDS Confidentiality Act
has taken place.
(f) The Illinois Department of Public Health shall adopt
necessary rules to implement this Act by July 1, 2008.
(Source: P.A. 94-910, eff. 6-23-06; 95-702, eff. 6-1-08.)
(410 ILCS 335/15)
Sec. 15. Reporting.
(a) Health A health care facilities facility shall adopt a
policy that provides that a report of a preliminarily
HIV-positive woman identified by a rapid HIV test or and a
report of a preliminarily HIV-exposed newborn infant
identified by a rapid HIV test conducted during labor and
delivery or after delivery shall be made to the Department's
Perinatal HIV Hotline within 12 hours but not later than 24
hours of the test result after birth. Section 15 of the AIDS
Confidentiality Act applies to reporting under this Act, except
that the immunities set forth in that Section do not apply in
cases of willful or wanton misconduct.
(b) The Department shall adopt rules specifying the
information required in reporting the preliminarily
HIV-positive pregnant or post-partum woman and preliminarily
HIV-exposed newborn infant and the method of reporting. In
adopting the rules, the Department shall consider the need for

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information, protections for the privacy and confidentiality
of the infant and parents, the need to provide access to care
and follow-up services to the infant, and procedures for
destruction of records maintained by the Department if, through
subsequent HIV testing, the pregnant or post-partum woman or
newborn infant is found to be HIV-negative.
(c) The confidentiality provisions of the AIDS
Confidentiality Act shall apply to the reports of cases of
perinatal HIV made pursuant to this Section.
(d) Health care facilities shall monthly report aggregate
statistics to the Department that include the number of
pregnant or delivering infected women who presented with known
HIV status; , the number of pregnant women rapidly tested for
HIV in labor and delivery as either a first HIV test or a
repeat third trimester HIV test; , the number of newborn infants
rapidly tested for HIV-exposure because the HIV status of the
delivering woman was unknown in the third trimester, or the
delivering woman refused testing; , the number of preliminarily
HIV-positive pregnant or delivering women and preliminarily
HIV-exposed newborn infants identified; , the number of
families referred to case management; , and other information
the Department determines is necessary to measure progress
under the provisions of this Act. Health care facilities must
report the confirmatory test result when it becomes available
for each preliminarily positive rapid HIV test performed on the
pregnant or delivering woman and on a newborn.

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(e) The Department or its authorized representative shall
provide case management services to the preliminarily positive
pregnant or post-partum woman or the parent or guardian of the
preliminarily positive newborn infant to ensure access to
treatment and care and other services where the pregnant or
post-partum woman or the as appropriate if the parent or
guardian of the newborn infant has consented to the services.
(f) Every health care facility caring for a newborn infant
whose mother had been diagnosed HIV positive prior to labor and
delivery shall report a case of perinatal HIV exposure in
accordance with the HIV/AIDS Registry Act, the Illinois
Sexually Transmissible Disease Control Act, and rules to be
developed by the Department. If after 18 months from the date
that the report was submitted, a newborn infant is determined
to not have HIV or AIDS, the Department shall remove the
newborn infant's name from all reports, records, and files
collected or created under this subsection (f).
(Source: P.A. 94-910, eff. 6-23-06; 95-702, eff. 6-1-08.)
(410 ILCS 335/30)
Sec. 30. Objections of parent or guardian to test. The
provisions of this Act requiring testing for HIV shall not
apply when a parent or guardian of a child objects to HIV
testing thereto on the grounds that the test conflicts with the
parent's his or her religious tenets and practices. A written
statement of the objection shall be presented to the physician

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or other person whose duty it is to administer and report the
tests under the provisions of this Act.
(Source: P.A. 94-910, eff. 6-23-06.)
(410 ILCS 335/35)
Sec. 35. Department report. The Department of Public Health
shall prepare an annual report for the Governor and the General
Assembly on the implementation of this Act that includes
information on the number of HIV-positive pregnant women who
presented with known HIV status, the number of pregnant women
rapidly tested for HIV in labor and delivery, the number of
newborn infants rapidly tested for HIV exposure, the number of
preliminarily HIV-positive pregnant women and preliminarily
HIV-exposed newborn infants identified, the confirmatory test
result for each preliminarily positive rapid HIV test performed
on the woman and newborn, the number of families referred to
case management, and other information the Department
determines is necessary to measure progress under the
provisions of this Act. The Department shall assess the needs
of health care professionals and facilities for ongoing
training in implementation of the provisions of this Act and
make recommendations to improve the program.
(Source: P.A. 94-910, eff. 6-23-06.)
Section 99. Effective date. This Act takes effect upon
becoming law.".