1Amending the act of November 29, 1990 (P.L.585, No.148),
2entitled "An act providing for confidentiality of certain
3records; providing for the authorized sharing of certain
4information; providing for written consent prior to an HIV-
5related test, with certain exceptions; providing for civil
6immunity for certain licensed physicians; providing for
7protective procedures and equipment; and creating a civil
8cause of action," further providing for definitions, for
9certification of significant exposure and testing procedures,
10for confidentiality of records and for court order.

11The General Assembly of the Commonwealth of Pennsylvania
12hereby enacts as follows:

13Section 1. Section 3 of the act of November 29, 1990
14(P.L.585, No.148), known as the Confidentiality of HIV-Related
15Information Act, is amended by adding definitions to read:

16Section 3. Definitions.

17The following words and phrases when used in this act shall
18have the meanings given to them in this section unless the
19context clearly indicates otherwise:

20* * *

21"Blood-borne pathogen." A pathogenic microorganism which is
22present in human blood and can cause disease in humans. The term

1includes hepatitis B virus (HBV), hepatitis C virus (HCV) and
2human immunodeficiency virus (HIV).

3* * *

4"Community contract facility." A residential facility
5operated by a private vendor that both:

6(1) Houses offenders pursuant to a contract with the
7Department of Corrections.

8(2) Is operated in accordance with 61 Pa.C.S. Ch. 50
9(relating to community corrections centers and community
10corrections facilities).

11"Community corrections center." A residential facility
12operated by the Department of Corrections that houses inmates of
13the Department of Corrections, parolees, parole violators or all
14of the preceding.

15* * *

16"Corrections contractor." A person who provides services to
17the Department of Corrections pursuant to a contract with the
18Department of Corrections or as an employee of such a person.

19"Corrections employee." Any employee of a department or
20agency, responsible for operating a corrections facility in the
21Commonwealth of Pennsylvania.

22"Corrections facility." A State correctional institution,
23community corrections center or community contract facility.

24"Corrections volunteer." A person who, without financial
25remuneration, provides services to inmates housed in a
26corrections facility.

27* * *

28"High-risk worker." An individual health care provider,
29first responder, corrections employee, corrections contractor or
30corrections volunteer.

1* * *

2Section 2. Section 6 of the act, amended July 7, 2011
3(P.L.274, No.59), is amended to read:

4Section 6. Certification of significant exposure and testing
5procedures.

6(a) Physician's evaluation of significant exposure.--

7(1) Whenever [an individual health care provider or
8first responder] a high-risk worker experiences an exposure
9to a patient's blood or bodily fluids during the course of
10rendering health care or during the course of his or her
11occupational services, the individual may request an
12evaluation of the exposure, by a physician, to determine if
13it is a significant exposure as defined in this act. No
14physician shall certify his own significant exposure or that
15of any of his employees. Such requests shall be made within
1672 hours of the exposure.

17(2) Within 72 hours of the request, the physician shall
18make written certification of the significance of the
19exposure.

20(3) If the physician determines that the individual
21health care provider or first responder has experienced a
22significant exposure, the physician shall offer the exposed
23individual the opportunity to undergo testing, following the
24procedure outlined in section 5.

25(b) Opportunity for source patient to consent.--

26(1) In the event that an exposed [individual health care
27provider or first responder] high-risk worker is certified to
28have experienced a significant exposure and has submitted to
29an HIV-related test, no testing shall be performed on a
30source patient's available blood unless the certifying

1physician provides a copy of the written certification of
2significant exposure to the source patient's physician or
3institutional health care provider in possession of the
4available blood and the source patient's physician or
5institutional health care provider has made a good faith
6effort to:

7(i) Notify the source patient or substitute
8decisionmaker of the significant exposure.

9(ii) Seek the source [patient's] patient or 
10substitute decisionmaker's voluntary informed consent to
11the HIV-related testing as specified in section 5(a).

12(2) The source patient's physician or institutional
13health care provider that receives a certification of
14significant exposure shall begin to comply with the request
15within 24 hours. If the source patient's physician or
16institutional health care provider is unable to secure the
17source [patient's] patient or substitute decisionmaker's
18consent because the source patient or the source patient's
19substitute decisionmaker refuses to grant informed consent or
20[the source patient] cannot be located, the source patient's
21physician or institutional health care provider shall arrange
22for an entry to be placed on the source patient's medical
23record to that effect. If these procedures are followed and
24the entry is made on the source patient's medical record,
25then HIV-related tests shall be performed on the source
26patient's available blood if requested by the exposed
27[individual health care provider or first responder] high-
28risk worker who has submitted to an HIV-related test.

29(2.1) If the source patient has provided a blood sample,
30but does not consent to blood-borne pathogens testing, the

1correctional facility shall ensure that the blood is tested
2for blood-borne pathogens if the high-risk worker requests
3the test, provided all of the following criteria are met:

4(i) The high-risk worker and the Department of
5Corrections have documented exposure to blood or body
6fluids during performance of the high-risk worker's
7services.

8(ii) A licensed physician has determined that a
9significant exposure has occurred as is prescribed in
10this section and has documented that blood-borne pathogen
11test results are needed for beginning, modifying,
12continuing or discontinuing medical treatment for the
13high-risk worker as recommended by the most current
14guidelines of the United States Public Health Service.

15(iii) The high-risk worker provides a blood sample
16for testing for blood-borne pathogens within 72 hours or
17as soon as feasible.

18(iv) The correctional facility asks the source
19patient to consent to a test for blood-borne pathogens
20and the source patient does not consent.

21(3) The physician ordering the HIV-related test on a
22source patient's available blood on behalf of the source
23patient's physician or institutional health care provider
24shall comply with section 5(c) through (e).

25(4) The [health care provider or first responder] high-
26risk worker shall be notified of the results of the HIV-
27related test on the source patient's blood if the [health
28care provider or first responder's] high-risk worker's
29baseline HIV-related test is negative. Further disclosure of
30the test results is prohibited unless authorized under

1section 7.

2Section 3. Section 7(a) of the act is amended by adding
3paragraphs to read:

4Section 7. Confidentiality of records.

5(a) Limitations on disclosure.--No person or employee, or
6agent of such person, who obtains confidential HIV-related
7information in the course of providing any health or social
8service or pursuant to a release of confidential HIV-related
9information under subsection (c) may disclose or be compelled to
10disclose the information, except to the following persons:

11(1) The subject.

12(2) The physician who ordered the test, or the
13physician's designee.

14(3) Any person specifically designated in a written
15consent as provided for in subsection (c).

16(4) An agent, employee or medical staff member of a
17health care provider, when the health care provider has
18received confidential HIV-related information during the
19course of the subject's diagnosis or treatment by the health
20care provider, provided that the agent, employee or medical
21staff member is involved in the medical care or treatment of
22the subject. Nothing in this paragraph shall be construed to
23require the segregation of confidential HIV-related
24information from a subject's medical record.

25(5) A peer review organization or committee as defined
26in the act of July 20, 1974 (P.L.564, No.193), known as the
27Peer Review Protection Act, a nationally recognized
28accrediting agency, or as otherwise provided by law, any
29Federal or State government agency with oversight
30responsibilities over health care providers.

1(6) Individual health care providers involved in the
2care of the subject with an HIV-related condition or a
3positive test, when knowledge of the condition or test result
4is necessary to provide emergency care or treatment
5appropriate to the individual; or health care providers
6consulted to determine diagnosis and treatment of the
7individual.

8(7) An insurer, to the extent necessary to reimburse
9health care providers or to make any payment of a claim
10submitted pursuant to an insured's policy.

11(8) The department and persons authorized to gather,
12transmit or receive vital statistics under the act of June
1329, 1953 (P.L.304, No.66), known as the Vital Statistics Law
14of 1953.

15(9) The department and local boards and departments of
16health, as authorized by the act of April 23, 1956 (1955
17P.L.1510, No.500), known as the Disease Prevention and
18Control Law of 1955.

19(10) A person allowed access to the information by a
20court order issued pursuant to section 8.

21(11) A funeral director responsible for the acceptance
22and preparation of the deceased subject.

23(12) Employees of county mental health/mental
24retardation agencies, county children and youth agencies,
25county juvenile probation departments, county or State
26facilities for delinquent youth, and contracted residential
27providers of the above-named entities receiving or
28contemplating residential placement of the subject, who:

29(i) generally are authorized to receive medical
30information; and

1(ii) are responsible for ensuring that the subject
2receives appropriate health care; and

3(iii) have a need to know the HIV-related
4information in order to ensure such care is provided.

5The above-named entities may release the information to a
6court in the course of a dispositional proceeding under 42
7Pa.C.S. §§ 6351 (relating to disposition of dependent child)
8and 6352 (relating to disposition of delinquent child) when
9it is determined that such information is necessary to meet
10the medical needs of the subject.

11(13) A person authorized to receive the information
12pursuant to this section.

13(14) A high-risk worker who has suffered a significant
14exposure in the course of his or her occupational duties in a
15corrections facility or county jail.

16(15) The Pennsylvania State Police, local police
17department, other law enforcement agency, Office of Attorney
18General or office of the district attorney or an agency
19investigating or prosecuting an allegation that an inmate of
20a corrections facility or county jail has committed an
21offense under one or more of the following:

22(i) 18 Pa.C.S. § 2703 (relating to assault by 
23prisoner).

24(ii) 18 Pa.C.S. § 2703.1 (relating to aggravated
25harassment by prisoner).

26(iii) 18 Pa.C.S. § 2704 (relating to assault by life
27prisoner).

28* * *

29Section 4. Section 8(c) of the act is amended to read:

30Section 8. Court order.

1* * *

2(c) Compelling need.--In assessing compelling need for
3subsections (a) and (b), the court shall weigh the need for
4disclosure against the privacy interest of the individual and
5the public interests which may be harmed by disclosure. A high-
6risk worker who has suffered a significant exposure in the 
7course of his or her occupational duties in a correctional 
8facility or county jail shall be presumed to have a compelling 
9need for the information that cannot be accommodated by other 
10means. The presumption can only be overcome by clear and 
11convincing evidence to the contrary.

12* * *

13Section 5. This act shall take effect in 60 days.