La. Admin. Code tit. 48 § I-13505

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-13505 - Disclosure of HIV-Related Test Results

A. Provision for Refusal of Disclosure. Except as otherwise provided by law or regulation, no person who obtains, retains, or becomes the recipient of confidential HIV test results in the course of providing any health or social service or pursuant to a release of confidential HIV test results may disclose such information pursuant to a written authorization to release medical information when the authorization contains a refusal to release HIV test results. The form developed by the Department of Health and Hospitals, Office of Public Health, for the authorization for the release of confidential information has been developed in accordance with the Administrative Procedures Act for the release of medical information allowing a person to refuse to disclose HIV test results.

B. Disclosure of HIV Test Results without the Subject's Consent. HIV test results may be released to the following entities without authorization from the subject (or the person authorized by law to consent to health care for the subject);

1. to any person to whom disclosure of medical information is authorized by law without the consent of the patient;

2. to al health care facility/provider or employee thereof which;

a. is permitted to access medical records;

b. is authorized to obtain HIV test results;

c. maintains or processes medical records for billing or reimbursement purposes.

3. to a health care facility/provider or employee thereof when knowledge of HIV test results is necessary to provide appropriate care or treatment and afford the provider an opportunity to protect themselves from transmission of the virus;

4. to a health care facility/provider or employee thereof in relation to use of body parts for medical education, research, therapy, or transplantation;

5. to a health care facility staff committee, accreditation or oversight review organization authorized to access medical records;

6. to a federal, state, parish, or local health officer when the disclosure is mandated by federal or state law;

7. to an agency or individual in connection with the foster care programs of the Department of Social Services or to an agency or individual in connection with the adoption of a child;

8. to any person to whom disclosure is ordered by a court of competent jurisdiction;

9. to an employee or agent of the Board of Parole of the Department of Public Safety and Corrections (or of its office of parole) to the extent the employee or agent is authorized to access records containing HIV test results;

10. to a medical director of a local correctional institution to the extent he/she is authorized to access records containing HIV test results;

11. to an employee or authorized agent of the Department of Social Services, Office of Rehabilitative Services;

12. to an insurer, insurance administrator, self-insured employer, self-insured trust, or other person or entity responsible for paying or determining payment for medical services to the extent necessary to secure payment for those services.

C. Disclosure of HIV Test Results by a State, Parish or Local Health Officer. A state, parish, or local health officer may disclose confidential HIV test results when disclosure is specifically authorized or required by state law, disclosure is made pursuant to a release of confidential HIV test results, disclosure is requested by a physician pursuant to Subsection E below, or disclosure is authorized by a court order.

D. Disclosure by Persons to whom HIV Test Results have been Disclosed. Except for the individual or a natural person who is authorized to consent to health care for the individual, no person to whom confidential HIV test results have been disclosed pursuant to this Part shall disclose the information to another person except as authorized by this Part.

E. Notification of Contacts. A physician may, but is not obligated to, notify a contact of an HIV infected person if:

1. the physician reasonably believes the disclosure is medically appropriate and there is a significant risk of infection to the contact;

2. the physician has counseled the infected patient, if alive, regarding the need to notify the contact, and the physician reasonably believes the patient will not inform the contact;

3. the physician has informed the patient, if alive, of his or her intent to make such a disclosure and has given the patient the opportunity to express a preference as to whether the disclosure should be made by the physician directly or to a public health officer for the purpose of disclosure. This preference shall be honored by the physician. When making the disclosure, the physician or the public health officer shall not disclose the identity of the patient to the contact. A physician shall have no obligation to identify or locate any contact.

F. Other Disclosures Authorized by Law. A physician may, upon the consent of the parent or guardian, disclose confidential HIV test results to a state, parish or local health officer for the purpose or reviewing the medical history of a child to determine fitness of the child to attend school. A physician may disclose confidential HIV test results pertaining to a patient to a person authorized by law to consent to health care for the patient when the physician reasonably believes the disclosure is medically necessary in order to provide timely care and treatment for the patient and, after appropriate counseling as to the need for such disclosure, the patient has not and will not inform the person authorized by law to consent for health care. The physician shall not make such disclosure if, in the judgment of the physician, the disclosure would not be in the best interest of the patient or of the individual authorized by law to consent for such care and treatment. Any decision or action by a physician pursuant to this Subsection, and the basis thereof shall be recorded in the patient's medical record. A physician may choose not to disclose the results of a confidential HIV test to a person upon whom such a test has been performed when in the medical opinion of the physician the disclosure of such results would be medically contraindicated.

G. Court Authorization for Disclosure of Confidential HIV Test Results

1. Only a court of competent jurisdiction shall issue and order for the disclosure of confidential HIV test results.

2. A court may grant an order for disclosure if:

a. there is a compelling need for adjudication;

b. there is clear and imminent danger to the individual;

c. there is clear and imminent danger to the public health;

d. the applicant is lawfully entitled to the disclosure.

3. The court order authorizing disclosure shall direct communications to be sealed and shall direct further proceedings to be conducted in camera so as to protect the subject's confidentiality.

4. Adequate notice shall be given to those from whom disclosure is requested to allow them to prepare a written or personal response unless there is a clear and imminent danger to an individual. A court must weigh the compelling need for disclosure against the privacy interest of the protected individual and against the public interest which may not be served by disclosure which deters future testing or treatment or which may lead to discrimination.

5. No subpoena for hospital or other medical records shall be construed as a court order for disclosure of HIV-related test results unless accompanied by a copy of a court order authorizing the issue of a subpoena for such test results, after compliance with this Subsection. No release by a hospital or other health care provider made pursuant to and in compliance with a subpoena which is valid on its face, shall be considered to be in violation of this Section.

6. An order shall limit disclosure to necessary information and limit disclosure to those persons whose need for the information is the basis for the order and specifically prohibit additional disclosure by such persons to other persons, regardless of whether they are parties to the action.

La. Admin. Code tit. 48, § I-13505

Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 18:184 (February 1992).

AUTHORITY NOTE: Promulgated in accordance with R.S.40:38.5.