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/* Florida has passed laws addressing several issues which other
states have ignored, including the relevance of HIV positivity in
child custody procedures; and topics usually found in
administrative codes, such as school curricula and disease
control measures. This state is presented in two parts. */
39.058. Serious or habitual juvenile offender. --
***
(4) Assessments, testing, records, and information. --
(e) The results of any serologic blood or urine test on a
serious or habitual juvenile offender shall become a part of that
child's permanent medical file. Upon transfer of the child to
any other designated medical facility, such file shall be
transferred in an envelope marked confidential. The results of
any test designed to identify the human immunodeficiency virus,
or its antigen or antibody, shall be accessible only to persons
designated by rule of the department. The provisions of such
rule shall be consistent with the guidelines established by the
Centers for Disease Control.
61.13. Custody and support of children; visitation rights; power
of court in making orders. --
***
(6) In any proceeding under this section, the court may not deny
shared parental responsibility, custody, or visitation rights to
a parent or grandparent solely because that parent or grandparent
is or is believed to be infected with human immunodeficiency
virus; but the court may condition such rights upon the parent's
or grandparent's agreement to observe measures approved by the
Centers for Disease Control of the United States Public Health
Service or by the Department of Health and Rehabilitative
Services for preventing the spread of human immunodeficiency
virus to the child.
110.1125. Information requirements; human immunodeficiency virus
infection and acquired immune deficiency syndrome. --
Each agency shall provide to each new state employee, and to each
state employee on an annual basis, an informational pamphlet
about human immunodeficiency virus (HIV) infection and acquired
immune deficiency syndrome (AIDS). The pamphlet shall be written
and printed by the Department of Health and Rehabilitative
Services and shall contain information about the nature and
extent of HIV and AIDS, methods of transmission and preventive
measures, and referral services.
230.2319 Florida Progressive Middle Childhood Education Program
(PRIME). --
***
(5) General requirements for grades 6, 7, and 8. --
(a) by the beginning of the 1986-1987 school year and each year
thereafter, students entering the 6th grade shall receive
instruction in grades 6 through 8 in the following basic
subjects:
(7) By the beginning of the 1990-1991 school year, each school
district and laboratory school shall regularly schedule
comprehensive health education. Such education shall include.
but not be limited to, substance abuse prevention, acquired
immune deficiency syndrome and communicable disease prevention,
human growth and sexuality and pregnancy prevention, and personal
health and hygiene, and shall also provide for instruction, where
appropriate, that:
a. abstinence from sexual activity outside of marriage is the
expected standard for all school age children; and
b. Abstinence from sexual activity is a certain way to avoid
pregnancy, sexual transmission of acquired immune deficiency
syndrome, and other communicable diseases which are transmitted
sexually.
Any student whose parent makes written request to the school
principal shall be exempt from reproductive health or AIDS
instructional activities, as requested. The requirement for
comprehensive health education shall not interfere with the local
determination of appropriate curriculum which reflects local
values and concerns.
232.246. General requirements for high school graduation. --
(i) one-half credit in life management skills to include
consumer education, positive emotional development, nutrition,
prevention of human immunodeficiency virus infection and acquired
immune deficiency syndrome and other sexually transmissible
diseases, benefits of sexual abstinence and consequences of
teenage pregnancy, information and instruction on breast cancer
detection and breast self-examination, cardiopulmonary
resuscitation, drug education, and the hazards of smoking. Such
credit shall be given for a course to be taken by all students in
either the 9th or 10th grade.
240.2097 Educational programs, limited access status; transfer
students; studfent handbook; rules. -- The Board of Regentsa
shall adopt rules to include the following provisions:
***
3. Each university shall provide and update annually a student
handbook that includes, but is not limited to,
***
a statement as to the Stae University System policy on acquired
Immune Deficiency Syndrome including the name and telephone
number of the university acquired immune deficiency syndrome
counselor.
***
4. The development of a comprehensive State University System
policy that addresses the provision of instruction, information,
and activities regarding human immunodeficiency virus infection
and acquired immune deficiency syndrome. Such instruction,
information, or activities shall emphasize the known modes of
transmission or human immunodeficiency virus infection and
acquired immune deficiency syndrome, signs and symptoms,
associated risk factors, approrpiate behavior and attitude change
and means used to control the spread of human immunodeficiency
virus infection and acquired immune deficiency syndrome.
240.3192. Community colleges; HIV and AIDS policy. -- Each
commuity college shall develop a comprehensive policy that
addresses the provision of insturction, information, and
activities regarding human immunodeficiency virus infection and
acquired immune deficiency syndrome. Such instruction,
information, or activities shall emphasize the known modes of
transmission of human immunodeficiency virus infection and
acquired imune deficiency syndrome, signs and symptoms,
associated risk factors, appropriate behavior and attitude
change, and means used to control the spread of human
immunodeficiency virus infection and acquired immune deficiency
syndrome.
233.067 Comprehensive health education and substance abuse
prevention.-
(1) SHORT TITLE. This section shall be known and may be cited
as the "Florida Comprehensive Health Education and Substance
Abuse Prevention Act."
(2) INTENT. The Legislature recognizes that sound health habits
are essential to the educational and personal success of the
student. The Legislature further recognizes that schools are
uniquely situated to effectively promote the establishment of
sound health habits among our youth, including prevention of
substance abuse and an awareness of the benefits of sexual absti
nence and the consequences of teenage pregnancy. To this end, it
is the intent of the Legislature to implement a comprehensive
health education and substance abuse prevention program in
Florida's public schools.
(3) DEFINITIONS. As used in this section. the term
"comprehensive health education" includes, but is not limited to,
such concerns as mental and emotional health, sexually
transmissible diseases, human immunodeficiency virus infection,
acquired immune deficiency syndrome and other communicable
diseases, substance abuse (including alcohol and tobacco), bene
fits of sexual abstinence and consequences of teenage pregnancy,
environmental health, safety and emergency care, nutrition and
food management, personal health and hygiene, dental health,
hereditary diseases, developmental disabilities, growth and
development, and consumer health and careers.
(4) ADMINISTRATION OF THE COMPREHENSIVE HEALTH EDUCATION AND
SUBSTANCE ABUSE PREVENTION PROGRAM.
(a) There is created a comprehensive health education and
substance abuse prevention program for children and youths in
kindergarten and grades 1 through 12. Responsibility for the
administration of this section shall rest with the Department of
Education, in cooperation with, and with the advice of, the
Department of Health and Rehabilitative Services. The
administration of the program shall be pursuant to rules and
regulations adopted by the State Board of Education, provided
that such rules shall require the minimum amount of paperwork and
reporting necessary to comply with this section. For purposes of
administering this section, the commissioner shall establish a
Prevention Resource Center within the department and shall assign
appropriate staff to work directly with school district
personnel. The center shall serve as a clearinghouse for
evaluation and dissemination of information, materials, and model
programs and shall provide program and technical assistance and
other prevention services as determined by the commissioner.
(b) In administering this section, the department shall take
into consideration the advice of an advisory council to the
Prevention Resource Center consisting of representatives of the
Florida Medical Association school health medical advisory
committee to the department, the state university and community
college systems, school food service personnel, governmental
agencies, school boards, district school personnel, teachers'
associations, and any official and voluntary health or substance
abuse prevention and treatment agencies as may be deemed
appropriate. The department is authorized to reimburse the
members of this advisory council for travel and per diem expense,
as provided by law, when performing advisory services requested
by the department.
(c) The comprehensive health education and substance abuse
prevention program shall include the following in all public and
laboratory schools:
1. Implementation of inservice education programs for teachers,
counselors, and other persons, which programs deal with
comprehensive health education, substance abuse prevention,
prevention of sexually transmissible diseases, especially human
immunodeficiency virus infection and acquired immune deficiency
syndrome, and the benefits of sexual abstinence and consequences
of teenage pregnancy. Such inservice education programs shall be
consistent with the 5-year master plan, as specified in s.
236.0811, and shall include training in substance abuse
identification and prevention. The training plan may provide for
the option of using teachers as trainers and shall include, but
not be limited to: information on current theory, knowledge, and
practice regarding substance abuse; identification and referral
procedures; legal issues; peer counseling; and methods of
teaching decisionmaking skills and building self-concept.
Inservice teacher education materials and student materials which
are based upon individual performance and designed for use with a
minimum of supervision shall be developed and made available to
all school districts and laboratory schools.
2. Implementation of management training programs consistent
with the provisions of s. 231.087 for principals and other school
leaders on the identification, prevention, and treatment of
substance abuse and the availability of local and regional
referral resources.
3. Instruction in nutrition education as a specific area of
health education instruction. Nutrition education shall include,
but not be limited to, sound nutritional practices, wise food
selection, analysis of advertising claims about food, proper food
preparation, and food storage procedures. The purpose of such
nutrition education programs shall be to educate students in the
overall area of nutrition education and significantly reduce
health problems associated with poor or improper nutrition
practices.
4. Instruction in substance abuse prevention in kindergarten
through grade 12. Such instruction shall be designed to meet
local needs and priorities and shall articulate clear
instructional objectives aimed at the prevention of alcohol and
substance abuse. The instruction shall be appropriate for the
grade and age of the student and shall reflect current theory,
knowledge, and practice regarding prevention of substance abuse
and may contain instruction in such components as health,
personal, and economic consequences of substance abuse and
instruction in decisionmaking, resisting peer pressure, self-
concept building skills, and identifying and dealing with
situations that pose a risk to one's health and may lead to
substance abuse.
5. Instruction in the causes, transmission, and prevention of
human immunodeficiency virus infection and acquired immune
deficiency syndrome and other sexually transmissible diseases for
students. Such instruction shall be included in appropriate
middle school or junior high school health and science courses
and in life management skills and other high school courses. Any
student whose parent makes written request to the school
principal shall be exempt from reproductive health or AIDS
instructional activities, as requested. Curriculum frameworks for
comprehensive health education shall not interfere with the local
determination of appropriate curriculum which reflects local
values and concerns.
6. Upon approval by the district school board, an opportunity
for 9th-12th grade students to receive instruction in
cardiopulmonary resuscitation in order to become certified in
that technique. A school district may enter a cooperative
arrangement with a local government or nonprofit association to
provide training in cardiopulmonary resuscitation through
instructors certified in that technique.
7. Design and development of programs for the selection and
training of health education instructors from existing teaching
staff and the orientation to teaching roles for persons employed
in appropriate health fields and community volunteers.
8. Development of training programs to allow the use of school
food service personnel as resource persons.
9. Instruction in reproductive health, interpersonal skills,
and parenting to reduce teenage pregnancy and to promote healthy
behavior in Florida's children for all students in kindergarten
through grade 12, beginning with the 1991-1992 school year. In
order that children make informed and constructive decisions
about their lives, complete and accurate comprehensive health edu
cation shall be made available to all young people. Curriculum
shall be developed to reduce destructive behavior in children,
including early sexual involvement, substance abuse, suicide, and
activities which result in sexually transmitted diseases,
acquired immune deficiency syndrome, and early teenage pregnancy,
with subject materials appropriate to the grade level and values
consistent with those of the community. Instruction shall also
include an understanding of the body and its systems and
identification and prevention of child abuse in the lower grades
and decisionmaking in the middle and higher grades. Instruction
in human sexuality shall take into account the whole person,
shall present ethical and moral dimensions, shall not be an
expression of any one sectarian or secular philosophy, and shall
respect the conscience and rights of students and parents. School
districts and laboratory schools are encouraged to provide
written materials on reproductive health to parents, as well as
opportunities for parents to become informed about the
instruction their children are receiving and to receive
instruction themselves. All course materials and oral or visual
instruction shall conform to the requisites and intent of all
Florida law and the State Constitution. All instructional
materials, including teachers' manuals, films, tapes, or other
supplementary instructional material shall be available for
inspection by parents or guardians of the children engaged in
such classes.
10. Instruction in the benefits of sexual abstinence and
consequences of teenage pregnancy, sexually transmitted diseases,
and acquired immune deficiency syndrome in appropriate middle
school or junior high school health, science, and home economics
courses and in life management skills and other appropriate high
school courses. Curriculum frameworks shall be created or
modified as necessary to help ensure such instruction.
(5) DISTRICT PROGRAM RESPONSIBILITIES.
(a) Each school district shall designate one or more contact
persons to coordinate the district's comprehensive health
education and substance abuse prevention program and to receive
materials and information from the Prevention Resource Center.
District responsibilities may include cooperating with law
enforcement and alcohol abuse and substance abuse treatment
agencies and encouraging business and community involvement in
prevention activities. Each district shall plan for efficient use
of state resources and prevention center resources, including,
but not limited to, training programs for school personnel,
curriculum materials, and identification, referral, and legal
guidelines.
(b) Pursuant to policies and regulations to be adopted by the
Commissioner of Education, each district school board, laboratory
school, or consortium thereof shall submit to the commissioner a
proposed program designed to effectuate an exemplary compre
hensive health education and substance abuse prevention program
for kindergarten through grade 12. Such programs shall be
implemented no later than the 1988-1989 school year in each
public school within the district. The proposal shall include:
1. A statement of the nature of the comprehensive health
education and substance abuse prevention program proposed;
2. A provision for a sequential program of instruction in
comprehensive health education, including nutrition education and
substance abuse education, at the four progressional levels K-3,
4-6, 7-9, and 10-12. The sequential program shall be integrated
into the curriculum for each grade, kindergarten through 12, with
special emphasis in the middle grades. The program for kin
dergarten through grade 3 shall take into account the
developmental needs of young children and shall emphasize
personal health and safety;
3. The number of teachers and students to be involved;
4. A provision stating how the involvement of governmental
agencies and private organizations will be enlisted in order to
ensure the use of all available resources in the implementation
of the program;
5. An estimate of the cost;
6. A plan for evaluation of the program;
7. A plan for coordinating this program with student services
and dropout prevention, pursuant to the provisions of ss.
230.2313 and 230.2316, respectively, and other social services,
and for the provision of support activities for students in
treatment and those returning to school after treatment or
suspension;
8. A plan for integration of the program into the general
curricular and financial program of the district;
9. A provision for involvement by parents or legal guardians,
the community, and businesses; and
10. Such other information as the commissioner shall by
regulation require.
(6) TECHNICAL ASSISTANCE. Upon request of a district school
board, laboratory school, or consortium thereof, the department
shall provide such technical assistance as is necessary to
develop and submit a proposed program for comprehensive health
education and substance abuse prevention. The department shall
develop and make available to any requesting district school
board one or more model suggested programs for substance abuse
prevention, including recommended minimum number of hours of
instruction in substance abuse prevention appropriate for each
grade level, kindergarten through 12.
(7) PROGRAM REVIEW; FUNDING. The commissioner shall review and
approve, disapprove, or resubmit for modification all proposed
comprehensive health education and substance abuse prevention
programs submitted. Approval shall be based on the assurance that
components specified in this section have been met. For those
programs approved, the commissioner shall authorize distribution
of funds equal to the cost of the program from funds appropriated
to the Department of Education for comprehensive health education
and substance abuse prevention purposes.
(8) PROGRAM EVALUATION AND MONITORING.
The department shall monitor and evaluate the programs or
projects funded under subsection (7) and evaluate the overall
comprehensive health education and substance abuse prevention
program. The department shall collect, analyze, evaluate, and
disseminate to all school districts, laboratory schools, or
consortia thereof, resource information on effective
comprehensive health education and substance abuse programs.
Program evaluations shall include, but not be limited to, compo
nents for determining program or project effectiveness,
efficiency, and use of resources. A report on the overall
evaluation as well as recommendations for funding and any other
recommendations deemed to be appropriate by the commissioner
shall be included in the annual report of the Commissioner of
Education required under s. 229.575(1).
(9) NONPUBLIC PERSONNEL PERMITTED TO PARTICIPATE.-Teachers or
school administrators employed by a nonpublic school may
participate as students in inservice teacher education institutes
or curriculum development programs conducted pursuant to this
section, provided such participants assume the pro rata share of
the cost or charges for tuition.
(10) STUDENT EXEMPTION.-Any child whose parent presents to the
school principal a signed statement that the teaching of disease
and its symptoms, development, and treatment, and the use of
instructional aids and materials of such subjects, conflicts with
his religious beliefs shall be exempt from such instruction. No
child so exempt shall be penalized by reason of such exemption.
(11) USE OF FUNDS-In implementing this section, every effort
shall be made to combine funds appropriated for this purpose with
funds available from all other sources, federal, state, local, or
private, in order to achieve maximum benefits for improving
health education and substance abuse prevention.
(12) APPLICABILITY OF SUBSECTIONS (4) AND (10). -Subsections (4)
and (10) apply regardless of the extent to which the provisions
of those subsections are specifically funded in the General
Appropriations Act.
233.0672 Health education; instruction in acquired immune
deficiency syndrome.-
(1) Each district school board may provide instruction in
acquired immune deficiency syndrome education as a specific area
of health education. Such instruction may include, but not be
limited to, the known modes of transmission, signs and symptoms,
risk factors associated with acquired immune deficiency syndrome,
and means used to control the spread of acquired immune
deficiency syndrome. The instruction shall be appropriate for the
grade and age of the student and shall reflect current theory,
knowledge, and practice regarding acquired immune deficiency
syndrome and its prevention.
(2) Throughout instruction in acquired immune deficiency
syndrome, sexually transmitted diseases, or health education,
when such instruction and course material contains instruction in
human sexuality, a school shall:
(a) Teach abstinence from sexual activity outside of marriage as
the expected standard for all school-age children while teaching
the benefits of monogamous heterosexual marriage.
(b) Emphasize that abstinence from sexual activity is a certain
way to avoid out-of-wedlock pregnancy, sexually transmitted
diseases, including acquired immune deficiency syndrome, and
other associated health problems.
(c) Teach that each student has the power to control personal
behavior and encourage students to base actions on reasoning,
self-esteem, and respect for others.
(d) Provide instruction and material that is appropriate for the
grade and age of the student.
381.003 Communicable disease and acquired immune deficiency
syndrome prevention and control.
(1) The department shall conduct a communicable disease
prevention and control program as part of fulfilling its public
health mission. This program shall include, but is not limited
to:
(a) Programs for the prevention and control of tuberculosis in
accordance with chapter 392.
(b) Programs for the prevention and control of human
immunodeficiency virus infection and acquired immune deficiency
syndrome in accordance with chapter 384 and this chapter.
(c) Programs for the prevention and control of sexually
transmissible diseases in accordance with chapter 384.
(d) Programs for the prevention, control, and reporting of
diseases of public health significance as provided for in this
chapter.
(e) Programs for the prevention and control of vaccine-
preventable diseases, including programs to immunize school
children as required by s. 232.032.
(2) The department may adopt, repeal, and amend rules related to
the programs discussed in this section.
381.0031 Report of diseases of public health significance to
department.-
(1) Any attending practitioner, licensed in Florida to practice
medicine, osteopathic medicine, chiropractic, naturopathy, or
veterinary medicine, who diagnoses or suspects the existence of a
disease of public health significance shall immediately report
the fact to the Department of Health and Rehabilitative Services.
(2) Periodically the department shall issue a list of diseases
determined by it to be of public health significance within the
meaning of this chapter and shall furnish a copy of said list to
the practitioners listed in subsection (1).
(3) Reports required by this section shall be made on forms
furnished by the department.
(4) Information submitted in reports required by this section is
confidential, exempt from the provisions of s. 119.07(1), and
shall be made public only when necessary to public health. No
report so submitted shall be considered a violation of the
confidential relationship between practitioner and patient. This
exemption is subject to the Open Government Sunset Review Act in
accordance with s. 119.14.
381.0032 Epidemiological research.-
(1) The department may conduct studies concerning the
epidemiology of diseases of public health significance, such as
acquired immune deficiency syndrome and other diseases in
Florida. These studies may not duplicate national studies but
shall be designed to provide special insight and understanding
into Florida-specific problems given this state's unique climate
and geography, demographic mix, and high rate of immigration.
(2) Epidemiological studies designed by the department shall
emphasize practical applications and utility in the control of
diseases of public health significance, such as acute or chronic
diseases caused by infectious agents, host factors, or toxic
substances. These studies shall, to the maximum extent possible,
use state and local public health workers as field teams, study
design team members, reviewers, and co-authors. Epidemiological
studies conducted pursuant to this section shall be directed by
the State Health Officer or his designee.
(3) The department shall work with the various universities and
colleges in this state, including, but not limited to, the
College of Public Health at the University of South Florida, when
it deems it appropriate and necessary in carrying out such
studies.
381.0034 Requirement for instruction on human immunodeficiency
virus and acquired immune deficiency syndrome.-
(1) As of July 1, 1991, the Department of Health and
Rehabilitative Services shall require each person licensed or
certified under chapter 401, chapter 467, part IV of chapter 468,
or chapter 483, as a condition of biennial relicensure, to
complete an educational course approved by the department on the
modes of transmission, infection control procedures, clinical
management, and prevention of human immunodeficiency virus and
acquired immune deficiency syndrome. Such course shall include
information on current Florida law on acquired immune deficiency
syndrome and its impact on testing, confidentiality of test
results, and treatment of patients. Each such licensee or
certificateholder shall submit confirmation of having completed
said course, on a form provided by the department, when
submitting fees or application for each biennial renewal.
(2) Failure to complete the requirements of this section shall
be grounds for disciplinary action contained in the chapters
specified in subsection (1). In addition to discipline by the
department, the licensee or certificate-holder shall be required
to complete said course.
(3) The department shall require, as a condition of granting a
license under the chapters specified in subsection (1), that an
applicant making initial application for licensure complete an
educational course acceptable to the department on human
immunodeficiency virus and acquired immune deficiency syndrome.
An applicant who has not taken a course at the time of licensure
shall, upon an affidavit showing good cause, be allowed 6 months
to complete this requirement.
(4) The department shall have the authority to adopt rules to
carry out the provisions of this section.
(5) Any professional holding two or more licenses or
certificates subject to the provisions of this section shall be
permitted to show proof of having taken one department-approved
course on human immunodeficiency virus and acquired immune
deficiency syndrome, for purposes of relicensure or
recertification for the additional licenses.
(6) The department shall report to the Speaker of the House of
Representatives and the President of the Senate by March 1 of
each year as to the implementation of and compliance with the
requirements of this section.
381.0035 Educational course on human immunodeficiency virus and
acquired immune deficiency syndrome; employees and clients of
certain health care facilities.-
(1) The Department of Health and Rehabilitative Services shall
require all employees and clients of facilities licensed under
chapters 393, 394, and 397 and employees of facilities licensed
under chapter 395 and parts II,III, IV, and VI of chapter 400 to
complete, biennially, a continuing educational course on the
modes of transmission, infection control procedures, clinical
management, and prevention of human immunodeficiency virus and
acquired immune deficiency syndrome with an emphasis on
appropriate behavior and attitude change. Such instruction shall
include information on current Florida law and its impact on
testing, confidentiality of test results, and treatment of
patients.
(2) New employees shall be required to complete a course on
human immunodeficiency virus and acquired immune deficiency
syndrome, with instruction to include information on current
Florida law and its impact on testing, confidentiality of test
results, and treatment of patients.
(3) Facilities licensed under chapters 393, 394, 395, 397, and
parts 11,111, IV, and VI of chapter 400 shall maintain a record
of employees and dates of attendance at human immunodeficiency
virus and acquired immune deficiency syndrome educational
courses.
(4) The department shall have the authority to review the
records of each facility to determine compliance with the
requirements of this section. The department may adopt rules to
carry out the provisions of this section.
381.0036 Planning for implementation of educational requirements
concerning human immunodeficiency virus and acquired immune
deficiency syndrome for specified applicants for professional
licensure.-The Department of Professional Regulation and the
Department of Health and Rehabilitative Services are hereby
directed to begin planning for the implementation of the sections
of this act which require, as a part -of initial licensure,
applicants for certain specified professions to complete an
educational course on the transmission, control, treatment, and
prevention of human immunodeficiency virus and acquired immune
deficiency syndrome. Such planning shall include collecting
information from the facilities and programs which educate and
train the licensed professionals affected by the licensure
requirements of this act and shall also include developing rules
for the implementation of the licensure requirements.
381.0037 Findings; intent.-The Legislature finds that acquired
immune deficiency syndrome, otherwise known as AIDS, constitutes
a serious and unique danger to the public health and welfare. The
Legislature finds that acquired immune deficiency syndrome is
transmitted by sexual activity, by intravenous drug use, or from
an infected mother to a fetus and that public fear of contagion
from casual contact is not supported by any scientific evidence.
The Legislature finds that acquired immune deficiency syndrome is
transmitted by a retrovirus which makes the possibility of
development of an immunization or cure highly unlikely in the
near future. The Legislature finds that, once infected, there is
a high probability that an individual will develop acquired
immune deficiency syndrome or a related syndrome and die a
premature death as a result but may live productively for years
in a communicable state without showing any signs or symptoms of
illness. The Legislature finds the unique methods of transmission
of this disease and its inevitably fatal course have raised
public fears; changed the attitudes of employers, insurers, educa
tors, law enforcement personnel, and health and medical providers
about dealing with the disease; and unexpectedly raised the
medical costs of this state. The Legislature intends to establish
programs and requirements related to acquired immune deficiency
syndrome which carefully balance medical necessity, the right to
privacy, and protection of the public from harm and which estab
lish public programs for the care and treatment of persons with
acquired immune deficiency syndrome and related conditions.
381.0038 Education.-The Department of Health and Rehabilitative
Services shall establish a program to educate the public about
the threat of acquired immune deficiency syndrome.
()) The acquired immune deficiency syndrome education program
shall:
(a) Be designed to reach all segments of Florida's population;
(b) Contain special components designed to reach non-English-
speaking and other minority groups within the state;
(c) Impart knowledge to the public about methods of transmission
of acquired immune deficiency syndrome and methods of prevention;
(d) Educate the public about transmission risks in social,
employment, and educational situations;
(e) Educate health care workers and health facility employees
about methods of transmission and prevention in their unique
workplace environments;
(f) Contain special components designed to reach persons who may
frequently engage in behaviors placing them at a high risk for
acquiring acquired immune deficiency syndrome;
(g) Provide information and consultation to state agencies to
educate all state employees; and
(h) Provide information and consultation to state and local
agencies to educate law enforcement and correctional personnel
and inmates.
(i) Provide information and consultation to local governments to
educate local government employees.
(j) Make information available to private employers and
encourage them to distribute this information to their employees.
(k) Contain special components which emphasize appropriate
behavior and attitude change.
(2) The program designed by the Department of Health and
Rehabilitative Services shall utilize all forms of the media and
shall place emphasis on the design of educational materials that
can be used by businesses, schools, and health care providers in
the regular course of their business.
(3) The department may contract with other persons in the
design, development, and distribution of the components of the
education program.
381.0039 Oversight of acquired immune deficiency syndrome
education programs.-The Department of Education, the Department
of Health and Rehabilitative Services, and the Department of
Professional Regulation are directed to establish an interagency
agreement to oversee the quality and cost-efficiency of acquired
immune deficiency syndrome education programs being administered
in the state pursuant to chapters 381, 455, 943, and 945. The
interagency agreement shall also include development, where
appropriate, of methods for coordinating educational programs for
various professional groups. A report on the status of acquired
immune deficiency syndrome education programs shall be made to
the Legislature on or before March 1, 1990.
381.004 Testing for human immunodeficiency virus.
(1) LEGISLATIVE INTENT.-The Legislature finds that the use of
tests designed to reveal a condition indicative of human
immunodeficiency virus infection can be a valuable tool in
protecting the public health. The Legislature finds that despite
existing laws, regulations, and professional standards which
require or promote the informed, voluntary, and confidential use
of tests designed to reveal human immunodeficiency virus infec
tion, many members of the public are deterred from seeking such
testing because they misunderstand the nature of the test or fear
that test results will be disclosed without their consent, The
Legislature finds that the public health will be served by
facilitating informed, voluntary, and confidential use of tests
designed to detect human immunodeficiency virus infection.
(2) DEFINITIONS.-As used in this section:
(a) "HIV test" means a test ordered after July 6,1988, to
determine the presence of the antibody or antigen to human
immunodeficiency virus or the presence of human immunodeficiency
virus infection.
(b) "HIV test result" means a laboratory report of a human
immunodeficiency virus test result entered into a medical record
on or after July 6, 1988, or any report or notation in a medical
record of a laboratory report of a human immunodeficiency virus
test. As used in this section, the term "HIV test result" does
not include test results reported to a health care provider by a
patient.
(c) "Significant exposure" means:
1. Exposure to blood or body fluids through needlestick,
instruments, or sharps;
2. Exposure of mucous membranes to visible blood or body
fluids, to which universal precautions apply according to the
National Centers for Disease Control, including, without
limitations, the following body fluids:
a. Blood.
b. Semen.
c. Vaginal secretions.
d. Cerebro-spinal fluid (CSF).
e. Synovial fluid.
f. Pleural fluid.
g. Peritoneal fluid.
h. Pericardial fluid.
i. Amniotic fluid.
j. Laboratory specimens that contain HIV (e.g., suspensions of
concentrated virus); or
3. Exposure of skin to visible blood or body fluids, especially
when the exposed skin is chapped, abraded, or afflicted with
dermatitis or the contact is prolonged or involving an extensive
area.
(d) "Test subject" or "subject of the test" means the person
upon whom an HIV test is performed, or the person who has legal
authority to make health care decisions for the test subject.
(3) HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED CONSENT;
RESULTS; COUNSELING; CONFIDENTIALITY,-
(a) No person in this state shall perform a test designed to
identify the human immunodeficiency virus, or its antigen or
antibody, without first obtaining the informed consent of the
person upon whom the test is being performed, except as specified
in paragraph (i). Informed consent shall be preceded by an
explanation of the right to confidential treatment of information
identifying the subject of the test and the results of the test
to the extent provided by law. Consent need not be in writing
provided there is documentation in the medical record that the
test has been explained and the consent has been obtained.
(b) Except as provided in paragraph (i), informed consent must
be obtained from a legal guardian or other person authorized by
law when the person:
1. Is not competent or is otherwise unable to make an informed
judgment; or
2. Has not reached the age of majority, except as provided in
s. 384.30.
(c) No person shall order a test without making available to the
person tested, prior to the test, information regarding measures
for the prevention of, exposure to, and transmission of human
immunodeficiency virus. At the time an HIV test is ordered, the
person ordering the test shall schedule a return visit with the
test subject for the purpose of disclosing the test results and
conducting posttest counseling as described in paragraph (e).
(d) No test result shall be determined as positive, and no
positive test result shall be revealed to any person, without
corroborating or confirmatory tests being conducted, However,
preliminary test results may be released to licensed physicians
or the medical personnel subject to the significant exposure for
purposes of subparagraphs (i)10. and 11. Except as provided in
this section, test results are confidential and exempt from the
provisions of s. 119.07(1). This exemption is subject to the Open
Government Sunset Review Act in accordance with s. 119.14.
(e) No test result shall be revealed to the person upon whom the
test was performed without affording that person the immediate
opportunity for individual, face-to-face counseling about:
1. The meaning of the test results;
2. The possible need for additional testing;
3. Measures for the prevention of the transmission of the human
immunodeficiency virus infection;
4. The availability in the geographic area of any appropriate
health care services, including mental health care, and
appropriate social and support services;
5. The benefits of locating and counseling any individual by
whom the infected individual may have been exposed to the human
immunodeficiency virus infection and any individual whom the
infected individual may have exposed to such human
immunodeficiency virus infection; and
6. The availability, if any, of the services of public health
authorities with respect to locating and counseling any
individual described in subparagraph 5.
Except as provided in this section, test results are confidential
and exempt from the provisions of s. 119.07(1). This exemption is
subject to the Open Government Sunset Review Act in accordance
with s. 119.14.
(f) Except as provided in this section, the identity of any
person upon whom a test has been performed and test results are
confidential and exempt from the provisions of s. 119.07(1). This
exemption is subject to the Open Government Sunset Review Act in
accordance with s. 119.14, No person who has obtained or has
knowledge of a test result pursuant to this section may disclose
or be compelled to disclose the identity of any person upon whom
a test is performed, or the results of such a test in a manner
which permits identification of the subject of the test, except
to the following persons:
1. The subject of the test or the subject's legally authorized
representative.
2. Any person, including third-party payors, designated in a
legally effective release of the test results executed prior to
or after the test by the subject of the test or the subject's
legally authorized representative. The test subject may in
writing authorize the disclosure of the test subject's HIV test
results to third party payors, who need not be specifically
identified, and to other persons to whom the test subject
subsequently issues a general release of medical information, A
general release without such prior written authorization is not
sufficient to release HIV test results.
3. An authorized agent or employee of a health facility or
health care provider if the health facility or health care
provider itself is authorized to obtain the test results, the
agent or employee participates in the administration or provision
of patient care or handles or processes specimens of body fluids
or tissues, and the agent or employee has a need to know such
information, -The department shall adopt a rule defining which
persons have a need to know pursuant to this subparagraph.
4. Health care providers consulting between themselves or with
health care facilities to determine diagnosis and treatment, For
purposes of this subparagraph, health care providers shall
include licensed health care professionals employed by or
associated with state, county, or municipal detention facilities
when such health care professionals are acting exclusively for
the purpose of providing diagnoses or treatment of persons in the
custody of such facilities.
5. The department, in accordance with rules for reporting and
controlling the spread of disease, as otherwise provided by state
law.
6. A health facility or health care provider which procures,
processes, distributes, or uses:
a. A human body part from a deceased person, with respect to
medical information regarding that person; or
b. Semen provided prior to July 6,1988, for the purpose of
artificial insemination.
7. Health facility staff committees, for the purposes of
conducting program monitoring, program evaluation, or service
reviews pursuant to chapters 395 and 766.
8. Authorized medical or epidemiological researchers who may
not further disclose any identifying characteristics or
information.
9. A person allowed access by a court order which is issued in
compliance with the following provisions:
a. No court of this state shall issue such order unless the
court finds that the person seeking the test results has
demonstrated a compelling need for the test results which cannot
be accommodated by other means. In assessing compelling need, the
court shall weigh the need for disclosure against the privacy
interest of the test subject and the public interest which may be
disserved by disclosure which deters blood, organ, and semen
donation and future human immunodeficiency virus-related testing
or which may lead to discrimination. This paragraph shall not
apply to blood bank donor records.
b. Pleadings pertaining to disclosure of test results shall
substitute a pseudonym for the true name of the subject of the
test. The disclosure to the parties of the subject's true name
shall be communicated confidentially in documents not filed with
the court.
c. Before granting any such order, the court shall provide the
individual whose test result is in question with notice and a
reasonable opportunity to participate in the proceedings if he is
not already a party.
d. Court proceedings as to disclosure of test results shall be
conducted in camera, unless the subject of the test agrees to a
hearing in open court or unless the court determines that a
public hearing is necessary to the public interest and the proper
administration of justice.
e. Upon the issuance of an order to disclose test results, the
court shall impose appropriate safeguards against unauthorized
disclosure which shall specify the persons who may have access to
the information, the purposes for which the information shall be
used, and appropriate prohibitions on future disclosure.
10. A person allowed access by order of a judge of compensation
claims of the Division of Workers' Compensation of the Department
of Labor and Employment Security. A judge of compensation claims
shall not issue such order unless he finds that the person
seeking the test results has demonstrated a compelling need for
the test results which cannot be accommodated by other means.
11. Those employees of the department or of child-placing or
child-caring agencies or of family foster homes, licensed
pursuant to s. 409.175, who are directly involved in the
placement, care, control, or custody of such test subject and who
have a need to know such information; adoptive parents of such
test subject; or any adult custodian, any adult relative, or any
person responsible for the child's welfare, if the test subject
was not tested under subparagraph (b)2. and if a reasonable
attempt has been made to locate and inform the legal guardian of
a test result, The department shall adopt a rule to implement
this subparagraph.
12. Medical personnel who have been subject to a significant
exposure during the course of medical practice or in the
performance of professional duties, or individuals who are the
subject of the significant exposure as provided in subparagraphs
(i)10. and 11.
1(g) Except as provided in this section, the identity of a
person upon whom a test has been performed is confidential and
exempt from the provisions of s. 119.07(1). This exemption is
subject to the Open Government Sunset Review Act in accordance
with s. 119.14. No person to whom the results of a test have been
disclosed may disclose the test results to another person except
as authorized by this subsection and by ss. 951.27 and 960.003.
Whenever disclosure is made pursuant to this subsection, it shall
be accompanied by a statement in writing which includes the
following or substantially similar language: "This information
has been disclosed to you from records whose confidentiality is
protected by state law. State law prohibits you from making any
further disclosure of such information without the specific
written consent of the person to whom such information pertains,
or as otherwise permitted by state law, A general authorization
for the release of medical or other information is NOT sufficient
for this purpose," An oral disclosure shall be accompanied by
oral notice and followed by a written notice within 10 days,
except that this notice shall not be required for disclosures
made pursuant to subparagraphs (f)3. and 4.
(h) Human immunodeficiency virus test results contained in the
medical records of a hospital licensed under chapter 395 may be
released in accordance with s. 395.3025 without being subject to
the requirements of subparagraph (f)2., subparagraph (f)9., or
paragraph (g); provided the hospital has obtained written
informed consent for the HIV test in accordance with provisions
of this section.
(i) Notwithstanding the provisions of paragraph (a), informed
consent is not required:
1. When testing for sexually transmissible diseases is required
by state or federal law, or by rule including the following
situations:
a. HIV testing pursuant to s. 796.08 of persons convicted of
prostitution or of procuring another to commit prostitution.
b. Testing for HIV by a medical examiner in accordance with s.
406.11.
2. Those exceptions provided for blood, plasma, organs, skin,
semen, or other human tissue pursuant to s. 381.0041.
3. For the performance of an HIV-related test by licensed
medical personnel in bona fide medical emergencies when the test
results are necessary for medical diagnostic purposes to provide
appropriate emergency care or treatment to the person being
tested and the patient is unable to consent, as supported by
documentation in the medical record. Posttest counseling is
required.
4. For the performance of an HIV-related test by licensed
medical personnel for medical diagnosis of acute illness where,
in the opinion of the attending physician, obtaining informed
consent would be detrimental to the patient, as supported by
documentation in the medical record, and the test results are
necessary for medical diagnostic purposes to provide appropriate
care or treatment to the person being tested. Posttest counseling
is required if it would not be detrimental to the patient. This
subparagraph does not authorize the routine testing of patients
for HIV infection without informed consent.
5. When HIV testing is performed as part of an autopsy for
which consent was obtained pursuant to s. 872.04.
6. For the performance of an HIV test upon a defendant pursuant
to the victim's request in a prosecution for any type of sexual
battery where a blood sample is taken from the defendant
voluntarily, pursuant to court order for any purpose, or pursuant
to the provisions of s. 775.0877, s. 951.27, or s. 960.003;
however, the results of any HIV test performed shall be disclosed
solely to the victim and the defendant, except as provided in ss.
775.0877, 951.27, and 960.003.
7. When an HIV test is mandated by court order.
8. For epidemiological research pursuant to s. 381.0032, for
research consistent with institutional review boards created by
45 C.F.R. part 46, or for the performance of an HIV-related test
for the purpose of research, if the testing is performed in a
manner by which the identity of the test subject is not known and
may not be retrieved by the researcher.
9. When human tissue is collected lawfully without the consent
of the donor for corneal removal as authorized by s. 732.9185 or
enucleation of the eyes as authorized by s. 732.919.
10. For the performance of an HIV test upon an individual who
comes into contact with medical personnel in such a way that a
significant exposure has occurred during the course of employment
or within the scope of practice and where a blood sample is taken
from that individual voluntarily by medical personnel for other
purposes. 'Medical personnel" includes a licensed or certified
health care professional; an employee of a health care
professional, health care facility, or blood bank; and a
paramedic or emergency medical technician as defined in s.
401.23.
a. Prior to performance of an HIV test on a voluntarily
obtained blood sample, the individual from whom the blood was
obtained shall be requested to consent to the performance of the
test and to the release of the results. The individual's refusal
to consent and all information concerning the performance of an
HIV test and any HIV test result shall be documented only in the
medical personnel's record unless the individual gives written
consent to entering this information on the individual's medical
record.
b. Reasonable attempts to locate the individual and to obtain
consent shall be made and all attempts must be documented. If the
individual cannot be found, an HIV test may be conducted on the
available blood sample. If the individual does not voluntarily
consent to the performance of an HIV test, the individual shall
be informed that an HIV test will be performed, and counseling
shall be furnished as provided in this section. However, HIV
testing shall be conducted only after a licensed physician
documents, in the medical record of the medical personnel, that
there has been a significant exposure and that, in the
physician's medical judgment, the information is medically
necessary to determine the course of treatment for the medical
personnel.
c. Costs of any HIV test of a blood sample performed with or
without the consent of the individual, as provided in this
subparagraph, shall be borne by the medical personnel or the
employer of the medical personnel. However, costs of testing or
treatment not directly related to the initial HIV tests or costs
of subsequent testing or treatment shall not be borne by the
medical personnel or the employer of the medical personnel.
d. In order to utilize the provisions of this subparagraph, the
medical personnel must either be tested for HIV pursuant to this
section or provide the results of an HIV test taken within 6
months prior to the significant exposure if such test results are
negative.
e. A person who receives the results of an HIV test pursuant to
this subparagraph shall maintain the confidentiality of the
information received and of the persons tested. Such confidential
information is exempt from s. 119.07(1). The exemption from s.
119.07(1) provided by this sub-subparagraph is subject to the
Open Government Sunset Review Act in accordance with s. 119.14.
11. For the performance of an HIV test upon an individual who
comes into contact with medical personnel in such a way that a
significant exposure has occurred during the course of employment
or within the scope of practice of the medical personnel while
the medical personnel provides emergency medical treatment to the
individual; or who comes into contact with nonmedical personnel
in such a way that a significant exposure has occurred while the
nonmedical personnel provides emergency medical assistance during
a medical emergency. For the purposes of this subparagraph, a
medical emergency means an emergency medical condition outside of
a hospital or health care facility that provides physician care.
The test may be performed only during the course of treatment for
the medical emergency.
a. An individual who is capable of providing consent shall be
requested to consent to an HIV test prior to the testing. The
individual's refusal to consent, and all information concerning
the performance of an HIV test and its result, shall be
documented only in the medical personnel's record unless the
individual gives written consent to entering this information on
the individual's medical record.
b. HIV testing shall be conducted only after a licensed
physician documents, in the medical record of the medical
personnel or nonmedical personnel, that there has been a
significant exposure and that, in the physician's medical
judgment, the information is medically necessary to determine the
course of treatment for the medical personnel or nonmedical
personnel.
c. Costs of any HIV test performed with or without the consent
of the individual, as provided in this subparagraph, shall be
borne by the medical personnel or the employer of the medical
personnel or nonmedical personnel. However, costs of testing or
treatment not directly related to the initial HIV tests or costs
of subsequent testing or treatment shall not be borne by the
medical personnel or the employer of the medical personnel or
nonmedical personnel.
d. In order to utilize the provisions of this subparagraph, the
medical personnel or nonmedical personnel shall be tested for HIV
pursuant to this section or shall provide the results of an HIV
test taken within 6 months prior to the significant exposure if
such test results are negative.
e. A person who receives the results of an HIV test pursuant to
this subparagraph shall maintain the confidentiality of the
information received and of the persons tested. Such confidential
information is exempt from s. 119.07(1). The exemption from s.
119.07(1) provided by this sub-subparagraph is subject to the
Open Government Sunset Review Act in accordance with s. 119.14.
12. For the performance of an HIV-related test medically
indicated by licensed medical personnel for medical diagnosis of
a hospitalized infant as necessary to provide appropriate care
and treatment of the infant when, after a reasonable attempt, a
parent cannot be contacted to provide consent. The medical
records of the infant shall reflect the reason consent of the
parent was not initially obtained. Test results and posttest
counseling shall be provided to the parent when the parent is
located.
(4) PUBLIC HEALTH UNIT NETWORK OF VOLUNTARY HUMAN
IMMUNODEFICIENCY VIRUS TESTING PROGRAMS.-
(a) The Department of Health and Rehabilitative Services shall
establish a network of voluntary human immunodeficiency virus
testing programs in every county in the state, These programs
shall be conducted in each public health unit established under
the provisions of chapter 154, part I. Additional programs may be
contracted to other private providers to the extent that finances
permit and local circumstances dictate.
(b) Each public health unit shall have the ability to provide
counseling and testing for human immunodeficiency virus to each
patient who receives services and shall offer such testing on a
voluntary basis to each patient who presents himself for services
in a public health program designated by the State Health Officer
by rule.
(c) Each public health unit shall provide a program of
counseling and testing for human immunodeficiency virus
infection, on an anonymous or confidential basis, dependent on
the patient's desire, The Department of Health and Rehabilitative
Services or its designated agent shall continue to provide for
anonymous testing through an alternative testing site program
with sites throughout all areas of the state, Except as provided
in this section, the identity of a person upon whom a test has
been performed and test results are confidential and exempt from
the provisions of s. 119.07(1). This exemption is subject to the
Open Government Sunset Review Act in accordance with s. 119,14.
(d) The result of a serologic test conducted under the auspices
of the Department of Health and Rehabilitative Services shall not
be used to determine if a person may be insured for disability,
health, or life insurance or to screen or determine suitability
for, or to discharge a person from, employment. Any person who
violates the provisions of this subsection is guilty of a
misdemeanor of the first degree, punishable as provided in s.
775.082 or s. 775.083.
(5) HUMAN IMMUNODEFICIENCY VIRUS TESTING REQUIREMENTS;
REGISTRATION WITH THE DEPARTMENT OF HEALTH AND REHABILITATIVE
SERVICES; EXEMPTIONS FROM REGISTRATION.-No public health unit and
no other person in this state shall conduct or hold themselves
out to the public as conducting a testing program for acquired
immune deficiency syndrome, acquired immune deficiency syndrome
related complex, or human immunodeficiency virus status without
first registering with the Department of Health and
Rehabilitative Services, complying with all other applicable
provisions of state law, and meeting the following requirements:
(a) The program must be directed by a person with a minimum
number of contact hours of experience in the counseling of
persons with acquired immune deficiency syndrome, acquired immune
deficiency syndrome related complex, or human immunodeficiency
virus infection, as established by the Department of Health and
Rehabilitative Services by rule.
(b) The program must have all medical care supervised by a
physician licensed under the provisions of chapter 458 or chapter
459.
(c) The program shall have all laboratory procedures performed
in a laboratory licensed under the provisions of chapter 483.
(d) The program must meet all the informed consent criteria
contained in subsection (3).
(e) The program must provide pretest counseling on the meaning
of a test for human immunodeficiency virus, including medical
indications for the test; the possibility of false positive or
false negative results; the potential need for confirmatory
testing; the potential social, medical, and economic consequences
of a positive test result; and the need to eliminate high-risk
behavior.
(f) The program must provide supplemental corroborative testing
on all positive test results before the results of any positive
test are provided to the patient. Except as provided in this
section, the identity of any person upon whom a test has been
performed and test results are confidential and exempt from the
provisions of s. 119.07(1). This exemption is subject to the Open
Government Sunset Review Act in accordance with s. 119.14.
(g) The program must provide face-to-face posttest counseling on
the meaning of the test results; the possible need for additional
testing; the social, medical, and economic consequences of a
positive test result; and the need to eliminate behavior which
might spread the disease to others.
(h) Each person providing posttest counseling to a patient with
a positive test result shall receive specialized training, to be
specified by rule of the department, about the special needs of
persons with positive results, including recognition of possible
suicidal behavior, and shall refer the patient for further health
and social services as appropriate.
(i) When services are provided for a charge during pretest
counseling, testing, supplemental testing, and posttest
counseling, the program must provide a complete list of all such
charges to the patient and the Department of Health and
Rehabilitative Services.
(j) Nothing in this subsection shall be construed to require a
facility licensed under chapter 483 or a person licensed under
the provisions of chapter 457, chapter 458, chapter 459, chapter
460, chapter 461, chapter 466, or chapter 467 to register with
the Department of Health and Rehabilitative Services if he does
not advertise or hold himself out to the public as conducting
testing programs for human immunodeficiency virus infection or
specializing in such testing.
(6) PENALTIES.
(a) Any violation of this section by a facility or licensed
health care provider shall be a ground for disciplinary action
contained in the facility's or professional's respective
licensing chapter.
(b) Any person who intentionally violates the confidentiality
provisions of this section and s. 951.27 is guilty of a
misdemeanor of the second degree, punishable as provided in s.
775.082 or s. 775.083. This exemption is subject to the Open
Government Sunset Review Act in accordance with s. 119.14.
(7) EXEMPTIONS. Except as provided in paragraph (4)(d) and ss.
627.429 and 641.3007, insurers and others participating in
activities related to the insurance application and underwriting
process shall be exempt from this section.
(8) MODEL PROTOCOL FOR COUNSELING AND TESTING FOR HUMAN
IMMUNODEFICIENCY VIRUS.
The Department of Health and Rehabilitative Services shall
develop a model protocol consistent with the provisions of this
section for counseling and testing persons for the human
immunodeficiency virus.
(9) FEES.-
(a) Each person or private organization registered as an AIDS or
HIV testing site shall pay the department a fee which shall be
set by rule of the department.
(b) Fees established pursuant to paragraph (a) shall be an
amount sufficient to meet all costs incurred by the department in
carrying out its registration, data collection, complaint
monitoring, and administrative responsibilities under this
section, for all private AIDS or HIV testing sites, but shall not
exceed $100.
(c) No other fees shall be charged by other governmental
agencies for these purposes.
(10) RULES.-The Department of Health and Rehabilitative Services
may adopt such rules as are necessary to implement this section.
(11) TESTING AS A CONDITION OF TREATMENT OR ADMISSION.-
(a) It is unlawful for any facility the operation of which, or
for any person engaged in an occupation the practice of which,
requires a license by the Agency for Health Care Administration,
the Department of Health and Rehabilitative Services, or the
Department of Professional Regulation, to require any person to
take or submit to a human immunodeficiency virus-related test as
a condition of admission to any such facility or as a condition
of purchasing or obtaining any service or product for which the
license is required. This subsection shall not be construed to
prohibit any physician in good faith from declining to provide a
particular treatment requested by a patient if the
appropriateness of that treatment can only be determined through
a human immunodeficiency virus-related test.
(b) The Agency for Health Care Administration, the Department of
Health and Rehabilitative Services, and the Department of
Professional Regulation shall adopt rules implementing this
subsection.
(c) Any violation of this subsection or the rules implementing
it shall be punishable as provided in subsection (6).
381.0041 Donation and transfer of human tissue; testing
requirements.
(1) Every donation of blood, plasma, organs, skin, or other
human tissue for transfusion or transplantation to another shall
be tested prior to transfusion or other use for human
immunodeficiency virus infection and other communicable diseases
specified by rule of the Department of Health and Rehabilitative
Services. Tests for the human immunodeficiency virus infection
shall be performed only after obtaining written, informed consent
from the potential donor or the donor's legal representative.
Such consent may be given by a minor pursuant to s. 743.06.
Obtaining consent shall include a fair explanation of the
procedures to be followed and the meaning and use of the test
results, Such explanation shall include a description of the
confidential nature of the test as described in s 381.004(3). If
consent for testing is not given, then the person shall not be
accepted as a donor except as otherwise provided in subsection
(3).
(2) Notwithstanding the provisions of subsection (1), written,
informed consent to perform testing shall not be required:
(a) When the blood, plasma, organ, skin, or other human tissue
is received for processing or testing from an out-of-state blood
bank;
(b) When blood or tissue is received from a health care facility
or health care provider for reference testing or processing and
the results of such test are reported back to the facility or
provider; or
(c) When an unrevoked anatomical gift has been made pursuant to
s. 732.914, by will or other written instrument, and the donor is
deceased or incompetent.
(3) No person shall collect any blood, organ, skin, or other
human tissue from one human being and hold it for, or actually
perform, any implantation, transplantation, transfusion,
grafting, or any other method of transfer to another human being
without first testing such tissue for the human immunodeficiency
virus and other communicable diseases specified by rule of the
Department of Health and Rehabilitative Services, or without
performing another process approved by rule of the Department of
Health and Rehabilitative Services capable of killing the
causative agent of those diseases specified by rule. Such testing
shall not be required:
(a) When there is insufficient time to perform testing because
of a life-threatening emergency circumstance and the blood is
transferred with the recipient's informed consent.
(b) For a donation of semen made by the spouse of a recipient
for the purposes of artificial insemination or other reproductive
procedure.
(c) When there is insufficient time to obtain the results of a
confirmatory test for any tissue or organ which is to be
transplanted, notwithstanding the provisions of s. 381.004(3)(d).
In such circumstances, the results of preliminary screening tests
may be released to the potential recipient's treating physician
for use in determining organ or tissue suitability.
(4) All human blood, organs, skin, or other human tissue which
is to be transfused or transplanted to another and is found
positive for human immunodeficiency virus or other communicable
disease specified by rule of the Department of Health and
Rehabilitative Services shall be rendered noncommunicable by the
person holding the tissue or shall be destroyed, unless the human
tissue is specifically labeled to identify the human immu
nodeficiency virus and:
(a) Is used for research purposes; or
(b) Is used to save the life of another and is transferred with
the recipient's informed consent.
(5) Each person who collects human blood, organs, skin, or other
human tissue who finds evidence after confirmatory testing of
human immunodeficiency virus in the donor shall notify the donor
of the presence of the virus. When notifying the donor pursuant
to this requirement, the donor shall be provided the following
information:
(a) The meaning of the test results;
(b) Measures for the prevention of the transmission of the human
immunodeficiency virus;
(c) The availability in the geographic area of any appropriate
health care services, including mental health care, and
appropriate social and support services;
(d) The benefits of locating and counseling any individual by
whom the infected individual may have been exposed to human
immunodeficiency virus and any individual whom the infected
individual may have exposed to the virus; and
(e) The availability, if any, of the services of public health
authorities with respect to locating and counseling any
individual described in paragraph (d).
(6) Human immunodeficiency virus tests performed pursuant to
autologous blood donations which have not been confirmed as
positive by confirmatory testing may be revealed to the donor's
treating physician when such test results may be necessary for
the diagnosis, treatment, or care of the donor.
(7) Any blood donor who tests positive for human
immunodeficiency virus based upon confirmatory testing shall be
notified in the following manner:
(a) The donor shall be sent written notification by certified
mail that abnormal test results exist with respect to his blood
donation, and the blood bank shall offer the opportunity to
discuss the nature and significance of the findings by telephone
or in person.
(b) If the blood bank does not receive a response from the donor
within 30 days, it shall send the actual test results and the
information required by subsection (5) to the donor by certified
mail.
(8) The Department of Health and Rehabilitative Services shall
develop, in conjunction with persons who collect human tissue, a
model protocol for providing the information required in
subsection (5).
(9) All blood banks shall be governed by the confidentiality
provisions of s. 381.004(3). This exemption is subject to the
Open Government Sunset Review Act in accordance with s. 119.14.
(10) The Department of Health and Rehabilitative Services is
authorized to adopt rules to implement this section. In adopting
rules pertaining to this section, the department shall consider
the rules of the United States Food and Drug Administration and
shall conform to those rules to the extent feasible without
jeopardizing the public health.
(11)(a) Any person who fails to test blood, plasma, organs, skin,
or other human tissue which is to be transfused or transplanted,
or violates the confidentiality provisions required by this
section, is guilty of a misdemeanor of the first degree,
punishable as provided in s. 775.082 or s. 775.083. This
exemption is subject to the Open Government Sunset Review Act in
accordance with s. 119.14.
(b) Any person who has human immunodeficiency virus infection,
who knows he is infected with human immunodeficiency virus, and
who has been informed that he may communicate this disease by
donating blood, plasma, organs, skin, or other human tissue who
donates blood, plasma, organs, skin, or other human tissue is
guilty of a felony of the third degree, punishable as provided in
s. 775.082, s. 775.083, or s. 775.084.
(12) Prior to the transplant of an organ or artificial
insemination, the institution or physician responsible for
overseeing the procedure must provide the prospective recipient a
warning as to the risks of contracting human immunodeficiency
virus.
381.0042 Patient care for persons with human immunodeficiency
virus infection.-The department may establish acquired immune
deficiency syndrome patient care networks in each region of the
state where the numbers of cases of acquired immune deficiency
syndrome and other human immunodeficiency virus infections
justifies the establishment of cost-effective regional patient
care networks. Such networks shall be delineated by rule of the
department which shall take into account natural trade areas and
centers of medical excellence that specialize in the treatment of
acquired immune deficiency syndrome, as well as available fed
eral, state, and other funds. Each patient care network shall
include representation of persons with human immunodeficiency
virus infection; health care providers; business interests; the
department, including, but not limited to, public health units;
and local units of government, Each network shall plan for the
care and treatment of persons with acquired immune deficiency
syndrome and acquired immune deficiency syndrome related complex
in a cost-effective, dignified manner which emphasizes outpatient
and home care. Once each year, beginning April 1989, each network
shall make its recommendations concerning the needs for patient
care to the department.
381.045 Hepatitis B or human immunodeficiency carriers.-The
Department of Health and Rehabilitative Services shall have the
authority to establish procedures to handle, counsel, and provide
other services to health care professionals licensed or certified
under chapter 401, chapter 467, part IV of chapter 468, and
chapter 483 who are infected with hepatitis B or the human
immunodeficiency virus.
381.0601 Self-derived and directed-donor blood programs.
(1) Any person residing in this state shall be entitled and
allowed to participate in a program to donate his own blood, in
order to have such blood available for autologous, or self-
derived, transfusion at the time of a planned medical need.
(2) Any person residing in this state shall be entitled and
allowed to participate in a directed-donor blood program to
donate the blood of specific donors for use by a designated
recipient, in order to have such blood available for blood
transfusions at the time of a planned medical need.
(3) Such blood shall not be administered to any other individual
until such time as the designated recipient no longer has a need
for the blood, after which time the blood shall revert to the
blood bank's general account, except that in the event of a
medical emergency, such blood from a designated donor may be used
to meet the emergency need.
CHAPTER 384 SEXUALLY TRANSMISSIBLE DISEASES
384.21 Short title.-This chapter may be cited as the "Control
of Sexually Transmissible Disease Act."
384.22 Findings; intent.-The Legislature finds and declares
that sexually transmissible diseases constitute a serious and
sometimes fatal threat to the public and individual health and
welfare of the people of the state and to visitors to the state.
The Legislature finds that the incidence of sexually
transmissible diseases is rising at an alarming rate and that
these diseases result in significant social, health, and economic
costs, including infant and maternal mortality, temporary and
lifelong disability, and premature death. The Legislature finds
that sexually transmissible diseases, by their nature, involve
sensitive issues of privacy, and it is the intent of the
Legislature that all programs designed to deal with these
diseases afford patients privacy, confidentiality, and dignity.
The Legislature finds that medical knowledge and information
about sexually transmissible diseases are rapidly changing. The
Legislature intends to provide a program that is sufficiently
flexible to meet emerging needs, deals efficiently and
effectively with reducing the incidence of sexually transmissible
diseases, and provides patients with a secure knowledge that
information they provide will remain private and confidential.
384.23 Definitions.-
(1) "Department" means the Department of Health and
Rehabilitative Services.
(2) "County public health unit means agencies and entities as
designated in chapter 154.
(3) "Sexually transmissible disease" means a bacterial, viral,
fungal, or parasitic disease, determined by rule of the
department to be sexually transmissible, to be a threat to the
public health and welfare, and to be a disease for which a
legitimate public interest will be served by providing for
regulation and treatment. In considering which diseases are to be
designated as sexually transmissible diseases, the department
shall consider such diseases as chancroid, gonorrhea, granuloma
inguinale, lymphogranuloma venereum, genital herpes simplex,
chlamydia, nongonococcal urethritis (NGU), pelvic inflammatory
disease (PID)/acute salpingitis, syphilis, and human immune
deficiency virus infection for designation, and shall consider
the recommendations and classifications of the centers for
disease control and other nationally recognized medical
authorities. Not all diseases that are sexually transmissible
need be designated for the purposes of this act.
384.24 Unlawful acts.-It is unlawful for any person who has
chancroid, gonorrhea, granuloma inguinale, lymphogranuloma
venereum, genital herpes simplex, chlamydia, nongonococcal
urethritis (NGU), pelvic inflammatory disease (PID)/acute
salpingitis, syphilis, or human immune deficiency virus
infection, when such person knows he is infected with one or more
of these diseases and when such person has been informed that he
may communicate this disease to another person through sexual
intercourse, to have sexual intercourse with any other person,
unless such other person has been informed of the presence of the
sexually transmissible disease and has consented to the sexual
intercourse.
384.25 Reporting required.-
(1) Each person who makes a diagnosis of or treats a person with
a sexually transmissible disease and each laboratory that
performs a test for a sexually transmissible disease which
concludes with a positive result shall report such facts as may
be required by the department by rule, within a time period as
specified by rule of the department, but in no case to exceed 2
weeks.
(2) The department shall adopt rules specifying the information
required in and a minimum time period for reporting a sexually
transmissible disease. In adopting such rules, the department
shall consider the need for information, protections for the
privacy and confidentiality of the patient, and the practical
ability of persons and laboratories to report in a reasonable
fashion.
(3) The department shall require reporting of physician
diagnosed cases of acquired immune deficiency syndrome (AIDS) and
AIDS related complex based upon diagnostic criteria from the
Centers for Disease Control of the United States Public Health
Service. The department may authorize county public health units
to accept reports of cases of human immunodeficiency virus infec
tion by October 1, 1989. However, in the case of human
immunodeficiency virus reports, the department is prohibited from
requiring the reporting of or collection of any information which
would identify individual persons, including: name, address,
identifying numbers or symbols, or any other identifying
information except as authorized in subsection (4).
(4) The department may require physician reporting of human
immunodeficiency virus infection with information sufficient to
identify the test subject in those instances in which the test
subject has authorized the physician to disclose such information
to the county public health unit for the purposes of partner
notification and contact investigation pursuant to s. 384.26, How
ever, only reports of human immunodeficiency virus infection
identified on or after the effective date of the rule developed
by the department pursuant to this subsection shall be accepted.
Such rule shall only be adopted by the department when federal
funds are made available for the purposes of partner notification
and contact investigation. The reporting may not affect or relate
to anonymous human immunodeficiency virus testing programs
conducted pursuant to s. 381.004(4) or university-based medical
research protocols which include partner notification and contact
investigation as determined by the department. Human immunodefi
ciency virus reports shall include patient names and name
identifiers, shall be maintained in the form of individual client
records, and shall not be maintained in the form of a roster of
names. The department shall require county public health units to
submit periodically to the State Health Officer or his designee
demographic information compiled from reports of human immunodefi
ciency virus infection.
(5) After notification of the test subject pursuant to
subsection (4), the department may, with the consent of the test
subject, notify school superintendents of students and school
personnel whose human immunodeficiency virus tests are positive.
School superintendents shall maintain the confidentiality of the
report information, and the information shall be released only in
an emergency situation which results in a significant exposure by
students or school personnel to the blood or body fluids of the
person for whom a positive test result has been obtained. Such
information shall be released only to persons who have
experienced a significant exposure, and such persons shall comply
with the confidentiality provisions of s. 384.29.
(6) The department shall by February 1 of each year submit to
the Legislature an annual report relating to all information
obtained pursuant to this section.
(7) The rules promulgated by the department pursuant to this
section shall specify the protocols for the reporting required by
or permitted by subsections (3) or (4). The protocol developed
for implementation of subsection (4) shall include but not be
limited to: information to be given to a test subject during
pretest counseling, setting forth the partner notification and
contact investigation services available through county public
health units, the benefits of such services, and the confidential
ity protections available as part of such services.
(8) Each person who violates the provisions of this section or
the rules adopted hereunder may be fined by the department up to
$500 for each offense. The department shall report each violation
of this section to the regulatory agency responsible for
licensing each health care professional and each laboratory to
which these provisions apply.
384.26 Contact investigation.
(1) The department and its authorized representatives may
interview, or cause to be interviewed, all persons infected or
suspected of being infected with a sexually transmissible disease
for the purpose of investigating the source and spread of the
disease and for the purpose of ordering a person to submit to
examination and treatment as necessary.
1(2) All information gathered in the course of contact
investigation shall be confidential and exempt from the
provisions of s. 119.07(1), and subject to the provisions of s.
384.29. This exemption is subject to the Open Government Sunset
Review Act in accordance with s. 119.14.
(3) No person who is infected with a sexually transmissible
disease, or suspected of an infection, who reveals the name or
names of sexual contacts during the course of an investigation
shall be held liable in a civil action for such revelation,
unless the revelation is made falsely or with reckless disregard
for the truth.
384.27 Physical examination and treatment.
(1) Subject to the provisions of subsections (3) and (4), the
department and its authorized representatives may examine or
cause to be examined persons suspected of being infected with or
exposed to a sexually transmissible disease.
(2) Subject to the provisions of subsections (3) and (4),
persons with a sexually transmissible disease shall report for
appropriate treatment to a physician licensed under the
provisions of chapter 458 or chapter 459, or shall submit to
treatment at a county public health unit or other public
facility.
(3) No person shall be apprehended, examined, or treated for a
sexually transmissible disease against his will, except upon the
order of a court of competent jurisdiction. In petitioning the
court for a hearing for such an order, the department shall show
by clear and convincing evidence that a threat to the public's
health and welfare exists unless such order is issued and shall
show that all other reasonable means of obtaining compliance have
been exhausted and that no other less restrictive alternative is
available.
(4) No order requiring a person to be examined or treated for a
sexually transmissible disease shall be issued unless:
(a) A hearing has been held of which the person has received at
least 72 hours' prior written notification and unless the person
has received a list of the proposed actions to be taken and the
reasons for each one.
(b) The person has the right to attend the hearing, to cross-
examine witnesses, and to present evidence.
(c) The person has a right to an attorney to represent him, and
to have an attorney appointed on his behalf if he cannot afford
one.
(5) In issuing an order requiring a person to be examined or
treated, the court may, at the request of the department and upon
a showing of good cause, also order the person to participate in
a designated education or counseling program, or appear before
the department at regular intervals for periodic retesting, or
both, as the court determines appropriate based on the person's
actions, statements, and risk to the public.
(6) When a sexually transmissible disease is not capable of
being treated on an outpatient basis in order to render it
noncommunicable, or when a sexually transmissible disease can be
treated only by requiring hospitalization, placement in a
residential facility, or other similar methods, the provisions of
s. 384.28 rather than this section shall be applied. However, a
person may be examined for this type of sexually transmissible
disease under the provisions of this section.
384.28 Hospitalization, placement, and residential isolation.-
(1) Subject to the provisions of subsections (2) and (3), the
department may petition the circuit court to order a person to be
isolated, hospitalized, placed in another health care or
residential facility, or isolated from the general public in his
own or another's residence, or a place to be made off limits to
the public as a result of the probable spread of a sexually
transmissible disease, until such time as the condition can be
corrected or the threat to the public's health eliminated or
reduced in such a manner that a substantial threat to the
public's health no longer exists.
(2) No person may be ordered to be isolated, hospitalized,
placed in another health care or residential facility, or
isolated from the public in his own or another's residence, and
no place may be ordered to be made off limits, except upon the
order of a court of competent jurisdiction and upon proof:
(a) By the department by clear and convincing evidence that the
public's health and welfare are significantly endangered by a
person with a sexually transmissible disease or by a place where
there is a significant amount of sexual activity likely to spread
a sexually transmissible disease;
(b) That the person with the sexually transmissible disease has
been counseled about the disease, about the significant threat
the disease poses to other members of the public, and about
methods to minimize the -risk to the public and despite such
counseling indicates an intent to expose the public to infection
from the sexually transmissible disease; and
(c) That all other reasonable means of correcting the problem
have been exhausted and no less restrictive alternative exists.
(3) No person may be ordered to be hospitalized, placed in
another health care or residential facility, or isolated in his
own or another's residence by a court unless:
(a) A hearing has been held of which the person has received at
least 72 hours' prior written notification and unless the person
has received a list of the proposed actions to be taken and the
reasons for each one.
(b) The person has the right to attend the hearing, to cross-
examine witnesses, and to present evidence.
(c) The person has a right to an attorney to represent him, and
to have an attorney appointed on his behalf if he cannot afford
one.
(4) An order for hospitalization, placement in another health or
residential facility, or isolation from the general public in his
own or another's residence, if issued, will be valid for no more
than 120 days, or for a shorter period of time if the department,
or the court upon petition, determines that the person no longer
poses a substantial threat to the community. Orders for
hospitalization, placement, or isolation in a residence may
contain additional requirements for adherence to a treatment plan
or participation in counseling or education programs as
appropriate. Such orders may not be renewed without affording the
person all rights conferred in subsections (2) and (3).
(5) No order for hospitalization or placement in another health
care or residential facility may require the placement of a
person under the age of 18 years in a unit of a facility where
adults reside or have been hospitalized or placed.
(6) No order for hospitalization or placement in another health
care or residential facility shall require the placement of a
person in a facility designated for the treatment of acquired
immune deficiency syndrome, acquired immune deficiency syndrome
related complex, or human immunodeficiency virus infection when
that facility contains the maximum number of persons for which
the Legislature has appropriated funds in the annual
appropriations act.
(7) The department is authorized to establish, directly or by
contract, facilities to serve persons ordered to be hospitalized
or placed in another health care or residential facility pursuant
to a court order under this section.
(8) The court, counsel, and local law enforcement officials, as
appropriate, shall consult with the department to determine
advisable infection control procedures to be taken during any
court hearing or detention concerning a person infected with a
sexually transmissible disease.
384.281 Prehearing detention.-
(1) The department may file a petition before a circuit court
requesting that a prehearing detention order be placed on a
person when the department provides evidence that:
(a) The person is infected with a sexually transmitted disease;
(b) The person is engaging in behaviors which create an
immediate and substantial threat to the public;
(c) The person evidences an intentional disregard for the health
of the public and refuses to conduct himself in such a manner as
to not place others at risk; and
(d)1. The person will not appear at a hearing scheduled under s.
384.27 or s. 384.28; or
2. The person will leave the jurisdiction of the court prior to
his hearing date; and
3. The person will continue to expose the public to the risk of
a sexually transmissible disease until his hearing date.
(2) No prehearing detention order may be issued unless the court
finds that:
(a) The department has requested a hearing under s. 384.27 or s.
384.28 to consider the examination, treatment, or placement of
the person infected with a sexually transmissible disease;
(b) The department presents evidence that a substantial danger
to the public health will exist unless the prehearing detention
order is issued;
(c) The department has no other reasonable alternative means of
reducing the threat to the public health; and
(d) The department is likely to prevail on the merits in a
hearing under s. 384.27 or s. 384.28.
(3) When issuing an order for a prehearing detention, the court
shall direct the sheriff to immediately con-tine the person
infected with or reasonably suspected of being infected with a
sexually transmissible disease. The sheriff shall confine and
isolate the person in such a manner as required by the court. The
sheriff, counsel, and the court shall consult with the department
concerning advisable methods of infection control to be
undertaken in order to reduce the opportunity for the disease to
spread to other persons.
(4) A person detained under this section shall be taken before a
judicial officer for bail determination within 24 hours of
detention. The purpose of a bail determination is to ensure the
appearance of the person detained at the hearing scheduled
pursuant to s. 384.27 or s. 384.28. When determining whether to
release the person on bail or other conditions, and what the bail
or those conditions may be, the court shall consider the person's
past and present conduct, previous flight to avoid prosecution,
or failure to appear at court proceedings. The person detained is
entitled to be represented by counsel and to have counsel
appointed on his behalf if he cannot afford one. The person is
entitled to present witnesses and evidence, and to cross-examine
witnesses.
(5) A person detained under this section may apply for a writ of
habeas corpus attacking the detention.
(6) Upon motion of the person confined under a detention order,
the notice periods for hearings required under s. 384.27 or s.
384.28 may be waived. In no case may an order for a detention
under this section exceed 3 days.
384.282 Naming of parties.-
(1) When requesting an order from a circuit court under the
provisions of s. 38f.27, s. 384.28, or s. 384.281, the department
shall substitute a pseudonym for the true name of the person to
whom the order pertains. The actual name of the person shall be
revealed to the court only in camera, and the court shall seal
such name from further revelation.
(2) All court decisions, orders, petitions, and other formal
documents shall be styled in a manner to protect the name of the
party from public revelation.
1(3) The department and its authorized representatives, the
court, and other parties to the lawsuit shall not reveal the name
of any person subject to these proceedings except as permitted in
s. 384.29. Except as provided in this section, the name of any
person subject to these proceedings is confidential and exempt
from the provisions of s. 119.07(1). This exemption is subject to
the Open Government Sunset Review Act in accordance with s.
119.14.
384.283 Service of notice and processes; sheriff to deliver
person to state program.-
(1) All notices required to be given, all petitions and
warrants, and all processes issued and all orders entered
pursuant to ss. 384.27, 384.28, and 384.281 shall be served by
the sheriff of the county in which the person alleged to be
infected with a sexually transmissible disease resides or is
found.
(2) The judge, in his order for hospitalization or placement in
another health care or residential facility under s. 384.28,
shall direct the sheriff of the county in which such person
resides or is found to take the person into his custody and
immediately deliver him to the director of the facility named in
the order.
384.284 Forms to be developed.-The department shall develop and
furnish to the circuit court all forms necessary under ss.
384.27, 384.28, and 384.281, and the court may use such forms as
it determines appropriate.
384.285 Right of appeal; immediate release.-
(1) Any person who is aggrieved by the entry of an order under
s. 384.27, s. 384.28, or s. 384.281 shall have the period of time
provided by the Rules of Appellate Procedure within which to
appeal said order. Every order entered under the terms of ss.
384.27, 384.28, and 384.281 shall be executed immediately unless
the court entering such order or the appellate court, in its
discretion, enters a supersedeas order and fixes the terms and
conditions thereof.
(2) Any person who is examined, treated, hospitalized, placed in
another health care or residential facility, isolated in his
residence, or placed in emergency hold as a result of an order
entered under s. 384.27, s. 384.28, or s. 384.281 may at any time
petition the circuit court for immediate release and termination
of the order.
(3) Any person petitioning a court for immediate release and
termination of the order entered under authority of s. 384.27, s.
384.28, or s. 384.281 must show that the original order was
issued by mistake or fraud, or:
(a) That there has been a substantial change in the original
facts and circumstances upon which the order was issued; or
(b) That he no longer poses an immediate and substantial threat
to the health and welfare of the public.
(4) When considering a petition for immediate release, and prior
to making any release, the court shall consult the department and
the patient's physician, if any, concerning the patient's medical
condition and any other related factors that may affect the
present and future danger to the public that may be caused by the
patient's release.
(5) When granting a petition for immediate release, the court
may impose those conditions it believes reasonably necessary to
protect the public from infection with a sexually transmissible
disease.