Legislative Advocacy

September 1, 2016

Hon. Governor Edmund “Jerry” G. Brown
Office of the Governor, First Floor, California State Capitol
Sacramento, CA 95814
Fax: 916-558-3160 (1 page)

RE: Sign AB 2439 (Nazarian), Pilot Program for HIV Testing in Emergency Departments

Dear Governor Brown:

The Board of Beyond AIDS urges you to sign AB 2439, calling for a study in up to 4 hospitals for two years, to evaluate HIV testing in hospital ERs. Beyond AIDS is a national organization, centered in California, which advocates for improved public health approaches to HIV prevention.

Last year, we researched the issue of ER HIV testing, and found it to have been valuable in other states. We therefore supported AB 521, which would have mandated the offering of such testing. However, as you know, there was opposition to the original version of the bill from emergency physicians and hospitals based on theoretical concerns, leading to your veto of that bill, so a demonstration project in California by a few volunteer hospitals makes sense.

As for the evidence from other states, HIV screening in a low-income area ER was well-accepted and produced a 3% positive rate, higher than general population: http://www.sinai.org/sites/default/files/SUHI HIV testing in res poor urb ED.pdf. Emergency department HIV screening programs have yielded high efficacy in terms of discovering previously missed HIV infections: http://www.ncbi.nlm.nih.gov/pubmed/21630105. Moreover, high rates of patient satisfaction have been found in a survey of patients receiving HIV testing in an ER setting: http://www.catie.ca/en/catienews/2014-02-04/most-manitoba-patients-satisfied-hiv-testing-emergency-room.

We would also like you to be aware of a related issue. AB 446 of 2013 (Mitchell), a previous bill which is current law, requires offering HIV tests in primary care clinics. But most clinics to which it applies have never been notified of its requirements and are not following this law. We would appreciate it if you would direct the Department of Public Health, Department of Managed Care, and Department of Health Care Services to publicize the existing requirements of AB 446.

Ronald P. Hattis, MD, MPH
President, Beyond AIDS

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