| Policy |
All DCF children
· shall have their risks for HIV exposure assessed by the social
worker in order to determine the need for HIV testing
· thought to be candidates for HIV testing shall be referred to their
(primary care) physician who shall further evaluate the need for testing and will order
the HIV laboratory test if appropriate.
Note: Testing will not be considered as a routine
course of medical care. |
| Rationale |
While a cure for HIV infection remains
elusive, the benefits of early medical intervention, especially for children, are now well
established. As a result , it is essential that children deemed at risk for HIV infection
be tested as soon as the risk is known. Many of the children for whom DCF assumes
responsibility are likely to be at high risk for HIV infection. The Department, therefore,
believes it is essential to maintain a proactive stance on the matter of HIV testing for
children entering its care by actively encouraging testing in cases where high risk is
suspected or when risk is less apparent but concerns exist. |
| Legal Basis |
CONN. GEN. STAT. §19a-581 through
§19a-590 inclusive, establish strict requirements concerning the testing of individuals
for HIV infection and the confidentiality of such test results.
CONN. GEN. STAT. § 19a-582(a) provides that children may request and
be granted an HIV test and treatment without parental notification or consent.
Note: Before a test may be granted at the child’s
request, a determination should be made if the child has sufficient intellectual capacity,
maturity and stability to understand the seriousness of the test and the consequences of
the results. |
| High Risk Behaviors or Conditions |
There is significant risk for HIV disease
when a child has one or more of the following conditions:
· has parents known to be HIV positive
· is born to a mother who received no prenatal care
· is a newborn who tests positive for illicit drugs
· shared needles or was environmentally exposed to used needles
· has parents who are known to have used illicit drugs
· has been involved/ engaged in sexual activity, has had unprotected
sex, multiple sex partners, has a history of sexually transmitted disease, has traded sex
for money or drugs or has had a pregnancy
· is believed to have been sexually abused or assaulted
· other children in the family are HIV positive or have AIDS
· they or their parents received blood or blood components prior to
1985
· has an unknown medical history (including prenatal care and birth
history)
· the medical provider recommends testing
|
| Determination of Risk |
Anytime a social worker, supervisor or
clinician suspects or needs guidance in determining whether a child/youth is at risk due
to behaviors or experiences, they shall consult with the regional nurse/clinician and with
the child’s medical provider or regional medical consultant. |
| Social Work Staff and Administrative Responsibilities |
Social workers may have social histories
and other facts about a child that a medical provider may not have from any other source.
Therefore, it is essential that this information be given to the provider as soon as
possible. While this is true generally with regard to the medical care of a child, it is
of particular importance with HIV. This information may help identify a child as being at
high risk for HIV infection and may lead to more timely testing and diagnosis.
Social work staff are responsible for collecting all of the information
needed by the Regional Administrator to render a decision on whether a test should or
should not be performed. The Social Worker shall consult with the Regional Resource Group
nurse regarding the advisability of testing by using the DCF-2138 "HIV Authorization
for Confidential Testing" form. The recommendation of the nurse will be recorded on
DCF-2138 and will be sent to the Regional Administrator who shall authorize or deny the
request.
Note: Social Workers are responsible for
ensuring involvement of the biological parents in decision making and in accessing
counseling and information as appropriate.
Cross-Reference: See 44-5-5.5,
"HIV Testing: Confidential Testing". |
| Medical Provider Responsibility |
The child’s medical provider shall
· actively try to rule out the existence of any of the high risk
criteria for possible HIV infection by reviewing the medical and social history and
determining the child’s clinical status
· ensure that HIV testing is performed and that the child or guardian
receive appropriate pre- and post-test counseling should a child meet any of the high risk
criteria described above
|
| Parents Involvement in Decision to Test |
If a child is committed as neglected or
uncared for, discussions with the child’s biological parents should occur
unless a case assessment indicates that such discussion would clearly be contrary to the
child’s best interests.
However, the parent does not have the power to deny doing the testing
if there is a medical recommendation for testing a child who is committed to DCF as
neglected or uncared for.
Note: If the parents are not fluent in English, any
discussions which occur pursuant to obtaining consent must be offered in the parent’s
native language. |
| If an Employee is Exposed |
If a Department employee or health care
provider experiences a significant exposure as the result of his/her occupational duties,
he/she may request that an HIV test be done on the child or youth with the voluntary
consent of such child/youth or the parent/guardian.
The exposed employee must submit to a HIV antibody baseline test within
seventy-two (72) hours of initial exposure before the provisions of the statute can be
pursued.
If certain conditions are met, as described in CONN. GEN. STAT.
§19a-582(e), testing may be done without the source individual’s consent. |
