New Laws For The New Year – Part 2: Mandatory Prenatal HIV Testing In Texas And Affordable Housing For AIDS Patients In New York
Among new laws enacted at the start of 2010, Texas now requires testing pregnant women multiple times for HIV, and New York may provide more affordable housing for people living with HIV/AIDS.
Put into effect January 1, Texas legislation mandates physicians to administer HIV tests, with informed consent, to all pregnant women during their third trimester.
Prior to this law, standard procedures involved testing soon-to-be mothers for HIV, syphilis, and hepatitis B during their first prenatal visit as well as when the women are admitted to the hospital for delivery.
The new law requires health care providers to conduct an additional HIV test during the third trimester of pregnancy, which is the last three months before childbirth. Provisions also include expedited testing for newborns if the mother’s test results are unknown.
The Texas Department of State Health Services states, “If HIV positive pregnant women and their children know their status and receive appropriate care and treatment […] the perinatal transmission rate can be decreased to two percent or less.”
In New York, a bill yet to be passed would provide more affordable housing for HIV-positive individuals living in New York City.
So far, it has passed in the State Senate and the Assembly. However, since the Senate passed the bill last year, it must be passed again before going to the governor’s desk. Governor David Paterson has declined to say whether he would sign the measure.
Currently, the HIV/AIDS Services Administration asks eligible clients to pay 30 percent of their income on rent. Of the 31,000 individuals supported by the program, about 11,000 fail to qualify for this assistance and are required to pay all but $344 of their income toward rent each month.
The proposed legislation will extend the 30 percent cap to include all clients. Rent assistance is intended to help clients afford medication, food, and secure housing.
Opponents of the bill argue it is too expensive at a time when the state is facing budget cuts. They also claim that the law does not help people with other health and income issues.
For more information, please visit the Texas Department of State Health Services Web site or the timesunion.com Web site for the New York issue. For more New Laws For The New Year, please see Part 1 of the series about medical marijuana.
for the HIV tests does the L&D unit have to have actual copies of the lab results or is it sufficient to have prenatal records that document negative HIV status at trimester 1 and 3. Also, is a business card with lab results written on it sufficient for documentation of HIV status or not?
Thank you,
Angella Mudd
Director, The Birthing Center
CHRISTUS St. Catherine
281-599-4457
Hi, Angella. We are currently looking into this question for you. It looks as though you need a copy of the actual lab report, but the statute is not entirely clear. Most likely a business card is not sufficient. Here is what the statute says:
A physician or other person permitted by law to attend a pregnant woman during gestation or at delivery of an infant shall:
(1) take or cause to be taken a sample of the woman’s blood or other appropriate specimen at the first examination and visit;
(2) submit the sample to an appropriately certified laboratory for diagnostic testing approved by the United States Food and Drug Administration for:
(A) syphilis;
(B) HIV infection; and
(C) hepatitis B infection; and
(3) retain a report of each case for nine months and deliver the report to any successor in the case.
(a-1) A physician or other person permitted by law to attend a pregnant woman during gestation or at delivery of an infant shall:
(1) take or cause to be taken a sample of the woman’s blood or other appropriate specimen at an examination in the third trimester of the pregnancy;
(2) submit the sample to an appropriately certified laboratory for a diagnostic test approved by the United States Food and Drug Administration for HIV infection; and
(3) retain a report of each case for nine months and deliver the report to any successor in the case.
(b) A successor is presumed to have complied with this section if the successor in good faith obtains a record that indicates compliance with Subsections (a) and (a-1), if applicable.
(c) A physician or other person in attendance at a delivery shall:
(1) take or cause to be taken a sample of blood or other appropriate specimen from the mother on admission for delivery; and
(2) submit the sample to an appropriately certified laboratory for diagnostic testing approved by the United States Food and Drug Administration for:
(A) syphilis; and
(B) hepatitis B infection.
(c-1) If the physician or other person in attendance at the delivery does not find in the woman’s medical records results from the diagnostic test for HIV infection performed under Subsection (a-1), the physician or person shall:
(1) take or cause to be taken a sample of blood or other appropriate specimen from the mother;
(2) submit the sample to an appropriately certified laboratory for diagnostic testing approved by the United States Food and Drug Administration for HIV infection; and
(3) instruct the laboratory to expedite the processing of the test so that the results are received less than six hours after the time the sample is submitted.
The statute can be found here:
http://www.statutes.legis.state.tx.us/Docs/HS/htm/HS.81.htm#81.090
We have contacted the Texas Department of State Health Services and the National HIV/AIDS Clinicians’ Consultation Center; we’ll post more information if we hear back from them. Here are some additional resources you might find helpful:
http://www.dshs.state.tx.us/hivstd/default.shtm
(Texas DSHS)
http://www.nccc.ucsf.edu/home/
(NCCC)
Courtney McQueen
Associate Publisher, The AIDS Beacon
Hi, Angella. We have heard back from a representative from the Texas DSHS HIV/STD program. They have indicated that you do not need an actual copy of the lab reports; however, you do need records showing when HIV testing was done and what the results were. The records must show HIV testing was done in the third trimester, or the expedited testing at delivery must be performed.
With regards to whether a business card or other records would be acceptable, she recommended you contact your legal department to see what they recommend and feel comfortable with.
Please feel free to contact us with additional questions. If we receive more information, we will post it here.
Courtney McQueen
Associate Publisher, The AIDS Beacon
One last piece of additional information from Dr. Janak Patel, the Director of Pediatric Infectious Disease and Immunology at the University of Texas Medical Branch:
“As for the required documentation at delivery, verbal report of the test by the pregnant woman is not acceptable. Of the written records you mentioned, the prenatal records documenting the results should be acceptable. For the results written on a business card, it is an unusual method of providing results and might not be acceptable as anyone can obtain a business card from a doctor’s office and self-write the results (my opinion). Anyway, it is up to to the care provider to determine what kind of document being presented is adequate. When in doubt, it would be best to repeat the test at delivery.
Regards,
Janak A. Patel, M.D.”
He also provided an updated link to the Texas Perinatal HIV Prevention Guide:
http://www.aidseducation.org/documents/PerinatalHIVGuidelines_000.pdf
Courtney McQueen
Associate Publisher, The AIDS Beacon