<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 10.18.08.06" title_num="10" subtitle_num="18" chapter_num="08" heading="Consent and Pretest Requirements for HIV Testing by Health Care Providers.">
  <paragraph num="A.">
    <text>General medical consent is sufficient to perform HIV testing.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Consent for HIV testing is only required to be obtained one time during a patient’s visit.</text>
  </paragraph>
  <paragraph num="C.">
    <text>A health care provider who obtains consent for HIV testing shall:</text>
    <paragraph num="(1)">
      <text>Obtain consent as a part of a patient’s general consent for medical care in the same manner as for other screening and diagnostic tests;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Document all declinations of an HIV test in the medical record of the patient; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>When needed, obtain:</text>
      <paragraph num="(a)">
        <text>Consent from a health care agent designated per Health-General Article, §5-602, Annotated Code of Maryland; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Surrogate consent per Health-General Article, §5-605 Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The general informed consent form for medical care may specify that an HIV test will be performed.</text>
  </paragraph>
  <paragraph num="E.">
    <text>Except as provided under Regulation .08 of this chapter, a health care provider may not be required to obtain consent for HIV testing on a separate consent form.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Pretest information, including counseling for pregnant women, shall be provided to the patient to be tested for HIV before each specimen is tested.</text>
  </paragraph>
  <paragraph num="G.">
    <text>A health care provider providing pretest information, including counseling for pregnant women, shall:</text>
    <paragraph num="(1)">
      <text>Provide HIV-specific information:</text>
      <paragraph num="(a)">
        <text>Verbally;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>In writing;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Through video; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Through any combination of §G(1)(a)—(c) of this regulation;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide HIV information in a manner that protects the confidentiality of the patient being tested;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Using layman’s terms, provide, at minimum, the following information to the patient being tested:</text>
      <paragraph num="(a)">
        <text>That the patient is being tested for HIV;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>That the patient has the right to:</text>
        <paragraph num="(i)">
          <text>Ask questions; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Decline the test without penalty;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>An explanation of HIV infection;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>That a negative HIV test result means that:</text>
        <paragraph num="(i)">
          <text>A patient is not infected with HIV or that the test was unable to detect the presence of HIV because a patient is in the early stage of infection and has not yet developed detectable evidence of HIV infection; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>If the patient has had any potential recent exposures, the patient should be retested within an appropriate time frame based on the type of testing used; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(e)">
        <text>That a positive HIV test result means the patient:</text>
        <paragraph num="(i)">
          <text>Is infected with HIV; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Will be linked with medical treatment and other supportive services;</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Provide counseling as defined in Regulation .02 of this chapter to pregnant women;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Include an opportunity for the patient to:</text>
      <paragraph num="(a)">
        <text>Ask questions and receive answers about HIV and other topics described in this regulation; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Decline an HIV test; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Make necessary accommodation with respect to language or disability to ensure that the patient being tested understands the information presented.</text>
    </paragraph>
  </paragraph>
</regulation>