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HomeMy WebLinkAboutMINUTES - 12191995 - SD13 S D 3 R" TO: BOARD OF SUPERVISORS F&HS-04 Contra FROM: FAMILY AND HUMAN SERVICES COMMITTEE Costa Count �: . y DATE: December 11, 1995 Sra coiir+'� SUBJECT: REPORT ON TESTING OF PRISONERS AND OTHERS FOR THE HIV VIRUS SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1. ADOPT the attached Resolution pursuant to the provisions of Penal Code Section 7505 in order to make the provisions of Title 8 of Part 3 (Commencing with Section 7500 et seq.) of the Penal Code operative in Contra Costa County with the understanding-that Title 8 will be implemented based on the attached protocols and consistent with the attached policies and procedures manual section from the Sheriff's Department. 2. REMOVE this item as a referral to the 1995 Family and Human Services Committee. BACKGROUND: On October 3, 1995,the Board of Supervisors referred to our Committee the request of the Sheriff-Coroner that the Board adopt a Resolution in order to make that portion of the Penal Code which deals with the medical testing of prisoners operative in this County. CONTINUED ON ATTACHMENT: X YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD M ITT APPROVE OTHER SIGNATURES ACTION OF BOARD ON December I q 1995 PPROVED AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE X UNANIMOUS(ABSENT None ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED December 19, 1995 Contact: County Administrator PHIL BATCHELOR,CLERK OF THE BOARD OF CC: Sheriff-Coroner SUPERVISORS AN COUNTY ADMINISTRATOR Health Services Director County Health Officer County Counsel BY - DEPUTY F&HS-04 On November 7, 1995, the Board of Supervisors approved a report from our Committee which included the following recommendations: 1. DIRECT the County Health Officer to prepare and forward to the Family and Human Services Committee on December 11, 1995 a policy statement which discusses the factors outlined in Penal Code Section 7511 which are to be taken into consideration by the chief medical officer (County Health Officer) in making a decision to order a non-consensual test of certain individuals for the HIV virus,which discusses other criteria or circumstances which the County Health Officer may take into consideration in making this decision,which describe the County Health Officer's understanding of the phrase"...could have resulted in a significant risk of AIDS infection..:'as used in Penal Code Section 7511 (b)(1) and which,to the extent this is possible, could be a guide for the actions of the County Health Officer in this regard. 2. REQUEST the Sheriff-Coroner to prepare and forward to the Family and Human Services Committee on December 11, 1995 a protocol which will be followed by his staff in reporting situations which may result in a non-consensual test of certain individuals for the HIV virus and which will outline the manner in which the confidentiality of the involved parties will be maintained. 3. REQUEST both the Health Services Director and the Sheriff-Coroner to survey other counties to determine which have implemented Title 8, Part 3 (commencing with Section 7500) of the Penal Code and what their experiences have been with the implementation of this Title, including the number of reports that have been made pursuant to Title 8,the frequency with which non-consensual testing has been performed and what criteria, protocols or policy statements have been adopted by the County Health Officer,Sheriff,or Board of Supervisors in this regard and report their findings to the Family and Human Services Committee on December 11, 1995. On December 11, 1995, our Committee met with staff from the Sheriff's Department and the Health Services Department. We also received and reviewed the attached reports from the Public Health Director and Sheriff-Coroner. The report from the Public Health Director dated December 9, 1995, includes the necessary protocols to implement the testing program in this County, as. requested by the Board of Supervisors. These protocols were developed jointly by the Health Services Department and the Sheriffs Department and both Departments urge their approval. The policies and procedures manual section from the Sheriff outlines the procedures and responsibilities of the staff in the Sheriffs Department in regard to implementing Title 8. We believe that the protocols and policies and procedures provide for the necessary precautions and for the preservation of the rights of all involved individuals. In view of the approval of the protocols by both Departments and in light of the policies and procedures manual section from the Sheriff's Department, our Committee is prepared to recommend adoption of the necessary Resolution to make Title 8 operative in Contra Costa County. -2- THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this order on December 19.1995 by the following vote: AYES: _,STT-PFRUISORS ROGERS, SMITH, DeSAULNIER, TORLAKSON and BISHOP NOES: NONE ABSENT: NONE ABSTAIN: NONE RESOLUTION NO. 95/641 WHEREAS, the public peace, health. and safety is endangered by the spread of acquired Immune deficiency syndrome (AIDS); and WHEREAS, the spread of AIDS presents a grave danger to law enforcement personnel who come Into contact with arrestees and prisoners infected with the AIDS virus; and WHEREAS, the protection of the health and safety of these personnel is of great Importance to the people of Contra Costa County; and WHEREAS, the testing of individuals in custody of law enforcement for evidence of infection by the HIV virus, AIDS or AIDS related complex would help provide a level of information necessary for effective disease control within custodial institutions, and would help preserve the health of law enforcement personnel, inmates and the public at large; and WHEREAS, such testing would be undertaken only in those cases deemed appropriate by the chief medical officer and in compliance with all legal requirements, including those provisions pertaining to the confidentiality of results. NOW THEREFORE, BE IT RESOLVED that the provisions of Title 8 of Part 3 of the Penal Code (sections 7500 et seq.) regarding the medical testing of persons therein designated for the HIV virus, AIDS or AIDS related complex, shall be operative in Contra Costa County. I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. Attested: December 19, 1995 ` Phil Batchelor, Clerk of the Board of Supervisors and County Administrator. By: Deputy cc: W.E. Rupf, Sheriff G.T. Yancy, District Attorney M. Finucane, Director of Health Service Department RESOLUTION NO. 95/641 CONTRA COSTA COUNTY SHERIFF-CORONER Number 6-2. 10 DEPARTMENT MANUAL Replaces 6-2.10 of 1-31-91 POLICIES AND PROCEDURES Date December 8. 1995 Approved SUBJECT COMMUNICABLE DISEASE - PREVENTION AND CONTROL POLICY The Department bears the responsibility to the public and its employees to increase awareness about risks, methods of transmission, and procedures for handling communicable diseases. REFERENCE California Penal Code §1524.1 California Penal Code §7500-7540 Health and Safety Code §199.95-199.99 California Government Code §13960-13973 Center for Disease Control Guidelines_ Contra Costa County Sheriff's Department Policy #5-2. 1 Contra Costa County Sheriff's Department Bloodborne Pathogens Exposure Control Plan - Appendix DEFINITIONS A.I.D.S. : Acquired Immune Deficiency Syndrome, caused by H.I.V. , is a disease that results in the body's inability to fight infections which results in illness and death. A.R.C. : A.I.D.S. related complex is a condition caused by the A. I .D.S. virus and has a specific set of symptoms. Body Fluids: Blood, semen, drainage, pus, saliva, sputum, mucus, vomit, urine, feces, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, and amniotic fluid. Chief Medical Officer: As used' in this policy is the County Helath Officer-via Communicable Disease Control/AIDS Program, 597 Center Ave., Suite 200, Martinez. Communicable Disease: An infectious disease capable of being passed to another by contact with an infected person or their body fluids. C.P.R. : Cardiopulmonary Resuscitation is a life saving technique whereby the rescuer temporarily maintains the function of an individual's respiratory and circulatory systems. Excreta: Waste matter eliminated or separated from an organism. H.B.V. : Hepatitis B virus causes an infectious disease of the liver transmitted by blood or sexual fluids. Herpes: Inflammatory viral diseases of the skin and nerve endings characterized by clusters of blisters transmitted by direct contact with blisters. H.I.V. : Human Immunodeficiency Virus is the virus that causes A.I .D.S. . A • Meningitis: A disease in which inflammation of the meninges . (membranes that envelope the brain and spinal cord) occurs caused by several kinds of virus or bacteria and may be transmitted by respiratory contact such as mouth to mouth resuscitation. DEFINITIONS Syphilis: A contagious venereal disease caused by bacteria transmitted by blood or direct contact with open lesions. Tuberculosis: A bacterial disease that can be transmitted through sputum and is spread by inhaling airborne droplets from infected people. GENERAL INFORMATION The guidelines set forth in this policy apply to the following communicable diseases: 1) A. I.D.S. 3) H.B.V. 5) Herpes 7) Syphilis 2) A.R.C. 4) H.I.V. 6) Meningitis 8) Tuberculosis The following guidelines shall be followed when on-duty employees contact another individual's body fluids or excreta in the following ways: 1) Blood, semen, drainage, pus, saliva, sputum, mucus, vomit, feces, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, and amniotic fluid in an employee's eyes, mouth, or broken skin 2) Needle stick from used needle 3) Mouth to mouth breathing (CPR) unprotected 4) Human bites UNIVERSAL PRECAUTIONARY MEASURES Should Departmental employees reasonably expect contact with or by another individual's body secretions or excreta, preventive measures should be taken to avoid possible disease contamination. A. Employees should always assume that all body secretions are potentially infectious, regardless of the source. B. The best practice is to wear disposable gloves to protect the hands and keep them clean. 1) Replace gloves that are heavily stained during the course of routine tasks. 2) Upon task completion wash hands thoroughly with soap and water. 3) Use a 1:10 solution of chlorine bleach and water or at least 70% alcohol to thoroughly disinfect hands, when available. C. Keep hands away from the eyes, nose, and mouth. 6-2.10:2 I) If eyes, nose, and mouth become contaminated rinse thoroughly with water. D. Always maintain a clearly marked plastic bag for no other purpose than to collect contaminated items. GENERAL INFORMATION E. Constantly be alert for sharp objects, such as hypodermic needles, knives, razors, nails, etc. Use utmost care to prevent cuts and punctures. 1. Do not use hands to search areas out of view. Use a mirror to look under seats and a long-handled spoon to probe between seat cushions. F. All clothing articles contaminated with body fluids should be removed and placed in a marked plastic bag for cleaning. G. All contaminated equipment (from automobiles to ink pens) and work surfaces should be disinfected with a 1:10 solution of bleach and water to avoid further possible disease contamination. H. Contact your physician immediately. TRAINING A. Continual Essential Training on the implementation of this policy shall be given to all employees. (Reference Department Policy #5-2.1) B. All new employees shall receive training during divisional orientation. C. Divisions will maintain records of employees who have completed communicable disease training. LEGAL AUTHORITY A. Health and Safety Code §199.95-199.99: Authorizes testing if a valid criminal charge has been filed against an individual by the District Attorney. Deputies and victims of crimes may petition the court to request authorization for testing of an individual who has been accused of specified crimes (including assault on a police officer, resisting or interfering) for the HIV virus and other communicable diseases. B. Penal Code §7500-7540: Allows and authorizes testing of individuals in certain circumstances, whether or not a criminal charge has been filed. This legislation also allows inmates to request testing of other inmates in certain situations. This legislation also permits revoking the bail, probation or parole of individuals who refuse to comply with 6-2.10:3 • ordered testing. Prior to forced testing under this legislation: 1. The County Health Officer must make a finding that there is a reasonable belief that a significant risk of exposure occurred. The County Health Officer may interview witnesses and receive testimony from involved parties prior to making a decision. 2. The person requesting the test must undergo a baseline test prior to forced testing. 3. An appeals process, for anyone disagreeing with the findings of the County Health Officer; allows either the petitioning employee, or the subject from whom testing is sought to petition to a Hearing Panel and to Superior Court for an ultimate finding. TEST RESULTS Test results are forwarded to each requesting victim and the accused. CONFIDENTIALITY Physicians are not subject to civil or criminal liability for performing an HIV test, or for disclosing the HIV status of a source patient to a physician certifying the exposure, the exposed individual, or any attending physician of the exposed individual, if the physician acted in good faith in compliance with the law. The exposed individual MUST keep the HIV test results and any HIV- related information about the source patient confidential and may not further disclose the information. EXPOSED INDIVIDUALS BREACHING STATE CONFIDENTIALITY LAWS ARE SUBJECT TO CIVIL AND CRIMINAL LIABILITY! PROCEDURE 1 EMPLOYEE RESPONSIBILITIES A. Any employee who feels that they might have been exposed to a communicable disease while on duty will immediately notify their immediate supervisor. The employee MILL NOT request voluntary testing, but will ensure that his immediate supervisor makes this request from the involved subject. B. If the criteria for voluntary testing is not met, the employee will complete: 1. "Notification of Possible Communicable Disease Exposure" (form EMS 6) . 2. "Petition for Order to Test Accused's Blood" form to request authorization for testing. 6-2.10:4 3. "Report of Request and Decision for HIV Testing" (form DHS 8459). C. All employees are encouraged to contact the County Health Department to be serially tested and receive counseling. Follow-up testing is highly recommended to establish a baseline. PROCEDURE 2 SUPERVISOR'S RESPONSIBILITIES A. The supervisor on duty at the time of the incident will request voluntary testing from an arrestee/inmate via written consent, or obtain samples incident to the arrest, if possible. The supervisor WILL NOT have the involved employee request voluntary testing. Samples may be drawn upon request by MDF nursing staff. B. The supervisor will ensure the completion and signing of the following and submit all through the chain of command to the Division Commanders: 1. "Supervisor's Occupational and Injury Report" (form AK30), 2. "Employees Claim for Workers' Compensation Benefits" Form, 3. "Notification of Possible Communicable Disease Exposure" (to be completed by the employee) , 4. "Consent for the HIV Antibody Blood Test" if applicable, 5. "Petition for Order to Test Accused's Blood" if applicable (to be completed by the employee), 6. "Authorization for Disclosure of the Results of Blood Test(s) to Detect the presence of HIV Antibodies", 7. "Report of Request and Decision for HIV Testing" (to be completed by the employee). (Forms available from Resources & Planning/respective division administrations) C. Ensure that all documents have been completed and forwarded through the chain of command to the Division Commander within twenty-four hours. D. If blood is drawn voluntarily, or incident to the arrest, the supervisor will forward the two labeled blood samples along 6-2.10:5 with the completed forms below to the County Health Department (Monday through Friday) for testing as soon as possible. Exception: Samples should given to the Intake Nurse at the Martinez Detention Facility for refrigeration if the Health Department is closed, who will ensure delivery to the Health Department when opened. IMPORTANT IMPORTANT IMPORTANT Note: Whole blood samples must be placed in red top vacutainer vials (i.e., uncontaminated vials with no preservatives.) Blood and urine alcohol vacutainer (gray top) or blood typing vacutainers (purple top) cannot be used for HIV testing. D. Forward copies of the forms listed below to the Professional Standards and Resources Bureau Commander, via the chain of command. 1. "Consent for the HIV antibody Blood Test" 2. "Notification of Possible Communicable Disease Exposure" 3. "Authorization for Disclosure of the Results of Blood Test(s) to detect the Presence of HIV Antibodies 4. "Petition for Order to Test Accused's Blood" E. Supervisors should encourage employees to contact the County Health Department or their personal physician for personal testing and counselling. PROCEDURE 3 DIVISION COMMANDER'S RESPONSIBILITIES A. In all cases where voluntary testing has been refused, the Division Commander will: 1. Ensure that all documents have been completed for processing the victim's request to the court within twenty-four hours of possible exposure. (Refer to Procedure 2, Section B above. ) 2. Forward all documents (including support documentation, crime report, etc. ) to the Professional Standards & Resources Bureau Commander within twenty-four hours of the exposure. B. Assign an employee to sit on an Appeal Board, when requested by the County Health Officer. C. Ensure that all employees receive divisional training on the implementation of this policy. 6-2.10:6 PROCEDURE 4 THE PROFESSIONAL STANDARDS AND RESOURCES BUREAU'S RESPONSIBILITY The Commander of the Professional Standards and Resources Bureau will ensure that the following occurs: Criminal Actions A. Review a l l documents received from the concerned Division and ensure the documents listed below are completed: 1. "Consent for the HIV antibody Blood Test", 2. "Notification of Possible Communicable Disease Exposure", 3. "Authorization for Disclosure of the Results of Blood Test(s) to detect the Presence of HIV Antibodies, 4. "Petition for Order to Test Accused's Blood", 5. "Proposition 96 Order to Test Accused Blood" Form, B. Take all completed documents to the District Attorney's Office accompanied by the investigator seeking a Criminal Complaint. 1. Once the Criminal Complaint has been issued it shall be hand carried to the appropriate court along with the Petition For Order and Order to Test. 2. When the Complaint is filed with the Clerk of the Court the Professional Standards and Resources Bureau Commander will request a meeting with a judge to review the petition and grant the order. 3. If there will be a delay in issuing a Complaint the Professional Standards & Resources Bureau Commander will hand carry the Petition for Order, and Order to Test, along with supporting documents to the appropriate court for review by a judge and request the issuance of the Order. 4. The original Petition and Order will be filed along with the Criminal Complaint with the Clerk of the Court. Certified copies of the Petition and Order will be needed for: a. One set to the Martinez Detention Facility, "M" Module, if blood is to be drawn b. One set to County Health Department along with blood samples to allow testing (Do not 6-2.10:7 • send samples to the Criminalistics Laboratory) C. One set for Department files PROCEDURE 4 C. Notify Risk Management D. Notify the County Infectious Disease Control Unit E. Refer victim to the County Health Department-A.I.D.S. program for pre-request counseling. F. Coordinate A. I.D.S. transmission training with the County Health Services Department and the divisions. Non Criminal Actions California Penal Code §7500 et seq. , addresses the requirements and procedures for communicable disease testing where no criminal charge has been filed, or is anticipated. This would apply where incidental contact occurs, or as is sometimes the case at Detention Facilities, the incident will be handled through inmate disciplinary procedures. The process under this section requires the completion of the forms indicated under Procedure 2 B. The Supervisor must also ensure that the "Report of Request and Decision for HIV Testing" (form #DHS8459) form is completed and forwarded through the chain of command. G. Review and ensure all appropriate documents (listed in Procedure 4 A) received from the concerned divisions are completed properly. H. Will notify the County Health Officer-via Communicable Disease Control/AIDS Program, 597 Center Ave. , Martinez to request a formal decision to have an unconsenting individual serially tested for communicable diseases. 1. Appropriate documents will be delivered to the County Health Officer within forty-eight hours of the exposure. I . When the County Health Officer issues a decision to order testing (and the appeal process has been completed); 1. Professional Resources and Standards will receive the "Report of Request and Decision for HIV Testing", signed by the County Health Officer. 2. Professional Resources and Standards will ensure that blood is drawn and delivered to the County Health Department, Laboratory. 3. Complete steps listed in Procedure 4 C-E. 6-2.10:8 J. If the County Health Officers issues a decision to deny testing; 1. Professional Resources and Standards will ensure that the Deputy is notified and aware of his/her appeal rights. 2. If the employee chooses to -appeal a negative decision by the County Health Officer, ensure that the employee completes the "Report of Request for Appeal for HIV Testing" (form DHS 8457) within the three day period allowed for appeals. 3. Will notify County Health Officer immediately of appeal, when requested. 4. If the Appeal Board also issues a negative finding, Professional Resources and Standards will, at the request of the involved employee, carry the appeal to Superior Court for review by a judge. 5. If testing does not occur, complete steps listed in Procedure 4 C-E. J. If at any time during the process listed in this section, the Sheriff's Office determines to proceed with a criminal complaint and testing as authorized in H+S 199.95-199.99, Professional Resources and Standards will immediately notify the County Health Officer to suspend his investigation. PROCEDURE 5 INMATES REQUESTING TESTING A. Inmates requesting testing of another inmate should be immediately reffered to the medical staff of the detention facility. 1. Deputies should not question or comment on the inmates request. 6-2.10:9 I 1 SE Contra Costa County _L Health Services Department --- __ PUBLIC HEALTH DIVISION Administrative Offices 40 597 Center Avenue Suite 200 Martinez,California 94553 STS co December 9, 1995 To: Family and Human Services Committee Contra Costa County Board of Supervisors / From: Wendel Brunner, M.D. Associate Director for Public Health Health Services Department Re: New legislation regarding HIV testing in correctional institutions Attached is a copy of a draft protocol developed by Public Health in collaboration with the Sheriff's Office. This protocol is focussed on operational concerns in implementing this law between Health Services and Sheriff's Departments. Further work will need to be done with all police agencies operating within the county and the Probation Department. We do not see any major obstacles in implementing this new law. cc: William Walker, Health Officer Mark Finucane, Director, Health Services Department A'179 (7 4„ 1 I i DRAFT To: From: Francie Wise,PHN, MPH Director, Communicable Disease Control Public Health Division Re: Legislation allowing certain involuntary HIV testing of inmates in specific circumstances when law enforcement employees or other inmates have been exposed to potentially HIV infectious body fluids. i Attached is a packet of information related to Title 8, Part 3 of the Penal Code (Sections 7500 et seq.) which provides for the testing of inmates for HIV when requested by a law enforcement employee* or another inmate when the our county health officer determines that the requestor* has been exposed to a bodily fluid of an inmate which presents a significant risk of HIV transmission. * See Definitions - Section A Included in this packet are: Section A Definition of terms Section B Protocols for implementing the law in Contra Costa County (including the process of both voluntary consent for testing of the inmate and involuntary testing of the inmate as the law specifies B 1 Protocol for obtaining voluntary consent for HIV testing of an inmate B2 Protocol for obtaining an involuntary order for an HIV test of an inmate B3 Protocol for requesting an appeal of the Health Officer's order B4 Other requirements of the law: revocation of probation, notification requirements and inadmissibility of evidence for criminal or disciplinary proceedings j Attachments Report of Request& Decision for HIV Testing (Involuntary) I Authorization for Disclosure of Results of Blood Tests Consent for HIV Antibody Test Notice of Right of Appeal i Report to Request Appeal for HIV Testing Title 8/Part 3 of Penal Code (Sections 7500 et seq) I Section A - Definition of Terms 1. "Chief Medical Officer"in Contra Costa County refers to the county's Health Officer §7510(c)(4). 2. "Correctional institution" in Contra Costa County refers to any city or county jail or city or county juvenile facility §7502(a). 3. "Law enforcement employee"means • staff of correctional institutions (see 2 above) • California Highway Patrol officers • County Sheriff's deputies • city police officers • probation officers • city and county employees "including but not limited to judges, bailiffs, court personnel and public defenders who, as part of the judicial process involving an inmate of a correctional facility, or a person charged with a crime, including a minor charged with an offense for which he or she may be made a ward of the court- are engaged in the custody,transportation or care of these persons." §7502(c) 4. "HIV"means Human Immunodeficiency Virus,the virus that causes AIDS (Acquired Immune Deficiency Syndrome. §7502(d)(e) 5. "Inmate" in Contra Costa County refers to either of the following: (a) a person in a city or county jail who has either been convicted of a crime or arrested or taken into custody whether or not he or she has been charged with a crime or (b) any person in a city or county-operated juvenile facility who has committed an act or been charged with an act specified in Section 602 of the Welfare and Institutions Code § 7502(g). 6. "Bodily fluids"means blood, semen or any other body fluid identified by the Centers for Disease Control or the State Department of Health Services as capable of transmitting HIV §7502(h). 7. "Requestor"means any employee listed in#3 above or an inmate 45 (a) above. For a juvenile#5(b)to be a requestor, he or she must be 15 years old or older. A minor may file a request through a staff member of the facility in which s/he is confined or a staff member may, on his or her own volition, may file a report on behalf of the minor. 8. "Medical staff'means the staff providing medical care within the correctional institution. 3 B 1 - Protocol for obtaining voluntary consent for HIV testing of an inmate When the requestor believes s/he has been exposed to a high risk bodily fluid of an inmate: Who What Timing Requirement Law Inform medical staff of your exposure and request a voluntary Must occur within enforcement HIV test of the inmate. Simultaneously, complete form DHS two working days officer or an . 8459 notifying Public Health of the exposure and describing the of the incident inmate exposure incident. Forms will be located with your supervisor. Send forms according to Sheriff's Department protocols. Juvenile If the requestor is a juvenile,the parent/guardian of the requestor Facility Staff should be notified. Director of If the parent/guardian refuses consent,the Youth Authority Youth Director may request the juvenile court to rule on whether the Authority request procedure should continue Juvenile Determines whether procedure should continue Within five days Court of case being brought before the court Medical Approach the inmate for a voluntary consent to be tested. Within two days Staff Inmates must sign a consent to be tested and a consent for the of receipt of test result to be released to the requestor. Inform inmate report. regarding process for involuntary testing and possible consequences of non-cooperation(e.g., court order, revocation of probation, etc.)with involuntary testing if ordered. Medical At the time of drawing blood for voluntary testing, staff will Staff provide the inmate with information about how to receive his/her test results should s/he be released prior to receipt of the test results. Medical Will notify Public Health that the inmate has consented to Same day or Staff voluntary testing. following working day Note: If a voluntary test is given,the process to implement sections B2-B4 are discontinued at this point. Medical If the inmate agrees to a voluntary test,the requestor and the Within five days Staff inmate will be provided counseling. The requestor will be of the request offered testing;the inmate will be tested. 4 Who What Timing Requirement Medical Will provide test results to inmate and requestor along with Within two Module Staff appropriate HIV counseling working days of receipt of the test results If the inmate refuses to consent to a voluntary test and/or to the consent to release the test result to the requestor, proceed to B2. 5 B2 - Protocol for Obtaining an Involuntary Order for an HIV Test of an inmate Who What When Note: This section applies only after a voluntary HIV test has been refused by the inmate and/or the inmate has refused to consent to disclose the test result to the requestor. County Following receipt of Form DHS 8459(see Section B 1),the Within five days Health County Health Officer may receive written or oral testimony of receipt of form Officer from the requestor, from the inmate and from witnesses to the through the incident. This process will be facilitated by the Public Health Public AIDS Program. Health AIDS Program County Responds in writing to the request by either ordering the inmate' Within five days Health to be tested or by denying the request. of receipt of form Officer County Copies of the decision are provided to the requestor's supervisor Within five days Health to deliver to the requestor,to the subject of the request and to the of receipt of form Officer superintendent of the correctional institution. In the case of a minor, a copy of the decision is also provided to the parents or guardian of the minor. Requestor If either the employee or inmate requesting the test wishes to appeal the decision, proceed here to B3. Medical If no party files an appeal the Health Officer's decision,the Staff decision is considered final. If there is no appeal and the Health Officer has ordered testing,counseling will be provided to the requestor and the inmate. The requestor will be offered testing; the inmate will be tested. Counseling will be provided to both the requestor and the inmate at the time test results are provided. Public If the inmate has been released from the facility at the time to Health AIDS Health Officer's order to test has occurred,the inmate will be Program contacted and informed of the order,of their rights under the law and of consequences of non-cooperation. The AIDS Program will also make an appointment for the subject of the test to be tested. 6 133- Protocol for Requesting an Appeal to the Health Officer's Order Who What Timing Requirement County A description of the right to appeal will accompany the copies of Health the decision which are provided to the requestor, to the subject Officer of the request and to the superintendent of the correctional institution. In the case of a minor, a copy of the decision is also provided to the parents or guardian of the minor. Requestor or. Must file form DHS 8457 requesting of an appeal. Forms to Within three days parent of request an appeal are available with Medical staff. Forms of receipt of the requesting should be faxed to the AIDS Program Testing Unit(313-6798) , Health Officer's juvenile who will decision Public Contact the State Department of Health Services to supply the Within three days Health AIDS physician/surgeon to preside at the hearing and serve as of receipt of the Program(on chairperson. Health Officer's behalf of the report Health Officer) The panel consists of: (1)the County Health Officer (2)If the requestor is a law enforcement employee, a supervisory representative from the law enforcement agency employing him/her. If the requestor is a juvenile, a supervisory representative of the law enforcement agency with jurisdiction over the facility. (3)A physician or surgeon under contract with the State. What about inmate? Law Appoints an individual to serve on the panel as described above Within three days enforcement and notifies the Public Health AIDS Program(313-6791)of of receipt of the agency panel members Health Officer's employing report the requestor or the Sheriff's Department See Section 7515 (c 1-d)for those who may attend the hearing 7 3-member Determines whether to require the inmate to be tested. The Within 10 days of panel determination to test an inmate must be unanimous. Each the date the member of the panel will sign the decision. appeal is filed. Note: Who puts together the panel? Public Health or the State? AIDS Provides written copies of the decision to the requestor via Program on his/her supervisor,to the agency filing the report,the subject of behalf of the test and to the superintendent of the institution except that Health when the subject of the test is a minor,also to the parent or Officer guardian of the juvenile The decision of the 3-member panel may be appealed to the As expeditiously Superior Court either by the requestor,the inmate or the Health as possible. Officer. } 8 B 4 - Other Issues Notification of Grounds for Revocation of Parole Inmate or When no longer being held, must undergo testing. Failure to appear may be grounds juvenile to for revocation of probation or parole. be tested Notification Requirements When informed of the HIV status of an inmate(including juveniles)or a probationer,a law enforcement employees must maintain the confidentiality of information except as authorized by the law. Medical Upon release of an inmate from a correctional institution, must Staff notify the inmate's probation officer when the inmate has tested positive for HIV. Any information on necessary cautions should be included in the report to probation Probation When a probation officer learns from medical authorities that a Officer probationer has tested-positive for HIV, and the parolee has not notified his/her spouse,the probation officer should inform the Public Health AIDS Program (313-6777). Probation When the probation officer has learned that a probationer is Officer HIV-infected and has a record of assault on a peace officer and the officer seeks the aid of local law enforcement to apprehend or take the probationer into custody, s/he shall inform the officers assisting him or her in apprehending the probationer and aid them in protecting themselves from contracting HIV. Test Results as Admissible Evidence in Criminal or Disciplinary Proceedings Specimens and results of testing may not be admissible evidence in any criminal or disciplinary proceedings. 9