N.J. Admin. Code § 8:61-4.3

Current through Register Vol. 57, No. 1, January 6, 2025

Section 8:61-4.3 - Obligations of birthing facilities regarding HIV screening of pregnant person in labor and delivery; documentation and communication of results

(a) Upon presentation and/or admission of a pregnant person to a birthing facility for any reason, including through an emergency room or outpatient service of the birthing facility for reasons that may be unrelated to the pregnancy, the birthing facility shall ensure that a responsible staff member asks the pregnant person if the pregnant person has a primary care provider or a prenatal care provider and is seeing that provider for prenatal care, and memorializes the pregnant person's response in the patient's medical record.

1. If the pregnant person indicates that the pregnant person has a primary care provider or a prenatal care provider and is seeing that provider for prenatal care, the birthing facility shall ensure that the provider, in accordance with N.J.A.C. 8:61-4.4, has given the pregnant person information, testing as medically appropriate under the circumstances, and the test results; and

2. If the pregnant person indicates that the pregnant person does not have, and/or has not seen, a primary care provider or a prenatal care provider for prenatal care and/or has not received information and testing pursuant to N.J.A.C. 8:61-4.4, then the birthing facility shall ensure that a health care provider at the birthing facility gives the pregnant person information, testing as medically appropriate under the circumstances, and the test results, pursuant to N.J.A.C. 8:61-4.4.

(b) Upon admission of a pregnant person to a birthing facility for labor and delivery, the birthing facility shall:

1. Determine whether:

i. The pregnant person's HIV infection status is known or unknown; and

ii. The pregnant person received an HIV test during the third trimester;

2. If the pregnant person's HIV infection status is known and the pregnant person received an HIV test during the third trimester, annotate the pregnant person's status as either HIV-positive or HIV-negative in the pregnant person's medical record;

3. Ensure that the labor and delivery unit of the birthing facility promptly receives the pregnant person's HIV status information in time to alert the unit of the need, if the pregnant person's HIV status is known to be positive or is unknown, to implement interventions to reduce the risk of HIV transmission to the fetus or newborn during the pregnant person's labor and delivery, in accordance with the Perinatal HIV Clinical Guidelines;

4. Ensure that a health care provider at the facility completes in its entirety a Perinatal HIV Exposure Reporting form and submits it to the Division pursuant to N.J.A.C. 8:65 within 24 hours of identifying a case of perinatal exposure to HIV; and

5. Ensure, if the birthing facility transfers the pregnant person to another birthing facility, that the pregnant person's HIV status is memorialized in a document or electronic file that:

i. Accompanies, or otherwise is annexed to, the uniform transfer form that N.J.A.C. 8:43E-13 requires the birthing facility to issue; and

ii. Is sealed and/or secured in a manner that maintains the confidentiality of the pregnant person's HIV status during transfer.

(c) If a birthing facility admits to labor and delivery a pregnant person whose HIV status is unknown and/or not of record, and/or who did not have an HIV test during the third trimester, the birthing facility shall ensure that:

1. A health care provider, in accordance with N.J.A.C. 8:61-4.4, gives the pregnant person information, expedited HIV testing as soon as it is medically appropriate, and the test results;

2. The labor and delivery unit receives the pregnant person's HIV test result in time to alert the unit, if applicable, of the need to implement interventions to reduce the risk of HIV transmission to the fetus or newborn during the pregnant person's labor and delivery, in accordance with the Perinatal HIV Clinical Guidelines; and

3. If the result of the pregnant person's initial HIV test is positive, a health care provider initiates:

i. Supplemental testing, medical care, and referrals, as and when appropriate under the circumstances, consistent with N.J.A.C. 8:61-4.2, for the pregnant person; and

ii. Interventions to reduce the risk of HIV transmission to the fetus or newborn in accordance with N.J.A.C. 8:61-4.2 and the Perinatal HIV Clinical Guidelines, without awaiting the results of confirmatory testing.

(d) A birthing facility shall not deny a pregnant person:

1. Appropriate prenatal or other medical care because the pregnant person declines to receive an HIV test; or

2. HIV testing based on the pregnant person's economic status.

N.J. Admin. Code § 8:61-4.3

Amended by 49 N.J.R. 2796(a), effective 8/21/2017

Adopted by 57 N.J.R. 29(a), effective 1/6/2025