AIDS Counseling and Testing Act of 1988

(Reported to House from the Committee on Energy and Commerce with amendment, H. Rept. 100-783)

AIDS Counseling and Testing Act of 1988 - Amends the Public Health Service Act to create a new title on counseling and testing with respect to acquired immune deficiency syndrome (AIDS).

Directs the Secretary of Health and Human Services to make a grant allotment for each State for each of FY 1989 through 1991. Authorizes the Secretary to make grants to entities which are grantees under other specified provisions, have received appropriated funds as alternate blood testing sites, or are nonprofit hospitals. Requires the allotments and grants be used only for counseling individuals with respect to AIDS and testing individuals for infection with the etiologic agent for AIDS. Directs the Secretary, in making the grants, to give preference to applicants in geographic areas where in FY 1989, the number of additional cases of AIDS, or in FY 1990 and subsequent fiscal years, if sufficient and accurate data are available, the number of additional cases of infection with the etiologic agent constitutes one percent or greater of such cases in the United States.

Prohibits the Secretary from making an allotment or grant unless the applicant agrees to ensure, in accordance with Federal law and with State and local law not superseded by Federal law, the confidentiality of information and records with respect to individuals counseled or tested.

Requires a written, signed statement of informed consent by the individual to be tested, with special provisions relating to testing through the use of a pseudonym and anonymous testing.

Requires grantees to provide counseling which includes coverage of specified points before testing, after a negative test result, and after a positive test result. Requires grantees, where appropriate, to provide opportunities for women, children, hemophiliacs, and emergency response employees to undergo counseling under conditions appropriate to their needs. Allows grantees to use the grant to provide counseling without testing.

Requires applicants who regularly provide treatment for sexually transmitted diseases or for intravenous substance abuse and applicants who are family planning clinics or tuberculosis clinics to routinely test for infection with the etiologic agent for AIDS.

Prohibits the Secretary from making a grant to a State unless the State requires testing of each individual who is convicted of prostitution, a crime relating to sexual assault, or a crime relating to intravenous drug abuse. Requires the State to notify the individual before the test is performed. Requires, on request of a victim of a crime relating to sexual assault, that the victim be notified of the results of the testing. Allows the Secretary to make a grant to a State for each of the FY 1989 and 1990 if the State provides assurances that it will establish the requirements not later than October 1, 1990.

Prohibits the Secretary from making a grant to a State unless the State provides assurances that it will: (1) encourage individuals in the State receiving, after 1976, a transfusion of any blood product to undergo testing; and (2) inform the individuals of public health facilities in the area that offer testing.

Prohibits the Secretary from making a grant to a State unless the State requires that: (1) any entity carrying out testing confidentially report to the State public health officer information sufficient to perform statistical and epidemiological analyses of the incidence and demographic characteristics of cases of infection; and (2) the State public health officer, to the extent appropriate in the determination of the officer, carry out a program of contact tracing.

Requires State grantees to establish a civil cause of action and a criminal penalty for knowing actions by an infected individual which exposes another individual to the etiologic agent through: (1) donation of blood, semen, breast milk, or an organ; (2) sexual activity; and (3) any behavior with intent to expose another individual. Provides for an exception where the person exposed gives prior consent to being exposed. Allows the Secretary to make a grant to a State for each of the FY 1989 and 1990 if the State provides assurances that it will establish the civil and criminal actions not later than October 1, 1990. Allows the State chief executive officer to certify, in lieu of enactment of any statute or issuance of any regulation, that the law of the State is in substantial compliance.

Requires States, to the extent permitted under State law, to offer substantial opportunities for an individual to undergo counseling and testing anonymously and through the use of a pseudonym.

Prohibits requiring testing as a condition of receiving other health services, unless the testing is medically indicated in the health services being sought.

Requires that grantees who provided counseling and testing before receipt of these grants use the grants to increase the availability of counseling and testing.

Provides for administration of the grant, including prohibiting: (1) imposing a charge on any individual seeking counseling or testing who is unable to pay the charge; and (2) expending more than ten percent of the grant for administration.

Sets forth a formula for determination of the amount of allotments for States.

Authorizes the Secretary, on request of a grantee, to provide supplies, equipment, services, and detailed personnel in lieu of grant funds.

Directs the Secretary, directly or through grants and contracts, to evaluate programs carried out with grants made under this Act for counseling and testing.

Authorizes appropriations for FY 1989 through 1991, with 50 percent of any appropriations going to allotments and 50 percent going to grants.

Requires all individuals receiving counseling under these provisions to be counseled about the harmful effects of promiscuous sexual activity and intravenous substance abuse, and the benefits of abstaining from such activities. Prohibits funds from being used to provide counseling that promotes or encourages, directly, homosexual or unsafe heterosexual sexual activity or intravenous substance abuse, but declares that this may not be construed to prohibit a counselor from providing the most current scientific knowledge to reduce the individual's risk of exposure to, or the transmission of, the etiologic agent, provided any informational materials used are not obscene.

Creates another new part in the new subtitle established by this Act concerning confidentiality with respect to counseling and testing. Prohibits certain persons, without regard to whether such persons receive Federal financial assistance, from disclosing identifying information with respect to a protected individual or a contact of such individual. Includes among such persons anyone who obtains identifying information: (1) directly or indirectly in connection with counseling or testing with regard to AIDS, providing health care to the protected individual, or carrying out a disclosure authorized by this Act or ordered by a court under this Act; (2) by directly perceiving any record developed in such counseling, testing, health care, or disclosure; or (3) in connection with notification of emergency response employees under specified provisions of this Act.

Authorizes consensual disclosure of identifying information through a specified procedure, including consent by a guardian of a legally incompetent person and consent, after the death of the protected individual, by the claimant of life insurance proceeds, for disclosure to the insurance company.

Provides for nonconsensual disclosure: (1) to a health care provider in connection with counseling or testing, to the protected individual, or to the guardian of an incompetent individual; (2) to a health care provider who is likely to be occupationally exposed to the etiologic agent; (3) to a State public health officer if required by State law; (4) in connection with donation of blood, semen, breast milk, or an organ; (5) to a person preparing the body of a protected individual for burial; (6) intraorganizationally as necessary; (7) from a person receiving disclosure to any person authorized in these provisions for authorized purposes; (8) in connection with certain sales, transfers, mergers, or consolidations of all or portions of organizations; and (9) in certain circumstances involving insurance policies and health plans.

Authorizes a court of competent jurisdiction, with respect to the protected individual or contact involved, to: (1) order disclosure of identifying information to a State health officer in order to prevent a clear and imminent danger of transmission, by the individual or contact, of the etiologic agent; and (2) authorize the officer to disclose identifying information to the extent reasonably necessary to prevent such danger. Sets forth procedures, including in camera hearings, use of pseudonyms, and sealing of records.

Provides for nonconsensual disclosures to victims of sexual assault.

Authorizes physicians and counselors to make nonconsensual disclosures to spouses, sexual contacts, and people with whom the protected individual has shared a hypodermic needle, in certain circumstances.

Requires, subject to exception, that: (1) disclosures be accompanined by a written declaration that redisclosure may be prohibited by law; and (2) in certain circumstances, the protected individual be notified in writing of the disclosure.

Provides for civil monetary penalties and civil causes of action for intentional or negligent violation of disclosure provisions of this part. Authorizes injunctive relief initiated by the Secretary and a civil cause of action by any aggrieved individual. Provides for in camera proceedings, use of pseudonyms, and sealing of records.

Provides for criminal penalties for intentional violation of disclosure provisions.

Provides for termination of grants and contracts with any Federal agency and suspension or debarment of any Federal grantee or contractor for violation of certain disclosure provisions of this part.

Declares that the imposition of a penalty or the receipt of relief under specified provisions of this part does not preclude other penalties or relief under Federal law.

Declares that this part supersedes any State law that provides penalties or causes of action for failure to make disclosures not authorized by this part or for making disclosures authorized by this part.

Directs the Secretary, acting through the Director of the Centers for Disease Control, to develop guidelines and a model curriculum for emergency response employees (EREs) with respect to the prevention of exposure to AIDS during the process of responding to emergencies. Directs the Secretary to establish a task force to assist in developing the guidelines and model curriculum, appointing to the task force representatives of the Centers for Disease Control, State governments, and EREs.

Directs the Secretary to make grants to States and local governments to assist with initial implementation of the guidelines and model curriculum. Authorizes appropriations.

Requires a medical facility to notify the designated officer of an ERE if the facility determines that a victim the ERE transported to the facility is infected with the etiologic agent for AIDS. Requires a medical facility, upon request of the designated officer of any EREs who attended, assisted, or transported the victim, to notify the designated officer if the facility makes a determination that a victim transported by EREs is infected with the etiologic agent for AIDS. Makes notification requirements apply to both the facility receiving the victim and, if the victim dies, to the facility ascertaining the cause of death.

Directs the public health officer of each State to designate one official or officer of each employer of EREs to make requests and receive notifications. Sets forth notification procedures. Provides for notification of EREs and for requests from an ERE to a designated officer that the designated officer request notification from the medical facility.

Declares that these provisions relating to EREs shall not be construed to authorize or require: (1) a medical facility to test any victim for infection with the etiologic agent; or (2) any medical facility, designated officer, or ERE to disclose identifying information with respect to a protected individual.

Provides, for violations of certain provisions of this Act, for civil monetary penalties, injunctive relief, and civil causes of action.

Directs the Secretary to issue guidelines describing circumstances under which an individual infected with the etiologic agent can expose other individuals to the agent.