LANSING — For the second time in the last month, the Ingham County Health Department has changed the procedures of post-test counseling for persons testing positive for HIV. Previously, the ICHD had required those persons to sign a “contract.”
“Up until the last month the health department has not received any complaints about the form either in content or presentation,” Dr. Dean Seinko, director of the Ingham County Health Department told county commissioners.
“Recently, however, media reports have questioned the use of the form and suggested the use of the word contract and the requirement for the client’s signature might make some hesitant to present for HIV testing.”
“To mitigate any misunderstanding of our intent we eliminated the contract language and adjusted our form,” Seinko said.
The “contract” was changed on Aug. 23 to a “Legal Notification.” Both documents asked the HIV positive person to sign the form. The goal was to demonstrate ICHD had fulfilled its obligation, under Michigan law, to inform HIV positive persons of their legal obligations to notify future sexual and needle sharing partners of their HIV status prior to engaging in needle sharing or sexual behavior.
The documents also included the name of the HIV positive person as well as a requirement that HIV positive persons disclose their status to all past sexual and needle sharing partners within four weeks of signing the document.
Michigan law requires those testing positive who are single to inform sexual partners from up to one year previous to the positive test, and to inform married partners from up to ten years previous to the positive test result.
Both documents were identified by the Michigan Department of Community Health HIV/AIDS Prevention and Intervention Section as “unnecessary.” MDCH spokesman TJ Bulcholz also said the keeping of client counseling charts was not authorized in any Michigan law.
The new forms require the Communicable Disease Investigator to sign a case file note indicating the client has been informed and to provide an HIV positive person a form which includes the relevant laws. The progress note, which includes the name of the HIV positive person, will be kept in the client chart.
“There is no limitation to keeping the case file,” Seinko said in an interview after the meeting. He and county attorney Tim Perrone claim the files are mandated by the state. Seinko also stated the ICHD would not go back and destroy the 17-years worth of signed contracts currently in ICHD files.
But some are not satisfied with the new procedures the ICHD has created. “From the very beginning there is no statutory authority for this (keeping files). I have been staring at these laws for 10 years. If there is some law that allows them to keep the file on someone living with HIV I for one will call them out. I would like to see the authority from 17 years ago,” said Kendra Kleber a Royal Oak attorney who specializes in HIV law. Kleber did add that the new procedure was better than the old one.
Kleber has maintained that keeping the names of persons with HIV in the files could lead to the creation of a roster of HIV positive people in the county, something Seinko denies would happen. His reasoning?
“Because it has never happened in 17 years,” Seinko said.
County attorney Perrone went a step further, after rolling his eyes at a request for assurances the county would not create a roster of HIV positive persons, he responded, “You want the health department to assure you they will not break the law by assembling a roster?”
“I think they are making a somewhat important point, they have to prove to the state that they have informed persons of their legal responsibilities,” said Curtis Hertel Jr. “There is not a list of names, there are files. The file doesn’t just keep the form in it, it has, I believe the HIV positive test result.”
“Can I tell you no one has committed a crime in the health department? No, I can’t, ” said Hertel.
“There is a balance, I am not saying we have reached it yet,” Hertel said. “I would hope we treat every other disease the same way, and I don’t know, I will ask about that.”
“I find that answer to be alarmingly incomplete,” Kleber said.
During the hearing, Hertel asked Seinko if he had contacted two persons whose names Hertel had forwarded to him to advise the department about the matter and Seinko said he had not. Seinko and the ICHD had promised to consult with AIDS activists. Instead, Seinko only spoke with lawyers from the county and leaders of the Lansing Area AIDS Network.
“Am I happy that I sent names to the Health Department and they didn’t call them? Is that what you are asking me?” Hertel said in an interview after the meeting. “No, I am not happy with that. I sent names in and I expected them to be called.”
“Would I have cast a wider net?” he asked. “Yes. I was surprised the people I asked to be contacted were not contacted.”