Res. No. 2060
Resolution calling upon the New York State Legislature to pass and the Governor to sign A.7757 and S.4484, legislation that would amend the Public Health Law in relation to removing the need for health care providers to receive or provide separate written consent for the performance of an HIV test and provide counseling or referrals when a positive result is reported.
By Council Members Vann, Vallone Jr., White Jr., Brewer, Liu, Palma, Mark-Viverito and Barron
Whereas, The Centers for Disease Control and Prevention (CDC) estimate that nearly 56,300 individuals were infected with HIV throughout the United States in 2006 and that more than 1,106,400 people were living with HIV; and
Whereas, According to the New York City Department of Health and Mental Hygiene (DOHMH), New York City is the epicenter of the HIV/AIDS epidemic, with more than 100,000 New Yorkers living with HIV, and approximately one-fourth of such individuals do not know that they are infected; and
Whereas, DOHMH indicated that New York City has the highest AIDS case rate in the country, with more cases than Los Angeles, San Francisco, Miami and Washington, D.C. combined; and
Whereas, HIV/AIDS is a significant public health problem with major disparities among races, and DOHMH estimates that African Americans and Hispanics make up 80 percent of new AIDS diagnoses and deaths; and
Whereas, There are several evidence-based methods which influence HIV/AIDS mortality, including getting tested, knowing one’s status, using condoms, expanding education and combating stigma; and
Whereas, In September 2006, the CDC revised their recommendations regarding HIV testing in health care settings, including advocating that screening be incorporated into the general consent for medical care, so as to remove the requirement for a separate written consent, as this was generally viewed as a barrier to widespread HIV screening; and
Whereas, These recommendations seek to routinize testing in health care settings, with a goal to expand the number of individuals who have been tested and made aware of their status in order to make better, more informed decisions; and
Whereas, The CDC also recommends that individuals at a high rate of infection be tested annually, that broad-based testing for patients ages 13 to 64 be offered in all health care settings, and that health care settings also offer opt-out screening; and
Whereas, New York State’s current informed consent law was passed in the 1980s to protect people living with HIV/AIDS, and to ensure that these individuals were aware of their rights as patients as well as the risks associated with HIV; and
Whereas, While these are important purposes, HIV/AIDS care has evolved over the last thirty years and treatment options have improved, allowing people to live longer and more normal lives; and
Whereas, As of December 2006, thirty-eight states allowed oral consent for an HIV/AIDS test, rather than requiring a more cumbersome, separate written consent; and
Whereas, Research suggests that requiring a separate written consent is a barrier to testing as it affects not only the patient from receiving the test but may also influence the physician to not offer the test; and
Whereas, In a case study in San Francisco County Hospital in 2006, the hospital transitioned from written informed consent to documented oral consent, and the hospital experienced a 17 percent increase in the number of people tested for HIV and a 36 percent increase in the number of identified infections; and
Whereas, Legislation, A.7757 and S.4484, has been introduced in the New York State Legislature, by Assembly Member Annette Robinson and Senator Shirley Huntley, which would implement many of the CDC’s recommendations, including eliminating separate written informed consent, testing all individuals between the ages of 13 and 64 who seek medical care and testing all high-risk individuals; and
Whereas, Enactment of this legislation would allow HIV/AIDS testing to become a more routine part of medical care and result in a greater number of New Yorkers getting tested, which would positively affect the number of earlier diagnoses and allow for more effective treatment options; now, therefore, be it
Resolved, That the Council of the City of New York calls upon the New York State Legislature to pass and the Governor to sign A.7757 and S.4484, legislation that would amend the Public Health Law in relation to removing the need for health care providers to receive or provide separate written consent for the performance of an HIV test and provide counseling or referrals when a positive result is reported.
JM
LS# 7543
June 17, 2009