June 16, 2011

Honorable Governor Jerry Brown
Office of the Governor, California State Capitol
Sacramento, CA 95814
FAX: 916-558-3160 (2 pages)

RE: URGE SIGNING OF SENATE BILL 422 (WRIGHT): HELPING PUBLIC HEALTH TO CONTROL THE SPREAD OF HIV

Dear Governor Brown:

I am writing as President of Beyond AIDS, the sponsor of Senate Bill 422, to urge your signature on this important bill.  SB 422 is needed in order to better empower California's local public health departments to do an optimal job in helping to prevent the spread of HIV.  It provides a method for physicians to legally refer patients to local public health department staff to help trace and notify persons who may have been exposed to HIV, and it assures that local public health staff will not incur liability for performing partner notification as otherwise permitted by law. By relieving physicians and, public health staff of fear of criminal and civil sanctions, SB 422 can help encourage the notification, testing, and counseling of persons exposed to HIV. It can thereby help interrupt the spread of HIV and thus save lives, as well as saving significant health care expenses to the state that would result from preventable new infections.

Beyond AIDS is a nonprofit organization dedicated to improving public health policy for HIV prevention. Members include physicians, nurses, other health professionals including public health workers, and concerned citizens. My personal background includes 24 years of dedication to HIV testing, counseling, treatment, and prevention, with past positions as an epidemiologist for the Centers for Disease Control and Prevention, and as a county health officer here in California.

When partners become aware that they may have been exposed to HIV and are referred for testing and other treatment, it can help to prevent further infections and to save lives. If the partners have not yet been infected, they can take appropriate precautions to avoid this happening. If they have already been infected, they can promptly enter medical care and take precautions to avoid passing the virus on to others.

 For any other communicable disease, this bill would not be necessary, because physicians and local public health agencies would automatically be communicating in this manner. But because there are unique and significant penalties in the Health and Safety Code for "unauthorized disclosure," of HIV case records, including public health records, it is necessary to clarify in the law just what types of disclosure are authorized by law.

SB 422 does not violate patient confidentiality in any way. HIV cases are already known to public health departments by means of mandatory reporting, and the bill furthermore requires a consent procedure before a partner or even the public health staff can be notified about who the source of exposure is. HIV information in public health records is strictly protected from unauthorized disclosure, with criminal and civil sanctions for violations, so this bill is needed to clarify that partner notification does not constitute such disclosure. Also, public health staff should not be liable for a domestic dispute arising from someone suspecting that he or she has been infected or knowingly exposed by a partner (even though those staff are prohibited from identifying the source of exposure when notifying a partner).

SB 422 is strongly supported by the two medical specialty societies that have the most involvement with HIV prevention and treatment, the Infectious Disease Association of California which represents the infectious disease specialists including our top medical experts on HIV, and the California Academy of Preventive Medicine, which represents the public health and prevention specialists who work to stop the spread of diseases including HIV at the local and state levels. Supporting letters have been received from individual physicians and public health professionals.

SB 422 had no organized opposition. It passed the Senate by a vote of 39 to 1, and the Assembly by a unanimous vote of 77 to 0. It represents a consensus for the benefit of public health in our state.

Please sign this bill to enact it into law. Thank you for your assistance.

Sincerely,

Ronald P. Hattis, MD, MPH
President, Beyond AIDS
ronhattis@beyondaids.org
909-838-4157

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