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. <-further 
11providing for legislative intent and for definitions; 
12providing for certification of significant exposure of 
13inmate's blood or bodily fluid; and further providing for 
14court order.

15The General Assembly of the Commonwealth of Pennsylvania
16hereby enacts as follows:

<-17Section 1. Section 3 of the act of November 29, 1990
18(P.L.585, No.148), known as the Confidentiality of HIV-Related
19Information Act, is amended by adding definitions to read:

20Section 3. Definitions.

21The following words and phrases when used in this act shall
22have the meanings given to them in this section unless the
23context clearly indicates otherwise:

1* * *

2"Blood-borne pathogen." A pathogenic microorganism which is
3present in human blood and can cause disease in humans. The term
4includes hepatitis B virus (HBV), hepatitis C virus (HCV) and
5human immunodeficiency virus (HIV).

6* * *

7"Community contract facility." A residential facility
8operated by a private vendor that both:

9(1) Houses offenders pursuant to a contract with the
10Department of Corrections.

11(2) Is operated in accordance with 61 Pa.C.S. Ch. 50
12(relating to community corrections centers and community
13corrections facilities).

14"Community corrections center." A residential facility
15operated by the Department of Corrections that houses inmates of
16the Department of Corrections, parolees, parole violators or all
17of the preceding.

18* * *

19"Corrections contractor." A person who provides services to
20the Department of Corrections pursuant to a contract with the
21Department of Corrections or as an employee of such a person.

22"Corrections employee." Any employee of a department or
23agency, responsible for operating a corrections facility in the
24Commonwealth of Pennsylvania.

25"Corrections facility." A State correctional institution,
26community corrections center or community contract facility.

27"Corrections volunteer." A person who, without financial
28remuneration, provides services to inmates housed in a
29corrections facility.

30* * *

1"High-risk worker." An individual health care provider,
2first responder, corrections employee, corrections contractor or
3corrections volunteer.

4* * *

5Section 2. Section 6 of the act, amended July 7, 2011
6(P.L.274, No.59), is amended to read:

7Section 6. Certification of significant exposure and testing
8procedures.

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

10(1) Whenever [an individual health care provider or
11first responder] a high-risk worker experiences an exposure
12to a patient's blood or bodily fluids during the course of
13rendering health care or during the course of his or her
14occupational services, the individual may request an
15evaluation of the exposure, by a physician, to determine if
16it is a significant exposure as defined in this act. No
17physician shall certify his own significant exposure or that
18of any of his employees. Such requests shall be made within
1972 hours of the exposure.

20(2) Within 72 hours of the request, the physician shall
21make written certification of the significance of the
22exposure.

23(3) If the physician determines that the individual
24health care provider or first responder has experienced a
25significant exposure, the physician shall offer the exposed
26individual the opportunity to undergo testing, following the
27procedure outlined in section 5.

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

29(1) In the event that an exposed [individual health care
30provider or first responder] high-risk worker is certified to

1have experienced a significant exposure and has submitted to
2an HIV-related test, no testing shall be performed on a
3source patient's available blood unless the certifying
4physician provides a copy of the written certification of
5significant exposure to the source patient's physician or
6institutional health care provider in possession of the
7available blood and the source patient's physician or
8institutional health care provider has made a good faith
9effort to:

10(i) Notify the source patient or substitute
11decisionmaker of the significant exposure.

12(ii) Seek the source [patient's] patient or
13substitute decisionmaker's voluntary informed consent to
14the HIV-related testing as specified in section 5(a).

15(2) The source patient's physician or institutional
16health care provider that receives a certification of
17significant exposure shall begin to comply with the request
18within 24 hours. If the source patient's physician or
19institutional health care provider is unable to secure the
20source [patient's] patient or substitute decisionmaker's
21consent because the source patient or the source patient's
22substitute decisionmaker refuses to grant informed consent or
23[the source patient] cannot be located, the source patient's
24physician or institutional health care provider shall arrange
25for an entry to be placed on the source patient's medical
26record to that effect. If these procedures are followed and
27the entry is made on the source patient's medical record,
28then HIV-related tests shall be performed on the source
29patient's available blood if requested by the exposed
30[individual health care provider or first responder] high-

1risk worker who has submitted to an HIV-related test.

2(2.1) If the source patient has provided a blood sample,
3but does not consent to blood-borne pathogens testing, the
4correctional facility shall ensure that the blood is tested
5for blood-borne pathogens if the high-risk worker requests
6the test, provided all of the following criteria are met:

7(i) The high-risk worker and the Department of
8Corrections have documented exposure to blood or body
9fluids during performance of the high-risk worker's
10services.

11(ii) A licensed physician has determined that a
12significant exposure has occurred as is prescribed in
13this section and has documented that blood-borne pathogen
14test results are needed for beginning, modifying,
15continuing or discontinuing medical treatment for the
16high-risk worker as recommended by the most current
17guidelines of the United States Public Health Service.

18(iii) The high-risk worker provides a blood sample
19for testing for blood-borne pathogens within 72 hours or
20as soon as feasible.

21(iv) The correctional facility asks the source
22patient to consent to a test for blood-borne pathogens
23and the source patient does not consent.

24(3) The physician ordering the HIV-related test on a
25source patient's available blood on behalf of the source
26patient's physician or institutional health care provider
27shall comply with section 5(c) through (e).

28(4) The [health care provider or first responder] high-
29risk worker shall be notified of the results of the HIV-
30related test on the source patient's blood if the [health

1care provider or first responder's] high-risk worker's
2baseline HIV-related test is negative. Further disclosure of
3the test results is prohibited unless authorized under
4section 7.

5Section 3. Section 7(a) of the act is amended by adding
6paragraphs to read:

7Section 7. Confidentiality of records.

8(a) Limitations on disclosure.--No person or employee, or
9agent of such person, who obtains confidential HIV-related
10information in the course of providing any health or social
11service or pursuant to a release of confidential HIV-related
12information under subsection (c) may disclose or be compelled to
13disclose the information, except to the following persons:

14(1) The subject.

15(2) The physician who ordered the test, or the
16physician's designee.

17(3) Any person specifically designated in a written
18consent as provided for in subsection (c).

19(4) An agent, employee or medical staff member of a
20health care provider, when the health care provider has
21received confidential HIV-related information during the
22course of the subject's diagnosis or treatment by the health
23care provider, provided that the agent, employee or medical
24staff member is involved in the medical care or treatment of
25the subject. Nothing in this paragraph shall be construed to
26require the segregation of confidential HIV-related
27information from a subject's medical record.

28(5) A peer review organization or committee as defined
29in the act of July 20, 1974 (P.L.564, No.193), known as the
30Peer Review Protection Act, a nationally recognized

1accrediting agency, or as otherwise provided by law, any
2Federal or State government agency with oversight
3responsibilities over health care providers.

4(6) Individual health care providers involved in the
5care of the subject with an HIV-related condition or a
6positive test, when knowledge of the condition or test result
7is necessary to provide emergency care or treatment
8appropriate to the individual; or health care providers
9consulted to determine diagnosis and treatment of the
10individual.

11(7) An insurer, to the extent necessary to reimburse
12health care providers or to make any payment of a claim
13submitted pursuant to an insured's policy.

14(8) The department and persons authorized to gather,
15transmit or receive vital statistics under the act of June
1629, 1953 (P.L.304, No.66), known as the Vital Statistics Law
17of 1953.

18(9) The department and local boards and departments of
19health, as authorized by the act of April 23, 1956 (1955
20P.L.1510, No.500), known as the Disease Prevention and
21Control Law of 1955.

22(10) A person allowed access to the information by a
23court order issued pursuant to section 8.

24(11) A funeral director responsible for the acceptance
25and preparation of the deceased subject.

26(12) Employees of county mental health/mental
27retardation agencies, county children and youth agencies,
28county juvenile probation departments, county or State
29facilities for delinquent youth, and contracted residential
30providers of the above-named entities receiving or

1contemplating residential placement of the subject, who:

2(i) generally are authorized to receive medical
3information; and

4(ii) are responsible for ensuring that the subject
5receives appropriate health care; and

6(iii) have a need to know the HIV-related
7information in order to ensure such care is provided.

8The above-named entities may release the information to a
9court in the course of a dispositional proceeding under 42
10Pa.C.S. §§ 6351 (relating to disposition of dependent child)
11and 6352 (relating to disposition of delinquent child) when
12it is determined that such information is necessary to meet
13the medical needs of the subject.

14(13) A person authorized to receive the information
15pursuant to this section.

16(14) A high-risk worker who has suffered a significant
17exposure in the course of his or her occupational duties in a
18corrections facility or county jail.

19(15) The Pennsylvania State Police, local police
20department, other law enforcement agency, Office of Attorney
21General or office of the district attorney or an agency
22investigating or prosecuting an allegation that an inmate of
23a corrections facility or county jail has committed an
24offense under one or more of the following:

25(i) 18 Pa.C.S. § 2703 (relating to assault by 
26prisoner).

27(ii) 18 Pa.C.S. § 2703.1 (relating to aggravated
28harassment by prisoner).

29(iii) 18 Pa.C.S. § 2704 (relating to assault by life
30prisoner).

1* * *

2Section 4. Section 8(c) of the act is amended to read:

3Section 8. Court order.

4* * *

5(c) Compelling need.--In assessing compelling need for
6subsections (a) and (b), the court shall weigh the need for
7disclosure against the privacy interest of the individual and
8the public interests which may be harmed by disclosure. A high-
9risk worker who has suffered a significant exposure in the
10course of his or her occupational duties in a correctional
11facility or county jail shall be presumed to have a compelling
12need for the information that cannot be accommodated by other
13means. The presumption can only be overcome by clear and
14convincing evidence to the contrary.

15* * *

16Section 5. This act shall take effect in 60 days.

<-17Section 1. Section 2 of the act of November 29, 1990 
18(P.L.585, No.148), known as the Confidentiality of HIV-Related 
19Information Act, is amended by adding a subsection to read:

20Section 2. Legislative intent.

21* * *

22(e) Intent with respect to corrections staff.--It is the
23intent of the General Assembly to provide a mechanism for
24corrections staff members who experience a significant exposure
25of an inmate's blood and/or bodily fluids to learn of the
26inmate's status regarding infection of HIV, hepatitis B or
27hepatitis C. This knowledge will enable a corrections staff
28member to make informed decisions with respect to modes and
29duration of therapy as well as measures to reduce the likelihood
30of transmitting infection to others.

1Section 2. The definitions of "available blood" and
2"significant exposure" in section 3 of the act are amended and
3the section is amended by adding definitions to read:

4Section 3. Definitions.

5The following words and phrases when used in this act shall
6have the meanings given to them in this section unless the
7context clearly indicates otherwise:

8* * *

9"Available blood." The term means:

10(1) Blood that is in the possession of the institutional
11health care provider or the source patient's physician
12pursuant to a valid authorization.

13(2) For purposes of section 6.1, blood that is in
14possession of a correctional facility pursuant to medical
15care provided to the inmate prior to significant exposure, as
16defined in paragraph (2) of the definition of "significant
17exposure" in this section.

18* * *

19"Correctional facility." A State or a county correctional
20institution. The term includes a community corrections facility
21or community corrections center as defined in 61 Pa.C.S. § 5001
22(relating to definitions).

23"Corrections staff member." An individual who provides
24health care, occupational or other services to inmates at a
25correctional facility. The term includes an individual who is:

26(1) paid by the Commonwealth or a county;

27(2) paid by a private entity which has a contract with
28the Commonwealth or a county; or

29(3) a volunteer.

30* * *

1"Significant exposure." The term means:

2(1) Direct contact with blood or body fluids of a
3patient in a manner which, according to the most current
4guidelines of the Centers for Disease Control, is capable of
5transmitting human immunodeficiency virus, including, but not
6limited to, a percutaneous injury (e.g., a needle stick or
7cut with a sharp object), contact of mucous membranes or
8contact of skin (especially when the exposed skin is chapped,
9abraded or afflicted with dermatitis) or if the contact is
10prolonged or involves an extensive area.

11(2) For purposes of section 6.1, direct contact with
12blood or bodily fluids of an inmate in a correctional
13facility in a manner which:

14(i) according to the most current guidelines of the
15Centers for Disease Control, is capable of transmitting
16HIV, including, but not limited to, a percutaneous
17injury, that is, a needle stick or cut with a sharp
18object, contact with mucous membranes or contact of skin,
19especially when the skin is chapped, abraded or afflicted
20with dermatitis, or if the contact is prolonged or
21involves an extensive area; or

22(ii) is capable of transmitting hepatitis B virus or
23hepatitis C virus.

24* * *

25Section 3. The act is amended by adding a section to read:

26Section 6.1. Certification of significant exposure of inmate's
27blood or bodily fluid.

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

29(1) Whenever a corrections staff member experiences an
30exposure to an inmate's blood or bodily fluids during the

1course of rendering health care, occupational services or
2other services, the individual may request an evaluation of
3the exposure, by a physician, to determine if it is a
4significant exposure as defined in this act. No physician
5shall certify the physician's own significant exposure or
6that of any of the physician's employees. Requests must be
7made within 72 hours of the exposure.

8(2) Within 72 hours of the request, the physician shall
9make written certification of the significance of the
10exposure.

11(3) If the physician determines that the individual has
12experienced a significant exposure, the physician shall offer
13the exposed individual the opportunity to undergo testing for
14HIV, following the procedure outlined in section 5.

15(b) Use of available blood.--In the event that the inmate
16does not consent to a testing of the inmate's blood for HIV,
17hepatitis B or hepatitis C after the occurrence of the
18significant exposure to a corrections staff member, the
19correctional facility shall test the inmate's available blood
20for HIV, hepatitis B and hepatitis C if all of the following
21conditions are met:

22(1) The corrections staff member requests that the
23inmate's blood be tested for HIV, hepatitis B or hepatitis C.

24(2) A significant exposure to the inmate's blood has
25been documented by a physician in accordance with subsection
26(a).

27(3) A physician documented that the results of tests on
28the inmate's blood are needed to treat the individual as
29recommended by the most current guidelines of the United
30States Public Health Service.

1(4) The individual provides a blood sample within 72
2hours, or as soon as practicable, whichever is sooner.

3(c) If inmate consents to testing of blood.--The inmate
4shall be given the opportunity to consent to a testing of the
5inmate's blood after a significant exposure.

6(d) Test results.--The following are authorized to receive
7the results of the testing on the inmate's blood after a
8significant exposure occurs:

9(1) The corrections staff member.

10(2) The inmate.

11(3) The attorney for the Commonwealth, if the
12significant exposure is alleged to be a violation of an
13offense set forth in 18 Pa.C.S. (relating to crimes and
14offenses).

15(4) The physician set forth in subsection (b) and any
16other physician or health care provider who is involved with
17treatment of the individual or inmate.

18(5) With respect to a positive test for HIV, the
19department and local boards and departments of health, as
20authorized by the act of April 23, 1956 (1955 P.L.1510, 
21No.500), known as the Disease Prevention and Control Law of 
221955.

23(6) With respect to a positive test for HIV, the
24department and persons authorized to gather, transmit or
25receive vital statistics under the act of June 29, 1953 
26(P.L.304, No.66), known as the Vital Statistics Law of 1953.

27(e) Immunity for good faith conduct.--The following apply:

28(1) The physician who certifies that a significant
29exposure has occurred as provided in this section shall not
30be subject to civil liability if acting in the good faith and

1reasonable belief that the documentation of significant
2exposure was appropriate and consistent with this section.

3(2) Physicians, health care providers and employees of a
4correctional facility shall be immune for acts committed in
5good faith to implement the provisions of this section.

6(f) Construction.--This section shall not be construed to
7preclude or limit any other testing of an inmate's blood that is
8otherwise lawfully permitted by search warrant, court order,
9statute or common law.

10Section 4. Section 8(c) of the act is amended to read:

11Section 8. Court order.

12* * *

13(c) Compelling need.--In assessing compelling need for
14subsections (a) and (b), the court shall weigh the need for
15disclosure against the privacy interest of the individual and
16the public interests which may be harmed by disclosure. In the 
17event the court determines that a corrections staff member is 
18seeking access to confidential HIV-related information due to a 
19significant exposure to an inmate's blood under paragraph (2) of 
20the definition of "significant exposure" in section 3, there 
21shall be a presumption of compelling need. The presumption may 
22be overcome by clear and convincing evidence.

23* * *

24Section 5. The amendment or addition of sections 2(e), 3,
256.1 and 8(c) of the act shall apply to a significant exposure
26occurring on or after the effective date of this section.

27Section 6. This act shall take effect in 60 days.