(a) Public health records relating to human
immunodeficiency virus (HIV) or acquired immunodeficiency syndrome
(AIDS), containing personally identifying information, that were
developed or acquired by a state or local public health agency, or an
agent of that agency, are confidential and shall not be disclosed,
except as otherwise provided by law for public health purposes or
pursuant to a written authorization by the person who is the subject
of the record or by his or her guardian or conservator.
(b) In accordance with subdivision (g) of Section 121022, a state
or local public health agency, or an agent of that agency, may
disclose personally identifying information in public health records,
as described in subdivision (a), to other local, state, or federal
public health agencies or to corroborating medical researchers, when
the confidential information is necessary to carry out the duties of
the agency or researcher in the investigation, control, or
surveillance of disease, as determined by the state or local public
health agency.
(c) Any disclosures authorized by subdivision (a), (b), or this
subdivision shall include only the information necessary for the
purpose of that disclosure and shall be made only upon the agreement
that the information will be kept confidential as described in
subdivision (a). Except as provided in paragraphs (1) to (3),
inclusive, or as otherwise provided by law, any disclosure authorized
by subdivision (a) or (b) shall not be made without written
authorization as described in subdivision (a). Any unauthorized
further disclosure shall be subject to the penalties described in
subdivision (e).
(1) Notwithstanding any other law, the following disclosures are
authorized for the purpose of enhancing the completeness of reporting
to the federal Centers for Disease Control and Prevention (CDC) of
HIV/AIDS and coinfection with tuberculosis, syphilis, gonorrhea,
chlamydia, hepatitis B, hepatitis C, and meningococcal infection:
(A) The local public health agency HIV surveillance staff may
further disclose the information to the health care provider who
provides HIV care to the HIV-positive person who is the subject of
the record for the purpose of assisting in compliance with
subdivision (a) of Section 121022.
(B) Local public health agency tuberculosis control staff may
further disclose the information to state public health agency
tuberculosis control staff, who may further disclose the information,
without disclosing patient identifying information, to the CDC, to
the extent the information is requested by the CDC and permitted by
subdivision (b), for purposes of the investigation, control, or
surveillance of HIV and tuberculosis coinfections.
(C) Local public health agency sexually transmitted disease
control staff may further disclose the information to state public
health agency sexually transmitted disease control staff, who may
further disclose the information, without disclosing patient
identifying information, to the CDC, to the extent it is requested by
the CDC and permitted by subdivision (b), for the purposes of the
investigation, control, or surveillance of HIV and syphilis,
gonorrhea, or chlamydia coinfection.
(D) For purposes of the investigation, control, or surveillance of
HIV and its coinfection with hepatitis B, hepatitis C, and
meningococcal infection, local public health agency communicable
disease staff may further disclose the information to state public
health agency staff, who may further disclose the information,
without disclosing patient identifying information, to the CDC to the
extent the information is requested by the CDC and permitted by
subdivision (b).
(2) Notwithstanding any other law, the following disclosures are
authorized for the purpose of facilitating appropriate HIV/AIDS
medical care and treatment:
(A) State public health agency HIV surveillance staff, AIDS Drug
Assistance Program staff, and care services staff may further
disclose the information to local public health agency staff, who may
further disclose the information to the HIV-positive person who is
the subject of the record, or the health care provider who provides
his or her HIV care, for the purpose of proactively offering and
coordinating care and treatment services to him or her.
(B) AIDS Drug Assistance Program staff and care services staff in
the State Department of Public Health may further disclose the
information directly to the HIV-positive person who is the subject of
the record or the health care provider who provides his or her HIV
care, for the purpose of proactively offering and coordinating care
and treatment services to him or her.
(C) Local public health agency staff may further disclose acquired
or developed information to the HIV-positive person who is the
subject of the record or the health care provider who provides his or
her HIV care for the purpose of proactively offering and
coordinating care and treatment services to him or her.
(3) Notwithstanding any other law, for the purpose of facilitating
appropriate medical care and treatment of persons coinfected with
HIV and tuberculosis, syphilis, gonorrhea, chlamydia, hepatitis B,
hepatitis C, or meningococcal infection, local public health agency
sexually transmitted disease control, communicable disease control,
and tuberculosis control staff may further disclose the information
to state or local public health agency sexually transmitted disease
control, communicable disease control, and tuberculosis control
staff, the HIV-positive person who is the subject of the record, or
the health care provider who provides his or her HIV, tuberculosis,
hepatitis B, hepatitis C, meningococcal infection, and sexually
transmitted disease care.
(4) For the purposes of paragraphs (2) and (3), "staff" does not
include nongovernmental entities, but shall include state and local
contracted employees who work within state and local public health
departments.
(d) A confidential public health record, as defined in subdivision
(c) of Section 121035, shall not be disclosed, discoverable, or
compelled to be produced in any civil, criminal, administrative, or
other proceeding.
(e) (1) A person who negligently discloses the content of a
confidential public health record, as defined in subdivision (c) of
Section 121035, to a third party, except pursuant to a written
authorization, as described in subdivision (a), or as otherwise
authorized by law, shall be subject to a civil penalty in an amount
not to exceed five thousand dollars ($5,000), plus court costs, as
determined by the court. The penalty and costs shall be paid to the
person whose record was disclosed.
(2) A person who willfully or maliciously discloses the content of
any confidential public health record, as defined in subdivision (c)
of Section 121035, to a third party, except pursuant to a written
authorization, or as otherwise authorized by law, shall be subject to
a civil penalty in an amount not less than five thousand dollars
($5,000) and not more than twenty-five thousand dollars ($25,000),
plus court costs, as determined by the court. The penalty and costs
shall be paid to the person whose confidential public health record
was disclosed.
(3) A person who willfully, maliciously, or negligently discloses
the content of a confidential public health record, as defined in
subdivision (c) of Section 121035, to a third party, except pursuant
to a written authorization, or as otherwise authorized by law, that
results in economic, bodily, or psychological harm to the person
whose confidential public health record was disclosed, is guilty of a
misdemeanor, punishable by imprisonment in a county jail for a
period not to exceed one year, or a fine of not to exceed twenty-five
thousand dollars ($25,000), or both, plus court costs, as determined
by the court. The penalty and costs shall be paid to the person
whose confidential public health record was disclosed.
(4) A person who commits an act described in paragraph (1), (2),
or (3) is liable to the person whose confidential public health
record was disclosed for all actual damages for economic, bodily, or
psychological harm that is a proximate result of the act.
(5) Each violation of this section is a separate and actionable
offense.
(6) This section does not limit or expand the right of an injured
person whose confidential public health record was disclosed to
recover damages under any other applicable law.
(f) In the event that a confidential public health record, as
defined in subdivision (c) of Section 121035, is disclosed, the
information shall not be used to determine employability or
insurability of a person.
(a) Notwithstanding subdivision (f) of Section 120980,
Section 121010, subdivision (g) of Section 121022, subdivision (f) of
Section 121025, Section 121115, and Section 121280, the State
Department of Public Health and qualified entities may share with
each other health records involving the diagnosis, care, and
treatment of human immunodeficiency virus (HIV) or acquired
immunodeficiency syndrome (AIDS) related to a beneficiary enrolled in
federal Ryan White Act funded programs who may be eligible for
services under the federal Patient Protection and Affordable Care Act
(Public Law 111-148), as amended by the federal Health Care and
Education Reconciliation Act of 2010 (Public Law 111-152). The
qualified entities, who shall be covered entities under the federal
Health Insurance Portability and Accountability Act (Public Law
104-191) and the final regulations issued pursuant to the act by the
United States Department of Health and Human Services (45 C.F.R.
Parts 160 and 164), may share records only for the purpose of
enrolling the beneficiary in Medi-Cal, the bridge programs, Medicaid
expansion programs, and any insurance plan certified by the
California Health Benefit Exchange established pursuant to Title 22
(commencing with Section 100500) of the Government Code, or any other
programs authorized under the federal Patient Protection and
Affordable Care Act (Public Law 111-148), and for the purpose of
continuing his or her access to those programs and plans without
disruption.
(b) The information provided by the State Department of Public
Health pursuant to this section shall be limited to only the
information necessary for the purposes of this section and shall not
include HIV or AIDS surveillance data. This information shall not be
further disclosed by a qualified entity, except to any or all of the
following as necessary for the purposes of this section:
(1) The person who is the subject of the record or to his or her
guardian or conservator.
(2) The provider of health care for the person with HIV or AIDS to
whom the information pertains.
(3) The Office of AIDS within the State Department of Public
Health.
(c) For purposes of this section, the following definitions shall
apply:
(1) "Contractor" means any person or entity that is a medical
group, independent practice association, pharmaceutical benefits
manager, or a medical service organization and is not a health care
service plan or provider of health care.
(2) "Provider of health care" means any person licensed or
certified pursuant to Division 2 (commencing with Section 500) of the
Business and Professions Code; any person licensed pursuant to the
Osteopathic Initiative Act or the Chiropractic Initiative Act; any
person certified pursuant to Division 2.5 (commencing with Section
1797) of the Health and Safety Code; any clinic, health dispensary,
or health facility licensed pursuant to Division 2 (commencing with
Section 1200) of the Health and Safety Code.
(3) "Qualified entity" means any of the following:
(A) The State Department of Health Care Services.
(B) The California Health Benefit Exchange established pursuant to
Title 22 (commencing with Section 100500) of the Government Code.
(C) Medi-Cal managed care plans.
(D) Health plans participating in the Bridge Program.
(E) Health plans offered through the Exchange.
(F) County health departments delivering HIV or AIDS health care
services.
(d) Notwithstanding any other law, information shared pursuant to
this section shall not be disclosed, discoverable, or compelled to be
produced in any civil, criminal, administrative, or other
proceeding.
(e) This section shall be implemented only to the extent permitted
by federal law. All employees and contractors of a qualified entity
who have access to confidential HIV-related medical records pursuant
to this section shall be subject to, and all information shared
pursuant to this section shall be protected in accordance with, the
federal Health Insurance Portability and Accountability Act (Public
Law 104-191) and the final regulations issued pursuant to that act by
the United States Department of Health and Human Services (45 C.F.R.
Parts 160 and 164), the Confidentiality of Medical Information Act
(Part 2.6 (commencing with Section 56) of Division 1 of the Civil
Code), and the Insurance Information and Privacy Protection Act
(Article 6.6 (commencing with Section 791) of Part 2 of Division 1 of
the Insurance Code).