8010. Bloodborne Pathogens Implementation Practices and Procedures

Applies To:  This policy applies to Department of Children, Youth and Families (DCYF) employees.

Policy Number & Title:  8010. Bloodborne Pathogens Implementation Practices and Procedures

Effective Date:  March 1, 2022

Policy

  1. Non-Discrimination
    1. DCYF shall not discriminate against persons with or perceived to have Human Immunodeficiency Virus (HIV). This policy includes discrimination against employees, clients, licensees, contractors, or volunteers. Procedures for persons who believe they have been subjected to discrimination are found in DCYF Administrative 11.13 Preventing and Addressing Discrimination, Harassment, Sexual Harassment, and Retaliation policy.
    2. Licensees are not required by law to share their HIV status with licensers. If this information is shared by the licensee or prospective licensee, licensers may request additional health information, as is the case with disclosure of any serious illness of a licensee. Decisions regarding continued licensing of an HIV-infected person are made in the same manner as any serious illness.
  2. Regional HIV/Bloodborne Pathogens (BBP) Coordinator
    1. Each Regional Administrator must designate an HIV/BBP Coordinator to oversee issues related to HIV, Hepatitis B Virus (HBV), and other BBPs.
    2. The caseworker refers all HIV/HBV affected cases and issues related to BBP to the regional HIV/BBP Coordinator for consultation and staffing as appropriate.
    3. The Coordinator:
      1. Provides information and consultation on DCYF policy.
      2. Provides consultation for case management.
      3. Serves as liaison with the health care community and AIDS service organizations.
      4. Convenes the HIV/BBP Advisory Team.
  3. Regional HIV/BBP Advisory Team
    1. Each Regional Coordinator must develop an HIV/BBP Advisory Team to advise on issues related to HIV, HBV, and other BBP.
    2. The Regional HBV/BBP Advisory Team:
      1. Assists, as necessary, with development of regional guidelines on issues related to HIV/BBP.
      2. Provides case consultation, as needed.
  4. Universal Precautions-All staff, out-of-home care providers, volunteers, licensees, and respite care providers must use universal precautions when dealing with children or youth in care and treat all blood and body fluids containing blood as if known to be infectious.
  5. HIV Testing
    1. HIV testing of a child or youth is a medical procedure and, therefore, must be done only in consultation with the Regional HIV/BBP Coordinator and on the recommendation of the local health department or a licensed health care provider knowledgeable about HIV infection.
      1. When HIV testing of a child or youth under the age of 14 is being requested as a result of potential perinatal exposure, the caseworker or HIV/BBP Coordinator shall inform the child's or youth’s mother of the request and ask the mother to provide the results of their past HIV tests or to be tested in order to possibly eliminate the need for testing of the child or youth. This testing is voluntary and will be confidential, consistent with this section.
      2. When parental rights have been terminated, the caseworker of a child or youth under the age of 14 may authorize HIV testing.
      3. The caseworker shall obtain a court order for testing if the parent or legal guardian is unavailable or unwilling to provide consent for testing of a child or youth under the age of 14 and if a medical reason for testing exists.
      4. If a child or youth under 14 years of age tests positive for any Sexually Transmitted Disease, including HIV, the HIV/BBP Coordinator shall ensure that the medical professional or the local health department notifies the parent or legal guardian of the test results.
    2. HIV/Sexually Transmitted Disease (STD) testing of a youth age 14 or over requires the written consent of the youth or a court order. The youth may request testing on their own authority.
      1. The written consent or court order shall authorize test results for HIV or HBV to be released to the caseworker and out-of-home care provider.
      2. When obtaining a court order or a consent for HIV testing, the caseworker shall, if needed, also gain authority to share the results with others who have a compelling "need to know" and are not otherwise authorized to know under chapter 70.24 RCW. All such individuals shall be identified in the consent or court order. The consent or court order shall authorize treatment, as necessary.
  6. Confidentiality/Disclosure
    1. Infection with HIV and other sexually transmitted diseases is a personal and private matter. Employees, care providers, and volunteers shall treat information related to these issues in a confidential and respectful manner and shall not disclose this information except in accordance with state law.
    2. Disclosure Practices and Criteria
      1. The caseworker shall ensure that the child's or youth’s current health care provider is aware of the child's or youth’s exposure to HIV/HBV.
      2. Caseworkers shall not disclose information related to a parent or child's or youth’s HIV or other STD status to other DCYF employees, except their immediate supervisor, manager, and HIV/BBP Coordinator.
      3. When the caseworker or HIV/BBP coordinator provides written disclosure of HIV/BBP status information to someone outside of DCYF, the caseworker or HIV/BBP Coordinator shall include the following statement on the Disclosure of Confidential HIV/AIDS Information DCYF 09-837:
        "This information has been disclosed to you from records whose confidentiality is protected by state law. State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains or as otherwise permitted by state law. A general authorization for the release of medical or other information is not sufficient for this purpose."
      4. When the caseworker or HIV/BBP coordinator provides HIV/BBP information regarding a parent or child or youth is           disclosed orally to someone outside of DCYF, the caseworker shall send the Disclosure of Confidential HIV/AIDS Information DCYF 09-837 form to the persons receiving the information within 10 days of the disclosure.
      5. Documentation that a parent or child or youth has been tested for HIV or other BBP shall be recorded and stored electronically in FamLink.
      6. Document HIV/BBP status in the "Medical Problems" pop-up. Copies of medical records regarding the testing results or HIV/BBP related information will be scanned and stored in the FamLink "Filing Cabinet". Access to this information is secured and limited to the assigned caseworker and their supervisor.
      7. Copies of documents and medical records regarding HIV/BBP status or related information may also be kept in a "privileged/confidential information" envelope used to safeguard sensitive case information. Access to this envelope is strictly limited to those authorized by law, with consent or as noted on a court order. Access to other parts of the child's or youth’s record does not assume the right to access HIV/BBP information.
      8. Caseworkers shall not disclose HIV/BBP information in written reports to the court without consultation with the assigned legal counsel.
      9. When HIV/BBP information is discussed in court, the caseworker, through legal counsel, shall make special arrangements with the court to protect the confidentiality of the parties.
  7. Placement
    1. DCYF employees shall inform the residential care provider of the child's or youth’s HIV/HBV status, if known. The caseworker shall not inform the residential care provider of the HIV/HBV status of a youth age 14 or older without the youth's permission or a court order. However, the caseworker shall inform the youth that no placement will be made without disclosure of such status to the prospective residential care provider.
    2. HIV exposed/infected children or youth may be placed with other children or youth unless otherwise advised by the health care provider. However, DCYF staff shall not place known HBV infected children or youth or perinatally exposed infants in households with other unvaccinated persons.
    3. The caseworker shall strongly consider a child's or youth’s and parent's wish not to disclose a child's or youth’s positive HIV/HBV status to relatives when investigating a potential relative placement. However, if the child or youth is actually placed, the caseworker must disclose the child's or youth’s HIV/HBV status. This revelation could negatively impact family relationships.
    4. The caseworker shall arrange for provision of medical attention for the HIV/STD infected/exposed child or youth by a physician knowledgeable in this specialty area.
    5. When placing a child or youth known to be HIV/HBV exposed or infected, the caseworker, in addition to providing the residential care provider with information regarding the child's or youth’s current health status and names of all health care providers, shall inform the residential care provider of all resources involved and provide instruction in any special care needs of the child or youth prior to placement.
    6. If exposure of infection is discovered after placement, the caseworker shall immediately provide the above information to the residential care provider and ensure the provision of instruction in any special care needs.
    7. When HBV infection is discovered in an individual living or working in a foster/receiving/group home, the caseworker shall immediately notify the Regional HIV/BBP Coordinator and the local health department. Public health department recommendations for testing and immunization of household contacts shall be followed. DCYF employees shall place no additional unimmunized children or youth in the home while the possibility of exposure exists.
  8. Adoption
    1. The adoption worker or HIV/BBP Coordinator shall provide prospective adoptive parents with all available information on the STD/HIV/HBV status of children or youth under 14 years of age.
    2. For youth age 14 or above, the caseworker shall not disclose status without the youth's permission but shall not place the youth without such disclosure.
    3. DCYF employees shall share the STD/HIV/HBV status, if known, of the parents, if the possibility of infection of the child or youth by that parent exists. In such cases, the identity of the parents may not be disclosed.
    4. DCYF employees shall identify children or youth with HIV infection in adoption exchange media as having "serious medical problems." HIV exposure of uninfected children or youth does not need to be noted in exchange media. Only when a serious inquiry is received and the caseworker has determined that the family is a potential candidate should the child's or youth’s specific medical history be discussed. The caseworker shall not disclose the child's or youth’s name until the family is selected as the adoptive family.
    5. The caseworker shall provide prospective adoptive parents with the Family Genetic and Medical History DCYF 13-041 form. The caseworker shall include on the document all available medical information related to the child or youth and biological parent, including HIV/STD information if possibility of exposure exists. The identity of the parent is not disclosed on this form.
    6. When HIV testing is recommended, the caseworker shall consult with the HIV/BBP Coordinator and arrange for completion of the test prior to finalization of the adoption.
    7. The caseworker shall inform the prospective adoptive parents that HIV infection may qualify a child or youth for adoption support.
  9. Training
    1. DCYF shall arrange for all employees to receive HIV/BBP training which covers prevention, transmission, infection control, treatment, testing, confidentiality DCYF-related policy and procedure, as it relates to adults, children, and youth.
    2. All individuals and agencies licensed by DCYF shall receive HIV/BBP training which covers prevention, transmission, infection control, treatment, testing, confidentiality and DCYF-related policy and procedure, as it relates to adults, children, and youth.

Forms

Disclosure of Confidential HIV Information DCYF 09-837

Family Genetic and Medical History DCYF 13-041

Resources 

DCYF Administrative 11.13 Preventing and Addressing Discrimination, Harassment, Sexual Harassment, and Retaliation policy

Original Date:  March 1, 2022

Revised Date: 

Review Date:  March 1, 2026

Approved by: