12/3 Flashcards
MGL chapter 111, section 70 F
was what
THE MAss HIV TESTING STATUTE: MGL CHAPTER 111, SECTION 70F
legal sources of privacy protection
this law provides that a physician, healthcare provider, or healthcare facility may not do the following without first obtaining a persons WRITTEN INFORMED CONSENT
three things -
1. test a person for HIV
2. reveal to third’s paties that a person took an HIV test
3. disclose to third parties the results of a person’s HIV test
only time you release an ORIGINAL PATIENT FILE
subpoenas
- but remember the HIV patient
federal law - people with HIV are protected under which federal law
1 the americans with disabilitites act - 1990
- rehabilitation act of 1973
section 504 of federal rehab act of 1973
if violate that – monitary damages can be awarded
americans with dsabilitites act of 1990
elimination and descrimination against people with disabilitites, including people with HIV
americans with dsabilitites act of 1990
elimination and descrimination against people with disabilitites, including people with HIV
additional precautions with HIV patients
be careful only if do this ffor everyone
American disabilities act titles
which titles cover dentist?
I II and II
- prohibits discrimination against people with disabilities under:
dentists under 1 = employers
uner III - private business and “places of public accommodatin”
title I - employers may not discriminate against employees
walk from waiting room to exam room should not include
dialogue about patients presentation that day / medical condition
THIS IS A PUBLIC AREA
- may get confidential informtion
different times for HIV patients?
NO - discrimination
Ethics references
ADA Code
- discrimination of people with certain diseases
state law MGL Chapter 272 Section 98 is
State Law: Public Accomodation
State Law: Public Accomodation
MGL Chapter 272 Section 98
this prohibits disciination based on a persons disability in access to or treatment in a place of public accommodation
any business or service establishment that is open to the public and accepts public patronage
MAss HIV testing statute
MGL chapter 111 section 70F
type of consent with HIV -
SPECIFIC consent
T/F a release for HIV related information must state the purpose for which the information is beig requested
TRUE
exceptions to the HIV testing statute
NO – there are no exceptions sto the requirement of specific written informed consent, for an HIV test or the release of HIV-related inforrmation, including an emergecy or an occupational exposure to a patients blood
there must be an opportuity to withdraw the consent at any time without penalty?
true – this should be written into the consent
a witness signature needed with the consent?
may be prudent - not requirement
strategies to reduce the risk of liability for privacy violations
- train all staff and employees on privacy law
- if possible, segregate sensitive information from general medical information and limit access
- like front desk may not have access to medical history - create your own medical records or information release form . make sure every record which goes out is inspected
- be weary of subpoenas. Conslt an attorny , consult your patient, get permssion to talk to your patients attorny . prudent to err on the side of requesting an HIV specific release
only time you release an original copy?
subpoenas
obliation even if dentist doesnt have actual HIV test result
yes - still legal obligation to protect confidential HIV - related patient information
two disability discrimination laws
federal!
- the americans with disability act of 1990
- the rehabilitation act of 1973
**People with HIV are protected under these federal laws
Definition of disability
- a physical or mental impairment that substantially limits one or more of the major life activities of such individual
- a record of such impairment
- being regarded as having such impairment - this “regarded as” protects individuals with asymptomatic HIV even if they are not limited in any major life activity, but are excluded from services based on the negative perceptions or reactions of others to their physical impairment
asymptomatic HIV covered
yes
what constitutes discrimination
ADA example?
failure to give a person with a disability the equal opportunity to use or enjoy the public accomodations goods, services, or facilities
ADA example
- a dentist who categorically refused to treat all persons with HIV or AIDs
who must follow section 504
if recieve federal funds
section 504 part of
federal rehabilittion act of 1973 – this section was added in 1987
prohibits the discimination against people with disabilities from agencies or programs who receive FEDERAL FUNDS
- including private dental or medical offices and hospitals that accept medicare or medicaid
all programs and employees are covered by the rehabilitation act
these laws enforced?
yes plantiffs may obtain injunctive relief, emotional distress, and other compensatory damages
punitive damages may be awarded in the jury’s discretion to “deter egregious disciminatory conduct”
major difference between rehabilitation act and disability act
extended disability discrimination protetion to private places of public accomodations
guarantees equal opportunity for individuals with disabilities in public accomodations, employment, transportation, state and local government services, and telecommunications
eligibiltiy criteria
illegal
- cant establish this – these tend to screen out persons who have tested positive for HIV
AwDA covers persons associated with people with HIV?
yes– it is illegal to deny equal services to persons who is known to have a “relationship” or “association” to a person with HIV, such as a spouse, partner, child, or friend
deline based on percieved risk
no illegal
- cant refer out and say “have to see this pt.”
require person to take HIV test?
no - illegal
when can yu refer an HIV patient
like any other patient – if it extends outside your scope of practice
special equipment necessary for providing routien dental care for HIV AIDS beyond universal precautions?
NO – would violate ADA
double glove based on
procedure – not the patient
more vulnerable to blood borne exposure
when you alter you routine / precautions
CDC guidelines for
protect the providor
cover by rehab act
must be getting federal funds
