CHAPTER 334

FORMERLY

HOUSE BILL NO. 599

AS AMENDED BY HOUSE AMENDMENT NO. 1 AND HOUSE AMENDMENT NO. 2

AN ACT TO AMEND TITLE 16, OF THE DELAWARE CODE RELATING TO SEXUALLY TRANSMITTED DISEASES.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE (Two-thirds of all members elected to each House thereof concurring therein):

Section 1. Amend Chapter 7 of Title 16 of the Delaware Code by striking said chapter and substituting in lieu thereof the following:

"CHAPTER 7. SEXUALLY TRANSMITTED DISEASES

§701. Definitions

(a) Sexually Transmitted Diseases (formerly referred to as venereal diseases),

abbreviated STD, shall be designated by the State Board of Health as reportable through rules and regulations published by the State Board of Health pursuant to Section 706 of this chapter upon finding that such diseases:

(1) cause significant morbidity and mortality; and

(1) can be screened, diagnosed, and treated In a public health control
program, or If not, are a major public health concern such that surveillance of disease occurrence Is in the public interest.

(b) Any person falling into one or more of the following categories Is designated as a suspect:

(1) a person having positive laboratory or clinical findings of a STD;

(2) a person In whom epidemiologic evidence Indicates a STD may exist; and

(3) a person identified as a sexual contact of a STD case.

(c) Director - shal' mean the Director of the Division of Public Health or his

authorized deputies within their respective jurisdictions.

(d) Invasive Medical Procedures - shall mean surgical entry Into tissues.

cavaties, or organs.

(e) Health Care Professional - shall mean any physician, nurse, laboratory and

blood bank technologist or technician, and any others whose professions involve the diagnosis, care or treatment of persons, or the testing of bodily specimens for the purpose of finding evidence of disease.

(f) Health Facility - shall mean a hospital, nursing home, clinic, blood bank,

blood center, sperm bank, laboratory or other health care institution whether public or private.

§702. Reporting of STD's

(a) A physician or any other health care professional who diagnoses, suspects or
treats a reportable STD and every administrator of a health facility or State, County, or city prison in which there is a case of a reportable STD shall report such case to the Division of Public Health specifying the infected person's name, address, age, sex and race as well as the date of onset, name and stage of disease, type and amount of treatment given and the name and address of the submitting health professional within one working day. Certain STDs, which shall be
Identified by the Board of Health, shall be reported In number only In a manner determined by the Board.

(a) Any person who Is In charge of a clinical or hospital laboratory, blood bank, mobile unit, or other facility In which a laboratory examination of any specimen derived from a human body yields microscopical, cultural, serological, or other evidence suggestive of a reportable STD shall notify the Division of Public Health of Its findings within one working day. The Board of Health may require the
notification to contain any information necessary to achieve the purposes of this

act including the tests performed and the results, the name, age, race, sex and address of the persons from whom the specimen was obtained, the reason why the test was performed, and the name and address of the physician and that of the processing clinical laboratory. Certain STDs, which shall be identified by the Board of Health, shall be reported in number only and in a manner determined by the Board.

(c) The Board of Health shall prescribe the form and method of reporting to the
Division of Public Health which may be in writing, by telephone, by electronic data transmission, or by other means.

(a) All reports and notifications made pursuant to this section are confidential and protected from release except under the provisions of Sections 710 and 711 of this chapter. from information received from laboratory notifications, the
Division of Public Health may Contact attending physicians. The Division of Public Health shall inform the attending physician, if the notification indicates the person has an attending physician, before contacting a person from whom a specimen was obtained. However, if delays resulting form Informing the physician may
enhance the spread of the STD, or otherwise endanger the health of either individuals or the public, the Division of Health may contact the person without first informing the attending physician.

(a) Any laboratory which examines specimens for the purpose of finding evidence of a STD shall permit the Division of Public Health to examine the records of said laboratory in order to evaluate compliance with this section.

(a) Any Health Care Professional or other person making the reports required by this section shall be free of any liability or any cause of action arising out of the making of such report If such Health Care Professional or other person acts without malice and has made a reasonable effort to obtain the facts upon which the report Is based.

§703. Examination, Investigation and Treatment of Suspected Persons

The Director shall, when In his or her judgment it is necessary to protect the public health, make examinations of persons reasonably suspected of being infected with a STD of a communicable nature; examine medical records of suspect or diagnosed cases which may be maintained by a health facility or health care professional; require persons Infected with a STD of a communicable nature to report for treatment to a health care professional, public or private, qualified to provide treatment and continue treatment until cured, if possible, and also, when In his or her judgment it is necessary to protect the public health, may issue an order seeking to examine, isolate or quarantine persons Infected with a STD of a communicable nature or persons suspected of being infected with a STD.

§1. Procedure for Apprehension, Commitment, Treatment and Quarantine of an Infected Person

(a) Orders directed to persons with a STD of a communicable nature or restrictive measures on individuals with a communicable STD, as described herein and in Section 705 hereunder shall be used when other measures to protect the public health have failed, including reasonable efforts. which shall be documented, to obtain the voluntary cooperation of the individual who may be subject to such an order.

(a) When the Director knows or has reason to believe, because of medical or epidemiological Information, that a person has a STD of a communicable nature and Is a danger to the public health, he may Issue an order to:

(1) Require the person to be examined and tested to determine whether he has a STD of a communicable nature;

(1) Require the person with a STD of a communicable nature to report to a qualified health care professional for counseling on the disease and for information on how to avoid infecting others;

(2) Direct a person with a STD of a communicable nature to cease and desist from specified conduct which endangers the health of others when the Director has determined that reliable information exists to believe that such persons has been ordered to report for counseling as provided In paragraph (2) of this subsection (b) and continues to demonstrate behavior which endangers the health of others.

(c) If a person violates a cease and desist order issued pursuant to paragraph (3) subsection (b) of this section and it is shown that the person is a danger to others, the Director may enforce the cease and desist order by imposing such restrictions upon the person as are necessary to prevent the specific conduct which endangers the health of others. Any restriction shall be in writing, setting forth the name of the person to be restricted and the Initial period of time, not to exceed three months, during which the order shall remain effective, the terms of the restrictions, and such other conditions as may be necessary to protect the public health. The Director shall review appeals for reconsideration from the subject of the order issued pursuant to this subsection (c).

(d) (1) Any order by the Director pursuant to subsection (b) or (c) of this

section shall indicate to the subject of the order the grounds and provisions of the order and notify such person that if he refuses to comply with the order he has a right to be present at a judicial hearing in the Justice of the Peace Court to review the order and that he may have an attorney appear on his behalf in said hearing. Notice of any order by the Director shall either be by personal service or by prepaid certified mail return receipt requested at the subject's last known address.

(2) if the subject of the order refuses to comply with the order the Director may petition the Justice of the Peace Court for an order of compliance with such order. If an order of compliance is requested, the Court shall hear the matter
within 10 days after the request. Notice of the place, date, and time of the court hearing shall be made by personal service or, if the person is not available, shall be mailed to the subject of the order by prepaid certified mail, return receipt requested, at his last-known address. The burden of proof shall be on the Director to show by clear and convincing evidence that the specified grounds exist for the Issuance of the order and for the need for compliance and that the terms and conditions imposed are necessary to protect the public health. Upon conclusion of the hearing, the Court shall Issue appropriate orders affirming, modifying, or dismissing the order.

(3) If the Director does not petition the Justice of the Peace Court for an order of compliance within thirty days after the subject of the order refuses to comply, the Director's order shall expire automatically and upon application to the Director by the subject of the order, the fact that the order was Issued shall be expunged from the records of the Division of Public Health.

(e) Any hearing conducted pursuant to this section shall be closed and

confidential, and any transcripts or records relating thereto shall also be confidential.

§705. Emergency Public Health Procedures

(a) When the procedures of Section 704 have been exhausted or cannot be satisfied as a result of threatened criminal behavior and the Director knows or has reason to believe, because of medical or epidemiological information, that a person has a STD of a communicable nature and that such person presents an imminent danger to the public health, he may bring an action in the Justice of the Peace Court, seeking the following relief:

(I) an injunction prohibiting such person from engaging In or continuing to

engage in specific conduct which endangers the public health;

(2) other appropriate court orders including, but not limited to, an order to take such person into custody, for a period not to exceed seventy-two hours, and place him In a facility designated or approved by the Director.

(a) A custody order Issued pursuant to subsection (a) of this section for the
purpose of counseling and testing to determine whether such person has a STD of a communicable nature shall provide for the immediate release from custody and from the facility of any person who tests negative and may provide for counseling or other appropriate measures to be Imposed on any person who tests positive. The
subject of the order shall be given notice of the order promptly, personally, and confidentially stating the grounds and provisions of the order and notifying such person that If he refuses to comply with such order he has a right to be present at a hearing to review the order and that he may have an attorney appear on his behalf at the hearing. If such person contests testing or treatment, no invasive medical
procedures shall be carried out prior to a hearing being held pursuant to subsection (c) of this section. Nothing In this section shall be construed to deny
a person, as an exercise of religious freedom, to rely solely on spiritual means

through prayer to prevent or cure disease, provided that the person complies with all control measures, other than treatment, Imposed by the health authority or the department that are reasonable and necessary to prevent the introduction, transmission, and spread of the disease.

(c) Any order issued by the Justice of the Peace Court pursuant to subsection (a) or (b) of this section shall be subject to review In a court hearing. Notice of
the place, date, and time of the court hearing shall be given promptly, personally, and confidentially to the subject of the court order by the Sheriff of the appropriate county or by special process server appointed by the Court. Such
hearing shall be conducted by the Court no later than forty-eight hours after the Issuance of the order. Such person has a right to be present at the hearing and
may have an attorney appear on his behalf at the hearing. Upon conclusion of the hearing, the Court shall issue appropriate orders affirming, modifying, or
dismissing the order.

(d) The burden of proof shall be on the Director to show by clear and convincing evidence that grounds exist for the issuance of any court order pursuant to subsection (a), (b) or (c) of this section.

(e) Any hearing conducted by the Justice of the Peace Court pursuant to subsection (a), (b) or (c) of this section shall be closed and confidential, and any
transcripts or records relating thereto shall also be confidential.

(f) Any order entered by the Justice of the Peace Court pursuant to subsection (a), (b) or (c) of this section shall impose terms and conditions no more restrictive than necessary to protect the public health.

§706. Examination and Treatment of Prisoners

(a) Prison authorities of any State, County or city prison shall ensure that all
persons confined or imprisoned In their respective prisons are provided services for the examination, treatment and cure, if possible, of STDs as may be required according to accepted medical practice. Prison medical staff shall adhere to
current STD medical protocols established by the Division of Public Health for persons confined or imprisoned; shall Inform the Division of Public Health when a person(s) Infected with or suspected to have a STD Is released from prison without appropriate treatment, counseling or examination; and shall allow the Division of Public Health to examine medical records or other medical information to ensure that appropriate STD medical practices are followed.

(a) Prison authorities of any State, County or city prison shall make available to the Division of Public Health such portion of any State, County or city prison as may be necessary to Isolate or quarantine persons known or suspected to have a STD of a communicable nature under the provisions of Section 703, 704 and 705 of this title, provided that no other suitable place for such Isolation or quarantine Is available, and shall cooperate with the Division of Public Health In the provision of care and treatment to such persons.

§707. Rules and Regulations of Board

(a) The State Board of Health shall make such rules and regulations as may In its judgment be necessary to carry out of the provisions of this act, including rules and regulations designating STDs to be reported, providing for the control and treatment of persons Isolated or quarantined, and such other rules and regulations, not In conflict with the provisions of this chapter, concerning the control of STD, and concerning the care, treatment, and quarantine of persons Infected therewith, as It may from time to time deem advisable.

(b) All rules and regulations made pursuant to this chapter shall have the force and effect of law.

§708. Prenatal Standard Tests for Syphilis Gonnorhea, Chlamydia and other STD's

(a) Every Health Care Professional qualified to attend a pregnant woman in this

State during gestation shall take or cause to be taken suitable specimens of such woman and submit such specimens to an approved laboratory for standard tests for syphilis and gonorrhea, chlamydia, and other such tests for STDs as may be designated by the State Board of Health. Every other person permitted by law to attend upon pregnant women in the State but not permitted by law to take such specimens shall cause such specimens of such pregnant woman to be taken by a qualified health care professional and submitted to an approved laboratory for

standard tests for gonnorrehea, syphilis, and chlamydia, and other such tests for STDs as may be designated by the State Board of Health. The specimens shall be taken at the time of the first examination relating to the current pregnancy and a second specimen during the third trimester of pregnancy which is in addition to or exclusive of the test taken at delivery. Every pregnant woman shall permit the specimens to be taken by a qualified Health Care Professional as herein provided. However, the Director or his authorized deputy within the county wherein any person affected by this section resides may waive the requirements of this section if the Director or deputy is satisfied by written affidavit or other notarized written proof, that the tests required by this section are contrary to the tenets and practices of the religious teachings of which the applicant is an adherent, and that the public health and welfare would not be injuriously affected by such waiver.

(b) The term "approved laboratory" means a laboratory approved for this purpose by the State Board of Health. Standard tests for syphilis, chlamydia, and gonnorrhea are ones recognized as such by the State Board.

(a) The laboratory tests required by this section shall be made on request without charge by the State Board.

§709. Authority to Perform Venipuncture

Notwithstanding any other provision of law, a person employed by or detailed to the Division of Public Health as a STD case investigator may perform venipuncture or skin puncture for the purpose of withdrawing blood for test purposes, even though he or she is not otherwise licensed to withdraw blood; provided that such person meets all the following requirements:

(l) He or She works under the direction of licensed physician.

(2) He or She has been trained by a licensed physician In the proper procedures to be employed when withdrawing blood, in accordance with training requirements established by the Division of Public Health, and has a statement signed by the instructing physician that such training has been completed.

§710. Minors—Treatment, Consent, and Liability for Payment for Care

Any health facility or health care professional may examine and provide treatment for a STD for any minor if such facility or professional is qualified to provide such

examination or treatment. Consent to examination and treatment by a minor shall be

controlled by 13 Del. C., Sections 707 and 708. The health care professional in charge or

other appropriate authority of the health facility or the health care professional concerned shall prescribed an appropriate course of treatment for such minor. The fact of consultation, examination and treatment of such minor shall be strictly confidential and shall not be divulged by the facility or the health care professional, including sending of a bill for such services to any persons other than the minor, except as follows:

(1) to persons providing consent pursuant to 13 Del. C. §707 or persons Informed
of the minor's testing and treatment under 13 Del. C. Section 708;

(2) as is necessary to comply with the requirements of 16 Del. C. Section 901 et.
seq. relating to child abuse investigations;

(1) or as is necessary to comply with the requirements of this chapter concerning the control and treatment of STDs, as well as the permitted dissemination of records and information under Section 711 of this chapter.

§711. Confidentiality of Records and Information

All information and records held by the Division of Public Health relating to known or suspected causes of STD. Including infection with human immunodeficiency virus (HIV), the virus causing Acquired Immunodeficiency Syndrome (AIDS), shall be strictly

confidential. Such information shall not be released or made public upon subpoena or
otherwise, except that release may be made under the following circumstances:

(1) release is made of medical or epidemiological information for statistical

purposes so that no person can be identified; or,

(2) release is made of medical or epidemiological information with the consent of

all persons identified in the information released; or

(3) release is made of medical or epldemllogical information to medical personnel, appropriate State agencies or State courts to the extent required to enforce the provisions of this chapter and related rules and regulations concerning the control and treatment of STDs, or as related to child abuse investigations pursuant to 16 Del. C. Section 901 et. seq.

(4) release Is made of medical or epidemiological information to medical personnel In a medical emergency to the extent necessary to protect the health or life of the named party: or,

(5) release Is made during the course of civil or criminal litigation to a person allowed access to said records by a court order which is issued in compliance with the following provisions:

(a) No court of this State shalt Issue such order unless the court finds that
the person seeking the records and information has demonstrated a compelling need for such records which cannot be accommodated by other means. In
assessing compelling need, the court shall weight the need for disclosure against the privacy Interest of the subject and the public Interest which may be disserved by disclosure which deters future testing and treatment or which may lead to discrimination.

(b) pleadings pertaining to disclosure of such records shall substitute a
pseudonym for the true name of the subject of the records. The disclosure to the parties of the subject's true name shall be communicated confidentially, in documents not filed with the court.

(a) Before granting any such order, the court shall provide the subject whose records are in question with notice and a reasonable opportunity to participate In the proceedings if he or she is not already a party.

(b) Court proceedings as to disclosure of such records shall be conducted in
camera unless the subject agrees to a hearing In open court or unless the court determines that a public hearing Is necessary to the public interest and the proper administration of justice.

(a) Upon the Issuance of an order to disclose such records, the court shall impose appropriate safeguards against unauthorized disclosure, which shall specify the persons who may have access to the information, the purposes for which the information shall be used, and appropriate prohibitions on future disclosures.

§712 Custodian of Records

No State or local health department officer or employee shall be examined in a civil, criminal, special, or other proceeding as to the existence or contents of pertinent records for a period examined or treated for a STD or HIV infection by the Division of Public Health, or of the existence of contents of such reports received from a private health care professional or private health facility, without the consent of the person examined and treated for such diseases, except where the information la such records is disclosed pursuant to sections 710, 711(2), 711(3) or 711(5) of this chapter.

§713 penalties

(a) Except for Section 702, whoever violates this chapter or any lawful rule
or regulations made by the Board under Section 706 of this title, or falls to obey any lawful order issued by the Director under this chapter shall be fined not less than $100 nor more than $1,000.

(a) Whoever violates Section 702 of this chapter shall be fined not less than $25 and not more than $200 for each offense.

(b) Each separate day that a violation of this chapter as defined under
Sections 713(a) and (b) continues shall be deemed a separate offense for penalty purposes.

(c) Justices of the Peace shall have jurisdiction of offenses under this
chapter.

Approved July 11, 1988