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<section article="ghg" article_name="Health - General" number="18-338.3" title_number="18" title_name="Disease Prevention" subtitle_number="3" subtitle_name="Specific Diseases">
  <level label="a">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <level label="i">
        <text>“Body fluids” means:</text>
        <level label="1">
          <text>Any fluid containing visible blood, semen, or vaginal secretions; or</text>
        </level>
        <level label="2">
          <text>Cerebrospinal fluid, synovial fluid, or amniotic fluid.</text>
        </level>
      </level>
      <level label="ii">
        <text>“Body fluids” does not include saliva, stool, nasal secretions, sputum, tears, urine, or vomitus.</text>
      </level>
    </level>
    <level label="3">
      <text>“Exposure” means:</text>
      <level label="i">
        <text>Percutaneous contact with blood or body fluids;</text>
      </level>
      <level label="ii">
        <text>Mucocutaneous contact with blood or body fluids;</text>
      </level>
      <level label="iii">
        <text>Open wound, including dermatitis, exudative lesions, or chapped skin, contact with blood or body fluids for a prolonged period; or</text>
      </level>
      <level label="iv">
        <text>Intact skin contact with large amounts of blood or body fluids for a prolonged period.</text>
      </level>
    </level>
    <level label="4">
      <text>“First responder” means an individual who:</text>
      <level label="i">
        <text>Is licensed or certified under § 13–516 of the Education Article; and</text>
      </level>
      <level label="ii">
        <text>Provides services to an individual before the individual is admitted to a hospital.</text>
      </level>
    </level>
    <level label="5">
      <level label="i">
        <text>“Health care provider” means an individual who is licensed, certified, or otherwise authorized under the Health Occupations Article or this article to provide health or medical care in:</text>
        <level label="1">
          <text>The ordinary course of business or practice of a profession; or</text>
        </level>
        <level label="2">
          <text>An approved education or training program.</text>
        </level>
      </level>
      <level label="ii">
        <text>“Health care provider” includes any agent or employee of a hospital.</text>
      </level>
      <level label="iii">
        <text>“Health care provider” does not include an individual who is eligible to receive notification under the provisions of § 18–213 of this title, including any law enforcement officer or any member of any fire department, ambulance company, or rescue squad.</text>
      </level>
    </level>
    <level label="6">
      <text>“HIV” means the human immunodeficiency virus that causes acquired immune deficiency syndrome.</text>
    </level>
    <level label="7">
      <text>“Hospital” has the meaning stated in § 19–301 of this article.</text>
    </level>
    <level label="8">
      <text>“Public safety worker” means:</text>
      <level label="i">
        <text>A career or volunteer member of a fire, rescue, or emergency medical services department, company, squad, or auxiliary;</text>
      </level>
      <level label="ii">
        <text>A law enforcement officer;</text>
      </level>
      <level label="iii">
        <text>The State Fire Marshal or a sworn member of the State Fire Marshal’s office; or</text>
      </level>
      <level label="iv">
        <text>A forensic scientist who works under the direction of a law enforcement agency.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <text>Notwithstanding the provisions of § 18–338.1 of this subtitle, the designated infectious disease/communicable disease officer of a hospital shall order a test for the presence of antibodies to the human immunodeficiency virus (HIV) under subsection (d) of this section when:</text>
    <level label="1">
      <text>There has been an exposure in a hospital between a patient and a health care provider, an exposure between a patient and a first responder, or an exposure between a patient and a public safety worker before admission of the patient to a hospital, that, in accordance with the Centers for Disease Control and Prevention recommendations, would warrant recommending or offering chemoprophylaxis treatment for the health care provider, first responder, or public safety worker;</text>
    </level>
    <level label="2">
      <level label="i">
        <text>Informed consent, or substitute consent as required under § 18–338.1(c) of this subtitle, of the patient to test a blood sample of the patient for the presence of HIV was sought and the patient was unavailable or unable to consent; or</text>
      </level>
      <level label="ii">
        <text>Informed consent, or substitute consent as required under § 18–338.1(c) of this subtitle, of the patient to test a blood sample already obtained from the patient for the presence of HIV was sought, the patient refused, and the patient was informed of the provisions of this subsection;</text>
      </level>
    </level>
    <level label="3">
      <level label="i">
        <text>In accordance with hospital procedures, the health care provider involved in the exposure has given prompt notice of the exposure to the designated hospital infectious disease/communicable disease officer where the exposure occurred; or</text>
      </level>
      <level label="ii">
        <level label="1">
          <level label="A">
            <text>The first responder involved in the exposure has given prompt notice to the medical director with jurisdiction over the first responder; or</text>
          </level>
        </level>
        <level label="B">
          <text>The public safety worker involved in the exposure has given prompt notice to the medical director with jurisdiction over the public safety worker; and</text>
        </level>
        <level label="2">
          <text>The medical director has given prompt notice to the designated hospital infectious disease/communicable disease officer where the patient is admitted;</text>
        </level>
      </level>
    </level>
    <level label="4">
      <text>The health care provider, first responder, or public safety worker involved in the exposure has given informed consent and has submitted a blood sample to be tested for the presence of HIV; and</text>
    </level>
    <level label="5">
      <text>The designated hospital infectious disease/communicable disease officer has made a determination, in accordance with the Centers for Disease Control and Prevention recommendations, that the testing of blood samples or other body fluids of the patient for the presence of antibodies to the human immunodeficiency virus (HIV) would be helpful in managing the risk of disease and health outcome of the health care provider, first responder, or public safety worker.</text>
    </level>
  </level>
  <level label="c">
    <text>If there has been an exposure between a first responder and an individual or a public safety worker and an individual before the admission of the individual to a hospital:</text>
    <level label="1">
      <text>The first responder or public safety worker shall give notice to the first responder’s or public safety worker’s medical director in accordance with subsection (b)(3)(ii)1 of this section;</text>
    </level>
    <level label="2">
      <text>The medical director shall act as an intermediary at all times between the first responder or public safety worker and the designated hospital infectious disease/communicable disease officer; and</text>
    </level>
    <level label="3">
      <text>The medical director and the designated hospital infectious disease/communicable disease officer shall ensure that all communications and information related to the exposure of the first responder or public safety worker are confidential.</text>
    </level>
  </level>
  <level label="d">
    <text>If the requirements of subsections (b) and (c) of this section are satisfied, the designated hospital infectious disease/communicable disease officer shall order tests to be conducted for the presence of antibodies to the human immunodeficiency virus (HIV) using a test procedure approved by the Department on:</text>
    <level label="1">
      <text>Blood samples already obtained from the patient; or</text>
    </level>
    <level label="2">
      <text>Blood samples or other body fluids collected for the purpose of HIV testing under this section.</text>
    </level>
  </level>
  <level label="e">
    <text>When the designated hospital infectious disease/communicable disease officer obtains the results of an HIV test conducted in accordance with the provisions of subsection (d) of this section, the designated hospital infectious disease/communicable disease officer shall attempt to directly notify the patient of the results of the HIV test and, to the extent possible, in a manner that will protect the confidentiality of the health care provider, the first responder, or the public safety worker and the patient.</text>
  </level>
  <level label="f">
    <text>If the results of an HIV test conducted in accordance with the provisions of subsection (d) of this section are positive, the designated hospital infectious disease/communicable disease officer shall provide or arrange for the provision of appropriate counseling and treatment recommendations to the health care provider, first responder, or public safety worker and the patient.</text>
  </level>
  <level label="g">
    <level label="1">
      <text>Notwithstanding the provisions of Title 4, Subtitle 3 of this article, the medical records, including any physician order for an HIV test or the results of an HIV test conducted under this section, may not be documented in the medical record of the patient, health care provider, first responder, or public safety worker.</text>
    </level>
    <level label="2">
      <text>The hospital where the exposure occurred shall maintain a separate confidential record or incident report for all HIV tests conducted under this section.</text>
    </level>
    <level label="3">
      <text>Each hospital shall adopt procedures for the confidential HIV testing of blood samples or other body fluids used or collected for purposes of this section.</text>
    </level>
    <level label="4">
      <text>Except as provided in paragraph (5) of this subsection, the medical records, including any physician order for an HIV test or the results of any HIV test conducted under this section, are:</text>
      <level label="i">
        <text>Confidential; and</text>
      </level>
      <level label="ii">
        <text>Not discoverable or admissible in evidence in any criminal, civil, or administrative action.</text>
      </level>
    </level>
    <level label="5">
      <text>If the identity of the patient or any other information that could be readily associated with the identity of the patient is not disclosed, the results of an HIV test conducted on a patient for purposes of this section may be introduced into evidence in any criminal, civil, or administrative action including the adjudication of a workers’ compensation claim.</text>
    </level>
  </level>
  <level label="h">
    <text>The costs incurred in performing an HIV test on a patient in accordance with the provisions of this section shall be paid by the hospital.</text>
  </level>
  <level label="i">
    <text>Each hospital shall develop written procedures to implement the provisions of this section.</text>
  </level>
  <level label="j">
    <text>A health care provider, first responder, public safety worker, or hospital or designee of a hospital acting in good faith to provide notification or maintain the confidentiality of the results of a test conducted under this section may not be held liable in any cause of action related to a breach of patient, health care provider, first responder, or public safety worker confidentiality.</text>
  </level>
</section>
