HIV AIDS Resource Guide/HIV-AIDS Resource Guide.iso/STAT/STATE/DISTCOL.ASC

Text File | 1993-01-14 | 25KB | 621 lines

DISTRICT OF COLUMBIA



39-5408.  HTLV-III antibody. - Every hospital, bank or other
storage facility where a person has donated semen shall use all
reasonable means to detect if the donor has an antibody to HTLV-
III in his blood. In the event that an antibody to HTLV-III is
detected, such semen shall not be used for any purposes of
artificial insemination.

As used in this section, "HTLV-III" means the human T-cell
lymphotropic virus type III that causes acquired immunodeficiency
syndrome.



CHAPTER 28. AIDS HEALTH CARE.

     Sec.

     6-2801.   Definitions.

     6-2802.   Comprehensive AIDS Health-Care Response Plan.

     6-2803.   Residential health-care facility.

     6-2804.   AIDS Program Coordination Office.

     6-2805.   Confidentiality of medical records and
information.

     6-2806.   Rules.

 6-2801. Definitions.

For the purpose of this chapter, the term:

(1)  "AIDS" means acquired immune deficiency syndrome or any AIDS-
related condition.

(2)  "Council" means the Council of the District of Columbia.

(3)  "Director" means the Director of the Department of Human
Services, established by Reorganization Plan No. 2 of 1979,
approved February 21, 1980.

(4)  "Families" means persons who are related by blood, legal
custody, marriage, having a child in common, or who share or have
shared for at least 1 year a mutual residence and who maintain or
have maintained an intimate relationship rendering the
application of this chapter appropriate.

(5)  "Mayor" means the Mayor of the District of Columbia.



 6-2802. Comprehensive AIDS Health-Care  Response Plan.

(a)  Within 6 months of December 30, 1985, the Mayor shall
develop and present to the Council for its review and comment a
comprehensive AIDS Health-Care Response Plan for the District of
Columbia. The plan shall include, but not be limited to, the
development of short-term and long-term goals and schemes for
administrative coordination by District government agencies,
educational programs, prevention methods and programs, a compi
lation of private sector services available to AIDS patients,
medical research and information gathering, outpatient and
inpatient health-care services delivery, social services
delivery, exploration of the feasibility of establishing a
separate compensation rate for District employees working in the
health-care treatment facility or facilities contemplated in  6-
2803, housing, and identifying other general services needs.

(b)  The Mayor shall update annually the comprehensive plan
mandated by subsection (a) of this section.



 6-2803. Residential health-care facility.

(a)  In preparing the comprehensive plan mandated in  6-2802, the
Mayor shall investigate the need for a residential health-care
facility or facilities which shall provide a program of medical,
nursing, counseling, palliative, social, recreational, and
supportive services to AIDS patients and their families.

(b)  If, following an investigation, the Mayor identifies a need
for a residential health-care facility or facilities in the
District of Columbia, the Mayor shall establish the facility or
facilities.

(c)  In order to establish the facility or facilities, the Mayor
may acquire, by purchase, rehabilitation, condemnation, rental,
or otherwise, a building or buildings suitable for use as a
residential health-care facility or facilities including
furniture, medical equipment, and other necessary accessories.

(d)  The Mayor may enter into contractual arrangements with any
agency or organization qualified to provide the services
enumerated in subsection (a) of this section.



 6-2804. AIDS Program Coordination Office.

(a)  The Mayor shall establish, within the Department of Human
Services an AIDS Program Coordination Office.

(b)  The AIDS Program Coordination Office shall be supervised by
the AIDS Program Coordination Officer who shall, at the direction
of the Director of the Department of Human Services, be
responsible for' the coordination of and serving as the point of
contact for the District of Columbia's comprehensive AIDS Health-
Care Response Plan established by  6-2802.

(c)  The AIDS Program Coordination Officer shall:

(1)  Analyze medical data, reports, and information to determine
the effectiveness with which the AIDS program is meeting the
needs of the residents of the District of Columbia;

(2)  Coordinate and assist in the development of grant proposals
to obtain funds from both the federal government and the private
sector for AIDS and AIDS-related activities;

(3)  Develop and coordinate, with other agencies of the District
government, a program of health-care services delivery and other
supportive services for persons with AIDS living at home;

(4)  Disseminate information on AIDS to the public;

(5)  Assist officials from the federal government, community
groups, nursing homes, hospitals, and others in the coordination
of AIDS plans, programs, and services delivery for persons with
AIDS living in the District of Columbia;

(6)  Serve as the liaison officer for the District's AIDS program
to other District government agencies and monitor their
compliance with the District's comprehensive AIDS program;

(7)  Conduct community outreach and education programs; and

(8)  Perform other duties appropriate to accomplish the
objectives of this chapter.



 6-2805. Confidentiality of medical records and information.

The provisions of the Preventive Health Services Amendments Act
of 1985 (D.C. Law 6-83), pertaining to the confidentiality of
medical records and information on persons with AIDS, shall be
applicable to this chapter.



 6-2806. Rules.

The Mayor may issue rules necessary to implement this chapter
pursuant to subchapter I of Chapter 15 of Title 1.



Subchapter III Prohibition of Discrimination in the Provision of
Insurance on Basis of AIDS Test.



 35-221. Definitions.

For the purposes of this subchapter, the term:

(1)  "AIDS" means acquired immune deficiency syndrome as defined
by the Centers for Disease Control of the United States Public
Health Service.

(2)  "ARC" means AIDS-related complex as defined by the Centers
for Disease Control of the United States Public Health Service
or, during any period when the Centers for Disease Control have
not issued a definition, by the District of Columbia Commission
of Public Health.

(3)  "District" means the District of Columbia.

(4)  "Health maintenance organization" means a public or private
organization that is a qualifying health maintenance organization
under federal regulations, or has been determined to be a health
maintenance organization pursuant to regulations adopted by the
State Health Planning and Development Agency of the District of
Columbia.

(5)  "HTLV-III" means human T-lymphotropic virus, type-III.

(6)  "Mayor" means the Mayor of the District of Columbia.

(7)  "Insurer" means any individual, partnership, corporation,
association, fraternal benefit association, nonprofit health
service plan, health maintenance organization, or other business
entity that issues, amends, or renews individual or group health,
disability, or life insurance policies or contracts, including
health maintenance organization membership contracts, in the Dis
trict. The term "insurer" shall include Group Hospitalization and
Medical Services, Incorporated.



 35-222. Application of subchapter.

The requirements of this subchapter shall apply to the practices
and procedures employed by insurers and their agents and
employees in making determinations about any individual or group
policy or contract of health, disability, or life insurance.



 35-223. Prohibited actions.

(a)  An insurer may not deny, cancel, or refuse to renew
insurance coverage, or alter benefits covered or expenses
reimbursable, because an individual has tested positive on any
test to screen for the presence of any probable causative agent
of AIDS, ARC, or the HTLV-III infection, including, but not
limited to, a test to screen for the presence of any antibody to
the HTLV-III virus or because an individual has declined to take
such a test.

(b)  (1) In determining whether to issue, cancel, or renew
insurance coverage, an insurer may not use age, marital status,
geographic area of residence, occupation, sex, sexual
orientation, or any similar factor or combination of factors for
the purpose of seeking to predict whether any individual may in
the future develop AIDS or ARC.

(2)  In determining rates, premiums, dues, assessments, benefits
covered, or expenses reimbursable, or in any other aspect of
insurance marketing or coverage, an insurer may not use age,
marital status, geographic area of residence, occupation, sex,
sexual orientation, or any similar factor or combination of
factors for the purpose of seeking to predict whether any
individual may in the future develop AIDS or ARC.

(c)  No health or disability insurance policy or contract shall
contain any exclusion, reduction, other limitation of coverage,
deductibles, or coinsurance provisions related to the care and
treatment of AIDS, ARC, HTLV-III infection, or any illness or
disease arising from these medical conditions, unless the
provisions apply generally to all benefits under the policy or
contract.

(d)  No life insurance policy or contract shall contain any
exclusion, reduction, or other limitation of benefits related to
AIDS, ARC, HTLV-III infection, or any disease arising from these
medical conditions, as a cause of death.



 35-224. Permissible use of tests for ratemaking purposes.

(a)  In addition to the prohibitions set forth in  35-223, an
insurer, during the period of 5 years from August 7, 1986, may
not:

(1)  Require or request any individual, directly or indirectly,
to take any test to screen for the presence of any probable
causative agent of AIDS, ARC, or the HTLV-III infection,
including, but not limited to, a test to screen for the presence
of any antibody to the HTLV-III virus;

(2)  Require or request any individual, directly or directly, to
disclose whether he or she has taken such a test, or to provide
or authorize disclosure of the results of the test, if taken by
the individual; or

(3)  Consider in the determination of rates, premiums, dues, or
assessments whether any individual has taken such a test, or the
results of the test, if taken by the individual.

(b)  (1) Following the period of 5 years from August 7, 1986, an
insurer may apply to the Superintendent of Insurance for
permission to increase rates, premiums, dues, or assessments, or
impose a surcharge, for individuals who test positive for
exposure to the probable causative agent of AIDS. An insurer, in
its application, shall identify the test it proposes to use to
identify exposure to the probable causative agent of AIDS.

(2)  (A) The Superintendent of Insurance, upon receipt of an
application described in paragraph (1) of this subsection, shall
first request the District of Columbia Commissioner of Public
Health to determine whether the test proposed by the applicant is
reliable and accurate in identifying exposure to the probable
causative agent of AIDS.

(B)  If the District of Columbia Commissioner of Public Health
determines that the test is not reliable and accurate, the
Superintendent of Insurance shall deny the application.

(C)  If the District of Columbia Commissioner of Public Health
determines that the test is reliable and accurate, the
Superintendent of Insurance shall review the application further
and may approve the proposed increase or surcharge if he or she
determines that it is fair, reasonable, nondiscriminatory, and
related to actual experience or based on sound actuarial
principles applied to analyses of a substantial amount of
scientific data collected over a period of years.

(D) Upon approval of an application for an increase or surcharge,
an insurer may subsequently request or require individuals to
take the test specified in its application and may impose the
surcharge or increased rates, premiums, dues, or assessments upon
those who test positive and those who decline to take the test.



 35-225. Diagnosis of AIDS.

(a)  Nothing in this subchapter shall be construed as preventing
or restricting insurers or their agents or employees from
following standard procedures for determining the insurability of
or establishing the rates or premiums for new applicants
diagnosed by a licensed physician as having AIDS, provided that
the procedures:

(1)  Apply in the same manner to all other new applicants within
the same category of insurance;

(2)  Are justified on the basis of actuarial evidence; and

(3)  Comply with other laws and rules of the District.

(b)  An insurer may request or require a new applicant to take a
test otherwise prohibited by this subchapter if:

(1)  The test is administered by a licensed physician as a
required element of a diagnosis of AIDS; and

(2)  Other symptoms of AIDS, as specified by the Centers for
Disease Control of the United States Public Health Service, are
present to the degree that a licensed physician determines that
administration of the test is medically indicated.



 35-226. Restrictions on disclosure.

No insurer may request or require an individual to take a test or
series of tests pursuant to  35-224 or  35-225 unless:

(1)  The insurer agrees not to disclose the fact of the testing
or the test results to any person except as required by law, or
as authorized by the individual in writing; and

(2)  The individual provides his or her informed consent by
signing and dating a statement of agreement, which identifies the
specific test or tests to be performed and identifies the person
or persons to whom disclosure is authorized.



 35-227. Contestability.

An insurer may contest the validity of a policy or contract that
was issued, amended, or renewed in a period in which the
determination provided in  35-224 (b) is not in effect for a
period of up to 3 years from the date of issuance, amendment, or
renewal, if the basis for contesting the validity is that the
insured knowingly failed or refused to disclose to the insurer
that he or she had AIDS at the time of issuance, amendment, or
renewal.



 35-228. Special enforcement provisions.

(a)  Any practice that circumvents or contravenes or results in a
circumvention or contravention of the provisions of this
subchapter or rules issued pursuant to this subchapter is a
violation of this subchapter.

(b)  Each day that a violation continues shall constitute a
separate violation. The Corporation Counsel, in seeking penalties
for each day of a continuing violation, shall establish to the
satisfaction of the Superior Court of the District of Columbia
that a violation occurred on each day for which the penalty is
sought.

(c)  An insurer or its agent or employee who violates any
provision of this subchapter or rules issued pursuant to this
subchapter shall be subject to a civil penalty of not less than
$1,000 or more than $10,000 per violation in the case of
insurers, and not less than $50 or more than $300 in the case of
agents or employees.

(d)  Whenever it appears to the Mayor that an insurer or its
agent or employee has engaged, is engaging, or is about to engage
in any act or practice constituting a violation of this
subchapter or rules issued pursuant to this subchapter, the Mayor
shall request the Corporation Counsel to bring an action in the
Superior Court of the District of Columbia for penalties and
other appropriate relief. Relief may include an injunction
commanding compliance with this subchapter and rules issued
pursuant to this subchapter. Upon proper showing, a temporary or
permanent restraining order shall be granted without bond.

(e)  Any person injured by a violation of this subchapter or
rules issued pursuant to this subchapter may bring an action for
damages and other appropriate relief in the Superior Court of the
District of Columbia in lieu of pursuing administrative remedies.



 35-229. Rules.

The Mayor shall issue proposed rules, within 90 days of August 7,
1986, to implement the provisions of this subchapter. The
proposed rules shall be submitted to the Council of the District
of Columbia ("Council") for a 45-day period of review, excluding
Saturdays, Sundays, holidays, and days of Council recess. If the
Council does not disapprove the proposed rules by resolution,
within the 45-day review period, the proposed rules shall be
deemed approved. The Council may approve or disapprove the
proposed rules, in whole or in part, by resolution prior to the
expiration of the 45-day review period.



 35-223. Prohibited actions.

(a)  Repealed.

(c)  No health or disability insurance policy or contract shall
contain any exclusion, reduction, other limitation of coverage,
deductibles, or coinsurance provisions related to the care and
treatment of AIDS, ARC, HIV infection, or any illness or disease
arising from these medical conditions, unless the provisions
apply generally to all benefits under the policy or contract.

(d)  No life insurance policy or contract shall contain any
exclusion, reduction, or other limitation of benefits related to
AIDS, ARC, HIV infection, or any disease arising from these
medical conditions, as a cause of death.



 35-224. AIDS testing standards, protocols, and appeals.

(a)  (1) Within 30 days of March 16, 1989, the District of
Columbia Commissioner of Public Health ("Commissioner") shall
certify the testing protocol that is the most reliable and
accurate in identifying exposure to the probable causative agent
of AIDS, ARC, and the HIV infection. The notice of certification
shall include an estimate based on scientific evidence of the
proportion of false positive results expected in use of the
testing protocol.

(2)  Within 12 months from the date of the initial certification
and at least annually thereafter, the Commissioner shall publish
a new or renewal certification based upon an ongoing review of
scientific evidence regarding the accuracy and reliability of the
testing protocol.

(b)  (1) A named insured who tests positive under the testing
protocol certified by the Commissioner may appeal to the
Superintendent of Insurance ("Superintendent") to review the
testing procedures and results, and may present additional
medical evidence, including the results of similar tests for
exposure to the probable causative agent of AIDS that the named
insured independently obtains, to rebut the positive test
results. If the Superintendent determines that the result of the
test of the proposed insured is not a true positive, the
Superintendent shall order the insurer from which the applicant
sought coverage to disregard the positive test result. The
Superintendent shall, when necessary, request the advice of the
Commissioner in making this determination.

(2)  Hearings related to the appeal provided for in paragraph (1)
of this subsection shall be held in accordance with subchapter I
of Chapter 15 of Title 1.

(3)  An insurer shall apply standard underwriting practices, in
accordance with applicable laws and rules of the District, to all
life, health, or disability income insurance policies or
contracts for individuals who test positive under the testing
protocol certified by the Commissioner.



35-225. Diagnosis of AIDS.

(b) Repealed. (Aug. 7, 1986, D.C. Law 6-132,  6, 33 DCR 3615;
Mar. 16, 1989, D.C. Law 7-208,  2(d), 36 DCR 471.)



 35-226. Informed consent requirements; restrictions on
disclosure.

(a)  No insurer shall request or require a proposed insured to
take the testing protocol certified pursuant to  35-224 without
first obtaining the signature of the proposed insured or the
legal guardian of the named insured on a standard informed
consent statement prepared and furnished by the Superintendent.

(b)  An insurer shall provide information about the availability
of counseling at public and private health facilities to each
proposed insured who the insurer requests or requires to take the
testing protocol.

(c)  Before any proposed insured or his or her legal guardian is
requested to sign an informed consent statement, the insurer
shall provide the proposed insured or his or her legal guardian
an explanation of the nature of AIDS, ARC, and the HIV infection,
an explanation of the testing protocol, including its purpose,
potential uses, limitations, and an updated percentage of false
positives, and notice of the right of the proposed insured to
appeal to the Superintendent of Insurance, an explanation of the
meaning of test results, and a description of the disclosure
restrictions established by this subchapter.

(d)  Once an insurer has requested a signature on an informed
consent statement pursuant to subsection (a) of this section, and
has complied with subsections (b) and (c) of this section, the
proposed insured or legal guardian of the proposed insured may
wait 14 days before signing the informed consent statement.

(1)  An insurer shall not disclose the fact that a proposed
insured was tested or the results of the test except to:

(A)  The proposed insured or the legal guardian of the proposed
insured;

(B)  A court of competent jurisdiction, pursuant to a lawful
court order;

or

(C)  Any person named in a written authorization executed by the
proposed insured or the legal guardian of the proposed insured.

(2)  An insurer that requires testing of a proposed insured shall
maintain records and establish procedures in a manner that
protects the privacy of the proposed insured and the
confidentiality of the test results.

(3)  (A) The Superintendent of Insurance may, by rule, require an
insurer to report numerical data regarding test results to the
Commissioner for the limited purpose of performing
epidemiological studies. The name, address, or other information
that reveals the identity of the individual tested shall not be
reported to the Superintendent.

(B)  An insurer shall report numerical data regarding test
results to actuaries employed or consulted by the insurer for the
limited purpose of performing actuarial studies related to the
business of insurance. The name, address, or other information
that reveals the identity of the individual tested shall not be
reported to the actuaries.



 35-227. Contestability.

An insurer may contest the validity of a policy or contract for 3
years from the date of issuance, amendment, or renewal of the
policy or contract, if the basis for contesting the validity is
that the insured knowingly failed or refused to disclose to the
insurer that he or she had AIDS at the time of issuance,
amendment, or renewal of any policy issued under this subchapter,
and the insurance company was prohibited by law from conducting a
test to determine the exposure of the insured to the AIDS virus
on the date the insurer and insured entered into a contract.



 35-228. Special enforcement provisions.

(a)  An insurer or an agent, broker or employee of the insurer
who violates any provision of this subchapter or rule issued
pursuant to this subchapter shall be subject to the suspension or
revocation of its license or certificate of authority to transact
business in the District, as appropriate, in accordance with the
provisions of  35-405, 35-426, 35-1506, and 35-1540, or other
applicable District laws.

(b)  Any person who violates the restrictions on disclosure in
35-226(d) shall be fined not less than $500 or more than $5,000
for each disclosure. In the case of an insurer or an agent,
broker or employee of an insurer, the fine shall be in addition
to the penalties provided in subsection (a) of this section.

(c)  Any person injured as the result of a violation of this
subchapter or a rule issued pursuant to this subchapter, may
bring an action for civil damages and other appropriate relief in
the Superior Court of the District of Columbia without first
pursuing administrative remedies.



 35-230. Prohibition against discrimination in use of AIDS tests.

(a)  No insurer shall inquire about the sexual orientation of an
applicant in an application for health, life, or disability
income insurance coverage or in an investigation conducted by an
insurer or insurance support organization on behalf of an insurer
in connection with an application for the coverage.

(b)  Sexual orientation shall not be used as a factor in the
underwriting process or in the determination of insurability.

(c)  Insurance support organizations shall be directed by
insurers not to investigate, directly or indirectly, the sexual
orientation of a proposed insured.

(d)  An insurance company shall not use sexual orientation,
lifestyle, living arrangements, occupation, gender, or
beneficiary designation to determine whether to test an
individual who applies for life, health, or disability income
insurance.