SENATE, No. 2704

STATE OF NEW JERSEY

212th LEGISLATURE

 

INTRODUCED MAY 14, 2007

 


 

Sponsored by:

Senator RICHARD J. CODEY

District 27 (Essex)

Senator LORETTA WEINBERG

District 37 (Bergen)

 

Co-Sponsored by:

Senators Karcher, Allen and Turner

 

 

 

 

SYNOPSIS

     Requires health care providers to test pregnant women for HIV as part of routine prenatal care unless woman refuses testing, and requires testing of all newborns for HIV.

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act concerning testing of pregnant women and newborns for HIV, amending P.L.1995, c.174 and supplementing Title 26 of the Revised Statutes.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.  Section 1 of P.L.1995, c.174 (C.26:5C-15) is amended to read as follows:

     1.   As used in this act:

      "AIDS" means acquired immune deficiency syndrome as defined by the Centers for Disease Control and Prevention of the United States Public Health Service.

      "Commissioner" means the Commissioner of Health and Senior Services.

      "Department" means the Department of Health and Senior Services.

      "HIV" means the human immunodeficiency virus or any other related virus identified as a probable causative agent of AIDS. 

(cf: P.L.1995, c.174, s.1)

 

     2.  Section 2 of P.L.1995, c.174 (C.26:5C-16) is amended to read as follows:

     2. It is the policy of this State that testing of all pregnant women for HIV shall be part of routine prenatal care; and, in the absence of a specific written objection to the testing by the pregnant woman, all pregnant women shall be tested for HIV as early as possible in their pregnancy, and again during the third trimester of their pregnancy.

     a.  (1) A physician or other health care practitioner who is the primary caregiver for a pregnant woman [or a woman who seeks treatment within four weeks of giving birth,] shall, in accordance with guidelines developed by the commissioner, provide the woman with information about HIV and AIDS, and also inform the woman of the benefits of being tested for HIV [and present her with the option of being tested] as early as possible in the course of her pregnancy and a second time during the third trimester, the medical treatment available to treat HIV infection if diagnosed early, and the reduced rate of transmission of HIV to a fetus if an HIV-infected pregnant woman receives treatment for HIV.

     The physician or other health care practitioner shall also advise the woman that HIV testing is recommended for all pregnant women both early in their pregnancy and during the third trimester, and that she will receive HIV tests as part of the routine panel of prenatal tests unless she specifically refuses to be tested for HIV.

     The woman shall, on a form and in a manner prescribed by the commissioner, acknowledge receipt of the information and [indicate her preference regarding testing], when applicable, indicate her refusal to be tested.  A woman shall not be denied appropriate prenatal or other medical care because she [decides not] refuses to be tested for HIV.

     (2)  A pregnant woman, who presents herself for delivery and has not been tested for HIV during the course of her pregnancy, shall be given the information and counseling specified in paragraph (1) of this subsection as soon as may be medically appropriate and, unless she refuses in writing after receiving that information and counseling, shall be tested for HIV as soon as may be medically appropriate.   

      b.  The commissioner shall establish guidelines regarding notification to a woman whose test result is positive, and to provide, to the maximum extent possible, for counseling about the significance of the test result. 

      c.   Information about a woman which is obtained pursuant to this section shall be held confidential in accordance with the provisions of P.L.1989, c.303 (C.26:5C-5 et seq.). 

(cf: P. L.1995, c.174, s.2)

 

     3.  Section 6 of P.L.1995, c.174 (C.26:5C-20) is amended to read as follows:

     6.  The commissioner, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations to effect this act.  The regulations shall be consistent with the latest recommendations for HIV testing of pregnant women prepared by the United States Centers for Disease Control and Prevention.

(cf: P.L.1995, c.174, s.6)

 

     4.  (New section) a. The Commissioner of Health and Senior Services shall require each birthing facility in the State to administer to every newborn in its care a test for human immunodeficiency virus (HIV).

     b. The commissioner shall establish a comprehensive program for the testing of newborns for the presence of HIV, which shall include, but not be limited to, procedures for the administration of HIV testing, counseling of the newborn’s mother, tracking the newborn, disclosure of HIV test results to the mother, facility compliance reviews, and educational activities related to the HIV testing.

     c.  The provisions of this section shall not apply to a newborn whose parents object to the test as being in conflict with their religious tenets and practices.  The parents shall provide the health care facility with a written statement of the objection, and the statement shall be included in the newborn’s medical record.

     d.  As used in this section, “birthing facility” means an inpatient or ambulatory health care facility licensed by the Department of Health and Senior Services that provides birthing and newborn care services.

     e.  The Commissioner of Health and Senior Services shall adopt rules and regulations, pursuant to the “Administrative Procedure Act,” P.L.1968, c.410 (C.52:14B-1 et seq.), necessary to carry out the purposes of this section.

 

     5.  This act shall take effect on the 180th day after enactment but the commissioner may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.

 

 

STATEMENT

 

     This bill amends P.L.1995, c.174 (C.26:5C-15 et seq.) concerning voluntary testing of pregnant women for HIV to incorporate the recent recommendations of the Centers for Disease Control and Prevention (CDC) on HIV screening for pregnant women.  The bill also requires all birthing facilities in the State to test every newborn in their care for human immunodeficiency virus (HIV).

     The CDC recommends that all pregnant women be screened for HIV infection, and that screening occur after a women is notified that she will receive an HIV test as part of the routine panel of prenatal tests unless she declines, which is referred to as “opt-out screening.”  Under current State law, pregnant women are counseled by their health care providers about testing for HIV infection, but they must give consent to be tested and “opt-in” for HIV screening.

     The requirements in this bill for HIV testing of newborns are based on the universal newborn HIV testing program established in New York in 1997.  That program, which also encourages the prenatal testing of mothers, has been very successful in reducing the number of HIV-infected infants in New York.  Universal HIV testing of newborns, regardless of whether the mother’s HIV status is known at the time of birth, serves as a safety net to ensure that all newborns who may be at risk of contracting HIV receive prompt access to treatment, and that their mothers also receive necessary counseling and treatment for HIV.

     Specifically, the bill provides the following:

·   It is the policy of this State that testing of all pregnant women for HIV shall be part of routine prenatal care; and, in the absence of a specific written objection to the testing by the pregnant woman, all pregnant women shall be tested for HIV as early as possible in the course of their pregnancy, and again during their third trimester.

·   A physician or other health care practitioner who is the primary caregiver for a pregnant woman shall, in accordance with guidelines developed by the Commissioner of Health and Senior Services, provide the woman with information about HIV and AIDS, and also inform the woman of:

-- the benefits of being tested for HIV as early as possible in the course of her pregnancy and a second time during her third trimester,

-- the medical treatment available to treat HIV infection if diagnosed early, and

-- the reduced rate of transmission of HIV to a fetus if an HIV-infected pregnant woman receives treatment for HIV.

· The physician or other health care practitioner shall also advise the woman that HIV testing is recommended for all pregnant women both early in the pregnancy and during the third trimester, and that she will receive HIV tests as part of the routine panel of prenatal tests unless she specifically refuses to be tested for HIV.

· A woman will not be denied appropriate prenatal or other medical care because she refuses to be tested for HIV.

·   A pregnant woman, who presents herself for delivery and has not been tested for HIV during the course of her pregnancy, shall be given the information and counseling specified in the bill as soon as may be medically appropriate and, unless she refuses in writing after receiving that information and counseling, shall be tested for HIV as soon as may be medically appropriate.  

·   The commissioner shall adopt regulations to carry out the purposes of the bill, which regulations shall be consistent with the latest recommendations for HIV testing of pregnant women prepared by the CDC.

·   The commissioner shall establish a comprehensive program for the testing of newborns for the presence of HIV, which shall include, but not be limited to, procedures for the administration of HIV testing, counseling of the newborn’s mother, tracking the newborn, disclosure of HIV test results to the mother, facility compliance reviews, and educational activities related to the HIV testing.

·   The provisions of the bill would not apply to a newborn whose parents object to the test as being in conflict with their religious tenets and practices.  The parents shall provide the health care facility with a written statement of the objection, and the statement shall be included in the newborn’s medical record.