Medical Records and the Law

358 CHAPTER 9: HIV/AIDS: MANDATORY REPORTING AND CONFIDENTIALITYexposed to the victim, provided that a physician certifies in writing thatthe emergency caregiver has been significantly exposed, and that thiscertification accompanies any request for disclosure. 58A few states impose an affirmative duty on an attending physicianor healthcare facility to respond to inquiries by emergency rescuersregarding contact with a patient later diagnosed with a contagiousdisease or virus including HIV; 59 under such statutes, rescuers entitledto receive such information include paid or volunteer firefighters,emergency medical technicians, rescue squad personnel, and lawenforcement officers. Such statutes typically require that the rescueworker be notified within 48 hours after confirmation of the patient’sdiagnosis, and that the information be communicated to emergencycare personnel in a manner that protects the confidentiality of boththe patient and rescuer. In Maryland, each medical care facility mustdevelop and disseminate written procedures for exposure notification.A facility or provider acting in good faith under this section isnot liable for failure to give notice of exposure where the rescuer doesnot properly initiate the process as developed. 60 Other statutes in thisarea are permissive; Washington law, for example, authorizes certainemergency rescuers and other healthcare workers who come into significantcontact with the blood and/or other body fluids of anotherperson to request that an HIV test be performed on that person; therequester is then entitled to know the results. 61 California outlinesdetailed procedures to follow under circumstances where an exposedworker requests an evaluation of the exposure by a physician, includingmeasures to be taken in relaying information regarding HIV statusto the exposed worker. 62Disclosure Without Consent to Spouse orNeedle-Sharing PartnerMany states have confidentiality statutes that provide for notification ofan HIV patient’s spouse, needle-sharing partner, or other “contact” at58Wis. Stat. § 252.15(5)(11).59See, e.g., La. Rev. Stat. Ann. § 18-213(e); Mich. Comp. Laws § 333.20191(5).60Md. Code Ann., Health-Gen., § 18-213(i)(1).61Wash. Rev. Code § 70.24.105(2)(h).62Cal. Health & Safety Code § 121135.