IC 16-41-6
    Chapter 6. Communicable Disease: Mandatory Testing ofIndividuals With Communicable or Dangerous Diseases

IC 16-41-6-0.5
"Standard licensed diagnostic test for HIV"
    Sec. 0.5. As used in this chapter, "standard licensed diagnostictest for HIV" means a test recognized by the state department as astandard licensed diagnostic test for the antibody or antigen to HIV.
As added by P.L.237-2003, SEC.5.

IC 16-41-6-1
HIV screening and testing
    Sec. 1. (a) Except as provided in IC 16-41-8-6, IC 16-41-10-2.5,and subsection (b), a person may not perform a screening orconfirmatory test for the antibody or antigen to HIV without the oralor written consent of the individual to be tested or a representative asauthorized under IC 16-36-1. A physician ordering the test or thephysician's authorized representative shall document whether or notthe individual has consented. The test for the antibody or antigen toHIV may not be performed on a woman under section 5 or 6 of thischapter if the woman refuses under section 7 of this chapter toconsent to the test.
    (b) The test for the antibody or antigen to HIV may be performedif one (1) of the following conditions exists:
        (1) If ordered by a physician who has obtained a health careconsent under IC 16-36-1 or an implied consent underemergency circumstances and the test is medically necessary todiagnose or treat the patient's condition.
        (2) Under a court order based on clear and convincing evidenceof a serious and present health threat to others posed by anindividual. A hearing held under this subsection shall be held incamera at the request of the individual.
        (3) If the test is done on blood collected or tested anonymouslyas part of an epidemiologic survey under IC 16-41-2-3 orIC 16-41-17-10(a)(5).
        (4) The test is ordered under section 4 of this chapter.
        (5) The test is required or authorized under IC 11-10-3-2.5.
    (c) A court may order a person to undergo testing for HIV underIC 35-38-1-10.5(a) or IC 35-38-2-2.3(a)(16).
As added by P.L.2-1993, SEC.24. Amended by P.L.106-1998, SEC.1;P.L.293-2001, SEC.3; P.L.212-2003, SEC.4; P.L.237-2003, SEC.6;P.L.97-2004, SEC.67; P.L.125-2007, SEC.1; P.L.94-2010, SEC.4.

IC 16-41-6-2
Informed consent; court ordered examinations
    Sec. 2. (a) As used in this section, "informed consent" meansauthorization for physical examination, made without undueinducement or any form of force, fraud, constraint, deceit, duress, orcoercion after the following:        (1) A fair explanation of the examination, including thepurpose, potential uses, limitations, and the fair meaning of theexamination results.
        (2) A fair explanation of the procedures to be followed,including the following:
            (A) The voluntary nature of the examination.
            (B) The right to withdraw consent to the examinationprocess at any time.
            (C) The right to anonymity to the extent provided by lawwith respect to participation in the examination anddisclosure of examination results.
            (D) The right to confidential treatment to the extent providedby law of information identifying the subject of theexamination and the results of the examination.
    (b) If the state health commissioner, the state healthcommissioner's legally authorized agent, or local health official hasreasonable grounds to believe that an individual may have acommunicable disease or other disease that is a danger to health, thestate health commissioner, the state health commissioner's legallyauthorized agent, or local health officer may ask the individual forwritten informed consent to be examined to prevent the transmissionof the disease to other individuals.
    (c) If the individual, when requested, refuses such an examination,the state health commissioner, the state health commissioner's legallyauthorized agent, or local health officer may compel the examinationonly upon a court order based on clear and convincing evidence ofa serious and present health threat to others posed by the individual.
    (d) A hearing held under this section shall be held in camera at therequest of the individual.
As added by P.L.2-1993, SEC.24.

IC 16-41-6-2.5
Repealed
    (Repealed by P.L.237-2003, SEC.18.)

IC 16-41-6-3
Violations
    Sec. 3. (a) Except as otherwise provided, a person who recklesslyviolates or fails to comply with this chapter commits a Class Bmisdemeanor.
    (b) Each day a violation continues constitutes a separate offense.
As added by P.L.2-1993, SEC.24.

IC 16-41-6-4
Testing newborn infants; confidentiality; notice; information ontreatment options; objecting; rules
    Sec. 4. (a) Subject to subsection (f), if:
        (1) the mother of a newborn infant has not had a test performedunder section 5 or 6 of this chapter;
        (2) the mother of a newborn infant has refused a test for the

newborn infant to detect HIV or the antibody or antigen to HIV;and
        (3) a physician believes that testing the newborn infant ismedically necessary;
the physician overseeing the care of the newborn infant may order aconfidential test for the newborn infant in order to detect HIV or theantibody or antigen to HIV. The test must be ordered at the earliestfeasible time not exceeding forty-eight (48) hours after the birth ofthe infant.
    (b) If the physician orders a test under subsection (a), thephysician must:
        (1) notify the mother of the newborn infant of the test; and
        (2) provide HIV information and counseling to the mother. Theinformation and counseling must include the following:
            (A) The purpose of the test.
            (B) The risks and benefits of the test.
            (C) A description of the methods of HIV transmission.
            (D) A discussion of risk reduction behavior modifications,including methods to reduce the risk of perinatal HIVtransmission and HIV transmission through breast milk.
            (E) Referral information to other HIV prevention, healthcare, and psychosocial services.
    (c) The confidentiality provisions of IC 16-41-2-3 apply to thissection.
    (d) The results of the confidential test ordered under subsection(a) must be released to the mother of the newborn infant.
    (e) If a test ordered under subsection (a) is positive, the personwho provides the results of the test shall inform the mother of thenewborn infant of treatment options or referral options available tothe newborn infant.
    (f) If a parent of the newborn infant objects in writing for reasonspertaining to religious beliefs, the newborn infant is exempt from thetest under subsection (a).
    (g) The state department shall adopt rules under IC 4-22-2 to carryout this section.
    (h) The results of a test performed under this section areconfidential.
As added by P.L.106-1998, SEC.2. Amended by P.L.237-2003,SEC.7.

IC 16-41-6-5
Ordering and submitting a pregnant woman's blood sample fortesting
    Sec. 5. (a) This section applies to:
        (1) a physician licensed under IC 25-22.5; or
        (2) an advanced practice nurse licensed under IC 25-23;
who provides prenatal care within the scope of the provider's license.
    (b) Subject to section 8 of this chapter, an individual described insubsection (a) who:
        (1) diagnoses the pregnancy of a woman; or        (2) is primarily responsible for providing prenatal care to apregnant woman;
shall order to be taken a sample of the pregnant woman's blood andshall submit the sample to an approved laboratory for a standardlicensed diagnostic test for HIV.
As added by P.L.237-2003, SEC.8.

IC 16-41-6-6
No written evidence of testing; ordering and submitting sample
    Sec. 6. Subject to section 8 of this chapter, if, at the time ofdelivery, there is no written evidence that a standard licenseddiagnostic test for HIV has been performed under section 5 of thischapter, the physician or advanced practice nurse in attendance at thedelivery shall order to be taken a sample of the woman's blood at thetime of the delivery and shall submit the sample to an approvedlaboratory for a standard licensed diagnostic test for HIV.
As added by P.L.237-2003, SEC.9.

IC 16-41-6-7
Right to refuse test
    Sec. 7. A pregnant woman has a right to refuse a test undersection 5 or 6 of this chapter.
As added by P.L.237-2003, SEC.10.

IC 16-41-6-8
Informing pregnant woman of information; documentinginformation given and a refusal of test; information if test resultspositive; confidentiality
    Sec. 8. (a) This section applies to a physician or an advancedpractice nurse who orders an HIV test under section 5 or 6 of thischapter or to the physician's or nurse's designee.
    (b) An individual described in subsection (a) shall:
        (1) inform the pregnant woman that:
            (A) the individual is required by law to order an HIV testunless the pregnant woman refuses; and
            (B) the pregnant woman has a right to refuse the test; and
        (2) explain to the pregnant woman:
            (A) the purpose of the test; and
            (B) the risks and benefits of the test.
    (c) An individual described in subsection (a) shall document inthe pregnant woman's medical records that the pregnant womanreceived the information required under subsection (b).
    (d) If a pregnant woman refuses to consent to an HIV test, therefusal must be noted in the pregnant woman's medical records.
    (e) If a test ordered under section 5 or 6 of this chapter is positive,an individual described in subsection (a):
        (1) shall inform the pregnant woman of the test results;
        (2) shall inform the pregnant woman of the treatment options orreferral options available to the pregnant woman; and
        (3) shall:            (A) provide the pregnant woman with a description of themethods of HIV transmission;
            (B) discuss risk reduction behavior modifications with thepregnant woman, including methods to reduce the risk ofperinatal HIV transmission and HIV transmission throughbreast milk; and
            (C) provide the pregnant woman with referral information toother HIV prevention, health care, and psychosocialservices.
    (f) The provisions of IC 16-41-2-3 apply to a positive HIV testunder section 5 or 6 of this chapter.
    (g) The results of a test performed under section 5 or 6 of thischapter are confidential.
    (h) As a routine component of prenatal care, every individualdescribed in subsection (a) is required to provide information andcounseling regarding HIV and the standard licensed diagnostic testfor HIV and to offer and recommend the standard licensed diagnostictest for HIV.
    (i) An individual described in subsection (a) shall obtain astatement, signed by the pregnant woman, acknowledging that thepregnant woman was counseled and provided the requiredinformation set forth in subsection (b) to ensure that an informeddecision has been made.
    (j) A pregnant woman who refuses a test under this section mustdo so in writing.
As added by P.L.237-2003, SEC.11. Amended by P.L.97-2004,SEC.68.

IC 16-41-6-9
Information on confidential part of birth certificate
    Sec. 9. The state department shall require, on the confidential partof each birth certificate and stillbirth certificate retained by the statedepartment, in addition to the information otherwise required to beincluded on the certificate, the following information:
        (1) Whether a standard licensed diagnostic test for HIV wasperformed on the woman who bore the child.
        (2) If a standard licensed diagnostic test for HIV wasperformed:
            (A) the date the blood specimen was taken; and
            (B) whether the test was performed during pregnancy or atthe time of delivery.
        (3) If a standard licensed diagnostic test for HIV was notperformed, the reason the test was not performed.
As added by P.L.237-2003, SEC.12.

IC 16-41-6-10
Distributing information on HIV treatment options
    Sec. 10. The state department shall distribute to physicians and toother individuals who are allowed by law to attend a pregnantwoman information available from the federal Centers for Disease

Control and Prevention that explains the treatment options availableto an individual who has a positive test for HIV.
As added by P.L.237-2003, SEC.13.

IC 16-41-6-11
Rules
    Sec. 11. (a) The state department shall adopt rules under IC 4-22-2that include procedures:
        (1) to inform the woman of the test results under this chapter,whether they are positive or negative;
        (2) for explaining the side effects of any treatment for HIV ifthe test results under this chapter are positive; and
        (3) to establish a process for a woman who tests positive underthis chapter to appeal the woman's status on a waiting list on atreatment program for which the woman is eligible. The rulemust:
            (A) include a requirement that the state department make adetermination in the process described in this subdivisionnot later than seventy-two (72) hours after the statedepartment receives all the requested medical information;and
            (B) set forth the necessary medical information that must beprovided to the state department and reviewed by the statedepartment in the process described in this subdivision.
    (b) The state department shall maintain rules under IC 4-22-2 thatset forth standards to provide to women who are pregnant, beforedelivery, at delivery, and after delivery, information concerning HIV.The rules must include:
        (1) an explanation of the nature of AIDS and HIV;
        (2) information concerning discrimination and legal protections;
        (3) information concerning the duty to notify persons at risk asdescribed in IC 16-41-7-1;
        (4) information about risk behaviors for HIV transmission;
        (5) information about the risk of transmission through breastfeeding;
        (6) notification that if the woman chooses not to be tested forHIV before delivery, at delivery the child will be tested subjectto section 4 of this chapter;
        (7) procedures for obtaining informed, written consent fortesting under this chapter;
        (8) procedures for post-test counseling by a health care providerwhen the test results are communicated to the woman, whetherthe results are positive or negative;
        (9) procedures for referral for physical and emotional servicesif the test results are positive;
        (10) procedures for explaining the importance of immediateentry into medical care if the test results are positive; and
        (11) procedures for explaining that giving birth by cesareansection may lessen the likelihood of passing on HIV to the childduring childbirth, especially when done in combination with

medications, if the test results are positive.
As added by P.L.237-2003, SEC.14.

IC 16-41-6-12
Completing HIV test history and assessment form; retaining copyof form in patient's medical file; systemwide evaluation of prenatalHIV testing
    Sec. 12. (a) The state department shall provide that an HIV testhistory and assessment form from the patient's medical records or aninterview with the patient must be filled out. The state departmentshall develop the form to determine if:
        (1) the patient is HIV positive and has been informed; or
        (2) the patient was tested during the current pregnancy andtested negative or was not tested during the current pregnancyand the HIV status is unknown.
    (b) The form required under subsection (a) must identify whatspecial support or assistance for continued medical care the patientmight need as a result of a positive test.
    (c) A copy of the form must be:
        (1) kept in the patient's medical file;
        (2) kept in the baby's medical file; and
        (3) given to the doctor in the hospital designated to administerthe newborn HIV testing program.
    (d) The state department must maintain a systemwide evaluationof prenatal HIV testing in Indiana. The state department shallprescribe the HIV test history and assessment form and a newbornblood screening form. The state department shall remove allidentifying information from the maternal test history before the statedepartment performs its analyses and shall not maintain HIV testhistory data with identifying information.
As added by P.L.237-2003, SEC.15.

IC 16-41-6-13
Treatment program access for women who test positive for HIV
    Sec. 13. (a) Women who:
        (1) meet all qualifications to participate in the children's healthinsurance program, the AIDS drug assistance program, thehealth insurance assistance program, or any other health careprogram of the state; and
        (2) test positive under section 5 or 6 of this chapter;
shall be given first priority on a waiting list for the program if awaiting list exists. If a program does not have a waiting list, thewoman described in this subsection shall be automatically approvedand accepted into the program.
    (b) If the state department determines during the processdescribed in section 11(a)(3) of this chapter that the treatment of awoman who tests positive under this chapter should not beinterrupted because of medical necessity, the woman may enter aprogram described in subsection (a) regardless of the existence of awaiting list for the program.As added by P.L.237-2003, SEC.16.