Assembly health chair takes on city health commissioner’s HIV plan
Richard Gottfried, the Chelsea Democrat who is the longtime chair of the New York State Assembly Health Committee, told gay and AIDS activists this week that he opposes City Health Commissioner Thomas Frieden’s proposed relaxation of state laws related to HIV testing and the sharing of patient treatment information, including ending the requirement that patients give written consent prior to testing.
Gottfried took his stand just as the U.S. Centers for Disease Control and Prevention, or CDC, was preparing new guidelines set for release in June or July to make HIV testing as routine as many other blood tests and without any special consent form. Under the non-binding, advisory guidelines, a person would retain the right to decline the test whether receiving emergency or routine care.
“I don’t support the legislation the city health department is seeking,” Gottfried said in response to a question from Joey Lopez, coordinator of policy and training at the Ali Forney Center for homeless LGBT youth, who was part of the Equality and Justice Day lobbying effort in Albany put together by the Empire State Pride Agenda. Gottfried added, “It is important for the state health department to tell people if they support or oppose what the city is seeking.”
Robert Kenny, spokesman for the state health department, said it is “reviewing” Frieden’s proposals, but that officials “have not made a decision.” He said they would consult with the state HIV/AIDS Advisory Council in June. As for the potential changes in the CDC’s guidelines, he said they were “open” to them, noting that the state has already streamlined the written consent procedure, while not yet going so far as to include HIV testing in a general consent form listing a battery of standard tests.
“Any decision we make will be focused on protecting patient confidentiality,” he said, something Frieden has said he wants to ensure as well.
Frieden’s proposals would allow the health department to share treatment data on people living with HIV with health care providers and to contact people who have fallen out of care, provisions that along with the end of a written consent requirement have stirred opposition among AIDS advocates and many New Yorkers who have the virus.
Gottfried was the author of the state’s HIV testing confidentiality law in 1989.
“It’s a good piece of legislation,” he said. Doctors don’t fail to get written consent and talk to their patients because of the law, he explained, but because “it’s an uncomfortable topic.”
“You catch more flies with honey than vinegar,” he said, “and that’s just as important in public policy. There is a lot more you can accomplish by asking people and inviting people [into testing and treatment] rather than barging in on people.”
While noting that in the case of some diseases like TB the government does have the power to “barge in,” he does not think HIV/AIDS should join that list.
Gottfried said that in Albany, “there does not seem to be any support for what the city wants to do. A lot of my colleagues are skeptical. Others are openly critical. I would be surprised if something happened this year.”
As Gay City News reported last week, Senator Tom Duane, a gay Chelsea Democrat and the only legislator in Albany who is openly HIV-positive, conveyed his objections to Frieden’s proposals in a letter to his fellow members of the state HIV/AIDS Advisory Council.
Frieden has been campaigning for changes in the law for several months now, taking the case to public meetings throughout the city where he is often met with hostility. The New York AIDS Coalition has called on him to withdraw his proposals to end “written informed consent and pre-test counseling requirements.”
NYAC’s statement said, “Commissioner Frieden also proposes enabling the Department of Health staff and other public health officials to use clinical data and other information to contact a patient’s last known provider and the patient directly to discuss their existing (or nonexistent) treatment and care. Though fully sympathetic to Commissioner Frieden’s concerns that many HIV infected individuals have been ‘lost to care,’ NYAC questions the capacity of government to perform such a personal role without the established trust of the community.”
The group said the impact on “immigrants and other marginalized groups” could be “devastating” by driving them away from care out of fear of “government intervention.”
The city health department did not respond to a call for comment on Gottfried’s oposition.