does a therapist have to report hiv patient to board of health

Some states do not all require the reporting of HIV or AIDS status by licensed psychotherapists (e.g. Wisconsin) while other states require the reporting of it (e.g. Washington). So, knowledge of the relevant laws in one’s jurisdiction is essential.

Full Answer

Do HIV counselors need to report?

An HIV counselor can be designated by the physician who ordered the test to complete and submit the report form, but the form must be signed by the physician. Non-clinical staff do not report. How about social workers? Psychologists? And other licensed professionals?

Who will be reported to NYS HIV/AIDS Registry?

All HIV infected individuals receiving care in NYS will be reported. The names of those individuals living out of state but receiving care in NYS will be added to the NYS HIV/AIDS registry but will not be shared with the state of residence.

How do I report partners of newly diagnosed HIV?

Providers should report partners of newly diagnosed HIV cases using the medical provider report form (No. 4189). For initial diagnosis of HIV-related illness, providers should be aware that the first positive viral load or CD4<500 after June 1, 2000, will be reported by laboratories to the Health Department.

Are HIV+ patients who are part of a research study reportable?

Individuals in research studies generally receive primary care; their primary care provider is required to report initial diagnosis of HIV and AIDS, and CD4<500 and positive viral load results done as part of primary care are reportable. Why are patients who test HIV+, who are part of research vaccine trials, not being reported?

Does HIV have to be reported?

All 50 states and the District of Columbia require health-care providers to report new cases of acquired immunodeficiency syndrome (AIDS) to their state health departments. As of July 1989, 28 (56%) states also required reporting of persons infected with human immunodeficiency virus (HIV) (Figure 1).

What is the reporting protocol for HIV?

ACUTE HIV INFECTION REPORTING Labs and health care providers may call (213) 351-8516 to report a case of acute HIV infection. California law (17 CCR §2505) requires laboratories to report positive tests for syphilis, gonorrhea, chlamydia trachomatis infections, including lymphogranuloma venereum.

Do doctors have to disclose their HIV status?

Doctors generally need a patient's written consent to disclose HIV-related information to employers and others requiring medical forms. These consent requirements are in HIPAA and many state laws, including New York's.

Is HIV status protected under HIPAA?

In summary, HIPAA doesn't provide special protections for HIV diagnosis or status. Nevertheless, you must still follow your current privacy policies and procedures to protect all patient data.

What happens if you test positive for HIV?

If your HIV test is positive, the clinic or other testing site will report the results to your state health department. They do this so that public health officials can monitor what’s happening with the HIV epidemic in your city and state. (It’s important for them to know this, because Federal and state funding for HIV services is often targeted ...

What is the duty to warn in a clinic?

Some states also have laws that require clinic staff to notify a “third party” if they know that person has a significant risk for exposure to HIV from a patient the staff member knows is infected with HIV. This is called “duty to warn.”.

What agency is responsible for removing personal information from a test?

Your state health department will then remove all of your personal information (name, address, etc.) from your test results and send the information to the U.S. Centers for Disease Control and Prevention (CDC). CDC is the Federal agency responsible for tracking national public health trends.

Do you have to tell your partner if you test positive for HIV?

Many states and some cities have partner-notification laws—meaning that, if you test positive for HIV, you (or your healthcare provider) may be legally obligated to tell your sex or needle-sharing partner (s).

What is the purpose of the NCHHSTP report?

The purpose of this report is to help public health agencies and others understand and interpret their responsibilities under the Privacy Rule.

What is a loc map for HIV testing?

HIV Diagnostic Tests LOINC Map#N#excel icon#N#[XLS – 254 KB]#N#To increase semantic interoperability for HIV laboratory reporting, the Division of HIV/AIDS Prevention, HIV Incidence and Case Surveillance Branch at CDC participated in a pilot project to develop a LOINC map for all FDA-approved HIV diagnostic tests. The standardized mapping was developed in coordination with Association of Public Health Laboratories, the Regenstrief Institute, Inc., and the Division of Laboratory Systems at CDC. The benefits of the LOINC map is in providing a concise document that defines LOINC codes for use with specific tests.#N#Intended Audience: Diagnostic laboratory personnel, public health surveillance personnel and in vitro diagnostic developers.

Tarasoff 1974 and 1976

In 1974 in the initial ruling the court opined that “where a psychotherapist had reason, arising out of a professional relationship with a patient, to believe, or reasonably should have believed, that the patient was intending to harm a specific victim, that a duty existed to warn that victim” (Mills, 1984).

State's law

The Tarasoff rulings set legal precedent. But, over the years as states have passed laws to address these issues, the precedent has been codified into law. Yet, various states’ laws are different in their requirements.

Duty to warn specific to HIV and AIDS

With regard to the issue of a client with HIV or AIDS disclosing engaging in unprotected sex with other individuals this is of course a very serious concern that will hopefully be addressed in treatment. With regard to breaching confidentiality there are several issues of relevance and great importance.

Important disclaimers

I hope this is helpful to you. I do not represent myself as an attorney or an expert on every jurisdiction’s laws, and I do not know all the details of your case. But, I do hope this provides some issues for consideration and discussion. Please feel free to share your comments and any additional thoughts.

Why do we need to develop laws to determine the boundaries of liability and reporting in HIV and AIDS?

Laws to determine the boundaries of liability and reporting in HIV and AIDS will have to be developed because, clearly, there are conflicting legal doctrines at work in the mandatory reporting case law that judges have made.

What happens if you disclose HIV?

Patients may be debilitated and physically vulnerable and may be subject to significant insurance and social discrimination if HIV status is wrongfully disclosed. Physicians must be cognizant of their patients' circumstances and the sensitivities surrounding the discussion of HIV disclosure.

Why is public policy important for HIV testing?

Public policy encourages high-risk groups to submit to HIV testing because those individuals who know they are HIV-positive are more likely to seek treatment and take precautions that may prevent transmission of the virus.

What is the legal protection of patient privacy and confidentiality?

Legal protection of patient privacy and confidentiality depends on whether or not public health concerns outweigh the interest in preserving the doctor-patient privilege. The balancing of these interests is a particular challenge when it comes to privacy concerns associated with HIV status. A core legal dilemma in the case ...

What is the legal dilemma in HIV/AIDS?

A core legal dilemma in the case of HIV/AIDS is determining when the need to protect others, such as sex partners to whom the patient is likely to transmit HIV, supersedes the patient's right to confidentiality .

Can HIV be disclosed to health care providers?

However, if HIV-related information is readily disclosed by health care providers, individuals may become more reluctant to seek testing. When does the protection of others through a breach of patient confidentiality, ie, reporting cases to the authorities, become worth the risk to that individual who may be HIV-positive will avoid testing in order ...

Can a physician be held responsible for not warning third parties of foreseeable harm?

In other contexts, physicians have faced liability for not warning third parties of foreseeable harm. For example, a California court held that a psychotherapist had a legal duty to warn a third party of foreseeable harm, despite the presence of the client-therapist privilege [9].

Who can order a HIV test?

Only physicians, nurse practitioners, physician assistants and nurse mid-wives are authorized to order an HIV test. These individuals are required to report. An HIV counselor can be designated by the physician who ordered the test to complete and submit the report form, but the form must be signed by the physician.

What is the number to call for provider reporting in New York?

Providers not yet enrolled with the New York City Department of Health and Mental Hygiene who have not already received an enrollment package should call 212/442-3388 to arrange for enrollment in the provider reporting program and for pick-up of report forms.

What is a contact in the law?

The regulations define a contact as a spouse or sexual contact, a needle sharing partner, or a person who may have been exposed to HIV in defined occupational settings under circumstances that present a risk of transmission. Depending on the circumstances of exposure, a correctional worker could be a contact.

What is HIV infection?

For the purpose of this legislation, HIV infection is defined as infection with the human immunodeficiency viruses that are the cause of AIDS or as the term may be defined from time to time by the Centers for Disease Control and Prevention of the United States Public Health Service.

How will reports be unduplicated by DOH?

Please clarify how reports will be unduplicated by DOH? Each report received will be matched to the list which contains identifying information on all reported individuals. Duplicate reports will be removed and newly identified reports will be added to the list. This is a standard process which has been done for AIDS Surveillance since the mid-1980s.

Is HIV a primary care diagnosis?

Individuals in research studies generally receive primary care; their primary care provider is required to report initial diagnosis of HIV and AIDS, and CD4<500 and positive viral load results done as part of primary care are reportable.

Does HIV affect insurance?

Testing positive for HIV after June 1, 2000, does not affect insurance policies any differently than testing positive for HIV prior to June 1. The State HIV reporting registry data are not shared with or disclosed to health or life insurers.

What happens if a therapist fails to take reasonable steps to protect the intended victim from harm?

“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.

Should clients withhold anything from their therapist?

“Clients should not withhold anything from their therapist, because the therapist is only obligated to report situations in which they feel that another individual, whether it be the client or someone else, is at risk,” said Sophia Reed, a nationally certified counselor and transformation coach.

Can a therapist report a patient's intent to harm someone else?

A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.

Do therapists have to disclose information in court?

For instance, Reed noted that even if a wife is cheating on her husband and they are going through a divorce, the therapist has no legal obligation whatsoever to disclose that information in court. The last thing a therapist wants to do is defy their patient’s trust.

Do you have to report child abuse to a therapist?

“If a client experienced child abuse but is now 18 years of age then the therapist is not required to make a child abuse report, unless the abuser is currently abusing other minors,” Mayo said.

What is HIV counseling?

Providing services to people with HIV or other STDs, including risk-reduction counseling and referrals for medical care and other services (e.g., psychosocial support and prevention interventions). Ensuring that sexual and drug injection partners of people with HIV or other STDs are notified of their potential exposure, ...

What is the best treatment for HIV?

Discuss the importance of taking HIV medicine, or antiretroviral therapy (ART), to treat HIV as soon as possible. Viral suppression, or having an undetectable viral load, is the best thing people with HIV can do to stay healthy.

What are the most common reportable infections?

The list of reportable infections varies from state to state, but it typically includes HIV, syphilis, gonorrhea, and chlamydia. Other infections may also be reportable, and it is important for you as a health care provider to know which ones are reportable in your area.

What happens if a patient tests positive for a test?

If your patient tests positive for one of these infections, he or she will likely be contacted by someone from the health department. Therefore, it is important to let patients know that the health department may contact them if they test positive for one of the reportable infections and that this is a normal procedure.

What to do if you are seeing a patient for the first time?

If you are seeing a patient for the first time, speak with him or her about Partner Services to determine if partner notification was previously addressed. If not, repeat the same process listed above.

What is partner notification?

Notifying sexual or drug injection partners that they may have been exposed to an infectious disease is formally known as partner notification. Health departments use one of three methods in this process:

What is the responsibility of mental health professionals to communicate the threat to the victim?

Mental health professionals must make a reasonable effort to communicate, in timely manner, the threat to the victim and notify the law enforcement agency closest to the patient's or victim's residence and supply a requesting law enforcement agency with any information concerning the threat.

When can a holder of a patient's medical records disclose information?

The holder of the records may disclose information when the patient has communicated a serious threat of serious physical injury against a reasonably identifiable victim, the person with knowledge of the threat may disclose the threat to the potential victim or to any law enforcement officer, or both.

What is the duty of a mental health professional to protect against violent behavior?

A mental health professional has the duty to warn of or take reasonable precautions to provide protection from violent behavior only if the patient communicates an actual threat of physical violence by specific means and against a clearly identified or reasonably identifiable victim.

When does the duty to predict, warn, or take reasonable precautions to provide protection from, violent behavior arise?

The duty to predict, warn of, or take reasonable precautions to provide protection from, violent behavior arises only when a client or other person has communicated to the licensee a specific, serious threat of physical violence against a specific, clearly identified or identifiable potential victim.

What is client privilege in behavioral health?

Behavioral health professional - client privilege does not extend when the professional has a duty to (1) inform victims and appropriate authorities that a client's condition indicates a clear and imminent danger to the client or others; or (2) to report information required by law.

What is the Immunity for Mental Health Professionals?

Immunity for mental health professionals for release of information via 36-504 or 36-509. A release of information via 36-504 or 36-509 shall, at the request of the patient, be reviewed by a member of his family or a guardian. Section provides for appeal procedures.

When did California impose a legal duty on psychotherapists?

California courts imposed a legal duty on psychotherapists to warn third parties of patients’ threats to their safety in 1976 in Tarasoff v. The Regents of the University of California.

Tarasoff 1974 and 1976

State's Law

Duty to Warn Specific to HIV and Aids

The Importance of State's Law and HIV/AIDS Reporting

• Thus, it is important to keep in mind the requirements of your state’s laws. This includes duty to warn, protect, and treat laws as well as those relevant to reporting HIV. Some states do not all require the reporting of HIV or AIDS status by licensed psychotherapists (e.g. Wisconsin) while other states require the reporting of it (e.g. Washington)...

See more on societyforpsychotherapy.org

Important Disclaimers

Reporting Requirements

See more on journalofethics.ama-assn.org

Reporting Risk to Known Contacts

State Statutes

Disclosure and Hipaa

Ethics Considerations