Emails, Databases and Doctors – Are We Doing it Right ?

This article is a continuation of my examination of the testing facilities utilized by the adult industry to check for the presence of sexually transmitted diseases. There is a little known but albeit interesting law in California that should be of special interests to those in the adult industry for two reasons. First, California Health and Safety Code section 123148 requires that a “health care professional” who orders a laboratory test for sexually transmitted diseases “shall” provide those results to the patient. Further, test results for HIV antibodies cannot be provided to the patient by the healthcare professional by the Internet or other electronic means. The statute reads in relevant part;

123148.  (a) Notwithstanding any other provision of law, a health
care professional at whose request a test is performed shall provide
or arrange for the provision of the results of a clinical laboratory
test to the patient who is the subject of the test if so requested by
the patient, in oral or written form. The results shall be conveyed
in plain language and in oral or written form, except the results may
be conveyed in electronic form if requested by the patient and if
deemed most appropriate by the health care professional who requested
the test...

(f) Notwithstanding subdivisions (a) and (b), none of the
following clinical laboratory test results and any other related
results shall be conveyed to a patient by Internet posting or other
electronic means:
   (1) HIV antibody test.
   (2) Presence of antigens indicating a hepatitis infection.
   (3) Abusing the use of drugs.
   (4) Test results related to routinely processed tissues, including
skin biopsies, Pap smear tests, products of conception, and bone
marrow aspirations for morphological evaluation, if they reveal a
malignancy.

 

These two paragraphs have serious implications as to how the industry currently handles testing as well as how that information is shared with a performer. The first paragraph requires that only a physician or other “health care professional” order the testing for the sexually transmitted disease panel since only the physician or other “health care professional” can share the tests results with the patient. Also, if those test results include an HIV antibody test those results cannot be shared via the Internet on a database, by email or even through a phone call. You read that correctly. Test results cannot even be shared with a patient via a phone call. At this point you may be saying that I must be crazy – all doctors share those results by phone. Except that there is a current bill in the California Legislature to correct that problem with the original law. It is referred to as Assembly Bill 2253 and so far it appears to have bipartisan support in the Legislature but as yet to become law. ( See http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=ab_2253&sess=1112&house=A )

Here is a summary of the bill from MapLight California (See http://maplight.org/california/bill/2011-ab-2253/1069303/history )

Existing law authorizes the results of a clinical laboratory test performed at the request of a health care professional to be conveyed to the patient in electronic form if requested by the patient and if deemed most appropriate by the health care professional, except that existing law prohibits the conveyance by Internet posting or other electronic means of test results relating to HIV antibodies, the presence of hepatitis antigens, and the abuse of drugs, and specified test results that reveal a malignancy.

This bill would revise these provisions to refer to the disclosure of test results, would provide that the telephone is not a form of electronic communication, and would authorize the disclosure by Internet posting or other electronic means of clinical laboratory test results related to HIV antibodies, the presence of hepatitis antigens, and the abuse of drugs, and specified test results that reveal a malignancy if requested by the patient, the means of conveyance is deemed appropriate by the health care professional, and a health care professional has already discussed the results with the patient.

Obviously, if a bill is needed to make it legal for a doctor to tell you whether you have or don’t have HIV on the phone, it is still very much illegal to provide that information to you via email, a database or anything sent to your phone. Currently, it appears that only a “health care professional” can tell you in person what the results of your HIV test is. Some veteran performers may remember when testing started in the industry they had to wait for the results in the testing center in Venice, California. This was even prior to the establishment of the Adult Industry Medical clinic.

If you are now being “sent” your test results by the doctor or the lab that is not allowed under California Health and Safety Code section 123148 (See http://www.mbc.ca.gov/consumer/complaint_info_questions_practice.html#18 ). Further, even with the patient’s agreement the prohibition against sharing test results electronically is NOT allowed. A performer cannot even waive this provision of California law.

So who is a “health care professional” and does a performer actually need to be examined prior to having a test ordered or can a performer simply walk into a clinic and request a test. This is where the laws surrounding HIV testing are not quite clear. And the laws are different in regards to public free testing sponsored by a county or state health department as compared to private medical testing. It is not clear whether a full examination is required. However, it does appear that a performer themselves cannot order a test from a laboratory. That order must be placed by a health care professional.

Based on everything I have read it appears that only a “licensed health care professional” licensed under California’s Professions and Business codes can order an STD test from the lab. Obviously it would be lawful for a physician licensed in the state of California to order such a test. However, what about Nurse Practitioners, Physician’s Assistants and other medical personnel you might encounter in a testing facility ? Nurse Practitioners and Physician’s Assistants are licensed by the state of California so it seems that they can order STD testing. Can front desk clerks and other non-licensed staff order STD tests – the answer is probably not.

At this point in time it appears that the way tests results are ordered and provided to performers within the adult industry may not be in line with current California law. If Assembly Bill 2253 finally passes and is signed into law by the Governor of California we will be one step closer to being compliant with that change in the current law.

If you would like to learn more about laws pertaining to HIV and the testing for such in California please download this guide from the state of California -> http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=25&cad=rja&ved=0CGQQFjAEOBQ&url=http%3A%2F%2Fwww.cdph.ca.gov%2Fprograms%2Faids%2FDocuments%2FRPT2007-06-14-2849-2006AIDSLAWS.pdf&ei=LN48UMDIK8iz8AHtvYGoCw&usg=AFQjCNH63w71vDufrICv3mYyvdYKVm34Kw&sig2=ZGP8YZWMEBLk-WT1cM9ebw