In December, 2010 the state of Michigan’s Department of Community Health released mandatory changes for ordering HIV testing effective today, January 1, 2011.  This information can be used as a resource for developing in-house policies even if your facility is located outside the state of Michigan. 

The new requirements include:

Pretest information:
The following information must be provided to patients, either verbally or in writing, prior to ordering an HIV test:

(a) An explanation of the test, including, but not limited to, the purpose of the test, the potential uses and limitations of the test, and the meaning of test results.
(b) An explanation of how HIV is transmitted and how HIV can be prevented.
(c) An explanation of the rights of the test subject, including, but not limited to, all of the following:
(i) The right to decline the test at any time before the administration of the test and the circumstances under which the test subject does not have the right to decline the test.
(ii) The right to confidentiality of the test results under this part and under the Health
Insurance Portability and Accountability Act of 1996, Public Law 104-191.
(iii) The right under this part to consent to and participate in the test on an anonymous
basis.
(iv) The person or class of persons to whom the test results may be disclosed under this
part and under the health insurance portability and accountability act of 1996, Public
Law 104-191.

Consent
After receiving the required pretest information, a patient may decline an offer for HIV testing. Written consent on a separate form is no longer required, but may still be used if preferred.

Documentation in the medical record:
Both provisions of the required pretest information and whether the patient declined or agreed to HIV testing must be documented and maintained in the patient’s medical record.

Test results:
In addition to the existing requirement to inform patients of positive HIV results and provide appropriate counseling, there is a new requirement to inform patients of negative HIV test results through normal health care provider procedures which may include patient visits, mail, or telephone communication.

Additional information including sample forms, the complete educational brochure and suggestions for implementation can be accessed at www.michigan.gov/hivstd.