Current through Register Vol. 50, No. 9, September 20, 2024
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.
AUTHORITY NOTE:
Promulgated in accordance with R.S.40:38.5.
