CALIFORNIA HIV LAWS
CALIFORNIA
HIV/AIDS POLICY
RESEARCH CENTERS
March 2019
AUTHORS
Ayako Miyashita Ochoa, JD
Luisita Cordero, MA
Craig Pulsipher, MPP/MSW
Christian P. Paneda
FUNDERS
This study received support from the California HIV/AIDS Research Program through a grant to
the Southern California HIV/AIDS Policy Research Center (Grant Number RP15-LA-007).
ACKNOWLEDGMENTS
We would like to thank Luis Vasquez and Neha Divi for their legal research contribution.
ABOUT THE CALIFORNIA HIV/AIDS POLICY RESEARCH CENTERS
The California HIV/AIDS Policy Research Centers are funded by the California HIV/AIDS Research
Program to bring the most relevant and timely evidence to bear on HIV/AIDS policy making
in order to further California’s eorts to develop and maintain ecient, cost-eective, and
accessible programs and services to people with or at risk for HIV/AIDS.
CITATION
Miyashita Ochoa, A., Cordero, L., Pulsipher, C., & Paneda, C.P. (2019) California HIV Laws. http://
www.chprc.org/california-hiv-laws/
California HIV/AIDS Policy Research Centers
TABLE OF CONTENTS
Chapter 1 HIV Testing and Linkages to Care 4
Mandatory HIV Testing
Mandatory Oer of HIV Testing
Informed Consent Standard
Linkages to Care
Chapter 2 HIV Privacy and Condentiality 6
Constitutional Right to Privacy
Right to Privacy under Civil Law
Condentiality of HIV-Related Medical Records
Partner Notication Exception
Public Health-Related Disclosures
Research-Related Disclosures
Online Posting of HIV Test Results
Health Insurance Portability and Accountability Act (HIPAA)
Condential Medical Information Act (CMIA)
Chapter 3 HIV Criminalization and Criminal Laws 11
Mandatory HIV Testing in the Criminal Context
Disclosure of HIV-Positive Status in the Criminal Context
HIV Criminalization Laws
Chapter 4 HIV Discrimination 14
State-Based Protections
Housing and Employment
Public Accommodations
Hate Violence and Threats
Federal Non-Discrimination Laws
Chapter 5 Needle and Syringe Exchange Programs 17
History of Pharmacy Sale of Syringes
Current Law on Non-Prescription Sale of Syringes
Local Laws and Requirements
Clean Needle and Syringe Exchange Programs
Pending Litigation on Syringe Exchange Programs
Safer Drug Consumption Sites
Chapter 6 Comprehensive Sexual Health Education 21
Objectives of Comprehensive Sexual Health Education
Instructional Criteria and Content
Topics of Special Consideration
Parental Excuse and School District Notice
Other Requirements for School Districts
Youth Sexual Health Rights
Glossary 25
California HIV/AIDS Policy Research Centers
3
CHAPTER 1
HIV Testing and Linkages to Care
The following publication summarizes California laws related to HIV/AIDS. This document is
intended to provide an overview of the current state of the law as of the date of publication.
Statutes are provided as references; refer to California Legislative Information (http://leginfo.
legislature.ca.gov) for more information.
Mandatory HIV Testing
While HIV test results may not be used to determine eligibility for insurance or employment,
1
there is an exception for life and disability income insurance.
2
Thus, some individuals seeking life
and disability income insurance may be required to provide HIV test results.
Outside of the criminal context, mandatory HIV testing is limited to narrow and specic
circumstances. For example, mandatory HIV testing is required for professional boxers or
martial arts ghters applying for or renewing a license.
3
An infant under 12 months of age
4
that
is in the temporary custody of the state, is in the process of becoming, or has already become
a dependent child of the court may also be mandatorily tested if the attending physician or
surgeon believes testing is necessary to providing appropriate care.
5
For more information on mandatory HIV testing in the criminal context, see Chapter 3.
Mandatory Oer of HIV Testing
The Centers for Disease Control and Prevention (CDC) recommends that individuals between
the ages of 13 and 64 get tested for HIV at least once as part of routine health care; however,
this standard does not call for mandatory testing. California has aimed to increase HIV testing
through law, policy, and practice by decreasing barriers to testing, promoting opt-out HIV
testing as opposed to opt-in testing. More recent legislation includes mandates for providers to
oer an HIV test. These strategies have been used to increase HIV testing among the following
populations:
• pregnant women,
6
• individuals obtaining a marriage license,
7
• individuals that are having their blood drawn in the course of seeking primary care
services,
8
and
• individuals being seen at one of four (4) emergency departments in hospitals across
California that are currently piloting a project to conduct routine oering of an HIV test.
9
Informed Consent Standard
Voluntary testing with informed consent continues to be the law in California. Informed consent
requires providers to oer specic information prior to conducting HIV testing for a patient. This
includes informing the patient of the following:
• the test is planned,
• information about the test,
• that numerous treatment options are available for a patient who tests positive for HIV,
4
• that a person who tests negative should continue to be routinely tested, and
• they have the right to decline the test.
10
A patient can provide oral or written consent which the provider is required to document in
writing in the patient’s medical record.
11
If a patient declines the test, the medical care provider
shall note it in the patient’s le.
12
Linkages to Care
After a person has been tested for HIV, the medical care provider or person who administered
the test must provide specic information and counseling related to HIV.
13
If the person tests
positive, they must be informed that many treatment options are available and the provider
or person who administered the test must identify follow-up testing and care, including
contact information for medical and psychological services.
14
If a person tests negative and is
considered to be at high risk for HIV infection, they should be advised about the limits of current
testing technology and the need for periodic retesting due to the window period.
15
They must
also receive information on how to prevent or reduce the risk of contracting HIV, including
information about pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). The
medical care provider or person administering the test may also oer or provide a referral for HIV
prevention counseling.
16
1
Cal. Health & Safety Code § 120980(f).
2
Cal. Insurance Code §§ 799-799.10.
3
Cal. Business & Professions Code § 18712.
4
Cal. Welfare & Institutions Code § 369.
5
Id.
6
Cal. Health & Safety Code § 125107.
7
Cal. Family Code § 358.
8
Cal. Health & Safety Code § 120991.
9
Cal. Health & Safety Code § 120992.
10
Cal. Health & Safety Code § 120990(a).
11
Cal. Health & Safety Code § 120990(c).
12
Cal. Health & Safety Code § 120990(a).
13
Cal. Health & Safety Code § 120990(h).
14
Id.
15
State of California, Health and Human Services Agency, California Department of Public Health, 2014 HIV Testing
Law in Healthcare Settings Fact Sheet – June 2014, available at https://www.cdph.ca.gov/Programs/CID/DOA/CDPH%20
Document%20Library/AB%20446%20(2013)%20HIV%20Testing.pdf (providing guidance on how to describe the
window period required for verication of HIV test results).
16
Id. at 12.
California HIV/AIDS Policy Research Centers
5
CHAPTER 2
HIV Privacy and Condentiality
Laws relating to HIV privacy and condentiality in California can be found in the California
Civil Code, Health and Safety Code, California Constitution, tort law, and the Condential
Medical Information Act (CMIA). Federal protections include the right to privacy under the
U.S. Constitution and the Health Insurance Portability and Accountability Act (HIPAA). The
HIPAA Privacy Rule protects the condentiality of medical test results and records and sets the
conditions for disclosing such records without a patient’s prior written consent.
Constitutional Right to Privacy
The U.S. Supreme Court recognized a right to privacy
1
and made such a right applicable to states.
2
The right to privacy ensures that the state and federal government must respect your right to
information privacy, including information regarding your HIV-positive status. To determine if
a government can disclose a person’s HIV-positive status, the court balances the government’s
interest against the individual’s interests.
3
The results of cases where individuals wanted to stop
the government from disclosing their HIV status tend to favor the government. Courts have paid
particular attention to the government’s interest in ensuring public health and/or public safety.
4
California’s constitutional right to privacy
5
is broader than the federal constitutional right to
privacy.
6
To make a claim against a government entity, whether state or local, in California, an
individual must show the following:
• a legally protected privacy interest,
• a reasonable expectation of privacy in the circumstances, and
• conduct that constitutes a serious invasion of privacy.
7
The result in California’s cases have varied according to (1) whether the circumstances of
disclosure meant the plainti should have had a higher or lower expectation of privacy; and (2)
the relevance of the plainti’s HIV status to the particular set of circumstances.
Right to Privacy under Civil Law
Individuals whose HIV status is revealed against their will or without their consent can sue
another individual or entity under civil law. This would be considered a tort claim based on the
violation of privacy. There are several types of privacy violations recognized under tort law.
8
The
most relevant claim is public disclosure of private facts where the plainti must show:
• public disclosure
• of private fact/s
• considered oensive and objectionable to the reasonable person
• that are not a legitimate public concern.
9
Condentiality of HIV-Related Medical Records
Generally, disclosure of HIV test results is not permitted without the written consent of the
person. This is the rule in the context of public health, health care, medical records and research-
related records. State laws, however, carve out exceptions to this general rule. Understanding the
6
law regarding condentiality thus requires understanding the scope of these exceptions.
Public HIV-related records with identifying information are condential and may not be disclosed,
except with written authorization of the persons named in the record.
10
For minors below 12 years old, the parent, guardian or other person lawfully authorized to make
health care decisions on their behalf must generally provide written authorization for a physician
to disclose the minor child’s test results.
11
Some common exceptions to the written authorization requirement apply to physicians who
ordered an HIV test.
12
They may record the result and/or disclose it to other providers working
to provide care or treatment to the patient.
13
Test results can also be shared with a patient’s
legal representative(s).
14
Another exception includes circumstances when emergency response
employees and their designated ocers, all of whom are subject to condentiality requirements,
may have been exposed to HIV.
15
The more notable exceptions are described further.
Partner Notication Exception
As long as the patient’s identity is kept condential, a physician or surgeon may disclose the
results of a conrmed HIV-positive test result to the patient’s spouse, sexual or hypodermic
needle-sharing partner(s) to facilitate medical diagnosis and care or to prevent transmission.
16
A physician or surgeon is allowed to make this disclosure but is not required to do so.
17
If a
physician or surgeon decides to move forward with disclosure, before such disclosure, the
physician or surgeon must have rst done the following:
• discussed the result with the patient and oered counseling,
• attempted to get the patient’s consent to notify potentially aected contacts, and
• informed the patient of intent to notify the aected individuals.
18
Physicians or surgeons may opt for a local health ocer or agency sta to conduct partner
notications.
19
These services may alert spouses, sexual or hypodermic needle-sharing partner(s)
about potential exposure without disclosing the identity of the HIV-positive person.
20
Information
of partners contacted will be kept condential.
21
After referring partners to appropriate care,
records are expunged by the local health ocer.
22
Public Health-Related Disclosures
In general, the identity of a person being tested for HIV is protected from disclosure in the
course of any state, county, city, or other local civil, criminal, administrative, legislative, or other
proceedings.
23
Exceptions to this law are many. They include the following:
• cases where there is written consent from the person,
• disclosure of HIV-positive test results for mandated reporting to local health ocers,
• reporting HIV-positive test results in the context of blood donation, and
• when state or local public health agencies nd disclosure necessary for disease
investigation, surveillance, and control.
24
State and local health department employees and contractors must sign condentiality
agreements and understand the penalties if they engage in the unauthorized breach of
condentiality.
25
When there is a disclosure that is not permitted in exceptions described in
the law, penalties include possible criminal prosecution and/or nes.
26
The severity of the
California HIV/AIDS Policy Research Centers
7
punishment depends on whether the disclosure was done negligently, willfully, or maliciously.
27
Research-Related Disclosures
The information of persons obtained through an HIV/AIDS-related study and kept in research
records is condential and may not be disclosed without the person’s prior written consent.
28,29
Given the critical need for HIV-related research, condentiality of individuals’ identities in the
context of research is protected to a greater degree. Condential research records may not be
used to pursue a criminal charge against a research subject until after a showing of good cause in
a court proceeding.
30
The identity of persons included in research records is generally protected
during nancial audits and program evaluations.
31
There are three more exceptions for disclosure
of research-related records, determined on a case-by-case basis. Disclosure without prior consent
is permitted in these circumstances:
• if it is required by a duty to report HIV test results to the California Department of Public
Health (CDPH) or the U.S. CDC,
• when medical personnel need the information to help a research subject in a medical
emergency, and
• during a special investigation by CDPH.
32
Any disclosure authorized by a research participant must be accompanied with specic language
outlined in the law.
33
If there is a disclosure that is not otherwise permitted under the law, the
penalties include possible criminal penalties and/or nes.
34
Again, the punishment depends on
whether the disclosure was done negligently, willfully, or maliciously.
35
Online Posting of HIV Test Results
While electronic health records are common and patients can view much of their health record
through online platforms, there remain specic rules on the disclosure of HIV test results. To post
HIV antibody test results on the internet or by electronic means, healthcare providers must rst
decide if this type of disclosure is an appropriate means and have discussed the test results with
the patient in person, by telephone, or by other means of oral communication.
36
These prerequisites do not apply to patients that request the disclosure nor to individuals that
get tested anonymously and follow a secure protocol to access a single set of test results.
37
Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule
This federal law requires healthcare providers who transmit information electronically, health
plans, health care information clearinghouses, and their business associates--all collectively
referred to as “covered entities”
38
--to observe privacy and security standards for handling medical
information.
39
The privacy rule governs the disclosure of protected health information, which
includes information on a person’s physical or mental condition, the health care provided to the
person, payments related to those services, and other information that can be used to identify the
individual.
40
Aside from giving individuals the right to timely access to their health information,
41
HIPAA also enables individuals to make corrections to their health record and, upon request,
know who has accessed their records within the prior six years.
42
Except when required for patient treatment and care coordination, their health care operations,
and public health or safety purposes,
43
covered entities may not disclose protected health
information without the patient’s written authorization.
44
With an individual’s oral consent,
information may be shared with family, friends, and those involved in the patient’s care and
treatment and payment for those services.
45
An individual may le a complaint with the federal
government for a HIPAA violation,
46
but only the government may pursue civil and criminal
8
penalties
47
for violations of patients’ privacy rights. HIPAA does not allow patients to sue
healthcare providers or other covered entities if their health information was disclosed without
authorization.
48
Condential Medical Information Act (CMIA)
Unlike HIPAA, California’s CMIA allows a patient to personally take legal action for unauthorized
disclosures of medical information.
49
The law covers unauthorized disclosure(s) of patients’
medical history, conditions, and treatment, coupled with information that may reveal their
identity--such as name, address, social security number, or other items that can be combined
with publicly available information to identify them.
50
CMIA applies to health care providers like
licensed physicians or clinics, health care service plans like Health Maintenance Organizations
(HMOs), and contractors, such as a medical group.
51
A patient may sue for nominal damages of
$1,000 without proof of any harm. For violations leading to economic loss or personal injury, a
person may pursue actual damages, compensatory damages, as well as punitive damages up to
$3,000, attorney’s fees up to $1,000, and litigation costs.
52
Whether from negligence or willful disclosure, CMIA violations can be punished as misdemeanors
and may also result in an administrative ne to the government at rates from $2,500 to $25,000
per violation.
53
A person or organization that violates CMIA and is motivated by nancial gain
may face nes of $5,000 to $250,000 and may have to surrender those gains.
54
Similar to exceptions under HIPAA, under CMIA, medical information may be shared with other
health care providers or plans involved in the patient’s diagnosis or treatment, including in
medical emergencies; researchers, medical examiners, health care licensing bodies; and public
health authorities engaged in reporting and control of illness and injury, among others.
55,56
Authorized recipients of patient medical information may not disclose it further without new
authorization.
1
Griswold v. Connecticut, 381 U.S. 479 (1965).
2
Roe v. Wade, 410 U.S. 113 (1973).
3
Nixon v. Administrator of General Services, 433 U.S. 425 (1977).
4
AIDS Legal Referral Panel (ALRP), AIDS Law Manual, “Condentiality,” Ch. 16, p. 17 (citing Norman Viera, “Unwarranted
Government Disclosures,” Wayne Law Review 2001); Harris v. Thigpen, 941 F.2d 1495 (1991).
5
Cal. Const. art. 1, § 1.
Committee to Defend Reproductive Rights v. Myers, 29 Cal.3d 252 (1981).
Hill v. National Collegiate Athletic Assn., 7 Cal.4th 1 (1994); Heller v. Norcal Mutual Ins. Co., 8 Cal.4th 30 (1994).
William L. Prosser, Privacy, 48 Calif. L. Rev. 383 (1960).
 Forsher v. Bugliosi, 26 Cal.3d 792 (1980).
10
Cal. Health & Safety Code § 121025.
11
Cal. Health & Safety Code § 121020.
12
Cal. Health & Safety Code § 120985.
13
Id.
14
Id.
15
Cal. Health & Safety Code § 121010.
16
Cal. Health & Safety Code § 121015.
17
Cal. Health & Safety Code § 121015(c).
18
Cal. Health & Safety Code § 121015(b).
19
Cal. Health & Safety Code § 121015(d).
20
Id.
21
Id.
22
Id.
23
Cal. Health & Safety Code § 121025(a).
California HIV/AIDS Policy Research Centers
9
24
Cal. Health & Safety Code § 121025(b).
25
Cal. Health & Safety Code § 121022.
26
Cal. Health & Safety Code § 121025(e).
27
Id.
28
Cal. Health & Safety Code § 121075.
29
Cal. Health & Safety Code § 121080.
30
Cal. Health & Safety Code § 121100.
31
Cal. Health & Safety Code § 121085.
32
Cal. Health & Safety Code § 121090.
33
Id.
34
Cal. Health & Safety Code § 121110.
35
Id.
36
Cal. Health & Safety Code § 123148(f).
37
Cal. Health & Safety Code § 123148(f)(1).
38
45 C.F.R. § 160.103.
39
45 C.F.R. § 164.302.
40
45 C.F.R. § 160.103.
41
45 C.F.R. § 164.524.
42
45 C.F.R. § 164.528.
43
45 C.F.R. § 164.502.
44
45 C.F.R. § 164.508.
45
45 C.F.R. § 164.510(b).
46
45 C.F.R. § 160.306.
47
42 U.S.C. §§ 1320d-5 and 1320d-6.
48
Chris Dimick, “HIPAA Violation? Sue Me,” Journal of AHIMA, (March 1, 2011), available at https://journal.ahima.
org/2011/03/01/hipaa-violation-sue-me/; Kane Russell Coleman Logan, Is there a Private Cause of Action for HIPAA
Violations? (January 28, 2016), available at https://www.lexology.com/library/detail.aspx?g=a5bc1a0f-557a-4bf1-
8cd3-1498c872a4dc
49
Cal. Civil Code § 56.35.
50
Cal. Civil Code § 56.05(j).
51
Cal. Civil Code § 56.10(a).
52
Cal. Civil Code § 56.35.
53
Cal. Civil Code § 56.36(c).
54
Id.
55
Cal. Civil Code §§ 56.10-56.16.
56
Cal. Civil Code § 56.10.
10
CHAPTER 3
HIV Criminalization and Criminal Laws
Mandatory HIV Testing in the Criminal Context
In the criminal context, there are various circumstances under which a person may be required to
take an HIV test without their consent. For example, an HIV test without an individual’s consent
can occur if a person is convicted of specic sex oenses, including minors placed in custody
or sentenced to probation for specic sex oenses,
1
of if a person is charged with a specic sex
oense(s) and a victim requests testing and a court grants the request.
2
Generally, police and sta working at a jails and prisons cannot require a person to undergo an
HIV test without a court order. There are specic situations described under the law when a court
order may be granted.
3
A key example is in the circumstance where an arrestee has exposed
any peace ocer, reghter, custodial ocer, custody assistant, non-sworn employee of a law
enforcement agency, or emergency medical personnel, acting within the scope of his or her
duties, to the arrestee’s blood or body uids.
4
A court may order an HIV test against the wishes of
the person.
Additionally, a chief medical ocer of a custodial facility has the ability to test an inmate, a person
arrested or taken into custody, or a person on probation or parole to be tested without consent if
s/he deems it necessary. This is based on an analysis such as the following:
• the person appears to be exhibiting clinical symptoms of HIV/AIDS, or
• the person has exposed custodial and law enforcement personnel or another inmate, as
alleged in a report to the chief medical ocer, to bodily uids in a manner that represents
a signicant risk that HIV was transmitted.
5
The California Department of Public Health is also permitted to conduct periodic anonymous
testing of all or portions of the inmate population or persons under custody within a city or
county.
6
Disclosure of HIV-Positive Status in the Criminal Context
A person living with HIV is not required to disclose their HIV-positive status when stopped by the
police nor do they have to report what medications they might be taking.
7
If law enforcement
ocers were to nd out about a person’s HIV-positive status from a complaining witness or some
other means besides testing the person or obtaining public health records, there is little one
can do to address these disclosures through the law. Rules related to privacy and condentiality
often hinge on the established rights of those being voluntarily tested for HIV or HIV test
results held in public health records.
8
These same laws and protections likely do not apply in
the criminal context. Additionally, if a person chooses to disclose their HIV-positive status to
another inmate, there are no legal protections should that other inmate choose to disclose that
information to others.
While conned, a person may choose to, and, frankly, may need to, disclose their HIV-positive
status to seek care or stay engaged in care during connement. The risk of doing so involves
further disclosure that is required under the law. Medical personnel at local or state detention
facilities must notify the ocer in charge of the facility if they know an inmate is living with
HIV.
9
The ocer in charge is then required to notify any people who have or may have direct
contact with this person.
10
This includes employees, medical personnel, contract personnel, and
volunteers providing services at the facility.
11
California HIV/AIDS Policy Research Centers
11
HIV Criminalization Laws
HIV Criminalization is the use of laws to specically target people living with HIV with criminal
penalties. After much advocacy
12
and research
13
was conducted on the impact of these laws on
people living with HIV, California became one of the rst states to overhaul its HIV Criminalization
laws—both repealing and modernizing laws out of date with the science of HIV.
14
Changes
implemented on January 1, 2018 include:
• elimination of the HIV-specic exposure law that could trigger a felony prosecution under
certain circumstances, now treating HIV exposure and transmission in a manner similar to
all other communicable diseases,
15
• an update to include consideration of “practical means” taken to reduce the risk of
transmission, including using a condom and taking medications to treat HIV,
16
• elimination of felony for donating blood, tissue and/or semen while living with HIV,
17
• elimination of felony solicitation charge for people living with HIV,
18
• elimination of mandatory HIV testing for all those convicted of prostitution charges,
19
• elimination of mandatory AIDS education for those convicted of felony solicitation,
20
and
• invalidation of prior sentence(s) for felony solicitation.
21
With these changes to existing law, HIV is now treated like any other communicable disease.
Laws regarding intentional transmission of HIV make clear that criminal punishment is only
appropriate when the government can show the following:
• the person had knowledge of their infectious disease,
• they acted with specic intent to transmit it,
• they engaged in activity with a substantial risk of transmission, and
• they transmitted the infection to another person.
22
This crime is punishable as a misdemeanor and can result in imprisonment in county jail for
no more than six months.
23
If HIV is not transmitted, however, and the person is found to have
engaged in all the behaviors listed above, it can result in imprisonment in county jail for no more
than 90 days.
24
Health ocers continue to have the ability to use the law to address individuals
who engage in behaviors in direct contradiction to orders they may issue to protect public
health.
25
1
Cal. Penal Code § 1202.1
Cal. Health & Safety Code § 121055.
3
Cal. Health & Safety Code § 121055; See also Cal. Penal Code 1524.1(b).
4
Cal. Health & Safety Code § 121060.
5
Cal. Penal Code §§ 7500-7519; Cal. Health & Safety Code § 121070.
6
Cal. Penal Code § 7553.
7
Kastigar v. U.S., 406 U.S. 441, 462 (1972) (explaining that you are only compelled to talk when summoned
with a court order).
12
8
Cal. Health & Safety Code §§ 121070 and 121025.
9
Id. at 7.
10
Id.
11
Id.
12
See Equality California, Californians for HIV Criminalization Reform, available at https://www.eqca.org/chcr/ (last
accessed March 9, 2019).
13
Amira Hasenbush, Ayako Miyashita & Bianca D.M. Wilson, HIV Criminalization in California: Penal Implications for
People Living with HIV, The Williams Inst. of Cal. L.A. Sch. of Law (2015), https://williamsinstitute.law.ucla.edu/wp-
content/uploads/HIV-Criminalization-California-Updated-June-2016.pdf.
14 CA Senate Bill 239, Section 1, Session 2017-2018, available at https://leginfo.legislature.ca.gov/face/billTextClient.
xhtml?bill_id=201720180SB239 (last accessed on March 8, 2019).
15
Cal. Health & Safety Code § 120290.
16
Cal. Health & Safety Code § 120290(b).
17
Cal. Health & Safety Code § 1621.5 (repealed by S.B. 239, § 8, e. Jan. 1, 2018).
18
Cal. Penal Code § 647 f (repealed by S.B. 239, § 8, e. Jan. 1, 2018).
19
Cal. Penal Code § 1202.1 (modied by S.B. 239, § 8, e. Jan. 1, 2018); Cal. Penal Code § 1202.6 (repealed by
S.B. 239, § 8, e. Jan. 1, 2018).
20
Cal. Penal Code § 1001.10-1001.11 (repealed by S.B. 239, § 8, e. Jan. 1, 2018).
21
Cal. Penal Code § 1170.21.
22
Cal. Health & Safety Code § 120290.
23
Cal. Health & Safety Code § 120290(g)(1).
24
Cal. Health & Safety Code § 120290(g)(2).
25
Cal. Health & Safety Code § 120290(a)(2).
California HIV/AIDS Policy Research Centers
13
CHAPTER 4
HIV Discrimination
State-Based Protections
California has a number of state laws that protect people from being discriminated against on the
basis of their HIV-positive status. In many instances, California law provides for remedies broader
than those oered under federal law. This means that winning a case allows the person to
recover damages, and in some cases, more costs and damages. For example, nominal damages,
1
awards for punitive damages
2
, and attorney’s fees
3
are some of the allowable costs included in
California law. Non-discrimination provisions are increasingly being incorporated into dierent
laws, broadening non-discrimination protections for people living with HIV.
4
Housing and Employment
Both in employment and housing, HIV is listed as a specic ground for protection.
5
If a person
has been discriminated against on the basis of their HIV-positive status, often the rst step is to
le a complaint. The California Department of Fair Employment and Housing oversees these
complaints regarding HIV-based discrimination.
6
A complaint must be led within one year
of the last incident, so seeking assistance as soon as possible is important to a legal claim for
discrimination.
7
The role of the Department is to investigate the facts and seek to resolve the issue
between the person ling the complaint and the alleged wrongdoer. In some instances where
the conict is not resolved, the Department will le a lawsuit.
8
The Department selects only
some cases in which to le a lawsuit, and when they do, they are representing the Department,
not the individual.
9
If the Department recovers damages, however, they will be awarded to the
individual.
10
Because the Department is selective and they are not representing the individual, it
is advised that individuals nd an attorney of their own to help them.
11
Employers that may have specic information regarding a person’s HIV-status must follow
special rules related to disclosure.
12,13
Employers may not discriminate against employees that
refuse to sign an authorization to disclose medical information.
14
If a person chooses to sign an
authorization, that authorization must be specic, including identifying who will receive that
information, limitations on its use, and a specic date after which the permission to release
information ends.
15
Public Accommodations
Under California’s Unruh Civil Rights Act
16
a person living with a disability is entitled to full and
equal access to “accommodations, advantages, facilities, privileges, or services in all business
establishments of every kind whatsoever.”
17
Business establishments include including hotels/
motels, restaurants, theaters, hospitals, barber and beauty shops, housing accommodations, and
retail stores.
18
Because a person living with HIV is regarded as living with a disability, this law’s
protections apply. Similar to claims under employment and housing, individuals should also le
a complaint with the California Department of Fair Employment and Housing within one year of
the last incident.
19
Hate Violence and Threats
California has a specic law regarding hate violence and threats motivated by hate. The Ralph
Civil Rights Act prohibits individuals from engaging in behaviors such as the following:
• threats, verbal or written,
• physical assault or attempted assault,
14
• hate-related grati, including swastikas and other oensive symbols,
• cross-burning,
• bomb threats,
• arson,
• disturbance of religious meetings, or
• vandalism or property damage.
20
Any such acts motivated by bias against individuals living with HIV are covered under this law.
21
Because violence or threat of violence is also a crime, it is recommended that law enforcement
be contacted as soon as the incident takes place. If a person living with HIV would like to le a
lawsuit against the perpetrator, they must do so within one year of the day they become aware of
the perpetrator’s identity, but not more than three years after the date of the injury.
22
In addition
to granting a victim survivor with damages (e.g. nancial compensation), they can also request
the court to provide a restraining order.
23
Federal Non-Discrimination Laws
Federal non-discrimination laws include protections for people living with disabilities. Under
federal law, similar to state law, living with HIV is regarded as living with a disability.
24
Federal
disability-related protections in employment
25
, housing
26
and public accommodations
27
apply
to people living with HIV. In addition to these laws, federal non-discrimination protections
for people living with disabilities are extended to a variety of additional contexts: state
and local government activities,
28
education,
29
transportation,
30
architectural barriers,
31
telecommunications,
32
employment leave,
33
voting,
34
and institutions
35
such as jails, prisons, youth
correctional facilities.
Because these laws can be dicult to understand, if a person living with HIV believes that they
may be experiencing discrimination on the basis of their HIV-positive status, it is very important
they nd legal help. With each of these laws, the protections vary, there are dierent federal
agencies in charge of implementing the law,
36
and there are dierent rules for ling complaints.
Additionally, the types of legal remedies available to the individual dier according to the law.
For this reason, it is best to speak to an attorney specializing in disability law. It is important to
determine whether an experience a person living with HIV is experiencing may be considered
unlawful discrimination and what the legal remedies may be.
1
Cal. Civil Code § 52(a).
 Cal. Civil Code § 52(b).
 Cal. Civil Code §§ 52(a) and 52(b)(3).
 See California Community Care Facilities Act, Cal. Health & Safety Code §§ 1500 - 1567.87.
 See California Fair Employment and Housing Act, Cal. Government Code § 12926.1(c).
 See Cal. Department of Fair Employment and Housing, Discriminations Laws regarding People with Disabilities,
available at https://www.dfeh.ca.gov/people-with-disabilities/.
 Cal. Code of Regulations § 10006.
 Cal. Government Code §§ 12930(f) - 12930(h).
 Cal. Government Code § 12930(f)(3).
10
Id.
11
See Cal. Department of Fair Employment and Housing, Employment FAQs: Does DFEH Represent Complainants?,
available at https://www.dfeh.ca.gov/resources/frequently-asked-questions/employment-faqs/.
California HIV/AIDS Policy Research Centers
15
12
Cal. Civil Code § 56.20.
13
Cal. Civil Code § 56.26.
14
Cal. Civil Code § 56.20(b).
15
Cal. Civil Code §§ 56.21(d) - 56.21(h).
16
Cal. Civil Code §§ 43 - 53.7.
17
Cal. Civil Code § 51(b).
18
See https://www.dfeh.ca.gov/wp-content/uploads/sites/32/2017/06/DFEH_UnruhFactSheet.pdf.
19
Cal. Code of Regulations § 10006.
20
Cal. Civil Code § 51.7(b); See also Cal. Department of Fair Employment and Housing, Hate Violence, available
at https://www.dfeh.ca.gov/hate-violence/.
21
Cal. Civil Code § 51.7(b).
22
Cal. Government Code § 12960(d)(3).
23
Cal. Civil Code § 52(c)(3).
24
See Bragdon v. Abbott, 524 U.S. 624 (1998)(nding HIV to be a disability under the Americans with
Disabilities Act).
25
Americans with Disabilities Act (ADA) Title I, 42 U.S.C. §§ 12101 et seq.; Section 504 of the Rehabilitation Act
of 1973, 29 U.S.C. § 794.
26
Fair Housing Act and Fair Housing Amendments Act of 1988, 42 U.S.C. §§ 3601 et seq.; Section 504 of the
Rehabilitation Act of 1973, 29 U.S.C. § 794.
27
Americans with Disabilities Act, Title III, 42 U.S.C. §§ 12101 et seq.
28
ADA Title II, 42 U.S.C. §§ 12101 et seq.
29
Americans with Disabilities Act, 42 U.S.C. §§ 12101 et seq.; Individuals with Disabilities Education Act (IDEA), 20
U.S.C. §§ 1400 et seq.
30
Air Carrier Access Act, 49 U.S.C. § 41705; ADA Title II, 42 U.S.C. §§ 12101 et seq.
31
Architectural Barriers Act of 1968, 42 U.S.C. §§ 4151 et seq.
32
Telecommunications Act, § 255 and 251(a)(2) of the Communications Act of 1934, 47 U.S.C. §§ 255, 251(a)(2);
Americans with Disabilities Act Title IV, 42 U.S.C. §§ 12101 et seq.
33
Family and Medical Leave Act of 1993, 29 U.S.C. §§ 2601 et. seq.
34
Voting Accessibility for the Elderly and Handicapped Act of 1984, 42 U.S.C. §§ 1973ee et seq.; National Voter
Registration Act, 42 U.S.C. §§ 1973gg et seq.
35
Civil Rights of Institutionalized Persons Act, 42 U.S.C. §§ 1997 et seq.
36
U.S. Department of Justice, Civil Rights Division, A Guide to Disability Rights Laws, July 2009, available at
https://www.ada.gov/cguide.htm#anchor63109.
16
CHAPTER 5
Needle and Syringe Exchange Programs
History of Pharmacy Sale of Syringes
California’s non-prescription sale of hypodermic needles and syringes (NPSS) eorts were rst
launched in 2005 under the Disease Prevention Demonstration Project.
1
The pilot program
allowed the non-prescription sale of up to 10 needles or syringes to adults by pharmacies
registered with the local government.
2
Within ve years, the program expanded to 15 counties
and four cities in California
3
and legislation in 2011 raised the cap on the allowed number of non-
prescription needles or syringes for personal use to 30.
4
Beginning in 2015, the numerical limit
was removed entirely.
5
Current Law on Non-Prescription Sale of Syringes
To prevent HIV, viral hepatitis, and other infections among persons using hypodermic needles
and syringes, physicians or pharmacists may supply or sell them to an adult 18 years of age or
older without a prescription and for personal use.
6
At the time of sale or supply, a pharmacy must counsel consumers in person or give them written
information on how to do the following:
• access drug treatment,
• access HIV and hepatitis C testing and treatment, and
• dispose of sharps waste safely.
7
Pharmacies must provide consumers with one or more of the following safe disposal options:
• onsite needle and syringe collection and disposal that meets federal standards for
collection and disposal of medical sharps waste,
• sharps containers that meet federal standards, and
• mail-back sharps containers authorized by the U.S. Postal Service that meet state and
federal standards, along with tracking forms to verify destruction at a disposal facility.
8
Pharmacies must also store hypodermic needles and syringes so that only authorized persons can
access them.
9
They are not required to log these over-the-counter needle and syringe sales nor to
check customer identication.
10
Local Laws and Requirements
Current law does not require local governments to authorize pharmacies for the non-prescription
sale of syringes and hypodermic needles. It does not require local health departments to register
pharmacies, compile a list of pharmacies that provide NPSS, provide pharmacies with educational
materials on proper disposal of needles and syringes, HIV and viral hepatitis treatment, and drug
treatment.
11
These responsibilities do not fall to local health departments. Such information is
now available on the California Department of Public Health (CDPH), Oce of AIDS website.
12
Clean Needle and Syringe Exchange Programs
The California legislature authorizes any city or county to have a clean needle and syringe
California HIV/AIDS Policy Research Centers
17
exchange program, if established by its respective county board of supervisors or city council
and mayor, along with the local health oce.
13
CDPH may authorize entities meeting a set of
minimum standards
14
to oer hypodermic needle and syringe exchange programs (SEPs) for a
two-year period, in places it deems at risk for the rapid spread of HIV, viral hepatitis, or other grave
infections.
A prospective SEP must provide either through direct services or through referrals the following
services:
• drug abuse treatment,
• screening for HIV, hepatitis, and other sexually transmitted infections,
• hepatitis A and B vaccination,
• housing services for the homeless, victims of domestic violence, or similar,
• educational services and materials for sexual risk reduction,
• to begin needle and syringe exchange services within three months of authorization,
• enough funding, at acceptable participation levels, to provide needle and exchange
services for all participants and safe recovery and disposal for their used syringes and
sharps waste, and
• collect data to evaluate program impact.
15
CDPH can only authorize an SEP program after consulting with the local health oce, local law
enforcement, and the public.
16
Sta and volunteers distributing such paraphernalia as part of
authorized SEPs are insulated from criminal prosecution.
17
Before authorization expires, an SEP may be renewed again after consultation with the
local health ocer and law enforcement.
18
The public and local government must have the
opportunity to give input on the program’s eect on public welfare every two years at an open
meeting.
19
Both the department and local health ocer must present biennial reports on the
needle and syringe exchange programs.
20
Pending Litigation on Syringe Exchange Programs
Since February, 2016, the Orange County Needle Exchange Program (OCNEP) had been operating
a mobile needle exchange program every Saturday at the Santa Ana Civic Center. It was the
only such program in Orange County.
21
It was re-authorized by the CDPH in January, 2018, but
Santa Ana city ocials rejected OCNEP’s permit application.
22
OCNEP’s mobile needle exchange
program was approved by the CDPH to begin in August, 2018, despite objections from city
ocials. Litigation ensued.
23
In November, 2018, a San Diego Superior Court granted an injunction blocking the OCNEP from
operating a mobile needle exchange program in Orange County and in the cities of Costa Mesa,
Anaheim, and Orange.
24
These local jurisdictions and the Orange County Flood District sued to
stop OCNEP from conducting mobile needle exchange services in their cities, including Santa
Ana.
25
The judge noted that while OCNEP gave “substantial evidence to support the social utility”
of a needle exchange program, he was swayed by the plainti County and city jurisdictions’
argument that inadequate recovery of used syringes and needles posed a greater risk to public
safety.
26
18
Safer Drug Consumption Sites
Overdose prevention programs, also commonly referred to as supervised drug consumption
facilities (SCFs), supervised consumption services (SCS), safer or supervised injection facilities
(SIFs), are one strategy to address HIV risk among people who inject drugs. Some 120 such
programs operate in ten countries
27
and have existed in Europe for the last 30 years.
28
Evidence-
based studies
29
show these programs are associated with a reduced number of deaths, calls to
emergency rooms and ambulances, higher uptake of drug treatment, no increase in drug use or
drug dealing, reduced disposal of syringes in streets, and fewer people using drugs in public.
30,31
With regard to HIV risk, it is estimated that a single safe injection site in San Francisco, California,
could prevent 3.3 new HIV transmissions per year. This would save the State of California
roughly $3.5 million per year in expenses related to healthcare, emergency services and crime.
32
Overdose prevention projects thus complement existing prevention, treatment, and harm
reduction measures.
In California, legislators passed Assembly Bill 186 in the 2017-2018 legislative session establishing
overdose prevention programs in the City and County of San Francisco. The bill was vetoed last
September, 2018, by then-Governor Jerry Brown.
33
Assembly Bill (AB) 362, introduced in the
2019-2020 legislative session, is another attempt to pass legislation in California that authorizes
the City and County of San Francisco to pilot and evaluate an overdose prevention program.
34
Passage of this bill would allow drug users to consume pre-obtained drugs in a hygienic space
supervised by health care professionals, get sterile supplies and obtain referrals to substance use
treatment and other medical and social services.
35
No sites have been formally authorized to operate in the United States. Given the risk of
criminal and civil liability that could be imposed by the federal government upon state or local
jurisdictions wishing to establish programs, the stakes of doing so are exceedingly high.
36
In
addition to federal laws that may hinder activities, current state law makes it a crime to knowingly
be in a room where controlled substances are being used unlawfully.
37
The bill would, thus,
protect property owners, managers, employees, volunteers, and program participants from state
criminal and civil liability and from being subjected to professional discipline solely for eorts
to support the operation of an authorized overdose prevention site.
38
It is important to note,
however, that this bill would not protect individuals from being subject to federal laws which may
prohibit certain conduct required to operate a site. Before approving such a program, the City
and County of San Francisco would have to give the public and local law enforcement and health
ocials an opportunity to comment in an open meeting.
39
Under the terms of the proposed bill, among other requirements, an entity seeking to conduct an
overdose prevention program must show it can do the following:
• provide a hygienic site staed by health care professionals trained in overdose recognition
and reversal,
• provide sterile consumption supplies, collect used supplies, and provide safe disposal,
• educate participants on HIV and viral hepatitis risk, proper needle and syringe disposal,
and overdose prevention,
• facilitate access and give referrals to providers of naloxone or other overdose reversal
medication, and
• provide reasonable security at the site and facilitate communication with local authorities
and the community.
40
It remains to be seen how California, under the leadership of newly-elected Governor Newsom,
may respond to this bill in the current legislative term.
California HIV/AIDS Policy Research Centers
19
1
Cal. Senate Bill 1159, Session 2003-2004; Cal. Health & Safety Code § 121285(a).
2
Cal. Senate Bill 1159, Section 1, Session 2003-2004; See also Cal. Department of Public Health, SB 1559 Report: An
Evaluation of Over-the-Counter Sale of Sterile Syringes in Cal. (July 2010), p. 15.
3
Id. at 8.
4
Cal. Senate Bill 41, Section 6, Session 2011-2012.
5
Cal. Business & Professions Code § 4145.5(b); Cal. Assembly Bill 1743 (2014), Section 4, Session 2013-2014.
6
Cal. Business & Professions Code § 4145.5(b).
7
Cal. Business & Professions Code § 4145.5(f).
8
Cal. Business & Professions Code § 4145.5(e).
9
Cal. Business & Professions Code § 4145.5(d).
10
Cal. Business & Professions Code § 4145.5(b); See also Cal. Department of Public Health Oce of AIDS,
Nonprescription Syringe Sale in Cal. Legislation and Requirements Fact Sheet (October 2014).
11
Id.
12
Id.
13
Cal. Health & Safety Code § 121349(b).
14
Cal. Health & Safety Code § 121349.1.
15
Cal. Health & Safety Code § 121349(d).
16
Cal. Health & Safety Code § 121349(c).
17
Cal. Health & Safety Code § 11364.7(a).
18
Cal. Health & Safety Code § 121349(c).
19
Cal. Health & Safety Code § 121349.3.
20
Id.
21
Mary Carreon, “Santa Ana Shuts Down the Only Needle Exchange Program in Orange County,” OC Weekly,
February 1, 2018.
22
Id.
23
See Complaint, City of Newport Beach v. Cal. Department of Public Health, 2018 WL 4362389 (Cal.Super. 2018);
See also Ben Brazil, “Cities Weigh Options after State Approves Orange County Needle Exchange Program,”
Los Angeles Times (Online), August 3, 2018.
24
Luke Money, “Court Ruling Blocks Proposed Needle Exchange Program,” Los Angeles Times (Online),
November 27, 2018.
25
Id.
26
Id.
27
Drug Policy Alliance, Supervised Consumption Services, August 2018, available at http://www.drugpolicy.org/sites/
default/les/supervised-consumption-services-opp_0.pdf.
28
European Monitoring Centre for Drugs and Drug Addiction, Drug Consumption Rooms: An Overview of Provision
and Evidence, June 2018, available at http://www.emcdda.europa.eu/topics/pods/drug-consumption-rooms_en.
29
Alex Kral and Peter Davidson (2017), “Addressing the Nation’s Opioid Epidemic: Lessons from an
Unsanctioned Supervised Injection Site in the U.S.”, American Journal of Preventive Medicine, Vol. 53(6) 919-
922.
30
A. Miyashita, R. Gamboa, A. Leibowitz, I Holloway, HIV and Safer Drug Consumption Programs in Cal., Cal. HIV/
AIDS Policy Research Center (March 2018).
31
Drug Policy Alliance, Cal. Legislature To Consider Allowing Pilot Overdose Prevention Projects, February 2019.
32
Irwin Amos, E. Jozaghi, R.N. Bluthenthal, A.H. Kral (2017), “A Cost-Benet Analysis of a Potential Supervised
Injection Facility in San Francisco, Cal., USA,” Journal of Drug Issues, Vol. 47(2) 164-184.
33
Edmund G. Brown, Oce of Governor, Letter to Members of the Cal. State Assembly, available at https://www.gov.
ca.gov/wp-content/uploads/2018/09/AB-186-veto-9.30.pdf (last accessed on March 8, 2019).
34
CA Assembly Bill 362, Section 1, Session 2019-2020, available at http://leginfo.legislature.ca.gov/faces/
billTextClient.xhtml?bill_id=201920200AB362 (last accessed on March 8, 2019).
35
Id.
36
U.S. Department of Justice, Statement of the U.S. Attorney’s Oce concerning Proposed Injection Sites,” (District
of Vermont, 2017), available at https://www.justice.gov/usao-vt/pr/statement-us-attorney-s-oce-concerning-
proposed-injection-sites (last accessed March 8, 2019).
37
Cal. Assembly Bill 362, Session 2019-2020, Legislative Counsel’s Digest.
38
Cal. Assembly Bill 362, Section 1, Session 2019-2020.
39
Id.
40
Id.
20
CHAPTER 6
Comprehensive Sexual Health Education
Objectives of Comprehensive Sexual Health Education
For all school districts and charter schools in the state, the 2016 California Healthy Youth Act
(CHYA) mandates both comprehensive sexual health and HIV prevention education.
1
CHYA
sets out guidelines for content in comprehensive sexual health instruction and HIV prevention
education for grades 7 to 12.
2
School districts must provide comprehensive sexual health
and HIV prevention education at least once in middle school and at least once in high school.
3
Information provided for by CHYA includes topics such as human development and sexuality,
pregnancy, contraception, and sexually transmitted infections (STIs).
4
Students are also required
to learn about HIV/AIDS, transmission methods, risk reduction strategies, and related social
and public health issues.
5
The law respects the rights of parents and guardians to supervise
their children’s sex education and recognizes their ultimate responsibility for passing on values
regarding sexuality to their children.
6
That said, comprehensive sexual health education must not
teach religious doctrine.
7
Like the law it replaced,
8
CHYA seeks to provide students with the knowledge and skills to protect
themselves from HIV, STIs and unintended pregnancy and to develop healthy attitudes toward
adolescent growth, body image, gender, sexual orientation, relationships, marriage, and family.
9
The law’s goals now include:
• promoting the understanding of sexuality as a normal part of human development,
• ensuring comprehensive, accurate, and unbiased sexual health and HIV prevention
education for students and clear tools and guidance for educators, and
• providing students with the knowledge and skills needed for healthy, positive, and safe
relationships and behaviors.
10
Providing only textbook descriptions or illustrations of the human reproductive system does not
qualify as comprehensive sexual health education.
11
Instructional Criteria and Content
All required instruction on sexual health and HIV prevention must meet all the following criteria:
• be age-appropriate and medically accurate,
• support and not conict with the ve purposes of the law (as stated above),
• be appropriate for and equally available to students of any race, ethnicity or culture,
gender, or sexual orientation—including those living with disabilities or English language
learners,
• reject bias against anyone owing to disability, gender, gender expression, gender identity,
sexual orientation, nationality, race or ethnicity, or religion,
• arm people’s dierent sexual orientations and be inclusive of same-sex relationships,
• teach students about gender, gender expression, gender identity, and the harm of
negative gender stereotypes,
California HIV/AIDS Policy Research Centers
21
• encourage communication with parents, guardians, and other trusted adults;
• teach students the value of and prepare them for committed relationships, such as
marriage,
• provide the knowledge and skills to form healthy relationships free from coercion,
intimidation, or violence, and
• provide the knowledge and skills to make healthy choices about sexuality, including
negotiation and refusal skills to counter peer pressure and decision making skills to avoid
high-risk activities.
12
Instruction regarding HIV must cover the following:
• the nature of HIV and other STIs and their physiological eects,
• the routes and relative risks of HIV and STI transmission,
• FDA-approved methods of preventing and reducing the risk of HIV and other STIs,
including use of antiretroviral medication (i.e., U=U, PrEP/PEP),
• reducing the risk of HIV transmission from injection drug use by avoiding needle use and
sharing, and
• social views of HIV/AIDS and associated myths and stereotypes, with an emphasis on
normal life expectancy with successful treatment.
13
Issues related to pregnancy and sexual health must include information about the following:
• FDA-approved contraceptive methods, including emergency contraception, and a
discussion of all possible pregnancy outcomes,
• medically accurate methods of preventing pregnancy and STIs and the value of delaying
sexual activity, and
• that abstinence from injection drug use and sex are the only certain ways to avoid STIs
and the latter is the only certain way to avoid unintended pregnancy.
14
Topics of Special Consideration
Great eorts have been made to include in the curriculum information regarding sexual
harassment, assault, abuse, and human tracking.
15
As a preventative measure, youth must
receive information regarding (1) the nature of human tracking and reducing risk; (2)
techniques to set healthy boundaries, and how to seek help; and (3) how social media and
mobile devices are used for human tracking.
16
Additionally, adolescent relationship abuse and
intimate partner violence, including early warning signs, are required to be discussed.
17
Finally,
comprehensive sexual health education programs must provide information on how youth can
access local resources for testing and treatment for infections, pregnancy prevention and care,
help for sexual assault and intimate partner violence and information on the legal rights of youth
to access sexual health and reproductive health care.
18
Parental Excuse and School District Notice
At the start of the school year, at enrollment if a student joins a school after the school year
has begun, or 14 days before the scheduled instruction if not arranged at the start of the
22
year, school districts must inform parents and guardians of their right to excuse their child,
through an opt-out process, from all or part of the planned sexual health and HIV prevention
instruction.
19
Notice to parents must state that the relevant teaching materials are available for
their inspection.
20
The notice given to parents and guardians must state if instruction is by school
district personnel, outside consultants, or through an assembly featuring guest speakers.
21
Any
outside consultants or guest speakers whom districts contract with for instruction of students or
training of school personnel must be experts in comprehensive sexual health and HIV prevention
education and knowledgeable of the latest, medically accurate research on these topics.
22
The
notice must include the date of instruction and must inform parents of their right to request
a copy of the Education Code’s chapter on CHYA.
23
One exception to the opt-out provision is
that parents may not selectively opt out of LGBT-related content delivered in the context of
comprehensive sexual health education. Doing so would be a violation of various federal non-
discrimination laws.
24
Other Requirements for School Districts
School districts include county boards of education or superintendents of schools, the California
School for the Deaf, the California School for the Blind, and charter schools.
25
Collaborating with
teachers and the Department of Education, these organizational bodies must plan and conduct
in-service training for all sta involved in HIV prevention education.
26
Such training has to be
given periodically to ensure sta stay informed of new, scientic developments on the subject.
27
Training on HIV prevention may also expand to include comprehensive sexual health education.
28
Youth Sexual Health Rights
Aside from being entitled to receive comprehensive sexual health and HIV prevention education
in California school districts, minors have the right to obtain certain forms of medical care or
treatment without parental consent.
29
Minors may seek the full range of care relating to the
prevention, continuation, or termination of pregnancy.
30
They may access birth control, prenatal
care, and abortion. Minors aged 12 or older may seek medical attention meant to diagnose, treat,
or prevent STIs (including PrEP and PEP)
31
and they can consent to an HIV test.
32
Minor youth
may also consent to medical care in response to rape,
33
sexual assault,
34
and intimate partner
violence,
35
including collecting medical evidence for such alleged acts. School districts must
excuse a student’s absence during school hours in order to receive condential medical care
without parental consent.
36
Districts must also inform students in grades 7 to 12 of this right.
37
If
minors seek services condentially, the California Attorney General has advised school districts
that their parents should not be notied in these circumstances.
38
In 2013, California lawmakers enacted the Condential Health Information Act to address privacy
concerns of individuals insured as dependents on a parent’s or partner’s health plan.
39
The law
allows individuals to submit a “condential communications request” to their health plan when
seeking sensitive services such as PrEP under another person’s policy.
40
While this law cannot
guarantee condentiality (e.g. it can take up to six weeks for the health plan to guarantee that
sensitive information will not be shared with the main policy holder) it is an additional tool used
to increase condentiality protections for youth seeking access to sexual health services.
1
Cal. Education Code § 51934.
2
Id.
3
Cal. Education Code § 51934(a).
Cal. Education Code § 51931(b).
Cal. Education Code § 51931(d).
Cal. Education Code § 51937.
Cal. Education Code § 51933(i).
California HIV/AIDS Policy Research Centers
23
California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act.
9
Cal. Education Code § 51930(a)
10
Id.
11
Cal. Education Code § 51932(a).
12
Cal. Education Code § 51933.
13
Cal. Education Code § 51934(a).
14
Id.
15
Cal. Education Code § 51934(a)(10).
16
Id.
17
Cal. Education Code § 51934(a)(11).
18
Cal. Education Code § 51934(a)(8).
19
Cal. Education Code § 51938(a).
20
Cal. Education Code § 51938(b).
21
Cal. Education Code § 51938(b).
22
Cal. Education Code § 51936.
23
Id.
24
Cal. Education Code § 220; Cal. Civil Code § 51; Title IX of the Civil Rights Act of 1964, 20 U.S.C. §§ 1681 et seq.
25
Cal. Education Code § 51931(g).
26
Cal. Education Code §§ 51935(a) and 51935(b).
27
Cal. Education Code § 51935(c).
28
Cal. Education Code § 51935(d).
29
American Academy of Pediatrics v. Lungren, 16 Cal.4th 307 (1997); See ACLU, Questions and Answers for School
Districts: California Healthy Youth Act Sexual Health Education Toolkit, on instruction about local health resources, p. 5.
30
Cal. Family Code § 6925
31
Cal. Family Code § 6926.
32
California Health and Safety Code § 121020(a).
33
Cal. Family Code § 6927.
34
Cal. Family Code § 6928(b).
35
Cal. Family Code § 6930(a).
36
Cal. Education Code § 48205.
37
Cal. Education Code § 46010.1.
38
87 Ops. Cal. Atty. Gen. 168 (2004).
39
Cal. Civil Code § 56.107.
40
Cal. Civil Code § 56.107(a)(3).
24
GLOSSARY
Assembly Bill – In California, this is a draft of a proposed law introduced by a member of the
Assembly side of the state legislature.
California Legislature – The state legislative branch of California is made up of the California
State Assembly (80 members) and the California State Senate (40 members). These two parts of
the legislature are also known as the “lower house” and “upper house,” respectively.
Civil Liability – Responsibility for payment of damages (e.g. nancial compensation) or a court
order that resulted from a lawsuit. Civil liability is dierent from criminal liability.
Criminal Liability – Responsibility for any illegal behavior that causes any harm or damage to an
individual or property. Criminal liability usually indicates a person will be subjected to a criminal
penalty (i.e. receive punishment for a crime).
Defendant – The accused party in a court of law
Electronic Health Records (EHR) – The digitized version of a patient’s chart that may include
information about medical history, diagnoses, and test results. These condential records are
meant to streamline patient care by making it easier and faster to send information among
providers and organizations related to the health care process including clinicians, laboratories,
pharmacies, physicians, as well as school and workplace clinics.
Felony – Considered the most serious type of crime that often involves some sort of violence. The
legal denition of a felony diers among states. The California Penal Code § 17(a) denes a felony
as “a crime that is punishable with death, by imprisonment in the state prison, or notwithstanding
any other provision of law, by imprisonment in a county jail under the provisions of subdivision
(h) of Section 1170.”
HIV Criminalization – The use of laws to specically target people living with HIV with criminal
penalties
Hypodermic Needles – A hollow needle commonly used with a syringe to inject substances into
the body or extract uids from it
Injunction – A judicial process to enforce an order or issue a warning to an individual or entity
Jurisdiction – An ocial power to make decisions in a legal setting including the extent of that
power to make legal decisions and issue judgements
Legislative Session – The period of time in which the legislature convenes for lawmaking
Litigation – The process of taking legal action. Such legal proceedings are between two
opposing parties to preserve or defend a legal right. Litigation can be settled by an agreement
between the two parties but can also be decided by a hearing decided by a jury or judge in court.
Litigation includes all activity that comes before, during and after a lawsuit is led.
Naloxone – Medication that is used to treat narcotic or opioid overdose. This medication is also
known by its brand name “Narcan®.”
Nominal Damages – A relatively small amount of money awarded to the plainti during a
lawsuit when the individual wins the case but has not suered signicant nancial loss
California HIV/AIDS Policy Research Centers
25
Plainti – A party who brings a case or legal action against another party (defendant) in a court
of law
Prosecution – The process of holding a criminal trial against an individual who is accused of a
crime or accused of breaking the law
Punitive Damages – Also referred to as “exemplary damages”. An amount of money awarded to
the plainti during a lawsuit to specically punish the defendant for truly bad behavior
Statutes – A law that is written and passed by a legislative body
Tort – Cases of a civil wrongdoing or wrongful act, regardless of if it was intentional or
unintentional, where an individual experiences a loss or harm resulting in civil liability
26