When used in this Part:
(a) AIDS means acquired immune deficiency
syndrome, as may be defined from time to time by the centers for disease
control (CDC) of the United States Public Health Service.
(b) HIV infection means infection with the
human immunodeficiency virus or any other related virus identified as a
probable causative agent of AIDS.
(c) HIV-related illness means any illness
that may result from or may be associated with HIV infection.
(d) HIV-related test means any laboratory
test or series of tests for any virus, antibody, antigen or etiologic agent
whatsoever thought to cause or to indicate the presence of AIDS.
(e) Protected individual means a person who
is the subject of an HIV-related test or who has been diagnosed as having HIV
infection, AIDS or HIV-related illness.
(f) Confidential HIV-related information
means any information concerning whether an individual has been the subject of
an HIV-related test, or has HIV infection, HIV-related illness or AIDS, or
information which identifies or reasonably could identify an individual as
having one or more of such conditions, including information pertaining to such
individual's contacts, when such information is in the possession of a provider
of one or more health or social services or has been obtained pursuant to a
release of confidential HIV-related information. Parole services provided by
the division are health or social services pursuant to Public Health Law,
2780(8). When such
information is in the possession of an authorized officer, employee or agent of
the division, the provisions of these regulations apply regardless of whether
the information has been obtained by consent, by authorized disclosure pursuant
to the provisions of the HIV- and AIDS-Related Information Act (Public Health
Law, article 27-F), or in any other manner, including from unofficial sources
or through unofficial communications.
Authorized officer or employee means an
officer or employee of the division who is permitted to have access to
confidential HIV information; such individuals, described more specifically in
of this Part, are those officers and employees who, in the performance of their
duties for the division, need to have access to records or information relating
to the care of, treatment of, or administration or provision of parole services
to, protected individuals.
Authorized agent means:
(1) an entity that has
contracted with the division to provide treatment or parole services to
parolees, or an employee of such entity, provided that the entity, or the
employee, needs to know confidential HIV-related information in order to
provide the contracted for service; and
(2) attorneys providing legal services to the
division, its officers, or employees provided that access occurs in the
ordinary course of providing legal services and is reasonably necessary for the
provision of legal services.
(i) Need to know means that knowledge of
confidential HIV-related information is reasonably necessary in order to
provide appropriate treatment or parole services to recipients of such
services, or to audit, monitor or supervise the provision of such services, or
to administer or plan the provision of such services on an individual, regional
or statewide planning basis.
Treatment or parole services means services provided to inmates or releasees by
officers, employees or agents of the division pursuant to article 12-B of the
Executive Law, officers or employees of the United States Parole Commission, or
parole officers of another state pursuant to article 12-B of the Executive
(k) Release of confidential
HIV-related information means a written authorization for disclosure of
confidential HIV-related information which complies with the requirements of
PHL, section 2780(9). Any such release obtained from a protected individual by
any officer or employee of the division shall be obtained only by using
Department of Health approved form (see subdivision [r] of this
section)--Division of Parole form 4136.
(l) Contact means an identified spouse or sex
partner of the protected individual or a person identified as having shared
hypodermic needles or syringes with the protected individual.
(m) Health care provider means any physician,
nurse, provider of services for the mentally disabled as defined in article one
of the Mental Hygiene Law, or other person involved in providing medical,
nursing, counseling or other health care or mental health service, including
those associated with, or under contract to, a health maintenance organization
or medical services plan. As used in this Part, the term includes the medical
director of a State correctional facility, and also includes any physician
providing any officer, employee or agent of the division with a confirmed
diagnosis of AIDS, HIV infection or HIV-related illness.
(n) Capacity to consent means an individual's
ability, determined without regard to such individual's age, to understand and
appreciate the nature and consequences of a proposed health care service,
treatment or procedure, and to make an informed decision concerning such
service, treatment, or procedure.
Significant risk of transmitting or
contracting HIV infection or significant risk means the circumstances set forth
in regulations promulgated by the Department of Health at 10 NYCRR section
. Those provisions
are summarized as follows. The following body fluids and substances are
currently considered to be significant risk body substances: blood, semen,
vaginal secretions, breast milk, tissue, cerebrospinal fluid, amniotic fluid,
peritoneal fluid, synovial fluid, pericardial fluid, and plueral fluid. The
following circumstances constitute significant risk of transmitting or
contracting HIV infection:
(1) sexual contact
which exposes a mucous membrane or broken skin to blood, semen or vaginal
secretions of an infected individual;
(2) sharing of needles or other paraphernalia
used for preparing and injecting drugs between infected and noninfected
(3) the gestation,
birthing or breast feeding of an infant when the mother is infected with
(4) transfusion or
transplantation of blood, organs, or other tissues obtained from an infected
individual to an uninfected individual, provided that such products have not
tested negatively for antibody or antigen and have not been rendered
noninfective by heat or chemical treatment; and
(5) other circumstances, not identified in
paragraphs (1) through (4) of this subdivision, during which a significant risk
body substance (other than breast milk) of an infected person contacts mucous
membranes (e.g., eyes, nose, mouth) or nonintact skin (e.g., open wound,
dermatitis, abraded areas) or the vascular system of a non-infected
Confirmed diagnosis means confirmation provided by an authorized laboratory
that an individual has AIDS, HIV-related illness, or HIV infection.
(q) Universal precautions means the use of
scientifically accepted protective barriers and preventive practices in
circumstances which involve, or may involve, exposure to significant risk body
substances or potentially contaminated implements which may cause puncture
4136--authorization for release of confidential HIV-related information.
Authorization for Release of Confidential HIV [FN*] Related
Confidential HIV-Related Information is any information
indicating that a person had an HIV-related test, or has HIV infection,
HIV-related illness, or AIDS, or any information which could indicate that a
person has been potentially exposed to HIV.
Under New York State Law, except for certain people,
confidential HIV-related information can only be given to persons you allow to
have it by signing a release. You can ask for a list of people who can be given
confidential HIV-related information without a release form.
If you sign this form, HIV-related information can be given
to the people listed on the form, and for the reason(s) listed on the form. You
do not have to sign the form, and you can change your mind at any time.
If you experience discrimination because of release of HIV
related information, you may contact the New York State Division of Human
Rights at (212) 870-8624 or the New York City Commission of Human Rights at
(212) 566-5493. These agencies are responsible for protecting your
Name of person whose HIV-related information will be
Name and address of person signing this form (of other than
Relationship to person whose HIV information will be
Reason for release of HIV-related information:
Time during which release is authorized:
My questions about this form have been answered. I know that
I do not have to allow release of HIV- related information, and that I can
change my mind at any time.
Division of Parole
[FN1] The following do not constitute significant risk:
exposure to urine, feces, sputum, nasal secretions, saliva, sweat, tears or
vomitus that does not contain visible blood; human bites where there is no
direct blood to blood or blood to mucous membrane contact; exposure of intact
skin to blood or any other body substance.
[FN*] Human Immunodeficiency Virus that causes