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HIV TESTING G-115 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HIV REPORTING AND TESTING REQUIREMENTS NO: G-115 FILE: HIV TESTING EFFECTIVE DATE: 12-18-89 REVISED: 12-25-94, 05-01-98, 08-01-01, 03-01-03 AUTHORITY: Sheriff J. Zanoni APPROVED BY: Captain J. Flores REFERENCE: Penal Code Sections 1524.1, 4018.1 and 7500, et seq; Health and Safety Code Section 121050 through 121070; Management Directive 2600; Departmental Policy Sections 1008 and 1016. PURPOSE: The purpose of this policy is to establish the procedures for the reporting and testing of HIV exposure, in accordance with the Legislature's declaration of a public health crisis in Penal Code §§ 7500, et seq. POLICY: It is the policy of the Fresno County Sheriffs Department Detention Bureau that employees may request and be granted a confidential HIV test of an inmate, if they have reason to believe that they have come into contact with an inmate in a way that could result in HIV infection. The decision to test an inmate shall not suspend or delay treatment of the exposed employee. It is the policy of the Fresno County Sheriffs Department Detention Bureau to permit inmates to file similar requests stemming from contacts with other inmates. PROCEDURES: I. EMPLOYEE EXPOSURE - REPORTING PROCEDURES An employee who believes they have come into contact with bodily fluids of an inmate shall report the incident. The following shall be performed: A. Immediately report the exposure to the Fresno County Communicable Disease Program. 1. Normal business hours, telephone 445-3569. 2. Nights, weekends and holidays, telephone 488-3111 and ask for the on-call Fresno County Emergency Response Team member. B. Complete Section I of a Communicable Disease Exposure Report. The employee's daytime contact telephone number must be included. Page 1 of 6 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HIV REPORTING AND TESTING REQUIREMENTS NO: G-115 FILE: HIV TESTING 1. The report shall be FAXed to Fresno County Communicable Disease Outreach at 445-3255. 2. One copy of the report shall be given to the employee, to be provided to the treating physician. The treating physician will complete Section II and return the form to Fresno County Communicable Disease Outreach. 3. The original report shall be filed in the employee's Bureau File. C. A JREP incident report shall be written, including the names of witnesses and persons involved in the incident. D. A State Department of Health Services form DHS-8459 (Report of Request and Decision for HIV Testing) shall be submitted by the end of the shift during which the incident occurred, or if not practicable, as soon as possible, but no longer than two days after the incident (unless waived by the Medical Director). 1. All witnesses and persons involved in the incident should submit reports and/or written statements. 2. The employee may request to have the inmate tested for HIV, and should indicate such a request on the form. 3. The form and all related reports shall be forwarded to the Director of Jail Medical Services. E. A Workers' Compensation packet shall be given to the employee to be completed. F. The Medical Director shall complete and submit a State Department of Health Services form DHS 8479 (Report of Potential HIV Exposure to Law Enforcement Employees). II. PROCEDURE TO DETERMINE TESTING AND RIGHT TO APPEAL A. Within five (5) calendar days of receipt of any form DHS-8459, regardless of whether or not a request for testing was made, the Medical Director shall determine whether or not the involved individual shall be required to submit to HIV testing. Page 2 of 6 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HIV REPORTING AND TESTING REQUIREMENTS NO: G-115 FILE: HIV TESTING B. An inmate who is ordered to have an HIV test shall also receive, in conjunction with the Medical Director's written order, the following: 1. A copy of Penal Code Section 3, Title 8, $$ 7500 et seq. 2. A written description of the right to appeal the Medical Director's decision, including the applicable timelines and notification of their right to receive pretest and posttest counseling by HIV counselors. 3. A copy of form DHS-8457 (Report of Request for Appeal for HIV Testing). C. An individual ordered by the Medical Director to submit to HIV testing has three (3) calendar days to appeal such an order by submitting form DHS-8457 (Report of Request for Appeal for HIV Testing). 1. A three-person appeal panel (comprised of physicians) shall be convened pursuant to Penal Code Section 7515 and the appeal shall be heard within thirty (30) calendar days from the date an appeal request is filed. 2. If no appeal is filed in a timely manner, the order of the Medical Director shall become final. D. Any decision made by the appeal panel may be appealed to the Superior Court, which is required to review the matter as expeditiously as possible. E. In the absence of filing a DHS-8459 form, the Medical Director may order a test of an inmate if he concludes there are clinical symptoms of HIV infection or AIDS pursuant to Penal Code Section 7512.5. Any decision made pursuant to this section shall not be appealable to a three-member panel. III. REQUESTS BY INMATES FOR TESTING OF ANOTHER INMATE A. An inmate may request HIV testing of another inmate if they have reason to believe that they have come into contact with body fluids of that inmate. Page 3 of 6 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HIV REPORTING AND TESTING REQUIREMENTS NO: G-115 FILE: HIV TESTING B. The inmate must submit the request within two (2) calendar days of the date when the incident causing the request occurred; however the Medical Director may waive this filing period requirement if he finds that good cause exists. C. The inmate shall be provided and complete a State Department of Health Services form DHS-8459 (Report of Request and Decision for HIV Testing). The inmate shall provide names or testimony of witnesses within the limits of their ability to do so. D. The employee who receives the request for testing shall be required to notify the Detention Custody Bureau Commander, via an incident report, within twenty-four (24) hours. E. The Detention Custody Bureau Commander, or their designee, shall forward a copy of the incident report to the Medical Director. The Medical Director shall be responsible to investigate and reach a decision as to mandatory testing, as outlined in Section II of this policy. F. A copy of the Medical Director's decision shall be provided to the inmate making the request, to the subject of the request, and to the Detention Custody Bureau Commander. IV. ADDITIONAL REPORTING REQUIREMENTS A. When an employee observes or is informed (by inmate, officer, or non-sworn staff) of activity in the jail that is classified as causing the transmission of the AIDS virus, they shall immediately take action as appropriate to stop and prevent a reoccurrence of the activity and report this information to the Detention Custody Bureau Commander, via an incident report. B. Reportable activities shall include, but not be limited to the following situations- 1. Sexual activity resulting in the exchange of bodily fluids 2. I.V. drug use 3. Incidents involving injury to inmates or staff in which bodily fluids are exchanged. Page 4 of 6 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HIV REPORTING AND TESTING REQUIREMENTS NO: G-115 FILE: HIV TESTING 4. Tampering with medical and food supplies or equipment 5. Tattooing among inmates 6. Inmates who state they are infected or have been exposed to HIV Disease or any other communicable diseases. C. The incident report shall be submitted and forwarded to the Detention Custody Bureau Commander within twenty-four (24) hours after observation or receipt of information. D. The Bureau Commander, or their designee, shall forward a copy of the incident report to the Medical Director. E. The Medical Director may investigate the report, conduct interviews, and determine whether the situation reported could pose a danger to the health and safety of the jail's staff and inmate population. F. If the Medical Director determines HIV testing should occur, the inmate(s) may appeal the decision, as provided in Section II of this policy. V. COUNSELING AND TESTING PROCEDURE A. Counseling shall be provided to any person filing a DHS-8459 report, as well as any potential test subject- 1. At the time the initial report or request for tests is made 2. At the time when tests are ordered 3. At the time when test results are provided 4. And whenever the Medical Director deems advisable B. In the event that an individual is ordered to be tested for HIV, such tests shall consist of a blood sample withdrawn in a medically approved manner by a certified HIV test counselor. VI. REFUSAL TO SUBMIT TO TESTING A. Any person who has been ordered to submit to HIV testing who refuses to submit to such testing shall be subject to revocation of bail, probation or other sentence. Page 5 of 6 FRESNO COUNTY SHERIFF'S OFFICE JAIL DIVISION POLICIES AND PROCEDURES TITLE: HIV REPORTING AND TESTING REQUIREMENTS NO: G-115 FILE: HIV TESTING B. The refusal of any probationer or parolee to submit to required HIV testing shall be considered a violation of probation or parole. VI I. FALSE REPORTS Any employee who willfully files a false form DHS-8459 or a false request for HIV testing may be subject to discipline, as well as misdemeanor criminal sanctions. Vill. CONFIDENTIALITY A. Information concerning the condition of any inmate may be disclosed to employees, medical personnel, contract personnel, and volunteers providing services at the facility who have or may have direct contact with an inmate infected by the AIDS virus or other communicable disease. B. Information that may be vital to the health and safety of custodial personnel, peace officers, firefighters and emergency medical personnel who are put at risk in the course of their official duties, may be disclosed in an appropriate manner in order that precautions can be taken to preserve their health and the health of others or that those persons can be relieved from groundless fear of infection. C. Information concerning the health status of an inmate may appear in the REMARKS section of the inmate's JAIL screen, or by inquiring with a health care provider. D. Any person who willfully discloses personal health information to any person who is not authorized to have access by law, is guilty of a misdemeanor and may be subject to disciplinary action. Page 6 of 6