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. The director shall establish any regulations and standards
for hereditary disorders programs as the director deems necessary to
promote and protect the public health and safety. Standards shall
include licensure of master level genetic counselors and doctoral
level geneticists. Regulations adopted shall implement the principles
established in this section. These principles shall include, but not
be limited to, the following:
(a) The public, especially communities and groups particularly
affected by programs on hereditary disorders, should be consulted
before any regulations and standards are adopted by the department.
(b) The incidence, severity, and treatment costs of each
hereditary disorder and its perceived burden by the affected
community should be considered and, where appropriate, state and
national experts in the medical, psychological, ethical, social, and
economic effects or programs for the detection and management of
hereditary disorders shall be consulted by the department.
(c) Information on the operation of all programs on hereditary
disorders within the state, except for confidential information
obtained from participants in the programs, shall be open and freely
available to the public.
(d) Clinical testing procedures established for use in programs,
facilities, and projects shall be accurate, provide maximum
information, and the testing procedures selected shall produce
results that are subject to minimum misinterpretation.
(e) No test or tests may be performed on any minor over the
objection of the minor's parents or guardian, nor may any tests be
performed unless the parent or guardian is fully informed of the
purposes of testing for hereditary disorders and is given reasonable
opportunity to object to the testing.
(f) No testing, except initial screening for phenylketonuria (PKU)
and other diseases that may be added to the newborn screening
program, shall require mandatory participation, and no testing
programs shall require restriction of childbearing, and participation
in a testing program shall not be a prerequisite to eligibility for,
or receipt of, any other service or assistance from, or to
participate in, any other program, except where necessary to
determine eligibility for further programs of diagnoses of or therapy
for hereditary conditions.
(g) Pretest and posttest counseling services for hereditary
disorders shall be available through the program or a referral source
for all persons determined to be or who believe themselves to be at
risk for a hereditary disorder. Genetic counseling shall be provided
by a physician, a certified advanced practice nurse with a genetics
specialty, or other appropriately trained licensed health care
professional and shall be nondirective, shall emphasize informing the
client, and shall not require restriction of childbearing.
(h) All participants in programs on hereditary disorders shall be
protected from undue physical and mental harm, and except for initial
screening for phenylketonuria (PKU) and other diseases that may be
added to newborn screening programs, shall be informed of the nature
of risks involved in participation in the programs, and those
determined to be affected with genetic disease shall be informed of
the nature, and where possible the cost, of available therapies or
maintenance programs, and shall be informed of the possible benefits
and risks associated with these therapies and programs.
(i) All testing results and personal information generated from
hereditary disorders programs shall be made available to an
individual over 18 years of age, or to the individual's parent or
guardian. If the individual is a minor or incompetent, all testing
results that have positively determined the individual to either
have, or be a carrier of, a hereditary disorder shall be given
through a physician or other source of health care.
(j) All testing results and personal information from hereditary
disorders programs obtained from any individual, or from specimens
from any individual, shall be held confidential and be considered a
confidential medical record except for information that the
individual, parent, or guardian consents to be released, provided
that the individual is first fully informed of the scope of the
information requested to be released, of all of the risks, benefits,
and purposes for the release, and of the identity of those to whom
the information will be released or made available, except for data
compiled without reference to the identity of any individual, and
except for research purposes, provided that pursuant to Subpart A
(commencing with Section 46.101) of Part 46 of Title 45 of the Code
of Federal Regulations entitled "Basic HHS Policy for Protection of
Human Subjects," the research has first been reviewed and approved by
an institutional review board that certifies the approval to the
custodian of the information and further certifies that in its
judgment the information is of such potentially substantial public
health value that modification of the requirement for legally
effective prior informed consent of the individual is ethically
justifiable.
(k) A physician providing information to patients on expanded
newborn screening shall disclose to the parent the physician's
financial interest, if any, in the laboratory to which the patient is
being referred.
( l) An individual whose confidentiality has been breached as a
result of any violation of the provisions of the Hereditary Disorders
Act, as defined in subdivision (b) of Section 27, may recover
compensatory and civil damages. Any person who negligently breaches
the confidentiality of an individual tested under this article shall
be subject to civil damages of not more than ten thousand dollars
($10,000), reasonable attorney's fees, and the costs of litigation.
Any person who knowingly breaches the confidentiality of an
individual tested under this article shall be subject to payment of
compensatory damages, and in addition, may be subject to civil
damages of fifty thousand dollars ($50,000), reasonable attorney's
fees, and the costs of litigation, or imprisonment in the county jail
of not more than one year. If the offense is committed under false
pretenses, the person may be subject to a fine of not more than one
hundred thousand dollars ($100,000), imprisonment in the county jail
of not more than one year, or both. If the offense is committed with
the intent to sell, transfer, or use individually identifiable health
information for commercial advantage, personal gain, or malicious
harm, the person may be subject to a fine of not more than two
hundred fifty thousand dollars ($250,000), imprisonment in the county
jail of not more than one year, or both.
(m) "Genetic counseling" as used in this section shall not include
communications that occur between patients and appropriately trained
and competent licensed health care professionals, such as
physicians, registered nurses, and physicians assistants who are
operating within the scope of their license and qualifications as
defined by their licensing authority.