HB-6018, As Passed Senate, December 19, 2018
SUBSTITUTE FOR
HOUSE BILL NO. 6018
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending section 5133 (MCL 333.5133), as amended by 2010 PA 320.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec.
5133. (1) Except as otherwise provided in this section,
by law, a physician who orders an HIV test or a health facility
that performs an HIV test shall provide information appropriate to
the test subject both before and after the test is administered.
(2)
Except as otherwise provided in this part, a physician, or
an
individual to whom the physician has delegated authority to
perform
a selected act, task, or function under section 16215,
shall
not order an HIV test for the purpose of diagnosing HIV
infection
without first providing the test subject with pretest
information
and receiving the informed consent of the test subject.
For
purposes of this section, informed consent means a written or
verbal
consent to the test by the test subject or the legally
authorized
representative of the test subject. The physician or
health
facility shall document the provision of informed consent,
including
pretest information, and whether the test subject or the
legally
authorized representative of the test subject declined the
offer
of HIV testing. Informed consent for HIV testing shall be
maintained
in the patient's medical records.
(3)
Beginning January 1, 2011, pretest information shall
include
all of the following:
(a)
An explanation of the test, including, but not limited to,
the
purpose of the test, the potential uses and limitations of the
test,
and the meaning of test results.
(b)
An explanation of how HIV is transmitted and how HIV can
be
prevented.
(c)
An explanation of the rights of the test subject,
including,
but not limited to, all of the following:
(i) The right to decline the test at any time before
the
administration
of the test and the circumstances under which the
test
subject does not have the right to decline the test.
(ii) The right to confidentiality of the test results
under
this
part and under the health insurance portability and
accountability
act of 1996, Public Law 104-191.
(iii) The right under this part to consent to and
participate
in
the test on an anonymous basis.
(iv) The person or class of persons to whom the test
results
may
be disclosed under this part and under the health insurance
portability
and accountability act of 1996, Public Law 104-191.
(4)
The department, the Michigan board of medicine, and the
Michigan
board of osteopathic medicine and surgery shall make the
information
required under subsection (3) available to physicians.
The
Michigan board of medicine and the Michigan board of
osteopathic
medicine and surgery shall notify in writing all
physicians
subject to this section of the requirements of this
section
and the availability of the information by January 1, 2011.
Upon
request, the Michigan board of medicine and the Michigan board
of
osteopathic medicine and surgery shall provide copies of the
information,
free of charge, to a physician who is subject to this
section.
(5)
A test subject who executes a signed writing pursuant to
subsection
(2) as that subsection read before September 1, 2010 is
barred
from subsequently bringing a civil action based on failure
to
obtain informed consent for the HIV test against the physician
who
ordered the HIV test.
(6)
The department shall develop the information required
under
subsection (3) in clear, nontechnical English and Spanish,
and
provide the information upon request and free of charge, to a
physician
or other person or a governmental entity that is subject
to
this section. Nothing in this section prohibits a physician or
health
facility from combining a form used to obtain informed
consent
for HIV testing with forms used to obtain consent for
general
medical care or any other medical tests or procedures if
the
forms make clear that the subject may consent to general
medical
care, tests, or medical procedures without being required
to
consent to HIV testing and, if applicable, that the subject may
decline
HIV testing at any time before the administration of the
test.
(7)
In addition to complying with the duties imposed under
subsection
(6), the department shall provide copies of the
information
required under subsection (3) to the Michigan board of
medicine
and the Michigan board of osteopathic medicine and
surgery.
The department shall provide copies of the information to
other
persons upon written request, at cost, and shall also provide
copies
of the information free of charge, upon request, to public
or
private schools, colleges, and universities.
(8)
An individual who undergoes an HIV test at a department
approved
testing site may request that the HIV test be performed on
an
anonymous basis. If an individual requests that the HIV test be
performed
on an anonymous basis, the staff of the department
approved
testing site shall administer the HIV test anonymously or
under
the condition that the test subject not be identified, and
shall
obtain consent to the test using a coded system that does not
link
the individual's identity with the request for the HIV test or
the
HIV test results.
(2) A test subject or his or her authorized representative who
provides general informed consent for medical care is considered to
have consented to an HIV test. A separate consent form for an HIV
test is not required. However, except as otherwise provided by law,
a health care provider shall not order an HIV test for a test
subject without first doing both of the following:
(a) Informing the test subject or his or her legally
authorized representative verbally or in writing that an HIV test
will be performed unless the test subject or his or her legally
authorized representative declines the HIV test.
(b) Offering the test subject or his or her legally authorized
representative an opportunity to ask questions and decline the HIV
test.
(3) If a test subject or the test subject's legally authorized
representative declines an HIV test under subsection (2), the
decision must be documented in the test subject's medical record.
(4) If a test subject undergoes an HIV test at a department
approved
testing site and the test results of an
the HIV test
performed under this subsection indicate that the test subject is
HIV infected, the staff of the department approved testing site
shall proceed with partner notification in the same manner in which
a local health department would proceed as described in section
5114a(3) to (5).
(5) (9)
This section does not apply to an
HIV test performed
for the purpose of research, if the test is performed in such a
manner that the identity of the test subject is not revealed to the
researcher and the test results are not made known to the test
subject.
(6) (10)
Except as otherwise provided in
subsection (12), (8),
this
section does not apply to an HIV test performed upon on a
patient in a health facility if the conditions in subdivisions (a)
and (b) or the conditions in subdivisions (a) and (c) are met:
(a) The patient is informed in writing upon admission to the
health
facility that an HIV test may be performed upon on the
patient without his or her right to decline under circumstances
described in subdivision (b) or (c). As used in this subdivision,
"admission" means the provision of an inpatient or outpatient
health care service in a health facility.
(b) The HIV test is performed after a health professional,
health facility employee, police officer, or fire fighter, or a
medical first responder, emergency medical technician, emergency
medical technician specialist, or paramedic licensed under section
20950 or 20952 sustains in the health facility, while treating the
patient before transport to the health facility, or while
transporting the patient to the health facility, a percutaneous,
mucous membrane, or open wound exposure to the blood or other body
fluids of the patient.
(c) The HIV test is performed pursuant to a request made under
section 20191(2).
(7) (11)
Except as otherwise provided in
subsection (12), (8),
this section does not apply if the test subject is unable to
receive or understand the information described in subsections (1)
to
(3) and (2) or to decline the test as described in subsection
(2),
(3), and the a legally authorized
representative of the test
subject is not readily available to receive the information or
decline for the test subject.
(8) (12)
If the results of an HIV test
performed under this
section indicate that the patient is HIV infected, the health
facility shall inform the patient of the positive test results and
shall provide the patient with appropriate counseling regarding HIV
infection and acquired immunodeficiency syndrome and referrals to
expedite HIV treatment and services. If the results of an HIV test
performed under this section indicate that the patient is not HIV
infected,
that information shall must
be provided to the patient
through
normal health care provider procedures.
, including, but
not
limited to, a patient visit, mail, or telephone communication.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.