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

Text File | 1993-01-14 | 25KB | 561 lines

/* Hawaii's AIDS-related laws are primarily concerned with
infectious and communicable disease control, and insurance
practices. */







CHAPTER 325

INFECTIOUS AND COMMUNICABLE DISEASES

PART I. GENERAL PROVISIONS

SECTION

325-1     DISEASES OR CONDITIONS DECLARED COMMUNICABLE OR
DANGEROUS TO PUBLIC HEALTH

325-1.5   PURPOSE

325-2     PHYSICIANS, LABORATORY DIRECTORS, AND HEALTH CARE
PROFESSIONALS TO REPORT

325-3     OTHERS TO REPORT

325-4     IDENTITY OP PATIENTS SAFEGUARDED

325-9     QUARANTINE WITHOUT REMOVAL; DUTY OF POLICE OFFICERS TO
ASSIST IN REMOVALS

326-11    REPEALED

325-16    INFORMED CONSENT FOR TESTING OR DISCLOSURE

325-17    Quality ASSURANCE STANDARDS FOR HIV ANTIBODY TESTING



325-1  Diseases or conditions declared communicable or dangerous
to public health.  The director of health by rules adopted
pursuant to chapter 91, may declare diseases or conditions to be
communicable or dangerous to the public health.



325-1.5  Purpose.  The purpose of this chapter is to address
prevention, control, and treatment of, and advancement of
knowledge about, communicable diseases in the State.



325-2  Physicians, laboratory directors, and health care
professionals to report.  Every physician or health care
professional having a client affected by or suspected of being
affected by a disease or condition declared to be communicable or
dangerous to the public health by the director of health shall
report the incidence or suspected incidence of such disease or
condition to the department of health in writing or in the manner
specified by the department of health. Every laboratory director
having laboratory data regarding an individual affected by or
suspected of being affected by a disease or condition declared to
be communicable or dangerous to the public health shall report
such diseases or conditions to the department of health in
writing or in a manner specified by the health department. Every
physician, laboratory director, or health care professional who
refuses or neglects to give such notice, or make such report, may
be fined in an amount not to exceed $1,000 per violation, to be
assessed by the director of health, The director of health is
authorized to impose the penalty pursuant to this section.



325-3  Others to report.  The director of health shall have the
authority to determine which other persons shall report to the
department of health communicable diseases or conditions
dangerous to the public health. The director of

health may assess an administrative fine not to exceed $1,000 per
violation against persons who refuse or neglect to report
immediately such diseases or conditions to the department of
health. Persons assessed an administrative fine under this
section shall not be subject to other sanctions provided by this
chapter.



325-4  Identity of patients safeguarded.  Reports to the
department of health provided for by this chapter shall not be
made public so as to disclose the identity of the persons to whom
they relate except as necessary to safeguard the public health
against those who disobey the rules relating to these diseases or
to secure conformity to the laws of the State.

Reports to the department of health of persons who had or have
diseases or conditions transmittable by blood or blood products
may be disclosed by the department to any blood batik to enable
it to reject as donors those individuals, any law to the contrary
notwithstanding. In addition, the department may disclose to any
blood bank information on persons suspected by physical symptoms,
clinical examination, or laboratory evidence of having diseases
or conditions transmittable by blood or blood products, any law
to the contrary notwithstanding.



325-16  Informed consent for testing or disclosure.  (a) No
health care provider, blood bank, plasma center, or any other
public or private agency, institution, or individual may subject
a person's body fluids or tissue to a test for the presence of
human immunodeficiency virus (HIV) infection unless the subject
of the test first provides informed written consent to the
testing. Any person in this State whose body fluids or tissue are
subject to a test for the presence of HIV infection shall be
afforded the opportunity to receive HIV counseling by the party
ordering or requesting that the test be performed and shall be
afforded the opportunity to obtain the test results. The
counseling provided shall be consistent with guidelines
established by the department. The opportunity to receive
counseling shall be afforded both prior to obtaining a sample for
HIV testing and upon disclosure of the test results, regardless
of the serostatas of the individual tested, except that testing
conducted pursuant to subsection (b)(l) and (2) shall be exempted
from the counseling requirements of this subsection.

(b)  Consent to testing is not required for any of the following:

(1)  Anatomical gifts. A health care provider or organ donor
center which procures, processes, distributes, or uses human body
parts donated for scientific purposes may, without obtaining
consent to the testing, test for the presence of HIV in order to
assure medical acceptability of the gift for the purpose
intended.

(2)  Research. The department, laboratories and research
facilities, health care providers, blood banks, plasma centers,
and educational institutions may subject any body fluids or
tissue to be used in research to a test for HIV infection if the
test is performed in a manner by which the identity of the test
subject is not known and may not be retrieved by the researcher.

(3)  Anonymous testing carried out at HIV test sites established
by the department provided that informed verbal consent is
obtained.

(4)  Testing of body fluids or tissue which is ordered by a third
party, so long as that third party, including but not limited to
an insurance company, employer, or school, obtains the informed
written consent of the person to be tested authorizing the
release of the test results to the third party, and transmits a
signed copy of the written informed consent to the health
provider prior to any release of the requested test results to
the third party.

(5)  Patient diagnosis or treatment. Informed consent is not
required where the patient is unable to give consent and it is
determined by the patient's treating physician that the patient's
HIV status is necessary (A) to make a diagnosis, or (B) to
determine an appropriate course of treatment for the patient. The
patient shall be informed in a timely manner that a test for the
presence of HIV has been performed pursuant to the provisions of
this paragraph and the patient shall be provided the opportunity
to obtain the test results and appropriate counseling.

(6)  Protection of health care workers. A treating physician may
order an HIV test without the patient's informed consent if the
physician has determined that the patient is incapable of giving
consent prior to the rendering of treatment and when there is
reason to believe that the safety of a health care worker may be
affected due to exposure to the blood or bodily fluids of a
patient suspected of possible HIV infection. The availability and
quality of health care services shall not be compromised based on
the findings and testing performed pursuant to this paragraph.
The costs of any testing performed shall be borne by the health
care provider and may not be claimed against the patient or the
patient's health care insurer. The patient and the health care
worker shall be informed in a timely manner that a test for the
presence of HIV has been performed pursuant to the provisions of
this paragraph, and the patient and the health care worker shall
be provided the opportunity to obtain the test results and
appropriate counseling.

(c)  Confidentiality. The confidentiality of all records held
pursuant to this section is governed by section 325-101.

(d)  Civil penalty. Any person or institution who wilfully
violates any provision of this section shall be fined not less
than $1,000 nor more than $10,000 for each violation plus
reasonable court costs and attorney's fees as determined by the
court, which penalty and costs shall be paid to the person whose
records were released. This subsection shall not be construed as
limiting the right of any person or persons to recover actual
damages.

(e)  Good faith exception. No health care provider, blood bank,
plasma center, or any other public or private agency,
institution, or individual, which, in good faith, provides
results of any test for the presence of HIV infection to a
specified third party as the result and in response to an
informed written consent by the person to be tested, shall be in
violation of confidentiality requirements pursuant to this
section and governed by section 325-101 if the test results later
prove to be false or otherwise defective.

(f)  The department shall adopt rules, pursuant to chapter 91, to
establish procedures and standards to implement this section.



325-17  Quality assurance standards for HIV antibody testing.
(a) All laboratories performing screening and diagnostic tests
for the presence of the antibody to HIV (Human Immunodeficiency
Virus) shall follow the recommended protocols as set forth below.
Any initially reactive ELISA (Enzyme-linked Immunosorbant Assay)
test must be confirmed by a second ELISA. Any sera yielding
reactive results to both ELISA tests must have a supplemental
test performed such as a Western Blot, an IFA (Immunofluorescence
Assay), or an antigen detection assay; provided that these
standards may be superseded by rules adopted by the department
pursuant to chapter 91.

(b)  Any laboratory performing tests for the presence of HIV may
be required by the department of health to refer a sample from
any specimen yielding a reactive result to the department for the
purpose of supplemental testing of some or all samples for
quality assurance purposes. The department may specify the
information which shall accompany the specimen for
epidemiological purposes; provided that the information shall not
include any personal identifiers.

(c)  The penalty for any violation of this section shall he as
specified in section 325-14.



325-4  Identity of patients safeguarded.  Reports to the
department of health provided for by this chapter shall not be
made public so as to disclose the identity of the persons to whom
they relate except insofar as may be necessary to safeguard the
public health against those who disobey the rules and regulations
relating to these diseases or to secure conformity to the laws of
the State.

Reports to the department of health of persons who have had viral
hepatitis may be disclosed by the department to any blood bank to
enable it to reject as donors any individual with such a history.



325-5  Antitoxins, antiserums, vaccines, biologics, and drugs.
The department of health shall purchase from time to time out of
moneys which may be available to it therefor, and keep on hand
and available for administration under this section in the
several counties to persons unable to pay for them, antitoxins,
antiserums, vaccines, and other biologics and drugs of types and
in a supply sufficient for the public health, welfare, and
safety.

The antitoxins, antiserums, vaccines, biologics, and drugs shall
by any physician of the department or of any such county be
administered free of charge to any person who is in need of them
and is unable to pay for them or shall be furnished free of
charge to the attending physician of the person for use in the
treatment of the person; provided that the person so benefited,
or the person's estate, or personal representatives, if
subsequently able to do so, may be required by the department to
pay for any such antitoxin, antiserum, vaccine, biologic, or drug
furnished free of charge to or for the person under this chapter.



325.6  Epidemic control fund.  Such appropriations as may be
provided for the purpose of controlling, suppressing, or
preventing the spread of any communicable or preventable disease
in the State or in any county thereof shall be immediately
deposited in the treasury in a special fund to be known as the
"epidemic control fund."

Whenever the department of health certifies that any communicable
or preventable disease is present to such an extent that the
usual facilities and personnel of the department are not adequate
to properly control, suppress, or prevent the spread of the
disease, withdrawals may be made from the epidemic control fund
by the department, with the approval of the governor, for use, in
whatever manner the department may deem necessary, in
controlling, suppressing, or preventing the spread of any such
disease. All the withdrawals shall be upon warrants of the
comptroller of the State on vouchers properly approved by the
director of health.



325.7  Potentially infectious laundry from hospitals and
sanatoria. Because of the potentially infectious nature of
laundry used by patients with infectious and communicable
diseases in hospitals and tuberculosis sanatoria, the managing
authority of each hospital and tuberculosis sanatorium in the
State providing care for persons ill with infectious and
contagious disease, shall arrange for the laundering and
sterilization of the laundry on the premises under the control
and supervision of the medical supervisor of the hospital or
tuberculosis sanatorium; provided that in the event the finances
and physical facilities of any hospital or tuberculosis
sanatorium are not adequate for such purpose, and it becomes
necessary for the hospital or tuberculosis sanatorium to send its
potentially infectious laundry to commercial establishments for
laundering and sterilization, the following procedure is hereby
prescribed and required:

(1)  Noninfectious laundry shall be separated from potentially
infectious laundry by hospital or sanatorium authorities.

(2)  Potentially infectious laundry shall be bagged and the bags
tied securely by hospital or sanatorium personnel responsible
directly to the institution's medical authorities for the
techniques and protective procedures used. The bags used shall be
of solid or tightly woven material or of water soluble plastic
approved by the department of health, and shall be securely tied.

(3)  If the bags are of solid or tightly woven material, when
they are loaded on or unloaded from the commercial laundry's
trucks the loader shall wear a protective face mask and gown of a
type approved by the hospital's or tuberculosis sanatorium's
medical authorities. The mask and gown shall be laundered after
each usage. The use of a mask and gown may be omitted if water
soluble plastic bags are used.

(4)  No other laundry shall be carried in the trucks with the
potentially infectious laundry unless the potentially infectious
laundry is in water soluble plastic bags. The trucks used shall
be of the closed panel type. They shall be periodically washed
and disinfected as directed by duly authorized agents of the
department.

(5)  Commercial laundry workers who handle the potentially
infectious laundry in solid or tightly woven bags shall wear
protective masks and gowns of a type approved by the hospital's
or sanatorium's medical authorities. The laundry shall be placed
directly in the washers from the bags. There shall be no shake
out or sorting procedure carried on at the laundry prior to
washing. All protective clothing and all laundry bags shall be
laundered after each usage. If the potentially infectious laundry
is in water soluble plastic bags, no protective clothing need be
worn and the laundry shall be placed directly? in the washers
without opening the bags.

(6)  The laundering procedure to be followed by the commercial
laundry for potentially infectious laundry and for protective
clothing and laundry bags, which protective clothing and laundry
bags shall be laundered separately from the potentially
infectious laundry, shall consist of the following:

                                       Holding
                                     Temperature     Time
Operation       Purpose & Action     Degrees F.     Minutes

(1)  Flush        Wets clothes           100           5
(2)  First "breakrun"      Alkali           160          10
(3)  Second "breakrun"     Alkali        160          10
(4)  First suds     Detergent            180          10
(5)  Second suds     Detergent           180                10
(6)  Third suds     Soap and bleach    180-210        10
(7)  First rinse    Removes detergents   180           5
(8)  Second rinse   Removes detergents   180           5
(9)  Third rinse    Removes detergents   160           5
(10) Fourth rinse   Sour added (removes  110 or over   5
                       residual detergents-
                    starch added, if necessary)



325-8  Infected persons, removal and quarantine.  When any person
is infected or suspected of being infected with any infectious,
communicable, or other disease dangerous to the public health,
the department of health or its agent, may, for the safety of the
public, remove the sick or infected person to a separate house or
hospital, and provide the person with medical care and other
necessaries, which shall be at the expense of the person's self,
the person's parents or guardian, if able to meet the expense,
otherwise at the expense of the county i~ which the person is ill
or infected. The county council shall pay the expenses upon
certification by the department or its agents that a person has
been so removed and that expense has been incurred under this
section.



325-9  Quarantine without removal; duty' of police officers to
assist in removals.  If the department of health or its agent
determines that the removal of the person infected or suspected
of being infected would directly and seriously aggravate the
disease so as to endanger the person's life, the department, or
its agent may make provision for the person, as directed in
section 325-8, in the house in which the person may be; and, in
such case, the department or its agent may cause the persons in
the neighborhood to be removed, and may take such other measures
as it judges necessary for the public health and safety. The
department or its agent, in effecting any removal under this or
section 325-8, may require any sheriff, deputy sheriff, chief of
police, or police officer to aid and assist it, and such force as
is reasonably necessary to effect any such removal may be used.

Every sheriff, deputy sheriff, chief of police, or police officer
who is so required to aid and assist the department or its agent
shall immediately aid and assist it.



325-10  Master of vessel liable for expense.  In case any moneys
are expended by the department of health, for any sick person
brought into the State in any vessel from abroad, the department,
or its agent, shall demand the same from the master of the vessel
in which the sick person was brought. The master of the vessel
shall be liable for the amount of the moneys thus expended.



325-11  Spitting prohibited  No person shall spit or expectorate
upon any railway passenger coach or other public conveyance,
sidewalk, or any building wherein business with the public is
conducted, except in a spittoon or cuspidor provided for such
purpose.



325-12  Common drinking cup prohibited.  The use of a common
drinking cup is prohibited in all public places within the State.



325-13  Regulations.  For the purpose of carrying out this
chapter, the director of health, with the approval of the
governor, may make such regulations as the director deems
necessary which, when adopted in accordance with section 321-10,
shall have the force of law.



325-14.  Penalty.  Any person violating this chapter, or any rule
or regulation of the department of health relating thereto, shall
be deemed guilty of a misdemeanor. Except as herein otherwise
provided the punishment therefor shall be the same as provided by
section 321-18.



325-15.  Infectious and communicable diseases, examination and
treatment.  United States citizens or nationals, upon returning
to this State after five or more years residence in any territory
or possession of the United States, or any foreign country, with
a high occurrence of infectious and communicable diseases, shall
submit a medical examination report that shall include a
tuberculin skin test or a chest x-ray examination, and in the
case of a positive skin test a chest x-ray report shall be
submitted, to the department of health within sixty days of
return to this State. The department of health shall cooperate
with public and private authorities, where feasible, in
implementing this section. [L 1978, c 130, 1]



ARTICLE 13

UNFAIR METHODS OF COMPETITION AND UNFAIR AND DECEPTIVE ACTS AND
PRACTICES IN THE BUSINESS OF INSURANCE

PART I. GENERAL PROVISIONS



431:13-103  Unfair methods of competition and unfair or deceptive
acts or practices defined.

(a) The following are defined as unfair methods of competition
and unfair or deceptive acts or practices in the business of
insurance:

(i)  Unfair discrimination.

(A)  Making or permitting any unfair discrimination between
individuals of the same class and equal expectation of life in
the rates charged for any contract of life insurance or of life
annuity or in the dividends or other benefits payable thereon, or
in any other of the terms and conditions of the contract;

(B)  Making or permitting any unfair discrimination in favor of
particular individuals or persons, or between insureds or
subjects of insurance having substantially like insuring, risk,
and exposure factors, or expense elements, in the term or
conditions of any insurance contract, or in the rate or amount of
premium charge therefor, or in the benefits payable or in any
other rights or privilege accruing thereunder;

(C)  Making or permitting any unfair discrimination between
individuals or risks of the same class and of essentially the
same hazards by refusing to issue, refusing to renew, canceling,
or limiting the amount of insurance coverage on a property or
casualty risk because of the geographic location of the risk,
unless:

(i)  The refusal, cancellation or limitation is for a business
purpose which is not a mere pretext for unfair discrimination,

(ii) The refusal, cancellation or limitation is required by law
or regulatory mandate; or

(D)  Making or permitting any unfair discrimination between
individuals or risks of the same class and of essentially the
same hazards by refusing to issue, refusing in renew, canceling
or limiting the amount of insurance coverage on a residential
property risk, or the personal property contained therein,
because of the age of the residential property, unless:

(i)  The refusal, cancellation or limitation is for a business
purpose which is not a mere pretext for unfair discrimination, or

(ii) The refusal, cancellation or limitation is required by law
or regulatory mandate;

(E)  Refusing to insure, refusing to continue to insure, or
limiting the amount of coverage available to an individual
because of the sex or marital status of the individual; however,
nothing in this subsection shall prohibit an insurer from taking
marital status into account for the purpose of defining persons
eligible for dependent benefits; or

(F)  To terminate, or to modify,. coverage or to refuse to issue
or refuse to renew any property or casualty policy or contract of
insurance solely because the applicant or insured or any employee
of either is mentally or physically impaired: provided that this
subsection shall not apply to disability insurance sold by a
casualty insurer; provided further that this subsection shall not
be interpreted to modify any other provision of law relating to
the termination, modification, issuance or renewal of any
insurance

(G)  Refusing to insure, refusing to continue to insure, or
limiting the amount of coverage available to an individual based
solely upon the individual's having taken a human
immunodeficiency virus (HIV) test prior to applying for
insurance; or

(H)  Refusing to insure, refusing to continue to insure, or
limiting the amount of coverage available to an individual
because the individual refuses to consent to the release of
information which is confidential as provided in section 325-101;
provided that nothing in this subparagraph shall prohibit an
insurer from obtaining and using the results of a test satisfying
the requirements of the commissioner, which was taken with the
consent of an applicant for insurance; provided further that any
applicant for insurance who is tested for HIV infection shall be
afforded the opportunity to obtain the test results, within a
reasonable time after being tested, and that the confidentiality
of the test results shall be maintained as provided by section
325-101.

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