Following SB 5454, requiring HIV-testing in infants

Brynn writes:

In January I wrote about Mary Jones, the Central Kitsap woman who has cared for some of the state’s most medically fragile babies while they were placed in state custody. (Read that story here).

Jones started fostering 31 years ago, but in December she terminated her foster care license with the state because she’d finally had enough with the state’s Department of Social and Health Services.

It takes a lot to get Jones that upset — this is a woman who has the patience of a saint — but after an infant in her care was not tested for HIV, even though the child’s mother gave permission, Jones had had enough. She was told by DSHS officials that a court order was needed to test the child, but it took close to six months for that order to be issued. Testing the infant as soon as possible would have been in the baby’s best interest, because if the infant tested positive it would have been given necessary antiviral medication to potentially keep the disease away.

It wasn’t until Jones terminated her license and the baby was moved to a different foster family that Jones received a call from the baby’s caseworker saying the court order had been issued. But even then if the infant tested positive for HIV, the state wouldn’t tell Jones the results because she longer was caring for the child — even though she’d cared for the baby for three months, potentially exposing herself to the disease.

This isn’t the first time Jones has run up against DSHS about its lack of policy on whether to test infants at birth for HIV. She has tried since 2004 to get legislation passed that would test infants for HIV if the status of the mother is unknown, and if the mother is at high risk for the disease (i.e. an intravenous drug user). Many pregnant women whose children enter state custody after birth receive prenatal care, so the percentage of women whose HIV status is unknown at the time of delivery is low. But it’s the babies born to women who are intravenous drug users, or who don’t receive any medical attention during pregnancy, and who don’t know if they’re HIV positive, that the bill aims to reach.

Working with Sen. Christine Rolfes, D-Bainbridge Island, Jones hopes to see legislation passed this year that would update state law to require the test in infants whose status is unknown.

The bill, SB 5454, made it out of the Senate Human Services and Corrections Committee and after a detour through the Senate Ways and Means committee (an inaccurate fiscal note was attached to the bill, which is how it ended up there) the bill is now waiting on the rules committee to be brought to the floor for a vote.

This is the first time this legislation has made it out of committee. Rolfes is optimistic the bill will pass once on the floor, but she’s also pragmatic and knows it faces an uphill battle.

“The challenge is right now we have hundreds of bills waiting to get to the floor for a vote,” Rolfes said Wednesday. “We have another week or so to get the bills out and the Senate moves very slowly. Whether I can get it to the floor is the big ‘if.'”

Jones has been holding her breath, waiting to see if the bill finally passes. Seeing this legislation approved might help heal Jones’ wounds — the 63-year-old planned to retire this spring when her license ran out; terminating her license early was an act of desperation. While she knows she did the right thing, there’s still a part of her that is upset she didn’t get to retire the way she wanted.

Even though she’s no longer caring for the medically fragile babies, she’s still fighting for them in Olympia.

“When I go down there to testify I am always just focused on who I am there for, which is always my babies,” she said earlier this month.

If the bill doesn’t make it to the floor this session, Rolfes isn’t discouraged, in fact she’s optimistic that it will be even easier to get it passed during the next session.

“A lot times when the bills get this far you can get them out the next year,” she said. “Where we are right now is strategically a good spot. We’ll know in another couple of weeks if it’s still alive. It’s certainly my priority.”

Here’s some excerpts from SB 5454, which updates RCW 13.34.315:

When an infant under one year of age is placed in out-of-home care under this chapter, the department or other supervising agency shall request that the infant’s treating physician test the infant for human immunodeficiency virus, if the human immunodeficiency virus status of the mother of the infant:

(i) Is known to be positive; or

(ii) Is unknown and the department has specific information indicating that the mother is at increased risk of human immunodeficiency virus infection, including, but not limited to, a history of drug abuse.

The bill goes on to indicate the supervising agency must then follow a treating physician’s recommendation for follow-up testing and care for infants that test positive. It also says the child’s parent must be asked for consent. If they object for any reason, including conflicts with religious beliefs, a court order is required to perform the test.

Click here to see the TVW footage of the Feb. 12 Senate Human Services and Corrections Committee hearing on SB 5454.

Click here for a history of SB 5454, which includes links to a pdf of the original bill.

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