[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3937 Introduced in House (IH)]







104th CONGRESS
  2d Session
                                H. R. 3937

     To amend title XIX of the Social Security Act with respect to 
    preventing the transmission of the human immunodeficiency virus 
            (commonly known as HIV), and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 1, 1996

  Mr. Coburn (for himself, Ms. Molinari, Mr. DeLay, Mrs. Fowler, Mr. 
   Weldon of Florida, Mr. Norwood, Mr. Hutchinson, Mr. Largent, Mr. 
 Souder, Mr. Stockman, Mr. Dornan, and Mr. Hostettler) introduced the 
    following bill; which was referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
     To amend title XIX of the Social Security Act with respect to 
    preventing the transmission of the human immunodeficiency virus 
            (commonly known as HIV), 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 ``HIV Prevention Act of 1996''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) The States should recognize that the terms ``acquired 
        immune deficiency syndrome'' and ``AIDS'' are obsolete. In the 
        case of individuals who are infected with the human 
        immunodeficiency virus (commonly known as HIV), the more 
        important medical fact for the individuals and for the 
        protection of the public health is the fact of infection, and 
        not just the later development of AIDS (the stage at which the 
        infection causes symptoms). The term ``HIV disease'', meaning 
        infection with HIV regardless of whether the infection has 
        progressed to AIDS, more correctly defines the medical 
        condition.
            (2) The medical, public health, political, and community 
        leadership must focus on the full course of HIV disease rather 
        than concentrating on later stages of the disease. Continual 
        focus on AIDS rather than the entire spectrum of HIV disease 
        has left our Nation unable to deal adequately with the 
        epidemic. Federal and State data collection efforts should 
        focus on obtaining data as early as possible after infection 
        occurs, while continuing to collect data on the symptomatic 
        stage of the disease.
            (3) Recent medical breakthroughs may enable doctors to 
        treat HIV disease as a chronic disease rather than as a 
        terminal disease. Early intervention in the progression of the 
        infection is imperative to prolonging and improving the lives 
        of individuals with the disease.
            (4) The Centers for Disease Control and Prevention has 
        recommended partner notification as a primary prevention 
        service. The health needs of the general public, and the care 
        and protection of those who do not have the disease, should be 
        balanced with the needs of individuals with the disease in a 
        manner that allows for the infected individuals to receive 
        optimal medical care and for public health services to protect 
        the uninfected.
            (5) Individuals with HIV disease have an obligation to 
        protect others from being exposed to HIV by avoiding behaviors 
        that place others at risk of becoming infected. Each of the 
        States should have in effect laws that provide that the 
        intentional or reckless exposure of others to HIV is a felony, 
        even if the infection is not transmitted.

SEC. 3. ESTABLISHMENT OF HIV-RELATED REQUIREMENTS IN MEDICAID PROGRAM.

    (a) In General.--Title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) is amended--
            (1) in section 1902(a)--
                    (A) in paragraph (61), by striking ``and'' after 
                the semicolon at the end;
                    (B) in paragraph (62), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by inserting after paragraph (62) the following 
                paragraph:
            ``(63) meet the requirements of section 1930A (relating to 
        the prevention of the transmission of the human 
        immunodeficiency virus, commonly known as HIV).''; and
            (2) by inserting after section 1930 the following section:

                  ``prevention of transmission of hiv

    ``Sec. 1930A. (a) For purposes of section 1902(a)(63), a State plan 
meets the requirements of this subsection if the plan demonstrates to 
the satisfaction of the Secretary that the law or regulations of the 
State are in accordance with the following:
            ``(1) The State requires that, in the case of a health 
        professional or other entity that provides for the performance 
        of a test for HIV on an individual, the entity confidentially 
        report positive test results to the State public health 
        officer, together with any additional necessary information, in 
        order to carry out the following purposes:
                    ``(A) The performance of statistical and 
                epidemiological analyses of the incidence in the State 
                of cases of such disease.
                    ``(B) The performance of statistical and 
                epidemiological analyses of the demographic 
                characteristics of the population of individuals in the 
                State who have the disease.
                    ``(C) The assessment of the adequacy of preventive 
                services in the State with respect to the disease.
            ``(2)(A) The State requires that the public health officer 
        of the State carry out a program to inform individuals that the 
        individuals may have been exposed to HIV (referred to in this 
        paragraph as `partner notification'). For purposes of this 
        paragraph, the term `partner' includes the sexual partners of 
        individuals with HIV disease, and the partners of such 
        individuals in the sharing of hypodermic needles for the 
        intravenous injection of drugs.
            ``(B) The State requires that any information collected for 
        purposes of partner notification be sufficient for the 
        following purposes:
                            ``(i) To provide the partners of the 
                        individual with HIV disease with an appropriate 
                        opportunity to learn that the partners have 
                        been exposed to HIV.
                            ``(ii) To provide the partners with 
                        counseling and testing for HIV disease.
                            ``(iii) To provide the individual who has 
                        the disease with information regarding 
                        therapeutic measures for preventing and 
                        treating the deterioration of the immune system 
                        and conditions arising from the disease, and to 
                        provide the individual with other preventive 
                        information.
                            ``(iv) With respect to an individual who 
                        undergoes testing for HIV disease but does not 
                        seek the results of the testing, to recall and 
                        provide the individual with counseling, 
                        therapeutic information, and other information 
                        regarding preventative health services 
                        appropriate for the individual.
            ``(C) The State cooperates with the Director of the Centers 
        for Disease Control and Prevention in carrying out a national 
        program of partner notification, including the sharing of 
        information between the public health officers of the States.
            ``(3) With respect to a defendant against whom an 
        information or indictment is presented for a crime in which by 
        force or threat of force the perpetrator compels the victim to 
        engage in sexual activity, the State requires as follows:
                    ``(A) That the defendant be tested for HIV disease 
                if--
                            ``(i) the nature of the alleged crime is 
                        such that the sexual activity would have placed 
                        the victim at risk of becoming infected with 
                        HIV; or
                            ``(ii) the victim requests that the 
                        defendant be so tested.
                    ``(B) That if the conditions specified in 
                subparagraph (A) are met, the defendant undergo the 
                test not later than 48 hours after the date on which 
                the information or indictment is presented, and that as 
                soon thereafter as is practicable the results of the 
                test be made available to the victim; the defendant (or 
                if the defendant is a minor, to the legal guardian of 
                the defendant); the attorneys of the victim; 
the attorneys of the defendant; the prosecuting attorneys; the judge 
presiding at the trial, if any; and the principal public health 
official for the local governmental jurisdiction in which the crime is 
alleged to have occurred.
                    ``(C) That, if the results of the test indicate 
                that the defendant has HIV disease, such fact may, as 
                relevant, be considered in the judicial proceedings 
                conducted with respect to the alleged crime.
            ``(4)(A) With respect to a patient who is to undergo an 
        invasive medical procedure that would place the health 
        professionals involved at risk of becoming infected with HIV, 
        the State--
                    ``(i) authorizes such health professionals to 
                provide that the procedure will not be performed unless 
                the patient undergoes a test for HIV disease and the 
                health professionals are notified of the results of the 
                test; and
                    ``(ii) requires that, if such test is performed and 
                the patient has positive test results, the patient be 
                informed of the results.
            ``(B) The State authorizes funeral-services practitioners 
        to provide that invasive procedures will not be performed 
        unless the body involved undergoes a test for HIV disease and 
        the practitioners are notified of the results of the test.
            ``(5) The State requires that, if a health care entity 
        (including a hospital) transfers a body to a funeral-services 
        practitioner and such entity knows that the body is infected 
        with HIV, the entity notify the funeral-services practitioner 
        of such fact.
            ``(6) The State requires that, if a health professional 
        knows that the professional has HIV disease, the professional 
        notify a patient of the professional before performing any 
        invasive medical procedure on the patient.
    ``(b) For purposes of this section, the term `HIV' means the human 
immunodeficiency virus; and the term `HIV disease' means infection with 
HIV and includes any condition arising from such infection.''.
    (b) Sense of Congress Regarding Health Professionals With HIV 
Disease.--It is the sense of the Congress that, with respect to health 
professionals who have HIV disease and who perform invasive medical 
procedures on patients, the medical profession should develop 
guidelines to assist such professionals in complying with requirements 
established by the States pursuant to section 1930A(a)(6) of the Social 
Security Act (as added by subsection (a) of this section).
    (c) Applicability of Requirements.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendment made by subsection (a) applies upon the expiration of 
        the 120-day period beginning on the date of the enactment of 
        this Act.
            (2) Delayed applicability for certain states.--In the case 
        of the State involved, if the Secretary determines that a 
        requirement established by the amendment made by subsection (a) 
        cannot be implemented in the State without the enactment of 
        State legislation, then such requirement applies to the State 
        on and after the first day of the first calendar quarter that 
        begins after the close of the first regular session of the 
        State legislature that begins after the date of the enactment 
        of this Act. For purposes of the preceding sentence, in the 
        case of a State that has a 2-year legislative session, each 
        year of such session is deemed to be a separate regular session 
        of the State legislature.
    (c) Rule of Construction.--Part D of title XXVI of the Public 
Health Service Act (42 U.S.C. 300ff-71 et seq.) is amended by inserting 
after section 2675 the following section:

``SEC. 2675A. RULE OF CONSTRUCTION.

    ``With respect to an entity that is an applicant for or a recipient 
of financial assistance under this title, compliance by the entity with 
any State law or regulation that is consistent with section 1930A of 
the Social Security Act may not be considered to constitute a violation 
of any condition under this title for the receipt of such 
assistance.''.

SEC. 4. SENSE OF CONGRESS REGARDING INTENTIONAL TRANSMISSION OF HIV.

    It is the sense of the Congress that the States should have in 
effect laws providing that, in the case of individuals who know they 
have HIV disease, it is a felony for the individuals to engage in any 
behaviors that the individuals know will place others at risk of 
infection with the disease, regardless of whether the behaviors 
actually transmit the infection.

SEC. 5. SENSE OF CONGRESS REGARDING CONFIDENTIALITY.

    It is the sense of the Congress that strict confidentiality should 
be maintained in carrying out the provisions of section 1930A of the 
Social Security Act (as added by section 3(a) of this Act).
                                 <all>