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Friday, January 15, 1999

KING COUNTY, WA - The King County Board of Health (KCBOH) passed a resolution today advising the State Board of Health (SBOH) to require named HIV reporting at the local level with the names being converted to a "soundex" code when passed on to the state. In this system, the names reported locally would be expunged after 90 days. A "soundex" code is a unique set of identifiers used to classify case reports without using a patient's name. The SBOH is currently considering revisions to the Washington Administrative Code (WAC 246-100) to make HIV infection reportable.

This plan was developed and agreed upon by the "Common Ground" Group which included representatives from the Public Health Department (including the Director), the KCBOH, the Governor's Advisory Council on HIV/AIDS, and community HIV/AIDS service agencies such as Northwest AIDS Foundation and People of Color Against AIDS Network. While group members agreed that HIV ought to become a reportable condition, there was initially a difference of opinion about what method should be used to achieve such a policy. After months of diligence and tenacity, all Common Ground Group members agreed on several recommendations, all of which were adopted into the KCBOH's resolution.

Summary of Recommendations:

  • Reporting Methodology: HIV cases ought to be reported by patient name locally (or regionally); however, names should be converted to a "soundex" code before being passed on to the state. In addition, these names should be expunged from local case reports within 90 days of reception. If they are to be kept as a reference after 90 days, they should be converted to a "soundex" code. Finally, a systematic evaluation of the "soundex" system model should be performed to assure that it meets performance standards set by the Centers for Disease Control and Prevention.

  • Access to Anonymous Testing: The availability of anonymous HIV testing services should continue (even expand) when HIV reporting is enacted. Clients ought to be made aware of these services as well as how to access them in the community.

  • Maintenance of Confidentiality by All Persons with Access to Medical Information Related to HIV Status: Penalties for breaches of confidentiality should be commensurate with potential loss and discrimination suffered by the affected individual, and this breach should be raised to a felony for anyone who discloses another person's HIV status with malicious intent.

  • Notification of Exposed Partners: Partner notification should remain voluntary, should comply with federal guidelines for spousal notification, and should protect the identity of the infected person. When partner notification is provided by the Public Health Department, it should be initiated through contact with a primary health provider who has obtained consent from the infected individual.

  • Education/Information Campaign to Inform Providers and Clients: An education campaign targeting appropriate audiences (people at-risk and health providers) should be developed and implemented. This education effort should cover a range of issues including: the importance of knowing HIV status, the benefits of early access to care, the purposes of case reporting, how confidentiality is protected, and how to access anonymous services, among others.

  • Clarify the WAC language and Summarize the Impact of these Code Changes: The WAC language should be clearly stated and logically formatted so that readers may easily understand its intent as well as the purpose of reporting.

Director of Public Health's Statement:

After adoption of these recommendations by the King County Board of Health, Dr. Alonzo L. Plough, Director, Seattle-King County Department of Public Health, issued the following statement:

"Passage of this resolution is an enormous victory for community advocates and public health practitioners alike. It is the culmination of months of work and combines the best of ideas into one strong framework.

I congratulate my colleagues on the "Common Ground" Group for working assiduously and in good faith to find areas of mutual agreement on the difficult and important issue of HIV reporting. I am very pleased with the resulting approach, and delighted that it was passed by the King County Board of Health and forwarded to the state for consideration.

I pledge to advocate vigorously for the adoption of this plan by the state Board of Health. I believe this course to be the best for ending the spread of HIV and providing the best care possible for those with HIV and AIDS."

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