S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  6246

                            I N  S E N A T E

                               (PREFILED)

                             January 8, 2014
                               ___________

Introduced  by  Sen. MARTINS -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health  law,  in  relation  to  toxoplasmosis
  testing of pregnant women

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The public health law is amended by adding  a  new  section
2523 to read as follows:
  S  2523.  TOXOPLASMOSIS TESTING. 1. DEFINITIONS.  FOR PURPOSES OF THIS
SECTION THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS:
  (A) "ACUTE ACQUIRED TOXOPLASMOSIS" MEANS THE DISEASE CAUSED BY  RECENT
ACQUISITION OF T. GONDII.
  (B)  "HEALTH  CARE FACILITY" OR "FACILITY" MEANS ANY HOSPITAL OR OTHER
INSTITUTION THAT IS LICENSED OR OTHERWISE AUTHORIZED TO  DELIVER  HEALTH
CARE SERVICES.
  (C)  "HEALTH CARE PROFESSIONAL" MEANS A PHYSICIAN LICENSED TO PRACTICE
MEDICINE IN ALL ITS BRANCHES, A PHYSICIAN ASSISTANT WHO HAS BEEN  DELEG-
ATED  THE  PROVISION OF HEALTH SERVICES BY HIS OR HER SUPERVISING PHYSI-
CIAN, OR AN ADVANCED PRACTICE REGISTERED NURSE WHO HAS WRITTEN  COLLABO-
RATIVE  AGREEMENTS  WITH  A  COLLABORATING PHYSICIAN THAT AUTHORIZES THE
PROVISION OF HEALTH SERVICES.
  (D) "HEALTH CARE SERVICES" MEANS ANY PRENATAL MEDICAL  CARE  OR  LABOR
DELIVERY  SERVICES TO A PREGNANT WOMAN AND HER NEWBORN INFANT, INCLUDING
HOSPITALIZATION.
  (E) "IGG" MEANS IMMUNOGLOBULIN  G,  AN  ANTIBODY  DETERMINING  THAT  A
PERSON IS INFECTED WITH T. GONDII.
  (F) "T. GONDII" MEANS THE PARASITE TOXOPLASMA GONDII.
  (G)"TOXOPLASMOSIS" MEANS THE DISEASE CAUSED BY T. GONDII.
  2.  REQUIRED TOXOPLASMOSIS COUNSELING AND OFFER OF TOXOPLASMOSIS TEST-
ING. (A)  EVERY  HEALTH  CARE  PROFESSIONAL  WHO  PROVIDES  HEALTH  CARE
SERVICES  TO A PREGNANT WOMAN SHALL, UNLESS THE WOMAN HAS BEEN DIAGNOSED
WITH TOXOPLASMA INFECTION THOUGH SEROLOGIC TESTING PRIOR TO THE  CURRENT
PREGNANCY,  PROVIDE  THE  WOMAN  WITH TOXOPLASMOSIS COUNSELING AND SHALL
OFFER A TEST TO HER FOR T. GONDII.
  (B) THE COUNSELING AND TESTING OR REFUSAL OF TESTING  SHALL  BE  DOCU-
              

MENTED IN THE WOMAN'S MEDICAL RECORD. A REFUSAL OF SUCH TESTING SHALL BE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD13321-01-3

S. 6246                             2

IN  WRITING. A HEALTH CARE PROFESSIONAL SHALL PROVIDE THE COUNSELING AND
RECOMMEND THE TESTING AS EARLY IN THE  WOMAN'S  PREGNANCY  AS  POSSIBLE.
FOR  WOMEN  WHO  ARE  NEGATIVE  FOR ANTIBODIES TO T. GONDII, IGG TESTING
SHALL CONTINUE THROUGHOUT PREGNANCY AT AN INTERVAL OF ONCE PER MONTH.
  (C)  THE  HEALTH CARE FACILITY SHALL ADOPT A POLICY THAT PROVIDES THAT
AS SOON AS POSSIBLE WITHIN MEDICAL STANDARDS AFTER THE  INFANT'S  BIRTH,
THE  MOTHER'S TOXOPLASMOSIS TEST RESULT, IF AVAILABLE, SHALL BE NOTED IN
THE NEWBORN INFANT'S MEDICAL RECORD. IT  SHALL  ALSO  BE  NOTED  IN  THE
NEWBORN  INFANT'S  MEDICAL  RECORD  IF  THE  MOTHER'S TOXOPLASMOSIS TEST
RESULT IS NOT AVAILABLE BECAUSE SHE HAS NOT BEEN TESTED OR HAS  DECLINED
TESTING.  ANY  TESTING OR TEST RESULTS SHALL BE DOCUMENTED IN ACCORDANCE
WITH CURRENT STANDARDS OF PATIENT CONFIDENTIALITY.
  (D) EVERY HEALTH CARE PROFESSIONAL OR FACILITY CARING  FOR  A  NEWBORN
INFANT SHALL, UPON DELIVERY OR AS SOON AS POSSIBLE WITHIN MEDICAL STAND-
ARDS AFTER THE INFANT'S BIRTH, PROVIDE COUNSELING TO THE PARENT OR GUAR-
DIAN  OF THE INFANT AND PERFORM TOXOPLASMOSIS TESTING ON THE INFANT WHEN
THE TOXOPLASMOSIS STATUS OF THE INFANT'S MOTHER IS UNKNOWN OR WHEN THERE
IS EVIDENCE OF ACUTE ACQUIRED TOXOPLASMOSIS.
  (E) THE COUNSELING REQUIRED UNDER THIS SECTION  MUST  BE  PROVIDED  IN
ACCORDANCE  WITH  THE  FEDERAL HEALTH INSURANCE PORTABILITY AND ACCOUNT-
ABILITY ACT AND MUST INCLUDE ALL OF THE FOLLOWING:
  (I) FOR THE HEALTH OF THE PREGNANT WOMAN, THE VOLUNTARY NATURE OF  THE
TESTING,  THE BENEFITS OF TOXOPLASMOSIS TESTING, INCLUDING PREVENTION OF
ACQUISITION AND TREATMENT, AND THE REQUIREMENT THAT TOXOPLASMOSIS  TEST-
ING  BE  PERFORMED  UNLESS  SHE REFUSES AND THE METHODS BY WHICH SHE CAN
REFUSE;
  (II) THE BENEFIT OF TOXOPLASMOSIS TESTING FOR HERSELF AND THE  NEWBORN
INFANT, INCLUDING INTERVENTIONS AND TREATMENT TO PREVENT TOXOPLASMOSIS;
  (III) THE SIDE EFFECTS OF INTERVENTIONS TO PREVENT AND TREAT TOXOPLAS-
MOSIS;
  (IV) THE REQUIREMENT FOR MANDATORY TESTING OF THE NEWBORN IF THE MOTH-
ER'S TOXOPLASMOSIS STATUS IS UNKNOWN AT THE TIME OF DELIVERY;
  (V)  AN  EXPLANATION  OF THE TEST, INCLUDING ITS PURPOSE, LIMITATIONS,
AND THE MEANING OF ITS RESULTS;
  (VI) AN EXPLANATION OF THE PROCEDURES TO BE FOLLOWED;
  (VII) THE AVAILABILITY  OF  ADDITIONAL  OR  CONFIRMATORY  TESTING,  IF
APPROPRIATE;
  (VIII)  COUNSELING  MAY BE PROVIDED IN WRITING, VERBALLY, OR BY VIDEO,
ELECTRONIC, OR OTHER MEANS. THE WOMAN MUST BE OFFERED AN OPPORTUNITY  TO
ASK QUESTIONS ABOUT TESTING AND TO DECLINE TESTING FOR HERSELF; AND
  (IX)  CONSENT FOR TESTING OF A NEWBORN INFANT SHALL BE PRESUMED WHEN A
HEALTH CARE PROFESSIONAL OR HEALTH CARE FACILITY SEEKS TO PERFORM A TEST
ON A NEWBORN INFANT WHOSE  MOTHER'S  TOXOPLASMOSIS  STATUS  IS  UNKNOWN,
PROVIDED THAT REQUIRED COUNSELING HAS TAKEN PLACE.
  S  2.  The commissioner of health is hereby authorized and directed to
adopt necessary rules and regulations to  implement  the  provisions  of
this act.
  S  3. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become  a  law;  provided,  however,
that effective immediately, the addition, amendment and/or repeal of any
rule  or  regulation necessary for the implementation of this act on its
effective date is authorized to be made and completed on or before  such
date.