Missouri 2025 Regular Session

Missouri Senate Bill SB609 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
3	3	and is intended to be omitted in the law.
4	4	FIRST REGULAR SESSION
5	5	SENATE BILL NO. 609
6	6	103RD GENERAL ASSEMBLY
7	7	INTRODUCED BY SENATOR LEWIS.
8	8	2074S.01I KRISTINA MARTIN, Secretary
9	9	AN ACT
10	10	To repeal sections 191.226, 191.653, 191.656, 191.657, 191.658, 191.659, 191.662, 191.663,
11	11	191.671, 191.674, 191.680, 191.683, 191.689, 191.692, 191.694, 191.695, 191.699,
12	12	191.700, 191.703, 338.010, 338.730, 375.1300, 442.600, 545.940, 567.020, 567.120,
13	13	and 595.226, RSMo, and to enact in lieu thereof thirteen new sections relating to the
14	14	human immunodeficiency virus, with penalty provisions.
15	15
16	16	Be it enacted by the General Assembly of the State of Missouri, as follows:
17	17	Section A. Sections 191.226, 191.653, 191.656, 191.657, 1
18	18	191.658, 191.659, 191.662, 191.663, 191.671, 191.674, 191.680, 2
19	19	191.683, 191.689, 191.692, 191.694, 191.695, 191.699, 191.700, 3
20	20	191.703, 338.010, 338.730, 375.1300, 442.600, 545.940, 567.020, 4
21	21	567.120, and 595.226, RSMo, are repealed and thirteen new 5
22	22	sections enacted in lieu thereof, to be known as sections 6
23	23	191.226, 191.663, 191.694, 191.695, 191.699, 191. 700, 191.703, 7
24	24	338.010, 338.730, 375.1300, 442.600, 567.020, and 595.226, to 8
25	25	read as follows:9
26	26	191.226. The department of health and senior services 1
27	27	shall pay for the cost of conducting [HIV] testing for 2
28	28	sexually transmitted infections or diseases for a victim of 3
29	29	the crime of rape as defined in section 556.030, or of the 4
30	30	crime of sodomy as defined in section 566.060, or of the 5
31	31	crime of incest as defined in section 568.020 [, if a person 6
32	32	who is convicted of such crime is determined to be infected 7
33	33	with HIV based upon HIV testing conducted upon delivery of 8
34	34	the person to the department of corrections pursuant to 9 SB 609 2
35	35	section 191.659. Such testing shall be limited to not more 10
36	36	than two enzyme-linked immunosorbent assay (ELISA) tests per 11
37	37	year and such cost of such tests shall not be paid by the 12
38	38	department of health and senior services for more than five 13
39	39	years after the date the crime was committed. HIV 14
40	40	testing]. Such testing shall be limited to two rounds of 15
41	41	testing and shall follow the best medical guidance for each 16
42	42	infection or disease being screened. Testing conducted 17
43	43	pursuant to this section shall be performed by the public 18
44	44	health laboratory of the department of health and senior 19
45	45	services. 20
46	46	191.663. 1. As used in this section [and section 1
47	47	191.659], the term ["HIV testing" means serological test or 2
48	48	other test upon a biological specimen to determine the 3
49	49	presence of the human immunodeficiency virus that causes 4
50	50	acquired immunodeficiency syndrome or its antibodies in the 5
51	51	specimen] "testing" means the current medically recommended 6
52	52	set of tests to screen for sexually transmitted infections 7
53	53	or diseases. 8
54	54	2. Any person who is convicted or who pleads guilty or 9
55	55	nolo contendere to any sexual offense defined in chapter 566 10
56	56	or any juvenile who is adjudicated pursuant to subsection 3 11
57	57	of section 211.181 for an offense which would have been a 12
58	58	sexual offense defined in chapter 566 if committed by an 13
59	59	adult, which includes, in accordance with subsection (f) of 14
60	60	42 U.S.C. 3756, a sexual act as defined in subparagraphs (A) 15
61	61	and (B) of paragraph (2) of 18 U.S.C. 2245 as an element of 16
62	62	the offense, shall be ordered by the court to undergo [HIV] 17
63	63	testing prior to incarceration without the right of refusal. 18
64	64	3. Costs of such [HIV] testing shall be taxed to the 19
65	65	defendant as costs in the criminal proceeding unless 20
66	66	otherwise prohibited by law . Such testing costs may be 21 SB 609 3
67	67	retained by the court from the bond filed by the defendant 22
68	68	pursuant to subsection 4 of this section. Costs of such 23
69	69	[HIV] testing for juveniles [may be collected as provided 24
70	70	for in section 211.281 ] shall be paid for by the county in 25
71	71	which the offense occurred . 26
72	72	4. Any defendant charged in a court of general 27
73	73	jurisdiction with a sexual offense defined in cha pter 566 28
74	74	which includes, in accordance with subsection (f) of 42 29
75	75	U.S.C. 3756, a sexual act as defined in subparagraphs (A) 30
76	76	and (B) of paragraph (2) of 18 U.S.C. 2245 as an element of 31
77	77	the crime, shall be required to post a minimum bond amount 32
78	78	for his or her release prior to trial. The minimum bond 33
79	79	amount shall be sufficient to cover the cost of any post - 34
80	80	trial [HIV] testing ordered by the court. 35
81	81	5. Notwithstanding any provision of [section 191.656, 36
82	82	or any other] law to the contrary, the victim of any crime 37
83	83	defined in chapter 566 which includes, in accordance with 38
84	84	subsection (f) of 42 U.S.C. 3756, a sexual act as defined in 39
85	85	subparagraphs (A) and (B) of paragraph (2) of 18 U.S.C. 2245 40
86	86	as an element, shall have a right to access to the results 41
87	87	of any [HIV] testing performed pursuant to the provisions of 42
88	88	this section, and the victim shall be informed of any 43
89	89	confirmed positive results of the [HIV] testing. If the 44
90	90	victim is an unemancipated minor, the minor's parents or 45
91	91	custodian, if any, sha ll also be informed. The 46
92	92	administrator of the jail or correctional facility in which 47
93	93	the defendant is confined shall also have access to the test 48
94	94	results. 49
95	95	191.694. 1. All health care professionals and health 1
96	96	care facilities shall adhere to universal precautions, as 2
97	97	defined by the Centers for Disease Control of the United 3
98	98	States Public Health Service, including the appropriate use 4 SB 609 4
99	99	of hand washing, protective barriers, and care in the use 5
100	100	and disposal of needles and other sharp i nstruments, to 6
101	101	minimize the risk of transmission of [HIV, HBV and other 7
102	102	blood-borne infections] serious infectious or communicable 8
103	103	disease to patients. Health care professionals and health 9
104	104	care facilities shall comply with current guidelines, 10
105	105	established by the Centers for Disease Control, for 11
106	106	disinfection and sterilization of reusable devices used in 12
107	107	invasive procedures. 13
108	108	2. Health care professionals who have exudative 14
109	109	lesions or weeping dermatitis of the hands, forearms, or 15
110	110	other locations that may contact patients, particularly on 16
111	111	exposed areas such as hands or forearms, shall refrain from 17
112	112	performing all invasive procedures, and from handling 18
113	113	patient-care equipment and devices used in performing 19
114	114	invasive procedures until the condition r esolves. 20
115	115	3. As a condition for renewal of a certificate of 21
116	116	registration or authority, permit, or license, all health 22
117	117	care facilities shall provide satisfactory evidence that 23
118	118	periodic training in infection control procedures, including 24
119	119	universal precautions, is provided to all personnel who 25
120	120	perform patient care services at or from such facilities. 26
121	121	Regulations for such training shall be promulgated by the 27
122	122	state regulatory authorities or bodies responsible for 28
123	123	licensing the respective health car e facilities. 29
124	124	4. All health care professionals who perform invasive 30
125	125	procedures shall receive training on infection control 31
126	126	procedures relevant to [HIV and related] serious infectious 32
127	127	or communicable diseases, including universal precautions 33
128	128	and prevention of percutaneous injuries, appropriate for 34
129	129	their specialty and approved by the department of health and 35
130	130	senior services. The department of health and senior 36 SB 609 5
131	131	services, in cooperation with appropriate state regulatory 37
132	132	authorities responsible fo r licensing the respective health 38
133	133	care professionals and in cooperation with professional 39
134	134	societies, shall develop regulations for such training. The 40
135	135	requirements set forth in this subsection shall be deemed 41
136	136	satisfied if the health care professional c ompletes the 42
137	137	training provided in accordance with the provisions of 43
138	138	subsection 3 of this section. 44
139	139	191.695. No rule or portion of a rule promulgated 1
140	140	under the authority of sections 191.650 to [191.700] 191.703 2
141	141	shall become effective unless it has been promulgated 3
142	142	pursuant to the provisions of section 536.024. 4
143	143	191.699. Any health care professional who, after 1
144	144	disclosure has been made by a patient of [HIV infection] a 2
145	145	serious infectious or communicable disease , discriminates 3
146	146	against the patient on the basis of that [HIV infection] 4
147	147	serious infectious or communicable disease or who, prior to 5
148	148	such disclosure, makes [HIV] testing for serious infectious 6
149	149	or communicable disease a condition of treatment shall be 7
150	150	subject to administrative disciplinary action for violation 8
151	151	of a professional trust or confidence or the commission of 9
152	152	an act of unprofessional conduct as those terms are used in 10
153	153	sections 330.160, 332.321, 334.100, and 335.066. 11
154	154	191.700. 1. [The current assessment by the Centers 1
155	155	for Disease Control of the risk that infected health care 2
156	156	professionals will transmit HIV or HBV to patients during 3
157	157	invasive procedures does not justify mandatory testing to 4
158	158	detect infection with those viruses. Health care 5
159	159	professionals who perform invasive procedures are advised, 6
160	160	however, to know their HIV antibody status and their 7
161	161	hepatitis B antigen status. 8 SB 609 6
162	162	2.] (1) The department of health and senior services 9
163	163	shall establish and oversee a voluntar y evaluation process 10
164	164	for health care professionals infected with [HIV or HBV] a 11
165	165	serious infectious or communicable disease who perform 12
166	166	invasive procedures. This evaluation process may be 13
167	167	accessed directly by an infected health care professional, 14
168	168	or by the director of a health care facility with the 15
169	169	consent of the infected health care professional and after 16
170	170	consultation with his private physician. 17
171	171	(2) The confidential and individualized evaluation 18
172	172	shall be conducted by an expert review panel a ppointed by 19
173	173	the department of health and senior services. Each panel 20
174	174	shall include at least such individuals as: 21
175	175	(a) The health care professional's private physician; 22
176	176	(b) An infectious disease specialist with expertise in 23
177	177	the epidemiology of [HIV and HBV] serious infectious or 24
178	178	communicable disease transmission who is not involved in the 25
179	179	care of the health care professional; 26
180	180	(c) A health care professional with expertise in the 27
181	181	procedures performed by the infected health care 28
182	182	professional; and 29
183	183	(d) A state or local public health official. 30
184	184	(3) The department of health and senior services, in 31
185	185	cooperation with appropriate state regulatory authorities or 32
186	186	bodies responsible for licensing the respective health care 33
187	187	professionals and with professional societies, shall develop 34
188	188	uniform evaluation criteria which shall be used in 35
189	189	determining whether, and under what circumstances, any 36
190	190	restrictions or limitations should be placed on an 37
191	191	individual health care professional's medical practice. 38
192	192	These criteria shall, consistent with guidelines from the 39 SB 609 7
193	193	Centers for Disease Control, include at least the following 40
194	194	inquiries: 41
195	195	(a) Whether the health care professional performs 42
196	196	procedures in which injury could result in that individ ual's 43
197	197	blood contamination of a patient's body cavity, subcutaneous 44
198	198	tissues, or mucous membranes; 45
199	199	(b) The nature of the invasive procedures performed by 46
200	200	the health care professional and the techniques used, skill 47
201	201	and experience, and compliance wit h infection control 48
202	202	practices demonstrated by that individual; and 49
203	203	(c) Whether the presence of physical or mental 50
204	204	impairments may interfere with the health care 51
205	205	professional's ability to perform such invasive procedures 52
206	206	safely. 53
207	207	(4) (a) The individualized evaluation and the 54
208	208	recommendations of the panel shall be based on the premise 55
209	209	that [HIV or HBV infection ] a serious infectious or 56
210	210	communicable disease alone does not justify limiting the 57
211	211	health care professional's duties. 58
212	212	(b) The panel may determine which procedures the 59
213	213	health care professional may or may not perform, or perform 60
214	214	with modifications. If the panel is uncertain about whether 61
215	215	a procedure may pose some risk of [HIV or HBV] serious 62
216	216	infectious or communicable disease transmission, it may 63
217	217	recommend that such procedures be performed only after the 64
218	218	patients have been informed of the health care 65
219	219	professional's infection status. 66
220	220	(5) (a) Information obtained during the evaluation 67
221	221	process shall be confidential and shall not be disclosed 68
222	222	except to health care facilities where the health care 69
223	223	professional provides patient care. The department of 70
224	224	health and senior services may only notify or disclose to 71 SB 609 8
225	225	such facilities the practice restrictions and limitations 72
226	226	imposed on the health care professional. Such restrictions 73
227	227	and limitations shall be disclosed only to those employed by 74
228	228	such health care facilities who have a reasonable need to 75
229	229	know the information. 76
230	230	(b) Practice restrictions or limitations recomme nded 77
231	231	by the department of health and senior services shall be 78
232	232	monitored by the health care facilities in which the 79
233	233	infected health care professional is employed. If practice 80
234	234	restrictions or limitations are placed on community based 81
235	235	health care professionals, periodic monitoring to ensure 82
236	236	compliance shall be performed by the department of health 83
237	237	and senior services. 84
238	238	(c) Health care professionals whose practices are 85
239	239	restricted or limited because of their [HIV or HBV] serious 86
240	240	infectious or communicable disease infection status shall, 87
241	241	whenever possible, be provided opportunities to continue 88
242	242	appropriate patient care activities. 89
243	243	(d) Health care facilities regulated under sections 90
244	244	197.010 to 197.120 may maintain or establish peer review 91
245	245	panels that operate under the regulations developed by the 92
246	246	department of health and senior services and the 93
247	247	recommendations of the Centers for Disease Control of the 94
248	248	United States Public Health Service. 95
249	249	(e) Any violation of practice restrictions or 96
250	250	limitations by a health care professional shall constitute 97
251	251	either an act violative of professional trust and 98
252	252	confidence, or failure or refusal to properly guard against 99
253	253	contagious infections or communicable diseases or the spread 100
254	254	thereof, or both, as these terms are used in sections 101
255	255	330.160, 332.321, 334.100, and 335.066. Complaints of 102
256	256	possible violations of practice restrictions or limitations 103 SB 609 9
257	257	may be made to the appropriate state board, as provided 104
258	258	under chapter 330, chapter 332, chapter 334, or chapter 335. 105
259	259	[3.] 2. The department of health and senior services 106
260	260	shall, from time to time, review established standards for 107
261	261	preventing the transmission of [HIV or HBV] serious 108
262	262	infectious or communicable diseases from health care 109
263	263	professionals to patients and, consistent with current 110
264	264	medical knowledge and revised or updated guidelines from the 111
265	265	Centers for Disease Control, modify existing standards and 112
266	266	require additional minimum standards, as appropriate. 113
267	267	[4.] 3. Notwithstanding the provis ions of sections 114
268	268	191.650 to 191.698, the department of health and senior 115
269	269	services may exercise the general authority and power under 116
270	270	section 192.020 to intervene in instances where there is 117
271	271	reason to believe that a health care professional is 118
272	272	practicing in a manner that creates a grave and 119
273	273	unjustifiable risk of injury to others. 120
274	274	191.703. A licensed health care facility that treats a 1
275	275	patient having [HIV or HBV infection ] a serious infectious 2
276	276	or communicable disease or any other reportable infectious 3
277	277	or contagious disease as defined by the department of health 4
278	278	and senior services shall notify the funeral establishment 5
279	279	personnel, coroner or medical examiner involved of such 6
280	280	disease prior to the removal of the patient, when deceas ed, 7
281	281	from the licensed health care facility. Notification shall 8
282	282	be conducted in a manner that protects the confidentiality 9
283	283	of the deceased patient. 10
284	284	338.010. 1. The "practice of pharmacy" includes: 1
285	285	(1) The interpretation, imple mentation, and evaluation 2
286	286	of medical prescription orders, including any legend drugs 3
287	287	under 21 U.S.C. Section 353, and the receipt, transmission, 4 SB 609 10
288	288	or handling of such orders or facilitating the dispensing of 5
289	289	such orders; 6
290	290	(2) The designing, initiati ng, implementing, and 7
291	291	monitoring of a medication therapeutic plan in accordance 8
292	292	with the provisions of this section; 9
293	293	(3) The compounding, dispensing, labeling, and 10
294	294	administration of drugs and devices pursuant to medical 11
295	295	prescription orders; 12
296	296	(4) The ordering and administration of vaccines 13
297	297	approved or authorized by the U.S. Food and Drug 14
298	298	Administration, excluding vaccines for cholera, monkeypox, 15
299	299	Japanese encephalitis, typhoid, rabies, yellow fever, tick - 16
300	300	borne encephalitis, anthrax, tubercu losis, dengue, Hib, 17
301	301	polio, rotavirus, smallpox, and any vaccine approved after 18
302	302	January 1, 2023, to persons at least seven years of age or 19
303	303	the age recommended by the Centers for Disease Control and 20
304	304	Prevention, whichever is older, pursuant to joint 21
305	305	promulgation of rules established by the board of pharmacy 22
306	306	and the state board of registration for the healing arts 23
307	307	unless rules are established under a state of emergency as 24
308	308	described in section 44.100; 25
309	309	(5) The participation in drug selection accordi ng to 26
310	310	state law and participation in drug utilization reviews; 27
311	311	(6) The proper and safe storage of drugs and devices 28
312	312	and the maintenance of proper records thereof; 29
313	313	(7) Consultation with patients and other health care 30
314	314	practitioners, and veteri narians and their clients about 31
315	315	legend drugs, about the safe and effective use of drugs and 32
316	316	devices; 33
317	317	(8) The prescribing and dispensing of any nicotine 34
318	318	replacement therapy product under section 338.665; 35 SB 609 11
319	319	(9) The dispensing of HIV preexposure and postexposure 36
320	320	prophylaxis pursuant to section 338.730; and 37
321	321	(10) The offering or performing of those acts, 38
322	322	services, operations, or transactions necessary in the 39
323	323	conduct, operation, management and control of a pharmacy. 40
324	324	2. No person shall engage in the practice of pharmacy 41
325	325	unless he or she is licensed under the provisions of this 42
326	326	chapter. 43
327	327	3. This chapter shall not be construed to prohibit the 44
328	328	use of auxiliary personnel under the direct supervision of a 45
329	329	pharmacist from assisting th e pharmacist in any of his or 46
330	330	her duties. This assistance in no way is intended to 47
331	331	relieve the pharmacist from his or her responsibilities for 48
332	332	compliance with this chapter and he or she will be 49
333	333	responsible for the actions of the auxiliary personnel 50
334	334	acting in his or her assistance. 51
335	335	4. This chapter shall not be construed to prohibit or 52
336	336	interfere with any legally registered practitioner of 53
337	337	medicine, dentistry, or podiatry, or veterinary medicine 54
338	338	only for use in animals, or the practice of optome try in 55
339	339	accordance with and as provided in sections 195.070 and 56
340	340	336.220 in the compounding, administering, prescribing, or 57
341	341	dispensing of his or her own prescriptions. 58
342	342	5. A pharmacist with a certificate of medication 59
343	343	therapeutic plan authority may provide medication therapy 60
344	344	services pursuant to a written protocol from a physician 61
345	345	licensed under chapter 334 to patients who have established 62
346	346	a physician-patient relationship, as described in 63
347	347	subdivision (1) of subsection 1 of section 191.1146, with 64
348	348	the protocol physician. The written protocol authorized by 65
349	349	this section shall come only from the physician and shall 66
350	350	not come from a nurse engaged in a collaborative practice 67 SB 609 12
351	351	arrangement under section 334.104, or from a physician 68
352	352	assistant engaged in a collaborative practice arrangement 69
353	353	under section 334.735. 70
354	354	6. Nothing in this section shall be construed as to 71
355	355	prevent any person, firm or corporation from owning a 72
356	356	pharmacy regulated by sections 338.210 to 338.315, provided 73
357	357	that a licensed pharmacist is in charge of such pharmacy. 74
358	358	7. Nothing in this section shall be construed to apply 75
359	359	to or interfere with the sale of nonprescription drugs and 76
360	360	the ordinary household remedies and such drugs or medicines 77
361	361	as are normally sold by those enga ged in the sale of general 78
362	362	merchandise. 79
363	363	8. No health carrier as defined in chapter 376 shall 80
364	364	require any physician with which they contract to enter into 81
365	365	a written protocol with a pharmacist for medication 82
366	366	therapeutic services. 83
367	367	9. This section shall not be construed to allow a 84
368	368	pharmacist to diagnose or independently prescribe 85
369	369	pharmaceuticals. 86
370	370	10. The state board of registration for the healing 87
371	371	arts, under section 334.125, and the state board of 88
372	372	pharmacy, under section 338.140, shal l jointly promulgate 89
373	373	rules regulating the use of protocols for medication therapy 90
374	374	services. Such rules shall require protocols to include 91
375	375	provisions allowing for timely communication between the 92
376	376	pharmacist and the protocol physician or similar body 93
377	377	authorized by this section, and any other patient protection 94
378	378	provisions deemed appropriate by both boards. In order to 95
379	379	take effect, such rules shall be approved by a majority vote 96
380	380	of a quorum of each board. Neither board shall separately 97
381	381	promulgate rules regulating the use of protocols for 98
382	382	medication therapy services. Any rule or portion of a rule, 99 SB 609 13
383	383	as that term is defined in section 536.010, that is created 100
384	384	under the authority delegated in this section shall become 101
385	385	effective only if it complies wi th and is subject to all of 102
386	386	the provisions of chapter 536 and, if applicable, section 103
387	387	536.028. This section and chapter 536 are nonseverable and 104
388	388	if any of the powers vested with the general assembly 105
389	389	pursuant to chapter 536 to review, to delay the effe ctive 106
390	390	date, or to disapprove and annul a rule are subsequently 107
391	391	held unconstitutional, then the grant of rulemaking 108
392	392	authority and any rule proposed or adopted after August 28, 109
393	393	2007, shall be invalid and void. 110
394	394	11. The state board of pharmacy may gr ant a 111
395	395	certificate of medication therapeutic plan authority to a 112
396	396	licensed pharmacist who submits proof of successful 113
397	397	completion of a board -approved course of academic clinical 114
398	398	study beyond a bachelor of science in pharmacy, including 115
399	399	but not limited to clinical assessment skills, from a 116
400	400	nationally accredited college or university, or a 117
401	401	certification of equivalence issued by a nationally 118
402	402	recognized professional organization and approved by the 119
403	403	board of pharmacy. 120
404	404	12. Any pharmacist who has recei ved a certificate of 121
405	405	medication therapeutic plan authority may engage in the 122
406	406	designing, initiating, implementing, and monitoring of a 123
407	407	medication therapeutic plan as defined by a written protocol 124
408	408	from a physician that may be specific to each patient for 125
409	409	care by a pharmacist. 126
410	410	13. Nothing in this section shall be construed to 127
411	411	allow a pharmacist to make a therapeutic substitution of a 128
412	412	pharmaceutical prescribed by a physician unless authorized 129
413	413	by the written protocol or the physician's prescription 130
414	414	order. 131 SB 609 14
415	415	14. "Veterinarian", "doctor of veterinary medicine", 132
416	416	"practitioner of veterinary medicine", "DVM", "VMD", "BVSe", 133
417	417	"BVMS", "BSe (Vet Science)", "VMB", "MRCVS", or an 134
418	418	equivalent title means a person who has received a doctor's 135
419	419	degree in veterinary medicine from an accredited school of 136
420	420	veterinary medicine or holds an Educational Commission for 137
421	421	Foreign Veterinary Graduates (EDFVG) certificate issued by 138
422	422	the American Veterinary Medical Association (AVMA). 139
423	423	15. In addition to other requi rements established by 140
424	424	the joint promulgation of rules by the board of pharmacy and 141
425	425	the state board of registration for the healing arts: 142
426	426	(1) A pharmacist shall administer vaccines by protocol 143
427	427	in accordance with treatment guidelines established by the 144
428	428	Centers for Disease Control and Prevention (CDC); 145
429	429	(2) A pharmacist who is administering a vaccine shall 146
430	430	request a patient to remain in the pharmacy a safe amount of 147
431	431	time after administering the vaccine to observe any adverse 148
432	432	reactions. Such pharmacist shall have adopted emergency 149
433	433	treatment protocols. 150
434	434	16. In addition to other requirements by the board, a 151
435	435	pharmacist shall receive additional training as required by 152
436	436	the board and evidenced by receiving a certificate from the 153
437	437	board upon completion, and shall display the certification 154
438	438	in his or her pharmacy where vaccines are delivered. 155
439	439	17. A pharmacist shall inform the patient that the 156
440	440	administration of a vaccine will be entered into the 157
441	441	ShowMeVax system, as administered by the department of 158
442	442	health and senior services. The patient shall attest to the 159
443	443	inclusion of such information in the system by signing a 160
444	444	form provided by the pharmacist. If the patient indicates 161
445	445	that he or she does not want such information entered into 162
446	446	the ShowMeVax system, the pharmacist shall provide a written 163 SB 609 15
447	447	report within fourteen days of administration of a vaccine 164
448	448	to the patient's health care provider, if provided by the 165
449	449	patient, containing: 166
450	450	(1) The identity of the patient; 167
451	451	(2) The identity of the vaccine or vaccines 168
452	452	administered; 169
453	453	(3) The route of administration; 170
454	454	(4) The anatomic site of the administration; 171
455	455	(5) The dose administered; and 172
456	456	(6) The date of administration. 173
457	457	18. A pharmacist licensed under this chapter may order 174
458	458	and administer vaccines approved or authorized by the U.S. 175
459	459	Food and Drug Administration to address a public health 176
460	460	need, as lawfully authorized by the state or federal 177
461	461	government, or a department or agency thereof, during a 178
462	462	state or federally declared public health emergency. 179
463	463	338.730. 1. Notwithstanding any other law to the 1
464	464	contrary, a pharmacist may dispense HIV preexposure and 2
465	465	postexposure prophylaxis in accordance with this section. 3
466	466	Such prophylaxis shall be dispensed only if the pharmacist 4
467	467	follows a written protocol authorized by a licensed 5
468	468	physician. 6
469	469	2. For purposes of this section, " preexposure and 7
470	470	postexposure prophylaxis" shall mean any drug approved by 8
471	471	the Food and Drug Administration that m eets the same 9
472	472	clinical eligibility recommendations provided in CDC 10
473	473	guidelines for either preexposure prophylaxis or 11
474	474	postexposure prophylaxis . 12
475	475	3. For purposes of this section, "CDC guidelines" 13
476	476	shall mean the current HIV guidelines published by the 14
477	477	federal Centers for Disease Control and Prevention. 15 SB 609 16
478	478	4. The state board of registration for the healing 16
479	479	arts and the state board of pharmacy shall jointly 17
480	480	promulgate rules and regulations for the administration of 18
481	481	this section. Neither board shall separately promulgate 19
482	482	rules governing a pharmacist's authority to dispense HIV 20
483	483	preexposure and postexposure prophylaxis under this section. 21
484	484	5. Any rule or portion of a rule, as that term is 22
485	485	defined in section 536.010, that is created under the 23
486	486	authority delegated in this section shall become effective 24
487	487	only if it complies with and is subject to all of the 25
488	488	provisions of chapter 536 and, if applicable, section 26
489	489	536.028. This section and chapter 536 are nonseverable and 27
490	490	if any of the powers ves ted with the general assembly 28
491	491	pursuant to chapter 536 to review, to delay the effective 29
492	492	date, or to disapprove and annul a rule are subsequently 30
493	493	held unconstitutional, then the grant of rulemaking 31
494	494	authority and any rule proposed or adopted after August 28, 32
495	495	2021, shall be invalid and void. 33
496	496	375.1300. When used in sections 375.1300 to 375.1312, 1
497	497	the following terms mean: 2
498	498	(1) "Consultant", an individual, partnership or 3
499	499	corporation who, for a fee, holds himself or itself out to 4
500	500	the public as engaged in the business of offering any 5
501	501	advice, counsel, opinion or service with respect to the 6
502	502	benefits, advantages or disadvantages promised under any 7
503	503	policy of insurance that could be issued in this state; 8
504	504	(2) "Director", the direc tor of the department of 9
505	505	commerce and insurance of this state; 10
506	506	(3) "Genetic information", the results of a genetic 11
507	507	test. Genetic information shall not include family history, 12
508	508	the results of routine physical measurements, or the results 13
509	509	of chemical, blood, urine analysis, or the results of tests 14 SB 609 17
510	510	for drugs or the presence of the human immunodeficiency 15
511	511	virus, or from results of any other tests commonly accepted 16
512	512	in clinical practice at the time; 17
513	513	(4) "Genetic test", a laboratory test of human 18
514	514	deoxyribonucleic acid (DNA) or ribonucleic acid (RNA) used 19
515	515	to identify the presence or absence of inherited alterations 20
516	516	in the DNA or RNA which cause predisposition to disease or 21
517	517	illness. The term does not include routine physical 22
518	518	measurements and examinations, routine tests performed as a 23
519	519	part of a physical examination, chemical, blood or urine 24
520	520	analysis, cholesterol tests, tests for the presence of [the 25
521	521	human immunodeficiency virus ] infection or disease , a test 26
522	522	for drugs, or tests commonly accep ted in clinical practice 27
523	523	at the time; 28
524	524	(5) "Insurer", any person, reciprocal exchange, 29
525	525	interinsurer, Lloyds insurer, fraternal benefit society, and 30
526	526	any other legal entity engaged in the business of insurance, 31
527	527	including agents, brokers, adjusters a nd third-party 32
528	528	administrators. "Insurer" also includes health services 33
529	529	corporations, health maintenance organizations, prepaid 34
530	530	limited health care service plans, dental, optometry and 35
531	531	other similar health service plans. For purposes of 36
532	532	sections 375.930 to 375.948, such entities shall be deemed 37
533	533	to be engaged in the business of insurance. "Insurer" shall 38
534	534	also include all companies organized, incorporated or doing 39
535	535	business pursuant to the provisions of chapters 325, 375, 40
536	536	376, 377, 378, 379, 381 and 383; 41
537	537	(6) "Person", any natural or artificial entity, 42
538	538	including, but not limited to, individuals, partnerships, 43
539	539	associations, trusts or corporations; 44
540	540	(7) "Policy", "certificate" or "contract" includes any 45
541	541	contract of insurance, indemnity, me dical, health or 46 SB 609 18
542	542	hospital service, suretyship, or annuity issued, proposed 47
543	543	for issuance, or intended for issuance by any insurer. 48
544	544	442.600. 1. The fact that a parcel of real property, 1
545	545	or any building or structure thereon, may be a 2
546	546	psychologically impacted real property, or may be in close 3
547	547	proximity to a psychologically impacted real property shall 4
548	548	not be a material or substantial fact that is required to be 5
549	549	disclosed in a sale, exchange or other transfer of real 6
550	550	estate. 7
551	551	2. "Psychologically impacted real property" is defined 8
552	552	to include: 9
553	553	(1) Real property in which an occupant is, or was at 10
554	554	any time, infected [with human immunodeficiency virus ] or 11
555	555	diagnosed with [acquired immune deficiency syndrome, or 12
556	556	with] any [other] disease which has been determined by 13
557	557	medical evidence to be highly unlikely to be transmitted 14
558	558	through the occupancy of a dwelling place; or 15
559	559	(2) Real property which was the site of a homicide or 16
560	560	other felony, or of a suicide. 17
561	561	3. No cause of action shall arise nor may any action 18
562	562	be brought against any real estate agent or broker for the 19
563	563	failure to disclose to a buyer or other transferee of real 20
564	564	estate that the transferred real property was a 21
565	565	psychologically impacted real property. 22
566	566	567.020. 1. A person commits the offense of 1
567	567	prostitution if he or she engages in or offers or agrees to 2
568	568	engage in sexual conduct with another person in return for 3
569	569	something of value to be received by any person. 4
570	570	2. The offense of prostitution is a class B 5
571	571	misdemeanor [unless the person knew prior to performing the 6
572	572	act of prostitution that he or she was infected with HIV in 7 SB 609 19
573	573	which case prostitution is a class B felony. The use of 8
574	574	condoms is not a defense to this offense ]. 9
575	575	3. [As used in this section, "HIV" means the human 10
576	576	immunodeficiency virus that causes acquired immunodeficiency 11
577	577	syndrome. 12
578	578	4.] The judge may order a drug and alcohol abuse 13
579	579	treatment program for any person found guilty of 14
580	580	prostitution, either after trial or upon a plea of guilty, 15
581	581	before sentencing. [For the class B misdemeanor offense, ] 16
582	582	Upon the successful completion of such program by the 17
583	583	defendant, the court may at its discretion allow the 18
584	584	defendant to withdraw the plea of guilty or reve rse the 19
585	585	verdict and enter a judgment of not guilty. [For the class 20
586	586	B felony offense, the court shall not allow the defendant to 21
587	587	withdraw the plea of guilty or reverse the verdict and enter 22
588	588	a judgment of not guilty. The judge, however, has 23
589	589	discretion to take into consideration successful completion 24
590	590	of a drug or alcohol treatment program in determining the 25
591	591	defendant's sentence. 26
592	592	5.] 4. A person shall not be certified as an adult or 27
593	593	adjudicated as a delinquent for the offense of prostitution 28
594	594	under this section if the person was under the age of 29
595	595	eighteen at the time the offense occurred. In such cases 30
596	596	where the person was under the age of eighteen, the person 31
597	597	shall be classified as a victim of abuse, as defined under 32
598	598	section 210.110, and suc h abuse shall be reported 33
599	599	immediately to the children's division, as required under 34
600	600	section 210.115 and to the juvenile officer for appropriate 35
601	601	services, treatment, investigation, and other proceedings as 36
602	602	provided under chapters 207, 210, and 211. Upon request, 37
603	603	the local law enforcement agency and the prosecuting 38 SB 609 20
604	604	attorney shall assist the children's division and the 39
605	605	juvenile officer in conducting the investigation. 40
606	606	595.226. 1. After August 28, 2007, any information 1
607	607	contained in any court record, whether written or published 2
608	608	on the internet, including any visual or aural recordings 3
609	609	that could be used to identify or locate any victim of an 4
610	610	offense under chapter 566 or a victim of domestic assault or 5
611	611	stalking shall be closed an d redacted from such record prior 6
612	612	to disclosure to the public. Identifying information shall 7
613	613	include, but shall not be limited to, the name, home or 8
614	614	temporary address, personal email address, telephone number, 9
615	615	Social Security number, birth date, place of employment, any 10
616	616	health information, [including human immunodeficiency virus 11
617	617	(HIV) status,] any information from a forensic testing 12
618	618	report, or physical characteristics, including an 13
619	619	unobstructed visual image of the victim's face or body. 14
620	620	2. Any person who is requesting identifying 15
621	621	information of a victim and who has a legitimate interest in 16
622	622	obtaining such information may petition the court for an in 17
623	623	camera inspection of the records. If the court determines 18
624	624	the person is entitled to all or any part of such records, 19
625	625	the court may order production and disclosure of the 20
626	626	records, but only if the court determines that the 21
627	627	disclosure to the person or entity would not compromise the 22
628	628	welfare or safety of the victim, and only after providing 23
629	629	reasonable notice to the victim and after allowing the 24
630	630	victim the right to respond to such request. 25
631	631	3. Notwithstanding the provisions of subsection 1 of 26
632	632	this section, the judge presiding over a case under chapter 27
633	633	566 or a case of domestic assault or stalking shall have the 28
634	634	discretion to publicly disclose identifying information 29
635	635	regarding the defendant which could be used to identify or 30 SB 609 21
636	636	locate the victim of the crime. The victim may provide a 31
637	637	statement to the court regarding whether he or she desi res 32
638	638	such information to remain closed. When making the decision 33
639	639	to disclose such information, the judge shall consider the 34
640	640	welfare and safety of the victim and any statement to the 35
641	641	court received from the victim regarding the disclosure. 36
642	642	[191.653. 1. No person shall perform or 1
643	643	conduct HIV testing except physicians, 2
644	644	hospitals, and those persons authorized by the 3
645	645	department of health and senior services. No 4
646	646	person shall be authorized by the department of 5
647	647	health and senior servi ces to perform or conduct 6
648	648	HIV testing unless such person provides suitable 7
649	649	verification to the department that such testing 8
650	650	shall be performed in accordance with 9
651	651	departmental regulations governing the types of 10
652	652	tests performed and the manner in which t hey are 11
653	653	administered. The department may monitor the 12
654	654	continued compliance of such persons with 13
655	655	departmental regulations. Hospitals licensed 14
656	656	pursuant to chapter 197 shall be deemed to be in 15
657	657	compliance with departmental regulations 16
658	658	governing HIV testing. 17
659	659	2. All HIV testing shall be performed in 18
660	660	accordance with the department rules governing 19
661	661	HIV testing procedures. 20
662	662	3. Except as provided in sections 191.671 21
663	663	and 191.686, all physicians, hospitals, or other 22
664	664	persons authorized by the depart ment of health 23
665	665	and senior services who perform or conduct HIV 24
666	666	sampling shall provide consultation with the 25
667	667	subject prior to taking the specimen and during 26
668	668	the reporting of the test results and shall 27
669	669	report to the department of health and senior 28
670	670	services the identity of any individual 29
671	671	confirmed to be infected with HIV. ] 30
672	672	[191.656. 1. (1) All information known 1
673	673	to, and records containing any information held 2
674	674	or maintained by, any person, or by any agency, 3
675	675	department, or political subdivision of the 4
676	676	state concerning an individual's HIV infection 5 SB 609 22
677	677	status or the results of any individual's HIV 6
678	678	testing shall be strictly confidential and shall 7
679	679	not be disclosed except to: 8
680	680	(a) Public employees within the agency, 9
681	681	department, or political subdivision who need to 10
682	682	know to perform their public duties; 11
683	683	(b) Public employees of other agencies, 12
684	684	departments, or political subdivisions who need 13
685	685	to know to perform their public duties; 14
686	686	(c) Peace officers, as defined in section 15
687	687	590.100, the attorney general or any assistant 16
688	688	attorneys general acting on his or her behalf, 17
689	689	as defined in chapter 27, and prosecuting 18
690	690	attorneys or circuit attorneys as defined in 19
691	691	chapter 56 and pursuant to section 191.657; 20
692	692	(d) Prosecuting attorneys or circuit 21
693	693	attorneys as defined in chapter 56 to prosecute 22
694	694	cases pursuant to section 191.677 or 567.020. 23
695	695	Prosecuting attorneys or circuit attorneys may 24
696	696	obtain from the department of health and senior 25
697	697	services the contact information and test 26
698	698	results of individuals with whom the HIV - 27
699	699	infected individual has had sexual intercourse 28
700	700	or deviate sexual intercourse. Any prosecuting 29
701	701	attorney or circuit attorney who receives 30
702	702	information from the department of health and 31
703	703	senior services pursuant to the provisions of 32
704	704	this section shall use such information only for 33
705	705	investigative and prosecutorial purposes and 34
706	706	such information shall be considered strictly 35
707	707	confidential and shall only be released as 36
708	708	authorized by this section; 37
709	709	(e)Persons other than public employees who 38
710	710	are entrusted with the regular care of those 39
711	711	under the care and custody of a state agency, 40
712	712	including but not limited to operators of day 41
713	713	care facilities, group homes, residential care 42
714	714	facilities and adoptive or foster parents ; 43
715	715	(f) As authorized by subsection 2 of this 44
716	716	section; 45
717	717	(g) Victims of any sexual offense defined 46
718	718	in chapter 566, which includes sexual 47
719	719	intercourse or deviate sexual intercourse, as an 48
720	720	element of the crime or to a victim of a section 49 SB 609 23
721	721	545.940 offense, in which the court, for good 50
722	722	cause shown, orders the defendant to be tested 51
723	723	for HIV, hepatitis B, hepatitis C, syphilis, 52
724	724	gonorrhea, or chlamydia, once the charge is 53
725	725	filed. Prosecuting attorneys or circuit 54
726	726	attorneys, or the department of heal th and 55
727	727	senior services may release information to such 56
728	728	victims; 57
729	729	(h) Any individual who has tested positive 58
730	730	or false positive to HIV, hepatitis B, hepatitis 59
731	731	C, syphilis, gonorrhea, or chlamydia, may 60
732	732	request copies of any and all test results 61
733	733	relating to said infections. 62
734	734	(2) Further disclosure by public employees 63
735	735	shall be governed by subsections 2 and 3 of this 64
736	736	section; 65
737	737	(3) Disclosure by a public employee or any 66
738	738	other person in violation of this section may be 67
739	739	subject to civil acti ons brought under 68
740	740	subsection 6 of this section, unless otherwise 69
741	741	required by chapter 330, 332, 334, or 335, 70
742	742	pursuant to discipline taken by a state 71
743	743	licensing board. 72
744	744	2. (1) Unless the person acted in bad 73
745	745	faith or with conscious disregard, no per son 74
746	746	shall be liable for violating any duty or right 75
747	747	of confidentiality established by law for 76
748	748	disclosing the results of an individual's HIV 77
749	749	testing: 78
750	750	(a) To the department of health and senior 79
751	751	services; 80
752	752	(b) To health care personnel working 81
753	753	directly with the infected individual who have a 82
754	754	reasonable need to know the results for the 83
755	755	purpose of providing direct patient health care; 84
756	756	(c) Pursuant to the written authorization 85
757	757	of the subject of the test result or results; 86
758	758	(d) To the spouse of the subject of the 87
759	759	test result or results; 88
760	760	(e) To the subject of the test result or 89
761	761	results; 90
762	762	(f) To the parent or legal guardian or 91
763	763	custodian of the subject of the testing, if he 92
764	764	is an unemancipated minor; 93 SB 609 24
765	765	(g) To the victim of any sexual offense 94
766	766	defined in chapter 566, which includes sexual 95
767	767	intercourse or deviate sexual intercourse, as an 96
768	768	element of the crime or to a victim of a section 97
769	769	545.940 offense, in which the court, for good 98
770	770	cause shown, orders the defendant to b e tested 99
771	771	for HIV, hepatitis B, hepatitis C, syphilis, 100
772	772	gonorrhea, or chlamydia, once the charge is 101
773	773	filed; 102
774	774	(h) To employees of a state licensing 103
775	775	board in the execution of their duties under 104
776	776	chapter 330, 332, 334, or 335 pursuant to 105
777	777	discipline taken by a state licensing board; 106
778	778	The department of health and senior services and 107
779	779	its employees shall not be held liable for 108
780	780	disclosing an HIV-infected person's HIV status 109
781	781	to individuals with whom that person had sexual 110
782	782	intercourse or deviate sexual int ercourse; 111
783	783	(2) Paragraphs (b) and (d) of subdivision 112
784	784	(1) of this subsection shall not be construed in 113
785	785	any court to impose any duty on a person to 114
786	786	disclose the results of an individual's HIV 115
787	787	testing to a spouse or health care professional 116
788	788	or other potentially exposed person, parent or 117
789	789	guardian; 118
790	790	(3) No person to whom the results of an 119
791	791	individual's HIV testing has been disclosed 120
792	792	pursuant to paragraphs (b) and (c) of 121
793	793	subdivision (1) of this subsection shall further 122
794	794	disclose such results; ex cept that prosecuting 123
795	795	attorneys or circuit attorneys may disclose such 124
796	796	information to defense attorneys defending 125
797	797	actions pursuant to section 191.677 or 567.020 126
798	798	under the rules of discovery, or jurors or court 127
799	799	personnel hearing cases pursuant to secti on 128
800	800	191.677 or 567.020. Such information shall not 129
801	801	be used or disclosed for any other purpose; 130
802	802	(4) When the results of HIV testing, 131
803	803	disclosed pursuant to paragraph (b) of 132
804	804	subdivision (1) of this subsection, are included 133
805	805	in the medical record of the patient who is 134
806	806	subject to the test, the inclusion is not a 135
807	807	disclosure for purposes of such paragraph so 136
808	808	long as such medical record is afforded the same 137 SB 609 25
809	809	confidentiality protection afforded other 138
810	810	medical records. 139
811	811	3. All communications between the subject 140
812	812	of HIV testing and a physician, hospital, or 141
813	813	other person authorized by the department of 142
814	814	health and senior services who performs or 143
815	815	conducts HIV sampling shall be privileged 144
816	816	communications. 145
817	817	4. The identity of any individual 146
818	818	participating in a research project approved by 147
819	819	an institutional review board shall not be 148
820	820	reported to the department of health and senior 149
821	821	services by the physician conducting the 150
822	822	research project. 151
823	823	5. The subject of HIV testing who is found 152
824	824	to have HIV infection and is aware of his or her 153
825	825	HIV status shall disclose such information to 154
826	826	any health care professional from whom such 155
827	827	person receives health care services. Said 156
828	828	notification shall be made prior to receiving 157
829	829	services from such health care p rofessional if 158
830	830	the HIV-infected person is medically capable of 159
831	831	conveying that information or as soon as he or 160
832	832	she becomes capable of conveying that 161
833	833	information. 162
834	834	6. Any individual aggrieved by a violation 163
835	835	of this section or regulations promulgate d by 164
836	836	the department of health and senior services may 165
837	837	bring a civil action for damages. If it is 166
838	838	found in a civil action that: 167
839	839	(1) A person has negligently violated this 168
840	840	section, the person is liable, for each 169
841	841	violation, for: 170
842	842	(a) The greater of actual damages or 171
843	843	liquidated damages of one thousand dollars; and 172
844	844	(b) Court costs and reasonable attorney's 173
845	845	fees incurred by the person bringing the action; 174
846	846	and 175
847	847	(c) Such other relief, including 176
848	848	injunctive relief, as the court may dee m 177
849	849	appropriate; or 178
850	850	(2) A person has willfully or 179
851	851	intentionally or recklessly violated this 180 SB 609 26
852	852	section, the person is liable, for each 181
853	853	violation, for: 182
854	854	(a) The greater of actual damages or 183
855	855	liquidated damages of five thousand dollars; and 184
856	856	(b) Exemplary damages; and 185
857	857	(c) Court costs and reasonable attorney's 186
858	858	fees incurred by the person bringing the action; 187
859	859	and 188
860	860	(d) Such other relief, including 189
861	861	injunctive relief, as the court may deem 190
862	862	appropriate. 191
863	863	7. No civil liability shal l accrue to any 192
864	864	health care provider as a result of making a 193
865	865	good faith report to the department of health 194
866	866	and senior services about a person reasonably 195
867	867	believed to be infected with HIV, or cooperating 196
868	868	in good faith with the department in an 197
869	869	investigation determining whether a court order 198
870	870	directing an individual to undergo HIV testing 199
871	871	will be sought, or in participating in good 200
872	872	faith in any judicial proceeding resulting from 201
873	873	such a report or investigations; and any person 202
874	874	making such a report, or cooperating with such 203
875	875	an investigation or participating in such a 204
876	876	judicial proceeding, shall be immune from civil 205
877	877	liability as a result of such actions so long as 206
878	878	taken in good faith. ] 207
879	879	[191.657. 1. No court shall issue an 1
880	880	order for the disclosure of confidential HIV - 2
881	881	related information, except a court of record of 3
882	882	competent jurisdiction in accordance with the 4
883	883	provisions of this section. 5
884	884	2. Pursuant to section 191.656, a court 6
885	885	may grant an order for disclosure of 7
886	886	confidential HIV-related information to peace 8
887	887	officers, the attorney general or any assistant 9
888	888	attorneys general acting on his or her behalf, 10
889	889	and prosecuting attorneys upon an application 11
890	890	showing: 12
891	891	(1) A compelling need for disclosure of 13
892	892	the information for the adjudication of a 14
893	893	criminal or civil proceeding; 15 SB 609 27
894	894	(2) A clear and imminent danger to an 16
895	895	individual whose life or health may unknowingly 17
896	896	be at significant risk as a result of contact 18
897	897	with the individual to whom the information 19
898	898	pertains; 20
899	899	(3) Upon application of a state, county or 21
900	900	local health officer, a clear and imminent 22
901	901	danger to the public health; or 23
902	902	(4) That the applicant is lawfully 24
903	903	entitled to the disclosure and the disclosure is 25
904	904	consistent with the provisions of this se ction. 26
905	905	3. Upon receiving an application for an 27
906	906	order authorizing disclosure pursuant to this 28
907	907	section, the court shall enter an order 29
908	908	directing that all pleadings, papers, 30
909	909	affidavits, judgments, orders of the court, 31
910	910	briefs and memoranda of law wh ich are part of 32
911	911	the application or the decision thereon, be 33
912	912	sealed and not made available to any person, 34
913	913	except to the extent necessary to conduct any 35
914	914	proceedings in connection with the determination 36
915	915	of whether to grant or deny the application, 37
916	916	including any appeal. Such an order shall 38
917	917	further direct that all subsequent proceedings 39
918	918	in connection with the application shall be 40
919	919	conducted in camera, and, where appropriate to 41
920	920	prevent the unauthorized disclosure of 42
921	921	confidential HIV-related information, that any 43
922	922	pleadings, papers, affidavits, judgments, orders 44
923	923	of the court, briefs and memoranda of law which 45
924	924	are part of the application or the decision 46
925	925	thereon not state the name of the individual 47
926	926	concerning whom confidential HIV -related 48
927	927	information is sought. 49
928	928	4. (1) The individual concerning whom 50
929	929	confidential HIV-related information is sought 51
930	930	and any person holding records concerning 52
931	931	confidential HIV-related information from whom 53
932	932	disclosure is sought shall be given adequate 54
933	933	notice of such application in a manner which 55
934	934	will not disclose to any other person the 56
935	935	identity of the individual, and shall be 57
936	936	afforded an opportunity to file a written 58
937	937	response to the application, or to appear in 59 SB 609 28
938	938	person for the limited purpose of providing 60
939	939	evidence on the statutory criteria for the 61
940	940	issuance of an order pursuant to this section. 62
941	941	(2) The court may grant an order without 63
942	942	such notice and opportunity to be heard, where 64
943	943	an ex parte application by a state, county, or 65
944	944	local health officer shows that a clear and 66
945	945	imminent danger to an individual, whose life or 67
946	946	health may unknowingly be at risk, requires an 68
947	947	immediate order. 69
948	948	(3) Service of a subpoena shall not be 70
949	949	subject to this subdivision. 71
950	950	5. In assessing compelling need and clear 72
951	951	and imminent danger, the court shall provide 73
952	952	written findings of fact, including scientific 74
953	953	or medical findings, citing specific evidence in 75
954	954	the record which supports each finding, and 76
955	955	shall weigh the need for disclosure against the 77
956	956	privacy interest of the protected individual and 78
957	957	the public interest which may be disserved by 79
958	958	disclosure which deters future testing or 80
959	959	treatment or which may lead to discrimination. 81
960	960	6. An order authorizing disclosure of 82
961	961	confidential HIV-related information shal l: 83
962	962	(1) Limit disclosure to that information 84
963	963	which is necessary to fulfill the purpose for 85
964	964	which the order is granted; and 86
965	965	(2) Limit disclosure to those persons 87
966	966	whose need for the information is the basis for 88
967	967	the order, and specifically proh ibit 89
968	968	redisclosure by such persons to any other 90
969	969	persons, whether or not they are parties to the 91
970	970	action; and 92
971	971	(3) To the extent possible consistent with 93
972	972	this section, conform to the provisions of this 94
973	973	section; and 95
974	974	(4) Include such other measu res as the 96
975	975	court deems necessary to limit any disclosures 97
976	976	not authorized by its order. ] 98
977	977	[191.658. 1. As used in this section, the 1
978	978	following terms shall mean: 2
979	979	(1) "Disclose", to disclose, release, 3
980	980	transfer, disseminate or othe rwise communicate 4 SB 609 29
981	981	all or any part of any record orally, in writing 5
982	982	or by electronic means to any person or entity; 6
983	983	(2) "Health care practitioner", any 7
984	984	licensed physician, nurse practitioner or 8
985	985	physician's assistant; 9
986	986	(3) "HIV", the human imm unodeficiency 10
987	987	virus that causes acquired immunodeficiency 11
988	988	syndrome; 12
989	989	(4) "HIV infection", the pathological 13
990	990	state of the human body in response to HIV; 14
991	991	(5) "Medically significant exposure", a 15
992	992	puncture through or laceration of the skin, or 16
993	993	contact of mucous membrane or nonintact skin 17
994	994	with blood, tissue, wound exudate or other body 18
995	995	fluids, including semen, vaginal secretions, 19
996	996	cerebrospinal fluid, synovial fluid, pleural 20
997	997	fluid, peritoneal fluid, pericardial fluid, 21
998	998	amniotic fluid or any body fluid containing 22
999	999	visible blood, or contact of intact skin with 23
1000	1000	any such body fluids when the duration of 24
1001	1001	contact is prolonged or involves an extensive 25
1002	1002	area of skin; 26
1003	1003	(6) "Person", private individuals, private 27
1004	1004	or public bodies politic, and corpor ations, 28
1005	1005	partnerships, trusts, and unincorporated 29
1006	1006	associations and their officers, directors, 30
1007	1007	agents or employees; 31
1008	1008	(7) "Source individual", the person who is 32
1009	1009	the source of the blood or other body fluids to 33
1010	1010	which medically significant exposure occ urred. 34
1011	1011	2. A health care practitioner providing 35
1012	1012	medical treatment for a health care worker or 36
1013	1013	law enforcement officer because of a medically 37
1014	1014	significant exposure to blood or other body 38
1015	1015	fluids that occurred in the course of the 39
1016	1016	worker's or officer's employment may request 40
1017	1017	from the department of health and senior 41
1018	1018	services information regarding the HIV infection 42
1019	1019	status of the source individual. The department 43
1020	1020	of health and senior services may disclose to 44
1021	1021	the health care practitioner the HIV inf ection 45
1022	1022	status of the source individual if such 46
1023	1023	information is on file with the department. 47 SB 609 30
1024	1024	3. The health care practitioner shall 48
1025	1025	disclose the HIV infection status of the source 49
1026	1026	individual to the exposed health care worker or 50
1027	1027	law enforcement offi cer if, in the professional 51
1028	1028	judgment of the health care practitioner, such 52
1029	1029	disclosure is necessary to assure adherence to a 53
1030	1030	prescribed treatment regimen. 54
1031	1031	4. No person to whom information about an 55
1032	1032	individual's HIV infection has been disclosed 56
1033	1033	pursuant to this section shall further disclose 57
1034	1034	such results. 58
1035	1035	5. Any person who knowingly releases 59
1036	1036	information in violation of this section is 60
1037	1037	guilty of a class A misdemeanor. ] 61
1038	1038	[191.659. 1. Except as provided in 1
1039	1039	subsection 2 of this section, all individuals 2
1040	1040	who are delivered to the department of 3
1041	1041	corrections and all individuals who are released 4
1042	1042	or discharged from any correctional facility 5
1043	1043	operated by the department of corrections, 6
1044	1044	before such individuals are released or 7
1045	1045	discharged, shall undergo HIV and tuberculosis 8
1046	1046	testing without the right of refusal. In 9
1047	1047	addition, the department of corrections may 10
1048	1048	perform or conduct infectious disease testing on 11
1049	1049	offenders without the right of refusal. 12
1050	1050	2. The department of correct ions shall not 13
1051	1051	perform HIV testing on an individual delivered 14
1052	1052	to the department if similar HIV testing has 15
1053	1053	been performed on the individual subsequent to 16
1054	1054	trial and if the department is able to obtain 17
1055	1055	the results of the prior HIV test. 18
1056	1056	3. The department shall inform the victim 19
1057	1057	of any sexual offense defined in chapter 566, 20
1058	1058	which includes sexual intercourse or deviate 21
1059	1059	sexual intercourse as an element of the crime, 22
1060	1060	of any confirmed positive results of HIV testing 23
1061	1061	performed on an offender within the custody of 24
1062	1062	the department. If the victim is an 25
1063	1063	unemancipated minor, the department shall also 26
1064	1064	inform the minor's parents or custodian, if any. ] 27 SB 609 31
1065	1065	[191.662. 1. The department of mental 1
1066	1066	health may perform or conduct HIV testing or HIV 2
1067	1067	sampling without the right of refusal on: 3
1068	1068	(1) Any individual participating in a 4
1069	1069	methadone treatment program for the treatment of 5
1070	1070	intravenous drug abuse and who has refused to 6
1071	1071	undergo such testing whenever there are 7
1072	1072	reasonable grounds to bel ieve that the 8
1073	1073	individual is infected with HIV and is a 9
1074	1074	reasonable health threat to others; 10
1075	1075	(2) Any individual under the care and 11
1076	1076	custody of the department of mental health who 12
1077	1077	has refused to undergo testing whenever there 13
1078	1078	are reasonable grounds to believe that the 14
1079	1079	individual is infected with HIV and is a 15
1080	1080	reasonable health threat to others, unless such 16
1081	1081	testing is otherwise prohibited by law. 17
1082	1082	2. The department of mental health shall 18
1083	1083	not report to the department of health and 19
1084	1084	senior services the identity of any individual 20
1085	1085	for whom HIV testing pursuant to this section 21
1086	1086	confirms HIV infection if such reporting is 22
1087	1087	prohibited by federal law or regulation. ] 23
1088	1088	[191.671. 1. No other section of this act 1
1089	1089	shall apply to any ins urer, health services 2
1090	1090	corporation, or health maintenance organization 3
1091	1091	licensed by the department of commerce and 4
1092	1092	insurance which conducts HIV testing only for 5
1093	1093	the purposes of assessing a person's fitness for 6
1094	1094	insurance coverage offered by such insurer, 7
1095	1095	health services corporation, or health 8
1096	1096	maintenance corporation, except that nothing in 9
1097	1097	this section shall be construed to exempt any 10
1098	1098	insurer, health services corporation or health 11
1099	1099	maintenance organization in their capacity as 12
1100	1100	employers from the prov isions of section 191.665 13
1101	1101	relating to employment practices. 14
1102	1102	2. Upon renewal of any individual or group 15
1103	1103	insurance policy, subscriber contractor health 16
1104	1104	maintenance organization contract covering 17
1105	1105	medical expenses, no insurer, health services 18
1106	1106	corporation or health maintenance organization 19
1107	1107	shall deny or alter coverage to any previously 20 SB 609 32
1108	1108	covered individual who has been diagnosed as 21
1109	1109	having HIV infection or any HIV -related 22
1110	1110	condition during the previous policy or contract 23
1111	1111	period only because of such d iagnosis, nor shall 24
1112	1112	any such insurer, health services corporation or 25
1113	1113	health maintenance organization exclude coverage 26
1114	1114	for treatment of such infection or condition 27
1115	1115	with respect to any such individual. 28
1116	1116	3. The director of the department of 29
1117	1117	commerce and insurance shall establish by 30
1118	1118	regulation standards for the use of HIV testing 31
1119	1119	by insurers, health services corporations and 32
1120	1120	health maintenance organizations. 33
1121	1121	4. A laboratory certified by the U.S. 34
1122	1122	Department of Health and Human Services under 35
1123	1123	the Clinical Laboratory Improvement Act of 1967, 36
1124	1124	permitting testing of specimens obtained in 37
1125	1125	interstate commerce, and which subjects itself 38
1126	1126	to ongoing proficiency testing by the College of 39
1127	1127	American Pathologists, the American Association 40
1128	1128	of Bio Analysts, or an equivalent program 41
1129	1129	approved by the Centers for Disease Control 42
1130	1130	shall be authorized to perform or conduct HIV 43
1131	1131	testing for an insurer, health services 44
1132	1132	corporation or health maintenance organization 45
1133	1133	pursuant to this section. 46
1134	1134	5. The result or results of HIV testing of 47
1135	1135	an applicant for insurance coverage shall not be 48
1136	1136	disclosed by an insurer, health services 49
1137	1137	corporation or health maintenance organization, 50
1138	1138	except as specifically authorized by such 51
1139	1139	applicant in writing. Such result or results 52
1140	1140	shall, however, be disclosed to a physician 53
1141	1141	designated by the subject of the test. If there 54
1142	1142	is no physician designated, the insurer, health 55
1143	1143	services corporation, or health maintenance 56
1144	1144	organization shall disclose the identity of 57
1145	1145	individuals residing in Missouri having a 58
1146	1146	confirmed positive HIV test result to the 59
1147	1147	department of health and senior services. 60
1148	1148	Provided, further, that no such insurer, health 61
1149	1149	services corporation or health maintenance 62
1150	1150	organization shall be liable for violating any 63
1151	1151	duty or right of confidentiality established by 64 SB 609 33
1152	1152	law for disclosing such identity of individuals 65
1153	1153	having a confirmed positive HIV test result to 66
1154	1154	the department of health and senior services. 67
1155	1155	Such disclosure shall be in a manner that 68
1156	1156	ensures confidential ity. Disclosure of test 69
1157	1157	results in violation of this section shall 70
1158	1158	constitute a violation of sections 375.930 to 71
1159	1159	375.948 regulating trade practices in the 72
1160	1160	business of insurance. Nothing in this 73
1161	1161	subsection shall be construed to foreclose any 74
1162	1162	remedies existing on June 1, 1988. ] 75
1163	1163	[191.674. 1. The department of health and 1
1164	1164	senior services may seek in its own name in a 2
1165	1165	court of competent jurisdiction a court order 3
1166	1166	directing an individual to undergo HIV testing 4
1167	1167	without the right of refusal after reasonable 5
1168	1168	efforts have been made by the department to 6
1169	1169	obtain informed consent to HIV testing. The 7
1170	1170	court shall grant such order whenever there are 8
1171	1171	reasonable grounds to believe that an individual 9
1172	1172	is infected with HIV and there is clear and 10
1173	1173	convincing evidence of a serious and present 11
1174	1174	health threat to others posed by the individual 12
1175	1175	if infected. 13
1176	1176	2. The record of any suit filed pursuant 14
1177	1177	to this section shall be closed to the public 15
1178	1178	and, at the request of the individual, any 16
1179	1179	hearing shall be held in camera. ] 17
1180	1180	[191.680. 1. Any person who shall erect, 1
1181	1181	establish, continue, maintain, use, own, or 2
1182	1182	lease any building, structure, or place used for 3
1183	1183	the purpose of lewdness, assignation, or illegal 4
1184	1184	purpose involving sexual or other contact 5
1185	1185	through which transmission of HIV infection can 6
1186	1186	occur is guilty of maintaining a nuisance. 7
1187	1187	2. The building, structure, or place, or 8
1188	1188	the ground itself, in or upon which any such 9
1189	1189	lewdness, assignation, or illegal purpose is 10
1190	1190	conducted, permitted, carried on, continued, or 11
1191	1191	exists, and the furniture, fixtures, musical 12
1192	1192	instruments, and movable property used in 13
1193	1193	conducting or maintaining such nuisance, are 14
1194	1194	hereby declared to be a nuisance and shall be 15 SB 609 34
1195	1195	enjoined and abated as p rovided in subsection 3 16
1196	1196	of this section. 17
1197	1197	3. If the existence of a nuisance is 18
1198	1198	admitted or established in an action pursuant to 19
1199	1199	this section or in a criminal proceeding in any 20
1200	1200	court, an order of abatement shall be entered as 21
1201	1201	part of the judgment in the case. The order 22
1202	1202	shall direct the effectual closing of the 23
1203	1203	business for any purpose, and so keeping it 24
1204	1204	closed for a period of one year. 25
1205	1205	4. The department of health and senior 26
1206	1206	services, a county prosecutor, or a circuit 27
1207	1207	attorney shall file suit in its own name in any 28
1208	1208	court of competent jurisdiction to enforce the 29
1209	1209	provisions of this section. ] 30
1210	1210	[191.683. The department of health and 1
1211	1211	senior services shall regularly report to the 2
1212	1212	appropriate committees of both houses of t he 3
1213	1213	general assembly: 4
1214	1214	(1) The number of individuals with HIV 5
1215	1215	infection for whom a health care plan has been 6
1216	1216	developed detailing the form and impact of such 7
1217	1217	health care plans in a manner that does not 8
1218	1218	identify or provide identifying characteristic s 9
1219	1219	of an individual infected with HIV; 10
1220	1220	(2) The nature and extent to which the 11
1221	1221	department has utilized judicial proceedings in 12
1222	1222	a manner that does not identify or provide 13
1223	1223	identifying characteristics of any individual 14
1224	1224	subject to such proceedings; 15
1225	1225	(3) The form and extent of the handling of 16
1226	1226	federal funds available to the department of 17
1227	1227	health and senior services for disbursement; 18
1228	1228	(4) The form and extent of programs and 19
1229	1229	efforts funded by state funds; and 20
1230	1230	(5) Any other information suc h committees 21
1231	1231	shall seek.] 22
1232	1232	[191.689. 1. Only after a school has 1
1233	1233	adopted a policy consistent with recommendations 2
1234	1234	of the Centers for Disease Control on school 3
1235	1235	children who test positive for HIV shall the 4
1236	1236	department of health and sen ior services give 5
1237	1237	prompt and confidential notice of the identity 6 SB 609 35
1238	1238	of any child reported to the department to have 7
1239	1239	HIV infection and the parent or guardian of any 8
1240	1240	child confirmed by the department of health and 9
1241	1241	senior services standards to have HIV infe ction 10
1242	1242	shall also give prompt and confidential notice 11
1243	1243	of the identity of such child to the 12
1244	1244	superintendent of the school district in which 13
1245	1245	the child resides, and if the child attends a 14
1246	1246	nonpublic elementary or secondary school, to the 15
1247	1247	chief administrative officer of such school. 16
1248	1248	2. The superintendent or chief 17
1249	1249	administrative officer may disclose the identity 18
1250	1250	of an infected child to those persons: 19
1251	1251	(1) Who are designated by the school 20
1252	1252	district to determine the fitness of an 21
1253	1253	individual to attend school; and 22
1254	1254	(2) Who have a reasonable need to know the 23
1255	1255	identity of the child in order to provide proper 24
1256	1256	health care.] 25
1257	1257	[191.692. The department of health and 1
1258	1258	senior services may promulgate rules providing 2
1259	1259	for mandatory premarital HIV testing if the 3
1260	1260	Centers for Disease Control so indicates.] 4
1261	1261	[545.940. 1. Pursuant to a motion filed 1
1262	1262	by the prosecuting attorney or circuit attorney 2
1263	1263	with notice given to the defense attorney and 3
1264	1264	for good cause shown, in any criminal case in 4
1265	1265	which a defendant has been charged by the 5
1266	1266	prosecuting attorney's office or circuit 6
1267	1267	attorney's office with any offense under chapter 7
1268	1268	566 or section 565.050, assault in the first 8
1269	1269	degree; section 565.052 or 565.060, assault in 9
1270	1270	the second degree; section 565.054 or 565.070, 10
1271	1271	assault in the third degree; section 565.056, 11
1272	1272	assault in the fourth degree; section 565.072, 12
1273	1273	domestic assault in the first degree; section 13
1274	1274	565.073, domestic assault in the second degree; 14
1275	1275	section 565.074, domestic assault in the third 15
1276	1276	degree; section 565.075, assault while on school 16
1277	1277	property; section 565.076, domestic assault in 17
1278	1278	the fourth degree; section 565.081, 565.082, or 18
1279	1279	565.083, assault of a law enforcement officer, 19
1280	1280	corrections officer, emergency personn el, 20 SB 609 36
1281	1281	highway worker in a construction zone or work 21
1282	1282	zone, utility worker, cable worker, or probation 22
1283	1283	and parole officer in the first, second, or 23
1284	1284	third degree; section 567.020, prostitution; 24
1285	1285	section 568.045, endangering the welfare of a 25
1286	1286	child in the first degree; section 568.050, 26
1287	1287	endangering the welfare of a child in the second 27
1288	1288	degree; section 568.060, abuse of a child; 28
1289	1289	section 575.150, resisting or interfering with 29
1290	1290	an arrest; or subdivision (2) or (3) of 30
1291	1291	subsection 2 of section 191.677, knowingly o r 31
1292	1292	recklessly exposing a person to a serious 32
1293	1293	infectious or communicable disease, the court 33
1294	1294	may order that the defendant be conveyed to a 34
1295	1295	state-, city-, or county-operated HIV clinic for 35
1296	1296	testing for HIV, hepatitis B, hepatitis C, 36
1297	1297	syphilis, gonorrhea, a nd chlamydia. The results 37
1298	1298	of such tests shall be released to the victim 38
1299	1299	and his or her parent or legal guardian if the 39
1300	1300	victim is a minor. The results of such tests 40
1301	1301	shall also be released to the prosecuting 41
1302	1302	attorney or circuit attorney and the defend ant's 42
1303	1303	attorney. The state's motion to obtain said 43
1304	1304	testing, the court's order of the same, and the 44
1305	1305	test results shall be sealed in the court file. 45
1306	1306	2. As used in this section, "HIV" means 46
1307	1307	the human immunodeficiency virus that causes 47
1308	1308	acquired immunodeficiency syndrome. ] 48
1309	1309	[567.120. Any person arrested for a 1
1310	1310	prostitution-related offense, who has been found 2
1311	1311	guilty of a prior prostitution -related offense, 3
1312	1312	may, within the sound discretion of the court, 4
1313	1313	be required to undergo HIV t esting as a 5
1314	1314	condition precedent to the issuance of bond for 6
1315	1315	the offense.] 7
1316	1316	