June 27, 2008
27-F STALLED FOR SESSION
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Mayersohn (center) and her bad testing bill stirred up the Health Committee |
Albany's two-year session ended with a whimper this week, and, after much drama in the New York State Assembly over dueling Article 27-f bills, nothing's going to happen after all. (This legislative HIV-testing squabble ended just in time for today's National HIV Testing Day).
Although both efforts to reform state law concerning HIV testing consent rules passed the Health Committee after some raucous debate, Mayersohn's bill A.4813-C died in the Codes Committee on Monday. Only eight of eighteen Assemblymembers voted to move the bill forward. Dick Gottfried's bill A.11461, written by the New York State Department of Health made it to a third reading in the Assembly, but didn't make it to a vote before session ended Tuesday.
Albany's inability to move forward on the two 27-f bills—which contrary to Mayersohn's claim were, in fact, incompatible and irreconcilable—might, in the end, be a good thing: It gives AIDS advocates time to push for a better reframing of the law, which is essential to protecting the confidentiality and privacy of anyone who has been tested for or exposed to HIV.
Props to last minute defections on A.4813 by Codes Committee members Vivian Cook and Michele Titus. They were actually cosponsors of the Mayersohn bill, and despite significant pressure, including Mayersohn herself circling around the room during the Codes vote, withstood the heat.
Mayersohn's bill would have allowed doctors to test for HIV without telling the patient, removed the provision of CDC-recommended pre-test counseling, would not have required that health care provider link people who test HIV positive to medical care, removed the requirement for post-test counseling for people who tested HIV negative, did not require that the health care provider offer an HIV test to her/his patients and inexplicably lowered the fine for breaching confidentiality from $10,000 to $5,000.
Though Gottfried's bill was championed as a "compromise bill," it included provisions that Housing Works won't compromise on. Bill A.11461 revised 27-f to include only an "opt-out" measure for declining an HIV test, undermining consent by failing to ensure that patients understand what tests they are agreeing to take.
Only two Members voted against moving Gottfried's bill forward from Codes. But despite Codes' blessing, and the bill finally getting a Senate counterpart, sponsored by Sen. Kemp Hannon, the full Assembly vote never materialized.
Health committee stands strongWhile the Codes Committee discussion was minimal, the Health Committee vote on June 17 sparked ample debate, with its resident nurse, social worker and dentist weighing in on Mayersohn's bill.
Assemblymember Aileen Gunther, a nurse in infection control who has also done HIV counseling, pointed out that women are most at risk for contracting HIV and that the most important thing that we can do when dealing with HIV or any sexually transmitted disease is educate. "We on the Assembly floor are carrying this torch that education is primary to stop the transmission of this disease and that people should be able to opt-out and be counseled for every decision concerning HIV," Gunther told her committee.
Mayersohn countered that 27-f was not about privacy but preventing the transmission of a deadly disease. She likened her bill to her 1997 "Baby AIDS" bill—mandatory testing of newborns, and by proxy, their mothers—and claimed that advocates were recycling arguments from that fight to denounce the 27-f bill. Mayersohn has given the 1997 bill credit for the sharp reduction in HIV infections among newborns since then, but other factors have more likely contributed to the decline, such as the ability to give babies AZT during their first weeks of life to reverse an HIV-positive status.
Assemblymember Patricia Eddington, a former social worker, thanked Health Commissioner Richard Daines for writing the bill introduced by Gottfried and for keeping the provision of informed consent. "HIV positive people have enough stigma. We can't even get people that have a drug or alcohol problem into treatment because of the stigma around that," she said. "To have opened this wound up to make it bleed further is totally unfair to the people that are infected and people who really need this type of treatment. As a social worker the most important thing I can offer my clients is choice and making sure that have consent and are informed decision-makers. That, to me is one of the most important parts of prevention. "
Assemblymember Joel Miller, a dentist, disagreed, arguing that rising HIV rates among minority women, many of who don't know their status, was a major problem. "It is nice that we make nice to people and play social worker but there is a public health crisis and the proof is that the earlier that you are identified and the earlier you start treatment, the more successful that treatment is."
Indeed, Miller likened informed HIV consent to treating people like children and said that legislators were acting arrogantly by legislatively treating HIV like a handicap and not a disease. He admonished the committee not to "play social worker," prompting Eddington to say that just as Miller does not "play" a doctor when he speaks of his experiences as a dentist, that she is a social worker, not "playing one."
Assemblymember Darryl Towns thanked Mayersohn for keeping AIDS on the forefront, but challenged aspects of her bill, such as the failure to educate people about treatment and educate to prevent further infections. He said that Daines' legislation did a better job of putting them on that track.
Mayersohn ended her pitch for her bill by exclaiming to the committee that she had met with "gay groups" and "what they seem most concerned about is protecting their privacy and secrecy," which further fuels the epidemic.