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HIV Policy Review

The State Board of Health has filed public notice of its intent to review rules adopted in 1999 requiring public health officials to convert the names of asymptomatic HIV cases to a code within 90 days of receipt of a complete case report. Case reports for symptomatic HIV cases, including AIDS cases, would continue to be maintained as standard named reports. In addition, current Board rules require the reporting of CD4+ (T4) lymphocyte counts less than 200 and/or CD4+ (T4) percents less than 14 percent of total lymphocytes (patients aged thirteen or older) and positive HIV viral culture tests.  

As federal funds are at risk if case reports are not maintained as standard named reports, drafts of both a limited emergency rule and a broader permanent rule have been prepared. 

Emergency Rules - Proposed Draft

Board of Health Hearing Scheduled For March 8, 2006

Draft of Emergency Rule

More Information

Permanent  Rules - Proposed Draft

Board of Health Hearing Tentatively Scheduled For June14, 2006

Draft 2 of Proposed Permanent Rule

More Information


 
 

Proposed Draft Emergency Rules - February 2006

Washington State will likely lose a portion of federal Ryan White CARE Act (RWCA) funding for the care and treatment of persons with HIV or AIDS if State Board of Health rules are not changed. This funding supports HIV case management, anti-HIV treatment regimens and HIV specific medical care in Washington State. Washington’s HIV case reports are not accepted by the CDC into the national HIV database because of the name to code reporting system that is in place.

The proposed emergency rule:

(1) Requires Department review of available records to reascertain the names of previously reported asymptomatic HIV cases.

(2) Allows the Department to maintain those cases in a named-based surveillance system, to comply with Centers for Disease Control and Prevention’s HIV reporting requirements.

(3) Permits local health jurisdiction's to assist Department in reascertaining names. Names must be destroyed at local level within 3 days of reporting the names to the Department.

The text of draft 1 of the emergency rule is available.  (Acrobat printable version)

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Proposed Draft Permanent Rules - February 2006

Names Retention of Asymptomatic HIV Case Reports and  Expanded HIV Laboratory Test Reporting

The State Board of Health has filed public notice of its intent to review rules adopted in 1999 requiring public health officials to convert the names of asymptomatic HIV cases to a code within 90 days of receipt of a complete case report. Case reports for symptomatic HIV cases, including AIDS cases, would continue to be maintained as standard named reports. In addition, current Board rules require the reporting of CD4+ (T4) lymphocyte counts less than 200 and/or CD4+ (T4) percents less than 14 percent of total lymphocytes (patients aged thirteen or older) and positive HIV viral culture tests.

Background information and an announcement of stakeholder meetings to be held in February are available below. (Acrobat printable versions)

Invitation to Meeting - February 22 and 24, 2006
Draft 2 of Proposed Rule Changes
Julie Gerberding Letter
Lisa Lee Letter

Council of State and Territorial Epidemiologists Position Statements

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Counseling & Testing Adopted Rule Changes as of June 18, 2005

The Washington State Board of Health adopted rule changes addressing HIV at their April 13, 2005 meeting. These new rules address:

  • consent for testing;
  • pre-test counseling;
  • post-test counseling;
  • notification of sexual and/or needle-sharing partners;
  • testing in persons who have another STD;
  • additional counseling for persons with HIV; and
  • rapid testing information.

A copy of the rule changes as published in the Washington State Register can be obtained below. The revised rules are effective June 18, 2005.

Below are documents describing the purpose for the rule changes, discussing some of the important policy changes, and providing a sample flow chart for HIV testing services according to the new rules.

 

Adopted Rule Changes (Acrobat printable version)

 

State Board of Health  Meeting Announcements, Dates, and Locations

Collaborative Workgroup
 

Description and Purpose (Acrobat printable version)

 

Membership

 

Meetings and Minutes

 

Background and Timeline Descriptions

 

Tackling HIV Policy Issues: Process and Step 1 - April 2003 (Acrobat printable version)

 

Tackling HIV Policy Issues: Process and Step 2 - November 2003 (Acrobat printable version)

 

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Existing Documents for Review

Document Link   Source/Contents
The HIV Policy Summit Report

(Acrobat printable version - 55 pages)
 

The 2001 Summit recommendations address the following areas: HIV Testing and Counseling; Integration of Care and Prevention Services; Stigma and Discrimination; Provider Education and Training; Effective Use of Emerging Technologies; and HIV Prevention and Care Funding and Accountability.
The HIV Study Committee Report

(Acrobat printable version -
76 pages)

An HIV/AIDS prevention study committee:
  • Reviews the goals of prevention strategies under the AIDS Omnibus Act.
  • Analyzes funding streams and levels prevention funding
  • Reviews the interaction and coordination of prevention programs with care services.
Barriers to HIV Counseling and Testing - DRAFT

(Acrobat printable version)
 

Issue Paper 1: Developed by regional AIDSNETs.
Absence in RCW and WAC of Prevention and Control of Bloodborne Infections other than HIV - DRAFT

(Acrobat printable version)
 

Issue Paper 2: Developed by regional AIDSNETs.
Barriers to Notifying Partners at Risk of HIV Infection - DRAFT

(Acrobat printable version)
 

Issue Paper 3: Developed by regional AIDSNETs.
Uniform Management of Accidental Exposure to HIV and Other Bloodborne Infections - DRAFT

(Acrobat printable version)
 

Issue Paper 4: Developed by regional AIDSNETs.
State Rules do Not Require Disclosure of HIV Infection to Another Person as Required for other Sexually Transmitted Diseases - DRAFT

(Acrobat printable version)
 

Issue Paper 5: Developed by regional AIDSNETs.
Implementation of Restrictive Measures to Control the Transmission of HIV, Especially Detention, is Not Effective - DRAFT

(Acrobat printable version)
 

Issue Paper 6: Developed by regional AIDSNETs.
RCW 70.24 has Not Been Updated to Include Reference to Current Standards and Practices - DRAFT

(Acrobat printable version)
 

Issue Paper 7: Developed by regional AIDSNETs.
Chapter 70.24 Revised Code of Washington

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Control and Treatment of Sexually Transmitted Diseases
Washington Administrative Code chapters 246-100 & 101

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246-100 - Communicable and Certain Other Diseases and 246-101 - Notifiable Conditions

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HIV Prevention & Education Services
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Documents posted in .pdf version on the Department of Health Web site will be made available in an alternative format on request to users who are unable to download or view .pdf files on the Web. To request an alternative format, contact: Beth Watkins.

Last Update: 06/24/2008