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HIPAA laws can be overruled if state law mandates HIV status reporting.


Senate vote could lift requirement for doctors to report students’ HIV status

by Lindsey Peterson
May 7, 2013


Illinois families with children who have HIV are awaiting a Senate vote this week that would help maintain their children’s privacy.

Under current Illinois law physicians are required to report a child’s HIV status to school principals. The pending legislation would repeal the requirement entirely.

 
Opponents worry anonymity would jeopardize public safety.

The bill, introduced by state Rep. La Shawn K. Ford (D-Chicago), passed narrowly in the House last month with a vote of 61-55.

Ford called the 1987 law, the only one of its kind in the U.S., outdated and unnecessary amid growing research and understanding of HIV.

“There’s no medical reason for a school to know a student’s status at this point, when the law was put into effect in the ’80s, there was a reason to know because research didn’t know all the contractible ways to get HIV AIDS,” Ford said.

“We now know it’s not an airborne disease, it’s a blood-to-blood disease. Now we have universal precautions; if we use it, then we can better prevent it,” Ford said.

But most pervasive for proponents of repealing the requirement is the right to privacy.

“What we have now is an opportunity to treat school age kids with the same protection that we provide for adults,” Ford said.

The federal Health Insurance Portability & Accountability Act and the Americans with Disabilities Act laws normally prohibit the disclosure of patients’ medical information.

Ann Hilton Fisher, executive director of the AIDS Legal Council of Chicago, said state law gives the requirement room to trump HIPAA regulations.

“HIPAA has an exception for mandated reporting -- if your state law requires it, it’s not a violation,” Hilton Fisher said.

“We feel it violates the ADA, which says that kids with disabilities should be able to access public education on the same terms as everyone else, but singling out kids with HIV, the only kids that have to send status to principal, you’re denied accessibility,” she added.

No families have challenged the law in court, which Hilton Fisher said is due to fear of disclosing their child’s HIV status.

“Families are terrified -- the point is to protect families. It’s completely contrary to what we want not to happen. We don’t want families to have to reveal themselves to community,” she said.

Supporters of the current law said school officials can be trusted with a student’s status, careful not to reveal the status to non-authorized personnel, and despite universal precautions, public safety, they said, is still at risk.

The Illinois Family Institute, a nonprofit ministry based out of Carol Stream, has been a vocal opponent of any bill looking to repeal the reporting law. Executive Director David Smith said knowing a student’s status can allow teachers and administrators to better protect a student living with HIV in addition to their classmates.

“Since it interferes with the body’s ability to fight infections, this would help the student, with the teachers knowing who it is, from other students that have other viruses like the flu,” Smith said.

“What teacher has ever been in a school … that hasn’t been in contact with blood, like nose bleeds on the playground? Can’t principals make reasonable decisions how to protect the child and themselves?” Smith said. “We do need a responsible adult to know who has HIV and AIDS. Not only for sake of child but also for staff and themselves.”

Smith said the Illinois Family Institute would continue lobbying to defeat the bill.

Illinois Rep. Natalie Manley (D-Belleville) voted no on lifting the reporting mandate. Manley said she trusts school officials with respecting the privacy of students.

“If I had a child that had HIV or AIDS, I would want those responsible for my child’s care and how to protect them and other children,” Manley said. “We trust teachers with our most precious possession, and should continue to do that. They will use good judgment and protect confidentiality and have a plan on how to best care for the situation.”

Currently, there are about 23,000 reported cases of HIV/AIDS in Chicago – half have not progressed to AIDS. A majority of HIV/AIDS cases are reported in minority communities nationwide.

In Chicago, black males account for 55 percent of people living with HIV/AIDS, according to the Chicago Department of Public Health.

While the overall number of reported HIV/AIDS cases in Chicago dropped 20 percent between 2000 and 2006, the rate among 15- to 24-year-old minority males soared 42 percent in the same time period, according to the health department. That group accounted for 16 percent of newly reported HIV cases in Chicago.

Ford said the disclosure law hinders curbing the trend and dissuades high school students from being tested.

“Rather than take the test and report it, they just opt out of taking test because they’re fearful their status would be reported,” Ford said.

Ford said the bill could be voted on by the end of the week.