[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 59 Introduced in Senate (IS)]
103d CONGRESS
1st Session
S. 59
To control the spread of AIDS, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 21 (legislative day, January 5), 1993
Mr. Helms introduced the following bill; which was read twice and
referred to the Committee on Labor and Human Resources
_______________________________________________________________________
A BILL
To control the spread of AIDS, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``AIDS Control Act of 1993''.
SEC. 2. RECORDKEEPING.
Part B of title III of the Public Health Service Act is amended by
inserting after section 318A (42 U.S.C. 247c-1) the following new
section:
``SEC. 318B. RECORDKEEPING OF CASES OF ACQUIRED IMMUNE DEFICIENCY
SYNDROME, ACQUIRED IMMUNE DEFICIENCY RELATED COMPLEX, AND
HUMAN IMMUNODEFICIENCY VIRUS INFECTIONS.
``The Director of the Centers for Disease Control and Prevention
shall keep records of cases of individuals who are infected with the
human immunodeficiency virus.''.
SEC. 3. TESTING OF BLOOD.
Section 351(d) of the Public Health Service Act (42 U.S.C. 262(d))
is amended by adding at the end thereof the following new paragraph:
``(3) Not later than 180 days after the date of enactment of the
AIDS Control Act of 1993, the Secretary shall promulgate regulations to
require that, as a condition of receiving a license under this section,
any entity that collects or distributes blood or blood components or
derivatives shall test all donors of such blood for the presence of the
human immunodeficiency virus prior to accepting a contribution of such
blood.''.
SEC. 4. PERMITTING DIRECTED AND AUTOLOGOUS BLOOD DONATIONS.
Section 351(d) of the Public Health Service Act (42 U.S.C. 262(d))
(as amended by section 3) is further amended by adding at the end
thereof the following new paragraphs:
``(4) Not later than 180 days after the date of enactment of the
AIDS Control Act of 1993, the Secretary shall promulgate regulations to
require that, as a condition of receiving a license under this section,
any entity that collects or distributes blood or blood components or
derivatives--
``(A) permit blood donations made by a donor to be used
directly for blood transfusions for such donor or for an
individual designated by the donor;
``(B) permit a donor of blood to direct that any blood
donated by such donor be used in a blood transfusion for such
donor or for an individual designated by such donor if the
blood type of such donated blood is compatible with the blood
type of such donor or the blood type of the designated
individual, as the case may be, and the use of such donated
blood is not contraindicated, as determined by the physician of
such donor or such designated individual, as the case may be;
and
``(C) permit blood donated in accordance with subparagraphs
(A) or (B) to be used for an individual other than the donor or
an individual designated by a donor, as the case may be, if--
``(i) the physician of such donor or such
designated individual determines that there is a more
immediate need for such blood; or
``(ii) the donor consents to the use of such blood
for an individual other than the donor or such
designated individual.
``(5) Regulations promulgated by the Secretary to carry out
paragraph (4) shall provide that any entity to which such paragraph
applies is only required to permit the donations of blood described in
such paragraph during the normal business hours of such entity.''.
SEC. 5. REQUIREMENTS FOR RECIPIENT OF SERVICES AUTHORIZED UNDER TITLE X
OF THE PUBLIC HEALTH SERVICE ACT.
Section 1006 of the Public Health Service Act (42 U.S.C. 300a-4) is
amended by adding at the end thereof the following new subsection:
``(e) A grant may be made or a contract entered into under this
title only after the intended recipient provides assurances
satisfactory to the Secretary that such recipient of the grant or
contract will, prior to providing to any individual any services with
amounts appropriated under this title, inform the individual--
``(1) of the effectiveness of the particular contraceptive
method provided to the individual by the recipient as a method
to prevent infection with the human immunodeficiency virus and
a comparison of such effectiveness with the effectiveness of
sexual abstinence;
``(2) that many individuals who are infected with the human
immunodeficiency virus will develop acquired immunodeficiency
syndrome, which is a fatal disease; and
``(3) that the most effective way to avoid becoming
infected with the human immunodeficiency virus is to abstain
from homosexual relations, from heterosexual relations outside
of a monogamous marriage, and from the sharing of needles used
to administer intravenous drugs.''.
SEC. 6. CONDITIONS ON GRANTS FOR THE PREVENTION, TREATMENT, AND CONTROL
OF ACQUIRED IMMUNE DEFICIENCY SYNDROME.
Title XXV of the Public Health Service Act (42 U.S.C. 300ee et
seq.) is amended by adding at the end thereof the following new part:
``Part C--Prohibition on Awarding of Grants
``SEC. 2531. PROHIBITION ON AWARDING OF GRANTS.
``The Secretary may not make a grant under this title to any State
or political subdivision of any State to support a project for
education, testing, or counseling concerning acquired immune deficiency
syndrome unless the State has taken administrative or legislative
action to require that--
``(1) any physician practicing in the State report to the
appropriate State public health authorities the name and
address of any individual residing in the State who is treated
by such physician and known by such physician to be infected
with the human immunodeficiency virus;
``(2) any physician or medical technician who analyzes the
results of clinical tests performed in the State report to the
appropriate State public health authorities the name and
address of any individual residing in the State who is
determined as a result of an analysis conducted by such
physician or medical technician to be infected with the human
immunodeficiency virus; and
``(3) reporting under the laws described in paragraphs (1)
and (2) to be carried out in accordance with State laws
regulating the confidentiality of records maintained by the
State or individuals with sexually transmitted diseases.''.
SEC. 7. SPOUSAL NOTIFICATION.
Part C of title XXV of the Public Health Service Act (as added by
section 6) is amended by adding at the end thereof the following new
section:
``SEC. 2532. SPOUSAL NOTIFICATION.
``(a) Prohibition on Use of Funds.--The Secretary may not make a
grant under this title to any State or political subdivision of any
State, nor shall any other funds made available under this Act, be
obligated or expended in any State unless such State takes
administrative or legislative action to require that, within 30 days of
diagnosis, a good faith effort shall be made to notify a spouse of an
AIDS-infected patient that such AIDS-infected patient is infected with
the human immunodeficiency virus.
``(b) Effective Date.--Subsection (a) shall take effect with
respect to a State on January 1 of the calendar year following the
first regular session of the legislative body of such State that is
convened following the date of enactment of this section.
``(c) Definitions.--As used in this section:
``(1) AIDS-infected patient.--The term `AIDS-infected
patient' means any person who has been diagnosed by a physician
or surgeon practicing medicine in such State to be infected
with the human immunodeficiency virus.
``(2) Good faith effort.--A `good faith' effort includes,
but is not limited to, a certified letter sent to the last
known address of the spouse.
``(3) State.--The term `State' means a State, the District
of Columbia, or any territory of the United States.
``(4) Spouse.--The term `spouse' means a person who is or
at any time since December 31, 1976, has been the marriage
partner of a person diagnosed as an AIDS-infected patient.''.
SEC. 8. BATHHOUSES.
Part C of title XXV of the Public Health Service Act (as added by
section 6 and amended by section 7) is further amended by adding at the
end thereof the following new section:
``SEC. 2533. BATHHOUSES.
``(a) Prohibition.--None of the funds made available under this
title shall be obligated or expended in any State if such State does
not close all bathhouses where a pattern of continuous homosexual
sexual activity or continuous illegal intravenous drug use occurs.
``(b) Homosexual Activity.--The homosexual activity described in
subsection (a) means any sexual activity between two or more males as
described in section 2256(2)(A) of title 18, United States Code.
``(c) Illegal Drugs.--The illegal drug use described in subsection
(a) means and includes any controlled substance as defined in section
102(6) of the Controlled Substance Act (21 U.S.C. 802(6)).
``(d) Bathhouse.--The term `bathhouse' means any business that
charges a fee for admission and for that fee offers the use of one or
more of the following--
``(1) a swimming pool;
``(2) a spa or whirlpool; or
``(3) a communal bath.
``(e) State.--The term `State' means any State, the District of
Columbia, or territory of the United States.
``(f) Failure to Act.--If on January 1 of the calendar year
following the first regular session that is convened following the date
of enactment of this Act, such State fails to take the action as
described in subsection (a), it shall refund to the Federal Government
by that date such sums as it received in accordance with this
section.''.
SEC. 9. PROHIBITION ON USE OF FUNDS FOR NEEDLES AND SYRINGES.
Part C of title XXV of the Public Health Service Act (as added by
section 6 and amended by sections 7 and 8) is further amended by adding
at the end thereof the following new section:
``SEC. 2534. PROHIBITION ON USE OF FUNDS FOR NEEDLES AND SYRINGES.
``None of the funds made available under this title shall be used
to provide individuals with hypodermic needles or syringes so that such
individuals may use illegal drugs, or to distribute bleach for the
purpose of cleansing needles for such use.''.
SEC. 10. PROHIBITION ON USE OF FUNDS FOR CONDOMS.
Part C of title XXV of the Public Health Service Act (as added by
section 6 and amended by sections 7, 8, and 9), is further amended by
adding at the end thereof the following new section:
``SEC. 2535. PROHIBITION ON USE OF FUNDS FOR CONDOMS.
``None of the funds made available under this title shall be used
in any manner to provide persons with condoms. Furthermore, none of the
funds made available under this title shall be used to promote condoms
as a method to prevent the spread of AIDS.''.
SEC. 11. PROHIBITION ON PROMOTION OF HOMOSEXUAL ACTIVITY.
Part C of title XXV of the Public Health Service Act (as added by
section 6 and amended by sections 7, 8, 9, and 10) is further amended
by adding at the end thereof the following new section:
``SEC. 2536. PROHIBITION ON PROMOTION OF HOMOSEXUAL ACTIVITY.
``(a) In General.--None of the funds made available under this
title shall be used to provide AIDS education, information, or
prevention materials and activities that promote or encourage, directly
or indirectly, homosexual sexual activities.
``(b) Requirement.--Education information, and prevention
activities and materials paid for with funds appropriated under this
Act shall emphasize--
``(1) abstinence from sexual activity outside a sexually
monogamous marriage (including abstinence from homosexual
sexual activities); and
``(2) abstinence from the use of illegal intravenous drugs.
``(c) Homosexual Activity.--The homosexual activity referred to in
subsection (b) includes any sexual activity between two or more males
as described in section 2256(2)(A) of title 18, United States Code.
``(d) Illegal Substances.--The illegal drugs referred to in
subsections (a) and (b) includes any controlled substance as defined in
section 102(6) of the Controlled Substance Act (21 U.S.C. 802(6)).
``(e) Failure to Comply.--If the Secretary of Health and Human
Services finds that a recipient of funds under this Act has failed to
comply with this section, the Secretary shall notify the recipient, if
the funds are paid directly to the recipient, or notify the State if
the recipient receives the funds from the State, of such finding and
that--
``(1) no further funds shall be provided to the recipient;
``(2) no further funds shall be provided to the State with
respect to noncompliance by the individual recipient;
``(3) further payment shall be limited to those recipients
not participating in such noncompliance; and
``(4) the recipient shall repay to the United States,
amounts found not to have been expended in accordance with this
section.''.
SEC. 12. HIV TEST AND NOTIFICATION AS A CONDITION OF MARRIAGE LICENSES.
Part C of title XXV of the Public Health Service Act (as added by
section 6 and amended by sections 7, 8, 9, and 10) is further amended
by adding at the end thereof the following new section:
``SEC. 2535. HIV TESTING AND NOTIFICATION AS A CONDITION OF MARRIAGE
LICENSES.
``(a) In General.-- None of the funds made available under this
title shall be available for use in any State, the District of
Columbia, or any territory of the United States unless such State,
District or territory requires, as a condition for the granting of a
marriage license, a test to determine whether the individuals applying
for such a license are infected with the human immunodeficiency virus
and that both individuals seeking such license shall be notified of
each test result.
``(b) Effective Date.--Subsection (a) shall take effect with
respect to a State, District, or territory on January 1 of the calendar
year following the first regular session of the legislative body of the
State, District, or territory that is convened following the date of
enactment of this Act.''.
SEC. 13. PROTECTING THE NATION'S BLOOD AND TISSUE SUPPLY.
(a) In General.--Part I of title 18, United States Code, is amended
by inserting after chapter 89 the following new chapter:
``CHAPTER 90--PUBLIC HEALTH PRESERVATION
``Sec.
``1831. Contamination of blood and tissue supply.
``Sec. 1831. Contamination of blood and tissue supply
``(a) It shall be unlawful for any individual to knowingly donate,
or to knowingly attempt to donate blood, semen, or organs, if such
individual--
``(1) knows, on the basis of clinical or laboratory
evidence, that such individual is infected with the human
immunodeficiency virus;
``(2) is a male individual who has had sexual intercourse
with another male individual at any time on or after January 1,
1977;
``(3) is an individual who, on or after January 1, 1977, is
or has been a user of any intravenous drug the sale,
distribution, or use of which is prohibited under Federal or
State law at the time the individual injected the drug;
``(4) is an individual who has emigrated to the United
States from Haiti, the Central African Republic, Zaire, Rwanda,
Burundi, the Congo, Chad, or Uganda on or after January 1,
1977;
``(5) is an individual who has hemophillia and has received
a clotting factor concentrate on or after January 1, 1977;
``(6) is an individual who has engaged in prostitution on
or after January 1, 1977;
``(7) is an individual who has had sexual intercourse with
an individual described in paragraph (1), (2), (3), (4), (5),
(6), (8), or (9);
``(8) is an individual who has used a needle for an
intravenous drug injection that the individual knows has
previously been used for an intravenous drug injection by an
individual described in paragraph (1), (2), (3), (4), (5), (6),
(7), or (9);
``(9) knows such individual is at high risk of contracting
acquired immune deficiency syndrome (as defined by the Director
of the Centers for Disease Control); or
``(10) is an individual who has engaged in an activity that
such individual knows places such individual at a high risk of
contracting such syndrome (as defined by such Director).
``(b) Any person who violates the provisions of subsection (a)
shall be subject to a fine of $10,000 or imprisonment for not more than
10 years, or both.
``(c) For purposes of this section, the term `sexual intercourse'
includes the acts described in section 2255(2)(A) of this title.''.
(b) Chapter Analysis.--The chapter analysis at the beginning of
part I of title 18 is amended by inserting after the item for chapter
89 the following:
``90. Public Health Preservation............................ 1831''.
SEC. 14. TESTING OF FEDERAL PRISONERS.
(a) In General.--Chapter 305 of part III of title 18, United States
Code, is amended by adding at the end thereof the following new
section:
``Sec. 4087. AIDS testing
``(a) The Director of the Bureau of Prisons shall test each person
incarcerated in a Federal penal or correctional institution for
infection with the human immunodeficiency virus--
``(1) on the date such person enters a Federal penal or
correctional institution;
``(2) every 12 months after the date described in paragraph
(1); and
``(3) at such other times as the Director determines are
appropriate.
``(b) The Director of the Bureau of Prisons shall report to the
Director of Centers for Disease Control the incidence of each
individual who tests positively for infection with the human
immunodeficiency virus.
``(c) Not later than 180 days after the date of enactment of the
AIDS Control Act of 1993, the Director of the Bureau of Prisons shall
promulgate regulations requiring that each individual tested under this
section who tests positively for infection with the human
immunodeficiency virus--
``(1) be placed in separate residential facilities in a
penal or correctional institution, if possible; and
``(2) be restricted from holding any employment in a penal
or correctional institution which involves duties that may
increase the transmission of the human immunodeficiency virus,
such as assignments in blood services, the barber shop, or
medical and dental services in any capacity.''.
(b) Table of Sections.--The table of sections for chapter 305 of
part III of title 18, United States Code, is amended by adding at the
end thereof the following:
``4087. AIDS testing.''.
SEC. 15. DISQUALIFICATION OF PERSONS FOR INDUCTION OR RETENTION IN THE
ARMED FORCES ON THE BASIS OF INFECTION WITH THE HUMAN
IMMUNODEFICIENCY VIRUS.
(a) In General.--Chapter 49 of title 10, United States Code, is
amended by adding at the end the following new section:
``Sec. 983. Disqualification of persons for induction or retention on
the basis of infection with the human immunodeficiency
virus
``(a) Except as provided in subsection (d)(2), no person may be
inducted into or retained in the armed forces (other than in a retired
status) if it is determined, on the basis of a test or tests
administered to such person under subsection (b), that such person is
infected with the human immunodeficiency virus.
``(b) Under regulations prescribed by the Secretary concerned--
``(1) each person examined for induction and re-enlistment
into the armed forces shall be tested for infection with the
human immunodeficiency virus before induction,
``(2) each member of the armed forces shall be tested for
infection with the human immuno-deficiency virus at least once
each year;
``(3) each time a member of the armed forces is admitted to
any medical facility of the uniformed services or of the
Veterans' Administration in order to receive in-patient care in
such facility, such member shall be tested for infection with
the human immunodeficiency virus; and
``(4) each member of the armed forces shall be tested for
infection with the human immunodeficiency virus at such times
(other than the times specified in paragraphs (2) and (3) of
this subsection) as the Secretary concerned considers
appropriate.''.
(b) Table of Sections.--The table of sections at the beginning of
chapter 49 of such title is amended by adding at the end thereof the
following:
``9830. Disqualification of persons for induction or retention on the
basis of infection with the human
immunodeficiency virus.''.
SEC. 16. VETERANS' ADMINISTRATION.
(a) Testing.--Section 124(b) of Veterans' Benefits and Services Act
of 1988 (38 U.S.C. 4133 note) is amended to read as follows:
``(b) Testing.--(1) The Administrator shall provide for a program
under which the Veterans' Administration routinely tests each patient
to whom the Veterans' Administration is furnishing health care or
services, as described in paragraph (2), for the human immunodeficiency
virus to determine whether such patient is infected with the virus.
``(2) Patients referred to in paragraph (1) are--
``(A) patients who are receiving treatment for intravenous
drug abuse;
``(B) patients who are receiving treatment for a disease
associated with the human immunodeficiency virus;
``(C) patients who are receiving treatment for a sexually
transmitted disease;
``(D) patients who are otherwise at high risk for infection
with such virus; and
``(E) patients seeking in-patient treatment who are 40 and
under.
``(3) The Administration shall provide pre- and post-test
counseling to each patient described in paragraph (2).''.
(b) Disclosure to Spouse or Sexual Partners.--Section 4132 of title
38, United States Code, is amended--
(1) by redesignating subsection (f) as subsection (g); and
(2) by inserting after subsection (e) the following new
subsection (f):
``(f)(1) Notwithstanding subsection (a), and subject to paragraph
(2) of this subsection, a physician or a professional counselor shall
disclose information or records indicating that a patient or subject is
infected with the human immunodeficiency virus if the disclosure is
made to--
``(A) the current spouse of the patient;
``(B) any other person who at any time since December 31,
1976 has been the marriage partner of the patient; or
``(C) to any individual whom the patient or subject has,
during the process of professional counseling or of testing to
determine whether the patient or subject is infected with such
virus, identified as being a sexual partner of such patient or
subject.
``(2) A disclosure under paragraph (1) may be made by a physician
or counselor other than the physician or counselor referred to in
paragraph (1)(A) if such physician or counselor is unavailable to make
the disclosure by reason of absence or termination of employment.''.
SEC. 17. USE OF PREVENTIVE HEALTH SERVICES APPROPRIATIONS.
(a) Regulations.--Not later than 180 days after the date of
enactment of this Act, the Secretary of Health and Human Services shall
promulgate regulations requiring the recipient of moneys appropriated
under section 317 of the Public Health Service Act (42 U.S.C. 247b)
to--
(1) routinely test each person receiving treatment for
tuberculosis to determine if such person is infected with the
human immunodeficiency virus; and
(2) provide pre- and post-test counseling on acquired
immunodeficiency syndrome to each such person.
(b) Confidentiality.--In promulgating regulations under subsection
(a), the Secretary shall ensure that confidentiality shall be provided
to those tested under such regulations in accordance with section
552(a) of title 5 of the United States Code.
SEC. 18. REQUIREMENT OF TESTING BY BLOCK GRANT RECIPIENTS.
(a) Regulations.--Not later than 180 days after the date of
enactment of this Act, the Secretary of Health and Human Services shall
promulgate regulations requiring the recipient of grant moneys under
subpart I of part B of title XIX of the Public Health Service Act (42
U.S.C. 300x et seq.) to--
(1) routinely test each person receiving treatment for
substance abuse through funds provided under such subpart for
substance abuse to determine if such person is infected with
the human immunodeficiency virus; and
(2) provide pre- and post-test counseling on acquired
immunodeficiency syndrome to each such patient.
(b) Confidentiality.--In promulgating regulations under subsection
(a), the Secretary shall ensure that confidentiality shall be provided
to those tested in accordance with section 552(a) of title 5 of the
United States Code.
SEC. 19. PROGRAMS FOR THE PREVENTION OF THE SPREAD OF AIDS.
(a) Regulations.--Not later than 180 days after the date of
enactment of this Act, the Secretary of Health and Human Services shall
promulgate regulations requiring the recipient of grant moneys
appropriated under section 318 of the Public Health Service Act (42
U.S.C. 247c) to--
(1) routinely test each person receiving treatment for a
sexually transmitted disease from the recipient to determine if
such person is infected with the human immunodeficiency virus;
and
(2) provide pre- and post-test counseling on acquired
immunodeficiency syndrome to each such person.
(b) Confidentiality.--In promulgating regulations under subsection
(a), the Secretary shall ensure that confidentiality shall be provided
to those tested under such regulations in accordance with section
552(a) of title 5 of the United States Code.
SEC. 20. IMMIGRATION REFORM.
Notwithstanding any other provision of law or any decision of the
Secretary of Health and Human Services or any other Federal official,
the President shall, pursuant to section 212(a)(6) of the Immigration
and Nationality Act, add infection with the human immunodeficiency
virus and syphillis to the list of dangerous contagious diseases
contained in title 42 of the Code of Federal Regulations.
SEC. 21. HEALTH CARE WORKERS PROTECTION ACT.
(a) Exposure Prone Invasive Procedures.--Notwithstanding any other
provision of law, a State shall, not later than 1 year after the date
of enactment of this Act, certify to the Secretary of Health and Human
Services that such State has in effect regulations, or has enacted
legislation, to protect licensed health care professionals from
contracting the human immunodeficiency virus and the hepatitis B virus
during the performance of exposure prone invasive procedures.
(b) Testing.--The regulations or legislation referred to in
subsection (a) shall permit health care professionals to require that,
prior to the commencement of or during the conduct of an exposure prone
invasive procedure, a patient may be tested for the etiologic agent for
the human immunodeficiency virus. Such regulations or legislation shall
not apply in emergency situations when the patient's life is in danger.
(c) Confidentiality of Results and Enforcement.--
(1) Results.--The result of tests conducted under
subsection (b) shall be confidential and shall not be released
to any other party without the prior written consent of the
patient.
(2) Enforcement.--The regulations or legislation referred
to in subsection (a) shall contain enforcement provisions that
subject an individual who violates the provisions of paragraph
(1) to a $10,000 fine or a prison term of not more than one
year for each such violation.
(d) Failure to Provide Certification.--Except as provided in
subsection (e), if a State does not provide the certification required
under subsection (a) within the 1-year period described in such
subsection, such State shall be ineligible to receive assistance under
the Public Health Service Act (42 U.S.C. 301 et seq.) until such
certification is provided.
(e) Exception.--The Secretary of Health and Human Services shall
extend the time period described in subsection (a) for a State, if--
(1) the State has determined not to promulgate regulations
to adopt the guidelines referred to in subsection (a); and
(2) the State legislature of such State meets on a biennial
basis and has not met within the 1-year period beginning on the
date of enactment of this Act.
(f) Definition.--As used in this section, the term ``exposure prone
invasive procedure'' means such procedures as listed in guidelines
promulgated by the Centers for Disease Control and Prevention
concerning recommendations for preventing the transmission by health
care professionals, of the human immunodeficiency virus and the
hepatitis B virus to patients during exposure prone invasive
procedures.
SEC. 22. DELIBERATE TRANSMISSION OF THE AIDS VIRUS.
(a) In General.--Whoever, being a registered physician, dentist,
nurse, or other health care provider, knowing that he or she is
infected with the human immunodeficiency virus, intentionally provides
medical or dental treatment to another individual, without prior
notification to such individual of such infection, shall be fined not
more than $10,000, or imprisoned not less than 10 years, or both.
(b) Applicability.--The provisions of this section shall not be
applicable in the case of a medical emergency in which alternative
medical treatment is not reasonably available.
(c) Definitions.--As used in this section the term ``treatment''
means the performance of any medical diagnosis or procedure that
involves an invasive physical contact between the patient being treated
and the physician or health professional administering the procedure.
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